Gene discovery: From biological plausibility to genetic evidence supporting disease causation
Methods of gene discovery have changed dramatically over the years. In the absence of automated DNA sequencing technology, classical genetics relied primarily on limited DNA sequence knowledge, specifically in the form of polymorphic DNA markers representing short sequences of repetitive nucleotide sequences. Knowledge of the distribution of these markers across the genome allowed researchers to perform linkage analysis studies in large families and to identify a shared set of DNA markers common to affected cases but absent in unaffected family members, effectively localizing a genomic region where the culprit gene must re...
Source: Heart Rhythm - July 29, 2019 Category: Cardiology Authors: Michael H. Gollob Tags: EDITORIAL COMMENTARY Source Type: research

Enhanced arrhythmogenic potential induced by renal autonomic nerve stimulation: Role of renal artery catheter ablation
Renal artery catheter ablation has been reported as a possible therapeutic option for drug-refractory ventricular arrhythmias (VAs) associated with structural heart diseases. (Source: Heart Rhythm)
Source: Heart Rhythm - July 29, 2019 Category: Cardiology Authors: Masaomi Chinushi, Osamu Saitoh, Ayari Sugai, Ayaka Oikawa, Junya Watanabe, Hiroshi Furushima Source Type: research

Enhanced arrhythmogenic potential induced by renal autonomic nerves stimulation: Role of renal artery catheter ablation
Renal artery catheter ablation has been reported as a possible therapeutic option for drug-refractory ventricular arrhythmias (VAs) associated with structural heart diseases. (Source: Heart Rhythm)
Source: Heart Rhythm - July 29, 2019 Category: Cardiology Authors: Masaomi Chinushi, Osamu Saitoh, Ayari Sugai, Ayaka Oikawa, Junya Watanabe, Hiroshi Furushima Source Type: research

Additional Antitachycardia Pacing Programming Strategies Further Reduce Unnecessary Implantable Cardioverter Defibrillator Shocks
Antitachycardia pacing (ATP) is routinely used to terminate ventricular tachyarrhythmias. However, little guidance exists on the most effective programming of ATP. (Source: Heart Rhythm)
Source: Heart Rhythm - July 29, 2019 Category: Cardiology Authors: Boyoung Joung, Daniel R. Lexcen, Chi-Keong Ching, Marc T. Silver, Jonathan P. Piccini, Laurence D. Sterns, Rafael Rabinovich, Robert A. Pickett, Shufeng Liu, MS; Mark L. Brown, Alan Cheng Source Type: research

Quadripolar versus Bipolar Leads in Cardiac Resynchronization Therapy: An Analysis from the National Cardiovascular Data Registry
The introduction of quadripolar (QP) cardiac resynchronization therapy (CRT) leads aimed to improve procedural and clinical outcomes. (Source: Heart Rhythm)
Source: Heart Rhythm - July 29, 2019 Category: Cardiology Authors: Emad Uddin Hakemi, Rami Doukky, Craig S. Parzynski, Jeptha P. Curtis, Christopher Madias Source Type: research

Enhanced arrhythmogenic potential induced by the renal autonomic nerves stimulation: Role of renal artery catheter ablation
Renal artery catheter ablation has been reported as a possible therapeutic option for drug-refractory ventricular arrhythmias (VA) associated with structural heart diseases. (Source: Heart Rhythm)
Source: Heart Rhythm - July 29, 2019 Category: Cardiology Authors: Masaomi Chinushi, Osamu Saitoh, Ayari Sugai, Ayaka Oikawa, Junya Watanabe, Hiroshi Furushima Source Type: research

Gene Discovery: From Biologic Plausibility to Genetic Evidence Supporting Disease Causation
Methods of gene discovery have changed dramatically over the years. In the absence of automated DNA sequencing technology, classical genetics relied primarily on limited DNA sequence knowledge, specifically in the form of polymorphic DNA markers representing short sequences of repetitive nucleotide sequences. Knowledge of the distribution of these markers across the genome allowed researchers to perform linkage analysis studies in large families, and to identify a shared set of DNA markers common to affected cases but absent in unaffected family members, effectively localizing a genomic region where the culprit gene must r...
Source: Heart Rhythm - July 29, 2019 Category: Cardiology Authors: Michael H. Gollob Source Type: research

