Real-world experience of leadless left ventricular endocardial cardiac resynchronization therapy: A multicenter international registry of the WiSE-CRT pacing system
Biventricular endocardial pacing (BiV ENDO) is a therapy for heart failure patients who cannot receive transvenous epicardial cardiac resynchronization therapy (CRT) or have not responded adequately to CRT. BiV ENDO CRT can be delivered by a new wireless LV ENDO pacing system (WiSE-CRT system; EBR Systems, Sunnyvale, CA), without the requirement for lifelong anticoagulation. (Source: Heart Rhythm)
Source: Heart Rhythm - March 8, 2020 Category: Cardiology Authors: Benjamin J. Sieniewicz, Timothy R. Betts, Simon James, Andrew Turley, Christian Butter, Martin Seifert, Lucas V.A. Boersma, Sam Riahi, Petr Neuzil, Mauro Biffi, Igor Diemberger, Pasquale Vergara, Martin Arnold, David T. Keane, Pascal Defaye, Jean-Claude D Source Type: research

Real World Experience of Leadless Left Ventricular Endocardial Cardiac Resynchronisation Therapy; A Multicenter International Registry of the WiSE-CRT Pacing System
Biventricular endocardial pacing (BiV ENDO) is a therapy for heart failure patients who cannot receive transvenous epicardial CRT or have failed to adequately respond. BiV ENDO CRT can be delivered by a new wireless LV ENDO pacing system (WiSE-CRT System, EBR Systems, Sunnyvale, California) without requiring lifelong anti-coagulation. (Source: Heart Rhythm)
Source: Heart Rhythm - March 8, 2020 Category: Cardiology Authors: Benjamin J. Sieniewicz, Timothy R. Betts, Simon James, Andrew Turley, Christian Butter, Martin Seifert, Lucas V.A. Boersma, Sam Riahi, Petr Neuzil, Mauro Biffi, Igor Diemberger, Pasquale Vergara, Martin Arnold, David T. Keane, Pascal Defaye, Jean-Claude D Source Type: research

A Longer Look at Preventing Cardiac Device Infection
The authors have no conflicts of interest to declare (Source: Heart Rhythm)
Source: Heart Rhythm - March 8, 2020 Category: Cardiology Authors: Andrew D. Krahn, David H. Birnie Source Type: research

To the Editor — Determinants of bipolar amplitude
Gaeta et  al1 describe the effect of the wavefront angle on the bipolar electrogram amplitude in relation to time difference between its component unipoles (Δt). The authors focus their work on a homogeneous tissue that had uniform conductivity. In border zone regions, where there are viable tissues of dif ferent conductivities mixed with fibrous tissue, there can be substantial detouring of the wavefront as it approaches individual unipoles. Therefore, 1-to-1 mathematical dependence of Δt on interelectrode spacing and conduction velocity is expected to be distorted. (Source: Heart Rhythm)
Source: Heart Rhythm - March 5, 2020 Category: Cardiology Authors: Sachin Nayyar, Stephane Mass é, Kumaraswamy Nanthakumar Tags: Letters to the Editor Source Type: research

Reply to the Editor — Determinants of Bipolar Amplitude
We thank Nayyar et  al for their interest in our work and for raising important comments. As addressed in our article, our computational and clinical models were indeed simplified systems compared to the complexity found in clinical conditions such as scar border zone. Our aim was not to characterize the morphology o f complex fractionated electrograms (EGMs) but rather to identify and validate the physical mechanism of directional sensitivity. Care should indeed be taken when extrapolating these results to more complex conditions, but we expect that the identified general principles of directional sensitivity w ill h...
Source: Heart Rhythm - March 5, 2020 Category: Cardiology Authors: Stephen Gaeta, Tristram D. Bahnson, Craig Henriquez Source Type: research

Heart failure with preserved ejection fraction meets atrial fibrillation: is enhanced inflammasome signaling a major common mechanism leading to these two frequent diseases?
Heart failure (HF) with preserved ejection fraction>50% (HFpEF) is a distinct disease entity, accounting for half of all HF diagnoses but with no available evidence-based treatment. How this specific form of HF develops and potentiates comorbidities is poorly understood, mainly because access to appropriate human samples is limited, and current experimental models cannot fully recapitulate the clinical HFpEF phenotype. HFpEF is a highly-heterogeneous condition, with several phenogroups distinguished by clinical and electrocardiography profile. (Source: Heart Rhythm)
Source: Heart Rhythm - March 5, 2020 Category: Cardiology Authors: Anke C. Fender, Dobromir Dobrev Source Type: research

