Anatomic approach with bipolar ablation between the left pulmonic cusp and left ventricular outflow tract for left ventricular summit arrhythmias
Radiofrequency catheter ablation (RFCA) of ventricular arrhythmias (VAs) arising from the inaccessible basal region of the left ventricular summit (LVS) is challenging due to proximity to coronary vessels, epicardial fat, and poor radiofrequency (RF) delivery within the distal coronary venous system. (Source: Heart Rhythm)
Source: Heart Rhythm - April 25, 2020 Category: Cardiology Authors: Piotr Futyma, Pasquale Santangeli, Helmut P ürerfellner, Naga Venkata Pothineni, Ryszard Głuszczyk, Kamil Ciąpała, Kgomotso Moroka, Martin Martinek, Marian Futyma, Francis E. Marchlinski, Piotr Kułakowski Source Type: research

Anatomical Approach With Bipolar Ablation Between the Left Pulmonic Cusp and the Left Ventricular Outflow Tract for Left Ventricular Summit Arrhythmias
Radiofrequency ablation (RFA) of ventricular arrhythmias (VAs) arising from the inaccessible basal region of the left ventricular summit (LVS) is challenging due to proximity to coronary vessels, epicardial fat and poor RF delivery within the distal coronary venous system. (Source: Heart Rhythm)
Source: Heart Rhythm - April 25, 2020 Category: Cardiology Authors: Piotr Futyma, Pasquale Santangeli, Helmut P ürerfellner, Naga Venkata Pothineni, Ryszard Głuszczyk, Kamil Ciąpała, Kgomotso Moroka, Martin Martinek, Marian Futyma, Francis E. Marchlinski, Piotr Kułakowski Source Type: research

Small-conductance Ca2+-activated K+ channels promote J-wave syndrome and phase 2 reentry
Small-conductance Ca2+-activated potassium (SK) channels play complex roles in cardiac arrhythmogenesis. SK channels colocalize with L-type Ca2+ channels, yet how this colocalization affects cardiac arrhythmogenesis is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 21, 2020 Category: Cardiology Authors: Julian Landaw, Zhaoyang Zhang, Zhen Song, Michael B. Liu, Riccardo Olcese, Peng-Sheng Chen, James N. Weiss, Zhilin Qu Source Type: research

Small-conductance Ca2+-activated K+ channels promote J-wave syndrome and phase-2 reentry
Small-conductance calcium (Ca2+)-activated potassium (SK) channels play complex roles in cardiac arrhythmogenesis. SK channels colocalize with L-type Ca2+ channels, yet how this colocalization affects cardiac arrhythmogenesis is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 21, 2020 Category: Cardiology Authors: Julian Landaw, Zhaoyang Zhang, Zhen Song, Michael B. Liu, Riccardo Olcese, Peng-Sheng Chen, James N. Weiss, Zhilin Qu Source Type: research

Modern Mapping and Ablation Techniques to Treat Ventricular Arrhythmias From the Left Ventricular Summit and Interventricular Septum
Managing arrhythmias from the left ventricular summit and interventricular septum is a major challenge for the clinical electrophysiologist requiring intimate knowledge of cardiac anatomy, advanced training and expertise. Novel mapping and ablation strategies are needed to treat arrhythmias originating from these regions given the suboptimal long-term success rates. Herein, we describe innovative approaches to improve acute and long-term clinical outcomes such as mapping and ablation using the septal coronary venous system, the septal coronary arteries, alcohol ablation, ablation of all early sites, among others. (Source: Heart Rhythm)
Source: Heart Rhythm - April 21, 2020 Category: Cardiology Authors: Jorge Romero, Kalayanam Shivkumar, Miguel Valderrabano, Juan Carlos Diaz, Isabella Alviz, David Briceno, Andrea Natale, Luigi Di Biase Source Type: research

EP News: Basic and Translational
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been shown to be associated with a high inflammatory burden that can induce vascular inflammation, myocarditis, and cardiac arrhythmias. The current study by Hoffmann et  al (Cell 2020;doi:10.1016/j.cell.2020.02.052; PMID 32142651) investigates the mechanisms of SARS-CoV-2 entry into mammalian cells. The spike (S) protein of coronaviruses facilitates viral entry into target cells by binding of the surface unit (S1) of the S protein to a cellular receptor, angiotens in-converting enzyme 2 (ACE2), as the...
Source: Heart Rhythm - April 20, 2020 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

