Incidence of myopotential induction in subcutaneous implantable cardioverter-defibrillator patients: Is the oversensing issue really solved?
The subcutaneous implantable cardioverter-defibrillator (S-ICD) has established its role in the prevention of sudden cardiac death in a defined population. Inappropriate shocks and device malfunction in S-ICD therapy may be caused by myopotential (MP) oversensing. (Source: Heart Rhythm)
Source: Heart Rhythm - April 29, 2019 Category: Cardiology Authors: Jan-Hendrik van den Bruck, Arian Sultan, Tobias Plenge, Katharina Seuthe, Tim M ödder, Christos Iliadis, Daniel Stern, Tatjana Blankenheim, Daniel Steven, Jakob Lüker Source Type: research

Permanent left bundle branch area pacing for atrioventricular block: Feasibility, safety, and acute effect
Left bundle branch area pacing (LBBAP), a new pacing approach, lacks adequate evaluation. (Source: Heart Rhythm)
Source: Heart Rhythm - April 29, 2019 Category: Cardiology Authors: Xiaofei Li, Hui Li, Wentao Ma, Xiaohui Ning, Erpeng Liang, Kunjing Pang, Yan Yao, Wei Hua, Shu Zhang, Xiaohan Fan Source Type: research

Permanent left bundle branch area pacing for atrioventricular block: feasibility, safety and acute effect
Left bundle branch area pacing (LBBAP), a new pacing approach, lacks adequate evaluation. (Source: Heart Rhythm)
Source: Heart Rhythm - April 29, 2019 Category: Cardiology Authors: Xiaofei Li, Hui Li, Wentao Ma, Xiaohui Ning, Erpeng Liang, Kunjing Pang, Yan Yao, Wei Hua, Shu Zhang, Xiaohan Fan Source Type: research

Incidence of myopotential induction in Subcutaneous Implantable Cardioverter Defibrillator patients – Is the oversensing issue really solved?
The subcutaneous ICD (S-ICD) has established its role in the prevention of sudden cardiac death in a defined population. Inappropriate shocks and device malfunction in S-ICD therapy may be caused by myopotential (MP) oversensing. (Source: Heart Rhythm)
Source: Heart Rhythm - April 29, 2019 Category: Cardiology Authors: Jan-Hendrik van den Bruck, Arian Sultan, Tobias Plenge, Katharina Seuthe, Tim M ödder, Christos Iliadis, Daniel Stern, Tatjana Blankenheim, none, Daniel Steven, Jakob Lüker Source Type: research

Radiofrequency ablation of the cavotricuspid isthmus for management of atrial flutter in patients with congenital heart disease after tricuspid valve surgery: A single Center experience
Typical atrial flutter involving the cavotricuspid isthmus (CTI) is the most common reentrant arrhythmia in congenital heart disease (CHD) and ablation is effective in its management. However, CHD patients often require surgical interventions on their tricuspid valve that utilize prosthetic material making CTI ablation technically challenging. (Source: Heart Rhythm)
Source: Heart Rhythm - April 29, 2019 Category: Cardiology Authors: Danesh K. Kella, Omar Z. Yasin, Ameesh M. Isath, Christopher J. McLeod, Bryan Canon, Samuel J. Asirvatham, Philip L. Wackel Source Type: research

New Insights on Ablation of Idiopathic Ventricular Arrhythmias Arising From the Right Ventricular Outflow tract
Soon after the recognition that radiofrequency energy is a safe and effective energy source for catheter ablation of cardiac arrhythmias, Morady and colleagues reported 100% efficacy for RF ablation of idiopathic VT arising in the right ventricular outflow tract.1 One of the next major milestones in perfection of catheter ablation of idiopathic ventricular arrhythmias was the identification of the aortic cusps as an important site of origin of idiopathic ventricular arrhythmias with a LBBB inferior axis that could not be ablated from the RVOT. (Source: Heart Rhythm)
Source: Heart Rhythm - April 29, 2019 Category: Cardiology Authors: Sunjeet Sidhu, Hugh Calkins Source Type: research