Termination of an unusual long RP tachycardia: What is the mechanism?
A 36-year-old woman underwent a diagnostic electrophysiology study because of rapid palpitations and KardiaPro (AliveCor, Mountain View, CA) documented supraventricular tachycardia unresponsive to metoprolol therapy. She denied syncope. Her 12-lead electrocardiogram was normal. Baseline atrio-His and His-ventricular intervals measured 48 and 42 ms, respectively. Programmed atrial extrastimulation using single atrial extrastimuli repeatedly induced her supraventricular tachycardia (Figure  1). The response to ventricular overdrive pacing is shown in Figure 2. (Source: Heart Rhythm)
Source: Heart Rhythm - July 26, 2019 Category: Cardiology Authors: Reginald T. Ho, Jonathan P. Logue Tags: Unknown of the Month Source Type: research

QRS complex change during carotid sinus massage in ventricular pre-excitation
A 27-year-old man with a 4-year history of palpitations was seen in the outpatient clinic. His 12-lead electrocardiogram showed ventricular preexcitation during sinus rhythm. Of interest, and shown in Figure  1, are the changes in the QRS configuration during carotid sinus massage. (Source: Heart Rhythm)
Source: Heart Rhythm - July 26, 2019 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

HRS 40th anniversary viewpoints: Present at the creation —My viewpoint on the origins of cellular and clinical electrophysiology of arrhythmias
To most cellular and clinical electrophysiologists studying arrhythmias today, the origin and development of their disciplines are in the forgotten past. While the mechanisms of cardiac arrhythmias had been a focus of interest since the early 20th century,1 the elucidation of the cellular electrophysiology (EP) of arrhythmias began to take shape in the early 1960s.2 The origin of clinical EP soon followed. To a septuagenarian such as myself who has been involved in both aspects, the 1960s feels like yesterday. (Source: Heart Rhythm)
Source: Heart Rhythm - July 26, 2019 Category: Cardiology Authors: Andrew L. Wit Tags: Viewpoint Source Type: research

Effect of remote ischemic preconditioning on electrophysiological parameters in nonvalvular paroxysmal atrial fibrillation: The RIPPAF Randomized Clinical Trial
Atrial fibrillation (AF) remains the most relevant arrhythmia with a prevalence of 2%. The treatment options are either highly invasive and cost-intensive or limited by potential side effects or insufficient efficacy. However, no direct means of prevention that could reduce the burden of AF have been tested. (Source: Heart Rhythm)
Source: Heart Rhythm - July 26, 2019 Category: Cardiology Authors: Jedrzej Kosiuk, Katharina Langenhan, Clara Stegmann, Tobias Uhe, Nikolaos Dagres, Borislav Dinov, Simon Kircher, Sergio Richter, Philipp Sommer, Livio Bertagnolli, Andreas Bollmann, Gerhard Hindricks Source Type: research

Effect of remote ischemic preconditioning on electrophysiological parameters in non-valvular paroxysmal atrial fibrillation: The RIPPAF Randomized Clinical Trial
Atrial fibrillation (AF) remains the most relevant arrhythmia with a prevalence of 2%. The treatment options are either highly invasive and cost-intensive or limited by potential side effects or insufficient efficacy. However, no direct means of prevention that could reduce the burden of AF have been tested. (Source: Heart Rhythm)
Source: Heart Rhythm - July 26, 2019 Category: Cardiology Authors: Jedrzej Kosiuk, Katharina Langenhan, Clara Stegmann, Tobias Uhe, Nikolaos Dagres, Borislav Dinov, Simon Kircher, Sergio Richter, Philipp Sommer, Livio Bertagnolli, Andreas Bollmann, Gerhard Hindricks Source Type: research

Mahaim fibers: Should they be renamed?
In 1938, Mahaim and Benatt described the pathological findings of fibers connecting the AV node and His bundle to the ventricular septum1. The role of such fibers in causing arrhythmias is controversial. (Source: Heart Rhythm)
Source: Heart Rhythm - July 24, 2019 Category: Cardiology Authors: Seshadri Balaji, Patrick Tchou, Ronald Kanter Source Type: research

