Ventricular Fibromas in Children, Arrhythmia Risk and Outcomes: A Multicentre Study
Although ventricular fibromas are a rare, they are the second most common type of cardiac tumor in children. While histologically benign, they have a propensity to cause malignant arrhythmias, with cardiac arrest often being the first presentation.; (Source: Heart Rhythm)
Source: Heart Rhythm - June 12, 2018 Category: Cardiology Authors: John P. Jones, Tristan Ramcharan, Milind Chaudhari, Vinay Bhole, Karen Mcleod, Shankar Sadagopan, Orhan Uzun, Andrew Parry, Jan Till, Colin J. McMahon, Alan G. Stuart, Mark A. Walsh Source Type: research

A QRS axis –based algorithm to identify the origin of scar-related ventricular tachycardia in the 17-segment American Heart Association model
Previously proposed algorithms to predict the ventricular tachycardia (VT) exit site have been based on diverse left ventricular models, but none of them identify the precise region of origin in the electroanatomic map. Moreover, no electrocardiographic (ECG) algorithm has been tested to predict the region of origin of scar-related VTs in patients with nonischemic cardiomyopathy. (Source: Heart Rhythm)
Source: Heart Rhythm - June 11, 2018 Category: Cardiology Authors: David Andreu, Juan Fern ández-Armenta, Juan Acosta, Diego Penela, Beatriz Jáuregui, David Soto-Iglesias, Vladimir Syrovnev, Elena Arbelo, José María Tolosana, Antonio Berruezo Source Type: research

Application of kinomic array analysis to screen for altered kinases in atrial fibrillation remodeling
Dysregulation of protein kinase –mediated signaling is an early event in many diseases, including the most common clinical cardiac arrhythmia, atrial fibrillation (AF). Kinomic profiling represents a promising technique to identify candidate kinases. (Source: Heart Rhythm)
Source: Heart Rhythm - June 11, 2018 Category: Cardiology Authors: Roelien A.M. Meijering, Marit Wiersma, Deli Zhang, Eva A.H. Lanters, Femke Hoogstra-Berends, Jetse Scholma, Sander Diks, XiaoYan Qi, Natasja M.S. de Groot, Stanley Nattel, Robert H. Henning, Bianca J.J.M. Brundel Source Type: research

A QRS axis –based algorithm to identify the origin of scar-related ventricular tachycardia in an American Heart Association 17-segment model
Previously proposed algorithms to predict the ventricular tachycardia (VT) exit site have been based on diverse left ventricular models, but none of them identify the precise region of origin in the electroanatomic map. Moreover, no electrocardiographic (ECG) algorithm has been tested to predict the region of origin of scar-related VTs in patients with nonischemic cardiomyopathy. (Source: Heart Rhythm)
Source: Heart Rhythm - June 11, 2018 Category: Cardiology Authors: David Andreu, Juan Fern ández-Armenta, Juan Acosta, Diego Penela, Beatriz Jáuregui, David Soto-Iglesias, Vladimir Syrovnev, Elena Arbelo, José María Tolosana, Antonio Berruezo Source Type: research

A QRS Axis-Based Algorithm to Identify the Origin of Scar-Related Ventricular Tachycardia in an American Heart Association 17-Segment Model
Previously proposed algorithms to predict the ventricular tachycardia (VT) exit site have been based on diverse left ventricle (LV) models, but none of them identify the precise region of origin on electroanatomical mapping (EAM). Moreover, no ECG algorithm has been tested to predict the region of origin of scar-related VTs in non-ischemic patients. (Source: Heart Rhythm)
Source: Heart Rhythm - June 11, 2018 Category: Cardiology Authors: David Andreu, Juan Fern ández-Armenta, Juan Acosta, Diego Penela, Beatriz Jáuregui, David Soto-Iglesias, Vladimir Syrovnev, Elena Arbelo, José María Tolosana, Antonio Berruezo Source Type: research