A young man with a narrow and a wide QRS tachycardia
Figure  1 shows electrocardiograms (ECGs) of a 22-year-old man with a history of palpitations. He was known at the emergency department because of a 2-year history of occasional episodes of a rapid heart rhythm. The ECGs recorded at those times, one shown in Figure 1B, always revealed a narrow QRS tachyc ardia with alternating R-R intervals of 280 and 320 ms. Each QRS complex is followed by a P wave. Those tachycardias were terminated by intravenous adenosine. The sinus rhythm ECG outside tachycardia is shown in Figure 1A. (Source: Heart Rhythm)
Source: Heart Rhythm - April 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

Prevalence of atrial fibrillation and association with clinical, sociocultural, and ancestral correlates among Hispanic/Latinos: The Hispanic Community Health Study/Study of Latinos
Hispanics/Latinos represent the largest ethnic minority group in the United States. Atrial fibrillation (AF) is the most common cardiac arrhythmia in the United States. (Source: Heart Rhythm)
Source: Heart Rhythm - April 26, 2019 Category: Cardiology Authors: Jered D. Linares, Larry R. Jackson, Farah Z. Dawood, Katrina Swett, Emelia J. Benjamin, Neil Schneiderman, Elsayed Z. Soliman, Jianwen Cai, Alvaro Alonso, Sylvia Wassertheil-Smoller, Gregory A. Talavera, James P. Daubert, Martha L. Daviglus, Carlos J. Rod Tags: Clinical Source Type: research

HRS 40th anniversary viewpoints: Fifty years of clinical cardiac arrhythmology –Reflections from a Dutchman on an exciting journey
My interest in cardiology started in the United States. After finishing my medical studies at Leiden University in the Netherlands, I went in 1960 for a rotating internship to Mercy Hospital in Baltimore. There I met Dr Marriott, one of the attending cardiologists, who always invited the interns to attend his reading of electrocardiograms (ECGs). Soon, I was fascinated by the way he analyzed and explained the tracings, emphasizing the simplicities rather than the complexities of the tracing and discussing all important ECG patterns known at that time. (Source: Heart Rhythm)
Source: Heart Rhythm - April 26, 2019 Category: Cardiology Authors: Hein J. Wellens Tags: Viewpoint Source Type: research

Heart Rhythm Society —40th anniversary: A history of success
Half a century ago, under the innovative direction of Dirk Durrer in Amsterdam and Philippe Coumel in Paris, the field of invasive cardiac electrophysiology was born. Approximately 10 years later, in 1980, the North American Society of Pacing and Electrophysiology (NASPE), the progenitor of the Heart Rhythm Society (HRS), was founded. This year HRS, which has served as the leading global home to cardiac electrophysiology professionals, celebrates its 40th anniversary. Readers are referred to an earlier publication, created at the time of our 25th anniversary by Dr Seymour Furman, one of our founders and the first historian...
Source: Heart Rhythm - April 26, 2019 Category: Cardiology Authors: Thomas F. Deering, Igor R. Efimov Tags: Editorial Source Type: research

Troubleshooting and programming considerations for His bundle pacing
Interest in permanent His bundle pacing as a means of both preventing pacing-induced cardiomyopathy and providing physiological resynchronization by normalization of His-Purkinje activation is steadily growing. However, there are differences in atrioventricular timing cycles, sensing, and tissue capture that distinguish His bundle pacing from right ventricular pacing, and hence it is of utmost importance to bear these differences in mind when implanting a His pacing lead and programming the His pacing system. (Source: Heart Rhythm)
Source: Heart Rhythm - April 26, 2019 Category: Cardiology Authors: Daniel L. Lustgarten, Parikshit S. Sharma, Pugazhendhi Vijayaraman Tags: Featured Article Source Type: research