The Electrocardiogram in the Diagnosis and Management of Patients with Hypertrophic Cardiomyopathy
In an era of rapid technological development and evolving diagnostic possibilities, the electrocardiogram (ECG) is living an authentic “renaissance” in myocardial diseases. To date, the ECG remains an irreplaceable first step when evaluating patients with hypertrophic cardiomyopathy (HCM) and an abnormal ECG may be the only manifestation of disease at an early stage. In some instances specific electrical anomalies may different iate HCM from phenocopies such as cardiac amyloidosis and glycogen storage diseases. (Source: Heart Rhythm)
Source: Heart Rhythm - July 23, 2019 Category: Cardiology Authors: Gherardo Finocchiaro, Nabeel Sheikh, Elena Biagini, Michael Papadakis, Nicolo ’ Maurizi, Gianfranco Sinagra, Antonio Pelliccia, Claudio Rapezzi, Sanjay Sharma, Iacopo Olivotto Source Type: research

Catheter Ablation Of Supraventricular Tachycardia After Tricuspid Valve Surgery In Patients With Congenital Heart Disease: A Multicenter Comparative Study
Tricuspid valve (TV) surgery is often required for congenital heart disease (CHD), but may hinder catheter ablation when artificial material or imbricated tissue cover the tricuspid annulus. (Source: Heart Rhythm)
Source: Heart Rhythm - July 23, 2019 Category: Cardiology Authors: Jeremy P. Moore, Roberto G. Gallotti, Anca Chiriac, Christopher J. McLeod, Elizabeth A. Stephenson, Khadijah Maghrabi, Frank A. Fish, Orhan U. Kilinc, David Bradley, Ulrich Krause, Seshadri Balaji, Kevin M. Shannon Source Type: research

EP News: Clinical
van der Werf et  al (Eur Heart J May 30, 2019; https://doi.org/10.1093/eurheartj/ehz309, PMID 31145795) assessed the efficacy and complications of implantable cardioverter-defibrillators (ICDs) placed in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT) and sudden cardiac arrest (SCA). The investigators analyzed 136 patients who presented with SCA and in whom CPVT was diagnosed subsequently, leading to the initiation of guideline-directed therapy, including β-blockers, flecainide, and/or left cardiac sympathetic denervation. (Source: Heart Rhythm)
Source: Heart Rhythm - July 22, 2019 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

Right anterior ganglionated plexus: the primary target of cardioneuroablation?
Catheter ablation on ganglionated plexus (GP) as cardioneuroablation in left atrium (LA) has been used to treat the vasovagal syncope (VVS). (Source: Heart Rhythm)
Source: Heart Rhythm - July 19, 2019 Category: Cardiology Authors: Feng Hu, Lihui Zheng, Erpeng Liang, Ligang Ding, Lingmin Wu, Gang Chen, Xiaohan Fan, Yan Yao Source Type: research

Incidence of false-positive transmissions during remote rhythm monitoring with implantable loop recorders
Implantable loop recorder (ILR) is preferred strategy for prolonged rhythm monitoring. (Source: Heart Rhythm)
Source: Heart Rhythm - July 16, 2019 Category: Cardiology Authors: Muhammad R. Afzal, Julie Mease, Tanner Koppert, Toshimasa Okabe, Jaret Tyler, Mahmoud Houmsse, Ralph S. Augostini, Raul Weiss, John D. Hummel, Steven J. Kalbfleisch, Emile G. Daoud Source Type: research

Multicenter prospective observational long-term follow-up study of endocardial cardiac resynchronization therapy using the Jurdham procedure
Endocardial cardiac resynchronization therapy (eCRT) avoids the limitations and failures of coronary sinus (CS) resynchronization. However, data regarding long-term outcomes are lacking. (Source: Heart Rhythm)
Source: Heart Rhythm - July 16, 2019 Category: Cardiology Authors: Benjamin Elencwajg, N éstor López-Cabanillas, Avi Fischer, Alberto Negrete, Jorge Marin, Lorena Delgado, Michael Glikson, Luis Molina, Seth Worley, Jaime Arnez, Fernando Vidal, Paul Friedman, Jurdham Group Source Type: research

Incidence Of False Positive Transmissions During Remote Rhythm Monitoring With Implantable Loop Recorders
Implantable loop recorder (ILR) is preferred strategy for prolonged rhythm monitoring. (Source: Heart Rhythm)
Source: Heart Rhythm - July 16, 2019 Category: Cardiology Authors: Muhammad R. Afzal, Julie Mease, Tanner Koppert, Toshimasa Okabe, Jaret Tyler, Mahmoud Houmsse, Ralph S. Augostini, Raul Weiss, John D. Hummel, Steven J. Kalbfleisch, Emile G. Daoud Source Type: research