Role of Angiopoietin-Like Protein 2 in Atrial Fibrosis Induced by Human Epicardial Adipose Tissue: Analysis Using Organo-Culture System
We have recently reported that peri-left atrial epicardial adipose tissue (EAT) is associated with atrial myocardial fibrosis, in which angiopoietin-like protein 2 (Angptl2) protein content in EAT is associated with atrial myocardial fibrosis. (Source: Heart Rhythm)
Source: Heart Rhythm - April 20, 2020 Category: Cardiology Authors: Shintaro Kira, Ichitaro Abe, Yumi Ishii, Miho Miyoshi, Takahiro Oniki, Motoki Arakane, Tsutomu Daa, Yasushi Teshima, Kunio Yufu, Tatsuo Shimada, Naohiko Takahashi Source Type: research

Cardiovascular autonomic reflex function after bilateral cardiac sympathetic denervation for ventricular arrhythmias
Bilateral cardiac sympathetic denervation (BCSD) is an effective therapy for ventricular arrhythmias (VAs) in cardiomyopathies (CMPs). After BCSD, residual autonomic nervous system (ANS) function is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 19, 2020 Category: Cardiology Authors: Veronica Dusi, Leila Shahabi, Rachel C. Lapidus, Julie M. Sorg, Bruce D. Naliboff, Kalyanam Shivkumar, Sahib S. Khalsa, Olujimi A. Ajijola Tags: Clinical Source Type: research

Significance of fragmented QRS complexes for predicting new-onset atrial fibrillation after cavotricuspid isthmus –dependent atrial flutter ablation
Atrial fibrillation (AF) and cavotricuspid isthmus (CTI) –dependent atrial flutter (AFL) are 2 separate entities that coexist in a significant ratio of patients. In patients with CTI ablation of AFL, the decision to hold anticoagulation often becomes an issue. (Source: Heart Rhythm)
Source: Heart Rhythm - April 19, 2020 Category: Cardiology Authors: Yuhi Fujimoto, Kenji Yodogawa, Eiichiro Oka, Hiroshi Hayashi, Teppei Yamamoto, Hiroshige Murata, Yu-ki Iwasaki, Meiso Hayashi, Wataru Shimizu Source Type: research

Periaortic ventricular tachycardia in structural heart disease: Evidence of localized reentrant mechanisms
The mechanisms for scar-related ventricular tachycardia (VT) originating from the periaortic region remain incompletely characterized. (Source: Heart Rhythm)
Source: Heart Rhythm - April 19, 2020 Category: Cardiology Authors: Takuro Nishimura, Andrew Beaser, Zaid Aziz, Gaurav A. Upadhyay, Cevher Ozcan, Michael Raiman, Dalise Shatz, Stephanie A. Besser, Nathan Shatz, Hemal M. Nayak, Roderick Tung Source Type: research

Peri-Aortic Ventricular Tachycardia in Structural Heart Disease: Evidence of Localized Reentrant Mechanisms
The mechanisms for scar-related ventricular tachycardia (VT) originating from the peri-aortic region remain incompletely characterized. (Source: Heart Rhythm)
Source: Heart Rhythm - April 19, 2020 Category: Cardiology Authors: Takuro Nishimura, Andrew Beaser, Zaid Aziz, Gaurav A. Upadhyay, Cevher Ozcan, Michael Raiman, Dalise Shatz, Stephanie A. Besser, Nathan Shatz, Hemal M. Nayak, Roderick Tung Source Type: research

Sex-specific efficacy and safety of cryoballoon versus radiofrequency ablation for atrial fibrillation: An individual patient data meta-analysis
Atrial fibrillation (AF) is a growing health burden and pulmonary vein isolation (PVI) using cryoballoon (CB) or radiofrequency (RF) represents an attractive therapeutic option. Sex-specific differences in the epidemiology, pathophysiology and clinical presentation of AF and PVI are recognized, (Source: Heart Rhythm)
Source: Heart Rhythm - April 19, 2020 Category: Cardiology Authors: Jeanne du Fay de Lavallaz, Patrick Badertscher, Atsushi Kobori, Karl-Heinz Kuck, Josep Brugada, Serge Boveda, Rui Provid ência, Ziad Khoueiry, Armin Luik, Fabien Squara, Ioanna Kosmidou, Karapet V. Davtyan, Arif Elvan, Nicasio Perez-Castellano, Ross J. H Source Type: research

