Cryoballoon Pulmonary Vein Ablation and Left Atrial Appendage Closure Combined Procedure: a long term follow up analysis Cryoablation with Concomitant Left Atrial Appendage Closure
combined left atrial appendage closure (LAAC) and cryo-energy pulmonary vein isolation (PVI) procedure has been proven safe and effective in managing stroke in patients with non-valvular atrial fibrillation (AF), although most data refer to procedures performed using radiofrequency (RF) as main energy source. (Source: Heart Rhythm)
Source: Heart Rhythm - March 27, 2019 Category: Cardiology Authors: Gaetano Fassini, Alessio Gasperetti, Gianpiero Italiano, Stefania Riva, Massimo Moltrasio, Antonio Dello Russo, Michela Casella, Anna Maltagliati, Fabrizio Tundo, Benedetta Majocchi, Luca Arioli, Ghaliah Al-Mohani, Gianluca Pontone, Mauro Pepi, Claudio To Source Type: research

Comparison of the Arrhythmogenic Substrate between Men and Women with Nonischemic Cardiomyopathy
Outcomes of ventricular tachycardia (VT) ablation in structural heart disease have been reported to differ by sex. Whether this is due to differences in the underlying arrhythmogenic substrates among patients with nonischemic cardiomyopathy (NICM) remains unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - March 27, 2019 Category: Cardiology Authors: Ling Kuo, Yasuhiro Shirai, Daniele Muser, Jackson J. Liang, Simon A. Castro, Pasquale Santangeli, Robert D. Schaller, Gregory E. Supple, David Lin, Saman Nazarian, Sanjay Dixit, David J. Callans, Francis E. Marchlinski, David S. Frankel Source Type: research

EP News: Clinical
van Rein et  al (Circulation 2019;139:775, PMID 30586754) evaluated bleeding rates in a comprehensive national database of patients with atrial fibrillation (AF) who were 50 years and older. Treatments included vitamin K antagonists (VKAs), direct oral anticoagulants (DOACs), platelet inhibitors, and combinati ons of antithrombotic drugs. Major bleeding was defined as bleeding requiring hospitalization or causing death. Overall, 272,315 patients with AF were followed for 1,373,131 patient-years (PYs); 31,459 major bleeds occurred for an incidence rate (IR) of 2.3 per 100 PYs. (Source: Heart Rhythm)
Source: Heart Rhythm - March 23, 2019 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Case Reports
Congenital short QT syndrome is a cardiac channelopathy with mutations identified in the KCNH2, KCNJ2, and KCNQ1 genes. The syndrome is associated with atrial and ventricular arrhythmias and typically manifests early with sudden death or aborted cardiac arrest. During an electrophysiology study, induction of ventricular fibrillation (VF) can be seen in the majority of patients and they display unique susceptibility to mechanical stimuli. Farag and Atallah (DOI: https://doi.org/10.1016/j.hrcr.2018.11.015) shared a case of a 7-year-old boy with short QT syndrome and recurrent VF despite flecainide and amiodarone. (Source: Heart Rhythm)
Source: Heart Rhythm - March 22, 2019 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

EP News: Basic and Translational
Muscle-specific mitsugumin 53 (MG53) is a muscle-specific tripartite motif family member in the heart and participates in membrane repair by recruiting vesicles to the site of injury. Liu  et al (Circulation February 14, 2019; https://doi.org/10.1161/CIRCULATIONAHA.118.029413, PMID 30760025) investigated the functional roles of cardiac MG53 in the regulation of KChIP2 (a K+ channel interacting protein), transient outward K+ current (Ito,f), and the arrhythmogenic potential in cardi ac hypertrophy using genetic ablation of MG53 in a mouse model. (Source: Heart Rhythm)
Source: Heart Rhythm - March 22, 2019 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

Algorithm-Based Reduction of Inappropriate Defibrillator Shock: Results of the Inappropriate Shock Reduction wIth PARAD+ Rhythm DiScrimination –Implantable Cardioverter Defibrillator Study
Inappropriate shocks (IS) continue to have a major negative impact on patients implanted with defibrillators. (Source: Heart Rhythm)
Source: Heart Rhythm - March 22, 2019 Category: Cardiology Authors: Ricardo Ruiz-Granell, Emilio Vincenzo Dovellini, Antoine Dompnier, Dr Koroush Khalighi, Enrique Garc ía-Campo, Audrey Olivier, Aina Barcelo, Philippe Ritter Source Type: research