Dielectric-Based Imaging And Navigation Of The Heart
Electroanatomic (EA) mapping systems are increasingly indispensable for complex mapping and ablation procedures in electrophysiology. An ideal ‘wish-list’ for such mapping may include accurate, real-time, acquisition of cardiac geometry, dynamic imaging of cardiac motion, localization of any catheter or wire within the heart, characterizing ablated versus non-ablated tissue, and electrophysiologic identification of voltage, activation times, physiological potentials and arrhythmogenic indices. In fact, few EA mapping systems meet these criteria. (Source: Heart Rhythm)
Source: Heart Rhythm - July 16, 2019 Category: Cardiology Authors: Albert J. Rogers, Sanjiv M. Narayan Source Type: research

A Multicenter prospective observational long-term follow up study of endocardial cardiac resynchronization therapy using the Jurdham procedure
Endocardial cardiac resynchronization therapy (eCRT) avoids the limitations and failures of coronary sinus (CS) resynchronization. However, data regarding long-term outcomes are lacking. (Source: Heart Rhythm)
Source: Heart Rhythm - July 16, 2019 Category: Cardiology Authors: Benjamin Elencwajg, N éstor López-Cabanillas, Avi Fischer, Alberto Negrete, Jorge Marin, Lorena Delgado, Michael Glikson, Luis Molina, Seth Worley, Jaime Arnez, Fernando Vidal, Paul Friedman, Jurdham Group Source Type: research

Making the case for cascade screening among families with inherited heart disease
A common scenario is that we spend time explaining the inheritance risks and need for evaluation of at-risk relatives in the family. Ultimately in many cases there is almost no uptake of these recommendations. We might try various methods, such as providing a letter to the family, giving specific details about local cardiologists, and offering to allow relatives to call us directly, yet the message does not get through to a sizeable proportion of families. This is not just a breakdown in communication but likely also is related to the perceived importance of screening. (Source: Heart Rhythm)
Source: Heart Rhythm - July 13, 2019 Category: Cardiology Authors: Jodie Ingles, Christopher Semsarian Tags: EDITORIAL COMMENTARY Source Type: research

EP News: Case Reports
Implantable cardiac device migration can negatively impact device function, result in patient discomfort, and adversely impact lead stability in patients with transvenous leads. In patients who receive a subcutaneous implantable cardioverter-defibrillator (SICD), device migration can significantly impact sensing of ventricular tachyarrhythmias as well as defibrillation thresholds. Xiang et  al (DOI: https://doi.org/10.1016/j.hrcr.2019.05.003) described a 44-year-old female patient with morbid obesity (body mass index 41 kg/m2) who underwent ICD implantation for secondary prevention after presentation with out-of-hospi...
Source: Heart Rhythm - July 13, 2019 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

Making The Case For Cascade Screening Amongst Families With Inherited Heart Diseases
A common scenario is that we spend time explaining the inheritance risks and need for evaluation of the at-risk relatives in the family, and ultimately in many cases there is almost no uptake of these recommendations. We might try various methods, providing a family letter, giving specific details of local cardiologists, offering for relatives to call us directly, yet there remains a sizeable proportion of families where the message does not get through. It is not just a break down in communication, but likely also relates to the perceived importance of screening. (Source: Heart Rhythm)
Source: Heart Rhythm - July 13, 2019 Category: Cardiology Authors: Jodie Ingles, Christopher Semsarian Source Type: research

An unusual type of long RP tachycardia: What is the mechanism?
An 81-year-old man underwent diagnostic electrophysiological study because of daily rapid palpitations. His 12-lead electrocardiogram and echocardiogram were normal. At baseline, he was in a nearly incessant tachycardia, which otherwise was easily inducible with atrial and ventricular stimulation (Figure  1, top). The response of tachycardia to ventricular premature depolarizations (VPDs) and entrainment from the ventricle are shown in Figure 1 (middle, bottom) and Figure 2, respectively. Based on the tracings, what is the mechanism of the tachycardia? (Source: Heart Rhythm)
Source: Heart Rhythm - July 12, 2019 Category: Cardiology Authors: Reginald T. Ho Tags: Unknown of the Month Source Type: research

