Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block.

Aims: The left bundle branch block (LBBB) is a strong predictor of response to cardiac resynchronization therapy (CRT). However, a significant number of patients do not respond to the treatment. The study sought to evaluate the impact of the stricter Strauss criteria for left bundle branch block (St-LBBB) on CRT response, hospitalizations, ventricular arrhythmia (VA) events and mortality.

Cardiac contractility modulation in patients with heart failure - A review of the literature.

Experimental in vivo and in vitro studies showed that electric currents applied during the absolute refractory period can modulate cardiac contractility. In preclinical studies, cardiac contractility modulation (CCM) was found to improve calcium handling, reverse the foetal myocyte gene programming associated with heart failure (HF), and facilitate reverse remodeling. Randomized control trials and observational studies have provided evidence about the safety and efficacy of CCM in patients with HF.

When anticoagulation management in atrial fibrillation becomes difficult: Focus on chronic kidney disease, coagulation disorders, and cancer.

Anticoagulation therapy (AT) is fundamental in atrial fibrillation (AF) treatment but poses challenges in implementation, especially in AF populations with elevated thromboembolic and bleeding risks. Current guidelines emphasize the need to estimate and balance thrombosis and bleeding risks for all potential candidates of antithrombotic therapy. However, administering oral AT raises concerns in specific populations, such as those with chronic kidney disease (CKD), coagulation disorders, and cancer due to lack of robust data.

Hyperacute synchronous cardiocerebral infarction in a patient with new-onset atrial fibrillation: a case of myocardial infarction with nonobstructive coronary arteries.

Hyperacute synchronous cardiocerebral infarction (CCI) is an extremely rare condition with an incidence of 0.009%. In the acute stage of ischemic stroke, there is a high prevalence of ECG abnormalities.

Implantable Cardiac Defibrillator-Related Culture-Negative Infection: A Case of Infection.

is one of the most common causes of blood culture-negative infective endocarditis (IE). However, only a few cases of cardiac implantable electronic devices (CIED) infection have been reported in the literature. Herein, we present a case of CIED-related blood culture-negative infection attributed to .

Chronic Thoracic Aortic Dissection: How to Treat, When to Intervene.

Thoracic aortic dissection (AD) is associated with increased morbidity and mortality. Acute aortic syndrome is the first presentation of the disease in most cases. While acute AD management follows concrete guidelines because of its urgent and life-threatening nature, chronic AD is usually overlooked, although it concerns a wide spectrum of patients surviving an acute event.

The RV-V transition ratio: A novel electrocardiographic criterion for the differentiation of right versus left outflow tract premature ventricular complexes.

Background: Several electrocardiographic (ECG) indices have been proposed to predict the origin of premature ventricular complexes (PVCs) with precordial transition in lead V. However, the accuracy of these algorithms is limited.

Objectives: We sought to evaluate a new ECG criterion differentiating the origin of outflow tract with precordial transition in lead V.

An uncommon cause of inappropriate ICD shock.

In cases of electromagnetic interference (EMI), if the source of the inappropriate EMI cannot be identified, then the sensitivity of the device could be decreased, or the cycle length of the VF detection trigger zone changed.

The management of atrial fibrillation in heart failure: an expert panel consensus.

Heart failure (HF) and atrial fibrillation (AF) often coexist, being closely interrelated as the one increases the prevalence and incidence and worsens the prognosis of the other. Their frequent coexistence raises several challenges, including under-diagnosis of HF with preserved ejection fraction in AF and of AF in HF, characterization and diagnosis of atrial cardiomyopathy, target and impact of rate control therapy on outcomes, optimal rhythm control strategy in the era of catheter ablation, HF-related thromboembolic risk and management of anticoagulation in patients with comorbidities, such as chronic kidney disease or transient renal function worsening, coronary artery disease or acute coronary syndromes, valvular or structural heart disease interventions and cancer. In the present document, derived by an expert panel meeting, we sought to focus on the above challenging issues, outlining the existing evidence and identifying gaps in knowledge that need to be addressed.

Catheter ablation of anteroseptal accessory pathways from the aortic cusps: A case series and a review of the literature.

Data regarding catheter ablation of anteroseptal accessory pathways through the aortic cusps are limited. We describe two cases of true para-Hisian accessory pathways successfully ablated from the aortic cusps (right coronary cusp and non-coronary cusp, respectively) along with a review of the current literature. Due to the close proximity to the atrioventricular node and the high risk of complication, mapping of the aortic cusps should always be considered in the case of anteroseptal accessory pathways.

