Computed Tomography Coronary Angiography Is Feasible and Reliable for Proximal Coronary Segment Interpretation in Patients with Elevated Body Mass Index.

Computed tomography coronary angiography (CTCA) is under-utilised in detecting coronary artery disease (CAD) in obese patients due to concerns about non-evaluable testing. We hypothesise that these concerns are predominantly related to smaller and branch coronary vessels, and CTCA remains adequate for proximal segment stenosis interpretation, which has significant clinical implications. This retrospective cohort study, on consecutive patients referred for CTCA for suspected CAD, grouped patients by body mass index.

Variation of computed tomography-derived extracellular volume fraction and the impact of protocol parameters: A systematic review and meta-analysis.

Background: Cardiac computed tomography quantification of extracellular volume fraction (CT-ECV) is an emerging biomarker of myocardial fibrosis which has demonstrated high reproducibility, diagnostic and prognostic utility. However, there has been wide variation in the CT-ECV protocol in the literature and useful disease cut-offs are yet to be established. The objectives of this meta-analysis were to describe mean CT-ECV estimates and to estimate the effect of CT-ECV protocol parameters on between-study variation.

Cardiovascular Risk in Cancer Patients Treated with Immune Checkpoint Inhibitors: Challenges and Future Directions.

Cardiovascular disease is the leading cause of non-cancer related mortality and morbidity among people living with or cured from cancer. Immune checkpoint inhibitors (ICIs) are systemic anti-cancer therapies that have revolutionised the treatment of numerous cancers, even achieving durable long-term responses among patients with metastatic disease. However, the pro-inflammatory effects of ICIs have been postulated to increase the risk of atherosclerotic cardiovascular disease (ASCVD) in cancer survivorship.

Incessant myopericarditis after mRNA vaccination requiring IL-1 receptor antagonist therapy and pericardiectomy: case report.

Background: During the COVID-19 pandemic, there has been global administration of novel mRNA vaccines that are effective in reducing the burden of COVID-19. In tandem with this administration, mRNA vaccine-associated complications have been identified. One such complication is mRNA vaccine-associated pericarditis.

Inter-software and inter-scan variability in measurement of epicardial adipose tissue: a three-way comparison of a research-specific, a freeware and a coronary application software platform.

Objectives: Epicardial adipose tissue (EAT) is a proposed marker of cardiovascular risk; however, clinical application may be limited by variability in post-processing software platforms. We assessed inter-vendor agreement of EAT volume (EATv) and attenuation on both contrast-enhanced (CE) and non-contrast CT (NCT) using a standard coronary CT reporting software (Vitrea), an EAT research-specific software (QFAT) and a freeware imaging software (OsiriX).

Methods: Seventy-six consecutive patients undergoing simultaneous CE and NCT had complete volumetric EAT measurement.

Socioeconomic determinants of health, traditional risk factors and cardiovascular outcomes in Australia.

Background: Cardiovascular disease burden is decreasing, but these reductions have not been distributed equally amongst socioeconomic groups.

Objectives: The aim of this study was to define the relationships between different domains of socioeconomic health, traditional cardiovascular risk factors and cardiovascular events.

Methods: This was a cross-sectional study of local government areas (LGAs) in Victoria, Australia.

Applications of Machine Learning in Cardiac Electrophysiology.

Artificial intelligence through machine learning (ML) methods is becoming prevalent throughout the world, with increasing adoption in healthcare. Improvements in technology have allowed early applications of machine learning to assist physician efficiency and diagnostic accuracy. In electrophysiology, ML has applications for use in every stage of patient care.

The Natural history of Epicardial Adipose Tissue Volume and Attenuation: A long-term prospective cohort follow-up study.

Epicardial adipose tissue (EAT) is associated with cardiovascular risk. The longitudinal change in EAT volume (EATv) and density (EATd), and potential modulators of these parameters, has not been described. We prospectively recruited 90 patients with non-obstructive coronary atherosclerosis on baseline computed tomography coronary angiography (CTCA) performed for suspected coronary artery disease to undergo a repeat research CTCA.