Relation of IGF-1 and IGFBP-3 with prevalent and incident atrial fibrillation in a population-based study
Insulin-like growth factor 1 (IGF-1) and its main binding protein IGFBP-3 have been related to several cardiovascular diseases. The relationship with atrial fibrillation (AF) is largely unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - March 22, 2019 Category: Cardiology Authors: Mathias Busch, Anne Kr üger, Stefan Gross, Till Ittermann, Nele Friedrich, Matthias Nauck, Marcus Dörr, Stephan B. Felix Source Type: research

Patterns of Amiodarone-Induced Thyroid Dysfunction in Infants and Children
Heart Rhythm Society guidelines recommend obtaining thyroid function tests (TFTs) at amiodarone initiation and every six months thereafter in adults, with no specific pediatric recommendations. Untreated hypothyroidism in young children negatively affects brain development and somatic growth, yet the optimal screening frequency for pediatric patients remains unclear and limited data exists on pediatric amiodarone-induced thyroid dysfunction. (Source: Heart Rhythm)
Source: Heart Rhythm - March 20, 2019 Category: Cardiology Authors: Ana Creo, Heather Anderson, Bryan Cannon, Aida Lteif, Seema Kumar, Peter Tebben, Anoop Mohamed Iqbal, Akhila Ramakrishna, Siobhan Pittock Source Type: research

Risk Factors and Localization of Silent Cerebral Infarction in Patients with Atrial Fibrillation
It is important to identify the risk factors and localization of silent cerebral infarction (SCI), especially in younger patients with atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - March 18, 2019 Category: Cardiology Authors: Keita Miki, Makoto Nakano, Kentaro Aizawa, Yuhi Hasebe, Yoshitaka Kimura, Susumu Morosawa, Toshiaki Akashi, Yohei Morishita, Satoshi Miyata, Koji Fukuda, Hiroaki Shimokawa Source Type: research

Alternative left ventricular pacing approaches for optimal cardiac resynchronization therapy
Cardiac resynchronization therapy (CRT) improves mortality, morbidity, and quality of life in selected heart failure patients with severe left ventricular (LV) ejection fraction impairment. However, between 20% and 40% of device recipients do not benefit clinically from CRT. Indeed, some anatomic and technical difficulties are related to the coronary venous implantation site via the coronary sinus (CS). Additionally, electrical constraints have been described, and CS does not always correspond to the optimal LV lead position. (Source: Heart Rhythm)
Source: Heart Rhythm - March 15, 2019 Category: Cardiology Authors: Vincent Galand, Jagmeet P. Singh, Christophe Leclercq Tags: Contemporary Review Source Type: research

Alternative left ventricular pacing approaches for an optimal cardiac resynchronization therapy
Cardiac resynchronization therapy (CRT) improves mortality, morbidity and quality of life in selected heart failure patients with severe left ventricular ejection fraction impairment. However, between 20% and 40% of device recipients do not benefit clinically from CRT. Indeed, some anatomical and technical difficulties are related to the coronary venous implantation site via the coronary sinus (CS). Additionally, electrical constraints have been described and CS does not always correspond to the optimal LV lead position. (Source: Heart Rhythm)
Source: Heart Rhythm - March 15, 2019 Category: Cardiology Authors: Vincent Galand, Jagmeet P. Singh, Christophe Leclercq Source Type: research

The rationale for isolation of the left atrial pulmonary venous component to control atrial fibrillation: a review article
Catheter ablation of persistent atrial fibrillation is an evolving field. In this review, we discuss the rationale for the isolation of the pulmonary venous component of the left atrium to control atrial fibrillation. The review describes the embryological origin of this component and makes the important distinction between the true posterior wall and the pulmonary venous component, which forms the dome of the left atrium. Studies that have examined the role of left atrial posterior wall isolation in AF ablation have loosely referred to the pulmonary venous component as the posterior wall. (Source: Heart Rhythm)
Source: Heart Rhythm - March 15, 2019 Category: Cardiology Authors: Ahmed I. Elbatran, Robert H. Anderson, Shumpei Mori, Magdi M. Saba Source Type: research