Pharmacological norepinephrine transporter inhibition for the prevention of vasovagal syncope in young and adult subjects: A systematic review and meta-analysis
Vasovagal syncope (VVS) significantly reduces quality of life yet lacks effective medical therapies. Pharmacological norepinephrine transporter (NET) inhibition increases synaptic norepinephrine reuptake, which may be able to prevent hypotension, bradycardia, and syncope. (Source: Heart Rhythm)
Source: Heart Rhythm - March 5, 2020 Category: Cardiology Authors: Lucy Y. Lei, Satish R. Raj, Robert S. Sheldon Source Type: research

Letter to the Editor - Determinants of Bipolar Amplitude
Gaeta et al 1 derive effect of wavefront angle on the bipolar electrogram amplitude in relation to time-difference between its component unipoles ( Δt). The authors focussed their work on a homogenous tissue that had uniform conductivity. In borderzone regions, where there are viable tissues of different conductivities mixed with fibrous tissue, there can be substantial detouring of the wavefront as it approaches individual unipoles. Therefore , one-to-one mathematical dependence of Δt on interelectrode spacing and conduction velocity is expected to be distorted. (Source: Heart Rhythm)
Source: Heart Rhythm - March 5, 2020 Category: Cardiology Authors: Sachin Nayyar, Stephane Mass é, Kumaraswamy Nanthakumar Source Type: research

Author's reply to Letter to the Editor- Determinants of Bipolar Amplitude.
We thank Dr. Nayyar and colleagues for their interest in our work and for raising important comments. As addressed in our manuscript, our computational and clinical models were indeed simplified systems compared to the complexity found in clinical conditions such as scar border zone. Our aim was not to characterize the morphology of complex, fractionated electrograms (EGMs) but rather to identify and validate the physical mechanism of directional sensitivity. Care should indeed be taken when extrapolating these results to more complex conditions, but we expect the identified general principles of directional sensitivity wi...
Source: Heart Rhythm - March 5, 2020 Category: Cardiology Authors: Stephen Gaeta, Tristram D. Bahnson, Craig Henriquez Source Type: research

Stereotactic arrhythmia radioablation for refractory scar-related ventricular tachycardia
Recently, stereotactic radiosurgery has been applied to arrhythmias (stereotactic arrhythmia radioablation – STAR), with promising results reported in patients with refractory, scar-related VT, a cohort with known high morbidity and mortality. (Source: Heart Rhythm)
Source: Heart Rhythm - March 5, 2020 Category: Cardiology Authors: Carola Gianni, Douglas Rivera, J David Burkhardt, Brad Pollard, Edward Gardner, Patrick Maguire, Paul C. Zei, Andrea Natale, Amin Al-Ahmad Source Type: research

How to use intracardiac echocardiography to guide catheter ablation of outflow tract ventricular arrhythmias
The anatomy of the ventricular outflow tracts and semilunar valves as it pertains to catheter ablation of outflow tract ventricular arrhythmias (OTVAs) has been previously described.1 Assessment of semilunar valve and regional anatomy by fluoroscopy and angiography has limitations. Coronary arteries may be subject to damage from catheter ablation near the semilunar valves due to their proximity to sites of origin of OTVAs. Detailed intracardiac echocardiography (ICE) views of the semilunar valves may be useful to understand anatomy, catheter location, and coronary artery proximity and variations. (Source: Heart Rhythm)
Source: Heart Rhythm - March 5, 2020 Category: Cardiology Authors: Ashkan Ehdaie, Fangzhou Liu, Eugenio Cingolani, Xunzhang Wang, Sumeet S. Chugh, Michael Shehata Source Type: research

Generalizability of the CASTLE-AF Trial: Catheter Ablation for Patients with Atrial Fibrillation and Heart Failure in Routine Practice
In the CASTLE-AF trial, catheter ablation reduced the risk of death and heart failure (HF) hospitalization in patients with atrial fibrillation (AF) and HF by 40%. (Source: Heart Rhythm)
Source: Heart Rhythm - March 3, 2020 Category: Cardiology Authors: Peter A. Noseworthy, Holly K. Van Houten, Bernard J. Gersh, Douglas L. Packer, Paul A. Friedman, Nilay D. Shah, Shannon M. Dunlay, Konstantinos C. Siontis, Jonathan P. Piccini, Xiaoxi Yao Source Type: research

