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

Implication of Ventricular Pacing Burden and Atrial Pacing Therapies on the Progression of Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Atrial fibrillation (AF) is common after pacemaker implantation. Nevertheless, the impact of pacemaker algorithms in AF prevention is not well understood. (Source: Heart Rhythm)
Source: Heart Rhythm - February 14, 2019 Category: Cardiology Authors: Dian A. Munawar, Rajiv Mahajan, Thomas A. Agbaedeng, Anand Thiyagarajah, Darragh J. Twomey, Kashif Khokar, Catherine O ’Shea, Glenn D. Young, Kurt C. Roberts-Thomson, Muhammad Munawar, Dennis H. Lau, Prashanthan Sanders Source Type: research

Patient-Reported Triggers of Paroxysmal Atrial Fibrillation
Triggers for discrete atrial fibrillation (AF) events remain poorly studied and incompletely characterized. (Source: Heart Rhythm)
Source: Heart Rhythm - February 14, 2019 Category: Cardiology Authors: Christopher A. Groh, Madelaine Faulkner, Shiffen Getabecha, Victoria Taffe, Gregory Nah, Kathi Sigona, Debbe McCall, Mellanie True Hills, Kathleen Sciarappa, Mark J. Pletcher, Jeffrey E. Olgin, Gregory M. Marcus 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 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 Tags: Contemporary Review Source Type: research

The 50 Year Anniversary of the His Bundle Recording and Pacing in Clinical Medicine
The discovery of the muscular connection between the atria and the ventricles was embroiled in controversy when Wilhelm His Jr. described the muscular connection in the heart that bears his name [1]. About the same time, Stanley Kent found multiple A-V connections [2] that were later found to be features of Wolff-Parkinson-White syndrome. Jesus Alanis and his associates [3] recorded the His bundle (HB) potential flanked by atrial and ventricular potentials. They were able to show that in atrial pacing with incremental frequencies, the atrium-to-His interval prolonged until only the atria potential remained with the loss of...
Source: Heart Rhythm - February 12, 2019 Category: Cardiology Authors: Benjamin J. Scherlag, Sunny S. Po Source Type: research

HRS 40th anniversary viewpoints: The 50-year anniversary of the His bundle recording and pacing in  clinical medicine
The discovery of the muscular connection between the atria and the ventricles was embroiled in controversy when Wilhelm His Jr1 described the muscular connection in the heart that bears his name. About the same time, Stanley Kent2 found multiple atrioventricular (AV) connections that were later found to be features of Wolff-Parkinson-White syndrome. Jesus Alanis and his associates3 recorded the His bundle (HB) potential flanked by atrial and ventricular potentials. They were able to show that in atrial pacing with incremental frequencies, the atrium-to-His interval prolonged until only the atria potential remained with the...
Source: Heart Rhythm - February 12, 2019 Category: Cardiology Authors: Benjamin J. Scherlag, Sunny S. Po Tags: Viewpoint Source Type: research

The 50-year anniversary of the His bundle recording and pacing in clinical medicine
The discovery of the muscular connection between the atria and the ventricles was embroiled in controversy when Wilhelm His Jr1 described the muscular connection in the heart that bears his name. About the same time, Stanley Kent2 found multiple atrioventricular (AV) connections that were later found to be features of Wolff-Parkinson-White syndrome. Jesus Alanis and his associates3 recorded the His bundle (HB) potential flanked by atrial and ventricular potentials. They were able to show that in atrial pacing with incremental frequencies, the atrium-to-His interval prolonged until only the atria potential remained with the...
Source: Heart Rhythm - February 12, 2019 Category: Cardiology Authors: Benjamin J. Scherlag, Sunny S. Po Tags: Viewpoint Source Type: research

