Left Atrial Wall Thickness Measured by a Machine Learning Method Predicts AF Recurrence After Pulmonary Vein Isolation.

Background: Left atrial (LA) remodeling plays a significant role in the progression of atrial fibrillation (AF). Although LA wall thickness (LAWT) has emerged as an indicator of structural remodeling, its impact on AF outcomes remains unclear. We aimed to determine the association between LAWT and AF recurrence after pulmonary vein isolation (PVI), as well as to evaluate the relationship between LAWT and LA fibrosis.

Digital health in cardiovascular medicine: An overview of key applications and clinical impact by the Portuguese Society of Cardiology Study Group on Digital Health.

Digital health interventions including telehealth, mobile health, artificial intelligence, big data, robotics, extended reality, computational and high-fidelity bench simulations are an integral part of the path toward precision medicine. Current applications encompass risk factor modification, chronic disease management, clinical decision support, diagnostics interpretation, preprocedural planning, evidence generation, education, and training. Despite the acknowledged potential, their development and implementation have faced several challenges and constraints, meaning few digital health tools have reached daily clinical practice.

Outcomes of ventricular tachycardia ablation in patients with ischemic and non-ischemic cardiomyopathy: A propensity-score matched analysis.

Introduction And Objectives: Catheter ablation (CA) is effective in the treatment of ventricular tachycardia (VT). Although some observational data suggest patients with non-ischemic cardiomyopathy (NICM) have less favorable outcomes when compared to those with an ischemic etiology (ICM), direct comparisons are rarely reported. We aimed to compare the outcomes of VT ablation in a propensity-score matched population of ICM or NICM patients.

Coronary atherosclerotic burden in veteran athletes: The relationship between cardiovascular risk and volume of exercise.

Introduction And Objectives: The association between exercise and coronary atherosclerosis still remains unclarified. We aimed to analyze the prevalence of high coronary atherosclerotic burden in veteran athletes, considering cardiovascular (CV) risk and volume of exercise.

Methods: A total of 105 asymptomatic male veteran athletes (48±5.

Quality indicators in atrial fibrillation ablation (RIQAFA). A national registry from the Portuguese Association of Arrhythmology, Pacing and Electrophysiology (APAPE).

Introduction And Objectives: Atrial fibrillation (AF) is the most common sustained arrhythmia, with significant burden for patients. Catheter ablation is safe and superior for symptom improvement. The purpose of this work was to assess how clinical practice compares with current scientific evidence and quality indicators for AF ablation.

Impact of Contact Force-Sensing Catheters on Fluoroscopy Time in Interventional Electrophysiology: A European Survey.

This multicenter European survey systematically evaluated the impact of using contact force-sensing catheters (CFSCs) on fluoroscopy and procedure time in interventional electrophysiology. Data from 25 participating centers were collected and analyzed, also considering important confounders. With the use of CFSCs, fluoroscopy time was reduced for right- and left-sided atrial ablations (median −6.

Independent factors of low radiation dose during atrial fibrillation ablation with cryoballoon or radiofrequency: Results from the "Go for zero fluoroscopy" registry.

Aims: Atrial fibrillation (AF) catheter ablation is a common procedure requiring in most cases the use of fluoroscopy. We aimed to evaluate the factors associated with a lower dose of fluoroscopy used during AF ablation with cryoballoon or radiofrequency.

Methods: In this prospective European registry, centers were requested to provide procedural characteristics of consecutive AF ablation cases.

Portuguese National Registry on Cardiac Electrophysiology, 2017 and 2018.

Introduction: The authors present the results of the national cardiac electrophysiology registry of the Portuguese Association of Arrhythmology, Pacing and Electrophysiology (APAPE) and the Portuguese Institute of Cardiac Rhythm (IPRC) for 2017 and 2018.

Methods: The registry is annual, voluntary, and observational. Data are collected retrospectively.

A new electrophysiologic triad for identification and localization of the critical isthmus in atrial flutter.

Introduction: Atypical atrial flutter (AFL) is a supraventricular arrhythmia that can be treated with catheter ablation. However, this strategy yields suboptimal results and the best approach is yet to be defined. Carto® electroanatomical mapping (EAM) version 7 displays a histogram of the local activation times (LAT) of the tachycardia cycle length (TCL), in addition to activation and voltage maps.

