Catheter ablation of atrial fibrillation using Ablation Index guided High Power (50W) for pulmonary vein isolation: with or without esophageal temperature probe?
High-power short-duration ablation for pulmonary vein isolation (PVI) in treating atrial fibrillation (AF) has been shown to facilitate the procedure and improve the effectiveness; however, esophageal injury remains one safety concern. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2020 Category: Cardiology Authors: Shaojie Chen, Boris Schmidt, Alexander Seegeer, Stefano Bordignon, Shota Tohoku, Franziska Willems, Lukas Urbanek, Christina Throm, Athanasios Konstantinou, Karin Plank, Max Hilbert, Simone Zanchi, Lorenzo Bianchini, Fabrizio Bologna, Nikolaos Tsianakas, Source Type: research

Clinical impact of left ventricular paced conduction disturbance in cardiac resynchronization therapy
Myocardial scarring is associated with non-response to cardiac resynchronization therapy (CRT) and conduction delay. Little is known about the significance and cause of left ventricular (LV) paced conduction disturbance (LPCD). (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2020 Category: Cardiology Authors: Nobuhiko Ueda, Takashi Noda, Ikutaro Nakajima, Kohei Ishibashi, Kenzaburo Nakajima, Tsukasa Kamakura, Mitsuru Wada, Kenichiro Yamagata, Yuko Inoue, Koji Miyamoto, Satoshi Nagase, Takeshi Aiba, Keisuke Kiso, Hideaki Kanzaki, Chisato Izumi, Teruo Noguchi, S Source Type: research

Percutanoeus approaches for retrieval of an embolized or malpositioned left atrial appendage closure device: a multicenter experience
Experience with retrieval of Watchman left atrial (LA) appendage (LAA) closure device (WD) is limited. An embolized or grossly malpositioned WD warrants retrieval to minimize risk of thromboembolic complications and vascular occlusion. (Source: Heart Rhythm)
Source: Heart Rhythm - May 24, 2020 Category: Cardiology Authors: Muhammad R. Afzal, Christopher R. Ellis, James Gabriels, Mikhael El-Chami, Anish Amin, Zaher Fanari, David Delurgio, Roy M. John, Apoor Patel, Thomas A. Haldis, Jeffrey A. Goldstein, Steven Yakubov, Emile G. Daoud, John D. Hummel Source Type: research

Purkinje System Hyperexcitability and Ventricular Arrhythmia Risk in Type 3 Long QT Syndrome
Gain-of-function variants in the SCN5A-encoded Nav1.5 sodium channel cause type 3 long QT syndrome (LQT3) and multifocal ectopic Purkinje-related premature contractions (MEPPC). Although the Purkinje system is uniquely sensitive to the action potential prolonging effects of LQT3-causative variants, the existence of additional Purkinje phenotype(s) in LQT3 is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - May 21, 2020 Category: Cardiology Authors: Walid Barake, John R. Giudicessi, Samuel J. Asirvatham, Michael J. Ackerman Source Type: research

QRS Morphology in Lead V1 for the Rapid Localization of Idiopathic Ventricular Arrhythmias Originating from The Left Ventricular Papillary Muscles: A Novel Electrocardiographic Criterion
12-lead electrocardiogram (ECG) criteria have been developed to identify idiopathic ventricular arrhythmias (VAs) from the left ventricular (LV) papillary muscles (PAPs), but accurate localization remains a challenge. (Source: Heart Rhythm)
Source: Heart Rhythm - May 21, 2020 Category: Cardiology Authors: David F. Brice ño, Pasquale Santangeli, David S. Frankel, Jackson J. Liang, Yasuhiro Shirai, Timothy Markman, Andres Enriquez, Katie Walsh, Michael P. Riley, Saman Nazarian, David Lin, Ramanan Kumareswaran, Jeffrey S. Arkles, Matthew C. Hyman, Rajat Deo, Source Type: research

Safety of Leadless Pacemaker Implantation in the Very Elderly
The MicraTM leadless pacemaker (MLP) has proven to be an effective alternative to a traditional transvenous pacemaker (TVP). However, there has been concern about using the MLP in frail, elderly patients due to the size of the implant sheath and perceived risk of perforation. (Source: Heart Rhythm)
Source: Heart Rhythm - May 21, 2020 Category: Cardiology Authors: Eric Pagan, James Gabriels, Alexander Khodak, David Chang, Stuart Beldner, Laurence M. Epstein, Jonathan Willner Source Type: research

