Left atrial appendage occlusion in patients with atrial fibrillation and intracerebral haemorrhage associated with cerebral amyloid angiopathy: a multicentre observational study and pooled analysis of published studies.

Background: Cerebral amyloid angiopathy (CAA) is a common cause of intracerebral haemorrhage (ICH) with a high recurrence risk. Left atrial appendage occlusion (LAAO) is a method for ischaemic stroke prevention in patients with atrial fibrillation (AF), potentially reducing the risk of intracranial bleeding in CAA-associated ICH. We aimed to determine the outcomes of patients with AF with CAA-associated ICH undergoing LAAO.

Ethanol ablation for ventricular arrhythmias: A systematic review and meta-analysis.

Introduction: Ethanol ablation (EA) is an alternative option for subjects with ventricular arrhythmias (VAs) refractory to conventional medical and ablative treatment. However, data on the efficacy and safety of EA remain sparse.

Methods: A systematic literature search was conducted.

An overview of heart rhythm disorders and management in myotonic dystrophy type 1.

Myotonic dystrophy type 1 (DM1) is the most common adult form of muscular dystrophy, presenting with a constellation of systemic findings secondary to a CTG triplet expansion of the noncoding region of the DMPK gene. Cardiac involvement is frequent, with conduction disease and supraventricular and ventricular arrhythmias being the most prevalent cardiac manifestations, often developing from a young age. The development of cardiac arrhythmias has been linked to increased morbidity and mortality, with sudden cardiac death well described.

A Normal Electrocardiogram Does Not Exclude Infra-Hisian Conduction Disease in Patients With Myotonic Dystrophy Type 1.

Objectives: This study aimed to identify electrocardiographic (ECG) predictors of a prolonged His-ventricular (HV) interval in patients with type 1 myotonic dystrophy (DM1).

Background: Patients with DM1 have an increased risk of sudden cardiac death. The presence of His-Purkinje system disease/prolonged HV interval (≥70 ms) is associated with a higher risk of potentially life-threatening bradyarrhythmic events.

Post-operative cardiac implantable electronic devices in patients undergoing cardiac surgery: a contemporary experience.

Aims: Optimum timing of pacemaker implantation following cardiac surgery is a clinical challenge. European and American guidelines recommend observation, to assess recovery of atrioventricular block (AVB) (up to 7 days) and sinus node (5 days to weeks) after cardiac surgery. This study aims to determine rates of cardiac implantable electronic devices (CIEDs) implants post-surgery at a high-volume tertiary centre over 3 years.

Effect of tricuspid regurgitation and right ventricular dysfunction on long-term mortality in patients undergoing cardiac devices implantation: >10-year follow-up study.

Background: The long-term effect of tricuspid regurgitation (TR) after device implantation on long-term mortality remains unknown. In the present study, we sought to examine whether patients undergoing an implantable cardiac device procedure (pacemaker, cardiac defibrillator or cardiac resynchronisation therapy) have an increased risk of TR and to determine the effect of this on long-term survival.

Methods: A total of 304 patients who underwent device implant and had pre- and post-implant transthoracic echocardiogram were included in the analysis.

Full blood count as potential predictor of outcomes in patients undergoing cardiac resynchronization therapy.

Almost a third of patients fulfilling current guidelines criteria have suboptimal responses following cardiac resynchronization therapy (CRT). Circulating biomarkers may help identify these patients. We aimed to assess the predictive role of full blood count (FBC) parameters in prognosis of heart failure (HF) patients undergoing CRT device implantation.

The use of a single chamber leadless pacemaker for the treatment of cardioinhibitory vasovagal syncope.

Background: The use of pacemakers in the treatment of cardioinhibitory vasovagal syncope is controversial with a mixed message from the limited evidence base. Single chamber leadless pacemakers have been shown to be an effective alternative option to conventional pacemakers.

Objective: This study examines the use of leadless pacemakers in a cardioinhibitory vasovagal population in the United Kingdom.

Procedural and quality assessment data on catheter ablation for fascicular ventricular tachycardia.

Data presented in this article are supplementary materials to our article entitled "Catheter Ablation for Fascicular Ventricular Tachycardia: A Systematic review" (Creta et al., 2018). The current article provides additional procedural data regarding the catheter ablation for fascicular ventricular tachycardia (FVT) performed in the patients enrolled in our analysis.

Differences in the upslope of the precordial body surface ECG T wave reflect right to left dispersion of repolarization in the intact human heart.

Background: The relationship between the surface electrocardiogram (ECG) T wave to intracardiac repolarization is poorly understood.

Objective: The purpose of this study was to examine the association between intracardiac ventricular repolarization and the T wave on the body surface ECG (SECG).

Methods: Ten patients with a normal heart (age 35 ± 15 years; 6 men) were studied.

Catheter ablation for fascicular ventricular tachycardia: A systematic review.

Introduction: Catheter ablation has been evaluated as treatment for fascicular ventricular tachycardia (FVT) in several single-centre cohort studies, with variable results regarding efficacy and outcomes.

Methods: A systematic search was performed on PubMed, EMBASE and Cochrane database (from inception to November 2017) that included studies on FVT catheter ablation.

Results: Thirty-eight observational non-controlled case series comprising 953 patients with FVT undergoing catheter ablation were identified.

