Predictive value of interatrial block on electrocardiogram among obese patients undergoing atrial fibrillation ablation.

Background: Determine a predictive value of interatrial block (IAB) on atrial fibrillation (AF) ablation outcomes in obese patients.

Methods: Medical records were retrospectively reviewed for 205 consecutive patients with body mass indices (BMI) ≥ 30 kg/m who underwent initial AF ablation. Evidence of partial IAB defined as P-wave duration (PWD) ≥ 120 ms and advanced IAB with PWD ≥ 120 ms and biphasic or negative P-wave in inferior leads was examined from sinus electrocardiograms (ECGs) within 1-year pre-ablation.

Predictors of high-degree atrioventricular block in patients with new-onset left bundle branch block following transcatheter aortic valve replacement.

Background: The development of new left bundle branch block (LBBB) is frequently seen post TAVR and is a known risk factor for progression to high degree AV block. The timing and likelihood of progression into complete heart block is variable and can develop after hospital discharge. We sought to determine predictors for the development of high degree AV block in patients who developed LBBB following TAVR.

Safety and efficacy of non-vitamin K antagonist oral anticoagulants for prevention of thromboembolism in adults with systemic right ventricle: Results from the NOTE international registry.

Background: Patients with systemic right ventricle (sRV), including transposition of great arteries (TGA) after atrial switch procedure and congenitally corrected transposition of great arteries (ccTGA), may require anticoagulation for thromboembolism (TE) prevention. In the absence of data on non-vitamin K antagonist oral anticoagulants (NOACs), vitamin K antagonists (VKAs) remain the agent of choice. We investigated the safety, efficacy and feasibility of NOACs treatment in adults with sRV in a worldwide study.

Surgical management of major intrathoracic hemorrhage resulting from high-risk transvenous pacemaker/defibrillator lead extraction.

A method, based on well-established trauma principles, is described for surgical management of serious intrathoracic bleeding complications that can occur during the extraction of pacemaker or defibrillator leads. Using this method, four patients who experienced rapid hemodynamic deterioration due to traumatic injury of the superior vena cava and its tributaries during defibrillator lead extraction underwent successful surgical repair. Perioperative preparation for high-risk lead extractions, management of major bleeding complications, and surgical repair techniques are discussed.

QTc compared to JTc for monitoring drug-induced repolarization changes in the setting of ventricular pacing.

Background: QT prolongation is a risk factor for proarrhythmia when beginning antiarrhythmic drug therapy (AAD). However, there are no data regarding monitoring repolarization changes during a ventricular paced (VP) rhythm.

Objective: The purpose of this study was to compare serial changes in corrected QT and JT intervals, during native conduction (NC) and VP rhythms when initiating Class III AADs.

Comparing imaging modalities for screening aortic complications in patients with bicuspid aortic valve.

Objective: Bicuspid aortic valve (BAV) is associated with aortic root and ascending aorta aneurysm and increased risk for aortic dissection. Guidelines recommend transthoracic echocardiography (TTE) for primary aortic evaluation, although cardiac magnetic resonance (CMR) may be superior at detecting abnormalities. This study compares TTE and CMR imaging for aortic evaluation in patients with BAV.

The Management of Atrial Fibrillation in a Patient with Unrepaired Atrial Septal Defect.

Atrial fibrillation (AF) is a frequent comorbidity in adults with atrial septal defect (ASD), one of the most common congenital heart defects. However, there are currently limited recommendations for the management of AF associated with ASD. This article describes a case using a planned approach of catheter ablation followed by transcatheter device closure and discusses management options.

Usefulness of screening cardiovascular magnetic resonance imaging to detect aortic abnormalities after repair of coarctation of the aorta.

Guidelines recommend screening cardiovascular magnetic resonance (Sc-CMR) imaging for all patients after coarctation of the aorta repair, although there are limited data verifying its clinical utility. Therefore, we sought to assess the value of Sc-CMR in detecting aortic complications and at-risk abnormalities after coarctation of the aorta repair and to identify significant risk factors. We reviewed 76 patients (mean age 31 ± 10 years), including 40 with symptomatically indicated CMR (Sx-CMR) and 36 with Sc-CMR studies.

Rate of inducible ventricular arrhythmia in adults with congenital heart disease.

Patients with adult congenital heart disease are at increased risk of ventricular arrhythmia (VA) and sudden cardiac death, although no clear predictors have been found. Ventricular programmed stimulation has been shown to predict clinical ventricular tachycardia and sudden death events, but the role of screening electrophysiology studies (S-EPSs) in this population remains poorly defined. Therefore, we sought to determine the prevalence of inducible VA and to evaluate the clinical predictors in a heterogeneous group of patients with adult congenital heart disease (> or =18 years old) undergoing S-EPSs at preoperative or interventional cardiac catheterization.

Is left ventricular noncompaction in children truly an isolated lesion?

Left ventricular noncompaction (LVNC) is a form of cardiomyopathy resulting from a disorder of endomyocardial morphogenesis. It has been associated with significant morbidity and mortality. The aim of this study was to characterize associated cardiac findings in children with LVNC and to identify risk factors associated with increased mortality.

Treatment of aortic arch aneurysm with a NuMED-covered stent and restoration of flow to excluded left subclavian artery: perforation and dilation of e-PTFE can be done!

We describe a case using a NuMED-covered Cheatham-Platinum (CP) stent (NuMED, Hopkinton, NY) to treat an aneurysm after previous balloon angioplasty and bare stent implantation for coarctation of the aorta (CoA). Exclusion of the left subclavian artery (LSCA) was anticipated. After wire perforation of the covered CP stent, balloon angioplasty was performed through a stent cell to recannulize the LSCA.