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

EP News: Clinical
Hohnloser et  al (Circulation 2019;139:2315, PMID 30976787) assessed the safety and efficacy of once-daily edoxaban 60 mg (30 mg in patients indicated for dose reduction) vs vitamin K antagonists (VKAs) in patients with atrial fibrillation undergoing catheter ablation in a multinational, multicenter, random ized, open-label, parallel-group trial. Patients were randomized 2:1 to edoxaban vs VKA. The primary end point was the time to first occurrence of all-cause death, stroke, or major bleeding during the period from the end of the ablation procedure to the end of treatment (90 days). (Source: Heart Rhythm)
Source: Heart Rhythm - June 25, 2019 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Allied Professionals
In nearly identical, non-randomized, feasibility studies performed at two European centers, the authors (Reddy et  al, J Am Coll Cardiol. 2019; epub ahead of print. PMID: 31085321) sought to assess the safety and efficacy of pulsed field ablation (PFA) for pulmonary vein isolation (PVI) to treat atrial fibrillation (AF). PFA is described as ultra-rapid electrical fields applied to tissues which leads to tiny pores in the cell membranes with leakage of cell contents which leads to cell death. (Source: Heart Rhythm)
Source: Heart Rhythm - June 25, 2019 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

Effects of anesthetic and sedative agents on sympathetic nerve activity
The effects of sedative and anesthetic agents on sympathetic nerve activity (SNA) are poorly understood. (Source: Heart Rhythm)
Source: Heart Rhythm - June 25, 2019 Category: Cardiology Authors: Xiao Liu, Perry Lee Rabin, Yuan Yuan, Awaneesh Kumar, Peter Vasallo, Johnson Wong, Gloria A. Mitscher, Thomas H. Everett, Peng-Sheng Chen Source Type: research

Cardiac Sympathetic Denervation for Refractory Ventricular Arrhythmias in Patients with Structural Heart Disease: A Systematic Review
Cardiac sympathetic denervation (CSD) is an important adjunctive option for patients with refractory ventricular arrhythmias (VAs). Reports of efficacy of CSD in patients with structural heart disease (SHD) and refractory VA vary widely in literature. (Source: Heart Rhythm)
Source: Heart Rhythm - June 25, 2019 Category: Cardiology Authors: Rushil Shah, Fabrizio Assis, Navya Alugubelli, David R. Okada, Rhanderson Cardoso, Kalyanam Shivkumar, Harikrishna Tandri Source Type: research

The outcome of patients with functional single ventricular heart after pacemaker implantation —what makes it poor and what can we do?
The pacemaker implantation in patients with single ventricle is known to be related 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

A beginner's guide to permanent left bundle branch pacing
Studies have demonstrated the feasibility and the clinical benefits of permanent His-bundle pacing (HBP)1. However, concerns regarding higher pacing thresholds, lower R wave amplitudes and the potential to develop distal conduction block have limited the clinical application of HBP in certain subgroups.1, 2 (Source: Heart Rhythm)
Source: Heart Rhythm - June 21, 2019 Category: Cardiology Authors: Weijian Huang, Xueying Chen, Lan Su, Shengjie Wu, Xue Xia, Pugazhendhi Vijayaraman Source Type: research

Genetic Testing and Cascade Screening in Pediatric Long QT Syndrome and Hypertrophic Cardiomyopathy
The efficacy of cascade screening for the inherited heart conditions long QT syndrome (LQTS) and hypertrophic cardiomyopathy (HCM) is incompletely characterized. (Source: Heart Rhythm)
Source: Heart Rhythm - June 20, 2019 Category: Cardiology Authors: Linda M. Knight, Erin Miller, Joshua Kovach, Patricia Arscott, Johannes C. von Alvensleben, David Bradley, Santiago O. Valdes, Stephanie M. Ware, Lindsey Meyers, Curtis D. Travers, Robert M. Campbell, Susan P. Etheridge Source Type: research

Left atrial size and total atrial emptying fraction in atrial fibrillation progression
Left atrial (LA) size and low voltage areas (LVA) mirror atrial fibrillation (AF) progression. Whether these factors are important for the impairment of total atrial emptying fraction is understudied. (Source: Heart Rhythm)
Source: Heart Rhythm - June 19, 2019 Category: Cardiology Authors: Timm Seew öster, Ricardo A. Spampinato, Philipp Sommer, Frank Lindemann, Cosima Jahnke, Ingo Paetsch, Gerhard Hindricks, Jelena Kornej Source Type: research