The application of kinomic array analysis to screen for altered kinases in atrial fibrillation remodeling
Dysregulation of protein kinase-mediated signaling is an early event in many diseases, including the most common clinical cardiac arrhythmia, atrial fibrillation (AF). Kinomic profiling represents a promising technique to identify candidate kinases. (Source: Heart Rhythm)
Source: Heart Rhythm - June 11, 2018 Category: Cardiology Authors: Roelien A.M. Meijering, Marit Wiersma, Deli Zhang, Eva A.H. Lanters, Femke Hoogstra-Berends, Jetse Scholma, Sander Diks, XiaoYan Qi, Natasja M.S. de Groot, Stanley Nattel, Robert H. Henning, Bianca J.J.M. Brundel Source Type: research

Mechanistic insight into an exonic splice defect mutation from native induced pluripotent stem cell-derived cardiomyocytes
Long QT syndrome (LQTS) –associated mutations are predominantly found in cardiac genes that are responsible for synchronous action potential generation.1 Depolarization begins with the opening of the voltage-gated sodium channel (INa) channel for the rapid passage of Na+ into cardiomyocytes (CMs).1 The SCN5A gene encodes for the α subunit of this INa channel.1 Depolarization is followed by repolarization, where outward potassium currents rapidly activating delayed rectifier potassium channel (IKr) and slowly activating delayed rectifier potassium channel (IKs) are the major currents. (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Zahurul A. Bhuiyan Tags: Editorial Commentary Source Type: research

Mechanistic insight into an exonic splice defect mutation from native iPSC-derived cardiomyocytes
Long QT syndrome (LQTS) –associated mutations are predominantly found in cardiac genes that are responsible for synchronous action potential generation.1 Depolarization begins with the opening of the INa channel for the rapid passage of Na+ into cardiomyocytes (CMs).1 The SCN5A gene encodes for the α subunit of this INa channel.1 Depolarization is followed by repolarization, where outward potassium currents IKr and IKs are the major currents.1 IKr is composed of KCNH2 encoding Kv11.1/HERG (α subunit) along with its β-subunit MiRP1 encoded by the KCNE2 gene. (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Zahurul A. Bhuiyan Tags: Editorial Commentary Source Type: research

Effectiveness of a nongovernmental organization –led large-scale community atrial fibrillation screening program using the smartphone electrocardiogram: An observational cohort study
Opportunistic screening for atrial fibrillation (AF) in patients older than 65 years is currently recommended. (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Ngai-Yin Chan, Chi-Chung Choy, Chi-Kin Chan, Chung-Wah Siu Source Type: research

Predicting cardiac resynchronization therapy outcomes: It is more than just left bundle branch block
Cardiac resynchronization therapy (CRT) is a cornerstone of therapy for the treatment of heart failure (HF) with a reduced ejection fraction with QRS prolongation. A large multicenter randomized trial established the benefit of CRT in appropriate cohorts to reduce HF hospitalization and mortality as well as to improve quality of life, exercise tolerance, and functional status. Despite these impressive results, much focus has recently been directed toward identifying nonresponders, which is commonly stated as constituting 30% of all patients receiving CRT. (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Hong-xia Niu, Michael R. Gold Tags: Editorial Commentary Source Type: research

To the Editor — Flecainide and propafenone: Good twins for premature ventricular contractions’ killing but not exactly superimposable
We have read with great interest the article by Hyman et  al1 dealing with successful use of class IC antiarrhythmic drugs (IC-AADs) in patients with premature ventricular contraction (PVC)–induced cardiomyopathy. Their results are of great practical interest despite the small population studied. Even though the long-term efficacy of IC-AADs as PVC kil ler is well known since 1980s,2 their use in people with left ventricular dysfunction is not established at all. We have 2 comments for the sake of practical use. (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Alessandro Capucci, Giuseppe Ciliberti, Federico Guerra Tags: Letter to the Editor Source Type: research

Reply to the Editor — Flecainide and Propafenone: Good Twins for Premature Ventricular Contractions’ Killing But Not Exactly Superimposable
We thank Capucci et  al for their thoughtful comments. We agree that mean doses of flecainide (88.5 ± 11.3 mg twice daily) and propafenone (extended release: 291.7 ± 19.5 mg twice daily; 1 patient immediate release: 150 mg thrice daily) were low. Despite this, mean premature ventricular contraction (PVC) burden decr eased by>72%. It is possible that higher doses of class IC antiarrhythmic drugs would have resulted in even greater efficacy. Capucci et  al also make an important point regarding the high rate of concomitant β-blocker use (90%). (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: David S. Frankel Source Type: research