Risk factors for Lethal Arrhythmic Events in Children and Adolescents with Hypertrophic Cardiomyopathy and an Implantable Defibrillator: An International Multi-Center Study
Predictors of risk for lethal arrhythmic events (LAE) is poorly understood and may differ from adults in children with hypertrophic cardiomyopathy (HCM). (Source: Heart Rhythm)
Source: Heart Rhythm - April 23, 2019 Category: Cardiology Authors: Seshadri Balaji, Michael P. DiLorenzo, Frank A. Fish, Susan P. Etheridge, Peter F. Aziz, Mark W. Russell, Svjetlana Tisma, Andreas Pflaumer, Narayanswami Sreeram, Peter Kubus, Ian H. Law, Michal J. Kantoch, Naomi J. Kertesz, Margaret Strieper, Christopher Source Type: research

Mastering the Art of Epicardial Access in Cardiac Electrophysiology
Access to the epicardial space is fundamental to several cardiac procedures. Whilst traditional indications include catheter ablation of ventricular arrhythmias and accessory pathways, novel indications include left atrial appendage occlusion, esophageal protection, mapping and ablation during atrial fibrillation procedures, implantation of epicardial pacing leads, and phrenic nerve displacement to facilitate safe ablation of arrhythmias. Accessing the epicardial space safely is a major challenge requiring intimate knowledge of cardiac anatomy, extensive training and expertise. (Source: Heart Rhythm)
Source: Heart Rhythm - April 20, 2019 Category: Cardiology Authors: Jorge Romero, Kalayanam Shivkumar, Luigi Di Biase, Ricardo Avendano, Robert D. Anderson, Andrea Natale, Saurabh Kumar Source Type: research

Fluctuations in premature ventricular contraction burden can affect medical assessment and management
Frequent premature ventricular contractions (PVCs) can cause disabling symptoms and decrease left ventricular ejection fraction. PVC burden, typically quantified by a 24-hour monitor, is one of the factors that determines the clinical management of PVCs. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Andin H. Mullis, Karam Ayoub, Jignesh Shah, Muhammad Butt, John Suffredini, Melissa Czarapata, Brian Delisle, Gbolahan O. Ogunbayo, Yousef Darrat, Claude S. Elayi Source Type: research

Left ventricular function after noninvasive cardiac ablation using proton beam therapy in a porcine model
Noninvasive cardiac ablation of ventricular tachycardia (VT) using radiotherapy has recently gained interest among electrophysiologists. The effects of left ventricular (LV) ablative radiation treatment on global LV function and volumes are unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Stephan Hohmann, Amanda J. Deisher, Atsushi Suzuki, Hiroki Konishi, Maryam E. Rettmann, Kenneth W. Merrell, Jon J. Kruse, Laura K. Newman, Kay D. Parker, Kristi H. Monahan, Robert L. Foote, Michael G. Herman, Douglas L. Packer Source Type: research

Cardiac resynchronization therapy using pacemakers vs defibrillators in patients with nonischemic cardiomyopathy: The United States experience from 2007 to 2014
The impact of implantable defibrillator therapy on outcomes of patients with nonischemic cardiomyopathy (NICM) who receive a cardiac resynchronization therapy (CRT) device is controversial. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Samir Saba, Terence McLaughlin, Meiqi He, Andrew Althouse, Suresh Mulukutla, Inmaculada Hernandez Source Type: research

Patient-independent human induced pluripotent stem cell model: A new tool for rapid determination of genetic variant pathogenicity in long QT syndrome
Commercial genetic testing for long QT syndrome (LQTS) has rapidly expanded, but the inability to accurately predict whether a rare variant is pathogenic has limited its clinical benefit. Novel missense variants are routinely reported as variant of unknown significance (VUS) and cannot be used to screen family members at risk for sudden cardiac death. Better approaches to determine the pathogenicity of VUS are needed. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Nikhil V. Chavali, Dmytro O. Kryshtal, Shan S. Parikh, Lili Wang, Andrew M. Glazer, Daniel J. Blackwell, Brett M. Kroncke, Moore Benjamin Shoemaker, Bjorn C. Knollmann Source Type: research

