Epicardial left ventricular lead implantation in cardiac resynchronization therapy patients via a video-assisted thoracoscopic technique: Long-term outcome.

Background: Epicardial placement of the left ventricular (LV) lead via a video-assisted thoracoscopic (VAT) approach is an alternative to the standard transvenous technique.

Hypothesis: Long-term safety and efficacy of VAT and transvenous LV lead implantation are comparable. To test it, we reviewed our experience and we compared the outcomes of patients who underwent implantation with the two techniques.

A randomized controlled trial of cardiac resynchronization therapy in patients with prolonged atrioventricular interval: the REAL-CRT pilot study.

Aims: A prolonged PR interval is known to be associated with increased mortality and a higher risk of developing atrial fibrillation (AF). We tested the hypothesis that cardiac resynchronization therapy (CRT) is superior to conventional dual-chamber pacing with algorithms for right ventricular pacing avoidance (DDD-VPA) in preserving systolic and diastolic function and in preventing new-onset AF in patients with normal systolic function, indication for pacing and prolonged atrioventricular conduction (PR interval ≥220 ms).

Methods And Results: We randomly assigned 82 patients with ejection fraction >35%, indication for pacing and PR interval ≥220 ms to CRT or to DDD-VPA.

Clinical and organizational management of cardiac implantable electronic device replacements: an Italian Survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing).

Aims: The aim of this survey was to assess the management and organization of cardiac implantable electronic device (CIED) replacement in Italy.

Methods: A questionnaire consisting of 24 questions on organizational aspects and on the peri-procedural management of anticoagulant therapies and antibiotic prophylaxis was sent via the Internet to 154 Italian arrhythmia centers.

Results: A total of 103 out of 154 centers completed the questionnaire (67% response rate).

[Management of outpatients with cardiac disease: follow-up timing and modalities].

The increasing rate of cardiovascular diseases, the improved survival after the acute phase, the aging of the population and the implementation of primary prevention caused an exponential increase in outpatient cardiac performance, thereby making it difficult to maintain a balance between the citizen-patient request and the economic sustainability of the healthcare system. On the other side, the prescription of many diagnostic tests with a view to defensive medicine and the related growth of patients' expectations, has led several scientific societies to educational campaigns highlighting the concept that "less is more".The present document is aimed at providing the general practitioner with practical information about a prompt diagnosis of signs/symptoms (angina, dyspnea, palpitations, syncope) of the major cardiovascular diseases.

Automatic management of atrial and ventricular stimulation in a contemporary unselected population of pacemaker recipients: the ESSENTIAL Registry.

Aims: We investigated the applicability of the Ventricular Capture Control (VCC) and Atrial Capture Control (ACC) algorithms for automatic management of cardiac stimulation featured by Biotronik pacemakers in a broad, unselected population of pacemaker recipients.

Methods And Results: Ventricular Capture Control and Atrial Capture Control were programmed to work at a maximum adapted output voltage as 4.8 V in consecutive recipients of Biotronik pacemakers.

Baseline heart rate variability predicts clinical events in heart failure patients implanted with cardiac resynchronization therapy: validation by means of related complexity index.

Background: Studies on the physiology of the cardiovascular system suggest that generation of the heart rate (HR) signal is governed by nonlinear dynamics. Linear and nonlinear indices of HR variability (HRV) have been shown to predict outcome in heart failure (HF). Aim of the present study is to assess if a HR-related complexity predicts adverse clinical and cardiovascular events at 1 year in patients implanted with cardiac resynchronization therapy (CRT).

An unusual case of permanent junctional reciprocating tachycardia: Successful ablation at the mitral annulus-aorta junction.

A 25-year-old woman with drug-refractory permanent junctional reciprocating tachycardia (PJRT) and a previous failed ablation, was referred to our institution. Electrophysiological study confirmed the diagnosis of orthodromic atrioventricular reentry tachycardia using a slowly conducting accessory pathway. This accessory pathway was successfully ablated by conventional radiofrequency at the left anteroseptal region using a transseptal approach.

Biventricular implantable cardiac defibrillator in dextrocardia with situs viscerum inversus.

A case of dextrocardia in situs viscerum inversus, prior myocardial infarction, dilated cardiomyopathy with severe left ventricular systolic dysfunction, ventricular tachyarrhythmias and recurrent episodes of heart failure is described. Coronary artery bypass grafting for multivessel coronary artery disease had been previously performed; coronary and graft anatomy evaluation excluded the possibility of any further revascularization procedure. Electrocardiography showed left bundle branch block and echocardiography revealed significant interventricular mechanical dyssynchrony.