Coronary Embolism Among Patients With ST-Segment-Elevation Myocardial Infarction and Atrial Fibrillation: An Underrecognized But Deadly Association.

Background: The prevalence and impact of coronary emboli (CE) in patients with ST-segment-elevation myocardial infarction (STEMI) and atrial fibrillation (AF) have not been specifically studied. The objective was to describe the clinical characteristics and outcomes of patients with AF and CE in a large series of patients with STEMI.

Methods And Results: We investigated 2292 consecutive patients with STEMI and among them 225 patients with AF: 46 patients with a STEMI related to CE (group A) and 179 patients with a STEMI related to an atherosclerotic cause (group B).

Bradycardia risk stratification with implantable loop recorder after unexplained syncope.

Background: An implantable loop recorder is an effective tool for diagnosing unexplained syncope. However, after a first episode in non-high-risk patients, the usefulness of implantable loop recorder implantation remains unclear.

Aims: To analyse relevant risk factors for significant bradycardia in order to identify patients who do or do not benefit from implantable loop recorder implantation.

Machine Learning-Based Phenogrouping in MVP Identifies Profiles Associated With Myocardial Fibrosis and Cardiovascular Events.

Background: Structural changes and myocardial fibrosis quantification by cardiac imaging have become increasingly important to predict cardiovascular events in patients with mitral valve prolapse (MVP). In this setting, it is likely that an unsupervised approach using machine learning may improve their risk assessment.

Objectives: This study used machine learning to improve the risk assessment of patients with MVP by identifying echocardiographic phenotypes and their respective association with myocardial fibrosis and prognosis.

Generalizable and robust deep learning algorithm for atrial fibrillation diagnosis across geography, ages and sexes.

To drive health innovation that meets the needs of all and democratize healthcare, there is a need to assess the generalization performance of deep learning (DL) algorithms across various distribution shifts to ensure that these algorithms are robust. This retrospective study is, to the best of our knowledge, an original attempt to develop and assess the generalization performance of a DL model for AF events detection from long term beat-to-beat intervals across geography, ages and sexes. The new recurrent DL model, denoted ArNet2, is developed on a large retrospective dataset of 2,147 patients totaling 51,386 h obtained from continuous electrocardiogram (ECG).

Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators.

Background: Women with congenital heart disease at high risk for sudden cardiac death have been poorly studied thus far.

Objectives: The aim of this study was to assess sex-related differences in patients with tetralogy of Fallot (TOF) and implantable cardioverter-defibrillators (ICDs).

Methods: Data were analyzed from the DAI-T4F (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator) cohort study, which has prospectively enrolled all patients with TOF with ICDs in France since 2010.

Cardiac Remodeling and Diastolic Dysfunction in Paroxysmal Atrial Fibrillation.

Background: Atrial fibrillation (AF) leads to the development of cardiac remodeling/diastolic dysfunction and vice versa. We intended to determine whether cardiac remodeling/diastolic dysfunction is present at early stages of AF.

Methods: We studied 175 patients with paroxysmal AF, compared with 175 matched control subjects, who had available echocardiography data to investigate the association between echocardiographic variables and AF from the STANISLAS cohort.

Is There an Association between Epicardial Adipose Tissue and Outcomes after Paroxysmal Atrial Fibrillation Catheter Ablation?

Background: In patients undergoing paroxysmal atrial fibrillation (PAF) ablation, pulmonary vein isolation (PVI) alone fails in maintaining sinus rhythm in up to one third of patients after a first catheter ablation. Epicardial adipose tissue (EAT), as an endocrine-active organ, could play a role in the recurrence of AF after catheter ablation.

Objective: To evaluate the predictive value of clinical, echocardiographic, biological parameters and epicardial fat density measured by computed tomography scan (CT-scan) on AF recurrence in PAF patients who underwent a first pulmonary vein isolation procedure using radiofrequency (RF).

Long-Term Follow-Up of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator: The DAI-T4F Nationwide Registry.

Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, and sudden cardiac death represents an important mode of death in these patients. Data evaluating the implantable cardioverter defibrillator (ICD) in this patient population remain scarce.

Methods: A Nationwide French Registry including all patients with tetralogy of Fallot with an ICD was initiated in 2010 by the French Institute of Health and Medical Research.

Recommendations for the use of electrophysiological study: Update 2018.

The field of cardiac electrophysiology has greatly developed during the past decades. Consequently, the use of electrophysiological studies (EPSs) in clinical practice has also significantly augmented, with a progressively increasing number of certified electrophysiology centers and specialists. Since Zipes et al published the Guidelines for Clinical Intracardiac Electrophysiology and Catheter Ablation Procedures in 1995, no official document summarizing current EPS indications has been published.

Atrial fibrillation patterns are associated with arrhythmia progression and clinical outcomes.

Objectives: Determinants of atrial fibrillation (AF) patterns and of progression of earlier forms to permanent AF, and their relationship with outcome are still poorly understood.

Methods: We examined AF patterns (paroxysmal, persistent and permanent), rate and predictors of AF progression, and outcomes in the PREFER (PREvention oF thromboembolic events-European Registry) in AF. The primary analysis was performed in the PREFER in AF prolongation dataset (n=3223 patients with AF with a complete 1-year follow-up, mean age 72±9 years, 40% women).

Influence of advancing age on clinical presentation, treatment efficacy and safety, and long-term outcome of inducible paroxysmal supraventricular tachycardia without pre-excitation syndromes: A cohort study of 1960 patients included over 25 years.