Conduction Patterns of Idiopathic Arrhythmias from the Endocardium and Epicardium of Outflow Tracts: New Insights with Non-Invasive Electroanatomic Mapping
Idiopathic arrhythmias commonly arise from the septal right ventricular outflow tract (sRVOT), sinuses of Valsalva (SoV) and great cardiac vein (GCV). Predicting exact site of origin is important for preparation for catheter ablation. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Stavros E. Mountantonakis, Aditi S. Vaishnav, Jeremy D. Jacobson, Neil E. Bernstein, Kabir Bhasin, Kristie M. Coleman, Nicholas T. Skipitaris Source Type: research

Cardiac Resynchronization Therapy Using Pacemakers versus Defibrillators in Patients with Non-Ischemic Cardiomyopathy: The United States Experience from 2007 to 2014
The impact of implantable defibrillator therapy on outcomes of patients with non-ischemic cardiomyopathy (NICM) who receive a cardiac resynchronization therapy (CRT) device is controversial. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Samir Saba, Terence McLaughlin, Meiqi He, Andrew Althouse, Suresh Mulukutla, Inmaculada Hernandez Source Type: research

Insights from atrial surface activation throughout atrial tachycardia cycle length: A new mapping tool
A novel ‘LUMIPOINT’-software in the Rhythmia system displays a histogram of activated area over the entire AT cycle length (CL) with a normalized score. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Masateru Takigawa, Claire A. Martin, Nicolas Derval, Arnaud Denis, Konstantinos Vlachos, Takeshi Kitamura, Antonio Frontera, Ruairidh Martin, Ghassen Cheniti, Anna Lam, Felix Bourier, Nathaniel Thompson, Michel Wolf, Gregoire Massoullie, William Escande, Source Type: research

Left Ventricular Function After Non-Invasive Cardiac Ablation Using Proton Beam Therapy In A Porcine Model
Non-invasive cardiac ablation of ventricular tachycardia (VT) using radiotherapy has recently gained interest among electrophysiologists. The effects of left ventricle (LV) ablative radiation treatment on global LV function and volumes are unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Stephan Hohmann, Amanda J. Deisher, Atsushi Suzuki, Hiroki Konishi, Maryam E. Rettmann, Kenneth W. Merrell, Jon J. Kruse, Laura K. Newman, Kay D. Parker, Kristi H. Monahan, Robert L. Foote, Michael G. Herman, Douglas L. Packer Source Type: research

The patient-independent human iPSC model – a new tool for rapid determination of genetic variant pathogenicity in long QT syndrome
Commercial genetic testing for Long QT Syndrome (LQTS) has rapidly expanded, but the inability to accurately predict whether a rare variant is pathogenic has limited its clinical benefit. Novel missense variants are routinely reported as “Variant of Unknown Significance (VUS)” and cannot be used to screen family members at-risk for sudden cardiac death. Better approaches to determine pathogenicity of VUS are needed. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Nikhil V. Chavali, Dmytro O. Kryshtal, Shan S. Parikh, Lili Wang, Andrew M. Glazer, Daniel J. Blackwell, Brett M. Kroncke, Moore Benjamin Shoemaker, Bjorn C. Knollmann Source Type: research

Fluctuations in premature ventricular contraction burden can impact medical assessment and management
Frequent premature ventricular contractions (PVCs) can cause disabling symptoms and decrease left ventricle ejection fraction. The PVC burden, typically quantified by a 24-hour monitor, is one of the factors that determines the clinical management of PVCs. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2019 Category: Cardiology Authors: Andin H. Mullis, Karam Ayoub, Jignesh Shah, Muhammad Butt, John Suffredini, Melissa Czarapata, Brian Delisle, Gbolahan O. Ogunbayo, Yousef Darrat, Claude S. Elayi Source Type: research

Idiopathic ventricular fibrillation with repetitive activity inducible within the distal Purkinje system
Ventricular ectopy mostly originating from the distal Purkinje system, are observed in approximately 30% of idiopathic ventricular fibrillation (VF)1-5. These ectopy have commonly short coupling R-on-T intervals. However the Purkinje triggers are often transient, only present during short arrhythmic periods, thus preventing the recognition of this condition and its treatment. Here, we report two cases of idiopathic VF in which altered electrophysiological properties and inducible repetitive activity were demonstrated in the peripheral Purkinje system in the absence of clinical short-coupled ectopy. (Source: Heart Rhythm)
Source: Heart Rhythm - April 10, 2019 Category: Cardiology Authors: Michel Haissaguerre, Ghassen Cheniti, William Escande, Alexandre Zhao, M élèze Hocini, Olivier Bernus Source Type: research

