Predicting Vasovagal Syncope from Heart Rate and Blood Pressure: A Prospective Study in 140 Subjects
We developed a vasovagal syncope (VVS) prediction algorithm for use during head-up tilt with simultaneous analysis of heart rate (HR) and systolic blood pressure (SBP). We previously tested this algorithm retrospectively in 1155 subjects, showing sensitivity 95%, specificity 93% and median prediction time of 59s. (Source: Heart Rhythm)
Source: Heart Rhythm - April 28, 2018 Category: Cardiology Authors: Nathalie Virag, Mark Erickson, Patricia Taraborrelli, Rolf Vetter, Phang Boon Lim, Richard Sutton Source Type: research

Fusion during entrainment at the cavotricuspid isthmus: What is the mechanism?
A 91-year-old man with persistent atrial flutter (AFL) underwent catheter ablation. The 12-lead ECG was compatible with a counterclockwise cavotricuspid isthmus (CTI)-dependent typical AFL. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Mark J. Shen, Bradley P. Knight, Susan S. Kim Tags: Unknown of the Month Source Type: research

Anterior myocardial infarction with high-degree AV block in a 62-year-old man
A 62-year-old man was admitted to hospital 20 hours after the onset of chest pain. The ECG recorded at that time is shown in Figure  1. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

Defibrillation testing is mandatory in patients with subcutaneous implantable cardioverter –defibrillator to confirm appropriate ventricular fibrillation detection
The subcutaneous implantable cardioverter –defibrillator (S-ICD) remains a new technology requiring accurate assessment of the various aspects of its functioning. Isolated cases of delayed sensing of ventricular arrhythmia have been described. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Jean-Benoit le Polain de Waroux, Sylvain Ploux, Pierre Mondoly, Romain Eschalier, Marc Strik, Laura Houard, Bertrand Pierre, Samuel Buliard, Nicolas Klotz, Philippe Ritter, Michel Haissaguerre, Karim Mahfouz, Pierre Bordachar Tags: Featured Article Source Type: research

Arthur J. Moss, MD —A giant who changed cardiology
On February 14, 2018, we lost Dr. Arthur J. Moss, our mentor, teacher, friend, unequivocal leader, clinician, and outstanding researcher in cardiology. He was 86 years old. He was born on June 21, 1931. After graduating with a psychology degree from Yale University in 1953 and Harvard Medical School in 1957, and after his military service in the US Navy, he joined the University of Rochester Medical School in 1961. In 1966, just after completing training in cardiology, he received his first grant from the National Institutes of Health (NIH) for research on catecholamines and cardiovascular dysfunction. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Wojciech Zareba, Valentina Kutyifa, Jean-Philippe Couderc Tags: In Memoriam Source Type: research

Leadership Letter
We've always been a grassroots organization. From our founding nearly 4 decades ago to today, our success is rooted in the passionate dedication of our members. We share a mission to end death and suffering from heart rhythm disorders, but we also share a spirit. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: George F. Van Hare, James H. Youngblood Tags: Editorial Source Type: research

Leadless pacemaker versus transvenous single-chamber pacemaker therapy: A propensity score-matched analysis
The recent introduction of leadless pacemakers (PMs) was aimed to eliminate transvenous lead- and pocket-related complications. While the initial results with the leadless PMs seem promising, the nonrandomized nature, limited implant experience of operators, and short follow-up period of these studies preclude a simple comparison to transvenous PMs. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Fleur V.Y. Tjong, Reinoud E. Knops, Erik O. Udo, Tom F. Brouwer, Srinivas R. Dukkipati, Jacob S. Koruth, Jan Petru, Lucie Sediva, Norbert M. van Hemel, Petr Neuzil, Vivek Y. Reddy Source Type: research

Leadless pacemaker versus transvenous single-chamber pacemaker therapy: A propensity-matched analysis
The recent introduction of leadless pacemakers (PMs) was aimed to eliminate transvenous lead- and pocket-related complications. While the initial results with the leadless PMs seem promising, the nonrandomized nature, limited implant experience of operators, and short follow-up period of these studies preclude a simple comparison to transvenous PMs. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Fleur V.Y. Tjong, Reinoud E. Knops, Erik O. Udo, Tom F. Brouwer, Srinivas R. Dukkipati, Jacob S. Koruth, Jan Petru, Lucie Sediva, Norbert M. van Hemel, Petr Neuzil, Vivek Y. Reddy Source Type: research