Evidence of Relevant Electrical Connection between the Left Atrial Appendage and the Great Cardiac Vein During Catheter Ablation of Atrial Fibrillation
Atrial fibrillation (AF) triggers within the coronary sinus (CS)/great cardiac vein (GCV) and the left atrial appendage (LAA) have been recognized as non-pulmonary veins (PV) triggers of AF. (Source: Heart Rhythm)
Source: Heart Rhythm - February 11, 2019 Category: Cardiology Authors: Luigi Di Biase, Jorge Romero, David Briceno, Miguel Valderrabano, Javier E. Sanchez, Domenico G. Della Rocca, Prasant Mohanty, Rodney Horton, G. Joseph Gallinghouse, Sanghamitra Mohanty, Chintan Trivedi, Salwa Beheiry, Carola Gianni, Claude S. Elayi, J. D Source Type: research

Differentiation of Fasciculoventricular Fibers from Anteroseptal Accessory Pathways Using the Surface Electrocardiogram
Fasciculoventricular fibers (FVFs) are responsible for 1-5% of cases of asymptomatic pre-excitation on surface electrocardiogram (ECG). Unlike ventricular pre-excitation seen in Wolff-Parkinson-White (WPW) syndrome, FVFs are not associated with sudden cardiac death from pre-excited atrial fibrillation. (Source: Heart Rhythm)
Source: Heart Rhythm - February 11, 2019 Category: Cardiology Authors: Edward T. O ’Leary, Elizabeth S. Dewitt, Douglas Y. Mah, Kimberlee Gauvreau, Edward P. Walsh, Vassilios J. Bezzerides Source Type: research

Exercise Testing Oversights Underlie Missed and Delayed Diagnosis of Catecholaminergic Polymorphic Ventricular Tachycardia in Young Sudden Cardiac Arrest Survivors
Catecholamingergic polymorphic ventricular tachycardia (CPVT) is characterized by adrenergically-induced VT, syncope, and sudden cardiac arrest (SCA). In the absence of structural disease, exercise-provoked premature ventricular contractions in bigeminy/couplets and non-sustained VT are highly predictive of CPVT. (Source: Heart Rhythm)
Source: Heart Rhythm - February 11, 2019 Category: Cardiology Authors: John R. Giudicessi, Michael J. Ackerman Source Type: research

Reply to the Editor —Performance and limitations of noninvasive activation mapping
We thank Dr Rudy for his remarkable contribution to the development of noninvasive electrocardiographic (ECG) mapping and for his interest in our work.1 The term ECGi was used in reference to an epicardial potential formulation using the method of fundamental solutions, as termed in previous publications. This method is used in the commercial system we evaluated. Historical validation of ECGi was performed by studying animal hearts placed in a tank filled with conductive saline, which we believe may overestimate the accuracy of the reconstruction. (Source: Heart Rhythm)
Source: Heart Rhythm - February 6, 2019 Category: Cardiology Authors: Josselin Duchateau, Michel Ha ïssaguerre, Rémi Dubois Source Type: research

Author reply to « Comments on ECGI and Activation Mapping »
Thank you for your remarkable contribution to the development of non-invasive ECG mapping and for your interest in our work1. The term ECGi was used in reference to an epicardial potential formulation using the method of fundamental solutions, as termed in prior publications. This method is used in the commercial system we evaluated. As you know, historical validation of ECGi was carried-out by studying animal hearts placed in a tank filled with conductive saline, which we believe may overestimate the accuracy of the reconstruction. (Source: Heart Rhythm)
Source: Heart Rhythm - February 6, 2019 Category: Cardiology Authors: Josselin Duchateau, Michel Ha ïssaguerre, Rémi Dubois Source Type: research

Reply to the Editor —Performance and limitations of noninvasive cardiac activation mapping
We thank Dr Rudy for his remarkable contribution to the development of noninvasive electrocardiographic (ECG) mapping and for his interest in our work.1 The term ECGi was used in reference to an epicardial potential formulation using the method of fundamental solutions, as termed in previous publications. This method is used in the commercial system we evaluated. Historical validation of ECGi was performed by studying animal hearts placed in a tank filled with conductive saline, which we believe may overestimate the accuracy of the reconstruction. (Source: Heart Rhythm)
Source: Heart Rhythm - February 6, 2019 Category: Cardiology Authors: Josselin Duchateau, Michel Ha ïssaguerre, Rémi Dubois Tags: Letter to the Editor Source Type: research