Catheter ablation of ventricular arrhythmias originating from the junction of the pulmonary sinus cusp via a nonreversed U curve approach
Ventricular arrhythmias (VAs) can originate from the pulmonary sinus cusp, and reversed U curve ablation has been highly efficient treatment. (Source: Heart Rhythm)
Source: Heart Rhythm - April 5, 2019 Category: Cardiology Authors: Xiaonan Dong, Qi Sun, Min Tang, Shu Zhang Source Type: research

Ibrutinib promotes atrial fibrillation by inducing structural remodeling and calcium dysregulation in the atrium
Ibrutinib is a novel anti-tumor drug that targets Bruton ’s tyrosine kinase (BTK) for the treatment of chronic lymphocytic leukemia. Atrial fibrillation (AF) occurs in 5—9% of patients during treatment, but the underlying mechanisms remain unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - April 5, 2019 Category: Cardiology Authors: Le Jiang, Linling Li, Yanfei Ruan, Song Zuo, Xiaoyan Wu, Qianqian zhao, Yanwei Xing, Xin Zhao, Shijun Xia, Rong Bai, Xin Du, Nian Liu, ChangSheng Ma Source Type: research

Catheter Ablation of Ventricular Arrhythmias Originating From the Junction of Pulmonary Sinus Cusp Via A Nonreversed U Curve Approach
Ventricular arrhythmias (VAs) could be originated from the pulmonary sinus cusp (PSC) and the reversed U curve ablation was highly efficient. (Source: Heart Rhythm)
Source: Heart Rhythm - April 5, 2019 Category: Cardiology Authors: Xiaonan Dong, Qi Sun, Min Tang, Shu Zhang Source Type: research

Regulation of the TRPC1 channel by endothelin-1 in human atrial myocytes
Our recent study demonstrated that the nonselective cation current mediated by the transient receptor potential channel 1 (TRPC1) channel is activated by endothelin-1 (ET-1) in human atrial myocytes; however, the related signal molecules involved are unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Kai Zhang, Wei-Yin Wu, Gang Li, Yan-Hui Zhang, Yong Sun, Feng Qiu, Qian Yang, Guo-Sheng Xiao, Gui-Rong Li, Yan Wang Source Type: research

Reply to the Editor — Patients with atrial fibrillation with hypertrophic cardiomyopathy: Do we need new stroke risk stratification?
We thank Joung et  al for their interest in our work.1 In our study, patients with nonvalvular atrial fibrillation (NVAF) with hypertrophic cardiomyopathy (HCM) had a higher risk of stroke than did patients with NVAF without HCM in all generations and all CHA2DS2-VASc score groups. As shown in the study by Jung et  al,2 stroke risk in patients with NVAF with HCM without any other stroke risk factor was higher than that in patients with NVAF with a CHA2DS2-VASc score of 2. We agree with their results, and all patients with NVAF with HCM should receive anticoagulation. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Toyonobu Tsuda, Akihiro Nomura, Kenshi Hayashi Source Type: research

To the Editor — Augmenting speed of conduction to improve CRT
We read with great interest the article by Yagishita et  al,1 which documents the correlation of the S-QRS interval (left ventricular pacing stimulus to QRS onset) with response to cardiac resynchronization therapy (CRT). It appears that slowed local conduction in the left ventricle (possibly from local scar formation) is associated with impaired respon ses. The advice is to search to avoid using left ventricular lead implantation site positions giving rise to long such intervals. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Morton M. Mower Tags: Letter to the Editor Source Type: research

