Feasibility of using chest strap and dry electrode system for longer term cardiac arrhythmia monitoring: Results from a pilot observational study.

Background And Aim: Cardiac arrhythmia diagnostic yield improves with increased duration of monitoring. We investigated patient comfort, diagnostic quality of ECG, and arrhythmia diagnostic yield using a single lead longer term external cardiac monitor (ECM).

Methods: The observational ECM feasibility study enrolled patients with increased risk of cardiac arrhythmia.

Outcome of tailored therapy in rheumatic heart disease with persistent atrial fibrillation (RHD-AF).

Introduction: Rheumatic heart disease with persistent atrial fibrillation (RHD-AF) is associated with increased morbidity. However, there is no standardized approach for the maintenance of sinus rhythm (SR) in them. We aimed to determine the utility of a stepwise approach to achieve SR in RHD-AF.

Radiofrequency catheter ablation of ventricular arrhythmias in patients with hypertrophic cardiomyopathy.

Background: Compared to other non-ischemic substrates, there is limited data on the role and outcome of catheter ablation in HCM. The objective of this study is to assess the safety and efficacy of catheter ablation for the treatment of VT in patients with HCM.

Methods: Fourteen patients with HCM and drug refractory VT who underwent catheter ablation at a single center were included in this study.

Catheter ablation of ventricular tachycardia: strategies to improve outcomes.

Catheter ablation of ventricular arrhythmias has evolved considerably since it was first described more than 3 decades ago. Advancements in understanding the underlying substrate, utilizing pre-procedural imaging, and evolving ablation techniques have improved the outcomes of catheter ablation. Ensuring safety and efficacy during catheter ablation requires adequate planning, including analysis of the 12 lead ECG and appropriate pre-procedural imaging.

Efficacy of SGLT2 Inhibitors in Patients With Diabetes and Nonobstructive Hypertrophic Cardiomyopathy.

The objective of this study was to evaluate the effects of sodium glucose co-transporter 2 inhibitors (SGLT2i) on functional capacity and diastolic function in patients with diabetes with nonobstructive hypertrophic cardiomyopathy (nHCM) and preserved left ventricular (LV) function. From January 2019 to October 2020, a prospective open-label study was performed on patients with type 2 diabetes mellitus and nHCM with New York Heart Association class II-III symptoms. Patients with a LV ejection fraction <50% were excluded.

Ventricular Tachycardia in Granulomatous Myocarditis: Role of Catheter Ablation.

Granulomatous myocarditis is an inflammatory disease of the myocardium, characterized by lymphocytic infiltration with characteristic granuloma formation. Although a host of disease processes can elicit myocardial granulomas, two common entities are cardiac sarcoidosis and cardiac tuberculosis. Cardiac arrhythmias in this condition are frequent and management of ventricular arrhythmias can be challenging, especially in those with drug-refractory ventricular tachycardia and electrical storm.

Catheter Ablation for Ventricular Arrhythmias in Hypertrophic Cardiomyopathy.

Implantable cardioverter-defibrillators are the mainstay of therapy for prevention of sudden cardiac death in high-risk patients with hypertrophic cardiomyopathy (HCM). Catheter ablation is a useful option for patients with recurrent, drug refractory monomorphic ventricular tachycardia (VT), and device therapy. Compared with other nonischemic substrates, there are limited data on the role and outcomes of catheter ablation in HCM.

Best Practices for the Catheter Ablation of Ventricular Arrhythmias.

Techniques for catheter ablation have evolved to effectively treat a range of ventricular arrhythmias. Pre-operative electrocardiographic and cardiac imaging data are very useful in understanding the arrhythmogenic substrate and can guide mapping and ablation. In this review, we focus on best practices for catheter ablation, with emphasis on tailoring ablation strategies, based on the presence or absence of structural heart disease, underlying clinical status, and hemodynamic stability of the ventricular arrhythmia.

Prevalence, clinical profile, and stroke risk of atrial fibrillation in rural Andhra Pradesh, India (the AP-AF study).

Unlabelled: The burden of atrial fibrillation (AF) is increasing worldwide. It is often asymptomatic, with stroke being the first manifestation in some. AF burden in the community and the practice of stroke prophylaxis has not been studied in India.

High rate episodes in a dual chamber pacemaker: What is the mechanism?

Detection of high rate episodes can potentially result from oversensing of physiological or nonphysiological signals. Assessment of lead integrity, lead connection and analysis of noise characteristics on electrograms are decisive steps in the evaluation of oversensing. We report a case of high atrial and ventricular rate episodes due to minute ventilation oversensing in the presence of lead connector issues.