Effectiveness of a Non-governmental Organization-led Large-scale Community Atrial Fibrillation Screening Program Using Smartphone Electrocardiogram: An Observational Cohort Study
Opportunistic screening for atrial fibrillation (AF) in patients over 65 years of age is currently recommended. (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Ngai-Yin Chan, Chi-Chung Choy, Chi-Kin Chan, Chung-Wah Siu Source Type: research

Flecainide and propafenone: good twins for premature ventricular contractions ’ killing but not exactly superimposable
We have read with great interest the paper by Hyman et al.1 dealing with a successful employment of Class IC antiarrhythmic drugs (AADs) in patients with premature ventricular contractions (PVCs) induced cardiomyopathy.Their results are of great practical interest despite the small population studied.If the long-term efficacy of 1C AADs as PVSs killer is well known since 80 ’s2, their use in people with left ventricular dysfunction is not established at all.We have two comments for practical use sake. (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Alessandro Capucci, Giuseppe Ciliberti, Federico Guerra Source Type: research

Author's reply to Flecainide and propafenone: good twins for premature ventricular contractions' killing but not exactly superimposable
We thank Capucci and colleagues for their thoughtful comments. We agree that mean doses of flecainide (88.5 ± 11.3 mg twice daily) and propafenone (extended-release 291.7 ± 19.5 mg twice daily, 1 patient immediate-release 150 mg three times daily) were low. Despite this, mean premature ventricular contraction (PVC) burden decreased by more than 72%. It is possible that higher doses of class 1C anti-arrh ythmic drugs would have resulted in even greater efficacy. Capucci and colleagues also make an important point regarding the high rate of concomitant beta blocker use (90%). (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: David S. Frankel Source Type: research

Race and Atrial Fibrillation: A Riddle, Wrapped in a Mystery, Inside an Enigma
In 1939, Winston Churchill famously referred to the future actions of Russia as, “a riddle, wrapped in mystery, inside an enigma.” While this quote is often used to describe the puzzles encountered in modern life, his point was that the riddle itself may reveal valuable clues. He continued, “but perhaps there is a key. That key is Russian national interest.” In this issu e of the Journal, Dr. Ugowe and colleagues provide a systematic review of the literature regarding racial and ethnic differences in the prevalence, management, and outcomes of atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Gregory M. Marcus Source Type: research

Mechanistic Insight into an Exonic Splice Defect Mutation from Native iPSC derived Cardiomyocytes
Dr. Z. Bhuiyan is funded by a grant from the Swiss Heart Foundation (no. 29283). (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Zahurul A. Bhuiyan Source Type: research

Predicting CRT Outcomes: It is more than just Left Bundle Branch Block
Cardiac resynchronization therapy (CRT) is a cornerstone of therapy for the treatment heart failure (HF) with a reduced ejection fraction with QRS prolongation. Large, multicenter, randomized trial established the benefit of CRT in appropriate cohorts to reduce heart failure hospitalization and mortality, as well as to improve quality of life, exercise tolerance and functional status. Despite these impressive results, much focus recently has been directed towards identifying nonresponders, which is commonly stated as constituting 30% of all CRT patients. (Source: Heart Rhythm)
Source: Heart Rhythm - June 8, 2018 Category: Cardiology Authors: Hong-xia Niu, Michael R. Gold Source Type: research

Signal-processing enhancement to reduce oversensing of T waves without increasing undersensing of ventricular fibrillation in the subcutaneous implantable cardioverter-defibrillator
In this issue of HeartRhythm, Theuns et  al1 report that a modified high-pass filter reduces P- and T-wave oversensing (P/TWOS) by the subcutaneous implantable cardioverter-defibrillator (S-ICD). Historically, TWOS has been an issue with ICDs.2 Pacemakers reject baseline-rhythm T waves reliably by using fixed sensing thresholds near 2 mV and high-pass filters near 20 Hz. ICDs cannot use this solution because they must sense ventricular fibrillation (VF), which has low-amplitude and lower-frequency electrograms (EGMs) than do conducted rhythms. (Source: Heart Rhythm)
Source: Heart Rhythm - June 5, 2018 Category: Cardiology Authors: Sandeep G. Nair, Charles D. Swerdlow Tags: Editorial Commentary Source Type: research