Endocardial ablation of ventricular ectopic beats arising from the basal inferoseptal process of the left ventricle
Idiopathic ventricular ectopy (VE) shows predilection to sites within the left ventricular (LV) base such as the outflow tract/aortic sinuses, LV summit, and areas adjacent to the aortomitral continuity. We characterize VE arising from the inferior septum of the LV base that was successfully managed by LV endocardial ablation from the inferoseptal recess of the LV. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Anthony Li, Zia Zuberi, Jason S. Bradfield, John K. Zarif, David E. Ward, Robert H. Anderson, Kalyanam Shivkumar, Magdi M. Saba Source Type: research

Arrhythmia genetics: Not dark and lite, but 50 shades of gray
The congenital long QT syndromes (cLQTS) were first described more than half a century ago. We now recognize multiple genetic and clinical subtypes, and the exploration of the disease has informed not only family screening but also our fundamental understanding of the electrophysiology of repolarization. Along with this new knowledge has come a new set of challenges centered around interpretation of the relationship between the presence of a variant in a known cLQTS disease gene and its relationship to phenotype. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Dan M. Roden, Andrew M. Glazer, Brett Kroncke Tags: Editorial Commentary Source Type: research

EP News: Allied Professionals
Using data from the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial, Lopes et  al (J Am Coll Cardiol 2018;71:1063, PMID 29519345) sought to determine the effect of digoxin on mortality in patients with atrial fibrillation (AF). ARISTOTLE is a pivotal trial involving ∼18,000 patients with AF and at least 1 risk factor for stroke with randomization to apixaban or warfarin. T he present study is a post hoc analysis of those patients who were on digoxin at baseline as compared with those not on digoxin as well as an analysis of patients taking digoxin during th...
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Erica S. Zado Source Type: research

Leadless Pacemaker Versus Transvenous Single-Chamber Pacemaker Therapy: A Propensity Matched Analysis
The recent introduction of leadless pacemakers (LP) was aimed to eliminate transvenous lead- and pocket-related complications. While the initial results with the leadless pacemakers seem promising, the non-randomized nature, limited implant experience of operators and short follow up period of these studies preclude a simple comparison to transvenous pacemakers (PM). (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Fleur V.Y. Tjong, Reinoud E. Knops, Erik O. Udo, Tom F. Brouwer, Srinivas R. Dukkipati, Jacob S. Koruth, Jan Petru, Lucie Sediva, Norbert M. van Hemel, Petr Neuzil, Vivek Y. Reddy Source Type: research

Endocardial Ablation Of Ventricular Ectopic Beats Arising From The Basal Infero-Septal Process Of The Left Ventricle
Idiopathic VE shows predilection to sites within the left ventricular base such as the outflow tract/aortic sinuses, LV summit and adjacent to the aorto-mitral continuity. We characterize VE arising from the inferior septum of the LV base that were successfully managed by LV endocardial ablation from the infero-septal recess of the LV. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Anthony Li, Zia Zuberi, Jason S. Bradfield, John K. Zarif, David E. Ward, Robert H. Anderson, Kalyanam Shivkumar, Magdi M. Saba Source Type: research

B-type natriuretic peptide and risk of sudden death in patients with hypertrophic cardiomyopathy
The association between B-type natriuretic peptide (BNP) level and sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM) remains unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Yuichiro Minami, Shintaro Haruki, Keigo Kanbayashi, Ryosuke Itani, Nobuhisa Hagiwara Source Type: research

Arrhythmia genetics: Not dark and lite, but fifty shades of grey
The congenital long QT syndromes (cLQTS) were first described over half a century ago: we now recognize multiple genetic and clinical subtypes and the exploration of the disease has informed not only family screening but also our fundamental understanding of the electrophysiology of repolarization. Along with this new knowledge has come a new set of challenges centered around interpretation of the relationship between the presence of a variant in a known cLQTS disease gene and its relationship to phenotype. (Source: Heart Rhythm)
Source: Heart Rhythm - April 27, 2018 Category: Cardiology Authors: Dan M. Roden, Andrew M. Glazer, Brett Kroncke Source Type: research