His-bundle pacing versus cardiac resynchronisation therapy: Effect on ECG parameters of repolarization.

Introduction: Cardiac resynchronization therapy (CRT) by biventricular pacing (BiV) may worsen indices of ventricular repolarization. The impact of His bundle pacing (HBP) on repolarization is not well studied in patients with left ventricular systolic dysfunction. The aim of the study is to compare the repolarization parameters in ECG between these two pacing modalities.

A case of cardiac sarcoidosis mimicking Brugada syndrome.

A 17-year-old boy was admitted for management of ventricular fibrillation (VF) with intermittent Brugada pattern on ECG. On evaluation, cardiac MRI revealed myocardial scar and mediastinal lymphadenopathy. 18-Fluorodeoxyglucose positron emission tomography scan showed inflammation in the heart, lungs, and lymph nodes.

CT-guided percutaneous epicardial access for ventricular tachycardia ablation: A proof-of-concept study.

Introduction: The objective of this study was to evaluate the safety and efficacy of preprocedural computed tomography (CT) to guide percutaneous epicardial puncture for catheter ablation of ventricular tachycardia.

Methods And Results: A preprocedural CT was used to plan the site, angle, and depth of needle insertion during epicardial access in 10 consecutive patients undergoing ventricular tachycardia (VT) ablation. Adjacent structures (right ventricle, diaphragm, liver, colon, internal mammary artery) were visualized and the course of the needle was planned avoiding these structures.

Looking above the heart: A rare cause of ventricular tachycardia.

We describe a 56-year old man with medically refractory ventricular tachycardia (VT) who was referred for catheter ablation. His examination revealed features suggestive of acromegaly. The diagnosis was confirmed by elevated levels of insulin like growth factor-1 and the presence of a pituitary adenoma.

Prevalence, clinical profile, and stroke risk of atrial fibrillation in rural Andhra Pradesh, India (The AP-AF study) - Rationale and design.

Introduction: The epidemiology of atrial fibrillation (AF) in India has not been studied systematically in large scale population based surveys. Stroke is one of the leading causes of death and disability in India. As AF is a major contributor of stroke, it is important to know the burden of AF and stroke risk in the population.

PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism?

A 40 year old man with frequent PVCs with two different morphologies was referred for catheter ablation. Although initial mapping in the RVOT revealed fragmented potentials 20ms earlier than PVC2 onset with a good pace map score, ablation at this site was unsuccessful. Subsequent mapping in the LCC/NCC junction revealed that local ventricular activation preceded QRS onset by 30 and 28 ms for PVC1 and PVC2, respectively.

Pre-Treatment Myocardial FDG Uptake Predicts Response to Immunosuppression in Patients With Cardiac Sarcoidosis.

Objectives: This study identified predictors of clinical (CR) and echocardiographic response (ER) following immunosuppressive therapy (IST) in patients with cardiac sarcoidosis (CS).

Background: IST has been the cornerstone of treatment for patients with CS and active myocardial inflammation. However, there are little data to explain the variable response to IST in CS.

Inappropriate defibrillator shock due to oversensing. What is the mechanism?

Implantable cardioverter defibrillator (ICD) is often advised for secondary prevention of sudden cardiac death. Inappropriate shocks from ICD is uncommon but can seriously affect the quality of life. One of the reasons for inappropriate ICD shock is loose set screw, which may remain undetected by device interrogation and/or fluoroscopy.

Mitral valve tuberculoma: Role of sequential multimodality imaging of an unusual intracardiac mass.

We present an unusual intracardiac mass posing a diagnostic dilemma. A middle-aged male patient was referred for workup of a symptomatic cardiac mass involving the mitral valve. Multimodality imaging consisting of cardiac magnetic resonance (CMR) imaging and 18F-fluorodeoxyglucose positron emission computerized tomography (18FDG-PET) scan was utilized to further characterize the mass after initial echocardiographic identification.

Clinical and electrophysiological characteristics of ventricular arrhythmias arising from pulmonary cusps.

Introduction: Ventricular arrhythmias (VAs) have been successfully ablated from the pulmonary sinus cusps establishing pulmonary artery (PA) as a distinct site of arrhythmic foci. The aim of the present study was to determine the clinical presentation, electrocardiographic, and ablation characteristics of PA-VAs.

Methods: Thirty consecutive patients with right ventricular outflow tract (RVOT)-type VAs were included in this retrospective study.