Techniques and outcomes of atrial fibrillation ablation in patients with persistent left superior vena cava.

Objectives: To investigate tailored approaches, techniques, and outcomes of catheter ablation in patients with persistent left superior vena cava (PLSVC) undergoing atrial fibrillation (AF) ablation.

Background: PLSVC presents unique challenges for AF ablation due to its potential as an arrhythmogenic source and the complex anatomical variations it introduces.

Methods: The retrospective cohort included 16 patients with PLSVC that underwent 21 AF ablation procedures between August 1, 2008, and February 14, 2024, at the Hospital of the University of Pennsylvania.

Evaluation of organized atrial arrhythmias after cryptogenic stroke.

Background: Long-term rhythm monitoring to detect atrial fibrillation (AF) following a cryptogenic stroke (CS) is well established. However, the burden of organized atrial arrhythmias in this population is not well defined.

Objective: The purpose of this study was to assess the incidence and risk factors for organized atrial arrhythmias in patients with CS.

Multicenter experience with andexanet alfa for refractory pericardial bleeding during catheter ablation of atrial fibrillation.

Introduction: Pericardial bleeding is a rare but life-threatening complication of atrial fibrillation (AF) ablation. Patients taking uninterrupted oral anticoagulation (AC) may be at increased risk for refractory bleeding despite pericardiocentesis and administration of protamine. In such cases, andexanet alfa can be given to reverse rivaroxaban or apixaban.

Atrial arrhythmias in chronic lung disease-associated pulmonary hypertension.

Atrial arrhythmias are common during episodes of acute respiratory failure in patients with chronic lung disease-associated pulmonary hypertension. Expert opinion suggests that management of atrial arrhythmias in patients with pulmonary hypertension should aim to restore sinus rhythm. This is clinically challenging in pulmonary hypertension patients with coexisting chronic lung disease, as there is controversy on the use of rhythm control agents; generally, in regard to either their pulmonary toxicity profile or the lack of evidence supporting their use.

Premature Ventricular Complexes in Apparently Normal Hearts.

Premature ventricular complexes (PVCs) are consistently associated with worse prognosis and higher morbidity and mortality. This article reviews PVCs and their presentation in patients with an apparently normal heart. Patients with PVCs may be completely asymptomatic, whereas others may note severely disabling symptoms.

Thyroid storm in a patient with Wolff-Parkinson-White syndrome.

A 44-year-old woman with no medical history presented to the emergency department with a 2 h history of sudden onset chest pressure, palpitations, diaphoresis and shortness of breath. She reported a 90-pound unintentional weight loss, increased appetite, irritability, night sweats and palpitations for 2 months. Physical examination revealed a heart rate (HR) of 269 bpm and a blood pressure of 116/94 mm Hg.

Association of physician certification and outcomes among patients receiving an implantable cardioverter-defibrillator.

Context: Allowing nonelectrophysiologists to perform implantable cardioverter-defibrillator (ICD) procedures is controversial. However, it is not known whether outcomes of ICD implantation vary by physician specialty.

Objective: To determine the association of implanting physician certification with outcomes following ICD implantation.

Pacemaker therapy for early and late sinus node dysfunction in orthotopic heart transplant recipients: a single-center experience.

Background: Sinus node dysfunction (SND) is a well-known early complication of orthotopic heart transplantation (OHT). Its incidence over the lifetime of transplant recipients is less well characterized. The goal of this study was to determine the incidence and timing of SND treated with a permanent pacemaker in a large cohort of OHT recipients.