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.

Refractory hypertensive emergency associated with complete heart block resolved after permanent pacemaker implantation: A case report.

Severe hypertension sometimes improves with treatment of bradycardia but this phenomenon is under-reported. Here, an elderly gentleman with complete heart block and a hypertensive emergency was refractory to medical therapies and blood pressure only improved following pacemaker implantation. We discuss the possible mechanisms relating to heart rate and artificial pacing.

UBLED AF (Uninterrupted BLackpool EDoxaban vs Warfarin vs Rivaroxaban in Atrial Fibrillation/Flutter ablation) Study.

Aim: Catheter ablation in patients with atrial fibrillation (AF)/atrial flutter carries a risk of thromboembolism and major bleeding. In light of recent prospective trial data on the safety and efficacy of uninterrupted edoxaban in patients undergoing AF/flutter ablation, real-world Data was aimed for validation.

Methods: A total of 228 patients who underwent AF/atrial flutter ablation over 14 months at our centre were retrospectively analyzed.

Contemporary Management of Patent Foramen Ovale: A Multinational Survey on Cardiologists' Perspective.

Objectives: The purpose of our survey is to analyze the clinical approach used by interventional and imaging cardiologists to diagnose, treat, and follow-up patients with PFO-related left circulation thromboembolism in different parts of the world with particular emphasis on adherence to current guidelines.

Background: Firm guidelines do not cover many aspects of PFO-related patient care. Consequently, very disparate approaches exist among clinicians in the real-world.

A 59-Year-Old Woman with Familial Brugada Syndrome and the c.664C>T Variant of the Sodium Voltage-Gated Channel Alpha Subunit 5 (SCN5A) Gene, Accompanied by Congenital Absence of the Right Coronary Artery, Patent Foramen Ovale, and Ischemic Stroke.

BACKGROUND Brugada syndrome is a rare inherited channelopathy that can lead to sudden cardiac death. The discovery of new variants of variable penetrance along with the current guidance for cascade family screening can be expected to lead to an increase in identified asymptomatic carriers of potentially causative mutations of channelopathies. A single coronary artery is a rare congenital anomaly of the coronary anatomy.

Mental Health Outcomes Among British Healthcare Workers-Lessons From the First Wave of the Covid-19 Pandemic.

Objective: To ascertain the level of psychological distress, using validated psychology tools, among British National healthcare workers (HCW) during the first wave of the Covid-19 crisis.

Methods: A multi-centre, anonymized, all-comer staff survey across 3 hospitals in Lancashire, England during the Covid-19 first wave (April to June 2020), consisting of Patient Health Questionnaire (PHQ-9), Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder-7 (GAD-7), and Impact of Events Scale (IES-6).

Results: Among 1113 HCW, median (IQR) PHQ-9, GAD-7, PSS-10, and IES-6 score was 7 (3 to 11), 6 (3 to 11), 19 (13 to 24), and 9 (5 to 14), respectively.

Coronovirus Disease-2019 (COVID-19) Pandemic and Cardiac Electrophysiology: Guidance Protocol From a UK Tertiary Cardiac Center.

Since December 2019, the coronovirus disease-2019 (COVID-19) pandemic has resulted in more than 2,160,000 positive cases and more than 145,000 deaths until April 18, 2020. The pressure to the health services worldwide has been unprecedented. The redeployment of staff and resources to treat more efficiently COVID-19 cases along with the need to reduce disease transmission has affected the field of electrophysiology among many others.

Bradyarrhythmias for the Internist.

In this article, the authors review the different types of sinus node and atrioventricular node diseases that lead to bradyarrhythmias with their associated symptoms, the diagnostic investigations needed to assess the degree of disease, and the therapeutic management, including the indications for permanent pacing.

Renal function and the long-term clinical outcomes of cardiac resynchronization therapy with or without defibrillation.

Background And Aims: Patients with moderate-to-severe chronic kidney disease (CKD) are underrepresented in clinical trials of cardiac resynchronization therapy (CRT)-defibrillation (CRT-D) or CRT-pacing (CRT-P). We sought to determine whether outcomes after CRT-D are better than after CRT-P over a wide spectrum of CKD.