An Unusual Type of Long RP Tachycardia - What is the Mechanism?
Case Presentation: An 81 year-old man underwent diagnostic electrophysiologic study because of daily rapid palpitations. His 12-lead ECG and echocardiogram were normal. At baseline, he was in a nearly incessant tachycardia which otherwise was easily inducible with atrial and ventricular stimulation (Figure 1, top). The response of tachycardia to ventricular premature depolarizations (VPDs) and entrainment from the ventricle are shown in Figure 1 (middle, bottom) and Figure 2, respectively. Based upon the tracings, what is the mechanism of tachycardia? (Source: Heart Rhythm)
Source: Heart Rhythm - July 12, 2019 Category: Cardiology Authors: Reginald T. Ho Source Type: research

Oral geranylgeranylacetone treatment increases heat shock protein expression in human atrial tissue
Heat shock proteins (HSPs) are important chaperones which regulate the maintenance of a healthy protein quality control in the cell. Impairment of HSPs is associated with ageing-related neurodegenerative and cardiac diseases. A well-known compound to increase HSPs, through the activation of heat shock factor-1 (HSF1), is geranylgeranylacetone (GGA). GGA increases HSPs in various tissues, but so far, it is unknown whether GGA can increase HSP expression in human heart tissue. (Source: Heart Rhythm)
Source: Heart Rhythm - July 12, 2019 Category: Cardiology Authors: Denise M.S van Marion, Larissa Dorsch, Femke Hoogstra-Berends, Tea Kakuchaya, Leo Bockeria, Natasja M.S de Groot, Bianca J.J.M Brundel Source Type: research

Left Atrial Appendage Closure Device Implantation in Patients at Very High Risk for Stroke
Little is known about the role of left atrial appendage closure using Watchman ™ device in patients who are at very high risk for stroke. (Source: Heart Rhythm)
Source: Heart Rhythm - July 12, 2019 Category: Cardiology Authors: Erika Hutt, Oussama M. Wazni, Simrat Kaur, Walid I. Saliba, Khaldoun G. Tarakji, Samir Kapadia, Jose Aguilera, Amr F. Barakat, Mouin Abdallah, Wael Jaber, Peter Rasmussen, Shazam Hussain, Ken Uchino, Dolora Wisco, Bruce D. Lindsay, Mohamed Kanj, Ayman A. Source Type: research

Effect of the variability of blood pressure, glucose level, total cholesterol level, and body mass index on the risk of atrial fibrillation in a healthy population
The variability of metabolic parameters might have an impact on the pathophysiology of atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - July 9, 2019 Category: Cardiology Authors: So-Ryoung Lee, Eue-Keun Choi, Kyung-Do Han, Seung-Hwan Lee, Seil Oh Source Type: research

Cardioversion on reduced-dose direct oral anticoagulants: Are we confident?
Electrical cardioversion is commonly performed in patients with symptomatic or hemodynamically unstable atrial fibrillation (AF). The associated risk of a periprocedural embolic event after cardioversion has significantly decreased from an estimated 5% –7% to approximately 1% with the use of uninterrupted anticoagulation. The introduction of direct oral anticoagulants (DOACs) over the past decade has greatly simplified periprocedural anticoagulation management by eliminating the need for intravenous heparin and avoiding delay and/or need for tra nsesophageal echocardiography (TEE) in patients with subtherapeutic or v...
Source: Heart Rhythm - July 9, 2019 Category: Cardiology Authors: Eran Leshem, Patricia Tung, Peter Noseworthy, Peter Zimetbaum Tags: Viewpoint Source Type: research

Cardioversion on Reduced Dose Direct Oral Anticoagulants (DOACs) - Are we Confident?
Electrical cardioversion is commonly performed in patients with symptomatic or hemodynamically unstable atrial fibrillation (AF). The associated risk of a periprocedural embolic event following cardioversion has significantly decreased from an estimated 5-7% to approximately 1% with the use of uninterrupted anticoagulation. The introduction of direct oral anticoagulants (DOACs) over the past decade has greatly simplified periprocedural anticoagulation management by eliminating the need for intravenous heparin and avoiding delay and/or need for transesophageal echocardiography in patients with subtherapeutic or variable INR...
Source: Heart Rhythm - July 9, 2019 Category: Cardiology Authors: Eran Leshem, Patricia Tung, Peter Noseworthy, Peter Zimetbaum Source Type: research

