Influence of PACE score and conduction disturbances in the incidence of early new onset atrial fibrillation after typical atrial flutter ablation.

Purpose: Patients undergoing cavotricuspid isthmus (CTI) ablation for typical flutter (AFL) have a high incidence of new onset atrial fibrillation (AF). We aimed to analyze the influence of PACE score to predict new onset AF in this subset of patients to stratify thromboembolic risk.

Methods: Between 2017 and 2019, patients undergoing CTI ablation for AFL and without history of AF were prospectively included.

Merged two-way mapping technique: an alternative 3D electroanatomical mapping approach to guide challenging ablation procedures of accessory pathways with bidirectional conduction properties.

Background: Catheter ablation of accessory pathways (AP) with bidirectional conduction may be challenging due to issues related to anatomical course or location.

Objective: We describe an alternative electro-anatomical mapping technique which aims at depicting the entire anatomic course of the AP from the atrial toward the ventricular insertion in order to guide catheter ablation.

Methods: Twenty consecutive patients with confirmed bidirectional AP conduction and at least one previous ablation procedure or para-Hisian location were included.

Mapping potentials adjacent to the cavo-tricuspid isthmus ablation line during incremental pacing: A feasible and highly accurate maneuver to confirm complete CTI conduction block.

Background: The diagnostic accuracy of incremental atrial pacing (IP) to determine complete cavo-tricuspid isthmus (CTI) block during typical atrial flutter (AFL) ablation is limited by both an extensive/nonlinear ablation and/or the presence of intra-atrial conduction delay elsewhere in the right atrium. We examined the diagnostic performance of an IP variant based on the assessment of the atrial potentials adjacent to the ablation line which aims at overcoming both limitations.

Methods: From a prospective population of 108 consecutive patients, 15 were excluded due to observation of inconclusive CTI ablation potentials precluding for a straight comparison between the IP maneuver and its variant.

Ultra-early continuous cardiac monitoring improves atrial fibrillation detection and prognosis of patients with cryptogenic stroke.

Background And Purpose: Subclinical atrial fibrillation (AF) is known to underlie a number of cases of cryptogenic stroke (CrS). However, there is need to define the most effective strategy for AF detection. The diagnostic usefulness was analysed of a strategy based on ultra-early continuous monitoring in patients with CrS in terms of AF detection, oral anticoagulation treatment and stroke recurrence, in comparison to a standard outpatient strategy.

Double factor single shot to diminish complications in cryoballoon ablation procedures for atrial fibrillation.

Purpose: Cryoballoon ablation (CBA) has become a standard treatment for recurrent atrial fibrillation (AF). There is need for improved CBA protocols. We aimed to demonstrate that a new protocol including minimum temperature (minT) reached could reduce procedure times and complications.

Simple predictors for new onset atrial fibrillation.

Background: Predicting atrial fibrillation is a tremendous challenge. Only few studies have included 24h-Holter monitoring characteristics to predict new onset AF (NOAF).

Objectives: Our aim is to define simple predictors for NOAF.

Burning the Gap: Electrical and Anatomical Basis of the Incremental Pacing Maneuver for Cavotricuspid Isthmus Block Assessment.

Introduction: The incremental pacing (IP) maneuver is a highly specific technique that improves the ability to confirm complete CTI conduction block during typical atrial flutter (AFL) ablation, and reduces long-term AFL recurrences. The purpose of this study is to assess the performance of new catheters equipped with additional high precision bipoles (AHPB) to allow the visualization of the cavotricuspid isthmus (CTI) conduction gap and to compare them with the IP maneuver.

Methods And Results: Twenty consecutive patients undergoing catheter ablation of the CTI for AFL were included.

Risk of pacemaker implantation after uneventful successful cavotricuspid isthmus radiofrequency ablation in patients with common atrial flutter.

Introduction: Little is known about the risk of pacemaker implantation after common atrial flutter ablation in the long-term.

Methods: We retrospectively reviewed the electrophysiology laboratory database at two Spanish University Hospitals from 1998 to 2012 to identify patients who had undergone successful ablation for cavotricuspid dependent atrial flutter. Cox regression analysis was used to examine the risk of pacemaker implantation.

Update in cardiac arrhythmias and pacing.

This article discusses the main advances in cardiac arrhythmias and pacing published between 2013 and 2014. Special attention is given to the interventional treatment of atrial fibrillation and ventricular arrhythmias, and on advances in cardiac pacing and implantable cardioverter defibrillators, with particular reference to the elderly patient.

Implantable Cardioverter-defibrillator Therapy for Hypertrophic Cardiomyopathy: Usefulness in Primary and Secondary Prevention.

Introduction And Objectives: Hypertrophic cardiomyopathy is a frequent cause of sudden death. Clinical practice guidelines indicate defibrillator implantation for primary prevention in patients with 1 or more risk factors and for secondary prevention in patients with a history of aborted sudden death or sustained ventricular arrhythmias. The aim of the present study was to analyze the follow-up of patients who received an implantable defibrillator following the current guidelines in nonreferral centers for this disease.

Spatial resolution of defibrillator electrograms to detect distinct exit sites of scar-related ventricular tachycardia.

Background: Analysis of implantable cardioverter-defibrillator electrograms (IEGMs) with pacing along the scar edge is often used to approximate distinct exit sites of scar-related ventricular tachycardia (VT). We evaluated the spatial resolution of IEGMs in identifying distinct exit sites of scar-related VT.

Methods And Results: Seventeen patients with scar-related VT were included.

Pseudoatrial fibrillation during pacemaker interrogation: what is the mechanism?

Background: Normal pacemaker response to magnet and programmer is almost universal and helps to interpret basal rhythm.

Methods And Results: In this report, we report an undescribed atypical magnet response due to an internal cross-talk with atrial oversensing during a specific part of interrogation, simulating atrial fibrillation.

Ultrasonic value is not useful to detect bone changes following a biliopancreatic diversion.

To study the evolution of the bone mass by ultrasonic transmission after biliopancreatic diversion. Forty eight morbid obese patients were prospectively studied during 36 months following the Larrad biliopancreatic diversion. The bone metabolism was studied by PTHi and the urinary pirydinolines.

High incidence of TIMI flow 0 to I in patients with ST-elevation myocardial infarction without electrocardiographic lytic criteria.

Background: Most patients with ST-elevation myocardial infarction fulfilling ST-segment elevation (STE) lytic criteria present an occluded culprit artery but the occlusion rate in those with minimal STE (minSTE) not fulfilling lytic criteria is unknown.

Methods: In 63 patients with minSTE (mean STE:1.2 +/- 0.