Early repolarization pattern in an ethnically diverse population: Increased risk in Hispanics.

Background: Early repolarization (ER) pattern on ECG is associated with an increased mortality in Caucasians. This study analyzed the association between ER pattern and all-cause mortality in a population of multiple ethnicities.

Methods: A total of 20 000 individuals were randomly selected and their ECGs were analyzed for ER pattern using the 2015 consensus: end-QRS notching or slurring with a J-point (Jp) ≥0.

Cardiac devices in patients with transthyretin amyloidosis: Impact on functional class, left ventricular function, mitral regurgitation, and mortality.

Background: The aim of our study was to investigate outcomes of patients with ATTR (amyloidosis and transthyretin) CA (cardiac amyloidosis) and implantable devices with respect to left ventricular ejection fraction (LVEF), mitral regurgitation (MR), New York Heart Association (NYHA) functional class, and mortality.

Methods: This was a retrospective observational cohort study of 78 patients with ATTR CA and implantable devices. During a mean follow-up of 42 months we investigated the impact of right ventricular (RV) pacing burden and biventricular (BiV) pacing on LVEF, MR severity, NYHA functional class, and mortality.

Association Between Pre-Ablation Glycemic Control and Outcomes Among Patients With Diabetes Undergoing Atrial Fibrillation Ablation.

Objectives: The aim of this study was to investigate the impact of improved glycemic control on atrial fibrillation (AF) recurrence rates after ablation.

Background: Diabetes is associated with increased rates of AF. The impact of improved pre-ablation glycemic control remains unknown.

Arrhythmias and Adaptations of the Cardiac Conduction System in Former National Football League Players.

Background Habitual high-intensity endurance exercise is associated with increased atrial fibrillation (AF) risk and impaired cardiac conduction. It is unknown whether these observations extend to prior strength-type sports exposure. The primary aim of this study was to compare AF prevalence in former National Football League (NFL) athletes to population-based controls.

Association between pre-ablation bariatric surgery and atrial fibrillation recurrence in morbidly obese patients undergoing atrial fibrillation ablation.

Aims: Obesity decreases arrhythmia-free survival after atrial fibrillation (AF) ablation by mechanisms that are not fully understood. We investigated the impact of pre-ablation bariatric surgery (BS) on AF recurrence after ablation.

Methods And Results: In this retrospective observational cohort study, 239 consecutive morbidly obese patients (body mass index ≥40 kg/m2 or ≥35 kg/m2 with obesity-related complications) were followed for a mean of 22 months prior to ablation.

Ascending Aortic Dimensions in Former National Football League Athletes.

Background: Ascending aortic dimensions are slightly larger in young competitive athletes compared with sedentary controls, but rarely >40 mm. Whether this finding translates to aortic enlargement in older, former athletes is unknown.

Methods And Results: This cross-sectional study involved a sample of 206 former National Football League (NFL) athletes compared with 759 male subjects from the DHS-2 (Dallas Heart Study-2; mean age of 57.

Socioeconomic status and the development of atrial fibrillation in Hispanics, African Americans and non-Hispanic whites.

Background: Atrial fibrillation (AF) is the most common arrhythmia and is associated with significant morbidity and mortality. Despite having a higher burden of traditional AF risk factors, African American and Hispanic minorities have a lower incidence of AF when compared to non-Hispanic whites, referred to as the "racial paradox."

Hypothesis: Lower SES among Hispanics and African Americans may help to explain the lower incidence rates of AF compared to non-Hispanic whites.

Socioeconomic Status as a Predictor of Mortality in Patients Admitted With Atrial Fibrillation.

Lower socioeconomic status (SES) is associated with a higher risk of cardiovascular disease. However, the association between SES and mortality in patients with atrial fibrillation (AF) is not clear. We examined whether SES predicts all-cause mortality in patients hospitalized with AF.

State Requirements for Automated External Defibrillators in American Schools: Framing the Debate About Legislative Action.

Installation of automated external defibrillators (AEDs) in schools has been associated with increased survival after sudden cardiac arrest. An authoritative academic research database was interrogated to identify all current state statutes pertaining to AEDs in schools. As of February 2016, 17 of 50 U.

Atrial Fibrillation Ablation and Stroke.

Catheter ablation has become a widely available and accepted treatment to restore sinus rhythm in atrial fibrillation patients who fail antiarrhythmic drug therapy. Although generally safe, the procedure carries a non-negligible risk of complications, including periprocedural cerebral insults. Uninterrupted anticoagulation, maintenance of an adequate ACT during the procedure, and measures to avoid and detect thrombus build-up on sheaths and atheters during the procedure, appears useful to reduce the risk of embolic events.

Remote Magnetic Navigation: A Focus on Catheter Ablation of Ventricular Arrhythmias.

VT ablation is based on percutaneous catheter insertion under fluoroscopic guidance to selectively destroy (i.e., ablate) myocardial tissue regions responsible for the initiation or propagation of ventricular arrhythmias.

Validation of the Framingham Heart Study and CHARGE-AF Risk Scores for Atrial Fibrillation in Hispanics, African-Americans, and Non-Hispanic Whites.

A risk score for atrial fibrillation (AF) has been developed by the Framingham Heart Study and Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE)-AF consortium. However, validation of these risk scores in an inner-city population is uncertain. Thus, a validation model was built using the Framingham Risk Score for AF and CHARGE-AF covariates.