Atrial Ca2+/calmodulin-dependent protein kinase II: A druggable master switch of atrial fibrillation-associated atrial remodeling?
Atrial fibrillation (AF) is the most common arrhythmia and is associated with increased morbidity and mortality, with heart failure (HF) and thromboembolism including stroke being the major consequences.1 Thus, stroke prevention with oral anticoagulants is crucial, but highly challenging, for AF management in many patients.2,3 Although our understanding of the underlying molecular mechanisms promoting AF increased substantially over the years, contemporary approaches using drugs are only moderately effective and have substantial side effects, including proarrhythmia. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2019 Category: Cardiology Authors: Dobromir Dobrev Tags: Editorial Commentary Source Type: research

Comments on ECGI and Activation Mapping
ECGI is a general approach for noninvasive reconstruction of epicardial potentials, from which activation-time and repolarization maps can be constructed. Duchateau1 compares noninvasive and invasive activation mapping, as conducted in their laboratory, using commercial systems. It is not general evaluation of ECGI. Accuracy of ECGI depends strongly on the exact methodology used and details of execution. Our laboratory experimental ECGI system employs armamentarium of custom methods/algorithms. Here I address points in Duchateau1 based on my extensive experience with ECGI. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2019 Category: Cardiology Authors: Yoram Rudy Source Type: research

Atrial Ca2+/calmodulin-dependent Protein Kinase-II: a Druggable Master Switch of Atrial Fibrillation-Associated Atrial Remodeling?
Dr. Dobrev is on the Scientific Advisory Board of OMEICOS and ACESION and received speaker ’s fees for educational lectures from Boston Scientific, Novartis, and Bristol Myers Squibb. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2019 Category: Cardiology Authors: Dobromir Dobrev Source Type: research

The sympathetic nervous system and arrhythmogenic right ventricular cardiomyopathy: Further evidence of a strong tie
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disorder characterized by a progressive fibrofatty replacement predominantly affecting the right ventricle (RV) with an epicardium to endocardium gradient. The cardiac sympathetic nervous system (SNS) is deeply involved in the pathogenesis of the disease suggesting a potential role for neuromodulation among the possible therapeutic approaches. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2019 Category: Cardiology Authors: Veronica Dusi, Gaetano M. De Ferrari Source Type: research

Letter to the Editor —ECG imaging and activation mapping
Electrocardiographic imaging (ECGi) is a general approach to noninvasive reconstruction of epicardial potentials, from which activation-time and repolarization maps can be constructed. Duchateau et  al1 compared noninvasive and invasive activation mapping, as conducted in their laboratory, using commercial systems. It is not a general evaluation of ECGi. The accuracy of ECGi depends strongly on the exact methodology used and the details of execution. Our laboratory experimental ECGi system us es an armamentarium of custom methods/algorithms. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2019 Category: Cardiology Authors: Yoram Rudy Source Type: research

Role of the Purkinje system in Heritable Arrhythmias
Much has been written about arrhythmias in structurally normal hearts. Here we have focused on rapid ventricular arrhythmias that occur in hearts where a pathogenic genetic variant has been found in families in which arrhythmias occur. We discuss these mutations in terms of their effect on cardiac cell electrical function and initiation of arrhythmias (see Supplement). In addition, we have focused on the Purkinje cell, their anatomic networks and molecular signatures as the sites of origin of arrhythmias. (Source: Heart Rhythm)
Source: Heart Rhythm - February 1, 2019 Category: Cardiology Authors: Arthur A.M. Wilde, Hasan Garan, Penelope A. Boyden Source Type: research