Significance of fragmented QRS complexes for predicting new-onset atrial fibrillation after cavo-tricuspid isthmus dependent atrial flutter ablation
Atrial fibrillation (AF) and cavo-tricuspid isthmus (CTI) dependent atrial flutter (AFL) are two separate entities that coexist in a significant ratio of patients. In patients with CTI ablation of AFL, the decision to hold anticoagulation often becomes an issue. (Source: Heart Rhythm)
Source: Heart Rhythm - April 19, 2020 Category: Cardiology Authors: Yuhi Fujimoto, Kenji Yodogawa, Eiichiro Oka, Hiroshi Hayashi, Teppei Yamamoto, Hiroshige Murata, Yu-ki Iwasaki, Meiso Hayashi, Wataru Shimizu Source Type: research

Cardiovascular Autonomic Reflex Function following Bilateral Cardiac Sympathetic Denervation for Ventricular Arrhythmias
Bilateral cardiac sympathetic denervation (BCSD) is an effective therapy for ventricular arrhythmias (VAs) in cardiomyopathies (CMP). Following BCSD, residual autonomic (ANS) function is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - April 19, 2020 Category: Cardiology Authors: Veronica Dusi, Leila Shahabi, Rachel C. Lapidus, Julie M. Sorg, Bruce D. Naliboff, Kalyanam Shivkumar, Sahib S. Khalsa, Olujimi A. Ajijola Source Type: research

EP News: Allied Professionals
In a departure from the usual format of review of 1 article followed by a discussion of 1 topic, given the unusual times, the discussion of 1 topic will predominate. There are already hundreds of articles with topics such as the cardiovascular manifestations of coronavirus disease (COVID-19), the increased risk to patients with preexisting cardiovascular disease, arrhythmias associated with infection, and proarrhythmic effects of proposed treatments to be found with a simple Google or PubMed search. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2020 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

EP News: Clinical
Lakkireddy et  al (Heart Rhythm April 1, 2020;https://doi.org/10.1016/j.hrthm.2020.03.028, PMID 32228309) summarized the available evidence and provided recommendations for electrophysiologists related to coronavirus 2019 (COVID-19) in a consensus document from the Heart Rhythm Society, American College of Cardi ology, and American Heart Association. They noted that electrophysiologists, like all cardiologists and other health care workers, have been affected personally and professionally by this global catastrophe. (Source: Heart Rhythm)
Source: Heart Rhythm - April 17, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

Improvement in sudden cardiac death risk prediction by the enhanced American College of Cardiology/American Heart Association strategy in Chinese patients with hypertrophic cardiomyopathy
The lack of validated and effective sudden cardiac death (SCD) risk prediction methods is the biggest barrier to perform the lifesaving treatment with a prophylactic implantable cardioverter-defibrillator in Chinese patients with hypertrophic cardiomyopathy (HCM). (Source: Heart Rhythm)
Source: Heart Rhythm - April 16, 2020 Category: Cardiology Authors: Jie Liu, Guixin Wu, Ce Zhang, Jieyun Ruan, Dong Wang, Mo Zhang, Limei Wang, Yaoyao Yang, Xinrong Li, Yilu Wang, Rutai Hui, Yubao Zou, Lianming Kang, Jizheng Wang, Lei Song Source Type: research

Improvement in sudden cardiac death risk prediction by the enhanced ACC/AHA strategy in Chinese patients with hypertrophic cardiomyopathy
The lack of validated and effective sudden cardiac death (SCD) risk prediction methods is the biggest barrier to perform the lifesaving treatment with a prophylactic implantable cardioverter-defibrillator in Chinese patients with hypertrophic cardiomyopathy (HCM). (Source: Heart Rhythm)
Source: Heart Rhythm - April 16, 2020 Category: Cardiology Authors: Jie Liu, Guixin Wu, Ce Zhang, Jieyun Ruan, Dong Wang, Mo Zhang, Limei Wang, Yaoyao Yang, Xinrong Li, Yilu Wang, Rutai Hui, Yubao Zou, Lianming Kang, Jizheng Wang, Lei Song Source Type: research

