Anatomic obstacles in cavotricuspid isthmus detected by modified 2D transthoracic echocardiography and long-term outcomes in radiofrequency ablation of typical atrial flutter.

Background: Although radiofrequency ablation of the cavotricuspid isthmus (CTI), responsible for sustaining atrial flutter, is a highly effective procedure, in extended patients' observations following this procedure, more than every tenth becomes unsuccessful. Therefore, this study aimed to provide helpful information about the anatomy of the CTI in transthoracic echocardiography, which can aid in better planning of the CTI radiofrequency ablation in patients with typical atrial flutter.

Materials And Methods: 56 patients with typical atrial flutter after radiofrequency ablation were evaluated at the end of the 24-month observation period.

Experience with transvenous lead extraction of His bundle pacing leads.

Background: Nowadays, we observe a growing interest in conduction system pacing (CSP). Therefore, we expect the number of patients with CSP to increase significantly in the coming years. However, there is a lack of large data on transvenous lead extraction (TLE) procedures of CSP leads, particularly His bundle pacing (HBP) leads in the adult population.

Endocardial lead insulation wear in a scanning and optical microscope.

Background: The path and interaction of leads within the cardiovascular system are influenced by various factors, including the implantation technique. Furthermore, the multifaceted composition of these leads, often comprising multiple materials, can contribute to their potential degradation and wear over time.

Objectives: Our aim was to investigate the wear of lead insulation following the removal of transvenous leads and pinpoint the regions of the lead most vulnerable to damage.

Importance of Comprehensive Assessment in Brugada Syndrome. Reply to Kataoka, N.; Imamura, T. How to Diagnose and Risk Stratify Brugada Syndrome. Comment on "Matusik et al. Twelve-Lead ECG, Holter Monitoring Parameters, and Genetic Testing in Brugada Syndrome: Insights from Analysis of Multigenerational Family with a History of Sudden Cardiac Arrest during Physical Activity. 2023, , 6581".

We would like to thank Dr. Imamura for their interest in our study and their valuable comments on diagnostics and risk stratification in Brugada syndrome (BrS) [..

Twelve-Lead ECG, Holter Monitoring Parameters, and Genetic Testing in Brugada Syndrome: Insights from Analysis of Multigenerational Family with a History of Sudden Cardiac Arrest during Physical Activity.

Brugada syndrome (BrS) is an arrhythmogenic disorder increasing the risk of syncopal episodes and sudden cardiac death. BrS usually runs through families with reduced penetrance and variable expression. We analyzed the multigenerational family of a patient who died after sudden cardiac arrest with post-mortem diagnosis of BrS.

The usefulness of echo-based hemodynamic parameters in cardiac resynchronization therapy with conduction system pacing for optimal device programing.

Background: His bundle pacing (HBP) has proved to be a valuable alternative enabling the physiological activation of cardiac contraction in cardiac resynchronization therapy (CRT). At present, however, little is known about the optimal method of programming of the His bundle-paced CRT systems in terms of achieving the best cardiac output.

Aim: The aim of this study was to evaluate the impact of cardiac resynchronization therapy with conduction system pacing (CRT+CSP) on echo-based hemodynamic parameters in the early post-operative measurements.

Permanent single-chamber atrial pacing: an obsolete or viable alternative to dual-chamber pacing in selected patients with sinus node disease?

Introduction: Single atrial stimulation (AAI) has been commonly used for permanent pacing in sick sinus syndrome and significant bradycardia.

Objective: The study aimed to evaluate long‑term AAI pacing and to identify timing and reasons for pacing mode change.

Patients And Methods: Retrospectively, we included 207 patients (60% women) with initial AAI pacing, who were followed‑up for an average of 12 years.

Mechanical extraction of implantable cardioverter-defibrillator leads with a dwell time of more than 10 years: insights from a single high-volume centre.

Aims: To analyze and compare the effectiveness and safety of transvenous lead extraction (TLE) of implantable cardioverter-defibrillator (ICD) leads with a dwell time of >10 years (Group A) vs. younger leads (Group B) using mechanical extraction systems.