HRS 40th anniversary viewpoints: The journey is more important than the finish
I am often asked for advice by younger colleagues who have the (misplaced?) belief that since I have more gray hair than they do, I must have the wisdom to match. In responding, I  often stress several things that have guided me: family first; follow your heart; find a great mentor; focus and become expert in something; persevere even when (especially when!) the going gets tough. And most critical, remember that the journey is more important than the finish because life is a long race, not a sprint. (Source: Heart Rhythm)
Source: Heart Rhythm - February 1, 2019 Category: Cardiology Authors: Douglas P. Zipes Tags: Viewpoint Source Type: research

A wide QRS tachycardia followed by alternating bundle branch block
A 72-year-old man presented to the emergency department with palpitations and dizziness. His history revealed myocardial infarction 4 years ago. Figure  1 shows the electrocardiogram (ECG) on admission. The lower panel is the continuation of the upper panel. (Source: Heart Rhythm)
Source: Heart Rhythm - February 1, 2019 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

Low complication rates using high power (45 –50 W) for short duration for atrial fibrillation ablations
Many centers use radiofrequency (RF) energy at 25 –35 W for 30–60 seconds. There is a safety concern about using higher power, especially on the posterior wall. (Source: Heart Rhythm)
Source: Heart Rhythm - February 1, 2019 Category: Cardiology Authors: Roger A. Winkle, Sanghamitra Mohanty, Rob A. Patrawala, R. Hardwin Mead, Melissa H. Kong, Gregory Engel, Jonathan Salcedo, Chintan G. Trivedi, Carola Gianni, Pierre Jais, Andrea Natale, John D. Day Tags: Featured Article Source Type: research

All electrophysiologists have ADD: Is a cure in sight?
My husband has ADD.So do all of his colleagues.My Wife (Source: Heart Rhythm)
Source: Heart Rhythm - February 1, 2019 Category: Cardiology Authors: John M. Miller, Jonathan T. Shirazi Tags: Editorial Commentary Source Type: research

Catheter ablation of polymorphic ventricular tachycardia/fibrillation in patients with and without structural heart disease
Catheter ablation for polymorphic ventricular tachycardia and ventricular fibrillation (PMVT/VF) may target triggering premature ventricular contractions (PVCs). Targeting ventricular scar has also been suggested, but data are limited. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Tomofumi Nakamura, Benjamin Schaeffer, Shinichi Tanigawa, Rahul G. Muthalaly, Roy M. John, Gregory F. Michaud, Usha B. Tedrow, William G. Stevenson Source Type: research

Clinical impact of ethanol infusion into the vein of Marshall on the mitral isthmus area evaluated by atrial electrograms recorded inside the coronary sinus
The left atrial myocardium (LAM) and coronary sinus (CS) musculature (CSM) generate atrial electrograms recorded inside the CS (AECSs). The vein of Marshall (VOM) courses the mitral isthmus (MI), and ethanol infusion into the VOM (EI-VOM) is useful to ablate it. However, i ∖Its detailed effect on the MI, which contains the LAM, CSM, and those connections, is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Naohiko Kawaguchi, Kaoru Okishige, Yasuteru Yamauchi, Manabu Kurabayashi, Tomofumi Nakamura, Takehiko Keida, Tetsuo Sasano, Kenzo Hirao, Miguel Valderr ábano Source Type: research

Safety of rapid switching from amiodarone to dofetilide in atrial fibrillation patients with an implantable cardioverter –defibrillator
Dofetilide is a class III antiarrhythmic drug commonly used for treatment of atrial fibrillation. Drug guidelines mandate a 3-month waiting period before initiating dofetilide after  amiodarone use. Whether patients with an implantable cardioverter–defibrillator (ICD) can be rapidly switched from amiodarone to dofetilide is not known. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Sharan Prakash Sharma, Mohit Turagam, Donita Atkins, Sudha Bommana, Courtney Jeffrey, Diana Newton, Cheri Nydegger, Heidi Carroll, Rakesh Gopinathannair, Andrea Natale, Dhanunjaya Lakkireddy Source Type: research