EP News: Case Reports
The phenotype of Brugada syndrome is associated with a decrease in the sodium current and can manifest with sudden death in previously healthy individuals. Many triggers have been described, including fever, alcohol intake, and medications that cause sodium channel blockade. Coronavirus disease 2019 (COVID-19) most commonly presents with fever and a cough. Chang et  al (doi: https://doi.org/10.1016/j.hrcr.2020.03.012) shared a case of a 49-year-old Bangladeshi man without a significant medical history who presented after an episode of syncope and fever. (Source: Heart Rhythm)
Source: Heart Rhythm - April 16, 2020 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

Improvement of sudden cardiac death risk prediction by enhanced ACC/AHA strategy in Chinese patients with hypertrophic cardiomyopathy
The lack of validated and effective sudden cardiac death (SCD) risk prediction method is the biggest barrier to perform the lifesaving treatment of prophylactic implantable cardioverter defibrillator (ICD) in Chinese patients with hypertrophic cardiomyopathy (HCM). (Source: Heart Rhythm)
Source: Heart Rhythm - April 16, 2020 Category: Cardiology Authors: Jie Liu, Guixin Wu, Ce Zhang, Jieyun Ruan, Dong Wang, Mo Zhang, Limei Wang, Yaoyao Yang, Xinrong Li, Yilu Wang, Rutai Hui, Yubao Zou, Lianming Kang, Jizheng Wang, Lei Song Source Type: research

Subcutaneous implantable cardioverter-defibrillator troubleshooting in patients with a left ventricular assist device: A case series and systematic review
There are limited data on the performance of the subcutaneous implantable cardioverter-defibrillator (S-ICD) in patients with a left ventricular assist device (LVAD). (Source: Heart Rhythm)
Source: Heart Rhythm - April 14, 2020 Category: Cardiology Authors: Eric Black-Maier, Robert K. Lewis, Adam S. Barnett, Sean D. Pokorney, Albert Y. Sun, Jason I. Koontz, James P. Daubert, Jonathan P. Piccini Tags: Clinical Source Type: research

Subcutaneous implantable cardioverter-defibrillator troubleshooting in patients with left ventricular assist devices: a case series and systematic review
There are limited data on the performance of the subcutaneous implantable cardioverter defibrillator (S-ICD) in patients with left ventricular assist devices (LVADs). (Source: Heart Rhythm)
Source: Heart Rhythm - April 14, 2020 Category: Cardiology Authors: Eric Black-Maier, Robert K. Lewis, Adam S. Barnett, Sean D. Pokorney, Albert Y. Sun, Jason I. Koontz, James P. .Daubert, Jonathan P. Piccini Source Type: research

Considerations for Drug Interactions on QTc Interval in Exploratory COVID-19 Treatment
Hydroxychloroquine and azithromycin have been touted for potential prophylaxis or treatment for patients with coronavirus disease 2019 (COVID-19). Both drugs are listed as definite causes of torsade de pointes at crediblemeds.org. There are occasional case reports of hydroxychloroquine ’s prolonging the QT interval and provoking torsade de pointes1–4 when used to treat systemic lupus erythematosus. Antimalarial prophylactic drugs, such as hydroxychloroquine, are believed to act on the entry and post-entry stages of severe acute respiratory syndrome–associated coronavirus (SA RS-CoV) and severe acute respi...
Source: Heart Rhythm - April 13, 2020 Category: Cardiology Authors: Dan M. Roden, Robert A. Harrington, Athena Poppas, Andrea M. Russo Source Type: research

Usefulness of positive T wave in lead aVR in predicting arrhythmic events and mortality in patients with hypertrophic cardiomyopathy
Positive T wave in lead aVR (TaVR) has been associated with increased risk of adverse events in patients with various cardiovascular diseases. (Source: Heart Rhythm)
Source: Heart Rhythm - April 13, 2020 Category: Cardiology Authors: Firdevs Aysenur Ekizler, Serkan Cay, Ozcan Ozeke, Bahar Tekin Tak, Habibe Kafes, Elif Hande Ozcan Cetin, Firat Ozcan, Serkan Topaloglu, Omac Tufekcioglu, Dursun Aras Source Type: research

Usefulness of Positive T Wave in Lead aVR on Predicting Arrhythmic Events and Mortality in Patients with Hypertrophic Cardiomyopathy
Positive T wave in lead aVR (TaVR) has been associated with increased risk of adverse events in various cardiovascular diseases. (Source: Heart Rhythm)
Source: Heart Rhythm - April 13, 2020 Category: Cardiology Authors: Firdevs Aysenur Ekizler, Serkan Cay, Ozcan Ozeke, Bahar Tekin Tak, Habibe Kafes, Elif Hande Ozcan Cetin, Firat Ozcan, Serkan Topaloglu, Omac Tufekcioglu, Dursun Aras Source Type: research

Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 2019) Treatment
Hydroxychloroquine and azithromycin have been touted for potential prophylaxis or treatment for COVID-19 (coronavirus disease 2019) infection. Both drugs are listed as definite causes of torsade de pointes at crediblemeds.org. There are occasional case reports of hydroxychloroquine prolonging the QT interval and provoking torsade de pointes1-4 when used to treat systemic lupus erythematosus. Antimalarial prophylactic drugs, such as hydroxychloroquine, are believed to act on the entry and post-entry stages of SARS-CoV (severe acute respiratory syndrome –associated coronavirus) and SARS-CoV-2 (severe acute respiratory ...
Source: Heart Rhythm - April 13, 2020 Category: Cardiology Authors: Dan M. Roden, Robert A. Harrington, Athena Poppas, Andrea M. Russo Source Type: research

Noninvasive ventricular tachycardia ablation: Should we apply the accelerator or the brake?
Stereotactic body radiation therapy (SBRT) or stereotactic arrhythmia radioablation (STAR) utilizes advanced external beam radiotherapy to accurately deliver ablative doses of ionizing radiation to a precisely defined 3-dimensional anatomic volume. Stereotactic radiosurgery initially was developed for treatment of brain tumors and subsequently was adapted for treatment of extracranial tumors with the advent of respiratory gating and image guidance to overcome obstacles posed by internal organ and external body movement. (Source: Heart Rhythm)
Source: Heart Rhythm - April 10, 2020 Category: Cardiology Authors: Thomas A. Dewland, Anthony C. Wong, Edward P. Gerstenfeld Tags: Editorial Commentary Source Type: research

Non-invasive VT Ablation: Should We Apply the Accelerator or the Brake?
Stereotactic body radiation therapy (SBRT) or stereotactic arrhythmia radioablation (STAR) utilizes advanced external beam radiotherapy to accurately deliver ablative doses of ionizing radiation to a precisely defined three-dimensional anatomic volume. Stereotactic radiosurgery was initially developed for brain tumors and was subsequently adapted to treat extracranial tumors with the advent of respiratory gating and image-guidance to overcome obstacles posed by internal organ and external body movement. (Source: Heart Rhythm)
Source: Heart Rhythm - April 10, 2020 Category: Cardiology Authors: Thomas A. Dewland, Anthony C. Wong, Edward P. Gerstenfeld Source Type: research

Assessing the cost-effectiveness of home automated external defibrillators for pediatric patients: Getting us closer to the truth
Risk matrices categorize risk level based on the probability of an event occurring vs the severity of that event. As a risk assessment tool, they help anticipate future events, understand the tolerability of consequences, and design effective prevention or mitigation strategies. In the case of cardiac conditions that predispose to sudden cardiac death at a young age, such as hypertrophic cardiomyopathy (HCM), the severity of the outcome is always catastrophic. Variability exists in the probability of that outcome. (Source: Heart Rhythm)
Source: Heart Rhythm - April 7, 2020 Category: Cardiology Authors: Jonathan R. Kaltman Tags: Editorial Commentary Source Type: research

Assessing the cost-effectiveness of home automated external defibrillators for pediatric patients – getting us closer to the truth
Risk matrices categorize risk level based on the probability of an event occurring versus the severity of that event. As a risk assessment tool, they help anticipate future events, understand the tolerability of consequences, and design effective prevention or mitigation strategies. In the case of cardiac conditions that predispose to sudden cardiac death at a young age, such as hypertrophic cardiomyopathy, the severity of the outcome is always catastrophic. Where variability exists is in the probability of that outcome. (Source: Heart Rhythm)
Source: Heart Rhythm - April 7, 2020 Category: Cardiology Authors: Jonathan R. Kaltman Source Type: research

Left Cardiac Sympathetic Denervation Reduces Skin Sympathetic Nerve Activity in Patients with Long QT Syndrome
Although left cardiac sympathetic denervation (LCSD) is an effective antiarrhythmic therapy for patients with long QT syndrome (LQTS), direct evidence of reduced sympathetic activity after LCSD in humans is limited. (Source: Heart Rhythm)
Source: Heart Rhythm - April 6, 2020 Category: Cardiology Authors: Jie Han, Michael J. Ackerman, Christopher Moir, Cheng Cai, Pei-Lin Xiao, Pei Zhang, Kaylie A. Briske, Liang-Rong Zheng, Peng-Sheng Chen, Yong-Mei Cha Source Type: research

