Guideline-Directed Medical Therapy Before and After Primary Prevention Implantable Cardioverter Defibrillator Implantation in New Zealand (ANZACS-QI 66).

Introduction: Guidelines recommend angiotensin converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB)/angiotensin receptor neprilysin inhibitors (ARNI); beta blockers; and mineralocorticoid receptor antagonists (MRA) in patients with symptomatic heart failure and reduced left ventricular ejection fraction before consideration of primary prevention implantable cardioverter defibrillator (ICD). This study aims to investigate dispensing rates of guideline-directed medical therapy (GDMT) before and after primary prevention ICD implantation in New Zealand.

Methods: All patients receiving a primary prevention ICD between 2009 and 2018 were identified using nationally collected data on all public hospital admissions in New Zealand.

Search for Low-Mass Axion Dark Matter with ABRACADABRA-10 cm.

Two of the most pressing questions in physics are the microscopic nature of the dark matter that comprises 84% of the mass in the Universe and the absence of a neutron electric dipole moment. These questions would be resolved by the existence of a hypothetical particle known as the quantum chromodynamics (QCD) axion. In this work, we probe the hypothesis that axions constitute dark matter, using the ABRACADABRA-10 cm experiment in a broadband configuration, with world-leading sensitivity.

Impact of cardiac resynchronisation therapy on burden of hospitalisations and survival: a retrospective observational study in the Northern Region of New Zealand.

Objective: Cardiac resynchronisation therapy (CRT) devices have been shown to improve heart failure (HF) symptoms, survival and improve quality of life (QoL). We evaluated the overall impact of CRT on recurrent hospitalisations and survival in real-world patients with HF.

Design: Retrospective observational study.

Outcomes of patients with heart failure after primary prevention ICD unit generator replacement.

Objective: Data describing outcomes after implantable cardioverter-defibrillator (ICD) unit generator replacement in patients with heart failure (HF) with primary prevention devices are limited.

Method: Data on patients with HF who underwent primary prevention ICD/cardiac resynchronisation therapy-defibrillator (CRT-D) implantation from 2007 until mid-2015 who subsequently received unit generator replacement were analysed. Outcomes assessed were mortality, appropriate ICD therapy and shock, and procedural complications.

Utilization of cardiac resynchronization therapy in patients with heart failure in the Northern Region of New Zealand.

Background: Cardiac resynchronization therapy (CRT) has been shown to improve morbidity and mortality for heart failure (HF) patients. Little is known about the trends in CRT use and outcomes of these patients in New Zealand.

Method: Mortality, hospitalization events and complications in HF patients in the Northern Region of New Zealand implanted with CRT devices from Jan-2007 to June-2015 were reviewed.

Long-term outcomes of heart failure patients who received primary prevention implantable cardioverter-defibrillator: An observational study.

Background: Implantable cardioverter-defibrillator (ICD) therapy is indicated for selected heart failure patients for the primary prevention of sudden cardiac death. Little is known about the outcomes in patients selected for primary prevention device therapy in the northern region of New Zealand.

Method: Heart failure patients with systolic dysfunction who underwent primary prevention ICD/cardiac resynchronization therapy-defibrillator (CRT-D) implantation between January 1, 2007, and June 1, 2015, were included.

Gender differences in the use of primary prevention ICDs in New Zealand patients with heart failure.

Objective: Women have been under-represented in randomised clinical trials for primary prevention implantable cardioverter defibrillators (ICDs), and there are concerns about the efficacy of devices between genders. Our study aimed to investigate gender differences in the use of primary prevention ICD in patients with heart failure from the northern region of New Zealand.

Methods: Patients with heart failure with systolic dysfunction who received primary prevention ICD/cardiac resynchronisation therapy-defibrillator (CRT-D) in the northern region of New Zealand from 1 January 2007 to 1 June 2015 were included.

ECG-derived spatial QRS-T angle is associated with ICD implantation, mortality and heart failure admissions in patients with LV systolic dysfunction.

Background: Increased spatial QRS-T angle has been shown to predict appropriate implantable cardioverter defibrilIator (ICD) therapy in patients with left ventricular systolic dysfunction (LVSD). We performed a retrospective cohort study in patients with left ventricular ejection fraction (LVEF) 31-40% to assess the relationship between the spatial QRS-T angle and other advanced ECG (A-ECG) as well as echocardiographic metadata, with all-cause mortality or ICD implantation for secondary prevention.

Methods: 534 patients ≤75 years of age with LVEF 31-40% were identified through an echocardiography reporting database.

Assessment of oesophageal position by direct visualization with luminal contrast compared with segmentation from pre-acquired computed tomography scan-implications for ablation strategy.

Aims: Atrio-oesophageal fistula is a rare but often fatal complication of catheter ablation for atrial fibrillation (AF). Various strategies are employed to evaluate the oesophageal position in relation to the posterior left atrium (LA). These include segmentation of the oesophagus from a pre-acquired computed tomography (CT) scan and direct, real-time assessment of the oesophageal position using contrast at the time of the procedure.

Brugada ECG Pattern Unmasked by IV Flecainide in an Individual with Idiopathic Fascicular Ventricular Tachycardia.

A 45-year old man presents with stable monomorphic ventricular tachycardia. He had previously been diagnosed with idiopathic fascicular ventricular tachycardia. Intravenous flecainide results in termination of his tachycardia but unmasks a latent type 1 Brugada ECG pattern not seen on his resting ECG.

Vertebral artery dissection secondary to defibrillation threshold testing.

We report a case of vertebral artery dissection presenting 2 days after ICD implantation with defibrillation threshold testing in a 57-year-old man with ischemic cardiomyopathy. The association between vertebral artery dissection and neck trauma and the role of DFT testing in ICD implantation are discussed.

Pulmonary venous isolation versus additional substrate modification as treatment for paroxysmal atrial fibrillation.

Background: Pulmonary vein isolation alone is ineffective in maintaining sinus rhythm in up to one third of patients with paroxysmal atrial fibrillation (AF). We compared pulmonary vein antral isolation plus additional limited ablation along the inferoposterior left atrium and epicardially within the adjacent coronary sinus (PVAI + CS) to pulmonary vein antral isolation (PVAI) alone in patients with paroxysmal AF.

Methods: Forty-two consecutive patients with paroxysmal AF were prospectively randomized to PVAI vs.

Hyperuricemia and adverse outcomes in cardiovascular disease: potential for therapeutic intervention.

High uric acid levels are associated with increased morbidity and mortality rates in cardiovascular disease. In this article we explore the relationship between cardiovascular disease and xanthine oxidase activity. We look at the evidence that uric acid and its production via the xanthine oxidase pathway, may directly contribute to this increased cardiovascular risk.