Strategically Targeting Calcium: Altering activation sequence to reverse remodel the failing ventricle
It is well known that abnormal ventricular activation promotes mechanical and electrical remodeling resulting in ventricular mechanical dysfunction and possibly arrhythmias.1, 2Altered ventricular activation is most deleterious when it is most dyssynchronous. Early-activated ventricular segments (typically septal) have early systolic shortening and decreased myocardial fiber strain, while late-activated segments (typically posterolateral wall) undergo significant late systolic strain, promoting adverse remodeling, with downstream effects on Ca2+ and ionic remodeling. (Source: Heart Rhythm)
Source: Heart Rhythm - April 21, 2018 Category: Cardiology Authors: Lance D. Wilson, Isabelle Deschenes Source Type: research

EP News: Clinical
Abdelrahman et  al (J Am Coll Cardiol March 5, 2018;Epub ahead of print, PMID 29535066) evaluated the clinical outcomes of His bundle pacing (HBP) compared to right ventricular pacing (RVP). All patients requiring initial pacemaker implantation over a 3-year period were included in the study. Permanent HBP was at tempted in consecutive patients at one hospital and RVP at an affiliated hospital. The primary outcome was the combined end point of death, heart failure hospitalization (HFH), or upgrade to a biventricular pacemaker (BiVP). (Source: Heart Rhythm)
Source: Heart Rhythm - April 20, 2018 Category: Cardiology Authors: N.A. Mark Estes Source Type: research

EP News: Basic and Translational
KCNQ1 is the pore-forming subunit of cardiac slow-delayed rectifier potassium channels. Mutations in the kcnq1 gene are the leading cause of congenital long QT syndrome (LQTS). Sun and MacKinnon (Cell 2017;169:1042, PMID 28575668) presented the cryoelectron microscopy structure of a KCNQ1/calmodulin (CaM) complex. The conformation corresponds to an “uncoupled” KCNQ1, with activated voltage sensors and a closed pore. Unique structural features within the S4-S5 linker permit uncoupling of the voltage sensor from the pore in the absence of PIP2. (Source: Heart Rhythm)
Source: Heart Rhythm - April 20, 2018 Category: Cardiology Authors: Penelope A. Boyden Source Type: research

Cryoballoon Best Practices II: Practical Guide to Procedural Monitoring and Dosing During Atrial Fibrillation Ablation From the Perspective of Experienced Users
Since cryoballoon was evaluated in STOP-AF, over 350,000 patients with AF have been treated. Several studies have reported improved outcomes using the second-generation cryoballoon, and recent publications have evaluated modifications, refinements, and improvements to procedural techniques. Here, peer-reviewed manuscripts published since the first cryoballoon best practices review were summarized against the technical practices of physicians with a high-level of experience with the cryoballoon (average ≥6 years of experience in ≥900 cases). (Source: Heart Rhythm)
Source: Heart Rhythm - April 20, 2018 Category: Cardiology Authors: Wilber Su, Arash Aryana, Rod Passman, Gurjit Singh, Robert Hokanson, Marcin Kowalski, Jason Andrade, Paul Wang Source Type: research

EP News: Clinical
Abdelrahman et  al (J Am Coll Cardiol March 5, 2018;Epub ahead of print, PMID 29535066) evaluated the clinical outcomes of His bundle pacing (HBP) compared to right ventricular pacing (RVP). All patients requiring initial pacemaker implantation over a 3-year period were included in the study. Permanent HBP was at tempted in consecutive patients at one hospital and RVP at an affiliated hospital. The primary outcome was the combined end point of death, heart failure hospitalization (HFH), or upgrade to a biventricular pacemaker (BiVP). (Source: Heart Rhythm)
Source: Heart Rhythm - April 20, 2018 Category: Cardiology Authors: N.A. Mark Estes Source Type: research