To the Editor — Mediterranean diet and wine intake could improve atrial function in patients with atrial fibrillation
This study found that regular moderate alcohol consumption, but not mild consumption, is an important modifiable risk factor for atrial fibrillation. (Source: Heart Rhythm)
Source: Heart Rhythm - March 13, 2019 Category: Cardiology Authors: Anna Vittoria Mattioli, Alberto Farinetti, Roberta Gelmini Tags: Letter to the Editor Source Type: research

Reply to the Editor — Mediterranean diet and wine intake could improve atrial function in patients with atrial fibrillation
We agree with Mattioli et  al1 that the Mediterranean diet appears to be beneficial for primary and secondary prevention of rhythm disorders. Observational studies demonstrate a lower risk of incident atrial fibrillation (AF) and higher rates of spontaneous conversion to sinus rhythm.2 Wine “in moderation” is one of the numerous components of this diet, which incorporates fruit, vegetables, moderate fish intake, olive oil, and avoidance of saturated fat, processed dairy, and meat. It remains unclear as to which components (eg, vitamins and omega-3 polyunsaturated fatty acids) are providing potential anti-i...
Source: Heart Rhythm - March 13, 2019 Category: Cardiology Authors: Aleksandr Voskoboinik, Peter M. Kistler Tags: Letter to the Editor Source Type: research

Mediterranean Diet and wine intake could improve atrial function in patients with atrial fibrillation
This study found that regular moderate alcohol consumption, but not mild consumption, is an important modifiable risk factor for atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - March 13, 2019 Category: Cardiology Authors: Anna Vittoria Mattioli, Alberto Farinetti, Roberta Gelmini Source Type: research

Author's reply to Mediterranean Diet and wine intake could improve atrial function in patients with atrial fibrillation
We agree with Mattioli et al1 that the Mediterranean diet appears to be beneficial for primary and secondary prevention of rhythm disorders. Observational studies demonstrate a lower risk of incident AF and higher rates of spontaneous conversion to sinus rhythm2. Wine ‘in moderation’ is one of numerous components of this diet, which incorporates fruit, vegetables, moderate fish intake, olive oil and avoidance of saturated fat, processed dairy and meat. It remains unclear as to which components (e.g. (Source: Heart Rhythm)
Source: Heart Rhythm - March 13, 2019 Category: Cardiology Authors: Aleksandr Voskoboinik, Peter M. Kistler Source Type: research

Iatrogenic Aortic Regurgitation after Radiofrequency Ablation of Idiopathic Ventricular Arrhythmias Originating from the Aortic Valvular Region
Radiofrequency ablation at the aortic root has the potential risk of aortic regurgitation (AR). (Source: Heart Rhythm)
Source: Heart Rhythm - March 13, 2019 Category: Cardiology Authors: Yasutoshi Shinoda, Yuki Komatsu, Yukio Sekiguchi, Akihiko Nogami, Kazutaka Aonuma, Masaki Ieda Source Type: research

Mean entropy predicts implantable cardioverter-defibrillator therapy using cardiac magnetic resonance texture analysis of scar heterogeneity
Risk stratification of ventricular arrhythmia (VA) remains complex in both ischemic and non-ischemic populations. (Source: Heart Rhythm)
Source: Heart Rhythm - March 5, 2019 Category: Cardiology Authors: Justin Gould, Bradley Porter, Simon Claridge, Zhong Chen, Benjamin.J. Sieniewicz, Baldeep.S. Sidhu, Steven Niederer, Martin.J. Bishop, Francis Murgatroyd, Balaji Ganeshan, Gerald Carr-White, Reza Razavi, Amedeo Chiribiri, Christopher.A. Rinaldi Source Type: research

Minimally invasive percutaneous epicardial placement of a prototype miniature pacemaker with a leadlet under direct visualization: A feasibility study in an infant porcine model
Pacemaker implantation in infants is limited to epicardial lead placement and an abdominal generator pocket. We propose a minimally invasive solution using a prototype miniature pacemaker with a steroid-eluting leadlet that can affix against the epicardium under thoracoscopy. (Source: Heart Rhythm)
Source: Heart Rhythm - March 1, 2019 Category: Cardiology Authors: Rohan N. Kumthekar, Justin D. Opfermann, Paige Mass, Bradley C. Clark, Jeffrey P. Moak, Elizabeth D. Sherwin, Teresa Whitman, Mark Marshall, Charles I. Berul Source Type: research