Reply to the Editor — Augmenting speed of conduction to improve CRT
We appreciate the constructive comments on our article. It has been reported that scar pacing should be avoided in order to obtain a better cardiac resynchronization therapy (CRT) response.1 In addition, we concluded that a left ventricular (LV) pacing site with a long S-QRS interval, which may reflect local conduction disturbance due to diseased myocardium, should be avoided. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Daigo Yagishita, Morio Shoda, Yoshimi Yagishita, Koichiro Ejima, Nobuhisa Hagiwara Source Type: research

To the Editor — Patients with atrial fibrillation with hypertrophic cardiomyopathy: Do we need new stroke risk stratification?
Because of high thromboembolic risk, lifelong oral anticoagulation is recommended in all patients with nonvalvular atrial fibrillation (NVAF) with hypertrophic cardiomyopathy (HCM).1 –3 We read with great interest the article by Tsuda et al,4 who rightly emphasized the importance of HCM in thromboembolism in patients with AF. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Boyoung Joung, Gregory Y.H. Lip Tags: Letter to the Editor Source Type: research

Author's reply to Atrial fibrillation patients with hypertrophic cardiomyopathy: Do we need new stroke risk stratification?
We thank Dr. Joung and colleagues for their interests in our work.1 In our study, patients with non-valvular atrial fibrillation (NVAF) with hypertrophic cardiomyopathy (HCM) had a higher risk of stroke than NVAF patients without HCM in all generations and all CHA2DS2-VASc score groups. As shown in the study of Jung et al.,2 the stroke risk in NVAF with HCM without any other stroke risk factor was greater than that in NVAF with a CHA2DS2-VASc score of 2. We agree with their results, and all NVAF patients with HCM should receive anticoagulation. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Toyonobu Tsuda, Akihiro Nomura, Kenshi Hayashi Source Type: research

How to Use the 12-lead ECG to Predict the Site of Origin of Idiopathic Ventricular Arrhythmias
Idiopathic ventricular arrhythmias (VAs) may arise from anywhere in the heart and the majority of them can be effectively treated with catheter ablation. The 12-lead electrocardiogram (ECG) is the initial mapping tool to predict the most likely site of origin and is valuable to choose the appropriate ablation strategy. Crucial to ECG interpretation is understanding the attitudinal orientation of the heart within the chest and the relationship between the different cardiac structures. In this review, we provide a stepwise anatomical approach for localization of idiopathic VAs based on sequential analysis of most relevant EC...
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Andres Enriquez, Adrian Baranchuk, David Briceno, Luis Saenz, Fermin Garcia Source Type: research

Regulation of TRPC1 channel by endothelin-1 in human atrial myocytes
Our recent study demonstrated that the non-selective cation current mediated by TRPC1 channel is activated by endothelin-1 (ET-1) in human atrial myocytes; however, the related signal molecules involved are unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Kai Zhang, Wei-Yin Wu, Gang Li, Yan-Hui Zhang, Yong Sun, Feng Qiu, Qian Yang, Guo-Sheng Xiao, Gui-Rong Li, Yan Wang Source Type: research

Author ’s reply to Augmenting speed of conduction to improve CRT
We appreciate the constructive comments on our article. It has been reported that scar pacing should be avoided in order to obtain a better cardiac resynchronization therapy (CRT) response1). Additionally, we also concluded that a left ventricular (LV) pacing site with a long S-QRS interval, which may reflect a local conduction disturbance due to diseased myocardium, should be avoided. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Daigo Yagishita, Morio Shoda, Yoshimi Yagishita, Koichiro Ejima, Nobuhisa Hagiwara Source Type: research

Augmenting Speed of Conduction to Improve CRT
We read with great interest the above paper documenting correlation of the S-QRS interval (LV pacing stimulus to QRS onset) with response to CRT. It appears that slowed local conduction in the left ventricle (possibly from local scar formation) is associated with impaired responses. The advice is to search to avoid using left ventricular lead implantation sites positions giving rise to long such intervals. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Morton M. Mower Source Type: research