Ventricular Tachycardia in cardiolaminopathy: characteristics and considerations for device programming
Mutations in LMNA cause an arrhythmogenic cardiomyopathy (cardiolaminopathy) with high risk of ventricular tachycardia (VT). However, the natural history of VT amongst patients with cardiolaminopathy is incompletely understood. (Source: Heart Rhythm)
Source: Heart Rhythm - May 21, 2020 Category: Cardiology Authors: Kiran Sidhu, Larry Han, Kermshlise C.I. Picard, Usha B. Tedrow, Neal K. Lakdawala Source Type: research

Automated Electrocardiographic Quantification of Myocardial Scar in Patients Undergoing Primary Prevention Implantable Cardioverter Defibrillator Implantation: Association with Mortality and Subsequent Appropriate and Inappropriate Therapies
Myocardial scarring from infarction or non-ischemic fibrosis forms an arrhythmogenic substrate. The Selvester QRS-score has been developed to estimate myocardial scar from the 12-lead ECG. (Source: Heart Rhythm)
Source: Heart Rhythm - May 15, 2020 Category: Cardiology Authors: Tobias Reichlin, Babken Asatryan, Marc A. Vos, Rik Willems, Heikki V. Huikuri, M. Juhani Junttila, Simon C. Schl ögl, Katerina Hnatkova, Beat A. Schaer, Marek Malik, Markus Zabel, Christian Sticherling, EU-CERT-ICD Investigators Source Type: research

A novel 9-partition method using fluoroscopic images for guiding left bundle branch pacing
Left bundle branch (LBB) pacing is a novel pacing modality, but there is no standard fluoroscopic methodology. (Source: Heart Rhythm)
Source: Heart Rhythm - May 13, 2020 Category: Cardiology Authors: Hai Jiang, Xiaofeng Hou, Zhiyong Qian, Yao Wang, Lijun Tang, Yuanhao Qiu, Zeyu Jiang, Xing Chen, Kebei Li, Jiangang Zou Source Type: research

EP News: Allied Professionals
Access to pacemakers (PMs) and implantable defibrillators (ICDs), collectively known as cardiac implantable electronic devices (CIEDs, in countries with limited resources can be problematic. One solution is the reuse of devices obtained post mortem after insuring good working condition/adequate remaining battery longevity along with rigorous resterilization to prevent infection. The authors (Khairy et al. N Engl J Med 2020;382:1823-31, PMID: 32374963) described their experience donating reused CIEDs by means of a registry developed in 2003 which tracks patients undergoing implantation of reused devices that were sent from ...
Source: Heart Rhythm - May 13, 2020 Category: Cardiology Authors: Erica S. Zado Source Type: research

Long-term Outcomes of Ventricular Tachycardia Substrate Ablation Incorporating Hidden Slow Conduction Analysis
Ventricular tachycardia substrate ablation (VTSA) incorporating hidden slow conduction (HSC) analysis allows further arrhythmic substrate identification. (Source: Heart Rhythm)
Source: Heart Rhythm - May 13, 2020 Category: Cardiology Authors: Juan Acosta, David Soto-Iglesias, Beatriz J áuregui, Juan Fernández Armenta, Diego Penela, Manuel Frutos-López, Eduardo Arana-Rueda, Alonso Pedrote, Lluís Mont, Antonio Berruezo Source Type: research

A novel nine-partition method using fluoroscopic images for guiding left bundle branch pacing
Left bundle branch (LBB) pacing is a novel pacing modality but there is no standard fluoroscopic methodology. (Source: Heart Rhythm)
Source: Heart Rhythm - May 13, 2020 Category: Cardiology Authors: Hai Jiang, Xiaofeng Hou, Zhiyong Qian, Yao Wang, Lijun Tang, Yuanhao Qiu, Zeyu Jiang, Xing Chen, Kebei Li, Jiangang Zou Source Type: research

Electrocardiographic interpretation of pacemaker algorithms enabling minimal ventricular pacing
Cardiac pacing from the apex of the right ventricle has been shown to result in left ventricular dysfunction, atrial fibrillation, and increased mortality. To counter these effects, one of the strategies developed is avoidance of ventricular pacing when not necessary, using programmable algorithms to minimize ventricular pacing. Seven algorithms are available from 5 manufacturers. Four of the manufacturers have mode conversion algorithms that pace AAI(R) but, in the presence of failed atrioventricular (AV) conduction, demonstrate algorithm-offset and convert to DDD(R) with ventricular pacing. (Source: Heart Rhythm)
Source: Heart Rhythm - May 11, 2020 Category: Cardiology Authors: Harry G. Mond Tags: Contemporary Review Source Type: research