Cryoballoon Ablation Dosing: From the Bench to the Bedside and Back
To date, multiple modes of research have been leveraged to study the optimal cryoballoon ablation parameters to safely, effectively and efficiently isolate the pulmonary veins for the treatment of atrial fibrillation. Basic scientific investigation, pre-clinical studies, clinical observations, trials and more recently computational modelling have helped to generate and test new hypotheses for the advancement of cryoballoon treatment in patients with atrial fibrillation. In this review, we examine the data and evidence that have contributed to the development of patient-tailored dosing strategies that are currently utilized...
Source: Heart Rhythm - March 2, 2020 Category: Cardiology Authors: Arash Aryana, Kendra M. Braegelmann, Hae W. Lim, Kenneth A. Ellenbogen Source Type: research

Remarkable Reviewers
(Source: Heart Rhythm)
Source: Heart Rhythm - February 28, 2020 Category: Cardiology Source Type: research

Reviewer Thanks
(Source: Heart Rhythm)
Source: Heart Rhythm - February 28, 2020 Category: Cardiology Source Type: research

Exercise and Arrhythmic Risk in TMEM43 p.S358L Arrhythmogenic Right Ventricular Cardiomyopathy
High level exercise has been associated with a malignant phenotype in desmosomal and genotype negative forms of arrhythmogenic right ventricular cardiomyopathy (ARVC). This is the first study to examine this issue with ARVC secondary to the TMEM43 p.S358L mutation. (Source: Heart Rhythm)
Source: Heart Rhythm - February 27, 2020 Category: Cardiology Authors: Fr édéric L. Paulin, Kathleen A. Hodgkinson, Sarah MacLaughlan, Susan N. Stuckless, Christina Templeton, Suryakant Shah, Heather Bremner, Jason D. Roberts, Terry-Lynn Young, Patrick S. Parfrey, Sean P. Connors Source Type: research

EP News: Basic and Translational
Recent studies for cardiac cell-based therapy have demonstrated significant improvements in cardiac function. However, there are high incidences of ventricular arrhythmias in animal models of myocardial infarction (MI) injected with pluripotent stem cell-derived cardiomyocytes (PSC-CMs). The current study by Yu et  al (Sci Rep 2019; 9:9238; PMID: 31239508) examined the underlying mechanisms of arrhythmogenesis. The authors provided a comprehensive computational modeling of direct remuscularization approaches to cell therapy using multiscale 3D whole-heart modeling integrating representations of cell delivery and trans...
Source: Heart Rhythm - February 26, 2020 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP NEWS Source Type: research

Cardiac Resynchronization Therapy Modulates Peripheral Sympathetic Activity
Heightened sympathetic nerve activity has been associated with poorer prognosis in patients with reduced left ventricular systolic function (HFrEF). (Source: Heart Rhythm)
Source: Heart Rhythm - February 26, 2020 Category: Cardiology Authors: Pei-Lin Xiao, Cheng Cai, Pei Zhang, Christopher V. DeSimone, Dereen K. Ernst, Yue-Hui Yin, Peng-Sheng Chen, Yong-Mei Cha Source Type: research

Antitachycardia Pacing for Shock Prevention in Patients with Hypertrophic Cardiomyopathy and Ventricular Tachycardia
Hypertrophic cardiomyopathy (HCM) carries an increased risk of sudden death due to ventricular arrhythmias (VA). The implantable defibrillator (ICD) is a well-established therapy to treat VA. Monomorphic ventricular tachycardias (MVT) are frequent in HCM patients and suitable for antitachycardia pacing (ATP) termination. (Source: Heart Rhythm)
Source: Heart Rhythm - February 26, 2020 Category: Cardiology Authors: Paolo Domenico Dallaglio, Andrea di Marco, Zoraida Moreno Weidmann, Luisa Perez, Javier Alzueta, Arcadio Garc ía-Alberola, Ignacio Fernandez-Lozano, Ernesto Díaz-Infante, Aníbal Rodriguez, Nuria Basterra, David Calvo, Marcos Rodriguez Garcia, Marta Ace Source Type: research