Characteristics of myocardial tissue staining and lesion creation with an infusion-needle ablation catheter for the treatment of ventricular tachycardia in humans.

Background: Intramural substrate causing ventricular tachycardia can be targeted by radiofrequency (RF) infusion-needle catheter ablation.

Objective: The purpose of the study was to assess fluid distribution within the myocardium after needle-ablation catheter infusion and its evidence to RF lesion creation.

Methods: In 25 patients (21 (84%) male; 67 ± 9 years; 8 (32%) with ischemic cardiomyopathy) intramural ablation of ventricular tachycardia was performed with a needle catheter.

Catheter ablation of polymorphic ventricular tachycardia/fibrillation in patients with and without structural heart disease.

Background: Catheter ablation for polymorphic ventricular tachycardia and ventricular fibrillation (PMVT/VF) may target triggering premature ventricular contractions (PVCs). Targeting ventricular scar has also been suggested, but data are limited.

Objective: The purpose of this study was to characterize the electrophysiological findings and ablation outcomes for patients with PMVT/VF and structural heart disease (SHD) compared to those with idiopathic VF.

Off- vs. On-Pump Coronary Artery Bypass Grafting Long-Term Survival is Driven by Incompleteness of Revascularisation.

Background: Off-pump coronary artery bypass grafting (CABG) negates the requirement for extracorporeal circulation used with the traditional on-pump approach. However, off-pump CABG is technically more challenging and may theoretically lead to less complete revascularisation. Recent data suggests a prognostic benefit for traditional on-pump CABG, but the mechanism for this remains unclear.

Endpoints for Successful Slow Pathway Catheter Ablation in Typical and Atypical Atrioventricular Nodal Re-Entrant Tachycardia: A Contemporary, Multicenter Study.

Objectives: This study sought to investigate markers of success following slow pathway ablation for atrioventricular nodal re-entrant tachycardia (AVNRT).

Background: Published data are conflicting.

Methods: The authors studied 1,007 patients with typical AVNRT and 77 patients with atypical AVNRT.

Population Prevalence and Correlates of Prolonged QT Interval: Cross-Sectional, Population-Based Study From Rural Uganda.

Objectives: We aimed to estimate the prevalence and correlates of QT interval prolongation in rural Uganda.

Background: Major electrocardiographic abnormalities, including prolonged QT interval, have been shown to be independently predictive of adverse cardiovascular events among Western populations. Cardiovascular diseases are on the rise in sub-Saharan Africa with poorly characterized context-specific risk factors.

Association of Volumetric Epicardial Adipose Tissue Quantification and Cardiac Structure and Function.

Background Epicardial adipose tissue ( EAT ) is in immediate apposition to the underlying myocardium and, therefore, has the potential to influence myocardial systolic and diastolic function or myocardial geometry, through paracrine or compressive mechanical effects. We aimed to review the association between volumetric EAT and markers of myocardial function and geometry. Methods and Results PubMed, Medline, and Embase were searched from inception to May 2018.

Complications and Anticoagulation Strategies for Percutaneous Epicardial Ablation Procedures.

Background: Percutaneous pericardial access for catheter ablation is associated with a bleeding risk. We sought to elucidate the relation of hemorrhagic and thromboembolic events associated with epicardial procedures to anticoagulation strategy.

Methods: Anticoagulation strategy before and during pericardial access for 355 patients (57±14 years old) who had ventricular arrhythmia mapping and ablation were reviewed.

MRI in Patients with Cardiac Implantable Electronic Devices.

Indications for MRI have grown considerably in recent years. However, many patients with cardiac implantable electronic devices are denied imaging due to physician misinterpretation of the risks associated with MRI. This review discusses the theoretical basis for the perceived risk by exploring preclinical literature.