Increased risk of late pacemaker implantation after ablation for atrioventricular nodal reentry tachycardia. A 10-year follow up of a nationwide cohort
Catheter ablation of the slow pathway is standard treatment for atrioventricular nodal reentry tachycardia (AVNRT), with a well-described, low risk for periprocedural atrioventricular block. Less is known about the risk of pacemaker implantation late after ablation. (Source: Heart Rhythm)
Source: Heart Rhythm - March 1, 2019 Category: Cardiology Authors: Milos Kesek, Daniel Lindmark, Amir Rashid, Steen M. Jensen Source Type: research

Minimally Invasive Percutaneous Epicardial Placement of a Prototype Miniature Pacemaker with Leadlet under Direct Visualization: A Feasibility Study in an Infant Porcine Model
Pacemaker implantation in infants is limited to epicardial lead placement and an abdominal generator pocket. We propose a minimally invasive solution using a prototype miniature pacemaker with a steroid-eluting leadlet that can affix against the epicardium under thoracoscopy. (Source: Heart Rhythm)
Source: Heart Rhythm - March 1, 2019 Category: Cardiology Authors: Rohan N. Kumthekar, Justin D. Opfermann, Paige Mass, Bradley C. Clark, Jeffrey P. Moak, Elizabeth D. Sherwin, Teresa Whitman, Mark Marshall, Charles I. Berul Source Type: research

A regular rhythm showing a change in rate and QRS width in a 41-year-old woman
The ECG shown in Figure  1 was recorded in a 41-year-woman with a 3-year history of palpitations of sudden onset, which lasted a few minutes and terminated spontaneously. The frequency of those episodes had increased during the past 2 months. (Source: Heart Rhythm)
Source: Heart Rhythm - February 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: What ’s it all about?
I am honored to be one of the individuals asked to write a point-of-view article in connection with the 40th anniversary of HRS/NASPE. In his invitation, Dr Chen stated, “The writer can talk about their career or anything else they would like to share.” I’ll do both. (Source: Heart Rhythm)
Source: Heart Rhythm - February 28, 2019 Category: Cardiology Authors: Raymond E. Ideker Tags: Viewpoint Source Type: research

Left atrial appendage closure with the Watchman device using intracardiac vs transesophageal echocardiography: Procedural and cost considerations
Imaging guidance for left atrial appendage (LAA) closure (LAAC) conventionally consists of transesophageal echocardiography (TEE) and fluoroscopy under general anesthesia (GA). Intracardiac echocardiography (ICE) can eliminate the need for GA, expedite procedural logistics, and reduce the patient experience to a simple venous puncture. (Source: Heart Rhythm)
Source: Heart Rhythm - February 28, 2019 Category: Cardiology Authors: Majd E. Hemam, Kenji Kuroki, Paul A. Schurmann, Amish S. Dave, Diego A. Rodr íguez, Luis C. Sáenz, Vivek Y. Reddy, Miguel Valderrábano Tags: Featured Article Source Type: research

Reviewer Thanks
(Source: Heart Rhythm)
Source: Heart Rhythm - February 28, 2019 Category: Cardiology Source Type: research

Remarkable Reviewers
(Source: Heart Rhythm)
Source: Heart Rhythm - February 28, 2019 Category: Cardiology Source Type: research

Author ’s Reply to “Interpretation of Electrograms is key to Understand the Clinical Potential of Ecgi”
We thank Dr Cluitmans et al. for their interest in our work and for pinpointing some of the key challenges in ECGi. (Source: Heart Rhythm)
Source: Heart Rhythm - February 27, 2019 Category: Cardiology Authors: Josselin Duchateau, Michel Ha ïssaguerre, Rémi Dubois Source Type: research

Interpretation of electrograms is key to understand the clinical potential of ECGI
With great interest we read the publication of Duchateau et al. on clinical validation of noninvasive electrical activation mapping by comparing electrocardiographic imaging (ECGI) with epicardial invasive contact mapping.1 We commend the authors for performing this much-needed study, which helps to further define the value of ECGI in the cardiology clinic. Overall, we find the approach of these investigators sound, but we also consider that the paper falls short in explaining the reported discrepancies. (Source: Heart Rhythm)
Source: Heart Rhythm - February 27, 2019 Category: Cardiology Authors: Matthijs JM. Cluitmans, Job Stoks, Paul GA. Volders Source Type: research