Clinical and Electrophysiological Characteristics of Idiopathic Ventricular Arrhythmias Originating from the Slow Pathway Region
The slow pathway region (SPR) is commonly targeted during ablation of atrio-ventricular nodal reentrant tachycardia. However, its role in idiopathic ventricular arrhythmias (IVAs) remains unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - June 18, 2019 Category: Cardiology Authors: David F. Brice ño, Jackson J. Liang, Yasuhiro Shirai, Timothy M. Markman, Andres Enriquez, Aung Lin, Pasquale Santangeli, Michael P. Riley, Robert D. Schaller, Saman Nazarian, David Lin, Ramanan Kumareswaram, Jeffery S. Arkles, Mathew C. Hyman, Gregory E Source Type: research

Are wall thickness channels defined by computed tomography predictive of isthmuses of postinfarction ventricular tachycardia?
Wall thickness (WT) in post –myocardial infarction scar is heterogenous, with channels of relatively preserved thickness bordered by thinner scar. (Source: Heart Rhythm)
Source: Heart Rhythm - June 14, 2019 Category: Cardiology Authors: Masateru Takigawa, Josselin Duchateau, Frederic Sacher, Ruairidh Martin, Konstantinos Vlachos, Takeshi Kitamura, Maxime Sermesant, Nicolas Cedilnik, Ghassen Cheniti, Antonio Frontera, Nathaniel Thompson, Calire Martin, Gregoire Massoullie, Felix Bourier, Source Type: research

Are wall thickness channels defined by computed tomography predictive of isthmuses of post-infarction ventricular tachycardia?
Wall thickness in post-MI scar is heterogenous, with channels of relatively preserved thickness bordered by thinner scar. (Source: Heart Rhythm)
Source: Heart Rhythm - June 14, 2019 Category: Cardiology Authors: Masateru Takigawa, Josselin Duchateau, Frederic Sacher, Ruairidh Martin, Konstantinos Vlachos, Takeshi Kitamura, Maxime Sermesant, Nicolas Cedilnik, Ghassen Cheniti, Antonio Frontera, Nathaniel Thompson, Calire Martin, Gregoire Massoullie, Felix Bourier, Source Type: research

Epicardial Adipose Tissue Thickness as an Independent Predictor of Ventricular Tachycardia Recurrence Following Ablation
Although several investigations have shown a relationship between increased epicardial adipose tissue (EAT) and atrial fibrillation (AF), the association between EAT and ventricular tachycardia (VT) has not been evaluated. (Source: Heart Rhythm)
Source: Heart Rhythm - June 13, 2019 Category: Cardiology Authors: Alireza Sepehri Shamloo, Katharina Schoene, Annina Stauber, Angeliki Darma, Nikolaos Dagres, Boris Dinov, Livio Bertagnolli, Sebastian Hilbert, Andreas M üssigbrodt, Daniela Husser, Andreas Bollmann, Gerhard Hindricks, Arash Arya Source Type: research

Isolated Very Low QRS Voltage In The Frontal Leads Predicts Recurrence of Neurally Mediated Syncope
The study was prompted by our observation that some patients with neurally mediated syncope (NMS) have an isolated QRS complex, of very low voltage ( ≤0.3mV cutoff), in one of the frontal leads on the 12-lead electrocardiogram. (Source: Heart Rhythm)
Source: Heart Rhythm - June 12, 2019 Category: Cardiology Authors: Dan Blendea, Craig A. McPherson, Sorin Pop, Jeremy N. Ruskin Source Type: research

Antiarrhythmic Drug Therapy and All-cause Mortality After Catheter Ablation of Atrial Fibrillation: A Propensity Matched Analysis
It is not clear if antiarrhythmic drug therapy (AAD) after catheter ablation (CA) of atrial fibrillation (AF) increases mortality. (Source: Heart Rhythm)
Source: Heart Rhythm - June 12, 2019 Category: Cardiology Authors: Ghanshyam Shantha, Daniel Alyesh, Hamid Ghanbari, Miki Yokokawa, Mohammed Saeed, Ryan Cunnane, Rakesh Latchamsetty, Thomas Crawford, Krit Jongnarangsin, Frank Bogun, Frank Pelosi, Aman Chugh, Fred Morady, Hakan Oral Source Type: research

