Comparison of P-wave parameter changes after radiofrequency ablation and cryoballoon ablation for paroxysmal atrial fibrillation: An observational cohort study.

Background: Pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) can be performed using one-shot cryoballoon ablation (cryo) or point-by-point radiofrequency ablation (RF). This study compares the changes in P-wave parameters between both ablation methods.

Methods: This single-centre retrospective study included contact force RF and second-generation cryo for PAF between 2018 and 2019.

The Value of P-Wave Parameters Changes in Predicting Catheter Ablation Outcomes for Paroxysmal Atrial Fibrillation.

Background: Pulmonary vein isolation (PVI) is the most promising management method for paroxysmal atrial fibrillation (PAF). The P wave in the electrocardiogram (ECG) represents atrial depolarization. This study aims to correlate P-wave parameters after PVI with outcomes.

Value of P-wave Parameters in Predicting Outcomes of Repeat Catheter Ablation for Paroxysmal Atrial Fibrillation.

Background: Pulmonary vein isolation (PVI) has been established as an effective management option for symptomatic paroxysmal atrial fibrillation (PAF). We aimed to explore the role of P-wave parameters in a 12-lead electrocardiogram (ECG) in predicting the success of repeat PAF ablation.

Methods: We enrolled consecutive patients who underwent a second AF ablation procedure for PAF in a UK tertiary center after an index ablation conducted between 2018 and 2019 and a repeat ablation up to 2021.

Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres.

Introduction: Pulsed-field ablation (PFA) is a novel modality for pulmonary vein isolation in patients with atrial fibrillation (AF). We describe the initial uptake and experience of PFA using a pentaspline catheter across selected National Health Service England (NHSE) centres.

Methods: Data collected by NHSE Specialised Services Development Programme regarding AF ablation procedures using a single-shot, pentaspline, multielectrode PFA catheter (FARAWAVE, Boston Scientific) between June 2022 and August 2024 were aggregated and analysed to examine procedural metrics, acute efficacy and safety outcomes over 3-month follow-up.

The prevalence and prognostic value of diabetes and hypertension in patients treated for cholera during the ongoing Syrian conflict.

Objectives: Little work has been done investigating the prevalence and impact of comorbidities on cholera outcomes within conflict settings. We describe the clinical outcomes of patients treated for cholera in Latakia, Syria, during the 2022-2023 cholera outbreak.

Methods: We performed a single-centre retrospective observational cohort study of patients admitted to the hospital with suspected cholera between 15th December 2022 and 15th February 2023 at National Hospital, Latakia, Syria.

Digitally enabled acute care for atrial fibrillation: conception, feasibility and early outcomes of an AF virtual ward.

Background: Atrial fibrillation (AF) represents a growing healthcare challenge, mainly driven by acute hospitalisations. Virtual wards could be the way forward to manage acute AF patients through remote monitoring, especially with the rise in global access to digital telecommunication and the growing acceptance of telemedicine post-COVID-19.

Methods: An AF virtual ward was implemented as a proof-of-concept care model.

Involuntary arm movements post-pacemaker insertion - real or Reel syndrome?

Background: Twiddler syndrome, and the variant Reel syndrome, are rare but important complications of pacemaker implantation.

Case Summary: We describe a rare complication of conventional permanent pacemaker implantation of rhythmic arm twitching secondary to brachial plexus stimulation from a displaced pacing lead caused by Reel syndrome.

Discussion: Twiddler syndrome and its variants are rare but important complications of pacemaker insertion.

COVID-19 inpatient treatments and outcomes during the conflict in Syria: an observational cohort study.

Background: During the COVID-19 pandemic, countries undergoing conflict have faced difficulties in mounting an effective health response. This observational cohort study describes the treatments and outcomes for inpatients with COVID-19 in the Syrian city of Latakia.

Design And Methods: A single-centre observational cohort study was conducted at Tishreen University Hospital, involving all patients over 18 admitted between October 1 and December 31, 2021 with a positive RT-PCR test for SARS-CoV-2.

UK Expert Consensus Statement for the Optimal Use and Clinical Utility of Leadless Pacing Systems on Behalf of the British Heart Rhythm Society.

Pacemakers are a key technology in the treatment of bradyarrhythmias. Leadless pacemakers (LP) were introduced to address limitations of transvenous devices. However, guidelines and other restrictions have led to LPs becoming niche products.

Bi-atrial thrombus straddling a patent foramen ovale with bilateral embolization: A therapeutic challenge.

Stroke is a leading cause of morbidity and mortality across the world and a significant portion of ischemic strokes have a cardiac source. We report a case of a 55-year-old male who presented with an ischemic stroke and bilateral pulmonary emboli secondary to an intra-cardiac thrombus straddling a patent foramen ovale, which was clearly seen using transesophageal echocardiography. We discuss the management dilemma associated with this clinical picture given the risk of hemorrhagic transformation in the acute phase of an ischemic stroke.

Atrioventricular synchronous pacing using leadless pacemaker in a heart transplant patient.

We report the first leadless pacemaker (L-PM) providing atrioventricular synchronous pacing implanted into a heart transplant patient receiving chronic immunosuppressive therapy. The patient presented with syncope corresponding to sinus rhythm with high-grade atrioventricular block. Previously, L-PMs provided only single-chamber ventricular sensing and pacing.

Fluoroscopic Appearance of a Single-Wall Cryoballoon Breach During Pulmonary Vein Isolation.

Cryoballoon ablation therapy is increasingly used for pulmonary vein isolation. Its safety and efficacy profile is comparable to that of radiofrequency ablation therapy. Double-wall cryoballoon breaches have been described in published reports.

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.

A Comparison of the Efficacy of Voltage-directed Cavotricuspid Isthmus Ablation Using Mini Versus Conventional Electrodes.

Cavotricuspid isthmus (CTI) ablation is a current first-line management method for typical atrial flutter. A voltage-directed technique that systematically targets points of maximal voltage has be found to reduce procedure and fluoroscopy times without increasing recurrence. We hypothesized that this technique's efficiency would be enhanced by using signals from radial minielectrodes of a novel catheter (IntellaTip MiFi™; Boston Scientific, Natick, MA, USA).

Long QT syndrome complicating atrioventricular block: arrhythmogenic effects of cardiac memory.

Background: The magnitude of QT prolongation in response to bradycardia, rather than the bradycardia per se, determines the risk for torsade de pointes during atrioventricular block (AVB). However, we do not know why some patients develop more QT prolongation than others, despite similar bradycardia. We hypothesized that in patients who develop significant QRS vector changes during AVB, the effects of cardiac memory lead to excessive QT prolongation.

Unnecessary shock from an implantable cardioverter-defibrillator following transcutaneous pacing.

As the population ages and cardiovascular disease becomes more prevalent, an increasing number of patients are receiving implantable cardioverter-defibrillators (ICDs). When these patients present to the emergency department, it is imperative that physicians are not only aware of the possible underlying medical issues that may have precipitated their admission but should also have a good understanding of the potential interactions that any medical intervention may have on the patient's device. We discuss a case in which a patient known to have an ICD in situ was transcutaneously paced for the management of bradycardia, leading to an unnecessary shock.

The peri-procedural use of dabigatran in patients undergoing left atrial ablation for atrial fibrillation.

Introduction: Pulmonary vein isolation is an effective strategy in patients with atrial fibrillation (AF). The peri-procedural use of anticoagulation is routinely employed to reduce thromboembolic risk.

Aims/methods: The aim of this study was to compare the use of Dabigatran to the other 2 strategies involving the use of Warfarin.