The electrocardiographic interpretation of pacemaker algorithms enabling minimal ventricular pacing
Cardiac pacing from the apex of the right ventricle has been shown to result in left ventricular dysfunction, atrial fibrillation and increased mortality. To counter this, one of the strategies developed, is to avoid ventricular pacing when not necessary, using programmable algorithms to minimize ventricular pacing. There are seven algorithms available from five manufacturers. Four of the manufacturers have mode conversion algorithms that pace AAI(R), but in the presence of failed atrio-ventricular (AV) conduction, demonstrate algorithm offset and convert to DDD(R) with ventricular pacing. (Source: Heart Rhythm)
Source: Heart Rhythm - May 11, 2020 Category: Cardiology Authors: Harry G. Mond Source Type: research

QT Interval Prolongation and Torsade De Pointes in Patients with COVID-19 treated with Hydroxychloroquine/Azithromycin
There is no known effective therapy for patients with COVID-19. Initial reports suggesting the potential benefit of Hydroxychloroquine/Azithromycin (HY/AZ) have resulted in massive adoption of this combination worldwide. However, while the true efficacy of this regimen is unknown, initial reports have raised concerns regarding the potential risk of QT prolongation and induction of torsade de pointes (TdP). (Source: Heart Rhythm)
Source: Heart Rhythm - May 10, 2020 Category: Cardiology Authors: Ehud Chorin, Lalit Wadhwani, Silvia Magnani, Matthew Dai, Eric Shulman, Charles Nadeau-Routhier, Robert Knotts, Roi Bar-Cohen, Edward Kogan, Chirag Barbhaiya, Anthony Aizer, Douglas Holmes, Scott Bernstein, Michael Spinelli, David S. Park, Carugo Stefano, Source Type: research

High-resolution, live, directional mapping
Conventional arrhythmia mapping involves building activation maps from numerous catheter placements and sequential acquisitions during a stable rhythm. Multielectrode high-density (HD) catheters have enabled comprehensive and dense maps of electrogram (EGM) amplitude and timing. Despite automated algorithms, activation mapping still involves time annotation, numerous acquisitions, and reannotation —often beyond the ability of an electrophysiologist to verify during mapping. Additionally, conventional activation mapping may involve using all or most of the cardiac chamber to locate the source of arrhythmia. (Source: Heart Rhythm)
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: D. Curtis Deno, Abhishek Bhaskaran, Dennis J. Morgan, Fikri Goksu, Katherine Batman, Gregory K. Olson, Karl Magtibay, Sachin Nayyar, Andreu Porta-S ánchez, Michael A. Laflamme, Stéphane Massé, Prashant Aukhojee, Krishnakumar Nair, Kumaraswamy Nanthakum Tags: Creative Concepts Source Type: research

Safety and efficacy of leadless pacemaker for cardioinhibitory vasovagal syncope
Single-chamber leadless pacemakers (LPs) have been shown to be an effective alternative to conventional transvenous pacemakers (CTPs), but their benefit in the context of cardioinhibitory vasovagal syncope (CI-VVS) is unknown.backgrou (Source: Heart Rhythm)
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: Mohit K. Turagam, Rakesh Gopinathannair, Peter H. Park, Rangarao V. Tummala, Chandrasekhar Vasamreddy, Alap Shah, Scott Koerber, Yoaav Krauthammer, Luigi Di Biase, Ghulam Murtaza, Krishna Akella, Donita Atkins, Sudharani Bommana, Naresh Kodwani, Jorge Rom Tags: Contemporary Review Source Type: research

Direct comparison of a novel antitachycardia pacing algorithm against present methods using virtual patient modeling
Antitachycardia pacing (ATP) success rates as low as 50% for fast ventricular tachycardias (VTs) have been reported, providing an opportunity for improved ATP to decrease shocks. (Source: Heart Rhythm)
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: Darrell J. Swenson, Robert T. Taepke, Josh J.E. Blauer, Eugene Kwan, Elyar Ghafoori, Gernot Plank, Edward Vigmond, Rob S. MacLeod, Paul DeGroot, Ravi Ranjan Source Type: research

QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or hydroxychloroquine as used in COVID-19: A systematic review
Chloroquine and hydroxychloroquine are now being widely used for treatment of COVID-19. Both medications prolong the QT interval and accordingly may put patients at increased risk for torsades de pointes and sudden death. Published guidance documents vary in their recommendations for monitoring and managing these potential adverse effects. Accordingly, we set out to conduct a systematic review of the arrhythmogenic effect of short courses of chloroquine or hydroxychloroquine. We searched on MEDLINE and Embase, as well as in the gray literature up to April 17, 2020, for the risk of QT prolongation, torsades, ventricular arr...
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: Lior Jankelson, Giorgio Karam, Matthijs L. Becker, Larry A. Chinitz, Meng-Chiao Tsai Tags: CONTEMPORARY REVIEW Source Type: research

High Resolution, Live, Directional Mapping
Conventional arrhythmia mapping involves building activation maps from numerous catheter placements and sequential acquisitions during a stable rhythm. Multi-electrode high-density (HD) catheters have enabled comprehensive and dense maps of electrogram (EGM) amplitude and timing. Despite automated algorithms, activation mapping still involves time annotation, numerous acquisitions, and re-annotation —often beyond the ability of an electrophysiologist to verify during mapping. Additionally, conventional activation mapping may involve using all or most of the cardiac chamber to locate the source of arrhythmia. (Source: Heart Rhythm)
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: D. Curtis Deno, Abhishek Bhaskaran, Dennis J. Morgan, Fikri Goksu, Katherine Batman, Gregory K. Olson, Karl Magtibay, Sachin Nayyar, Andreu Porta-S ánchez, Michael A. Laflamme, Stéphane Massé, Prashant Aukhojee, Krishnakumar Nair, Kumaraswamy Nanthakum Source Type: research

Safety and Efficacy of Leadless Pacemaker for Cardio Inhibitory Vasovagal Syncope
Single chamber leadless pacemakers (LP) have been shown to be an effective alternative to conventional transvenous pacemakers (CTP), but their benefit within the context of cardioinhibitory vasovagal syncope (CI-VVS) is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: Mohit K. Turagam, Rakesh Gopinathannair, Peter H. Park, Rangarao V. Tummala, Chandrasekhar Vasamreddy, Alap Shah, Scott Koerber, Yoaav Krauthammer, Luigi Di Biase, Ghulam Murtaza, Krishna Akella, Donita Atkins, Sudharani Bommana, Naresh Kodwani, Jorge Rom Source Type: research

Ten-year Outcomes of Transcaval Cardiac Puncture for Catheter Ablation after Extracardiac Fontan Surgery
Though at lower risk, patients with prior extracardiac conduit (EC) Fontan still may require catheter ablation for supraventricular arrhythmia. (Source: Heart Rhythm)
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: Jeremy P. Moore, Roberto G. Gallotti, Eric Tran, Gregory S. Perens, Kevin M. Shannon Source Type: research

EP News: Basic and Translational
In this timely review article by Liu et al (Circulation 2020; doi: 10.1161/ CIRCULATIONAHA.120.047549. PMID:32293910), the authors provide an overview of coronavirus disease 2019 (COVID-19) that is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The high infectivity of the SARS-CoV-2 virus is contributed by new mutations in the receptor binding domain, and acquisition of a furin cleavage site in the S spike protein. The virus uses the ACE2 receptor for cell entry which is mediated by host cell serine proteases, TMPRSS2. (Source: Heart Rhythm)
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: Nipavan Chiamvimonvat Source Type: research

A Direct Comparison of a Novel Antitachycardia Pacing Algorithm Against Present Methods Using Virtual Patient Modeling
Antitachycardia pacing (ATP) success rates have been reported as low as 50% for fast VTs, providing an opportunity for improved ATP to decrease shocks. A new self-adapting ATP algorithm, AATP, was compared to traditional Burst ATP using computer modeling to conduct a virtual study. (Source: Heart Rhythm)
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: Darrell J. Swenson, Robert T. Taepke, Josh JE. Blauer, Eugene Kwan, Elyar Ghafoori, Gernot Plank, Edward Vigmond, Rob S. MacLeod, Paul DeGroot, Ravi Ranjan Source Type: research

