Impact of contact force sensing technology on outcome of catheter ablation of idiopathic pre-mature ventricular contractions originating from the outflow tracts.

Aims: Catheter ablation of frequent idiopathic pre-mature ventricular contractions (PVC) is increasingly performed. While potential benefits of contact force (CF)-sensing technology for atrial fibrillation ablation have been assessed in several studies, the impact of CF-sensing on ventricular arrhythmia ablation remains unknown. This study aimed to compare outcomes of idiopathic outflow tract PVC ablation when using standard ablation catheters as opposed to CF-sensing catheters.

The Medtronic Sprint Fidelis® lead history revisited-Extended follow-up of passive leads.

Background: Due to high failure rates, Medtronic withdrew the Sprint Fidelis lead (SFL) from the market. Passive fixation lead models exhibited better survival than active models, but most studies have limited follow-up. Aim of this study was to give insights into passive lead survival with a follow-up of 10 years.

First clinical experience of a dedicated irrigated-tip radiofrequency ablation catheter for the ablation of cavotricuspid isthmus-dependent atrial flutter.

Background: Different types of irrigated-tip ablation catheters are available for ablation of atrial flutter (AFL). The aim of this study was to compare an established with a novel dedicated Gold irrigated-tip catheter for ablation of AFL.

Methods And Results: We compared consecutive patients undergoing ablation of AFL using a standard 3.

Individually tailored vs. standardized substrate modification during radiofrequency catheter ablation for atrial fibrillation: a randomized study.

Aims: This randomized single-centre study sought to compare the efficacy and safety of pulmonary vein isolation (PVI) plus voltage-guided ablation vs. PVI with or without linear ablation depending on the type of atrial fibrillation (AF).

Methods And Results: Overall, 124 ablation-naive patients with paroxysmal or persistent AF were randomized to PVI with (persistent AF) or without (paroxysmal AF) additional linear ablation (control group) vs.

Tailored atrial substrate modification based on low-voltage areas in catheter ablation of atrial fibrillation.

Background: Reduced electrogram amplitude has been shown to correlate with diseased myocardium. We describe a novel individualized approach for catheter ablation of atrial fibrillation (AF) based on low-voltage areas (LVAs) in the left atrium (LA). We sought to assess (1) the incidence of LVAs in patients undergoing AF catheter ablation, (2) the distribution of LVAs within the LA, and (3) the effect of an individualized ablation strategy on long-term rhythm outcomes.

Long-term comparison of cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: a propensity score matched analysis.

Background: Although radiofrequency (RF) and cryoballoon (CB) based technologies for pulmonary vein isolation (PVI) have both individually been demonstrated to be effective and safe for the treatment of paroxysmal AF, head-to-head comparisons are lacking. The purpose of this study was to compare the outcome of cryoballoon versus radiofrequency ablation in patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation.

Methods: Out of a prospective registry of 327 patients undergoing PVI, 208 patients (age 58±11 years, ejection fraction 59±6%, left atrial size 39±6 mm) with paroxysmal AF were identified.

[Rational use of ambulatory ECG recordings].

Ambulatory ECG recordings and the memory function of cardiac devices are very useful to record arrhythmias. For this purpose various modalities of documentation are available including externally worn ECGs with variable recording duration and implantable cardiac devices with recording periods over years. The probably most frequent indication for an ambulatory ECG recording is syncope.

Prevalence of severely impaired left ventricular ejection fraction after reperfused ST-elevation myocardial infarction.

Background: Preventive implantation of an implantable cardioverter defibrillator (ICD) early after myocardial infarction failed to demonstrate a survival benefit in patients with depressed left ventricular ejection fraction (LVEF). This may be explained by early recovery of the LVEF after percutaneous coronary intervention (PCI). We sought to determine the incidence of a sustained LVEF ≤35% in patients with severely depressed LVEF early after a revascularised acute ST-segment elevation myocardial infarction (STEMI).

Anatomical predictors for acute and mid-term success of cryoballoon ablation of atrial fibrillation using the 28 mm balloon.

Introduction: Cryoballoon (CB) pulmonary vein isolation (CB-PVI) for the treatment of paroxysmal atrial fibrillation (AF) has been demonstrated to be safe and reliable. Preprocedural patient selection to address the high variability in pulmonary vein (PV) anatomy may improve the acute and chronic success of CB-PVI. The purpose of this study was to identify anatomical predictors for CB-PVI failure using the 28 mm balloon.

Phrenic nerve palsy during ablation of atrial fibrillation using a 28-mm cryoballoon catheter: predictors and prevention.

Purpose: The purposes of this study were to determine whether predictors of phrenic nerve palsy (PNP) exist and to test whether a standardized ablation protocol may prevent PNP during cryoballoon (CB) ablation using the 28 mm CB.

Methods: Three-dimensional (3D) geometry of the pulmonary veins (PV) and their relationship to the superior vena cava (SVC) was analyzed. Phrenic nerve (PN) stimulation was performed during ablation of the right-sided PVs with a 28-mm CB.

