The role of timing in treatment of atrial fibrillation: An AFFIRM substudy.

Background: In contrast to historical trials, the Early Treatment of Atrial Fibrillation for Stroke Prevention Trial (EAST-AFNET 4) suggests the superiority of early rhythm control over rate control in patients with recent-onset atrial fibrillation (AF). The relative contribution of timing vs improvement in AF therapeutics over time is unclear.

Objective: This study aimed to isolate the assessment of early intervention for AF from temporal changes in AF treatments through a secondary analysis of subjects from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study.

Absence of electrocardiographic change after prolonged application of a conducted electrical weapon in physically exhausted adults.

Background: Conducted electrical weapons (CEWs) are used by law enforcement for control of subjects by causing neuromuscular incapacitation. There has been scrutiny of CEWs and their potential role in the occasional sudden death of subjects in custody. There is a hypothesized causal relationship due to induced cardiac dysrhythmia.

Circular mapping catheter entrapment in the mitral valve apparatus: a previously unrecognized complication of focal atrial fibrillation ablation.

Radiofrequency catheter ablation of focal atrial fibrillation triggers within the pulmonary veins is a rapidly developing therapy that relies on both recent technologies and evolving techniques. We describe the entrapment of a circular mapping catheter within the mitral valve apparatus after transseptal catheterization and mapping of the left atrium and pulmonary veins. The occurrence of this previously unreported complication stresses the need for continual monitoring and reporting of adverse effects from new devices and procedures to better inform patients and physicians of the benefits and risks of electrophysiologic interventions.

Radiofrequency Ablation for Atrial Fibrillation.

Catheter ablation has emerged as an excellent treatment option for atrial fibrillation. In appropriate patients, particularly those with paroxysmal atrial fibrillation in the absence of structural heart disease, catheter-based pulmonary vein isolation can eliminate or dramatically reduce the arrhythmia burden. However, with currently available tools, the procedure is complex and labor intensive.

Successful interventional treatment of an octogenarian presenting with syncope and Ebstein's anomaly of the tricuspid valve.

Syncope is a frequent occurrence in the elderly and cardiac causes are common. Therefore, accurate diagnosis is essential since specific treatments are often required. We present an 85-year-old woman with recurrent syncope secondary to sinus node reentrant tachycardia (SNRT), which was successfully treated by radiofrequency ablation.