QT prolongation, torsades de pointes and sudden death with short courses of chloroquine or hydroxychloroquine as used in COVID-19: a systematic review
Chloroquine and hydroxychloroquine are now being widely used as treatments for COVID-19. Both medications prolong the QT interval and accordingly may put patients at increased risk of torsades de pointes and sudden death. Published guidance documents vary in their recommendations for monitoring and managing these potential adverse effects. Accordingly, we set out to conduct a systematic review of the arrhythmogenic effect of short courses of chloroquine or hydroxychloroquine. We searched in MEDLINE and Embase, as well as grey literature up to April 17, 2020, on the risk of QT prolongation, torsades, ventricular arrhythmia,...
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: Lior Jankelson, Giorgio Karam, Matthijs L. Becker, Larry A. Chinitz, Meng-Chiao Tsai Source Type: research

Use of Virtual Visits for the Care of the Arrhythmia Patient
Virtual visits (VVs) are a modality for delivering health care services remotely through videoconferencing tools. Data about patient and physician experience in using VVs are limited. (Source: Heart Rhythm)
Source: Heart Rhythm - May 9, 2020 Category: Cardiology Authors: Peter T. Hu, Henry Hilow, Divyang Patel, Megan Eppich, Daniel Cantillon, Patrick Tchou, Mandeep Bhargava, Mohamed Kanj, Bryan Baranowski, Ayman Hussein, Thomas Callahan, Walid Saliba, Thomas Dresing, Bruce L. Wilkoff, Peter A. Rasmussen, Oussama Wazni, Kh Source Type: research

Phenotype-guided whole genome analysis in a patient with genetically elusive long QT syndrome yields a novel TRDN-encoded triadin pathogenetic substrate for triadin knockout syndrome and reveals a novel primate-specific cardiac TRDN transcript
Triadin knockout syndrome (TKOS) is a rare arrhythmia syndrome caused by recessive null variants in TRDN-encoded cardiac triadin 1. TKOS has presented frequently with cardiac arrest in childhood. (Source: Heart Rhythm)
Source: Heart Rhythm - May 8, 2020 Category: Cardiology Authors: Daniel J. Clemens, David J. Tester, Isabelle Marty, Michael J. Ackerman Source Type: research

LBCT01 - Late Breaking Clinical Trials - Randomized Trials
(Source: Heart Rhythm)
Source: Heart Rhythm - May 7, 2020 Category: Cardiology Source Type: research

LBCT02 - Late Breaking Clinical Trials - Innovation Boulevard
(Source: Heart Rhythm)
Source: Heart Rhythm - May 7, 2020 Category: Cardiology Source Type: research

LBCT03 - Late Breaking Clinical Trials - All About AFib
(Source: Heart Rhythm)
Source: Heart Rhythm - May 7, 2020 Category: Cardiology Source Type: research

LBCT04 - Late Breaking Clinical Trials - This Could Change My Practice
(Source: Heart Rhythm)
Source: Heart Rhythm - May 7, 2020 Category: Cardiology Source Type: research

EP News: Case Reports
Coronavirus Disease 2019 (COVID-19) is highly infectious and causes significant strains on healthcare systems. Routine testing within the hospital is weighed for needed value to minimize exposure to staff. The combination of hydroxychloroquine and azithromycin, both known to prolong the QT interval, was shown to lower viral load and early in the COVID-19 pandemic, the drugs were used to try to lower the morbidity and mortality of the infection. Gabriels and colleagues (DOI: https://doi.org/10.1016/j.hrcr.2020.03.017) shared a case of a 72-year-old female with paroxysmal atrial fibrillation, treated with flecainide and meto...
Source: Heart Rhythm - May 6, 2020 Category: Cardiology Authors: T. Jared Bunch Source Type: research

Durability of posterior wall isolation after catheter ablation among patients with recurrent atrial fibrillation
Electrical posterior wall isolation (PWI) is increasingly utilized for the treatment of patients with atrial fibrillation (AF). Little data exists on the durability of PWI using current technology. (Source: Heart Rhythm)
Source: Heart Rhythm - May 6, 2020 Category: Cardiology Authors: Timothy M. Markman, Matthew C. Hyman, Ramanan Kumareswaran, Jeffrey S. Arkles, Pasquale Santangeli, Robert D. Schaller, Gregory E. Supple, David S. Frankel, Michael P. Riley, David Lin, Fermin Garcia, Sanjay Dixit, David J. Callans, Francis E. Marchlinski Source Type: research