Reply to the Editor —Interpretation of electrograms is key to understand the clinical potential of ECGi
We thank Cluitmans et  al for their interest in our work and for pinpointing some of the key challenges in electrocardiographic imaging. (Source: Heart Rhythm)
Source: Heart Rhythm - February 27, 2019 Category: Cardiology Authors: Josselin Duchateau, Michel Ha ïssaguerre, Rémi Dubois Source Type: research

To the Editor — Interpretation of electrograms is key to understand the clinical potential of ECGI
With great interest we read the article of Duchateau et  al1 on clinical validation of noninvasive electrical activation mapping by comparing electrocardiographic imaging (ECGI) with epicardial invasive contact mapping. We commend the authors for performing this much-needed study, which helps to further define the value of ECGI in the cardiology clinic. Overall, we find the approach of these investigators sound, but we also consider that the study falls short of explaining the reported discrepancies. (Source: Heart Rhythm)
Source: Heart Rhythm - February 27, 2019 Category: Cardiology Authors: Matthijs J.M. Cluitmans, Job Stoks, Paul G.A. Volders Tags: Letter to the Editor Source Type: research

Erratum
In the article titled “Acute biventricular hemodynamic effects of cardiac resynchronization therapy in right bundle branch block” that published in the October 2018 issue of Heart Rhythm (Heart Rhythm. 2018 Oct;15(10):1525-1532), there was an error in figure 3. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2019 Category: Cardiology Tags: Erratum Source Type: research

Periodic Repolarization Dynamics as Risk Predictor after Myocardial Infarction: Prospective Validation Study
Periodic Repolarization Dynamics (PRD) is a novel electrocardiographic phenomenon that refers to sympathetic-activity associated low-frequency modulations of cardiac repolarization. Retrospective post myocardial infarction (MI) studies revealed that increased PRD indicates increased risk for subsequent death. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2019 Category: Cardiology Authors: Konstantinos D. Rizas, Angela J. Doller, Wolfgang Hamm, Nikolay Vdovin, Lukas von Stuelpnagel, Christine S. Zuern, Axel Bauer Source Type: research

Cardiac Sympathectomy For Refractory Ventricular Arrhythmias in Cardiac Sarcoidosis
Ventricular arrhythmias (VA) in cardiac sarcoidosis (CS) are frequently refractory to both anti-arrhythmic drug therapy (AAD) and catheter ablation (CA). Cardiac sympathetic denervation (CSD) has been shown to reduce VA burden and implantable cardioverter- defibrillator (ICD) shocks in patients with non-ischemic cardiomyopathy. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2019 Category: Cardiology Authors: David R. Okada, Fabrizio R. Assis, Nisha A. Gilotra, Jinny S. Ha, Ronald D. Berger, Hugh Calkins, Jonathan Chrispin, Kaushik Mandal, Harikrishna Tandri Source Type: research

Evolution of Post-Pulmonary Vein Isolation Atrial Fibrillation Inducibility at Redo Ablation: Electrophysiological Evidence of Extra-Pulmonary Vein Substrate Progression
The electrophysiological substrate underlying atrial fibrillation (AF) progression remains difficult to identify. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2019 Category: Cardiology Authors: Nicolas Johner, Dipen C. Shah, Georgios Giannakopoulos, Anne Girardet, Mehdi Namdar Source Type: research

Antiarrhythmic and proarrhythmic effects of subcutaneous nerve stimulation in ambulatory dogs
High output subcutaneous nerve stimulation (ScNS) remodels the stellate ganglia and suppresses cardiac arrhythmia. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2019 Category: Cardiology Authors: Juyi Wan, Mu Chen, Yuan Yuan, Zhuo Wang, Changyu Shen, Michael C. Fishbein, Zhenhui Chen, Johnson Wong, Maria B. Grant, Thomas H. Everett, Peng-Sheng Chen Source Type: research

Why did this patient experience a sudden cardiac arrest? Follow your curiosity!
When a young individual survives a sudden cardiac arrest (SCA) in a neurologic intact state and there is no obvious noncardiac or reversible cause identified, a defibrillator is not infrequently implanted in the absence of a complete diagnostic workup. Unfortunately, an incomplete diagnostic workup increases the odds of a wrongful diagnosis of idiopathic ventricular fibrillation (IVF), because this is a diagnosis per exclusionem. Some “true” and partially overlapping IVF subtypes, e.g. short-coupled torsades de pointes1 including the Dutch IVF subtype linked to a haplotype containing the DPP6 gene2, have been i...
Source: Heart Rhythm - February 25, 2019 Category: Cardiology Authors: Christian van der Werf, Arthur A.M. Wilde Source Type: research