Characterization of Skin Sympathetic Nerve Activity in Patients with Cardiomyopathy and Ventricular Arrhythmia
Heightened sympathetic nerve activity is associated with occurrence of ventricular arrhythmia (VA). (Source: Heart Rhythm)
Source: Heart Rhythm - June 12, 2019 Category: Cardiology Authors: Pei Zhang, Jin-jun Liang, Cheng Cai, Ying Tian, Ming-yan Dai, Johnson Wong, Thomas H. Everett, Erica D. Wittwer, Gregory W. Barsness, Peng-sheng Chen, Chen-yang Jiang, Yong-Mei Cha Source Type: research

Extraction of the permanent His bundle pacing lead: Safety outcomes and feasibility of reimplantation
Permanent His bundle pacing (HBP) is a physiological alternative to right ventricular pacing. However, concerns remain about the feasibility and safety of lead extraction from the His bundle region. (Source: Heart Rhythm)
Source: Heart Rhythm - June 11, 2019 Category: Cardiology Authors: Pugazhendhi Vijayaraman, Faiz A. Subzposh, Angela Naperkowski Source Type: research

EP News: Case Reports
Left cardiac sympathetic denervation (LCSD) is as an effective treatment for long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, and in select cases of substrate-mediated ventricular tachycardia (VT) or fibrillation (VF) in ischemic and nonischemic cardiomyopathy. The use and implications of LCSD on pediatric patients with congenital heart disease are not known. Bonura and colleagues (DOI: https://doi.org/10.1016/j.hrcr.2019.04.007) described two pediatric patients that underwent LCSD in the setting of refractory ventricular arrhythmias and congenital heart disease. (Source: Heart Rhythm)
Source: Heart Rhythm - June 11, 2019 Category: Cardiology Authors: T. Jared Bunch Source Type: research

Extraction of Permanent His Bundle Pacing Lead: Safety Outcomes and Feasibility of Re-implantation
Permanent His bundle pacing (HBP) is a physiologic alternative to right ventricular pacing. However concerns remain regarding the feasibility and safety of lead extraction from the His bundle region. (Source: Heart Rhythm)
Source: Heart Rhythm - June 11, 2019 Category: Cardiology Authors: Pugazhendhi Vijayaraman, Faiz A. Subzposh, Angela Naperkowski Source Type: research

His bundle has a shorter chronaxie than does the adjacent ventricular myocardium: Implications for pacemaker programming
Strength-duration curves for permanent His bundle (HB) pacing are potentially important for pacemaker programming. (Source: Heart Rhythm)
Source: Heart Rhythm - June 7, 2019 Category: Cardiology Authors: Marek Jastrz ębski, Paweł Moskal, Agnieszka Bednarek, Grzegorz Kiełbasa, Pugazhendhi Vijayaraman, Danuta Czarnecka Source Type: research

His bundle has shorter chronaxie than adjacent ventricular myocardium: Implications for pacemaker programming.
Strength-duration curves for permanent His bundle (HB) pacing are potentially important for pacemaker programming. (Source: Heart Rhythm)
Source: Heart Rhythm - June 7, 2019 Category: Cardiology Authors: Marek Jastrz ębski, Paweł Moskal, Agnieszka Bednarek, Grzegorz Kiełbasa, Pugazhendhi Vijayaraman, Danuta Czarnecka Source Type: research

A de novo gain-of-function KCND3 mutation in early repolarization syndrome
Early repolarization syndrome (ERS) is characterized by J-point elevation on electrocardiograms and ventricular fibrillation (VF). Early repolarization arises from augmentation of the transmural electrical gradient in the cardiac action potential, therefore, the transient outward potassium current (Ito) has been regarded as a key candidate current for elucidating the mechanism of ERS. KCND3 encoding Kv4.3, an α-subunit of the Ito channel, is considered as one of target genes. (Source: Heart Rhythm)
Source: Heart Rhythm - June 4, 2019 Category: Cardiology Authors: Koichiro Takayama, Seiko Ohno, Wei-Guang Ding, Takashi Ashihara, Daisuke Fukumoto, Yuko Wada, Takeru Makiyama, Hiroaki Kise, Minako Hoshiai, Hiroshi Matsuura, Minoru Horie Source Type: research