EP News: Clinical
Willems et  al (Circulation 2020;141:1057, PMID 32000514) evaluated the outcomes of preventive ventricular tachycardia (VT) ablation before implantable cardioverter-defibrillator (ICD) implantation and deferred ablation after 3 ICD shocks for VT in a prospective randomized multicenter trial. Patients with isc hemic cardiomyopathy, left ventricular ejection fraction between 30% and 50%, and VT were randomly assigned 1:1 to either strategy. The primary outcome was a composite of death and hospitalization for symptomatic ventricular arrhythmia or worsening heart failure. (Source: Heart Rhythm)
Source: Heart Rhythm - May 5, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Quality Improvement and Outcomes: Physician Burnout
In this issue of HeartRhythm, we present recent publications relevant to quality of care and outcomes, particularly in relation to physician burnout. Although a myriad of terms may be employed to define “burnout” as it relates to work, the core underlying characteristics consist of the triad including emotional exhaustion, depersonalization, and reduced personal accomplishment (Annu. Rev. Psychol. 2001. 52:397–422). More than 50% of physicians in the US report at least one symptom of burnout (Mayo Clinic Proceedings. (Source: Heart Rhythm)
Source: Heart Rhythm - May 5, 2020 Category: Cardiology Authors: Jennifer M. Wright, Anne Marie Smith, John N. Catanzaro Source Type: research

EP News Clinical May 2020
Willems and colleagues (Circulation. 2020;141(13):1057-1067. PMID:32000514) evaluated the outcomes of preventive VT ablation prior to ICD implantation and deferred ablation after 3 ICD shocks for VT in a prospective randomized multicenter trial. Patients with ischemic cardiomyopathy, a left ventricular ejection fraction between 30% and 50%, and VT were randomly assigned 1:1 to a either strategy. The primary outcome was a composite of death and hospitalization for symptomatic ventricular arrhythmia or worsening heart failure. (Source: Heart Rhythm)
Source: Heart Rhythm - May 5, 2020 Category: Cardiology Authors: N. A. Mark Estes Source Type: research

Rationale, considerations, and goals for atrial fibrillation centers of excellence: A Heart Rhythm Society perspective
Atrial fibrillation (AF) remains an important global problem.1 –3 AF continues to lead to poor health outcomes, including reduced quality of life (QoL) and increased risks of heart failure, cognitive impairment, stroke, and death.4,5 Moreover, it has a significant financial impact on health care systems and their associated economies.6–8 In order to improve care for patients with AF, there is an increasing recognition that current care must evolve. Health care organizations should move from a system of siloed outpatient and inpatient clinicians and health care facilities to a system of integrated, coordinated, ...
Source: Heart Rhythm - May 4, 2020 Category: Cardiology Authors: Jonathan P. Piccini, James Allred, T. Jared Bunch, Thomas F. Deering, Luigi Di Biase, Ayman A. Hussein, William R. Lewis, Suneet Mittal, Andrea Natale, Jose Osorio, Douglas L. Packer, Christian Ruff, Andrea M. Russo, Prashanthan Sanders, Amber Seiler, Dav Source Type: research

Enhanced electrocardiographic monitoring of patients with Coronavirus Disease 2019
Many of the drugs being used in the treatment of the ongoing pandemic coronavirus disease 2019 (COVID-19) are associated with QT prolongation. Expert guidance supports electrocardiographic (ECG) monitoring to optimize patient safety. (Source: Heart Rhythm)
Source: Heart Rhythm - May 4, 2020 Category: Cardiology Authors: Shashank Jain, Virginia Workman, Raj Ganeshan, Edinrin R. Obasare, Alicia Burr, Ralph M. DeBiasi, James V. Freeman, Joseph Akar, Rachel Lampert, Lynda E. Rosenfeld Source Type: research

Recognizing COVID-19 –related myocarditis: The possible pathophysiology and proposed guideline for diagnosis and management
Human coronavirus-associated myocarditis is known, and a number of coronavirus disease 19 (COVID-19) –related myocarditis cases have been reported. The pathophysiology of COVID-19–related myocarditis is thought to be a combination of direct viral injury and cardiac damage due to the host’s immune response. COVID-19 myocarditis diagnosis should be guided by insights from previous coronavirus a nd other myocarditis experience. The clinical findings include changes in electrocardiogram and cardiac biomarkers, and impaired cardiac function. (Source: Heart Rhythm)
Source: Heart Rhythm - May 4, 2020 Category: Cardiology Authors: Bhurint Siripanthong, Saman Nazarian, Daniele Muser, Rajat Deo, Pasquale Santangeli, Mohammed Y. Khanji, Leslie T. Cooper, C. Anwar A. Chahal Tags: Contemporary Review Source Type: research