EP News: Basic and Translational
KCNQ1 is the pore-forming subunit of cardiac slow-delayed rectifier potassium channels. Mutations in the kcnq1 gene are the leading cause of congenital long QT syndrome (LQTS). Sun and MacKinnon (Cell 2017;169:1042, PMID 28575668) presented the cryoelectron microscopy structure of a KCNQ1/calmodulin (CaM) complex. The conformation corresponds to an “uncoupled” KCNQ1, with activated voltage sensors and a closed pore. Unique structural features within the S4-S5 linker permit uncoupling of the voltage sensor from the pore in the absence of PIP2. (Source: Heart Rhythm)
Source: Heart Rhythm - April 20, 2018 Category: Cardiology Authors: Penelope A. Boyden Source Type: research

Cryoballoon Best Practices II: Practical Guide to Procedural Monitoring and Dosing During Atrial Fibrillation Ablation From the Perspective of Experienced Users
Since cryoballoon was evaluated in STOP-AF, over 350,000 patients with AF have been treated. Several studies have reported improved outcomes using the second-generation cryoballoon, and recent publications have evaluated modifications, refinements, and improvements to procedural techniques. Here, peer-reviewed manuscripts published since the first cryoballoon best practices review were summarized against the technical practices of physicians with a high-level of experience with the cryoballoon (average ≥6 years of experience in ≥900 cases). (Source: Heart Rhythm)
Source: Heart Rhythm - April 20, 2018 Category: Cardiology Authors: Wilber Su, Arash Aryana, Rod Passman, Gurjit Singh, Robert Hokanson, Marcin Kowalski, Jason Andrade, Paul Wang Source Type: research

EP News: Case Reports
Mitral valve prolapse (MVP) is a common valvular heart abnormality and often regarded as a relatively benign condition. However, in a subset of patients, ventricular arrhythmias and sudden death have been reported in both the presence and the absence of significant mitral valve regurgitation. Risk factors for sudden death include T-wave abnormalities in the inferior leads, right bundle branch block (RBBB) or polymorphic ventricular arrhythmias, and fibrosis at the base of the papillary muscle or inferobasal free wall. (Source: Heart Rhythm)
Source: Heart Rhythm - April 19, 2018 Category: Cardiology Authors: T. Jared Bunch Source Type: research

Clinical and electrophysiological characteristics of patients with paroxysmal intra-His block with narrow QRS complexes
Atrioventricular (AV) block is usually due to infranodal disease and associated with a wide QRS complex; such patients often progress to complete AV block and pacemaker dependency. Uncommonly, infranodal AV block can occur within the His bundle with a narrow QRS complex. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Loheetha Ragupathi, Drew Johnson, Arnold Greenspon, Daniel Frisch, Reginald T. Ho, Behzad B. Pavri Source Type: research

Feasibility, safety, and efficacy of a novel preshaped nitinol esophageal deviator to successfully deflect the esophagus and ablate left atrium without esophageal temperature rise during atrial fibrillation ablation: The DEFLECT GUT study
Esophageal thermal injury is a feared complication of radiofrequency ablation for atrial fibrillation (AF). Rise in luminal esophageal temperature (LET) limits the ability to deliver radiofrequency energy on the posterior wall of the left atrium. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Valay Parikh, Vijay Swarup, Jacob Hantla, Venkat Vuddanda, Tawseef Dar, Bharath Yarlagadda, Luigi Di Biase, Amin Al-Ahmad, Andrea Natale, Dhanunjaya Lakkireddy Source Type: research

Left ventricular regional remodeling and lead position during cardiac resynchronization therapy
Cardiac resynchronization therapy (CRT) induces segmental left ventricular (LV) remodeling. LV lead position (LV-LP) impacts response to CRT and remodeling. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Mads B. Kronborg, Anders Sommer, Daniel B. Fyenbo, Bjarne L. Norgaard, Christian Gerdes, Jesper Moller Jensen, Henrik Kj ærulf Jensen, Jens Kristensen, Jens C. Nielsen Source Type: research

Clinical and Electrophysiologic Characteristics of Patients with Paroxysmal Intra-His block with Narrow QRS complexes
Atrioventricular block (AVB) is usually due to infra-nodal disease and associated with a wide QRS complex; such patients often progress to complete AV block and pacemaker dependency. Uncommonly, infra-nodal AVB can occur within the His bundle with a narrow QRS complex. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Loheetha Ragupathi, Drew Johnson, Arnold Greenspon, Daniel Frisch, Reginald T. Ho, Behzad B. Pavri Source Type: research