Implantable Cardioverter-Defibrillators in Trials of Drug Therapy for Heart Failure: A Systematic Review and Meta-Analysis.

BACKGROUND Medical therapy for heart failure with reduced ejection fraction evolved since trials validated the use of implantable cardioverter-defibrillators (ICDs). We sought to evaluate the performance of ICDs in reducing mortality in the era of modern medical therapy by means of a systematic review and meta-analysis of contemporary randomized clinical trials of drug therapy for heart failure with reduced ejection fraction. METHODS AND RESULTS We systematically identified randomized clinical trials that evaluated drug therapy in patients with heart failure with reduced ejection fraction that reported mortality.

Impact of prophylactic cavotricuspid isthmus ablation in atrial fibrillation recurrence after a first pulmonary vein isolation procedure.

Introduction: PVI is a well-established therapy for patients with drug refractory atrial fibrillation (AF). However, it remains unclear whether prophylactic cavotricuspid isthmus (CTI) ablation at the time of PVI improves long-term freedom from AF.

Objective: To compare the outcomes of patients who underwent PVI alone vs.

Very long-term outcomes after a single catheter ablation procedure for the treatment of atrial fibrillation-the protective role of antiarrhythmic drug therapy.

Background: Pulmonary vein isolation (PVI) is the cornerstone of AF ablation, but its long-term clinical outcomes, predictors of relapse, and optimal pharmacological treatment remain controversial.

Objective: The objectives of this paper were to (1) assess very long-term AF recurrence, (2) identify predictors of relapse, and (3) evaluate the impact of continued antiarrhythmic drug (AAD) treatment after ablation.

Methods: Multicenter observational registry including all consecutive patients with drug-resistant AF who underwent a first PVI between 2006 and 2008 (n = 253 (age 55 years (IQR 48-63)), 80% males, 64% with paroxysmal AF.

Brugada syndrome is associated with scar and endocardial involvement: Insights from high-density mapping with the Rhythmia™ mapping system.

The authors report the first catheter ablation of Brugada syndrome in the literature using the Rhythmia™ mapping system. Learning points include: (1) low voltage areas can be documented while mapping in some individuals, suggesting that Brugada syndrome may not be a pure ion channel disorder; (2) typical long fractionated potentials can also be identified in the endocardium, supporting the need to map the endocardium in all Brugada patients requiring ablation; (3) disappearance of the typical coved pattern following ablation does not necessarily predict cure, as the patient we present experienced ventricular fibrillation recurrence a few months later.

Development and validation of a risk score for predicting atrial fibrillation recurrence after a first catheter ablation procedure - ATLAS score.

Aims: Several predictors of relapse after catheter ablation of atrial fibrillation (AF) have been established, but assessing each patient's individual risk remains challenging. Our aim was to develop and validate a score to estimate the risk of AF recurrence after the first radiofrequency pulmonary vein isolation (PVI) procedure.

Methods And Results: Independent predictors of AF relapse were identified retrospectively in a two-centre registry of 1934 patients who underwent a first PVI procedure.

Variability in interpretation of the electrocardiogram in athletes: Another limitation in pre-competitive screening.

Introduction: Assessment of the electrocardiogram (ECG) in athletes remains controversial, with lack of standardization and difficulty in applying specific criteria in its interpretation. The purpose of this study was to assess variability in the interpretation of the ECG in athletes.

Methods: Twenty ECGs of competitive athletes were assessed by cardiologists and cardiology residents, 11 of them normal or with isolated physiological changes and nine pathological.

Low previous cardiovascular risk of patients with ST-elevation myocardial infarction.

Background: Myocardial infarction is frequently the initial form of presentation of coronary artery disease (CAD). Systemic Coronary Risk Estimation (SCORE) risk tables are used in primary prevention and provide an estimate of cardiovascular (CV) risk through known risk factors. The aim of this study was to evaluate the performance of the SCORE, calculated using data previous to the event, to estimate CV risk of a population of patients presenting with ST-elevation myocardial infarction (STEMI) as the first manifestation of CAD.

Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysis.

Introduction: Rotors and complex fractionated atrial electrograms (CFAEs) have been suggested as possible therapeutic targets in ablation of atrial fibrillation (AF). The aim of this study was to assess the relationship between rotors and CFAEs in patients with AF.

Methods: We studied 18 patients with AF (mean age 69±8 years, 33% female) who underwent rotor ablation and pulmonary vein isolation.