Enhanced ecg monitoring of covid-19 patients
Many of the drugs being used in the treatment of the ongoing pandemic coronavirus disease 2019 (COVID-19) are associated with QT prolongation. Expert guidance supports ECG monitoring to optimize patient safety. (Source: Heart Rhythm)
Source: Heart Rhythm - May 4, 2020 Category: Cardiology Authors: Shashank Jain, Virginia Workman, Raj Ganeshan, Edinrin R. Obasare, Alicia Burr, Ralph M. DeBiasi, James V. Freeman, Joseph Akar, Rachel Lampert, Lynda E. Rosenfeld Source Type: research

Recognizing COVID-19-related myocarditis: the possible pathophysiology and proposed guideline for diagnosis and management
Human coronavirus-associated myocarditis is known, and a number of COVID-19-related myocarditis cases have been reported. The pathophysiology of COVID-19-related myocarditis is thought to be a combination of direct viral injury and cardiac damage due to the host ’s immune response. COVID-19 myocarditis diagnosis should be guided by insights from previous coronavirus and other myocarditis experience. The clinical findings include changes in ECG, cardiac biomarkers, and impaired cardiac function. When cardiac MRI is infeasible, cardiac CT angiography with d elayed myocardial imaging may serve to exclude significant cor...
Source: Heart Rhythm - May 4, 2020 Category: Cardiology Authors: Bhurint Siripanthong, Saman Nazarian, Daniele Muser, Rajat Deo, Pasquale Santangeli, Mohammed Y. Khanji, Leslie T. Cooper, C. Anwar A. Chahal Source Type: research

HRS white paper on atrial fibrillation centers of excellence: Rationale, considerations, and goals
Atrial fibrillation (AF) remains an important global problem.1 –3 AF continues to lead to poor health outcomes, including reduced quality of life (QoL) and increased risks of heart failure, cognitive impairment, stroke, and death.4,5 Moreover, it has a significant financial impact on health care systems and their associated economies.6–8 In order to improve care for patients with AF, there is an increasing recognition that current care must evolve. Health care organizations should move from a system of siloed outpatient and inpatient clinicians and health care facilities to a system of integrated, coordinated, ...
Source: Heart Rhythm - May 4, 2020 Category: Cardiology Authors: Jonathan P. Piccini, James Allred, T. Jared Bunch, Thomas F. Deering, Luigi Di Biase, Ayman A. Hussein, William R. Lewis, Suneet Mittal, Andrea Natale, Jose Osorio, Douglas L. Packer, Christian Ruff, Andrea M. Russo, Prashanthan Sanders, Amber Seiler, Dav Source Type: research

Genetic susceptibility for COVID-19 –associated sudden cardiac death in African Americans
Since emerging from Wuhan, China, in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), has infected>3.2 million individuals worldwide and ∼1 million in the United States (as of April 29, 2020).1,2 Despite the institution of measures designed to “flatten the curve,” COVID-19 has claimed the lives of>225,000 individuals worldwide and>60,000 individuals in the United States alone (as of April 29, 2020).2 Of note, mortality estimates in some of the hardest hit regions have already or may need to be revised to account ...
Source: Heart Rhythm - May 3, 2020 Category: Cardiology Authors: John R. Giudicessi, Dan M. Roden, Arthur A.M. Wilde, Michael J. Ackerman Tags: Creative Concepts Source Type: research

Chloroquine-induced torsades de pointes in a patient with coronavirus disease 2019
The case for chloroquine and hydroxychloroquine, as treatment of the coronavirus disease 2019 (COVID-19) pandemic, has been voiced not only in medical journals1 but also in the popular press.2 Not only is the efficacy of these antimalarial and anti-inflammatory compounds as antiviral drugs uncertain, but there is also an ongoing debate about their safety.3 In particular, the magnitude of the proarrhythmic potential of these drugs, specifically related to their QT prolongation effects, is questioned: On the one hand, the fact that chloroquine and hydroxychloroquine block the IKr potassium channel at the myocyte level, there...
Source: Heart Rhythm - May 3, 2020 Category: Cardiology Authors: Yishay Szekely, Yael Lichter, Bander Abu Shrkihe, Hila Bruck, Howard S. Oster, Sami Viskin Source Type: research