Novel Re-expression of L-type Calcium Channel Cav1.3 in Left Ventricles of Failing Human Heart
Heart failure (HF) is a major public health problem. It is estimated that 5.7 million Americans over the age of 20 suffer from HF, with an incidence of 10 in 1000 for the population above 65 years of age.1 Despite the progress in HF management over the years, the molecular processes that underlie HF pathogenesis are still poorly understood suggesting a need for a comprehensive understanding of HF mechanisms to inform the development of novel targeted therapeutic interventions. We and others have previously shown that some fetal genes normally not expressed in the adult ventricles are re-expressed in the failing heart. (Source: Heart Rhythm)
Source: Heart Rhythm - February 26, 2020 Category: Cardiology Authors: Ujala Srivastava, Rachael Jennings-Charles, Yongxia S. Qu, Samuel Sossalla, Mohamed Chahine, Mohamed Boutjdir Source Type: research

Neurocardiogenic Syncope: Pacemaker or Cardioneuroablation?
Sutton et al. present an excellent review regarding pacemaker (PM) in the treatment of neurocardiogenic syncope (NCS)[1]. It is a detailed approach of great value for updating the electrophysiologist, cardiologist and neurologist. The results of the main PM randomized trials of NCS are accurately discussed. (Source: Heart Rhythm)
Source: Heart Rhythm - February 26, 2020 Category: Cardiology Authors: J.C. Pachon-M Source Type: research

Outcomes of Catheter Ablation of Ventricular Arrhythmia Originating from the Left Ventricular Summit: A Multicenter Study
Catheter ablation has been considered an effective strategy for the treatment of ventricular arrhythmias (VA) originating from the left ventricular summit (LVS). However, the inherent complexity of the anatomy of the LVS may result in failed ablation or recurrence of VA. (Source: Heart Rhythm)
Source: Heart Rhythm - February 26, 2020 Category: Cardiology Authors: Fa-Po Chung, Chin-Yu Lin, Yasuhiro Shirai, Piotr Futyma, Pasquale Santangeli, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Hung-Yu Chang, Francis E. Marchlinski, Shih-Ann Chen Source Type: research

EP News: Center-Specific Quality Improvement
In this EP News, we focus on the concept of center-specific quality improvement (QI). Large multicenter trials, observational studies, and practice guidelines provide us with the evidence and expert recommendations to standardize care delivery, inform QI initiatives, and improve outcomes across care delivery systems. However, at its core, QI is a continuous process and not simply the achievement of a specific threshold goal or the ability to define a center ’s care as “high quality.” Center-specific QI projects are developed and implemented at individual centers. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2020 Category: Cardiology Authors: Martin J. LaPage, James V. Freeman, Anne Marie Smith Source Type: research

Clinical and Procedural Characteristics Predicting Need for Chronotropic Support and Permanent Pacing Post-Heart Transplantation
Post-operative bradycardia can complicate orthotopic heart transplantation (OHT). Previous studies suggested donor age, surgical technique as possible risk factors. However, risk factors in the era of bicaval anastomosis have not been elucidated. (Source: Heart Rhythm)
Source: Heart Rhythm - February 25, 2020 Category: Cardiology Authors: Tuna Ustunkaya, Jackson J. Liang, Aung N. Lin, Yasuhiro Shirai, Maria Molina, Anjali T. Owens, Michael A. Acker, Christian A. Bermudez, Pasquale Santangeli, Saman Nazarian, Sanjay Dixit, Francis E. Marchlinski, David J. Callans Source Type: research

EP News: Allied Professionals
The Preventive Ablation of Ventricular Tachycardia in Patients with Myocardial Infarction (BERLIN VT) trial investigators (Willems et  al; Circulation 2020;Epub ahead of print, PMID 32000514) sought to assess the effect of timing of ablation for ventricular tachycardia (VT) in patients with previous myocardial infarction (MI). In this randomized trial conducted at 26 European centers, patients with history of previous MI and left ventricular ejection fraction 30%–50% who presented with life-threatening ventricular arrhythmias necessitating implantable cardioverter–defibrillator (ICD) implantation were rand...
Source: Heart Rhythm - February 24, 2020 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