Atrial fibrillation patients with hypertrophic cardiomyopathy: Do we need new stroke risk stratification?
Due to very high thromboembolic risk, life-long oral anticoagulation is recommended in all hypertrophic cardiomyopathy (HCM) patients with non-valvular atrial fibrillation (NVAF).1-3 We read with great interest the paper by Tsuda et al.4 who rightly emphasized the importance of HCM on thromboembolism in patients with AF. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Boyoung Joung, Gregory Y.H. Lip Source Type: research

The Heart Rhythm Society/American College of Physicians Atrial Fibrillation Screening and Education Initiative
The prevalence of both atrial fibrillation (AF) and stroke is increasing. Stroke is common in AF and can have devastating consequences, especially when AF is unrecognized, and anticoagulation is not initiated. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2019 Category: Cardiology Authors: Lynda E. Rosenfeld, Alpesh Navin Amin, Jonathan C. Hsu, Asa Oxner, Mellanie True Hills, David S. Frankel Source Type: research

Ten-year ablation outcomes of patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation
Pulmonary vein isolation (PVI) is commonly performed in patients with drug-refractory symptomatic paroxysmal atrial fibrillation (PAF). However, the very long-term follow-up result is limited. (Source: Heart Rhythm)
Source: Heart Rhythm - April 1, 2019 Category: Cardiology Authors: Wen-Han Cheng, Li-Wei Lo, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Yuan Hung, Fa-Po Chung, Jo-Nan Liao, Ta-Chuan Tuan, Tze-Fan Chao, Tseng-Ying Tsai, Shin-Huei Liu, Shih-Ann Chen Tags: Clinical Source Type: research

Ten-year Ablation Outcomes of Patients With Paroxysmal Atrial Fibrillation Receiving Pulmonary Vein Isolation
Pulmonary vein isolation (PVI) is commonly performed in patients with drug-refractory symptomatic paroxysmal atrial fibrillation (PAF). However, the very long-term follow-up result is limited. (Source: Heart Rhythm)
Source: Heart Rhythm - April 1, 2019 Category: Cardiology Authors: Wen-Han Cheng, Li-Wei Lo, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Yuan Hung, Fa-Po Chung, Jo-Nan Liao, Ta-Chuan Tuan, Tze-Fan Chao, Tseng-Ying Tsai, Shin-Huei Liu, Shih-Ann Chen Source Type: research

Epicardial injection of nanoformulated calcium into cardiac ganglionic plexi suppresses autonomic nerve activity and postoperative atrial fibrillation
Imbalanced activation of the cardiac autonomic nervous system triggers postoperative atrial fibrillation (POAF). Neuronal calcium overload induces apoptosis. We hypothesize that epicardial injection of timed-release nanoformulated CaCl2 (nCaCl2) into left atrial ganglionic plexi (GP) modulates autonomic function and suppresses POAF. (Source: Heart Rhythm)
Source: Heart Rhythm - March 28, 2019 Category: Cardiology Authors: Michael P. O ’Quinn, Kenneth J. Dormer, Jose F. Huizar, Kytai T. Nguyen, Karoly Kaszala, Adam Sima, Kenneth A. Ellenbogen, Alex Y. Tan Tags: Experimental Source Type: research

A slow irregular rhythm in a 65-year-old woman
A 65-year-old woman was referred by her family physician to the outpatient clinic because of a slow irregular pulse. Since 1 month she suffered from lightheadedness and fatigue. (Source: Heart Rhythm)
Source: Heart Rhythm - March 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 arrhythmia surgery
Those of you who are following Editor-in-Chief Dr Chen ’s series of invited Viewpoint vignettes in celebration of the 40th anniversary of the Heart Rhythm Society will recognize that the title of my invited contribution to this celebratory series, “Reflections on a Career in Arrhythmia Surgery,” is a wordplay on the title of my friend Mel Scheinma n’s recent contribution, “Reflections on a Career in Academic Medicine.” This singular form of flattery—imitation—intentionally signifies the deep admiration I have for my electrophysiology colleagues with whom I have worked on a da...
Source: Heart Rhythm - March 28, 2019 Category: Cardiology Authors: James L. Cox Tags: Viewpoint Source Type: research

