Delineation of intracavitary electrograms for the automatic quantification of decrement-evoked potentials in the coronary sinus with deep-learning techniques.

Cardiac arrhythmias cause depolarization waves to conduct unevenly on the myocardial surface, potentially delaying local components with respect to a previous beat when stimulated at faster frequencies. Despite the diagnostic value of localizing the distinct local electrocardiogram (EGM) components for identifying regions with decrement-evoked potentials (DEEPs), current software solutions do not perform automatic signal quantification. Electrophysiologists must manually measure distances on the EGM signals to assess the existence of DEEPs during pacing or extra-stimuli protocols.

Automated isochronal late activation mapping for substrate characterization in patients with repaired tetralogy of Fallot.

Aims: Slow conduction (SC) anatomical isthmuses (AIs) are the dominant substrate for monomorphic ventricular tachycardia (VT) in patients with repaired tetralogy of Fallot (rTF). This study aimed to evaluate the utility of automated propagational analysis for the identification of SC-AI in patients with rTF.

Methods And Results: Consecutive rTF patients undergoing VT substrate characterization were included.

Long-Term Survival After Implantable Cardiac Defibrillator Therapy According to Sex: A Propensity Matched Study.

Whether the sex factor influences the benefit of the implantable cardioverter-defibrillator (ICD) for the prevention of sudden death remains a subject of debate. Using a prospective registry, we sought to analyze the survival and time to first ICD therapy according to sex. Retrospective analysis of a prospective cohort of patients undergoing an ICD implant from 2008 to 2019.

Intracoronary tenecteplase versus abciximab as adjunctive treatment during primary percutaneous coronary intervention in patients with anterior myocardial infarction.

Aims: We sought to compare the effects of intracoronary administration of a fibrinolytic drug (tenecteplase) to those of a glycoprotein IIb/IIIa inhibitor (abciximab) in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).

Methods And Results: In this pilot trial, 76 patients (59 male) with anterior STEMI were randomised to intracoronary infusion of reduced-dose tenecteplase or abciximab during PPCI. Angiography was repeated at 48 hours to assess corrected TIMI frame count (cTFC) and TIMI myocardial perfusion grade (TMPG).

Repeated procedures at the generator pocket are a determinant of implantable cardioverter-defibrillator infection.

Background: Rates of cardiac-device infections have increased in recent years, but the current incidence and risk factors for infection in patients with implantable cardioverter-defibrillators (ICDs) are not well known.

Hypothesis: The increasing number of ICD infections is related to accumulated pocket manipulations over time.

Methods: This single-center, prospective study included patients that underwent ICD implantation from 2008 to 2015.

Impact of Contact Force Monitoring in Acute Pulmonary Vein Isolation Using an Anatomic Approach. A Randomized Study.

Background: The impact of contact force (CF) monitoring in pulmonary vein (PV) isolation after a circumferential anatomic ablation (CAA) is unknown. We analyze the usefulness of CF monitoring in acute PV isolation and procedure parameters using a CAA.

Methods: Fifty patients with paroxysmal atrial fibrillation were randomized into CF-on (CF >10 grams; n = 25) or CF-off (CF blinded; n = 25) groups.

Reverse atrial remodeling following pulmonary vein isolation: the importance of the body mass index.

Background: Pulmonary vein isolation (PVI) causes a reduction in left atrium size that is attributable to reverse atrial remodeling (RAR). The objective of this study was to identify predictors of RAR and determine its association with other parameters of improvement in cardiac function.

Methods: It is a prospective study with 74 patients (52 ± 9 years old, 81% male), and 51% of patients had paroxysmal atrial fibrillation.

Paroxysmal atrial fibrillation burden before and after pulmonary veins isolation: an observational study through a subcutaneous leadless cardiac monitor.