Evolution of post –pulmonary vein isolation atrial fibrillation inducibility at redo ablation: Electrophysiological evidence of extra–pulmonary vein substrate progression
The electrophysiological substrate underlying atrial fibrillation (AF) progression remains difficult to identify. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2019 Category: Cardiology Authors: Nicolas Johner, Dipen C. Shah, Georgios Giannakopoulos, Anne Girardet, Mehdi Namdar Source Type: research

Corrigendum
In the article titled “Acute biventricular hemodynamic effects of cardiac resynchronization therapy in right bundle branch block” that published in the October 2018 issue of Heart Rhythm (Heart Rhythm. 2018 Oct;15(10):1525-1532), there was an error in figure 3. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2019 Category: Cardiology Tags: Corrigendum Source Type: research

Periodic repolarization dynamics as a risk predictor after myocardial infarction: Prospective validation study
Periodic repolarization dynamics (PRD) is a novel electrocardiographic phenomenon that refers to sympathetic activity –associated low-frequency modulations of cardiac repolarization. Retrospective post–myocardial infarction (MI) studies revealed that increased PRD indicates an increased risk of subsequent death. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2019 Category: Cardiology Authors: Konstantinos D. Rizas, Angela J. Doller, Wolfgang Hamm, Nikolay Vdovin, Lukas von Stuelpnagel, Christine S. Zuern, Axel Bauer Source Type: research

EP News: Case Reports
Up to 4% of patients who receive an initial implantable cardioverter-defibrillator (ICD) or receive a generator replacement have an elevated defibrillation threshold (DFT). The current use of DF-4 devices and a trend toward implantation of single-coil vs dual-coil defibrillator leads have negatively affected simple programming changes that can improve DFTs. Mitra (DOI: https://doi.org/10.1016/j.hrcr.2018.10.006) shared a case of a 48-year-old man with arrhythmogenic right ventricular cardiomyopathy and refractory ventricular arrhythmias with an ICD the required battery replacement. (Source: Heart Rhythm)
Source: Heart Rhythm - February 23, 2019 Category: Cardiology Authors: T. Jared Bunch Source Type: research

EP News: Quality Improvement and Outcomes
In this issue of HeartRhythm, we present a new quarterly feature highlighting quality improvement in the delivery of heart rhythm care. These quarterly features will summarize key publications of relevance to the electrophysiology community and provide a forum for recognizing the growing importance of measuring, reporting, and improving the quality of heart rhythm care. (Source: Heart Rhythm)
Source: Heart Rhythm - February 21, 2019 Category: Cardiology Authors: Paul D. Varosy, Anne Marie Smith, Jonathan P. Piccini Tags: EP News Source Type: research

EP News: Clinical
Robinson et  al (Circulation 2019;139:313, PMID 30586734) prospectively evaluated noninvasive cardiac radioablation in adults with treatment-refractory episodes of ventricular tachycardia (VT) or cardiomyopathy related to premature ventricular contractions (PVCs). Arrhythmogenic scar was targeted using noninva sive anatomic and electric cardiac imaging with standard stereotactic body radiation. The primary safety end point was serious adverse events in the first 90 days. The primary efficacy end point was reduction in VT episodes or PVC burden. (Source: Heart Rhythm)
Source: Heart Rhythm - February 21, 2019 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Allied Professionals
Using data from the American Heart Association ’s Get With the Guidelines – Atrial Fibrillation (GWTG-AFIB) program registry, Piccini et al (Circulation, January 31, 2019; Epub ahead of print, PMID 30700141) sought to assess whether adherence to guideline-directed oral anticoagulation (OAC) use would increase over time and whether this impr ovement would be associated with enhanced in-hospital outcomes. Data were obtained from 115 centers using the GWTG-AFIB program, which includes education for providers and patients along with tools to aid in shared decision making. (Source: Heart Rhythm)
Source: Heart Rhythm - February 21, 2019 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