Effect of β-blockers on triggering of symptomatic atrial fibrillation by anger or stress
Anger and stress can trigger episodes of atrial fibrillation (AF) in patients with a history of AF. (Source: Heart Rhythm)
Source: Heart Rhythm - June 3, 2019 Category: Cardiology Authors: Rachel Lampert, Matthew M. Burg, Larry D. Jamner, James Dziura, Cynthia Brandt, Fangyong Li, Theresa Donovan, Robert Soufer Source Type: research

Voltage during atrial fibrillation is superior to voltage during sinus rhythm in localizing areas of delayed enhancement on magnetic resonance imaging: An assessment of the posterior left atrium in patients with persistent atrial fibrillation
Bipolar electrogram voltage during sinus rhythm (VSR) has been used as a surrogate for atrial fibrosis in guiding catheter ablation of persistent AF, but the fixed rate and wavefront characteristics present during sinus rhythm may not accurately reflect underlying functional vulnerabilities responsible for AF maintenance. (Source: Heart Rhythm)
Source: Heart Rhythm - June 3, 2019 Category: Cardiology Authors: Norman Qureshi, Steven Kim, Chris Cantwell, Valtino Afonso, Wen Jia Bai, Rheeda Ali, Matt Shun-Shin, Louisa Malcolme-Lawes, Vishal Luther, Kevin Leong, Elaine Lim, Ian Wright, Szabi Nagy, Sajad Hayat, Fu Siong Ng, Michael Koa Wing, Nick Linton, David Lefr Source Type: research

Erratum
In the article “Ventricular arrhythmias and sudden cardiac arrest in Takotsubo cardiomyopathy: Incidence, predictive factors, and clinical implications” by Laurence Jesel, et al, published in the August 2018 issue of Heart Rhythm (2018;15:1171–1178), column headings in Tables 1 and 3 were mislabeled. The c olumn labeled LTA group (n = 191) should have been labeled Group LTA− (n = 191); the column labeled Non-LTA group (n = 23) should have been labeled Group LTA+ (n = 23). In Table 3, the row labeled “In-hospital mortality” should have been lab...
Source: Heart Rhythm - May 31, 2019 Category: Cardiology Tags: Corrigenda Source Type: research

The cavotricuspid isthmus in the setting of real cardiac anatomy
It is now well established that the typical form of atrial flutter can be “cured” by means of an ablative line placed across the cavotricuspid isthmus.1 The anatomy of this area, which is located in the inferior part of the septal wall of the right atrium, is well recognised.2,3 At the same time, it is also well established that variations in the specific morphology c an complicate the ablative procedure. The group from Padova, in this issue of the journal, concentrate on these variations in their correlative investigation, highlighting the role of the area they suggest we should now simply describe as the &ldq...
Source: Heart Rhythm - May 31, 2019 Category: Cardiology Authors: Robert H. Anderson Source Type: research

A narrow QRS tachycardia in a 35-year-old man
The electrocardiogram in Figure  1 is from a 35-year-old man with a history of episodes of rapid heart rhythm during exercise. He came to the hospital after a tachycardia started during a soccer match. (Source: Heart Rhythm)
Source: Heart Rhythm - May 29, 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: A serendipitous encounter in the world of pacing
My earliest memories of Hong Kong were with my brother Gene who was 2 years older than me, living with Popo (grandma) in her small one-room apartment. Our mother had left for America to prepare a place for us. We lived and played on Hennessy Road, in Wan Chai on Hong Kong Island. I remember our rice porridge and fried breadsticks for breakfast on the street, new year celebrations with firecrackers, the Mid-Autumn festivals with colorful lanterns and moon cakes, and always the sound and laughter of people walking among the sidewalk vendors. (Source: Heart Rhythm)
Source: Heart Rhythm - May 29, 2019 Category: Cardiology Authors: Susan L. Song Tags: Viewpoint Source Type: research