EP News: Clinical
Voskoboinik et  al (N Engl J Med 2020;382:20–28, PMID 31893513) conducted a multicenter, prospective, open-label, randomized controlled trial to evaluate the effects of alcohol abstinence on atrial fibrillation (AF). Adults who consumed 10 or more standard drinks per week and who had paroxysmal or persistent A F in sinus rhythm at baseline were randomly assigned in a 1:1 ratio to either abstain from alcohol or continue their usual alcohol consumption. The 2 primary endpoints were freedom from recurrence of AF and total AF burden (proportion of time in AF) during 6 months of follow-up. (Source: Heart Rhythm)
Source: Heart Rhythm - February 24, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Case Reports
Detection of atrial fibrillation (AF) in patients with cryptogenic stroke is critical and impacts treatment approaches. Multiple tools now are available that can detect AF with high sensitivity and specificity. However, continuous monitors often are required to detect subclinical, short, or infrequent AF episodes. Implantable cardiac monitors are expensive, require surgical insertion, and monitor for 2 –3 years on average. These limitations and the lack of broad availability of monitors prompt the need to consider novel approaches to AF risk assessment in patients post cryptogenic stroke. (Source: Heart Rhythm)
Source: Heart Rhythm - February 24, 2020 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

Predictors of Adverse Outcome in Patients with Frequent Premature Ventricular Complexes: the ABC-VT Risk Score
No independently-validated score currently exists for risk stratification of patients with frequent premature ventricular contractions (PVCs). (Source: Heart Rhythm)
Source: Heart Rhythm - February 24, 2020 Category: Cardiology Authors: Aleksandr Voskoboinik, Alexios Hadjis, Christina Alhede, Sung Il Im, Hansu Park, Joshua Moss, Gregory M. Marcus, Henry Hsia, Byron Lee, Zian Tseng, Randall Lee, Melvin Scheinman, Vasanth Vedantham, Eric Vittinghoff, Kyoung-Min Park, Edward P. Gerstenfeld Source Type: research

Intentional nontherapy in long QT syndrome
International guidelines advise universal beta-blocker therapy as either a class I (symptomatic or QTc ≥470 ms) or class II (asymptomatic and QTc (Source: Heart Rhythm)
Source: Heart Rhythm - February 23, 2020 Category: Cardiology Authors: Ciorsti J. MacIntyre, Ram K. Rohatgi, Alan M. Sugrue, J. Martijn Bos, Michael J. Ackerman Source Type: research

Intentional Non-Therapy in Long QT Syndrome (LQTS)
International guidelines advise universal beta blocker therapy as either a class I (symptomatic or QTc> 470 ms) or class II recommendation (asymptomatic and QTc (Source: Heart Rhythm)
Source: Heart Rhythm - February 23, 2020 Category: Cardiology Authors: Ciorsti J. MacIntyre, Ram K. Rohatgi, Alan M. Sugrue, J. Martijn Bos, Michael J. Ackerman Source Type: research

Pediatric Unexplained Cardiac Arrest: When No Answer is Also an Answer
Although any pediatric cardiac arrest is a devastating event, cases in which a cause not is identified leave families and practitioners with many more questions than answers. The uncertainties of prognosis, optimal management strategies, and lifestyle recommendations for the patient as well as the potential risk for family members can be particularly problematic. Thus, in effort to establish an etiology, extraordinary measures are often taken to evaluate pediatric survivors of unexplained cardiac arrest (UCA). (Source: Heart Rhythm)
Source: Heart Rhythm - February 23, 2020 Category: Cardiology Authors: Michael J. Silka, Allison C. Hill Source Type: research

Efficacy and Safety of Combined Endocardial/Epicardial Catheter Ablation for Ventricular Tachycardia in Chagas Disease. A Randomized Controlled Study
Epicardial mapping and ablation are frequently necessary to eliminate ventricular tachycardia (VT) in Chagas disease patients. Nonetheless, there are no randomized controlled trials demonstrating the role of this strategy. (Source: Heart Rhythm)
Source: Heart Rhythm - February 18, 2020 Category: Cardiology Authors: Cristiano F. Pisani, Jorge Romero, Sissy Lara, Carina Hardy, Muhieddine Chokr, Luciana Sacilotto, Tan Chen Wu, Francisco Darrieux, Denise Hachul, Roberto Kalil-Filho, Luigi Di Biase, Mauricio Scanavacca Source Type: research