Effect of the variability of blood pressure, glucose, total cholesterol, and body mass index on risk of atrial fibrillation in a healthy population
The variability of metabolic parameters might have an impact on the pathophysiology of atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - July 9, 2019 Category: Cardiology Authors: So-Ryoung Lee, Eue-Keun Choi, Kyung-Do Han, Seung-Hwan Lee, Seil Oh Source Type: research

Stroke and Dementia Risk in Patients with and without Atrial Fibrillation and Carotid Arterial Disease
We sought to understand the risks of stroke, transient ischemic attack(TIA), and dementia in patients with and without atrial fibrillation (AF) and carotid arterial disease (CD), or a combination of both, and determine if therapies for each disease may influence risks. 11,572 patients were included and matched into 4 groups of 2,893 by the presence of AF and CD. CD and AF augment risk of stroke/TIA and dementia in the general population and the coexistence of both diseases is additive in risk. Ablation of AF was associated with lower risk, the magnitude of which was greater in those with CD. (Source: Heart Rhythm)
Source: Heart Rhythm - July 9, 2019 Category: Cardiology Authors: T. Jared Bunch, Tami L. Bair, Brian G. Crandall, Michael J. Cutler, John D. Day, Kevin G. Graves, Victoria Jacobs, Charles Mallender, Jeffrey S. Osborn, J. Peter Weiss, Heidi T. May Source Type: research

Oversensing issues leading to device extraction: When subcutaneous implantable cardioverter-defibrillator reached a dead-end
Subcutaneous implantable cardioverter-defibrillator (S-ICD) implantations are rapidly expanding. However, the subcutaneous detection and interpretation of cardiac signals is much more challenging than by conventional devices. There is a complete paradigm shift in cardiac signal sensing with subcutaneous signal detection, leading in some cases to oversensing with restricted programming options. (Source: Heart Rhythm)
Source: Heart Rhythm - July 8, 2019 Category: Cardiology Authors: Antoine Noel, Sylvain Ploux, Samuel Bulliard, Marc Strik, Andreas Haeberlin, Nicolas Welte, Hugo Marchand, Nicolas Klotz, Philippe Ritter, Michel Ha ïssaguerre, Pierre Bordachar Source Type: research

Oversensing issues leading to device extraction: when subcutaneous implantable cardioverter defibrillator reached a dead-end
Subcutaneous implantable cardioverter defibrillators (S-ICD) implantations are rapidly expanding. However, the subcutaneous detection and interpretation of cardiac signals is much more challenging than in conventional devices. There is a complete paradigm shift in cardiac signal sensing with subcutaneous signal detection, leading in some cases to oversensing with restricted programming options. (Source: Heart Rhythm)
Source: Heart Rhythm - July 8, 2019 Category: Cardiology Authors: Antoine Noel, Sylvain Ploux, Samuel Bulliard, Marc Strik, Andreas Haeberlin, Nicolas Welte, Hugo Marchand, Nicolas Klotz, Philippe Ritter, Michel Ha ïssaguerre, Pierre Bordachar Source Type: research

Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome
There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs). (Source: Heart Rhythm)
Source: Heart Rhythm - July 5, 2019 Category: Cardiology Authors: Anat Milman, Antoine Andorin, Pieter G. Postema, Jean-Baptiste Gourraud, Frederic Sacher, Philippe Mabo, Sung-Hwan Kim, Shingo Maeda, Yoshihide Takahashi, Tsukasa Kamakura, Takeshi Aiba, Giulio Conte, Jimmy J.M. Juang, Eran Leshem, Yoav Michowitz, Rami Fo Tags: Clinical Source Type: research

When bigger is better: Novel use of a 27 F leadless pacemaker delivery sheath for femoral lead extractions
As the implantation rate of cardiac implantable electronic devices has continued to increase, lead extractions for clinical indications such as infection, lead failure, and lead recall have also increased.1 A femoral approach to transvenous lead extractions is needed when removing previously cut and abandoned leads, leads that disrupt during a superior extraction attempt and in some cases involving central venous obstruction.2 (Source: Heart Rhythm)
Source: Heart Rhythm - July 5, 2019 Category: Cardiology Authors: James Gabriels, David Chang, Joseph Donnelly, Beom Soo Kim, Jonathan Willner, Stuart Beldner, Laurence M. Epstein Tags: Hands On Source Type: research