Ostial Dimensional Changes After Pulmonary Vein Isolation: Pulsed Field Ablation vs Radiofrequency Ablation
Pulmonary vein (PV) stenosis is an important potential complication of PV isolation using thermal modalities such as radiofrequency ablation (RFA). Pulsed field ablation (PFA) is an alternative energy that causes non-thermal myocardial cell death. (Source: Heart Rhythm)
Source: Heart Rhythm - May 3, 2020 Category: Cardiology Authors: Kenji Kuroki, William Whang, Charles Eggert, Jeff Lam, Jonas Leavitt, Iwanari Kawamura, Ananya Reddy, Blake Morrow, Christopher Schneider, Jan Petru, Mohit Turagam, Jacob S. Koruth, Marc A. Miller, Subbarao Choudry, Betsy Ellsworth, Srinivas R. Dukkipati, Source Type: research

Ebstein ’s anomaly: structural insights for the interventional electrophysiologist
Ebstein ’s anomaly (EA), originally described in 18661 (Figure), is characterized by a spectrum of hemodynamic and electrophysiological abnormalities. The condition is associated with a proclivity for accessory pathways (AP) and recurrent supraventricular tachycardia. Historically, APs in EA have been des cribed as notoriously challenging to eliminate and associated with a relatively high rate of recurrence. (Source: Heart Rhythm)
Source: Heart Rhythm - May 3, 2020 Category: Cardiology Authors: Jeremy P. Moore, Kalyanam Shivkumar Source Type: research

Genetic Susceptibility for COVID-19-Associated Sudden Cardiac Death in African Americans
Since emerging from Wuhan, China in late 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), has infected over 3.2 million individuals worldwide and nearly 1 million in the United States (as of 04/29/2020).1,2 Despite the institution of measures designed to “flatten the curve”, COVID-19 has claimed the lives of> 225,000 individuals worldwide and> 60,000 individuals in the United States alone (as of 04/29/2020).2 Of note, mortality estimates in some of the hardest hit regions have already or may need to be revised to account for...
Source: Heart Rhythm - May 3, 2020 Category: Cardiology Authors: John R. Giudicessi, Dan M. Roden, Arthur A.M. Wilde, Michael J. Ackerman Source Type: research

Chloroquine-induced torsade de pointes in a COVID-19 patient
The case for chloroquine and hydroxychloroquine, as treatment for the COVID-19 pandemic, has been voiced not only in medical journals1, but also in the popular press.2 Not only is the efficacy of these antimalarial and anti-inflammatory compounds as antiviral drugs uncertain, but there is also ongoing debate as to their safety.3 In particular, the magnitude of the proarrhythmic potential of these drugs, specifically related to their QT-prolongation effects, is questioned: On the one hand, the fact chloroquine and hydroxychloroquine block the IKr potassium-channel at the myocyte level, therefore causing QT-prolongation, is ...
Source: Heart Rhythm - May 3, 2020 Category: Cardiology Authors: Yishay Szekely, Yael Lichter, Bander Abu Shrkihe, Hila Bruck, Howard S. Oster, Sami Viskin Source Type: research

Comparison of Cardiovascular Screening in College Athletes by History and Physical Examination with and without an Electrocardiogram: Efficacy and Cost
Preparticipation screening for conditions associated with sudden cardiac death (SCD) is required in college athletes. Prior cost analyses use theoretical models based on variable assumptions; but no study uses real-life outcomes. (Source: Heart Rhythm)
Source: Heart Rhythm - May 3, 2020 Category: Cardiology Authors: Kimberly G. Harmon, Monica Z. Suchsland, Jordan M. Prutkin, David S. Owens, Doug F. Aukerman, Calvin E. Hwang, Shanyn C. Lancaster, David J. Petron, Sourav K. Poddar, Donald E. Porter, Bradley J. Petek, Aneeq Malik, Jonathan A. Drezner Source Type: research

EP News: Pediatric and Congenital Electrophysiology
Shmuely et  al (Ann Clin Transl Neurol 2020;7:462, PMID 32207228) compared 59 cases with Dravet syndrome (DS), ≥6 years of age, SCN1A mutation, and ≥1 seizure/wk with age-/sex-matched controls with epilepsy and no DS but ≥1 major motor seizure. The ratio of Dravet syndrome to control enrollment was 2:1. The investigators analyzed 547 seizures in the DS group and 169 in the control group. Peri-ictal lengthening of ≥60 ms occurred more frequently in the DS group (12%) than in the control group (4.7%). (Source: Heart Rhythm)
Source: Heart Rhythm - May 2, 2020 Category: Cardiology Authors: Mitchell I. Cohen Tags: EP News Source Type: research