[Early repolarization in ECG. Definition, prevalence and prognostic significance].

Early repolarization defined as antero-lateral ST-segment elevation exists in 1-2 % of the general population and has been considered a benign ECG finding for decades. However, early repolarization, defined as infero-lateral J-waves, has in recent studies been associated with an increased - albeit low - risk of sudden and cardiovascular death. This ECG pattern is present in 3-13% of the general population.

The Prognostic Value of Early Repolarization with ST-Segment Elevation by Age and Gender in the Hispanic Population.

Background: Early repolarization (ER), once thought to be a benign finding on electrocardiograph (ECG), has recently been associated with an increased risk of sudden cardiac death. As there are limited data in the Hispanic population, we investigated possible associations between automated ECG ER readings and overall mortality, using the classic definition involving J-point elevation with ST segment elevation.

Methods: An ECG and electronic medical record (EMR) database from a regional medical center was interrogated.

Left Atrial Appendage Occlusion Device and Novel Oral Anticoagulants Versus Warfarin for Stroke Prevention in Nonvalvular Atrial Fibrillation: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Nonvalvular atrial fibrillation is the most common arrhythmia. Patients with nonvalvular atrial fibrillation are at increased risk of stroke; therefore, we evaluated the efficacy and safety of different approaches to prevent this major complication.

Methods And Results: We conducted electronic database searches of phase III randomized controlled trials.

Robotic navigation for catheter ablation: benefits and challenges.

Manual radio frequency (RF) ablation to restore a normal cardiac rhythm requires significant skill, manual dexterity and experience. In response to this, ablation methods and technologies have evolved rapidly in the past decade, including the development of remote navigation technologies. Today, two principal methods of remote navigation are available.

Validation of PR interval length as a criterion for development of atrial fibrillation in non-Hispanic whites, African Americans and Hispanics.

Background: PR interval prolongation on electrocardiogram (ECG) increases the risk of atrial fibrillation (AF). Non-Hispanic Whites are at higher risk of AF compared to African Americans and Hispanics. However, it remains unknown if prolongation of the PR interval for the development of AF varies by race/ethnicity.

Ablation of atrial arrhythmias in heart failure.

HF and AF are on the rise and often coexist. Pharmacologic rhythm control has not been shown to improve outcomes compared with pharmacologic rate control. It is possible that the benefits of maintaining SR are offset by the adverse effects of AADs.

Prognostic value of automatically detected early repolarization.

Early repolarization associated with sudden cardiac death is based on the presence of >1-mm J-point elevations in inferior and/or lateral leads with horizontal and/or downsloping ST segments. Automated electrocardiographic readings of early repolarization (AER) obtained in clinical practice, in contrast, are defined by ST-segment elevation in addition to J-point elevation. Nonetheless, such automated readings may cause alarm.

Heart rate and its variability in response to running-associations with troponin.

Purpose: The objective of this study is to investigate the time course of autonomic tone changes after a first-time endurance running race participation and associations with postexertional high-sensitivity troponin (hsTnT) levels in middle-aged males.

Methods: Male (n = 42) first-time long-distance running race (Lidingöloppet 30 km) participants ≥45 yr (50.5 ± 5) were examined.

Early repolarization in middle-age runners: cardiovascular characteristics.

Purpose: This study aimed to assess the prevalence and patterns of early repolarization (ER) in middle-age long-distance runners, its relation to cardiac structure and function, and its response to strenuous physical activity.

Methods: Male first-time cross-country race participants >45 yr were assessed pre- and postrace by medical history and physical examination, 12-lead ECG, vectorcardiography, blood tests, and echocardiography. ER was defined either as ST elevation or J wave and categorized according to localization and morphology.

Preparticipation evaluation of novice, middle-age, long-distance runners.

Purpose: The purpose of this study was to assess the cardiovascular health and risk profile in middle-age men making an entry to participate for their first time in a long-distance race.

Methods: Male first-time participants, 45 yr and older, in the world's largest cross-country running race, the Lidingöloppet, were evaluated with a medical history and physical examination, European systematic coronary risk evaluation (SCORE), 12-lead ECG, echocardiography, and blood tests. Further diagnostic workup was performed when clinically indicated.

Altered ventriculo-arterial coupling during exercise in athletes releasing biomarkers after endurance running.

Exercise can lead to release of biomarkers such as cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP), a poorly understood phenomenon proposed to especially occur with high-intensity exercise in less trained subjects. We hypothesised that haemodynamic perturbations during exercise are larger in athletes with cTnT release, and studied athletes with detectable cTnT levels after an endurance event (HIGH; n = 16; 46 ± 9 years) against matched controls whose levels were undetectable (LOW; n = 11; 44 ± 7 years). Echocardiography was performed at rest and at peak supine bicycle exercise stress.

Performance trends and cardiac biomarkers in a 30-km cross-country race, 1993-2007.

Purpose: Long-distance running events enjoy increasing popularity in all ages. Whereas the health benefits of regular moderate exercise are undisputed, the net health effects of single or repeated participation in endurance events of marathon type remain to be determined. We wanted to investigate performance trends over time and the relationship between race performance and cardiac biomarker levels among participants in a large annual 30-km cross-country race.