EP News: Basic and Translational
Right ventricular (RV) outflow tract (RVOT) is a common site of ventricular arrhythmias in the athlete ’s heart. In the present study, Gülan et al (Sci Rep 2019;9:100, PMID 30643204) tested the roles of RVOT in ventricular arrhythmias during exercise when the thin-walled RVOT is expected to be exposed to high wall shear stress (WSS). Phase contrast magnetic resonance imaging was used to obtain RV and RVOT flow patterns from 2 healthy athletic male proband’s hearts and 2 patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia. (Source: Heart Rhythm)
Source: Heart Rhythm - February 21, 2019 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

Anchoring in a storm: the importance of substrate in polymorphic ventricular arrhythmias
Management of drug refractory recurrent polymorphic ventricular tachycardia (PMVT) and ventricular fibrillation (VF) is a unique challenge in electrophysiology. When there is no reversible cause and medications are ineffective, patients face an immediately life-threatening condition and agonizing recurrent defibrillations. This situation represents a true EP emergency. The patient ’s clinical condition may deteriorate from the repeated shocks and/or prolonged periods of hypotension in the resuscitation effort requiring cardiopulmonary bypass or other forms of life-support. (Source: Heart Rhythm)
Source: Heart Rhythm - February 19, 2019 Category: Cardiology Authors: Jeffrey S. Arkles, Francis E. Marchlinski Source Type: research

Erratum
In the article “Prognostic efficacy of platelet count in patients with nonvalvular atrial fibrillation” by Jiesuck Park, et al that published in the February 2019 issue of Heart Rhythm (2019;16:197-203), the Methods noted that “Written informed consent was obtained from each participant for registration.” However, the study population was retrospectively analyzed based on the dedicated review of electronic medical records of the patients of a single center cohort. Therefore, the study protocol was waived from informed consent for the study population. (Source: Heart Rhythm)
Source: Heart Rhythm - February 15, 2019 Category: Cardiology Tags: Erratum Source Type: research

Feasibility Of Percutaneous Epicardial Mapping And Ablation For Refractory Atrial Fibrillation: Insights Into Substrate And Lesion Transmurality
Recurrences of atrial fibrillation (AF) after ablation have been attributed to conduction gaps and non-transmural ablation lesions (Source: Heart Rhythm)
Source: Heart Rhythm - February 15, 2019 Category: Cardiology Authors: Ruhong Jiang, Eric Buch, Jean Gima, Gaurav A. Upadhyay, Hemal M. Nayak, Andrew D. Beaser, Zaid Aziz, Kalyanam Shivkumar, Roderick Tung Source Type: research

Corrigendum
In the article “Prognostic efficacy of platelet count in patients with nonvalvular atrial fibrillation” by Jiesuck Park, et al that published in the February 2019 issue of Heart Rhythm (2019;16:197-203), the Methods noted that “Written informed consent was obtained from each participant for registration.” However, the study population was retrospectively analyzed based on the dedicated review of electronic medical records of the patients of a single center cohort. Therefore, the study protocol was waived from informed consent for the study population. (Source: Heart Rhythm)
Source: Heart Rhythm - February 15, 2019 Category: Cardiology Tags: Corrigendum Source Type: research

Autoimmune and inflammatory K+-channelopathies in cardiac arrhythmias: clinical evidence and molecular mechanisms.
Cardiac K+-channelopathies account for a significant proportion of arrhythmias and sudden cardiac death (SCD) in subjects without structural heart disease. It is well recognized that genetic defects are key factors in many cases and in practice, the term cardiac channelopathies currently coincides with that of inherited cardiac channelopathies. However, mounting evidence demonstrate that not only genetic alterations but also autoimmune and inflammatory factors can cause cardiac K+-channel dysfunction and arrhythmias in the setting of a structurally normal heart. (Source: Heart Rhythm)
Source: Heart Rhythm - February 14, 2019 Category: Cardiology Authors: Pier Leopoldo Capecchi, Franco Laghi-Pasini, Nabil El-Sherif, Yongixa QU, Mohamed Boutjdir, Pietro Enea Lazzerini Source Type: research

Internal insulation breaches in an implantable cardioverter-defibrillator lead with redundant conductors
Internal insulation breaches (IBR) may result ICD lead failure and adverse clinical events. Concerns exist that the Durata lead may be prone to IBR. (Source: Heart Rhythm)
Source: Heart Rhythm - February 14, 2019 Category: Cardiology Authors: Robert G. Hauser, Jay Sengupta, Edward J. Schloss, Larissa I. Stanberry, Moses K. Wananu, Raed Abdelhadi Source Type: research