Experience with the Wearable Cardioverter-Defibrillator in Older Patients: Results from the Prospective Registry of Patients Using the Wearable Cardioverter-Defibrillator (WEARIT-II Registry)
Use of the wearable cardioverter-defibrillator (WCD) in older patients has not been described previously. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Usama A. Daimee, Katherine Vermilye, Arthur J. Moss, Ilan Goldenberg, Helmut U. Klein, Scott McNitt, Wojciech Zareba, Valentina Kutyifa Source Type: research

Safety and Efficacy of Stereotactic Radioablation Targeting Pulmonary Vein Tissues in an Experimental Model
Stereotactic radioablation (SR), a commonly used therapy to treat malignancies, has been utilized to treat refractory ventricular tachycardia, but the feasibility of treating atrial fibrillation (AF) with SR is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Paul C. Zei, Doug Wong, Edward Gardner, Thomas Fogarty, Patrick Maguire Source Type: research

Early feasibility of Hypoglossal Nerve Upper Airway Stimulator in Patients with Cardiac Implantable Electronic Devices and Continuous Positive Airway Pressure-Intolerant Severe Obstructive Sleep Apnea
Implantable hypoglossal nerve upper airway stimulation (HNS) is a novel, FDA approved strategy for management of moderate to severe obstructive sleep apnea(OSA) patients with continuous positive airway pressure (CPAP) therapy intolerance or failure. Due to proximity of Cardiac Implantable Electronic Devices (CIED) and this stimulator, interaction between these devices is theoretically possible. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Valay Parikh, Erica Thaler, Masanari Kato, M. Boyd Gillespie, Shaun Nguyen, Kirk Withrow, David Calhoun, Ryan Soose, Damien Stevens, Suzanne Stevens, Chris Larsen, Madhu Reddy, Dhanunjaya Lakkireddy Source Type: research

Feasibility, Safety and Efficacy of a Novel Pre-Shaped Nitinol Esophageal Deviator to Successfully Deflect the Esophagus and Ablate Left Atrium without Esophageal Temperature Rise during Atrial Fibrillation Ablation – The DEFLECT GUT study
Esophageal thermal injury is a feared complication of radiofrequency ablation (RFA) for atrial fibrillation (AF). Rise in luminal esophageal temperature (LET) limits the ability to deliver RF energy on posterior wall of LA. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Valay Parikh, Vijay Swarup, Jacob Hantla, Venkat Vuddanda, Tawseef Dar, Bharath Yarlagadda, Luigi Di Biase, Amin Al-Ahmad, Andrea Natale, Dhanunjaya Lakkireddy Source Type: research

Hot topics in Brugada syndrome
Ventricular fibrillation (VF) in Brugada syndrome (BrS) usually occurs at night, but the trigger factors for VF are unclear in most of cases. Sleeping, having dinner and rest are often associated with VF, but we cannot recommend patients to avoid those in daily life. Fever, excessive alcohol intake and some drugs can be avoided to reduce the risk of VF in patients with BrS1. Among these risk factors, fever has been studied by many investigators. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Hiroshi Morita Source Type: research

A 10-year review of sudden death during sporting activities
Sudden death during sport is a rare but devastating event. Previous research has mostly focused on sudden deaths in young competitive athletes. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Mark Dennis, Alexander Elder, Christopher Semsarian, John Orchard, Isabel Brouwer, Rajesh Puranik Source Type: research

Left ventricular regional remodeling and lead position during cardiac resynchronization therapy
Cardiac resynchronization therapy (CRT) induces segmental left ventricular (LV) remodeling. LV lead position (LV-LP) impacts response to CRT and remodeling. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Mads B. Kronborg, Anders Sommer, Daniel B. Fyenbo, Bjarne L. Norgaard, Christian Gerdes, Jesper Moller Jensen, Henrik Kj ærulf Jensen, Jens Kristensen, Jens C. Nielsen Source Type: research

Clinical and Electrophysiologic Characteristics of Patients with Paroxysmal Intra-His block with Narrow QRS complexes
Atrioventricular block (AVB) is usually due to infra-nodal disease and associated with a wide QRS complex; such patients often progress to complete AV block and pacemaker dependency. Uncommonly, infra-nodal AVB can occur within the His bundle with a narrow QRS complex. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Loheetha Ragupathi, Drew Johnson, Arnold Greenspon, Daniel Frisch, Reginald T. Ho, Behzad B. Pavri Source Type: research