Arrhythmic burden among asymptomatic patients with ischemic cardiomyopathy and an implantable cardioverter-defibrillator
The clinical benefit of primary prevention implantable cardioverter-defibrillator (ICD) therapy in asymptomatic patients (New York Heart Association [NYHA] functional class I) with ischemic cardiomyopathy and left ventricular dysfunction is continually disputed. (Source: Heart Rhythm)
Source: Heart Rhythm - May 29, 2019 Category: Cardiology Authors: Avi Sabbag, Michael Glikson, Mahmoud Suleiman, Monther Boulos, Ilan Goldenberg, Roy Beinart, Eyal Nof Tags: Featured Article Source Type: research

Anatomy of the cavotricuspid isthmus for radiofrequency ablation in typical atrial flutter
Radiofrequency (RF) catheter ablation is one of the most common strategies for the current management of cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL). The interindividual anatomic variability can influence the duration and outcome of ablation procedure. (Source: Heart Rhythm)
Source: Heart Rhythm - May 28, 2019 Category: Cardiology Authors: Maria Stella Baccillieri, Stefania Rizzo, Monica De Gaspari, Beatrice Paradiso, Gaetano Thiene, Roberto Verlato, Cristina Basso Source Type: research

Time to therapy delivery and effectiveness of the subcutaneous implantable cardioverter-defibrillator
At the time of subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation, successful termination of ventricular fibrillation (VF) is confirmed. A previous study reported cases of prolonged time to therapy during defibrillation testing. (Source: Heart Rhythm)
Source: Heart Rhythm - May 28, 2019 Category: Cardiology Authors: Igor Diemberger, Federico Migliore, Giuseppe Ricciardi, Luca Ottaviano, Vincenzo Tavoletta, Pietro Francia, Stefano Viani, Alessandro Capucci, Paolo de Filippo, Gerardo Nigro, Fabrizio Caravati, Pietro Palmisano, Matteo Ziacchi, Mariolina Lovecchio, Sergi Source Type: research

Catheter Ablation versus Medical Therapy for Treatment of Ventricular Tachycardia associated with Structural Heart Disease: Systematic Review and Meta-analysis of Randomised Controlled Trials and Comparison with Observational Studies
Catheter ablation (CA) is an established therapeutic modality for ventricular tachycardia (VT). (Source: Heart Rhythm)
Source: Heart Rhythm - May 28, 2019 Category: Cardiology Authors: Robert D. Anderson, Nilshan Ariyarathna, Geoffrey Lee, Sohaib Virk, Ivana Trivic, Timothy Campbell, Clara K. Chow, Jonathan Kalman, Saurabh Kumar Source Type: research

Patient-independent iPS Cells and Modeling Long QT Syndrome
Three key susceptibility genes, KCNQ1, KCHN2, and SCN5A, account for approximately 75% of cases of congenital long QT syndrome (LQTS).1 With advances in DNA sequencing and human genomics, additional susceptibility genes have been identified, and genetic testing for LQTS patients has become standard practice. Genetic testing has empowered the care of patients with LQTS providing guidance for treatment strategies and enabling testing of family members for their carrier status. However, as the technology and scope of genetic analysis has continued to advance with databases containing a tens of thousands of whole exomes and wh...
Source: Heart Rhythm - May 28, 2019 Category: Cardiology Authors: Li Feng, Timothy J. Kamp Source Type: research

Time to therapy delivery and effectiveness of Subcutaneous Implantable Cardioverter –Defibrillator
At the time of subcutaneous implantable cardioverter –defibrillator (S-ICD) implantation, successful termination of ventricular fibrillation (VF) is confirmed. A previous study reported cases of prolonged time to therapy during defibrillation testing. (Source: Heart Rhythm)
Source: Heart Rhythm - May 28, 2019 Category: Cardiology Authors: Igor Diemberger, Federico Migliore, Giuseppe Ricciardi, Luca Ottaviano, Vincenzo Tavoletta, Pietro Francia, Stefano Viani, Alessandro Capucci, Paolo de Filippo, Gerardo Nigro, Fabrizio Caravati, Pietro Palmisano, Matteo Ziacchi, Mariolina Lovecchio, Sergi Source Type: research

