Performance and acute procedural outcomes of the EnSite Precision™ cardiac mapping system for electrophysiology mapping and ablation procedures: results from the EnSite Precision™ observational study.

Background: The EnSite Precision™ cardiac mapping system (Abbott) is a catheter navigation and mapping system capable of displaying the three-dimensional (3D) position of conventional and sensor-enabled electrophysiology catheters, as well as displaying cardiac electrical activity as waveform traces and dynamic 3D maps of cardiac chambers. The EnSite Precision™ Observational Study (NCT-03260244) was designed to quantify and characterize the use of the EnSite Precision™ cardiac mapping system for mapping and ablation of cardiac arrhythmias in a real-world environment and evaluate procedural outcomes.

Methods: A total of 1065 patients were enrolled at 38 centers in the USA and Canada between 2017 and 2018 and were followed for 12 months post procedure for arrhythmia recurrence, medication use, and quality-of-life changes.

Age-Related Changes in the Anatomy of the Triangle of Koch: Implications for Catheter Ablation of Atrioventricular Nodal Re-entry Tachycardia.

Background: Atrioventricular nodal re-entrant tachycardia is the most common type of paroxysmal supraventricular tachycardia. We sought to assess whether important anatomic factors, such as the location of the slow pathway, proximity to the bundle of His, and coronary sinus ostium dimensions, varied with patient age, and whether these factors had an impact on procedural duration, acute success, and complications.

Methods: Baseline demographic and procedural data were collected, and the maps were analyzed.

The use of minimal fluoroscopy for cardiac electrophysiology procedures: A meta-analysis and review of the literature.

Background: Conventional catheter ablation involves prolonged exposure to ionizing radiation, potentially leading to detrimental health effects. Minimal fluoroscopy (MF) represents a safer alternative, which should be explored. Data on the safety and efficacy of this technique are limited.

Canada-wide mixed methods analysis evaluating the reasons for inappropriate emergency department presentation in patients with a history of atrial fibrillation: the multicentre AF-ED trial.

Objectives: The primary objective of this study was to ascertain the reasons for emergency department (ED) attendance among patients with a history of atrial fibrillation (AF).

Design: Appropriate ED attendance was defined by the requirement for an electrical or chemical cardioversion and/or an attendance resulting in hospitalisation or administration of intravenous medications for ventricular rate control. Quantitative and qualitative responses were recorded and analysed using descriptive statistics and content analysis, respectively.

Epicardial Electrical Activation During Atrial Fibrillation: Looking at the Other Side of the Coin.

High-definition mapping of atrial fibrillation is most commonly performed from the endocardial surface. This report describes an example of a case in which combined mapping of the endocardium and epicardium of the left atrium demonstrated electrical dissociation between the 2 surfaces and implies that endocardial mapping alone may not provide sufficient information. ().

Impairment of the antegrade fast pathway in patients with atrioventricular nodal reentrant tachycardia can be functional and treated by slow pathway ablation: a case report study.

Background: Slow pathway (SP) ablation is considered to be the standard treatment for symptomatic atrioventricular nodal reentrant tachycardia (AVNRT). This may be challenging in patients with documented PR interval prolongation due to the potential increased risk of atrioventricular (AV) block in some patients.

Case Summary: We report two cases of symptomatic recurrent AVNRT refractory to medical treatment with significant baseline PR interval prolongation (304 ms and 336 ms).

Impact of body mass index on the outcome of catheter ablation of atrial fibrillation.

Objectives: The association between obesity and atrial fibrillation (AF) is well-established. We aimed to evaluate the impact of index body mass index (BMI) on AF recurrence at 12 months following catheter ablation using propensity-weighted analysis. In addition, periprocedural complications and fluoroscopy details were examined to assess overall safety in relationship to increasing BMI ranges.

The role of biomarkers in the diagnosis and risk stratification of acute coronary syndrome.

Coronary artery disease is a growing concern. Although traditional biomarkers, such as troponins and creatine kinase, play a central role in the diagnosis, risk stratification and management of coronary artery disease, they are unable to detect myocardial ischemia in the absence of necrosis. Therefore, early detection of ischemia in patients presenting with acute coronary syndrome still remains a burning question.

Catheter ablation for atrial flutter: a survey by the European Heart Rhythm Association and Canadian Heart Rhythm Society.

The purpose of this EP wire survey was to examine current practice in the management of both cavotricuspid isthmus (CTI)-dependent and non-CTI-dependent atrial flutter (AFL) ablation amongst electrophysiologists in European and Canadian centres and to understand how current opinions vary from guidelines. The results of the survey were collected from a detailed questionnaire that was created by the European Heart Rhythm Association Research Network and the Canadian Heart Rhythm Society. Responses were received from 89 centres in 12 countries.

A Guide to Transseptal Access.

Transseptal access is commonly performed for any procedure that requires access to the left side of the heart such as catheter ablation of atrial fibrillation, left atrial tachycardia, left-sided accessory pathways, ventricular tachycardia, left atrial appendage closure, percutaneous mitral valvuloplasty, and mitral valve repair. To perform this in a safe and effective manner it is important that the operator has a detailed knowledge of the relevant anatomy, the technique required, and the ability to deal with difficult cases and complications. The aim of this article is to provide a detailed description of the anatomy, techniques, potential complications, and difficulties associated with performing this procedure.

Dronedarone and Captisol-enabled amiodarone in an experimental cardiac arrest.

Objective: To compare the energy required for defibrillation and postshock outcomes after the administration of dronedarone, amiodarone, and placebo in a porcine model of cardiac arrest.

Methods: Forty-two pigs were randomized to amiodarone, dronedarone, or control treatments. After induction of ventricular fibrillation, compressions and ventilations were performed for 3 minutes and treatment was administered over 30 seconds.

Wide variability in drug use in out-of-hospital cardiac arrest: a report from the resuscitation outcomes consortium.

Background: Despite the publication and dissemination of the Advanced Cardiac Life Support guidelines, variability in the use of drugs during resuscitation from out-of-hospital cardiac arrest may exist between different Emergency Medical Services throughout North America. The purpose of this study was to characterize the use of such drugs and evaluate their relationship to cardiac arrest outcomes.

Methods And Results: The Resuscitation Outcomes Consortium Registry-Cardiac Arrest collects out-of-hospital cardiac arrest data from 264 Emergency Medical Services agencies in 11 geographical locations in the U.

Dual epicardial ventricular tachycardia: a tale of two VTs.

A young female with isolated ventricular noncompaction and acute myocarditis presented with incessant dual epicardial ventricular tachycardia consisting of a manifest reentrant circuit and a shorter cycle length concealed circuit. A single radiofrequency terminated both tachycardias.