Experience with the Wearable Cardioverter-Defibrillator in Older Patients: Results from the Prospective Registry of Patients Using the Wearable Cardioverter-Defibrillator (WEARIT-II Registry)
Use of the wearable cardioverter-defibrillator (WCD) in older patients has not been described previously. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Usama A. Daimee, Katherine Vermilye, Arthur J. Moss, Ilan Goldenberg, Helmut U. Klein, Scott McNitt, Wojciech Zareba, Valentina Kutyifa Source Type: research

Safety and Efficacy of Stereotactic Radioablation Targeting Pulmonary Vein Tissues in an Experimental Model
Stereotactic radioablation (SR), a commonly used therapy to treat malignancies, has been utilized to treat refractory ventricular tachycardia, but the feasibility of treating atrial fibrillation (AF) with SR is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Paul C. Zei, Doug Wong, Edward Gardner, Thomas Fogarty, Patrick Maguire Source Type: research

Early feasibility of Hypoglossal Nerve Upper Airway Stimulator in Patients with Cardiac Implantable Electronic Devices and Continuous Positive Airway Pressure-Intolerant Severe Obstructive Sleep Apnea
Implantable hypoglossal nerve upper airway stimulation (HNS) is a novel, FDA approved strategy for management of moderate to severe obstructive sleep apnea(OSA) patients with continuous positive airway pressure (CPAP) therapy intolerance or failure. Due to proximity of Cardiac Implantable Electronic Devices (CIED) and this stimulator, interaction between these devices is theoretically possible. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Valay Parikh, Erica Thaler, Masanari Kato, M. Boyd Gillespie, Shaun Nguyen, Kirk Withrow, David Calhoun, Ryan Soose, Damien Stevens, Suzanne Stevens, Chris Larsen, Madhu Reddy, Dhanunjaya Lakkireddy Source Type: research

Feasibility, Safety and Efficacy of a Novel Pre-Shaped Nitinol Esophageal Deviator to Successfully Deflect the Esophagus and Ablate Left Atrium without Esophageal Temperature Rise during Atrial Fibrillation Ablation – The DEFLECT GUT study
Esophageal thermal injury is a feared complication of radiofrequency ablation (RFA) for atrial fibrillation (AF). Rise in luminal esophageal temperature (LET) limits the ability to deliver RF energy on posterior wall of LA. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Valay Parikh, Vijay Swarup, Jacob Hantla, Venkat Vuddanda, Tawseef Dar, Bharath Yarlagadda, Luigi Di Biase, Amin Al-Ahmad, Andrea Natale, Dhanunjaya Lakkireddy Source Type: research

Hot topics in Brugada syndrome
Ventricular fibrillation (VF) in Brugada syndrome (BrS) usually occurs at night, but the trigger factors for VF are unclear in most of cases. Sleeping, having dinner and rest are often associated with VF, but we cannot recommend patients to avoid those in daily life. Fever, excessive alcohol intake and some drugs can be avoided to reduce the risk of VF in patients with BrS1. Among these risk factors, fever has been studied by many investigators. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Hiroshi Morita Source Type: research

A 10-year review of sudden death during sporting activities
Sudden death during sport is a rare but devastating event. Previous research has mostly focused on sudden deaths in young competitive athletes. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2018 Category: Cardiology Authors: Mark Dennis, Alexander Elder, Christopher Semsarian, John Orchard, Isabel Brouwer, Rajesh Puranik Source Type: research

Adherence to 2016 European Society of Cardiology Guidelines Predicts Outcome in a Large Real-World Population of Heart Failure Patients Requiring Cardiac Resynchronization Therapy Adherence to Guidelines Predicts CRT Outcome
Professional guidelines are based on the best available evidence. However, patients treated in clinical practice may differ from those included in reference trials. (Source: Heart Rhythm)
Source: Heart Rhythm - April 14, 2018 Category: Cardiology Authors: Giuseppe Stabile, Patrizia Pepi, Pietro Palmisano, Antonio D ’Onofrio, Antonio De Simone, Salvatore Ivan Caico, Domenico Pecora, Antonio Rapacciuolo, Giuseppe Arena, Massimiliano Marini, Paolo Pieragnoli, Sandra Badolati, Gianluca Savarese, Gianpiero Ma Source Type: research