Prediction of atrial fibrillation development and progression: Current perspectives.

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression (from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself.

Immunosenescence in patients with chronic systolic heart failure.

Aim: Chronic heart failure (CHF) is characterized by hemodynamic compromise, neurohormonal and immune activation. We sought to examine the presence and severity of immunosenescence and its relation with the stages of CHF.

Methods: We enrolled 86 consecutive stable systolic CHF patients and examined the relationship of leukocyte and lymphocyte subpopulation counts by flow cytometry with their functional status according to New York Heart Association (NYHA) class.

Catheter Ablation of Ventricular Arrhythmias Arising from the Distal Great Cardiac Vein.

Catheter ablation of idiopathic ventricular arrhythmias arising from the distal great cardiac vein represents a great challenge. We report data regarding the electrocardiographic and electrophysiologic characteristics in two patients with ventricular arrhythmias arising from the distal great cardiac vein. The technical difficulties to advance and navigate the ablation catheter within the coronary venous system as well as the close proximity to the major coronary vessels are discussed.

Differences in quality of life, anxiety and depression in patients with paroxysmal atrial fibrillation and common forms of atrioventricular reentry supraventricular tachycardias.

Introduction: The aim of this study was to evaluate the differences in quality of life and psychosocial stress parameters among patients with paroxysmal atrial fibrillation (AF) and common forms of atrioventricular reentry supraventricular tachycardias (SVTs).

Methods And Results: The total study population included 106 patients, 54 patients with paroxysmal AF (32 males, age 56.64±12.

The impact of vagotonic, adrenergic, and random type of paroxysmal atrial fibrillation on left atrial ablation outcomes.

Background: Accumulating data have shown that the autonomic nervous system is strongly implicated in the genesis of atrial fibrillation (AF). The aim of this study was to assess the efficacy of a single ablation procedure in patients with vagotonic, adrenergic and random type of paroxysmal AF.

Methods And Results: The clinical records of consecutive patients with symptomatic, drug-refractory paroxysmal AF who underwent pulmonary vein antral isolation were analysed.

CHADS2 and CHA2DS2-VASc scores as predictors of left atrial ablation outcomes for paroxysmal atrial fibrillation.

Aims: The selection of patients with atrial fibrillation (AF) that will benefit most by left atrial ablation remains suboptimal. CHADS2 score has been shown to be associated with post-ablation AF recurrences. However, data regarding the CHA2DS2-VASc score are lacking.

Electrocardiographic and electrophysiologic characteristics of ventricular extrasystoles arising from the aortomitral continuity.

Left ventricular outflow tract arrhythmias originating from the aortomitral continuity, the left coronary cusp, the superior basal septum, and the epicardial left ventricular summit display common electrocardiographic and electrophysiological features, probably due to the close proximity of those locations. Catheter ablation of these arrhythmias can be challenging. The case of a 68-year-old male with frequent premature ventricular extrasystoles arising from the aortomitral continuity of the basal left ventricle is described.

Epsilon-like waves and ventricular conduction abnormalities in subjects with type 1 ECG pattern of Brugada syndrome.

Background: Previous studies have demonstrated an overlap between the arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) and Brugada syndrome (BS). Conduction delay in the right ventricle has been demonstrated in both entities.

Objective: This study investigated specific ARVC/D electrocardiographic (ECG) markers in subjects with spontaneous or drug-induced type 1 ECG pattern of BS.

Potential-guided versus anatomic-guided approach for slow pathway ablation of the common type atrioventricular nodal reentry tachycardia: a randomized study.

Objective: The present study aimed to compare the effectiveness and safety of the potential- and the anatomic-guided approach for slow pathway ablation in patients with recurrent episodes of symptomatic common type atrioventricular (AV) nodal reentrant tachycardia.

Methods: Two hundred and twenty-eight patients were randomly assigned to undergo either a potential- (n=114, 47% men, mean age 52.85 +/- 14.

ECG findings of acute myocardial infarction and atrioventricular block during a transseptal procedure for left atrial ablation.

We report on a patient with transient atrioventricular block and ST-segment elevation mimicking the ECG of myocardial infarction during transseptal puncture for radiofrequency catheter ablation of atrial fibrillation. Symptoms and EGG findings resolved spontaneously. A neurally-mediated mechanism, activated by the mechanical effects of the transseptal puncture on the interatrial septum and leading to coronary artery spasm, may be considered as a possible explanation of this phenomenon.