Subcutaneous nerve stimulation for rate control in ambulatory dogs with persistent atrial fibrillation
Subcutaneous nerve stimulation (ScNS) damages the stellate ganglion and improves rhythm control of atrial fibrillation (AF) in ambulatory dogs. (Source: Heart Rhythm)
Source: Heart Rhythm - May 28, 2019 Category: Cardiology Authors: Yuan Yuan, Xiao Liu, Juyi Wan, Johnson Wong, Amanda A. Bedwell, Scott A. Persohn, Changyu Shen, Michael C. Fishbein, Lan S. Chen, Zhenhui Chen, Thomas H. Everett, Paul R. Territo, Peng-Sheng Chen Source Type: research

Anatomy of the cavo-tricuspid isthmus for radiofrequency ablation in typical atrial flutter
Radiofrequency (RF) catheter ablation is one of the most common strategies for the current management of cavo-tricuspid isthmus (CTI)-dependent atrial flutter (AFL). The inter-individual anatomical variability can influence the duration and outcome of ablation procedure. (Source: Heart Rhythm)
Source: Heart Rhythm - May 28, 2019 Category: Cardiology Authors: Maria Stella Baccillieri, Stefania Rizzo, Monica De Gaspari, Beatrice Paradiso, Gaetano Thiene, Roberto Verlato, Cristina Basso Source Type: research

Safety of Thoracic Magnetic Resonance Imaging for Patients with Pacemakers and Defibrillators
During magnetic resonance imaging (MRI), cardiac implantable electronic device (CIED) leads can be antennae to focus energy onto myocardium, which has caused heating and arrhythmias. Clinical data are limited on thoracic MRI safety for patients with legacy devices. (Source: Heart Rhythm)
Source: Heart Rhythm - May 28, 2019 Category: Cardiology Authors: Deepak Padmanabhan, Danesh K. Kella, Abhishek J. Deshmukh, Siva K. Mulpuru, Ramila A. Mehta, Connie M. Dalzell, Nora E. Olson, Joel P. Felmlee, Mary L. Jondal, Samuel J. Asirvatham, Robert E. Watson, Yong-Mei Cha, Paul A. Friedman Source Type: research

EP News: Quality Improvement and Outcomes
This is the second in a series of HeartRhythm quarterly features, highlighting science relevant to quality improvement. The focus of this feature is the prevention of cardiac implantable electronic device infection. (Source: Heart Rhythm)
Source: Heart Rhythm - May 25, 2019 Category: Cardiology Authors: John N. Catanzaro, Anne Marie Smith, Javed M. Nasir Tags: EP News Source Type: research

EP News: Basic and Translational
Hannun et  al (Nat Med 2019;25:65, PMID 30617320) developed a deep neural network (DNN) to classify 12 rhythm classes, ranging from supraventricular to ventricular tachycardia, using 91,232 single-lead electrocardiograms (ECGs) from 53,549 patients who used a single-lead ambulatory ECG monitoring device. The DNN was then validated against an independent test data set by a consensus committee of board-certified practicing cardiologists. The authors reported that the DNN achieved an average area under the receiver operating characteristic curve of 0.97. (Source: Heart Rhythm)
Source: Heart Rhythm - May 25, 2019 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

EP News: Clinical
Packer et  al (JAMA March 15, 2019;https://doi.org/10.1001/jama.2019.0693; Epub ahead of print, PMID 30874766) evaluated whether catheter ablation is more effective than conventional medical therapy for improving outcomes in atrial fibrillation (AF). A total of 2204 symptomatic patients with AF 65 years and older or younger than 65 years with 1 or more risk factors for stroke were enrolled. The catheter ablation group (n = 1108) underwent pulmonary vein isolation. The drug therapy group (n = 1096) received standard rhythm and/or rate control drugs. (Source: Heart Rhythm)
Source: Heart Rhythm - May 25, 2019 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Allied Professionals
In this multicenter, prospective, open-label study (ANNEXA-4, a Novel Antidote to the Anticoagulation Effects of Factor Xa Inhibitors), Connolly et  al (N Engl J Med 2019;380:1326, PMID 30730782) sought to assess the safety and efficacy of andexanet alfa in patients experiencing acute severe bleeding while taking factor Xa inhibitors. All patients presented with severe bleeding within 18 hours of taking a factor Xa inhibitor (apixaban, rivaro xaban, edoxaban, or enoxaparin). Severe bleeding was defined as having 1 or more of the following characteristics: potentially life-threatening bleeding; bleeding associated...
Source: Heart Rhythm - May 25, 2019 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research