Electrophysiological efficacy of temperature-controlled bipolar radiofrequency.

Objective: Clinical success of atrial fibrillation (AF) ablation depends on persistent block of electrical conduction across the ablation lines. The fate of ablations performed with temperature-controlled bipolar radiofrequency (RF) is unknown. The purpose of this study was to validate the electrophysiological (EP) efficacy of these lesions, recording pulmonary vein isolation (PVI) after open chest ablation, in the human being.

Long-term results of surgical minimally invasive pulmonary vein isolation for paroxysmal lone atrial fibrillation.

Aims: Transcatheter pulmonary vein ablation is the current treatment of choice for symptomatic drug-refractory atrial fibrillation (AF). Video-assisted surgical pulmonary vein isolation (sPVI) is an alternative therapy to percutaneous ablation for the treatment of AF. Long-term results of sPVI are currently unknown.

Impact of a chronic total occlusion in an infarct-related artery on the long-term outcome of ventricular tachycardia ablation.

Introduction: In patients with a prior myocardial infarction (MI), angiographic predictors of ventricular tachycardia (VT) recurrence after ablation are lacking. Recently, a proarrhythmic effect of a chronic total occlusion (CTO) in a coronary artery has been suggested.

Methods And Results: A total of 191 patients with prior MI were referred to our Hospital between 2010 and June 2013 for a first ablation of VT.

Draft Genome Sequence of Pseudomonas mediterranea Strain CFBP 5447T, a Producer of Filmable Medium-Chain-Length Polyhydroxyalkanoates.

Pseudomonas mediterranea strain CFBP 5447(T) is a phytopathogenic bacterium isolated from tomato plants affected by pith necrosis disease. Moreover, its ability to produce medium-chain-length polyhydroxyalkanoates (mcl-PHAs) in culture from different carbon sources and valuable microbial products, such as cyclic lipopeptides, has been well documented. Here, we report the first draft genome sequence of this species.

Application of ripple mapping to visualize slow conduction channels within the infarct-related left ventricular scar.

Background: Ripple mapping (RM) displays each electrogram at its 3-dimensional coordinate as a bar changing in length according to its voltage-time relationship with a fiduciary reference. We applied RM to left ventricular ischemic scar for evidence of slow-conducting channels that may act as ventricular tachycardia (VT) substrate.

Methods And Results: CARTO-3© (Biosense Webster Inc, Diamond Bar, CA) maps in patient undergoing VT ablation were analyzed on an offline MatLab RM system.

Pseudomonas corrugata crpCDE is part of the cyclic lipopeptide corpeptin biosynthetic gene cluster and is involved in bacterial virulence in tomato and in hypersensitive response in Nicotiana benthamiana.

Pseudomonas corrugata CFBP 5454 produces two kinds of cyclic lipopeptides (CLPs), cormycin A and corpeptins, both of which possess surfactant, antimicrobial and phytotoxic activities. In this study, we identified genes coding for a putative non-ribosomal peptide synthetase and an ABC-type transport system involved in corpeptin production. These genes belong to the same transcriptional unit, designated crpCDE.

Electrical storm induced by cardiac resynchronization therapy is determined by pacing on epicardial scar and can be successfully managed by catheter ablation.

Background: The mechanism of cardiac resynchronization therapy (CRT)-induced proarrhythmia remains unknown. We postulated that pacing from a left ventricular (LV) lead positioned on epicardial scar can facilitate re-entrant ventricular tachycardia. The aim of this study was to investigate the relationship between CRT-induced proarrhythmia and LV lead location within scar.

New diagnostic criteria for identifying left-sided ventricular ectopy using non-contact mapping and virtual unipolar electrogram analysis.

Aims: To assess the efficacy of non-contact mapping for outflow tract premature ventricular contraction (PVC) and ventricular tachycardia (VT) ablation in patients without structural heart disease and a precordial transition at V3 or later and to determine the diagnostic accuracy of new virtual unipolar electrogram criteria for distinguishing left from right-sided foci using a multi-electrode array positioned within the right ventricular outflow tract.

Methods And Results: Virtual unipolar electrograms at early activation (EA) and break out (BO) sites in 100 patients (36 left-sided foci) who underwent acutely successful outflow tract ablation were analysed and voltage and timing-based criteria measured. The best performing parameters were then re-assessed in 41 patients (14 left-sided) prospectively.

Noninducibility in postinfarction ventricular tachycardia as an end point for ventricular tachycardia ablation and its effects on outcomes: a meta-analysis.

Background: Although ventricular tachycardia (VT) ablation is a widely used therapy for patients with VT, the ideal end points for this procedure are not well defined. We performed a meta-analysis of the published literature to assess the predictive value of noninducibility of postinfarction VT for long-term outcomes after VT ablation.

Methods And Results: We performed a systematic review of MEDLINE (1950-2013), EMBASE (1988-2013), the Cochrane Controlled Trials Register (Fourth Quarter, 2012), and reports presented at scientific meetings (1994-2013).

Multiple sclerosis, solitary sclerosis or something else?

Background: Inflammatory demyelinating diseases of the central nervous system represent a wide spectrum of entities and their classification cannot currently be regarded complete.

Objective: Our aim is to describe a series of patients presenting with progressive myelopathy associated to a single demyelinating lesion of the spinal cord.

Methods: We identified the patients affected by chronic progressive spinal cord dysfunction related to a single spinal cord lesion not satisfying the diagnostic criteria for any of the currently defined diseases.