Ablation Strategies for Intramural Ventricular Arrhythmias
Intramural origin of ventricular arrhythmias is one of the reasons for failure of catheter ablation, especially in non-ischemic substrates. Conventional unipolar ablation has limited efficacy for creation of deep, transmural lesions in the ventricular myocardium and alternative ablation strategies have been developed to overcome this problem. These novel approaches include simultaneous unipolar ablation, bipolar ablation, use of low-ionic irrigant solution, needle ablation and ethanol ablation. This review provides an overview of each one of these techniques, including their main advantages and limitations. (Source: Heart Rhythm)
Source: Heart Rhythm - February 18, 2020 Category: Cardiology Authors: Victor Neira, Pasquale Santangeli, Piotr Futyma, John Sapp, Miguel Valderrabano, Fermin Garcia, Andres Enriquez Source Type: research

The World-Wide Randomized Antibiotic Envelope Infection Prevention (WRAP-IT) Trial: Long-Term Follow-Up
The WRAP-IT trial reported a 40% reduction in major CIED infection within 12 months of the procedure with the antibacterial-eluting envelope (TYRX). (Source: Heart Rhythm)
Source: Heart Rhythm - February 18, 2020 Category: Cardiology Authors: Suneet Mittal, Bruce L. Wilkoff, Charles Kennergren, Jeanne Poole, Ralph Corey, Frank Bracke, Antonio Curnis, Kamel Addo, Joaquin Martinez-Arraras, Ziad Issa, Calum Redpath, Jean Moubarak, Surinder Kaur Khelae, Lucas V.A. Boersma, Panagiotis Korantzopoulo Source Type: research

Epidemiology of cardiac implantable electronic device infections in the United States: a population-based cohort study
Trends in cardiac implantable electronic device (CIED) infections have been studied previously. However, coding for administrative data is more granular in contemporary datasets and indications for CIED implantations have expanded. (Source: Heart Rhythm)
Source: Heart Rhythm - February 18, 2020 Category: Cardiology Authors: Elissa Rennert-May, Derek Chew, Shengjie Lu, Angel Chu, Vikas Kuriachan, Ranjani Somayaji Source Type: research

Appropriate and Inappropriate Shocks in Hypertrophic Cardiomyopathy Patients with Subcutaneous Implantable Cardioverter Defibrillators: An International Multi-Center Study
Subcutaneous implantable cardioverter defibrillators (S-ICD) are attractive for preventing sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) as they mitigate risks of transvenous leads in young patients. However, S-ICDs may be associated with increased inappropriate shock (IAS) in HCM patients. (Source: Heart Rhythm)
Source: Heart Rhythm - February 17, 2020 Category: Cardiology Authors: Babak Nazer, Zack Dale, Gianmarco Carrassa, Nosheen Reza, Tuna Ustunkaya, Nikolaos Papoutsidakis, Andrew Gray, Stacey J. Howell, Miriam R. Elman, Paolo Pieragnoli, Giuseppe Ricciardi, Daniel Jacoby, David S. Frankel, Anjali Owens, Iacopo Olivotto, Stephen Source Type: research

Subcutaneous Nerve Stimulation Reduces Sympathetic Nerve Activity in Ambulatory Dogs with Myocardial Infarction
Subcutaneous nerve stimulation (ScNS) remodels the stellate ganglion and reduces stellate ganglion nerve activity (SGNA) in dogs. Acute myocardial infarction (MI) increases SGNA through nerve sprouting. (Source: Heart Rhythm)
Source: Heart Rhythm - February 13, 2020 Category: Cardiology Authors: Yuan Yuan, Ye Zhao, Johnson Wong, Wei-Chung Tsai, Zhaolei Jiang, Ryan A. Kabir, Seongwook Han, Changyu Shen, Michael C. Fishbein, Lan S. Chen, Zhenhui Chen, Thomas H. Everett, Peng-Sheng Chen Source Type: research

Mechanisms of atrial fibrillation in aged rats with heart failure with preserved ejection fraction
Although ∼20% of the elderly develop atrial fibrillation (AF), little is known about the mechanisms. Heart failure with preserved ejection fraction (HFpEF), which is associated with AF, is more common in aged females than in males (Source: Heart Rhythm)
Source: Heart Rhythm - February 13, 2020 Category: Cardiology Authors: Thassio Ricardo Ribeiro Mesquita, Rui Zhang, Geoffrey de Couto, Jackelyn Valle, Lizbeth Sanchez, Russell G. Rogers, Kevin Holm, Weixin Liu, Eduardo Marb án, Eugenio Cingolani Source Type: research

