Peak frequency analysis and functional substrate mapping to predict critical isthmus of atypical atrial tachycardia: Findings from a novel automated annotation algorithm to detect near-field signals.

Background: Atypical atrial tachycardia (AT) is a commonly encountered rhythm disorder, especially in patients with underlying atrial scar. Peak frequency (PF) annotation of bipolar electrograms is a novel method that mainly aims to discriminate near-field and far-field signals.

Objective: This study aimed to evaluate the PF annotation of low-voltage zones and deceleration zones during sinus/paced rhythm and their role in predicting the critical isthmus (CI) and termination sites of atypical ATs.

Immediate changes in depolarization and repolarization after left bundle branch area pacing and atrioventricular nodal ablation.

Background: Malignant arrhythmia due to ventricular depolarization and repolarization alterations after atrioventricular node (AVN) ablation is a known clinical entity. Here, we aimed to demonstrate the ventricular depolarization and repolarization changes in patients who underwent left bundle branch area pacing (LBBaP) and AVN ablation.

Methods: This is a single-center, retrospective preliminary study (n = 10).

Does cognitive function affect functional capacity and perceived fatigue severity after exercise in patients with coronary artery disease?

Background & Objective: Successful execution of exercise-based cardiac rehabilitation programs, an important branch of physiotherapy in individuals with coronary artery disease (CAD), depends on adequate cognitive abilities. It has been identified that coronary microvascular dysfunction, marked by reduced coronary flow reserve, is associated with impaired cerebral blood flow, affecting haemodynamic and cognitive performance. This study aimed to investigate how cognitive function influences functional capacity and differences in fatigue perception in CAD patients.

2024 updated European Heart Rhythm Association core curriculum for physicians and allied professionals: a statement of the European Heart Rhythm Association of the European Society of Cardiology.

Heart rhythm management is a continuously evolving sub-speciality of cardiology. Every year, many physicians and allied professionals (APs) start and complete their training in cardiac implantable electronic devices (CIEDs) or electrophysiology (EP) across the European Heart Rhythm Association (EHRA) member countries. While this training ideally ends with an EHRA certification, the description of the learning pathway (what, how, when, and where) through an EHRA core curriculum is also a prerequisite for a successful training.

Long-term Outcomes of Cryoballoon-based Empirical Superior Vena Cava Isolation in Addition to Pulmonary Vein Isolation in Persistent Atrial Fibrillation.

Background: Superior vena cava (SVC) is atrial fibrillation (AF)'s most common non-pulmonary vein (PV) foci. Studies reported conflictory results when SVC isolation (SVCi) was combined with PVi and long-term outcomes were lacking. Therefore, we aimed to evaluate the long-term efficacy and safety of empirical SVCi as an adjunct to cryoballoon-based PV isolation (PVi) in persistent AF ablation.

Functional substrate mapping of atrium in patients with atrial scar: A novel method to predict critical isthmus of atrial tachycardia.

Atrial tachycardia (AT) is a common rhythm disorder, especially in patients with atrial structural abnormalities. Although voltage mapping can provide a general picture of structural alterations which are mainly secondary to prior ablations, surgery or pressure/volume overload, data is scarce regarding the functional characteristics of low voltage regions in the atrium to predict critical isthmus of ATs. Recently, functional substrate mapping (FSM) emerged as a potential tool to evaluate the functionality of structurally altered regions in the atrium to predict critical sites of reentry.

Ictal Asystole During Focal Seizures Due to Left Occipital Glioneuronal Tumor: A Report of Case Treated With Cardiac Neuromodulation.

Ictal asystole (IA) is a rare but potentially life-threatening complication of focal epilepsy. The sudden onset of loss of consciousness and drop attacks in a patient with chronic epilepsy should suggest the possibility of this complication. Once the diagnosis is established, rapid management should be considered, especially in high-risk cases.

Cryoballoon ablation of non-PV triggers in persistent atrial fibrillation.

Cryoballoon-based catheter ablation has emerged as an efficacious and safe therapeutic intervention for patients with paroxysmal atrial fibrillation (PAF). PAF is primarily associated with the triggers in the pulmonary vein (PV). However, persistent atrial fibrillation (PeAF) is a complex condition that involves changes in the atrial substrate and the presence of non-PV triggers.

Atrial Late Activation Mapping Predicts the Critical Isthmus of Left Atrial Re-entrant Tachycardia.

Functional atrial mapping is an emerging mapping modality to predict potential critical sites with a role in the maintenance of tachycardia. We report a case of atrial late activation mapping under sinus rhythm predicting the critical isthmus of a left atrial tachycardia. Our findings demonstrate the utility of an atrial isochronal late-activation mapping approach to predict the critical isthmus of re-entry.

Functional substrate mapping characteristics during sinus rhythm predicts critical isthmus of reentrant atrial tachycardia.