In utero exposure to nicotine abolishes the postnatal response of the cardiac sodium current to isoproterenol in newborn rabbit atrium
In utero exposure to tobacco smoke is associated with sudden infant death syndrome (SIDS) and cardiac arrhythmias in newborns. The arrhythmogenic mechanisms seem linked to alterations of the cardiac sodium current (INa). We previously reported that in utero exposure to nicotine delays the postnatal development of the heart sinoatrial node in rabbits and altered expression of the sodium channels NaV1.5 and NaV1.1 in the atrium surrounding it. These channels react differently to sympathetic stimulation. (Source: Heart Rhythm)
Source: Heart Rhythm - March 28, 2019 Category: Cardiology Authors: Michael Biet, Anh Tuan Ton, Jean-Francois Delabre, Nathalie Morin, Robert Dumaine Tags: Featured Article Source Type: research

Notable Papers
(Source: Heart Rhythm)
Source: Heart Rhythm - March 28, 2019 Category: Cardiology Source Type: research

ECG-based cardiac screening programs: Legal, ethical, and logistical considerations
Screening asymptomatic people with a resting electrocardiogram (ECG) has been theorized to detect latent cardiovascular disease. However, resting ECG screening is not recommended for numerous populations, such as asymptomatic middle-age (sedentary) people, because it is not sufficiently sensitive to detect coronary artery disease. Although the issues raised in this article are common to all screening programs, this review focuses on 2 distinct programs: (1) screening elite athletes for conditions associated with sudden cardiac death (SCD); and (2) screening people age ≥65 years for atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - March 28, 2019 Category: Cardiology Authors: Jessica J. Orchard, Lis Neubeck, John W. Orchard, Rajesh Puranik, Hariharan Raju, Ben Freedman, Andre La Gerche, Christopher Semsarian Tags: Contemporary Review Source Type: research

Outcomes of His-bundle pacing upgrade after long-term right ventricular pacing and/or pacing-induced cardiomyopathy: Insights into disease progression
His-bundle pacing (HBP) is a physiological alternative to right ventricular pacing (RVP). The outcomes of HBP in patients with longstanding atrioventricular block (AVB) and RVP are unknown (Source: Heart Rhythm)
Source: Heart Rhythm - March 28, 2019 Category: Cardiology Authors: Pugazhendhi Vijayaraman, Bengt Herweg, Gopi Dandamudi, Suneet Mittal, Advay G. Bhatt, Lina Marcantoni, Angela Naperkowski, Parikshit S. Sharma, Francesco Zanon Source Type: research

ECG-based Cardiac Screening Programs: Legal, Ethical and Logistical Considerations
Screening asymptomatic people with a resting electrocardiogram (ECG) has been theorised to detect latent cardiovascular disease. However, resting ECG screening is not recommended for numerous populations, such as asymptomatic middle-aged (sedentary) people, as it is not sufficiently sensitive to detect coronary artery disease. While the issues raised in this article are largely common to all screening programs, this review focuses on two distinct programs: (1) screening elite athletes for conditions associated with sudden cardiac death (SCD); and (2) screening people aged ≥65 years for atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - March 28, 2019 Category: Cardiology Authors: Jessica J. Orchard, Lis Neubeck, John W. Orchard, Rajesh Puranik, Hariharan Raju, Ben Freedman, Andre La Gerche, Christopher Semsarian Source Type: research

Outcomes Of His Bundle Pacing Upgrade After Long-term Right Ventricular Pacing And / Or Pacing-Induced Cardiomyopathy: Insights Into Disease Progression
His bundle pacing (HBP) is a physiologic alternative to right ventricular pacing (RVP). The outcomes of HBP in patients with longstanding atrioventricular block (AVB) and RVP are unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - March 28, 2019 Category: Cardiology Authors: Pugazhendhi Vijayaraman, Bengt Herweg, Gopi Dandamudi, Suneet Mittal, Advay G. Bhatt, Lina Marcantoni, Angela Naperkowski, Parikshit S. Sharma, Francesco Zanon Source Type: research