Methods And Results: Between October 2011 and July 2022, we performed TLE in 318 patients.

Radiofrequency catheter ablation of ventricular tachycardia using combined endocardial techniques in patients with structural heart disease improves procedural effectiveness and reduces arrhythmia episodes.

Background: Evidence indicates that radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT) in patients with structural heart disease (SHD) is safe and effective. However, arrhythmia recurrence is still relatively high, and the optimal procedural strategy is unclear. In clinical practice, several combinations of mapping and ablation techniques are used to improve VT ablation efficacy.

Continuous positive airway pressure treatment reduces ventricular arrhythmias in obstructive sleep apnea patients with nocturnal dominance of arrhythmias and severe desaturations.

Introduction: Continuous positive airway pressure (CPAP) treatment is considered effective in reducing ventricular arrhythmias (VAs) in patients with obstructive sleep apnea (OSA).

Objectives: We aimed to assess the influence of this treatment and to identify determinants of antiarrhythmic response.

Patients And Methods: We included patients with OSA and VAs (corresponding to grades 2-5 in the Lown classification), who underwent CPAP treatment and controls, who refused CPAP therapy.

Contact Force-Sensing versus Standard Catheters in Non-Fluoroscopic Radiofrequency Catheter Ablation of Idiopathic Outflow Tract Ventricular Arrhythmias.

Background: Adequate contact between the catheter tip and tissue is important for optimal lesion formation and, in some procedures, it has been associated with improved effectiveness and safety. We evaluated the potential benefits of contact force-sensing (CFS) catheters during non-fluoroscopic radiofrequency catheter ablation (NF-RFCA) of idiopathic ventricular arrhythmias (VAs) originating from outflow tracts (OTs).

Methods: A group of 102 patients who underwent NF-RFCA (CARTO, Biosense Webster Inc.

Non-fluoroscopic radiofrequency catheter ablation of right- and left-sided ventricular arrhythmias.

Introduction: Radiofrequency catheter ablation (RFCA) is an important method of treatment of ventricular arrhythmias (VAs). In the majority of RFCA, fluoroscopy is used, exposing patients and medical staff to all related side effects. Current experience of non-fluoroscopic (NF)-RFCA in VAs from the left side is limited.

Thoracic impedance measurement in heart stimulation and cardiac arrhythmias.

The electrocardiogram (ECG) interpretation in patients with implantable cardioverter defibrillator (ICD) is often a puzzling problem. The difficulty of the device function evaluation further increases in the presence of unfamiliar timing cycles and additional functions. We present an interesting ECG with a special function of a Biotronik ICD devices called the thoracic impedance monitoring, and demonstrate its behavior in a patient with atrial fibrillation, pacing beats, ventricular ectopic beats, and couple of ventricular beats.

Tracing the Right Phrenic Nerve - A Systematic Review and Meta-Analysis.

Background: The Right phrenic nerve (RPN) is vulnerable to injury during the isolation of the right pulmonary veins (RPV). The study aimed to provide a comprehensive meta-analysis of the overall prevalence of right phrenic nerve injury (RPNI), its course and its association with the superior and inferior pulmonary veins.

Methods: Through December 2017, a database search was performed on PubMed, Science Direct, EMBASE, SciELO, and Web of Science.

Chronic Kidney Disease and Its Impact on a Prothrombotic State in Patients with Atrial Fibrillation.

It is unclear whether chronic kidney disease (CKD) increases thromboembolism in atrial fibrillation (AF). We conducted a retrospective cross-sectional analysis of 502 non-anticoagulated AF patients (median age, 66 (60-73) years, median CHADS-VASc score, 3.0 (2.

Applicability of computed tomography preoperative assessment of the LAA in LV summit ablations.

Purpose: Ventricular arrhythmias originating from the left ventricular summit (LVS) may present with challenges for catheter ablation. Recently, the left atrial appendage (LAA) became a new vantage point for mapping and ablating arrhythmias from that region, but data of possible usefulness is limited.

Methods: From September to December 2019, we retrospectively analyzed 48 consecutive patient hearts (20 male; mean age 57.