High-power, short-duration atrial fibrillation ablations using contact force sensing catheters: Outcomes and predictors of success including posterior wall isolation
Little is known about the long-term outcomes and predictors of success of high-power, short-duration (HPSD) contact force (CF) atrial fibrillation (AF) ablations. (Source: Heart Rhythm)
Source: Heart Rhythm - April 5, 2020 Category: Cardiology Authors: Roger A. Winkle, R. Hardwin Mead, Gregory Engel, Melissa H. Kong, Jonathan Salcedo, Chad R. Brodt, Rob A. Patrawala Source Type: research

Left ventricular endocardial pacing is less arrhythmogenic than conventional epicardial pacing when pacing in proximity to scar
Epicardial pacing increases risk of ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) when pacing in proximity to scar. Endocardial pacing may be less arrhythmogenic as it preserves the physiological sequence of activation and repolarization. (Source: Heart Rhythm)
Source: Heart Rhythm - April 5, 2020 Category: Cardiology Authors: Caroline Mendonca Costa, Aurel Neic, Karli Gillette, Bradley Porter, Justin Gould, Baldeep Sidhu, Zhong Chen, Mark Elliott, Vishal Mehta, Gernot Plank, Christopher A. Rinaldi, Martin J. Bishop, Steven A. Niederer Source Type: research

High Power Short Duration Atrial Fibrillation Ablations using Contact Force Sensing Catheters: Outcomes and Predictors of Success Including Posterior Wall Isolation
Little is known about the long-term outcomes and predictors of success for High Power Short Duration(HPSD) Contact Force(CF) atrial fibrillation(AF) ablations. (Source: Heart Rhythm)
Source: Heart Rhythm - April 5, 2020 Category: Cardiology Authors: Roger A. Winkle, R. Hardwin Mead, Gregory Engel, Melissa H. Kong, Jonathan Salcedo, Chad R. Brodt, Rob A. Patrawala Source Type: research

The various manifestations of concealed nodofascicular/nodoventricular bypass tracts
The various arrhythmic manifestations of concealed nodofascicular (NF)/nodoventricular (NV) bypass tracts (BPTs) are poorly understood. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2020 Category: Cardiology Authors: Reginald T. Ho, Matthew Ortman, Steven A. Levi Source Type: research

Linking Cellular Energy State to Atrial Fibrillation Pathogenesis: Potential Role of Adenosine Monophosphate-Activated Protein Kinase
AMP-activated protein kinase (AMPK) is the cellular stress-sensing molecule. Apart from maintaining cellular energy balance, AMPK also controls expression and regulation of ion channels and ion transporters, including cytosolic Ca2+ handling proteins. Emerging evidence suggests that metabolic impairment plays a crucial role in the pathogenesis of atrial fibrillation (AF). AMPK activation is thought to be protective by preventing metabolic stress, favorably modulating membrane electrophysiology including cytosolic Ca2+ dynamics, preventing cellular growth and hypertrophic remodeling. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2020 Category: Cardiology Authors: Praloy Chakraborty, Stanley Nattel, Kumaraswamy Nanthakumar Source Type: research

The Various Manifestations of Concealed Nodo-Fascicular/Nodo-Ventricular Bypass Tracts
The various arrhythmic manifestations of concealed nodo-fascicular (NF)/nodo-ventricular (NV) bypass tracts (BPT) are poorly understood. (Source: Heart Rhythm)
Source: Heart Rhythm - April 4, 2020 Category: Cardiology Authors: Reginald T. Ho, Matthew Ortman, Steven A. Levi Source Type: research

Leadless pacemakers reduce risk of device-related infection: Review of the potential mechanisms
Pacemaker-related infections remain a constant concern due to increased risk of patient morbidity and mortality. Although transvenous pacemakers are expected to have an infection rate ranging from 0.77% to 2.08%, no cases of leadless pacemaker infection have been reported in clinical trials enrolling more than 3000 patients. Many potential reasons why leadless pacemakers may be resistant to infection include the absence of a subcutaneous pocket and leads, reduced skin and glove contact, size, location, and device material. (Source: Heart Rhythm)
Source: Heart Rhythm - April 1, 2020 Category: Cardiology Authors: Mikhael F. El-Chami, Matt Bonner, Reece Holbrook, Kurt Stromberg, Jane Mayotte, Amy Molan, M. Rizwan Sohail, Laurence M. Epstein Tags: Contemporary Review Source Type: research