Validation of a novel spiral mapping catheter for real-time recordings from the pulmonary veins during cryoballoon ablation of atrial fibrillation.

Background: The Achieve mapping catheter allows real-time recordings from the pulmonary veins (PVs) during cryoballoon (CB) ablation of atrial fibrillation (AF).

Objective: To assess the clinical applicability of the Achieve mapping catheter and the value of real-time recordings from the PVs during CB.

Methods: Patients with paroxysmal AF undergoing CB ablation were studied.

Sustained monomorphic left ventricular outflow tract tachycardia early after aortic valve replacement.

Sustained monomorphic ventricular tachycardia (VT) after valve surgery is uncommon. Cases of focal VT or bundle-branch re-entry after aortic valve surgery have been reported. We present the case of a 60 year-old patient with an incessant outflow tract VT early after aortic valve replacement.

Treating Atrial Fibrillation With Cryoballoon Technology.

Cryoballoon ablation has emerged as a novel tool to perform pulmonary vein isolation. The aim of this paper is to review the advantages, drawbacks as well as possible complications and clinical outcomes of this technology and to discuss some important technical issues.

Long-term efficacy of single procedure remote magnetic catheter navigation for ablation of ischemic ventricular tachycardia: a retrospective study.

Background: Remote magnetic navigation (RMN) aims to reduce some inherent limitations of manual radiofrequency (RF) ablation. However, data comparing the effectiveness of both methods are scarce. This study evaluated the acute and long-term success of RMN guided versus manual RF ablation in patients with ischemic sustained ventricular tachycardia (sVT).

Clinical impact of screening for sleep related breathing disorders in atrial fibrillation.

Objective: The aim of this study was to quantify daytime symptoms in atrial fibrillation (AF) patients with and without sleep related breathing disorders (SRBD).

Background: SRBD are common in patients with AF but little is known about daytime symptoms among those with SRBD.

Methods: Patients with AF admitted to clinics of two tertiary referral hospitals for a variety of different cardiovascular diseases were screened with a trans-nasal airflow measurement device allowing measurement of the apnea-hypopnea-index.

The prognosis of implantable defibrillator patients treated with cardiac resynchronization therapy: comorbidity burden as predictor of mortality.

Aims: Comorbidity, such as myocardial infarction, diabetes, and renal failure, plays a pivotal role in the prognosis of a patient with arrhythmias. However, data on the prognostic impact of comorbiditiy in heart failure patients with cardiac resynchronization therapy and defibrillation (CRT-D) are scarce. The purpose of this study was to determine the impact of comorbidity on survival in CRT-D patients.

Cryoballoon versus radiofrequency catheter ablation of paroxysmal atrial fibrillation: biomarkers of myocardial injury, recurrence rates, and pulmonary vein reconnection patterns.

Background: Cryoballoon ablation has emerged as a novel treatment strategy for patients with atrial fibrillation (AF).

Objective: The purpose of this study was to compare pulmonary vein isolation (PVI) using cryoballoon ablation versus RF ablation with regard to myocardial injury, pulmonary vein (PV) reconnection patterns, and outcome.

Methods: Fifty patients (age 59 ± 9 years, ejection fraction 0.

Elevated cardiac troponin I in sepsis and septic shock: no evidence for thrombus associated myocardial necrosis.

Background: Elevated cardiac troponin I (cTnI) is frequently observed in patients with severe sepsis and septic shock. However, the mechanisms underlying cTnI release in these patients are still unknown. To date no data regarding coagulation disturbances as a possible mechanism for cTnI release during sepsis are available.

Longevity of implantable cardioverter-defibrillators, influencing factors, and comparison to industry-projected longevity.

Background: Because the best possible device longevity is crucial (i.e., risk of infection with premature device exchange, current cost-effectiveness calculations depending on reasonable longevity, patient comfort), industry-independent real-life data are fundamental.

Use of the CHADS2 risk score to guide antithrombotic treatment in patients with atrial fibrillation--room for improvement.

Background: Antithrombotic treatment (AT) is recommended for patients with atrial fibrillation (AF), except for those with lone AF or contraindications.

Aim: The aim of our study was to determine contemporary AT in AF patients and to ascertain reasons for withholding oral anticoagulant treatment (OAC) in eligible patients.

Design: Prospective observational study.

Remote monitoring of cardiovascular implantable electronic devices: prerequisite or luxury?

The number of patients implanted with cardiovascular electronic devices (CIED) like implantable defibrillators (ICD), cardiac resynchronisation (CRT) devices, and pacemakers continues to grow. These devices require regular follow-up interrogation in dedicated device clinics. Contemporary CIED are capable of wireless remote interrogation and monitoring.

[Drug induced QT prolongation].

Prolongation of the ventricular repolarisation manifests itself as a prolongation of the QT intervall on the surface ECG and represents a major risk for a special form of ventricular tachycardia called "torsades de pointes". Torsades de pointes are often self limited and are associated with palpitations, dizziness or syncope. Degeneration into ventricular fibrillation and sudden cardiac death can occur.