Incidence of atrial fibrillation in patients with atrioventricular nodal re-entrant tachycardia and its association with long-term outcome.

Background: Atrioventricular nodal re-entrant tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia. We sought to investigate the incidence of atrial fibrillation in patients with electrophysiologically confirmed/ablated AVNRT and its association with transient ischemic attack (TIA)/stroke as well as mortality during long-term follow-up.

Methods: From the Karolinska Ablation Registry, 2855 consecutive patients with a first-time ablation for AVNRT between 2005 and 2018 were analyzed.

Symptoms of gastroesophageal reflux disease predicts low voltage zones in the posteroinferior left atrium in patients with persistent atrial fibrillation.

Background: The presence of low voltage zones (LVZs) in the left atrium (LA) is associated with the recurrence of atrial fibrillation (AF) after pulmonary vein isolation. Numerous studies have posited a link between gastroesophageal reflux disease (GERD) and AF, attributing this relationship to the anatomical proximity of the esophagus to the posteroinferior wall of the LA.

Objective: The objective of this study was to investigate whether GERD can predict the presence of LVZs in the posteroinferior wall of the LA.

[VT ablation - a technically complex procedure].

Ventricular tachycardia (VT) in patients with structural heart disease is potentially life threatening, and most patients have an indication for an implantable cardioverter-defibrillator (ICD). Catheter ablation is an effective therapeutic strategy to reduce the risk of VT recurrence and subsequent ICD therapies. However, VT ablation is a technically complex procedure with significant risks and should be performed in experienced centers with appropriate resources.

Reduced dementia risk in patients with optimized anticoagulation therapy undergoing atrial fibrillation ablation.

Background: Atrial fibrillation (AF) is associated with the development of dementia, and observational studies have shown that oral anticoagulation and catheter ablation reduce dementia risk. However, such studies did not consistently report on periprocedural anticoagulation and long-term oral anticoagulation coverage, for which reason the separate effect of AF ablation on dementia risk could not be established.

Objective: We evaluated the protective effect of AF ablation in a large cohort of patients who received optimized anticoagulation and compared them with patients who were managed medically.

Risk assessment in patients with symptomatic and asymptomatic pre-excitation.

Aims: Controversy remains as to whether the exercise stress test (EST) is sufficient for risk evaluation in patients with pre-excitation. This study aims to clarify the usefulness of EST in risk stratification in both asymptomatic and symptomatic patients presenting with pre-excitation.

Methods And Results: This prospective study includes consecutive asymptomatic and symptomatic patients with pre-excitation referred for risk assessment.

Association between catheter ablation of atrial fibrillation and mortality or stroke.

Objective: Catheter ablation of atrial fibrillation effectively reduces symptomatic burden. However, its long-term effect on mortality and stroke is unclear. We investigated if patients with atrial fibrillation who undergo catheter ablation have lower risk for all-cause mortality or stroke than patients who are managed medically.

Feasibility of a novel algorithm for automated reconstruction of the left atrial anatomy based on intracardiac echocardiography.

Background: Intracardiac echocardiography (ICE) is frequently used to guide electrophysiology procedures. The novel automated algorithm Cartosoundfam is a model-based algorithm which reconstructs a 3D anatomy of the left atrium (LA) based on a set of 2D intracardiac echocardiography (ICE) frames, without the need to manually annotate ultrasound (US) contours.

Objective: The aim of this study was to determine the feasibility of the Cartosoundfam module in routine clinical setting.

Remarkable oxygen consumption improvement after auricular flutter ablation in a patient with constrictive pericarditis and severe mitral stenosis.

Atrial function is a key factor in cardiac output and oxygen consumption (VO). Substantial improvements in VO have been reported after restoring sinus rhythm (SR) in patients with atrial fibrillation. However, there are no published data on how atrial function affects VO in patients with both constrictive pericarditis (CP) and severe mitral stenosis (MS).

Premature ventricular contractions in patients with an implantable cardioverter defibrillator cardiac resynchronization therapy device: Results from the UMBRELLA registry.

Background: Premature ventricular contractions (PVC) are known to reduce the percentage of biventricular (BiV) pacing in patients with cardiac resynchronization (CRT), decreasing the clinical response. The aim of this study was to evaluate the prevalence of a high PVC burden, as well as therapeutic action (pharmacotherapy, catheter ablation or device programming), in a large CRT implantable-defibrillator (CRT-D) population.

Methods: Patients with a CRT-D device from the UMBRELLA multicenter prospective remote monitoring registry were included.

A scoring algorithm for the accurate differential diagnosis of regular wide QRS complex tachycardia.

Background: The differential diagnosis of regular wide QRS complex tachycardia (RWQRST) remains the subject of numerous publications, all of which aim at diagnosis during the acute phase. Although an accurate diagnosis is necessary to make long-term decisions, it often leads to invasive testing.

Methods: Criteria with high positive predictive values (PPVs) for diagnosis can be obtained by analyzing the electrocardiogram (ECG) data during RWQRST and comparing them with these data at baseline.

Paradoxical preexcitation during cryoablation of a concealed parahisian accessory pathway.

A 16-year-old male presented with an orthodromic atrioventricular reentrant tachycardia over a concealed parahisian accessory pathway (AP). Cryoablation of the AP resulted in transient manifestation of a fully preexcited sinus rhythm of parahisian AP morphology. Potential causes for the paradoxical preexcitation include inadvertent atrioventricular nodal block, sourse-sink mismatch, as well as the activation of a dormant AP capable of anterograde conduction.

Progression of Renal Insufficiency in Patients with Essential Hypertension Treated with Renin Angiotensin Aldosterone System Blockers: An Electrocardiographic Correlation.

Background: There is a frequent association between renal insufficiency and cardiovascular disease in patients with essential hypertension (HTN). The aim of this study was to analyze the relationship between ECG parameters and the progress of renal damage in patients with treated HTN.

Methods: 109 patients with HTN had their microalbuminuria monitored over a 3-year time frame.

Acute and Long-term Results After Contemporary Subcutaneous Implantable Cardioverter-defibrillator Implantation: A Single-center Experience.

Introduction And Objectives: The subcutaneous implantable cardioverter-defibrillator (S-ICD) has emerged as an alternative to the transvenous defibrillator. The incidence of complications is similar, with inappropriate shocks (IS) being more frequent than those occurring with contemporary programming of transvenous defibrillators. Several improvements have been implemented after the S-ICD was approved for use in Europe in 2009.

Estimation of the effects of multipoint pacing on battery longevity in routine clinical practice.

Aims: Multipoint pacing (MPP) permits simultaneous multisite pacing of the left ventricle (LV); initial studies suggest haemodynamic and clinical benefits over conventional (single LV site) cardiac resynchronization therapy (CRT). The aim of this study was to estimate the impact of MPP activation on battery longevity in routine clinical practice.

Methods And Results: Patient (n = 46) and device data were collected from two centres at least 3 months after MPP-CRT device implantation.