Increase in CO2 levels by upregulating late sodium current is proarrhythmic in the heart
Increased CO2 levels in the general circulation and/or in the myocardium are common under pathologic conditions. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Qing Zhang, Ji-Hua Ma, Hong Li, Xiao-Hong Wei, Jie Zheng, Gang Li, Cheng-Yu Wang, Ying Wu, Qi-Hua He, Lin Wu Source Type: research

Safety of Rapid-Switching from Amiodarone to Dofetilide in Atrial Fibrillation Patients with Implantable Cardioverter Defibrillators
Dofetilide is a commonly used class III anti-arrhythmic drug for atrial fibrillation. Drug guidelines mandates waiting for 3-month prior to initiating dofetilide after amiodarone use. It is not known if patients with implantable cardioverter defibrillator (ICD) can be rapidly switched from amiodarone to dofetilide. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Sharan Prakash Sharma, Mohit Turagam, Donita Atkins, Sudha Bommana, Courtney Jeffrey, Diana Newton, Cheri Nydegger, Heidi Carroll, Rakesh Gopinathannair, Andrea Natale, Dhanunjaya Lakkireddy Source Type: research

An increase in CO2 levels by upregulating late sodium current is proarrhythmic in the heart
Increased CO2 levels in general circulation and/or in the myocardium are common under pathological conditions. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Qing Zhang, Ji-Hua Ma, Hong Li, Xiao-Hong Wei, Jie Zheng, Gang Li, Cheng-Yu Wang, Ying Wu, Qi-Hua He, Lin Wu Source Type: research

Endoscopic evaluation of the esophagus after catheter ablation of atrial fibrillation using contiguous and optimized radiofrequency applications.
The incidence of endoscopically detected esophageal lesions after pulmonary vein isolation (PVI) is as high as 18%. Intra-esophageal temperature rise (ITR) during ablation is a predictor for esophageal injury. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Michael Wolf, Milad El Haddad, Vincent De Wilde, Thomas Phlips, Jan De Pooter, Alexandre Almorad, Teresa Strisciuglio, Yves Vandekerckhove, Ren é Tavernier, Harry J. Crijns, Sébastien Knecht, Mattias Duytschaever Source Type: research

Clinical Impact of an Ethanol Infusion into the Vein of Marshall on the Mitral Isthmus Area evaluated by Atrial Electrograms recorded inside the Coronary Sinus
The left atrial myocardium (LAM) and coronary sinus (CS) musculature (CSM) generate atrial electrograms recorded inside the CS (AECSs). The vein of Marshall (VOM) courses the mitral isthmus (MI) and VOM ethanol infusion (EI-VOM) is useful to ablate it. Its detailed effect on the MI, which contains LAM, CSM and those connections, is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Naohiko Kawaguchi, Kaoru Okishige, Yasuteru Yamauchi, Manabu Kurabayashi, Tomofumi Nakamura, Takehiko Keida, Tetsuo Sasano, Kenzo Hirao, Miguel Valderr ábano Source Type: research

Catheter ablation of polymorphic ventricular tachycardia / fibrillation in patients with and without structural heart disease
Catheter ablation for polymorphic ventricular tachycardia and ventricular fibrillation (PMVT/VF) may target triggering premature ventricular contractions (PVCs). Targeting ventricular scar has also been suggested but data are limited. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Tomofumi Nakamura, Benjamin Schaeffer, Shinichi Tanigawa, Rahul G. Muthalaly, Roy M. John, Gregory F. Michaud, Usha B. Tedrow, William G. Stevenson Source Type: research

Predicting defibrillator benefit in patients with cardiac resynchronization therapy: a competing risk study
Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in selected heart failure patients but decision-making regarding selection of CRT-defibrillator or CRT-pacemaker is an ongoing debate. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2019 Category: Cardiology Authors: Dorothea Weber, Michael Koller, Dominic Theuns, Sing Yap, Michael K ühne, Christian Sticherling, Tobias Reichlin, Tamas Szili-Torok, Stefan Osswald, Beat Schaer Source Type: research