Clinical characteristics and determinants of the phenotype in TMEM43 arrhythmogenic right ventricular cardiomyopathy type 5
Arrhythmogenic right ventricular cardiomyopathy type V (ARVC-5) is the most aggressive heterozygous form of ARVC. It is predominantly caused by a fully penetrant mutation (p.S358L) in the nondesmosomal gene TMEM43 —endemic to Newfoundland, Canada. To date, all familial cases reported worldwide share a common ancestral haplotype. It is unknown whether the p.S358L mutation by itself causes ARVC-5 or whether the disease is influenced by genetic or environmental factors. (Source: Heart Rhythm)
Source: Heart Rhythm - February 12, 2020 Category: Cardiology Authors: Fernando Dominguez, Esther Zorio, Juan Jimenez-Jaimez, Rafael Salguero-Bodes, Robert Zwart, Esther Gonzalez-Lopez, Pilar Molina, Francisco Berm údez-Jiménez, Juan F. Delgado, Aitana Braza-Boïls, Belen Bornstein, Jorge Toquero, Javier Segovia, J. Peter Source Type: research

Clinical characteristics and determinants of phenotype in TMEM43 Arrhythmogenic right ventricular cardiomyopathy type 5.
Arrhythmogenic right ventricular cardiomyopathy type V (ARVC-5) is the most aggressive heterozygous form of ARVC. It is predominantly caused by a fully penetrant mutation (p.S358L) in the non-desmosomal gene TMEM43 – endemic to Newfoundland, Canada. To date, all familial cases reported worldwide share a common ancestral haplotype. It is unknown whether the p.S358L mutation by itself causes ARVC-5 or if the disease is influenced by genetic or environmental factors. (Source: Heart Rhythm)
Source: Heart Rhythm - February 12, 2020 Category: Cardiology Authors: Fernando Dominguez, Esther Zorio, Juan Jimenez-Jaimez, Rafael Salguero-Bodes, Robert Zwart, Esther Gonzalez-Lopez, Pilar Molina, Francisco Berm údez-Jiménez, Juan F. Delgado, Aitana Braza-Boïls, Belen Bornstein, Jorge Toquero, Javier Segovia, J Peter V Source Type: research

Programming implantable cardioverter –defibrillator in primary prevention: Guideline concordance and outcomes
Inappropriate therapy is a common adverse effect in patients with an implantable cardioverter –defibrillator (ICD) that may be prevented by appropriate programming. (Source: Heart Rhythm)
Source: Heart Rhythm - February 10, 2020 Category: Cardiology Authors: Teetouch Ananwattanasuk, Tanyanan Tanawuttiwat, Ronpichai Chokesuwattanaskul, Sangeeta Lathkar-Pradhan, Waseem Barham, Hakan Oral, Ranjan K. Thakur, Krit Jongnarangsin Source Type: research

A paradigm shift to address occupational health risks in the EP laboratory
The electrophysiology (EP) laboratory has long been recognized as an environment for delivery of sophisticated health care to patients with arrhythmias that are often complex and found in the setting of complex cardiac conditions. While advances in our field have improved patient outcomes, significant health hazards still endure for the EP physicians and laboratory staff. In particular, repeated exposure to ionizing radiation, even at low levels, may increase the lifetime risk of malignancy.1 At the same time, wearing radiation protective garments exposes laboratory personnel to orthopedic risks associated with carrying th...
Source: Heart Rhythm - February 10, 2020 Category: Cardiology Authors: David E. Haines Tags: Editorial Commentary Source Type: research

Programming Implantable Cardioverter Defibrillator in Primary Prevention: Guideline Concordance and Outcomes
Inappropriate therapy is a common adverse effect in patients with implantable cardioverter defibrillator (ICD) that may be prevented by appropriate programming. (Source: Heart Rhythm)
Source: Heart Rhythm - February 10, 2020 Category: Cardiology Authors: Teetouch Ananwattanasuk, Tanyanan Tanawuttiwat, Ronpichai Chokesuwattanaskul, Sangeeta Lathkar-Pradhan, Waseem Barham, Hakan Oral, Ranjan K. Thakur, Krit Jongnarangsin Source Type: research