A Signal-Processing Enhancement to Reduce Oversensing of T-waves without Increasing Undersensing of Ventricular Fibrillation in the Subcutaneous ICD
Dr. Nair: None (Source: Heart Rhythm)
Source: Heart Rhythm - June 5, 2018 Category: Cardiology Authors: Sandeep G. Nair, Charles D. Swerdlow Source Type: research

Predicting Syncope: The First Step in a Long Journey?
Tilt table tests take time, of that there is no question. They also consume institutional resources and subject patients to a test that differs in nature from an ECG or an echocardiogram. Its purpose is to deliberately induce unconsciousness (or at least come very close). Those who have conducted tilt tests know that this can sometimes be unpleasant for the patient. Anything that minimizes the impact on the patient without sacrificing accuracy would seem like a good solution to the problem, and one potential solution is reported by Natalie Virag and her collaborators 1 in this issue. (Source: Heart Rhythm)
Source: Heart Rhythm - June 5, 2018 Category: Cardiology Authors: Robert S. Sheldon, Satish Raj Source Type: research

Field of view of mapping catheters quantified by electrogram associations with radius of myocardial attenuation on contrast-enhanced cardiac computed tomography
Contrast-enhanced cardiac computed tomography (CE-CT) provides useful substrate characterization in patients with ventricular tachycardia (VT). (Source: Heart Rhythm)
Source: Heart Rhythm - June 2, 2018 Category: Cardiology Authors: Satish Misra, Sohail Zahid, Adityo Prakosa, Nissi Saju, Hari Tandri, Ronald D. Berger, Joseph E. Marine, Hugh Calkins, Vadim Zipunnikov, Natalia Trayanova, Stefan L. Zimmerman, Saman Nazarian Source Type: research

Can Global Longitudinal Strain Predict Response to Cardiac Resynchronization Therapy?
Cardiac resynchronization therapy (CRT) can be a powerful treatment for patients suffering with heart failure (HF) resulting in reversing the myopathic process, improving symptoms and extending survival. Although a clear requirement for CRT efficacy is a component of electrical delay, many unanswered questions remain regarding patient selection and CRT response. In this journal issue, an important article by Khidir et al. demonstrates the striking prognostic information that left ventricular (LV) global longitudinal strain (GLS) may provide for patients undergoing CRT. (Source: Heart Rhythm)
Source: Heart Rhythm - June 2, 2018 Category: Cardiology Authors: John Gorcsan, Nobuyuki Kagiyama Source Type: research

Reflections on a career in Academic Medicine
When invited to write this essay, I long pondered whether to accept the challenge and concluded that I must have learned something over the past 5 decades in medicine that might be of interest to others. Let me start with the most important lesson. As a fellow in Cardiology, I became involved in a project involving measurement of Magnesium levels during and after open-heart surgery. We were to collect blood samples at varying intervals and several samples were inadvertently not collected. In my enthusiasm for completing a “perfect” manuscript, I fudged the missing data. (Source: Heart Rhythm)
Source: Heart Rhythm - June 2, 2018 Category: Cardiology Authors: Melvin M. Scheinman Source Type: research

The Field of View of Mapping Catheters Quantified by Electrogram Associations with Radius of Myocardial Attenuation on Contrast-Enhanced Cardiac Computed Tomography
Contrast enhanced cardiac computed tomography (CE-CT) provides useful substrate characterization in patients with ventricular tachycardia (VT). (Source: Heart Rhythm)
Source: Heart Rhythm - June 2, 2018 Category: Cardiology Authors: Satish Misra, Sohail Zahid, Adityo Prakosa, Nissi Saju, Hari Tandri, Ronald D. Berger, Joseph E. Marine, Hugh Calkins, Vadim Zipunnikov, Natalia Trayanova, Stefan L. Zimmerman, Saman Nazarian Source Type: research

A narrow QRS tachycardia with alternating R-R interval length in a 24 year old man
A 24-year-old man presented to the emergency room because of symptoms of dizziness and palpitations. He had these complaints before, but the episodes had never been documented electrocardiographically. Figure  1 shows the tachycardia recorded on admission. Intravenous adenosine administration resulted in termination of the tachycardia. (Source: Heart Rhythm)
Source: Heart Rhythm - May 29, 2018 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

