Cryothermal energy demonstrates shorter ablation time and lower complication rates compared with radiofrequency in surgical hybrid ablation for recurrent ventricular tachycardia.

Background: Recurrent ventricular tachycardia (VT) after prior endocardial catheter ablation(s) presents challenges in the setting of prior cardiac surgery where percutaneous epicardial access may not be feasible.

Objective: The purpose of this study was to compare the outcomes of cryothermal vs radiofrequency ablation in direct surgical epicardial access procedures.

Methods: We performed a retrospective study of consecutive surgical epicardial VT ablation cases.

Left atrial posterior wall isolation in conjunction with pulmonary vein isolation using cryoballoon for treatment of persistent atrial fibrillation (PIVoTAL): study rationale and design.

Background: There is growing evidence in support of pulmonary vein isolation (PVI) with concomitant posterior wall isolation (PWI) for the treatment of patients with symptomatic persistent atrial fibrillation (persAF). However, there is limited data on the safety and efficacy of this approach using the cryoballoon.

Objective: The aim of this multicenter, investigational device exemption trial (G190171) is to prospectively evaluate the acute and long-term outcomes of PVI versus PVI+PWI using the cryoballoon in patients with symptomatic persAF.

Recurrent ventricular tachycardia after cardiac sympathetic denervation: Prolonged cycle length with improved hemodynamic tolerance and ablation outcomes.

Introduction: Cardiac sympathetic denervation (CSD) is utilized for the management of ventricular tachycardia (VT) in structural heart disease when refractory to radiofrequency ablation (RFA) or when patient/VT characteristics are not conducive to RFA.

Methods: We studied consecutive patients who underwent CSD at our institution from 2009 to 2018 with VT requiring repeat RFA post-CSD. Patient demographics, VT/procedural characteristics, and outcomes were assessed.

Relationship between sinus rhythm late activation zones and critical sites for scar-related ventricular tachycardia: systematic analysis of isochronal late activation mapping.

Background: It is not known whether the most delayed late potentials are functionally most specific for scar-related ventricular tachycardia (VT) circuits.

Methods And Results: Isochronal late activation maps were constructed to display ventricular activation during sinus rhythm over 8 isochrones. Analysis was performed at successful VT termination sites and prospectively tested.

Analysis of emergency department visits for palpitations (from the National Hospital Ambulatory Medical Care Survey).

Palpitations is a common complaint in patients who visit the emergency department (ED), with causes ranging from benign to life threatening. We analyzed the ED component of the National Hospital Ambulatory Medical Care Survey for 2001 through 2010 for visits with a chief complaint of palpitations and calculated nationally representative weighted estimates for prevalence, demographic characteristics, and admission rates. ED and hospital discharge diagnoses were tabulated and categorized, and recursive partitioning was used to identify factors associated with admission.

Impact of local ablation on interconnected channels within ventricular scar: mechanistic implications for substrate modification.

Background: The extent to which channels within scar are interconnected is not known. The objective of the study was to evaluate the impact of local ablation of late potentials (LPs) on adjacent and remote areas of slow conduction with simultaneous multipolar mapping.

Methods And Results: Analysis was performed on consecutive patients referred for ablation of scar-mediated ventricular tachycardia with double ventricular access.