Clinical and functional reappraisal of alleged type 5 long QT syndrome: Causative genetic variants in the KCNE1-encoded minK β-subunit
KCNE1 loss-of-function variants cause type 5 long QT syndrome (LQT5). However, most alleged LQT5-causative KCNE1 variants were identified before the true rate of background genetic variation was appreciated fully. (Source: Heart Rhythm)
Source: Heart Rhythm - February 9, 2020 Category: Cardiology Authors: Ramin Garmany, John R. Giudicessi, Dan Ye, Wei Zhou, David J. Tester, Michael J. Ackerman Source Type: research

Clinical and Functional Reappraisal of Alleged Type 5 Long QT Syndrome-Causative Genetic Variants in the KCNE1-Encoded minK β-Subunit
KCNE1 loss-of-function variants cause type 5 long QT syndrome (LQT5). However, most alleged LQT5-causative KCNE1 variants were identified before the true rate of background genetic variation was appreciated fully. (Source: Heart Rhythm)
Source: Heart Rhythm - February 9, 2020 Category: Cardiology Authors: Ramin Garmany, John R. Giudicessi, Dan Ye, Wei Zhou, David J. Tester, Michael J. Ackerman Source Type: research

Pacing in vasovagal syncope: Physiology, pacemaker sensors, and recent clinical trials —Precise patient selection and measurable benefit
Asystole (a lack of ventricular complexes for a period of>3 seconds) occurs in vasovagal syncope (VVS), known as severe cardioinhibition.1 It usually follows hypotension and may even occur after loss of consciousness (LOC).2 It is tempting for the electrophysiologist, having seen asystole on tilt or implantable loop recorder (ILR) in association with syncope, to offer permanent pacing to combat bradycardia/asystole. This approach fails to address the physiology of the vasovagal reflex, in particular the relationship between timing of asystole and LOC and, furthermore, the details of how pacing is triggered by sensing of...
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Richard Sutton, Jelle S.Y. de Jong, Julian M. Stewart, Artur Fedorowski, Frederik J. de Lange Tags: Contemporary Review Source Type: research

Percutaneous Left Atrial Appendage Closure in Patients With Prior Intracranial Bleeding and Thromboembolism
Percutaneous left atrial appendage closure (LAAC) is an alternative treatment in atrial fibrillation patients with contraindication to oral anticoagulation. Still, patient selection criteria for LAAC are debated. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Jussi-Pekka Pouru, Juha Lund, Samuli Jaakkola, Tuija Vasankari, Fausto Biancari, Antti Saraste, K.E. Juhani Airaksinen Source Type: research

Pacing in vasovagal syncope: physiology, pacemaker sensors and recent clinical trials. Precise patient selection and measurable benefit.
The role of pacing in vasovagal syncope (VVS) is considered from a physiological basis. Most VVS patients lose consciousness due to hypotension before severe bradycardia/asystole occurs. Patients that benefit from dual-chamber pacing are typically older with highly symptomatic, late-onset, frequent and severe syncope with short/no prodrome and documented severe cardioinhibition. Tilt-testing is of value in patients with recurrent unexplained syncope to identify important hypotensive susceptibility stemming from reduced venous return and stroke volume. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Richard Sutton, Jelle SY. de Jong, Julian M. Stewart, Artur Fedorowski, Frederik J. de Lange Source Type: research

Initially Unexplained Cardiac Arrest in Children and Adolescents: A National Experience from the Canadian Pediatric Heart Rhythm Network
Unexplained cardiac arrest (UCA) is rare in children. Despite investigations, the etiology in up to half remains unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Taylor Cunningham, Thomas M. Roston, Sonia Franciosi, Michelle Chang Liu, Joseph Atallah, Carolina A. Escudero, Sharmila Udupa, Jason D. Roberts, Santokh Dhillon, Frederic Dallaire, Anne Fournier, Meena Fatah, Robert Hamilton, Shubhayan Sanatani Source Type: research

A Novel Method of Demonstrating Dual Atrioventricular Nodal Physiology in the Clinical Electrophysiology Lab
This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The author has no conflict of interest in the generation of this report. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Patrick Tchou Source Type: research