Cryoablation for AVNRT: importance of ablation endpoint criteria.

Background: For ablation of atrioventricular nodal reentrant tachycardia (AVNRT), cryoablation has been shown to be a safe alternative to radiofrequency ablation. However, previous studies have shown a higher recurrence rate with cryoablation compared to radiofrequency ablation.

Objective: This study reviewed our experience using cryoablation for typical AVNRT using stringent endpoint criteria for slow pathway ablation, yet preserving the desirable safety profile of cryoablation.

Alterations in corrected QT interval following liver transplant in patients with end-stage liver disease.

Background: Studies have demonstrated that patients with end-stage liver disease (ESLD) often have a prolonged corrected QT interval (QTc) with variable changes in the QTc post-transplant. We sought to characterize the prevalence and degree of QTc prolongation in ESLD patients, identify risk factors for QTc prolongation, and assess changes in QTc following transplant.

Hypothesis: QTc interval is prolonged in ESLD patients pre-transplant due to a variety of risk factors and shortens following liver transplantation.

Successful radiofrequency ablation therapy for intractable ventricular tachycardia with a ventricular assist device.

Refractory ventricular tachycardia (VT) can be a potentially life-threatening rhythm in the presence of non-ischemic dilated cardiomyopathy, particularly when it results in hemodynamic compromise. A 65-year-old man with non-ischemic cardiomyopathy was referred for multiple episodes of VT. A HeartMate left ventricular assist device (LVAD) was implanted to stabilize and control the VT.

Value of the 12-lead ECG in wide QRS tachycardia.

A wealth of useful diagnostic criteria is available to assist the health care worker in arriving at the correct diagnosis in cases of a wide QRS tachycardia (WQRST). Despite the abundance of good criteria for determining the diagnosis in cases of WQRST, they are of no use if they cannot be readily applied in an urgent clinical situation because they cannot be easily recalled or are too complex and cumbersome to use. It may be that refresher courses in the differential diagnosis of WQRST, especially for emergency physicians who are often the "first responders" to patients with WQRST, can improve physicians' diagnostic accuracy in this important disorder.

Use of nonantiarrhythmic drugs for prevention of sudden cardiac death.

It is of interest that the drugs having the most significant impact on total and sudden death mortality are those without direct electrophysiologic actions on myocardial excitable tissue. This observation may provide insight into mechanisms responsible for ventricular tachyarrhythmias causing cardiac arrest. One way to think about ventricular fibrillation is that it is the final common pathway of an electrically unstable heart.