Prognostic significance of ventricular late potentials in patients with pulmonary sarcoidosis
Early detection of cardiac involvement in sarcoidosis is difficult but essential to achieve optimal treatment. Signal-averaged electrocardiography (SAECG) can detect subtle cardiac electrical abnormalities termed late potentials (LPs) and would be useful for the early diagnosis of cardiac involvement. (Source: Heart Rhythm)
Source: Heart Rhythm - May 29, 2018 Category: Cardiology Authors: Kenji Yodogawa, Yoshihiko Seino, Toshihiko Ohara, Yu-ki Iwasaki, Meiso Hayashi, Yasushi Miyauchi, Arata Azuma, Wataru Shimizu Tags: Featured Article Source Type: research

Noninvasive electrophysiology in risk assessment and  screening
Invasive electrophysiology has substantially advanced over previous years. Procedures such as defibrillator implantations or pulmonary vein isolation that have previously been an exclusive domain of major centers are presently available from many small clinics. This somewhat contrasts with general perception of noninvasive electrophysiology. While substantial noninvasive research advances have been reported, their wide utility in clinical practice is not forthcoming. Some teaching centers even believe that noninvasive electrophysiology including electrocardiography is not worth teaching and that standard electrocardiograph...
Source: Heart Rhythm - May 29, 2018 Category: Cardiology Authors: Marek Malik, Alfred E. Buxton, Heikki Huikuri, Federico Lombardi, Georg Schmidt, Markus Zabel, e-Rhythm Study Group of EHRA Tags: Editorial Commentary Source Type: research

HRS publications' online development
Medical scientific publishing is becoming progressively electronic. While print material still plays an important role, today's readers are more likely to access scientific content via the Internet than by searching through print. As Online Editor of HeartRhythm and HeartRhythm Case Reports, I am writing to share our recent online growth and development and to forecast upcoming features. (Source: Heart Rhythm)
Source: Heart Rhythm - May 29, 2018 Category: Cardiology Authors: Daniel P. Morin Tags: Editorial Source Type: research

Complex aberrant splicing in the induced pluripotent stem cell –derived cardiomyocytes from a patient with long QT syndrome carrying KCNQ1-A344Aspl mutation
Long QT syndrome type 1 (LQT1) is caused by mutations in KCNQ1, which encodes the α subunit of the slow delayed rectifier potassium current channel. We previously reported that a synonymous mutation, c.1032G>A, p.A344Aspl, in KCNQ1 is most commonly identified in genotyped patients with LQT1 in Japan and the aberrant splicing was analyzed in the lymphocytes isolated from patients' blood samples. However, the mechanisms underlying the observed processes in human cardiomyocytes remain unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - May 29, 2018 Category: Cardiology Authors: Yimin Wuriyanghai, Takeru Makiyama, Kenichi Sasaki, Tsukasa Kamakura, Yuta Yamamoto, Mamoru Hayano, Takeshi Harita, Suguru Nishiuchi, Jiarong Chen, Hirohiko Kohjitani, Sayako Hirose, Fumika Yokoi, Jingshan Gao, Kazuhisa Chonabayashi, Ken Watanabe, Seiko O Source Type: research

Complex aberrant splicing in the induced pluripotent stem cell-derived cardiomyocytes from a patient with long-QT syndrome carrying KCNQ1-A344Aspl mutation
Long-QT syndrome type 1 (LQT1) is caused by mutations in KCNQ1, which encodes the α-subunit of the slow delayed rectifier potassium current (IKs) channel. We previously reported that a synonymous mutation, c.1032G>A, p.A344Aspl in KCNQ1 is most commonly identified in the genotyped LQT1 Japanese patients, and the aberrant splicing was analyzed in the lymphocytes isolated from patients ’ blood samples. However, the mechanisms underlying the observed processes in human cardiomyocytes remains unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - May 29, 2018 Category: Cardiology Authors: Yimin Wuriyanghai, Takeru Makiyama, Kenichi Sasaki, Tsukasa Kamakura, Yuta Yamamoto, Mamoru Hayano, Takeshi Harita, Suguru Nishiuchi, Jiarong Chen, Hirohiko Kohjitani, Sayako Hirose, Fumika Yokoi, Jingshan Gao, Kazuhisa Chonabayashi, Ken Watanabe, Seiko O Source Type: research

