Longitudinal comparison of dyssynchrony correction and 'strain' improvement by conduction system pacing: LEVEL-AT trial secondary findings.

Aims: Longitudinal dyssynchrony correction and 'strain' improvement by comparable cardiac resynchronization therapy (CRT) techniques is unreported. Our purpose was to compare echocardiographic dyssynchrony correction and 'strain' improvement by conduction system pacing (CSP) vs. biventricular pacing (BiVP) as a marker of contractility improvement during 1-year follow-up.

Same-day discharge after atrial fibrillation ablation under a nurse-coordinated standardized protocol.

Aims: Same-day discharge (SDD) after atrial fibrillation (AF) ablation is an effective means to spare healthcare resources. However, safety remains a concern, and besides structural adaptations, SDD requires more efficient logistics and coordination. Therefore, in this study, we implement a streamlined, nurse-coordinated SDD programme following a standardized protocol.

Vasovagal Responses to Human Monomorphic Ventricular Tachycardia: Hemodynamic Implications From Sinus Rate Analysis.

Background: Factors determining hemodynamic stability during human ventricular tachycardia (VT) are incompletely understood.

Objectives: The purposes of this study were to characterize sinus rate (SR) responses during monomorphic VT in association with hemodynamic stability and to prospectively assess the effects of vagolytic therapy on VT tolerance.

Methods: This is a retrospective analysis of patients undergoing scar-related VT ablation.

Left Bundle Branch Block: Characterization, Definitions, and Recent Insights into Conduction System Physiology.

Left bundle branch block (LBBB) is not just a simple electrocardiogram alteration. The intricacies of this general terminology go beyond simple conduction block. This review puts together current knowledge on the historical concept of LBBB, clinical significance, and recent insights into the pathophysiology of human LBBB.

Stepwise application of ECG and electrogram-based criteria to ensure electrical resynchronization with left bundle branch pacing.

Aims: To define a stepwise application of left bundle branch pacing (LBBP) criteria that will simplify implantation and guarantee electrical resynchronization. Left bundle branch pacing has emerged as an alternative to biventricular pacing. However, a systematic stepwise criterion to ensure electrical resynchronization is lacking.

Conduction System Pacing vs Biventricular Pacing in Heart Failure and Wide QRS Patients: LEVEL-AT Trial.

Background: Conduction system pacing (CSP) has emerged as an alternative to biventricular pacing (BiVP). Randomized studies comparing both therapies are scarce and do not include left bundle branch pacing.

Objectives: This study aims to compare ventricular resynchronization achieved by CSP vs BiVP in patients with cardiac resynchronization therapy indication.

Orthogonal high-density mapping with ventricular tachycardia isthmus analysis vs. pure substrate ventricular tachycardia ablation: A case-control study.

Background: Substrate-based ablation has become a successful technique for ventricular tachycardia (VT) ablation. High-density (HD) mapping catheters provide high-resolution electroanatomical maps and better discrimination of local abnormal electrograms. The HD Grid Mapping Catheter is an HD catheter with the ability to map orthogonal signals on top of conventional bipolar signals, which could provide better discrimination of the arrhythmic substrate.

Conduction system pacing vs. biventricular pacing in patients with ventricular dysfunction and AV block.

Background: It is unknown whether His-Purkinje conduction system pacing (HPCSP), as either His bundle or left bundle branch pacing, could be an alternative to cardiac resynchronization therapy (BiVCRT) for patients with left ventricular dysfunction needing ventricular pacing due to atrioventricular block. The aim of the study is to compare the echocardiographic response and clinical improvement between HPCSP and BiVCRT.

Methods: Consecutive patients who successfully received HPCSP were compared with a historical cohort of BiVCRT patients.

Septal flash correction with His-Purkinje pacing predicts echocardiographic response in resynchronization therapy.

Background: His-Purkinje conduction system pacing (HPCSP) has been proposed as an alternative to Cardiac Resynchronization Therapy (CRT); however, predictors of echocardiographic response have not been described in this population. Septal flash (SF), a fast contraction and relaxation of the septum, is a marker of intraventricular dyssynchrony.

Methods: The study aimed to analyze whether HPCSP corrects SF in patients with CRT indication, and if correction of SF predicts echocardiographic response.

Left Bundle Branch Block: Characterization, Definitions, and Recent Insights into Conduction System Physiology.

Left bundle branch block (LBBB) is not just a simple electrocardiogram alteration. The intricacies of this general terminology go beyond simple conduction block. This review puts together current knowledge on the historical concept of LBBB, clinical significance, and recent insights into the pathophysiology of human LBBB.

Left Bundle Branch Pacing: A New Alternative to Resynchronization Therapy in the 2020 Pacing Armamentarium.

His bundle pacing was developed while seeking a physiological alternative to biventricular cardiac resynchronization therapy. However, His bundle pacing may not be adequate in all patients. In this scenario, left bundle branch pacing has arisen as a new cardiac resynchronization therapy modality to correct left bundle branch block and restore ventricular synchrony.

Leadless pacemakers in critically ill patients requiring prolonged cardiac pacing: A multicenter international study.

Background: Temporary transvenous pacing in critically ill patients requiring prolonged cardiac pacing is associated with a high risk of complications. We sought to evaluate the safety and efficacy of self-contained intracardiac leadless pacemaker (LPM) implantation in this population.

Methods And Results: Consecutive patients implanted with a Micra LPM during the hospitalization in an intensive care unit were retrospectively included.

Cardiac Resynchronization Therapy Response Is Equalized in Men and Women by Electrical Optimization: PR Matters.

Objectives: This study hypothesized that the shorter intrinsic PR interval observed in women allows a greater degree of fusion with intrinsic conduction, achieving a shorter QRS interval duration and, thus, a better response.

Background: Women benefit more from cardiac resynchronization therapy (CRT) than men. However, the reason for this difference remains elusive.

Optimized single-point left ventricular pacing leads to improved resynchronization compared with multipoint pacing.

Background: Multipoint pacing (MPP) in cardiac resynchronization therapy (CRT) activates the left ventricle from two locations, thereby shortening the QRS duration and enabling better resynchronization; however, compared with conventional CRT, MPP reduces battery longevity. On the other hand, electrocardiogram-based optimization using the fusion-optimized intervals (FOI) method achieves more significant reverse remodeling than nominal CRT programming. Our study aimed to determine whether MPP could attain better resynchronization than single-point pacing (SPP) optimized by FOI.

Invasive pulmonary aspergillosis in heart transplant recipients: Is mortality decreasing?

Introduction: Infection remains a major complication among heart transplant (HT) recipients, causing approximately 20% of deaths in the first year after transplantation. In this population, Aspergillus species can have various clinical presentations including invasive pulmonary aspergillosis (IPA), which has high mortality (53-78%).

Aims: To establish the characteristics of IPA infection in HT recipients and their outcomes in our setting.