Catheter Ablation of Electrical Storm in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy
Therapeutic strategies for electrical storm (ES) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) are not well defined. (Source: Heart Rhythm)
Source: Heart Rhythm - July 5, 2019 Category: Cardiology Authors: Mikael Laredo, Ludivine Oliveira Da Silva, Fabrice Extramiana, Nicolas Lellouche, Émilie Varlet, Denis Amet, Vincent Algalarrondo, Xavier Waintraub, Guillaume Duthoit, Nicolas Badenco, Carole Maupain, Francoise Hidden-Lucet, Philippe Maury, Estelle Gandj Source Type: research

When Bigger is Better: Novel Use of a 27Fr Leadless Pacemaker Delivery Sheath for Femoral Lead Extractions
As the implantation rate of cardiac implantable electronic devices has continued to rise, lead extractions for clinical indications such as infection, lead failure, and lead recall have also increased1. A femoral approach to transvenous lead extractions is needed when removing previously cut and abandoned leads, leads that disrupt during a superior extraction attempt and in some cases involving central venous obstruction2. (Source: Heart Rhythm)
Source: Heart Rhythm - July 5, 2019 Category: Cardiology Authors: James Gabriels, David Chang, Joseph Donnelly, Beom Soo Kim, Jonathan Willner, Stuart Beldner, Laurence M. Epstein Source Type: research

Ethnic Differences in Patients with Brugada Syndrome and Arrhythmic Events: New Insights from SABRUS
There is limited information on ethnic differences between patients with Brugada syndrome (BrS) with arrhythmic events (AEs).Objectives: To compare clinical, electrocardiographic (ECG), electrophysiologic (EP) and genetic characteristics between White and Asian BrS-patients with AE. (Source: Heart Rhythm)
Source: Heart Rhythm - July 5, 2019 Category: Cardiology Authors: Anat Milman, Antoine Andorin, Pieter G. Postema, Jean-Baptiste Gourraud, Frederic Sacher, Philippe Mabo, Sung-Hwan Kim, Shingo Maeda, Yoshihide Takahashi, Tsukasa Kamakura, Takeshi Aiba, Giulio Conte, Jimmy JM. Juang, Eran Leshem, Yoav Michowitz, Rami Fog Source Type: research

Occurrence of unexpected ventriculoatrial block during parahisian pacing: What is the mechanism?
A 68-year-old man with documented supraventricular tachycardia was admitted to our hospital for electrophysiological study and catheter ablation. He had no structural heart disease. Baseline electrocardiogram did not show any evidence of pre-excitation. The electrode catheters were positioned at the high right atrium, parahisian region, coronary sinus, and right ventricular apex (RVA). Constant ventricular pacing from the RVA at a cycle length (CL) of 600 ms showed intact ventriculoatrial (VA) conduction. (Source: Heart Rhythm)
Source: Heart Rhythm - June 28, 2019 Category: Cardiology Authors: Itsuro Morishima, Fumio Suzuki, Yasunori Kanzaki Tags: Unknown of the Month Source Type: research

A 78-year-old man with syncope
A 78-year-old man came to the emergency department after a syncopal episode while shopping with his wife. The wife indicated that he suffered from myocardial infarction 2 years ago and complained about dizziness for about 2 weeks. His 12-lead electrocardiogram (ECG) recorded in the emergency department is shown in Figure  1A. In view of the history and the 12-lead ECG, a pacemaker lead was placed into the apex of the right ventricle. Shortly thereafter Figure 1B was recorded. (Source: Heart Rhythm)
Source: Heart Rhythm - June 28, 2019 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

HRS 40th anniversary viewpoints: Reflections on a career in cardiac electrophysiology — Parallel pathways and intersections
The invitation to provide a commentary on my views of the evolution of the field of cardiac electrophysiology, in the context of my personal career experience, is not a burden; rather, it is an opportunity. It forces me to reflect back on my attitudes toward science and clinical medicine, beginning with the early years of my education, continuing through research and clinical training, and ultimately into an academic career in my field of interest. (Source: Heart Rhythm)
Source: Heart Rhythm - June 28, 2019 Category: Cardiology Authors: Robert J. Myerburg Tags: Viewpoint Source Type: research