EP News: Basic and Translational
Scroll waves are the basis of the formation of complex spatiotemporal patterns in many excitable chemical and biological systems. Filament-like phase singularities are associated with 3-dimensional scroll waves and considered to be the organizing centers of cardiac arrhythmias. Christoph et  al (Nature 2018;555:667, PMID 29466325) showed that 3-dimensional mechanical scroll waves and filament-like phase singularities can be observed deep inside the contracting heart wall using high-resolution 4-dimensional ultrasound-based strain imaging. (Source: Heart Rhythm)
Source: Heart Rhythm - May 28, 2018 Category: Cardiology Authors: Penelope A. Boyden Tags: EP News Source Type: research

Scar Burden, Not Intraventricular Conduction Delay Pattern, Is Associated with Outcomes in Ischemic Cardiomyopathy Patients Receiving Cardiac Resynchronization Therapy
Patients with non-specific intraventricular conduction delay (IVCD) benefit less from cardiac resynchronization therapy (CRT) than patients with left bundle-branch block (LBBB). (Source: Heart Rhythm)
Source: Heart Rhythm - May 28, 2018 Category: Cardiology Authors: Evan C. Adelstein, Andrew D. Althouse, David Schwarzman, Sandeep K. Jain, Prem Soman, Samir Saba Source Type: research

EP News: Heart Rhythm Case Reports
Ehlers-Danlos syndrome (EDS) is among a family of disorders that involve the connective tissue. EDS can lead to multiple potential cardiovascular abnormalities related to fragility of arteries, veins, and valves, as well as their treatment because of altered wound and vessel healing. Such challenges and complications can be manifest in relatively normal procedures, such as implantable cardioverter-defibrillator (ICD) insertion. Garg et  al (https://doi.org/10.1016/j.hrcr.2018.03.008) present the case of a 59-year-old woman with EDS and recurrent idiopathic ventricular tachycardia associated with syncope. (Source: Heart Rhythm)
Source: Heart Rhythm - May 26, 2018 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

EP News: Case Reports
Ehlers-Danlos syndrome (EDS) is among a family of disorders that involve the connective tissue. EDS can lead to multiple potential cardiovascular abnormalities related to fragility of arteries, veins, and valves, as well as their treatment because of altered wound and vessel healing. Such challenges and complications can be manifest in relatively normal procedures, such as implantable cardioverter-defibrillator (ICD) insertion. Garg et  al (https://doi.org/10.1016/j.hrcr.2018.03.008) present the case of a 59-year-old woman with EDS and recurrent idiopathic ventricular tachycardia associated with syncope. (Source: Heart Rhythm)
Source: Heart Rhythm - May 26, 2018 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

EP News: Allied Professionals
Using data on 1710 patients with genotype-positive long QT syndrome (LQTS) type 1, 2, or 3 (LQT1, LQT2, or LQT3) followed for more than 7 years, Mazzanti et  al (J Am Coll Cardiol 2018;71:1663, PMID 29650123) sought to establish the risk of life-threatening arrhythmic events (LAEs) based on genotype and baseline QT interval as well as to assess the effect of β-blockers on this risk. LAEs were defined as sudden cardiac death (SCD), aborted cardiac arre st, and hemodynamically nontolerated polymorphic ventricular tachycardia (PMVT). (Source: Heart Rhythm)
Source: Heart Rhythm - May 25, 2018 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

EP News: Clinical
Duytschaever et  al (Eur Heart J 2018;39:1429, PMID 29211857) investigated whether continued use of previously ineffective antiarrhythmic drug therapy (ADT) beyond the postablation blanking period reduces recurrence of atrial tachyarrhythmia within the first year of ablation. All patients in this multicenter rando mized controlled study had previously ineffective ADT, which was continued for 3 months. If free of atrial fibrillation (AF) at the end of the blanking period, patients were randomly assigned in the ratio of 1:1 to continue ADT (ADT ON group; n  =  77) or discontinue ADT (ADT OFF group; ...
Source: Heart Rhythm - May 25, 2018 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