Background: Atrial tachycardia (AT) is a commonly encountered rhythm disorder in patients with underlying atrial scar. The role of atrial late activation mapping during sinus rhythm to predict the critical isthmus (CI) of AT has yet to be systematically evaluated. We aimed to investigate the relationship between the functional substrate mapping (FSM) characteristics and the CI of reentrant ATs in patients with underlying atrial low-voltage areas.

Epicardial mapping and ablation of biatrial macroreentrant tachycardia via Bachmann's bundle.

Introduction: Recent reports highlighted the role of epicardial connections in the development of biatrial tachycardia circuits.

Methods: We reported a case of 60-year-old female patient who was admitted with recurrent atrial tachycardia (AT) after endocardial pulmonary vein isolation and anterior mitral line formation.

Results: Epicardial activation map demonstrated fragmented continuous potentials at the Bachmann's bundle region with good entrainment response.

A worldwide survey on incidence, management, and prognosis of oesophageal fistula formation following atrial fibrillation catheter ablation: the POTTER-AF study.

Aims: Oesophageal fistula represents a rare but dreadful complication of atrial fibrillation catheter ablation. Data on its incidence, management, and outcome are sparse.

Methods And Results: This international multicentre registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation.

Role of echocardiography on early diagnosis of atrial remodelling and fibrosis in elite athletes.

There is emerging data indicating that long-standing vigorous exercise may be associated with atrial structural remodelling. This remodelling process is may be the cause of the increasing frequency of atrial arrythmias in athletes. Early diagnosis of atrial remodelling by atrial imaging could have a role in management of atrial arrythmias in elite athletes.

The Frequency of Fabry Disease in Patients with Cardiac Hypertrophy of Various Phenotypes Including Prominent Papillary Muscle: The TUCARFAB Study in Turkey.

Background: The present study aimed to identify the frequency of Fabry disease in patients with cardiac hypertrophy of unknown etiology and to evaluate demographic and clinical characteristics, enzyme activity levels, and genetic mutations at the time of diagnosis.

Methods: This national, multicenter, cross-sectional, single-arm, observational registry study was conducted in adult patients with a clinical echocardiographic diagnosis of left ventricular hypertrophy and/or the presence of prominent papillary muscle. In both genders, genetic analysis was performed by DNA Sanger sequence analysis.

Long-term outcomes of left atrial appendage isolation using cryoballoon in persistent atrial fibrillation.

Aims: There is an increasing trend evaluating the role of non-pulmonary vein (PV) triggers to improve ablation outcomes in persistent atrial fibrillation (AF) as pulmonary vein isolation (PVI) strategy alone has modest outcomes. We investigated the long-term safety and efficacy of left atrial appendage isolation (LAAi) in addition to PVI using cryoballoon (CB) in persistent AF.

Methods And Results: In this multicentre retrospective analysis, we included a total of 193 persistent AF patients (mean age: 60 ± 11 years, 50.

The impact of percutaneous left atrial appendage closure on left ventricular diastolic function and natriuretic peptide levels.

Objective: Although the efficacy and safety of left atrial (LA) appendage (LAA) closure in patients with atrial fibrillation (AF) have been well documented in randomized controlled trials and real-world experience, there are limited data in the literature about the impact of LAA closure on diastolic functions. The study aimed to examine the impact of LAA closure on diastolic function and natriuretic peptide levels in patients with AF.

Patients And Methods: Twelve non-valvular AF patients with high risk for developing cardioembolic stroke and contraindications to warfarin underwent LAA occlusion with the WATCHMAN device (Atritech Inc.

Evaluation of atrial fibrosis in atrial fibrillation patients with three different methods.

Background: The presence of atrial fibrosis has already been known as a risk factor for atrial fibrillation (AF) development. We aimed to evaluate atrial fibrosis with previously defined three different methods, which were cardiac magnetic resonance imaging (C-MRI), echocardiographic strain imaging, and biomarkers and show the relationship between these methods in patients with AF scheduled for cryoballoon ablation.

Methods: A total of 30 patients were enrolled.

Common ostium of inferior pulmonary veins: An extremely rare variant described by preprocedural computerized tomography angiography.

The common ostium of left and right inferior PVs is an extremely rare variant which was only reported in 16 cases undergoing catheter ablation. Thus, electrophysiologists should be careful about such an exremely rare PV variants for the safety and efficacy of ablation. Pre-procedural CTA is a valuable tool to decide on the ablation strategy in patients with such a very rare PV anomaly.

Correlation of vascular risk age with pulse wave velocity in young patients with low absolute cardiovascular risk.

Objective: The systematic coronary risk evaluation (SCORE) estimates the 10-year risk of fatal cardiovascular disease (CVD), and its application is recommended. The absolute risk of CVD, independent of risk factors, is relatively low in young individuals. Expressing the risk as their "risk age" may aid in understanding the risk.