Usefulness of a clinical risk score to predict the response to cardiac resynchronization therapy.

Background: Almost 1/3 of heart failure patients fail to respond to cardiac resynchronization therapy (CRT). A simple clinical score to predict who these patients are at the moment of referral or at time of implant may be of importance for early optimization of their management.

Methods: Observational study.

Empowerment of athletes with cardiac disorders: a new paradigm.

Athletes with cardiac disorders frequently pose an ethical and medical dilemma to physicians assessing their eligibility to participate in sport. In recent decades, patient empowerment has been gaining increasing recognition in clinical decision-making. Empowerment is a process through which people are involved over the decisions and actions that affect their own lives.

Call for joint informed consent in athletes with inherited cardiac conditions.

Informed consent is of the utmost importance, especially in complex clinical situations where patients may be exposed to a life-threatening risk. A particularly complex example is the eligibility of competitive athletes with inherited cardiac conditions on medical grounds, especially when the risk is low or unquantifiable. The rationale and benefits of a joint informed consent for athletes to compete with potentially life-threatening cardiac conditions are discussed in this manuscript.

Long-Term Results of Triventricular Versus Biventricular Pacing in Heart Failure: A Propensity-Matched Comparison.

Objectives: The goal of this study was to assess the impact of triventricular pacing (Tri-V) on long-term survival.

Background: Biventricular pacing (Bi-V) is an important adjunctive treatment in advanced heart failure, but almost one-third of patients experience no improvement with this therapy and are labeled as nonresponders. Adding a third ventricular lead (Tri-V) has been shown to be feasible and provides favorable acute results when assessed by using echocardiographic, hemodynamic, and clinical endpoints.

Adenosine-guided pulmonary vein isolation versus conventional pulmonary vein isolation in patients undergoing atrial fibrillation ablation: An updated meta-analysis.

Background: Recurrent atrial fibrillation episodes following pulmonary vein isolation (PVI) are frequently due to reconnection of PVs. Adenosine can unmask dormant conduction, leading to additional ablation to improve AF-free survival. We performed a meta-analysis of the literature to assess the role of adenosine testing in patients undergoing atrial fibrillation (AF) ablation.

Percutaneous left atrial appendage occlusion using different technologies in the United Kingdom: A multicenter registry.

Objectives: This study aimed at assessing the feasibility and long-term efficacy of left atrial appendage occlusion (LAAO) in a "real world" setting.

Background: Although LAAO has recently emerged as an alternative to oral anticoagulants in patients with atrial fibrillation for the prevention of thromboembolic stroke, "real world" data about the procedure with different devices are lacking.

Methods: Eight centers in the United Kingdom contributed to a retrospective registry for LAAO procedures undertaken between July 2009 and November 2014.

Ventricular Arrhythmia Burden in Patients With Heart Failure and Cardiac Resynchronization Devices: The Importance of Renal Function.

Background: Chronic kidney disease (CKD) is a risk factor for arrhythmias in patients with heart failure (HF). However, the effects of CKD on ventricular arrhythmia (VA) burden in patients with cardiac resynchronization therapy and defibrillator (CRT-D) devices in a primary prevention setting are unknown.

Objective: To determine whether baseline CKD is associated with increased risk of VA in patients implanted with primary prevention CRT-D devices.

Ventricular stimulus site influences dynamic dispersion of repolarization in the intact human heart.

The spatial variation in restitution properties in relation to varying stimulus site is poorly defined. This study aimed to investigate the effect of varying stimulus site on apicobasal and transmural activation time (AT), action potential duration (APD) and repolarization time (RT) during restitution studies in the intact human heart. Ten patients with structurally normal hearts, undergoing clinical electrophysiology studies, were enrolled.

Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis.

Objective: Atrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) and is associated with a high risk of stroke. The efficacy and safety of catheter ablation in this setting is poorly characterised. We aimed to systematically review the existing literature and to perform a meta-analysis to determine the efficacy and safety of catheter ablation of AF in patients with HCM.

Biventricular pacing and coronary sinus ICD lead implantation in a patient with a mechanical tricuspid valve replacement.

A 49-year-old man was admitted with symptomatic, sustained monomorphic ventricular tachycardia. He had a previous history of AMP-kinase disease associated with hypertrophic cardiomyopathy and complete heart block, and a pre-existing dual chamber pacemaker. He also had a mechanical tricuspid valve replacement and mitral valve replacement, for severe tricuspid regurgitation from right ventricle (RV) lead-induced injury to the tricuspid valve and a fibroblastoma on the mitral valve.

Is There Still a Role for Complex Fractionated Atrial Electrogram Ablation in Addition to Pulmonary Vein Isolation in Patients With Paroxysmal and Persistent Atrial Fibrillation? Meta-Analysis of 1415 Patients.

Background: Ablation of complex fractionated atrial electrograms (CFAEs) has been proposed as a strategy to improve outcomes in atrial fibrillation (AF) catheter ablation, but the use of this technique remains contentious. We aimed to assess the impact of CFAE ablation in addition to pulmonary vein isolation (PVI) in patients undergoing ablation for AF.

Methods And Results: We performed a random effects meta-analysis of studies comparing PVI versus PVI+CFAE ablation.