Thoracoscopic stapler-and-loop technique for left atrial appendage closure in nonvalvular atrial fibrillation: Mid-term outcomes in 201 patients
Left atrial appendage (LAA) closure can be an alternative to oral anticoagulation to prevent cardiogenic thromboembolisms in patients with nonvalvular atrial fibrillation. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2018 Category: Cardiology Authors: Toshiya Ohtsuka, Takahiro Nonaka, Motoyuki Hisagi, Mikio Ninomiya, Ai Masukawa, Takahiro Ota Source Type: research

Cost-effectiveness analysis of magnetic resonance imaging –conditional pacemaker implantation: Insights from a multicenter study and implications in the current era
Magnetic resonance imaging (MRI) –conditional pacemakers (M-PPMs) grant patients greater accessibility to MRI scans. The cost-effectiveness of implanting M-PPM is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2018 Category: Cardiology Authors: Philip L. Mar, Guanhua Chen, Gaurang Gandhi, Zheng-Zheng Tang, Amy Leiserowitz, Ajay Tripuraneni, Eric Kreps, Luke Botting, Dhanunjaya Lakkireddy, Jerome E. Granato, Rakesh Gopinathannair Source Type: research

Short-term heart rate variability: Easy to measure, difficult to interpret
Akselrod et  al1 were the first to report that the analysis of spontaneous fluctuations in RR interval could provide direct insight into the physiology of the autonomic control branches. Since then, heart rate variability (HRV) analysis2 has become the most used noninvasive tool to evaluate autonomic control m echanisms and to predict mortality risk in several clinical conditions. As explained in the 1996 Task Force document,2 the term HRV analysis accommodates a number of methodologies despite their major computational and physiological interpretive differences. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2018 Category: Cardiology Authors: Federico Lombardi, Heikki Huikuri, Georg Schmidt, Marek Malik, e-Rhythm Study Group of EHRA Tags: Editorial Commentary Source Type: research

Simultaneous Lead Traction from Above and Below: A Novel Technique to Reduce the Risk of Superior Vena Cava Injury During Transvenous Lead Extraction.
SVC injury is a rare but dreaded complication during percutaneous transvenous lead extraction (TLE) that carries high morbidity and mortality. Despite technological advances and improved efficacy, complication rates remain unchanged. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2018 Category: Cardiology Authors: Robert D. Schaller, Mouhannad M. Sadek, Joshua M. Cooper Source Type: research

Short-term heart rate variability: easy to measure, difficult to interpret.
Alkselroad et al (1) were the first to report that the analysis of spontaneous fluctuation of RR interval could provide direct insight into the physiology of the autonomic control branches. Since then, heart rate variability (HRV) analysis (2) has then become the most employed non-invasive tool to evaluate autonomic control mechanisms and to predict mortality risk in several clinical conditions. As explained (2) in the 1996 Task Force Document, the term of HRV analysis accommodates a number of methodologies despite their major computational and physiological interpretative differences. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2018 Category: Cardiology Authors: Federico Lombardi, Heikki Huikuri, Georg Schmidt, Marek Malik, e-Rhythm Study Group of EHRA Source Type: research

Cost-effectiveness Analysis of Magnetic Resonance Imaging-Conditional Pacemaker Implantation: Insights from a Multicenter Study and Implications in the Current Era
MRI-conditional pacemakers (M-PPM) grant patients more accessibility to MRI scans. The cost-effectiveness of implanting M-PPM is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2018 Category: Cardiology Authors: Philip L. Mar, Guanhua Chen, Gaurang Gandhi, Zheng-Zheng Tang, Amy Leiserowitz, Ajay Tripuraneni, Eric Kreps, Luke Botting, Dhanunjaya Lakkireddy, Jerome E. Granato, Rakesh Gopinathannair Source Type: research

Time until diagnosis of clinical events with different remote monitoring systems in Implantable Cardioverter-Defibrillator patients
Remote monitoring (RM) is an established technology integrated into routine follow-up of patients with implantable cardioverter-defibrillator (ICD). Current RM systems differ according to transmission frequency and alert definition. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2018 Category: Cardiology Authors: Malene S öth-Hansen, Christoffer Tobias Witt, Mathis Rasmussen, Jens Kristensen, Christian Gerdes, Jens Cosedis Nielsen Source Type: research