Leadless Pacemakers Reduce Risk of Device Related Infection: Review of The Potential Mechanisms
Pacemaker related infections remain a constant concern due to increased risk for patient morbidity and mortality. While transvenous pacemakers are expected to have an infection rate ranging from 0.77% to 2.08%, there have been no cases of leadless pacemaker infection reported in clinical trials enrolling more than 3000 patients. There are many potential reasons that leadless pacemakers may be resistant to infection including the absence of a subcutaneous pocket and leads, reduced skin and glove contact, size, location, and device material. (Source: Heart Rhythm)
Source: Heart Rhythm - April 1, 2020 Category: Cardiology Authors: Mikhael F. El-Chami, Matt Bonner, Reece Holbrook, Kurt Stromberg, Jane Mayotte, Amy Molan, M. Rizwan Sohail, Laurence M. Epstein Source Type: research

Guidance for Cardiac Electrophysiology During the COVID-19 Pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association
Coronavirus disease 2019 (COVID-19) is a global pandemic that is wreaking havoc on the health and economy of much of human civilization. Electrophysiologists have been impacted personally and professionally by this global catastrophe. In this joint article from representatives of the Heart Rhythm Society, the American College of Cardiology, and the American Heart Association, we identify the potential risks of exposure to patients, allied healthcare staff, industry representatives, and hospital administrators. (Source: Heart Rhythm)
Source: Heart Rhythm - March 31, 2020 Category: Cardiology Authors: Dhanunjaya R. Lakkireddy, Mina K. Chung, Rakesh Gopinathannair, Kristen K. Patton, Ty J. Gluckman, Mohit Turagam, Jim Cheung, Parin Patel, Juan Sotomonte, Rachel Lampert, Janet K. Han, Bharath Rajagopalan, Lee Eckhardt, Jose Joglar, Kristin Sandau, Brian Source Type: research

Exercise and detraining are modifiable factors for arrhythmic risk in arrhythmogenic cardiomyopathy needing correct dosage
Exercise is beneficial and improves health and well-being in the general population. In a small subset of individuals however, exercise can be harmful. Individuals with arrhythmogenic cardiomyopathy (ARVC) are vulnerable to exercise and exercise both accelerates and aggravates life threatening cardiac disease (1,2). These patients are advised to restrain from competitive sports (3). (Source: Heart Rhythm)
Source: Heart Rhythm - March 31, 2020 Category: Cardiology Authors: Kristina H. Haugaa Source Type: research

Guidance for Cardiac Electrophysiology During the Coronavirus (COVID-19) Pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association
We describe the impact of COVID-19 on cardiac arrhythmias and methods of triage based on acuity and patient comorbidities. (Source: Heart Rhythm)
Source: Heart Rhythm - March 31, 2020 Category: Cardiology Authors: Dhanunjaya R. Lakkireddy, Mina K. Chung, Rakesh Gopinathannair, Kristen K. Patton, Ty J. Gluckman, Mohit Turagam, Jim Cheung, Parin Patel, Juan Sotomonte, Rachel Lampert, Janet K. Han, Bharath Rajagopalan, Lee Eckhardt, Jose Joglar, Kristin Sandau, Brian Source Type: research

SARS-CoV-2, COVID-19, and inherited arrhythmia syndromes
Ever since the first case was reported at the end of 2019, the severe acute respiratory syndrome coronavirus 2 virus and associated lung disease coronavirus disease 2019 (COVID-19) has spread throughout the world and has become a pandemic. In particular, the high transmission rate of the virus has made it a threat to public health globally. Currently, there is no proven effective therapy against the virus, and the effect on other diseases is also uncertain, especially inherited arrhythmia syndrome. (Source: Heart Rhythm)
Source: Heart Rhythm - March 30, 2020 Category: Cardiology Authors: Cheng-I. Wu, Pieter G. Postema, Elena Arbelo, Elijah R. Behr, Connie R. Bezzina, Carlo Napolitano, Tomas Robyns, Vincent Probst, Eric Schulze-Bahr, Carol Ann Remme, Arthur A.M. Wilde Tags: Contemporary Review Source Type: research