Antiarrhythmic effects of stimulating the left dorsal branch of the thoracic nerve in a canine model of paroxysmal atrial tachyarrhythmias
Stellate ganglion nerve activity (SGNA) precedes paroxysmal atrial tachyarrhythmia (PAT) episodes in dogs with intermittent high-rate left atrial (LA) pacing. The left dorsal branch of the thoracic nerve (LDTN) contains sympathetic nerves originating from the stellate ganglia. (Source: Heart Rhythm)
Source: Heart Rhythm - April 11, 2018 Category: Cardiology Authors: Ye Zhao, Yuan Yuan, Wei-Chung Tsai, Zhaolei Jiang, Zhi-peng Tian, Changyu Shen, Shien-Fong Lin, Michael C. Fishbein, Thomas H. Everett, Zhenhui Chen, Peng-Sheng Chen Source Type: research

Antiarrhythmic effects of stimulating the left dorsal branch of the thoracic nerve in a canine model of paroxysmal atrial tachyarrhythmias
Stellate ganglion nerve activity (SGNA) precedes paroxysmal atrial tachyarrhythmias (PAT) episodes in dogs with intermittent high rate left atrium (LA) pacing. The left dorsal branch of thoracic nerve (LDTN) contains sympathetic nerves originating from the stellate ganglia. (Source: Heart Rhythm)
Source: Heart Rhythm - April 11, 2018 Category: Cardiology Authors: Ye Zhao, Yuan Yuan, Wei-Chung Tsai, Zhaolei Jiang, Zhi-peng Tian, Changyu Shen, Shien-Fong Lin, Michael C. Fishbein, Thomas H. Everett, Zhenhui Chen, Peng-Sheng Chen Source Type: research

Fever-related arrhythmic events in the multicenter Survey on Arrhythmic Events in Brugada Syndrome
The literature on fever-related arrhythmic events (AE) in Brugada syndrome (BrS) is currently limited to few case reports and small series. (Source: Heart Rhythm)
Source: Heart Rhythm - April 9, 2018 Category: Cardiology Authors: Yoav Michowitz, Anat Milman, Georgia Sarquella-Brugada, Antoine Andorin, Jean Champagne, Pieter G. Postema, Ruben Casado-Arroyo, Eran Leshem, Jimmy J.M. Juang, Carla Giustetto, Jacob Tfelt-Hansen, Yanushi D. Wijeyeratne, Christian Veltmann, Domenico Corra Source Type: research

Fever-Related Arrhythmic Events in the Multicenter Survey on Arrhythmic Events in Brugada Syndrome (SABRUS)
The literature on fever related arrhythmic events (AE) in Brugada syndrome (BrS) is currently limited to few case reports and small series. (Source: Heart Rhythm)
Source: Heart Rhythm - April 9, 2018 Category: Cardiology Authors: Yoav Michowitz, Anat Milman, Georgia Sarquella-Brugada, Antoine Andorin, Jean Champagne, Pieter G. Postema, Ruben Casado-Arroyo, Eran Leshem, Jimmy JM. Juang, Carla Giustetto, Jacob Tfelt-Hansen, Yanushi D. Wijeyeratne, Christian Veltmann, Domenico Corrad Source Type: research

Would I do it again? Reflections on a career in academia and electrophysiology
For a young person contemplating the electrophysiology scene in 1960's New York, the vistas were unlimited. The city was home to 3 giants: Brian Hoffman at Columbia, Tony Damato at the Public Health Service Hospital, and Paul Cranefield at the Rockefeller; and the Downstate Medical Center, whose Department of Physiology had spawned the careers of Hoffman, Cranefield, Mario Vassalle, and many others remained a force. Also evident was the influence of David Scherf, who —having emigrated from Vienna to New York—was a regular attendee at local electrophysiology meetings, reverentially deferred to by all. (Source: Heart Rhythm)
Source: Heart Rhythm - April 6, 2018 Category: Cardiology Authors: Michael R. Rosen Tags: Viewpoint Source Type: research