Intermittent high impedance from the lead-device compatibility problem
The reliability of an implantable cardioverter-defibrillator (ICD) system depends on the function of its components, including the pulse generator and ICD lead(s). The ICD lead is the critical interface linking a pulse generator to the myocardium and is used for delivery of short direct current electrical pulses including a high-energy pulse for lethal arrhythmia termination and a low-energy pulse for pacing. However, an ICD lead is the weakest link in all ICD systems. Lead failure rates range from 10% to 50% during long-term follow-up. (Source: Heart Rhythm)
Source: Heart Rhythm - January 29, 2019 Category: Cardiology Authors: Tanyanan Tanawuttiwat, Ronald D. Berger, Charles J. Love Source Type: research

Intermittent High Impedance from Lead-Device Compatibility Problem
The reliability of an implantable cardioverter defibrillator (ICD) system depends on the function of its components, including the pulse generator and ICD lead(s). The ICD lead is the critical interface linking a pulse generator to the myocardium and is used for delivery of short direct current electrical pulses including a high-energy pulse for lethal arrhythmia termination and a low-energy pulse for pacing. However, an ICD lead is the weakest link in all ICD systems. Lead failure rates range from 10-50% during long-term follow up (1). (Source: Heart Rhythm)
Source: Heart Rhythm - January 29, 2019 Category: Cardiology Authors: Tanyanan Tanawuttiwat, Ronald D. Berger, Charles J. Love Source Type: research

Incidence of atrial fibrillation in conjunction with breast cancer
Patients with breast cancer may have an increased incidence of atrial fibrillation (AF) because of the systemic inflammation induced by the cancer and side effects of treatments. (Source: Heart Rhythm)
Source: Heart Rhythm - January 28, 2019 Category: Cardiology Authors: Maria D ’Souza, Lærke Smedegaard, Christian Madelaire, Dorte Nielsen, Christian Torp-Pedersen, Gunnar Gislason, Morten Schou, Emil Fosbøl Source Type: research

Breast cancer and atrial fibrillation —A malignant combination?
Atrial fibrillation (AF) and breast cancer are common conditions and are reported to complicate each other ’s course. The incidence and prevalence of AF are increasing,1 with a lifetime risk of more than 1 in 3.2 Breast cancer is the most common malignant neoplasm in American women and is the second leading cause of cancer-related death in women behind lung cancer.3 In 2018, there will be an estimated 266,120 new cases of breast cancer and 40,920 breast cancer deaths.3 (Source: Heart Rhythm)
Source: Heart Rhythm - January 28, 2019 Category: Cardiology Authors: Ankur A. Karnik, Emelia J. Benjamin, Ludovic Trinquart Tags: EDITORIAL COMMENTARY Source Type: research

EP News: Basic and Translational
In a study reported by Zhu et  al (Circulation 2018;138:2682–2697, PMID 30571258), the investigators identified a rare, heterozygous ankyrin-B (ANK2) variant (p.Q1283H) in a proband with recurrent ventricular tachycardia. In order to determine the functional effects of the ANK2 variant, knockin (KI) mice harboring the p.Q1283 H variant were generated. The KI mice showed increased ventricular arrhythmias after catecholaminergic stimulation. Isoproterenol resulted in increased frequency of delayed afterdepolarizations and Ca2+ waves and sparks as well as decreased sarcoplasmic reticulum Ca2+ content in KI cardiomy...
Source: Heart Rhythm - January 28, 2019 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation
Glenn N. Levine, MD, FACC, FAHA, Chair (Source: Heart Rhythm)
Source: Heart Rhythm - January 28, 2019 Category: Cardiology Authors: Craig T. January, L. Samuel Wann, Hugh Calkins, Michael E. Field, Lin Y. Chen, Karen L. Furie, Joaquin E. Cigarroa, Paul A. Heidenreich, Joseph C. Cleveland, Katherine T. Murray, Patrick T. Ellinor, Julie B. Shea, Michael D. Ezekowitz, Cynthia M. Tracy, C Source Type: research