Thoracoscopic Stapler-and-loop Technique for Left Atrial Appendage Closure in Non-valvular Atrial Fibrillation: Mid-term Outcomes in 201 Patients
Left atrial appendage (LAA) closure can be an alternative to oral anticoagulation to prevent cardiogenic thromboembolisms in non-valvular atrial fibrillation. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2018 Category: Cardiology Authors: Toshiya Ohtsuka, Takahiro Nonaka, Motoyuki Hisagi, Mikio Ninomiya, Ai Masukawa, Takahiro Ota Source Type: research

Racial and ethnic differences in the prevalence, management, and outcomes in patients with atrial fibrillation: A systematic review
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the United States and is associated with increased morbidity, mortality, and health care expenditures. In this review, our aim was to assess the racial and ethnic differences in the epidemiology, management, and outcomes of patients with AF. A search of relevant studies from January 1, 2007, to December 30, 2017, was conducted in PubMed, EMBASE, and Web of Science and supplemented by manual searches of the bibliographies of retrieved articles. (Source: Heart Rhythm)
Source: Heart Rhythm - May 23, 2018 Category: Cardiology Authors: Francis E. Ugowe, Larry R. Jackson, Kevin L. Thomas Tags: Contemporary Review Source Type: research

Arterial hypertension drives arrhythmia progression via specific structural remodeling in a porcine model of atrial fibrillation
Arterial hypertension (HT) contributes to progression of atrial fibrillation (AF) via unknown mechanisms. (Source: Heart Rhythm)
Source: Heart Rhythm - May 23, 2018 Category: Cardiology Authors: Martin Manninger, David Zweiker, Arne van Hunnik, Alessio Alogna, Anton J. Prassl, Julia Schipke, Stef Zeemering, Birgit Zirngast, Patrick Sch önleitner, Michael Schwarzl, Viktoria Herbst, Eva Thon-Gutschi, Stefan Huber, Ursula Rohrer, Jakob Ebner, Helmu Source Type: research

Racial and Ethnic Differences in the Prevalence, Management and Outcomes in Patients with Atrial Fibrillation: A Systematic Review
Atrial Fibrillation (AF) is the most common cardiac arrhythmia in the United States (US) and is associated with increased morbidity, mortality, and healthcare expenditures. In this work, our aim was to assess for racial and ethnic differences in the epidemiology, management and outcomes of patients with AF. A search of relevant studies from January 1, 2007 to December 30, 2017 was conducted using PubMed, EMBASE, and Web of Science and supplemented by manual searches of the bibliographies of retrieved articles. (Source: Heart Rhythm)
Source: Heart Rhythm - May 23, 2018 Category: Cardiology Authors: Francis E. Ugowe, Larry R. Jackson, Kevin L. Thomas Source Type: research

How to Perform Left Atrial Appendage Electrical Isolation Using Radiofrequency Ablation
Although pulmonary vein isolation (PVI) has been considered an effective treatment for paroxysmal AF, non paroxysmal AF is a complex arrhythmia, for which no ablation strategy has been demonstrated to be effective and widely accepted. As such, a success rate of approximately 55% in these AF patients (Star AF II Trial) is not acceptable in our opinion and efforts should be made to seek for alternative strategies. A significant role of the left atrial appendage (LAA) in the genesis of AF has been described, with several studies reporting a substantial incremental benefit from LAA electrical isolation (LAAEI), in addition to ...
Source: Heart Rhythm - May 23, 2018 Category: Cardiology Authors: Jorge Romero, Andrea Natale, Luigi Di Biase Source Type: research

Safety and efficacy of catheter ablation of ventricular arrhythmias with para-Hisian origin via a systematic direct approach from the aortic sinus cusp
Catheter ablation of the ventricular arrhythmias (VAs) originating from para-Hisian region could be challenging due to a potential damage to atrio-ventricular (AV) conduction. (Source: Heart Rhythm)
Source: Heart Rhythm - May 23, 2018 Category: Cardiology Authors: Hui-Qiang Wei, Xiao-Gang Guo, Xu Liu, Gong-Bu Zhou, Qi Sun, Jian-Du Yang, Bin Luo, Shu Zhang, Jian Ma Source Type: research