Aim: To investigate the influence of increasing age on clinical presentation, treatment and long-term outcome in patients with inducible paroxysmal supraventricular tachycardia (SVT) without pre-excitation syndromes.

Methods: Clinical and electrophysiological study (EPS) data, as well as long-term clinical outcome (mean follow-up 2.4±4.

Platelet function and microparticle levels in atrial fibrillation: Changes during the acute episode.

Background: Thrombotic risk constitutes a major complication of atrial fibrillation (AF). Platelets and microparticles (MPs) are important for hemostasis and thrombosis, however their participation during AF is not well known. The aim of this study was to characterize platelet function and MPs procoagulant and fibrinolytic activity in AF patients and to determine the effects of an acute-AF episode.

Prediction of atrial fibrillation in patients with supraventricular tachyarrhythmias treated with catheter ablation or not. Classical scores are not useful.

Background: Atrial fibrillation (AF) and other supraventricular tachyarrhythmias (SVTA) [atrial flutter (AFL), atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT) and preexcitation syndrome (PS)] are frequently associated. We assessed the AF occurrence frequency and predictors according to the nature of SVTA and completion of SVTA ablation.

Methods And Results: 4169 patients were referred for SVTA (typical AVNRT: 1338, AVRT over a concealed accessory pathway: 329, atypical AVNRT: 205, AFL: 1321; PS: 976); mean age was 50±20years; electrophysiological study (EPS) was systematic; patients were followed for a mean duration of 3±4.

Age-related location of manifest accessory pathway and clinical consequences.

Background: Accessory pathway (AP) ablation is not always easy. Our purpose was to assess the age-related prevalence of AP location, electrophysiological and prognostic data according to this location.

Methods: Electrophysiologic study (EPS) was performed in 994 patients for a pre-excitation syndrome.

Predictors and prognostic significance of tachycardiomyopathy: insights from a cohort of 1269 patients undergoing atrial flutter ablation.

Background: Atrial flutter-related tachycardiomyopathy (AFL-TCM) is a rare and treatable cause of heart failure. Little is known about its epidemiology and long-term prognosis. Our aims are to determine the prevalence, predictors and outcomes of AFL-TCM.

Electrophysiological study generally is negative in patients <40 years suspected of supraventricular tachycardia but also complaining of chest pain and/or syncope.

Background: The diagnosis of paroxysmal supraventricular tachycardia (SVT) frequently is a dilemma. Electrophysiological study (EPS) is the only means to evaluate the nature of symptoms when noninvasive studies remain negative. Our objectives were to determine the clinical factors of negativity or positivity of (EPS) in patients suspected of SVT.

AV nodal reentrant tachycardia or AV reentrant tachycardia using a concealed bypass tract-related adverse events.

Objectives: To jointly study paroxysmal supraventricular tachycardia (SVT)-related adverse events (AE) and ablation-related complications, with specific emphasis on the predictors of SVT-related AE as well as their significance by investigating their association with long-term mortality.

Methods: 1770 patients were included, aged 6 to 97, with either atrioventricular nodal reentrant tachycardia (AVNRT) or orthodromic atrioventricular reciprocal tachycardia (AVRT) mediated by concealed accessory pathway, consecutively referred for SVT work-up in a tertiary care center.

Results: SVT-related AE were identified in 339 patients (19%).

Risk and outcome after ablation of isthmus-dependent atrial flutter in elderly patients.

Purpose Of The Research: To study the influence of age on the clinical presentation and long-term outcome of patients referred for atrial flutter (AFL) ablation. Age-related differences have been reported regarding the prognosis of arrhythmias.

Methods: A total of 1187 patients with a mean age 65±12 years consecutively referred for AFL ablation were retrospectively analyzed in the study.

Factors of negativity of electrophysiological study in children and teenagers complaining of tachycardia and prognostic significance.

When non-invasive studies remain negative, the diagnosis of unexplained tachycardia in the young is a dilemma. The purpose of the study was to determine the factors of negativity of transesophageal electrophysiological study (EPS) in children/teenagers complaining of tachycardia and the prognostic value. Two hundred and seventy-three children with a normal ECG in sinus rhythm, aged from 6 to 19 years (15 ± 3), complained of tachycardia.

Influence of the mode of management of acute myocardial infarction on the inducibility of ventricular tachyarrhythmias with programmed ventricular stimulation after myocardial infarction.

Background: Programmed ventricular stimulation (PVS) is a technique for screening patients at risk for ventricular tachycardia (VT) after myocardial infarction (MI), but the results might be difficult to interpret.

Objectives: To investigate the results of PVS after MI, according to date of completion.

Methods: PVS results were interpreted according to the mode of MI management in 801 asymptomatic patients: 301 (group I) during the period 1982-1989, 315 (group II) during 1990-1999, and 185 (group III) during 2000-2010.

A case series of patients with poorly-tolerated arrhythmias related to a preexcitation syndrome and presenting with atypical ECG.

Unlabelled: The aim of study was to report different and unusual patterns of preexcitation syndrome (PS) noted in patients referred for studied for poorly-tolerated arrhythmias and their frequency. Electrophysiologic study (EPS) is an easy means to identify a patient with PS at risk of serious events. However the main basis for this diagnosis is the ECG which associates short PR interval and widening of QRS complex with a delta wave.

Risk of atrial fibrillation after atrial flutter ablation: impact of AF history, gender, and antiarrhythmic drug medication.

Introduction: Atrial fibrillation (AF) and flutter (AFL) are frequently associated. We assessed the frequency and identified the predictors of AF occurrence after AFL ablation.

Methods And Results: A total of 1,121 patients referred for AFL ablation were followed for a mean duration of 2.