Noninducibility and late potential abolition: a novel combined prognostic procedural end point for catheter ablation of postinfarction ventricular tachycardia.

Background: Successful late potential (LP) abolition and postprocedural ventricular tachycardia (VT) noninducibility constitute significant end points after catheter ablation for VT. We investigated the prognostic impact of a combined procedural end point of VT noninducibility and LP abolition in a large series of post-myocardial infarction patients with VT.

Methods And Results: A total of 160 (154 men, 94% with implantable cardioverter defibrillators) consecutive post-myocardial infarction patients undergoing first-time ablation procedures from 2010 to 2012 were included.

Catheter ablation of ventricular arrhythmia in nonischemic cardiomyopathy: anteroseptal versus inferolateral scar sub-types.

Background: The aim was to relate distinct scar distributions found in nonischemic cardiomyopathy with ventricular tachycardia (VT) morphology, late potential distribution, ablation strategy, and outcome.

Methods And Results: Eighty-seven patients underwent catheter ablation for drug-refractory VT. Based on endocardial unipolar voltage, 44 were classified as predominantly anteroseptal and 43 as inferolateral.

Management of atrial fibrillation.

Atrial fibrillation (AF) is associated with increases in the risk of mortality, congestive heart failure, and stroke. Medical treatment is aimed at preventing thrombo-embolic complications and reducing symptoms and consequences related to the arrhythmia. In the first section of this review, we discuss the principles of mainstream oral anticoagulant therapy and the possible advantages of the new oral anticoagulants.

Maze surgery normalizes left ventricular function in patients with persistent lone atrial fibrillation.

Objectives: The aim of this study is to evaluate the mid-term clinical and functional outcomes of maze surgery in symptomatic refractory lone atrial fibrillation (AF) patients.

Methods: Between March 2008 and January 2013, 39 highly symptomatic patients [mean age 51 ± 10 (mean ± standard deviation); 95% CI, European Heart Rhythm Association class III-IV] underwent maze surgery for lone AF. Biatrial ablations were performed with bipolar radiofrequency and cryoenergy, according to a maze III lesion set (modified by omitting the intercaval line in 5 of 39 patients).

Imaging and epicardial substrate ablation of ventricular tachycardia in patients late after myocarditis.

Aims: We present clinical, electroanatomical mapping (EAM), imaging, and catheter ablation (CA) strategies in patients with myocarditis-related ventricular tachycardia (VT).

Methods And Results: Between January 2010 and July 2012, 26 consecutive patients underwent imaging-guided CA of myocarditis-related ventricular arrhythmias, 23 of 26 using a combined endo-epicardial approach. Segment per segment correspondence of late enhanced (LE) scar localization with EAM scar was assessed in all patients with available uni/bipolar maps (n = 19).

Draft genome sequence of Pseudomonas corrugata, a phytopathogenic bacterium with potential industrial applications.

Pseudomonas corrugata was first described as the causal agent of a tomato disease called 'pith necrosis' yet it is considered as a biological resource in various fields such as biocontrol of plant diseases and production of industrially promising microbial biopolymers (mcl-PHA). Here we report the first draft genome sequence of this species.

Radio-frequency ablation as primary management of well-tolerated sustained monomorphic ventricular tachycardia in patients with structural heart disease and left ventricular ejection fraction over 30%.

Aims: Patients with well-tolerated sustained monomorphic ventricular tachycardia (SMVT) and left ventricular ejection fraction (LVEF) over 30% may benefit from a primary strategy of VT ablation without immediate need for a 'back-up' implantable cardioverter-defibrillator (ICD).

Methods And Results: One hundred and sixty-six patients with structural heart disease (SHD), LVEF over 30%, and well-tolerated SMVT (no syncope) underwent primary radiofrequency ablation without ICD implantation at eight European centres. There were 139 men (84%) with mean age 62 ± 15 years and mean LVEF of 50 ± 10%.

Effects of sex on the incidence of cardiac tamponade after catheter ablation of atrial fibrillation: results from a worldwide survey in 34 943 atrial fibrillation ablation procedures.

Background: Cardiac tamponade is the most dramatic complication observed during atrial fibrillation (AF) ablation and the leading cause of procedure-related mortality. Female sex is a known risk factor for complications during AF ablation; however, it is unknown whether women have a higher risk of tamponade.

Methods And Results: A systematic Medline search was used to locate academic electrophysiological centers that reported cases of tamponade occurring during AF ablation.

Anterior tarsal tunnel syndrome: a misunderstood and a misleading entrapment neuropathy.

Anterior tarsal tunnel syndrome (ATTS) is a rare entrapment neuropathy of the deep peroneal nerve beneath the extensor retinaculum on the top of the ankle. ATTS is often asymptomatic or olygosymptomatic. There are few reports describing the ATTS.

Rhythm-symptom correlation in patients on continuous monitoring after catheter ablation of atrial fibrillation.

Introduction: Correlation between symptoms and atrial fibrillation (AF) episodes after catheter ablation may have clinical relevance, especially for anticoagulation usage. The aim of our project was to analyze the relationship between symptoms and AF recurrences in unselected patients following AF catheter ablation during long-term follow-up.

Methods And Results: One hundred and forty-three consecutive patients (mean age 59 ± 9 years, 85% male) were implanted with a continuous cardiac monitor (RevealXT, Medtronic Inc.