Aims: Data on the success rate of ablation in atrial fibrillation (AF) are controversial. Our hypothesis is that the efficacy must be evaluated considering the AF burden (AFB) before the procedure. Moreover, the clinical significance of early recurrence (ERAT) of AF or atrial tachyarrhythmias (AT) is debatable.

Ablation of atrioventricular nodal reentrant tachycardia in a patient with tricuspid atresia guided by electroanatomic mapping.

We describe a case of ablation of atrioventricular nodal reentrant tachycardia in a patient with tricuspid atresia and L-malposition of great vessels using an electroanatomical mapping system integrated with cardiac magnetic resonance imaging. Atrial activation mapping during tachycardia identified the retrograde fast pathway proximal to the His bundle, observed in the left interatrial septum. Ablation was successfully completed below this area.

T-wave Oversensing with Inappropriate Therapy in Remote Monitoring.

T-wave oversensing can cause inappropriate implantable cardioverter-defibrillator (ICD) therapies that are difficult to correct. Remote monitoring allows follow-up of ICD patients without visiting the hospital and can help in early detection of any malfunctions. We describe the case of a patient who experienced inappropriate antitachycardia pacing therapy due to T-wave oversensing; the problem was promptly detected by remote monitoring and corrected by device reprogramming.

Electroanatomical mapping of the esophagus in circumferential pulmonary vein isolation.

A virtual reconstruction of the geometry of the esophagus was produced using an electroanatomical mapping system and a specially designed catheter in 20 consecutive patients undergoing circumferential pulmonary vein isolation. The course of the esophagus, its motion and its proximity to the predicted lines of application of radiofrequency energy to the left atrium were evaluated. Thirteen (65%) were located centrally (i.

Unusual tachycardia association in a patient without structural heart disease.

We report an unusual association of persistent atrial flutter and bundle branch re-entrant ventricular tachycardia in a young patient without structural heart disease. Atrial flutter masked the infra-Hisian conduction disease, was fundamentally dependent on a long PR interval, and could be a possible trigger of ventricular tachycardia.

Three-dimensional impedance mapping as an aid to circumferential pulmonary vein isolation in paroxysmal atrial fibrillation.

During circumferential pulmonary vein isolation, radiofrequency lesions are created in the transition zone between the left atrium and the pulmonary veins, outside the ostia, to avoid stenosis. Three-dimensional impedance maps were constructed for 25 patients with paroxysmal atrial fibrillation. In the first 15 patients, impedance was measured inside the pulmonary veins (165.

Safety and efficacy of ezetimibe in a sample of cardiac transplant patients.

Objective: To evaluate the safety and efficacy of ezetimibe in a sample of transplanted cardiac patients.

Materials And Methods: We undertook a descriptive retrospective observational study of 19 transplanted cardiac patients in whom treatment with ezetimibe was initiated at doses of 10 mg/d between 2004 and 2006, assessing tolerability and changes in lipid levels (total cholesterol and triglycerides), doses of immunosuppressive drugs, and the hepatic profile after 12 months of treatment.

Results: There was no effect on the doses required of any immunosuppressive drugs.

Incidence and importance of de novo diabetes mellitus after heart transplantation.

Introduction: Diabetes mellitus is one of the main metabolic complications after heart transplantation. The aims of our study were to determine the incidence and factors that determine the appearance of posttransplantation diabetes mellitus (PTDM) and its prognostic value.

Materials And Methods: We performed a retrospective study of all heart transplant recipients in our hospital from January 1993 to December 2005, including 116 patients with prolonged monitoring with 59-month median follow-up.

Preliminary experience with conversion from calcineurin inhibitors to everolimus in cardiac transplantation maintenance therapy.

Introduction: Everolimus has been prescribed both for initial and maintenance therapy after cardiac transplantation. Herein, we present our initial experience with everolimus as maintenance therapy after cardiac transplantation.

Methods: We retrospectively included all of our patients in whom therapy was changed from calcineurin inhibitors to everolimus between September 2006 and October 2007.