Permanent conduction system pacing for congenitally corrected transposition of the great arteries: A Pediatric and Congenital Electrophysiology Society (PACES)/International Society for Adult Congenital Heart Disease (ISACHD) Collaborative Study
Congenitally corrected transposition of the great arteries (CCTGA) is associated with spontaneous atrioventricular block and pacing-induced cardiomyopathy. Conduction system pacing is a potential alternative to conventional cardiac resynchronization therapy (CRT). (Source: Heart Rhythm)
Source: Heart Rhythm - March 30, 2020 Category: Cardiology Authors: Jeremy P. Moore, Roberto Gallotti, Kevin M. Shannon, Thomas Pilcher, Jeffrey M. Vinocur, Óscar Cano, Adam Kean, Blandine Mondesert, Jan-Hendrik Nürnberg, Robert D. Schaller, Parikshit S. Sharma, Takuro Nishimura, Roderick Tung Source Type: research

SARS-CoV-2, COVID-19 and inherited arrhythmia syndromes
Ever since the first case was reported at the end of 2019, the SARS-COV-2 virus and associated lung disease COVID-19 has spread throughout the world and has become a pandemic. In particular, the high transmission rate of the virus has made it a threat to public health globally. Currently, there is no proven effective therapy against the virus, and the impact on other diseases is also uncertain, especially inherited arrhythmia syndrome.Arrhythmogenic effect of COVID-19 can be expected, potentially contributing to disease outcome. (Source: Heart Rhythm)
Source: Heart Rhythm - March 30, 2020 Category: Cardiology Authors: Cheng-I. Wu, Pieter G. Postema, Elena Arbelo, Elijah R. Behr, Connie R. Bezzina, Carlo Napolitano, Tomas Robyns, Vincent Probst, Eric Schulze-Bahr, Carol Ann Remme, Arthur A.M. Wilde Source Type: research

Combined Local Impedance and Contact Force for Radiofrequency Ablation Assessment
The combination of contact force (CF) and local impedance (LI) may improve tissue characterization and lesion prediction during radiofrequency (RF) ablation. (Source: Heart Rhythm)
Source: Heart Rhythm - March 29, 2020 Category: Cardiology Authors: Kara Garrott, Jacob Laughner, Sarah Gutbrod, Alan Sugrue, Allan Shuros, Matt Sulkin, Omar Yasin, Jamie Bush, Nathan Pottinger, Jason Meyers, Suraj Kapa Source Type: research

The ABC-VT Risk Score: Not as Simple as it Seems
Frequent premature ventricular complexes (PVCs) can result in cardiomyopathy, may be reversible with appropriate PVC suppression.1 Likewise, some type of PVCs are associated with an increased risk of sudden cardiac death (SCD).1 PVCs have been considered benign and treated conservatively in a significant percentage of patients because the fundamental pathogenesis of PVC-induced cardiomyopathy remains ill-defined. Several analyses of patients referred for catheter ablation have identified different PVC characteristics as independent risk factors for cardiomyopathy including but not limited to PVC burden, PVC origin and coup...
Source: Heart Rhythm - March 28, 2020 Category: Cardiology Authors: Luigi Di Biase, Jorge Romero, David F. Brice ño Source Type: research

Cost-effectiveness of in-home automated external defibrillators for children with cardiac conditions associated with risk for sudden cardiac death
While children at high risk of sudden cardiac death (SCD) (>6% over 5 years) receive implanted cardioverter defibrillators (ICDs), there are no guidelines for those at lower risk. For children at intermediate risk of SCD (4-6% over 5 years), the utility and cost effectiveness of in-home automated external defibrillators (AED) are unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - March 28, 2020 Category: Cardiology Authors: Meredith B. Haag, Alyssa R. Hersh, David E. Toffey, James A. Sargent, Eric C. Stecker, Stephen B. Heitner, Aaron B. Caughey, Seshadri Balaji Source Type: research

An unusual supraventricular tachycardia in a patient with ventricular preexcitation
A 59-year-old man presented to the hospital with palpitations, a sensation he never experienced before. (Source: Heart Rhythm)
Source: Heart Rhythm - March 27, 2020 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

Notable Papers
We are pleased to announce our annual list of Notable Papers judged by the Editors of Heart Rhythm as the most notable articles published in the areas of clinical and basic science. (Source: Heart Rhythm)
Source: Heart Rhythm - March 27, 2020 Category: Cardiology Source Type: research