Incidence, predictors, and clinical impact of electrical storm in patients with left ventricular assist devices: New insights from the ASSIST-ICD study
Ventricular arrhythmias (VAs) can occur after continuous flow left ventricular assist device (LVAD) implantation as a single arrhythmic event or as electrical storm (ES) with multiple repetitive VA episodes. (Source: Heart Rhythm)
Source: Heart Rhythm - June 27, 2019 Category: Cardiology Authors: Rapha ël P. Martins, Christophe Leclercq, Hamed Bourenane, Vincent Auffret, Stéphane Boulé, Valentin Loobuyck, Camille Dambrin, Pierre Mondoly, Frédéric Sacher, Pierre Bordachar, Michel Kindo, Thomas Cardi, Philippe Gaudard, Philippe Rouvière, Magal Source Type: research

High-resolution, real-time, and nonfluoroscopic 3-dimensional cardiac imaging and catheter navigation in humans using a novel dielectric-based system
Catheter navigation and 3-dimensional (3D) cardiac mapping are essential components of minimally invasive electrophysiological procedures. (Source: Heart Rhythm)
Source: Heart Rhythm - June 27, 2019 Category: Cardiology Authors: Alexander Romanov, Eli Dichterman, Yitzhack Schwartz, Zalman Ibragimov, Yehonatan Ben-David, Haim Rodriguez, Evgeny Pokushalov, Usman R. Siddiqui, Andrew Kadlec, Shlomo A. Ben-Haim Source Type: research

High-resolution, Real-time, and Nonfluoroscopic Three-Dimensional Cardiac Imaging and Catheter Navigation in Humans Using a Novel Dielectric-Based System
Catheter navigation and 3D cardiac mapping are essential components of minimally invasive electrophysiological procedures. (Source: Heart Rhythm)
Source: Heart Rhythm - June 27, 2019 Category: Cardiology Authors: Alexander Romanov, Eli Dichterman, Yitzhack Schwartz, Zalman Ibragimov, Yehonatan Ben-David, Haim Rodriguez, Evgeny Pokushalov, Usman R. Siddiqui, Andrew Kadlec, Shlomo A. Ben-Haim Source Type: research

Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study
Ventricular arrhythmias (VAs) can occur after continuous-flow left ventricular assist devices (LVAD) implantation, as a single arrhythmic event, or as an electrical storm (ES) with multiple repetitive VAs episodes. (Source: Heart Rhythm)
Source: Heart Rhythm - June 27, 2019 Category: Cardiology Authors: Rapha ël P. Martins, Christophe Leclercq, Hamed Bourenane, Vincent Auffret, Stéphane Boulé, Valentin Loobuyck, Camille Dambrin, Pierre Mondoly, Frédéric Sacher, Pierre Bordachar, Michel Kindo, Thomas Cardi, Philippe Gaudard, Philippe Rouvière, Magal Source Type: research

Outcome of patients with functional single ventricular heart after pacemaker implantation: What makes it poor, and what can we do?
Pacemaker implantation in patients with single ventricle is associated with poor outcomes. (Source: Heart Rhythm)
Source: Heart Rhythm - June 25, 2019 Category: Cardiology Authors: Yoshihiko Kodama, Ayako Kuraoka, Yuichi Ishikawa, Makoto Nakamura, Hiroya Ushinohama, Koichi Sagawa, Shintaro Umemoto, Toru Hashimoto, Ichiro Sakamoto, Kisho Ohtani, Tomomi Ide, Hiroyuki Tsutsui, Shiro Ishikawa Source Type: research

EP News: Basic and Translational
Voltage-gated Na+ (NaV) and Ca2+ (CaV) channels are targets for calmodulin (CaM). The binding sites for Ca2+-free and Ca2+-occupied CaM contain targets for mutations linked to long QT syndrome. In the present study, Gardill et  al (Proc Natl Acad Sci U S A 2019;116:10763, PMID 31072926) reported a crystal structure of Ca2+-occupied CaM, bound to the C terminus of the NaV1.5 channel. The structure shows the presence of the EF-hand that is critical in determining the binding mode of CaM on the IQ domain. (Source: Heart Rhythm)
Source: Heart Rhythm - June 25, 2019 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research