Methods And Results: Clinical events were quantified in relation to preimplant estimated glomerular filtration rate (eGFR) after CRT-D (n = 410 [39.

Long-term clinical outcomes of cardiac resynchronization therapy with or without defibrillation: impact of the aetiology of cardiomyopathy.

Aims: There is a continuing debate as to whether cardiac resynchronization therapy-defibrillation (CRT-D) is superior to CRT-pacing (CRT-P), particularly in patients with non-ischaemic cardiomyopathy (NICM). We sought to quantify the clinical outcomes after primary prevention of CRT-D and CRT-P and identify whether these differed according to the aetiology of cardiomyopathy.

Methods And Results: Analyses were undertaken in the total study population of patients treated with CRT-D (n = 551) or CRT-P (n = 999) and in propensity-matched samples.

Fluoroscopic left ventricular lead position and the long-term clinical outcome of cardiac resynchronization therapy.

Background: To determine the effects of left ventricular (LV) lead tip position on the long-term outcome of cardiac resynchronization therapy (CRT).

Setting: Cardiac device therapy center.

Patients: Five hundred and fifty-six patients (age 70.

Cardiac resynchronization therapy guided by late gadolinium-enhancement cardiovascular magnetic resonance.

Background: Myocardial scarring at the LV pacing site leads to incomplete resynchronization and a suboptimal symptomatic response to CRT. We sought to determine whether the use of late gadolinium cardiovascular magnetic resonance (LGE-CMR) to guide left ventricular (LV) lead deployment influences the long-term outcome of cardiac resynchronization therapy (CRT).

Methods: 559 patients with heart failure (age 70.

Female gender is associated with a better outcome after cardiac resynchronization therapy.

Background: Some studies have suggested that women respond differently to cardiac resynchronization therapy (CRT). We sought to determine whether female gender influences long-term clinical outcome, symptomatic response as well as echocardiographic response after CRT.

Methods And Results: A total of 550 patients (age 70.

Left ventricular reverse remodelling, long-term clinical outcome, and mode of death after cardiac resynchronization therapy.

Aims: To determine whether reverse left ventricular (LV) remodelling relates to long-term outcome, major adverse cardiovascular events (MACE), mode of death, and symptomatic response after cardiac resynchronization therapy (CRT).

Methods And Results: Three hundred and twenty-two patients with heart failure (HF) [age 69.2 ± 10.

Left ventricular non-compaction: clinical features and cardiovascular magnetic resonance imaging.

Background: It is apparent that despite lack of family history, patients with the morphological characteristics of left ventricular non-compaction develop arrhythmias, thrombo-embolism and left ventricular dysfunction.

Methods: Forty two patients, aged 48.7 +/- 2.

Long-term effects of upgrading from right ventricular pacing to cardiac resynchronization therapy in patients with heart failure.

Aims: To determine the effects of upgrading from right ventricular (RV) pacing to cardiac resynchronization therapy (CRT) in patients with heart failure.

Methods And Results: Patients with heart failure [age 67.3 +/- 9.

Effects of cardiac resynchronization therapy in patients unselected for mechanical dyssynchrony.

Background: Observational echocardiographic studies have suggested that pre-implant dyssynchrony is required for a response to cardiac resynchronization therapy. Some clinical guidelines on CRT have adopted dyssynchrony as a requirement prior to CRT.

Aims: To assess the effects of CRT in patients with heart failure who are unselected for mechanical dyssynchrony.

Late perforation of a defibrillator lead managed by percutaneous, intravenous extraction.

We report the case of a patient with ischaemic cardiomyopathy who underwent cardiac resynchronization therapy with defibrillator back-up. He re-presented 3 weeks later with chest pain, having received two shocks. We describe a case of late perforation with the Riata lead causing inappropriate shocks.

Long-term effects of cardiac resynchronization therapy in octogenarians: a comparative study with a younger population.

Aims: Heart failure is a disease of octogenarians. The evidence base for cardiac resynchronization therapy (CRT) has emerged from trials of patients in their 60s. We compared the effectiveness of CRT in octogenerians with younger patients.