Atrial Tachyarrhythmias With Ultra-Rapid Ventricular Response and Sudden Death in Patients Without Structural Heart Disease.

Background: Sudden cardiac death (SCD) is generally associated with life-threatening ventricular arrhythmias. Supraventricular arrhythmias are an accepted cause of SCD in Wolff-Parkinson-White syndrome and complex congenital heart disease. However, the role of atrial tachyarrhythmias (ATAs) in SCD in patients with structurally normal hearts is unclear.

International Multicenter Cohort Study on Beta-Blocker-Free Treatment Strategies for Catecholaminergic Polymorphic Ventricular Tachycardia Patients.

Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare, potentially life-threatening genetic heart disease. Nonselective beta-blockers (BBs) are highly effective in reducing CPVT-triggered arrhythmic events. However, some patients suffer from unacceptable BB side effects and might require strategies without a BB.

Magnetic Resonance Imaging in the Assessment of the Risk of Sudden Death in Cardiac Sarcoidosis: What Is Extensive or Significant Late Gadolinium Enhancement?

Background: Cardiac sarcoidosis involves a significant but difficult-to-define risk of sudden cardiac death (SCD). Current guidelines recommend consideration of an implantable cardioverter defibrillator for patients with extensive or significant myocardial late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging. However, extensive/significant LGE is not defined.

Takotsubo Cardiomyopathy in Epilepsy: A Systematic insight into the Existing Literature from 2000-2023.

Background & Objective: Takotsubo cardiomyopathy (TCM), manifests as left ventricular dysfunction triggered by physical or emotional stress. It leads to higher morbidity in epileptic patients and can progress to complications. To find out the correlation between Takotsubo cardiomyopathy and epilepsy and to investigate pathophysiology and associated types of epilepsy.

Management of patient with acute lymphocytic myocarditis and congenital long QT syndrome presenting with electrical storm and incessant Torsade de Pointes: a case report.

Background: This case highlights the management of concomitant acute myocarditis and congenital long QT syndrome with electrical storm and incessant Torsade de Pointes.

Case Presentation: An 18 years-old Southeast Asian para 1 abortus 0 (P1A0) postpartum patient with cesarean section owing to severe preeclampsia, acute lymphocytic myocarditis, and prolonged QT interval owing to long QT syndrome. She has incessant Torsade de Pointes treated with beta-blocker, lidocaine, overdrive pacing with a temporary transvenous pacemaker, left cardiac sympathetic denervation per video-assisted thoracoscopic surgery, and implantable cardioverter-defibrillator implantation.

Extracorporeal membrane oxygenation for patients with electrical storm or refractory ventricular arrhythmias: Management and outcomes.

Patients on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are at high risk for ventricular arrhythmias due to derangements in myocardial perfusion, hemodynamics, and heightened catecholamine states. Existing data on the management and outcomes of patients with electrical storm or refractory ventricular tachycardia/fibrillation (VT/VF) treated with VA-ECMO are primarily derived from retrospective observational studies. Typical survival rates are in the range of 40-50%, with 15-20% of patients undergoing VT ablation and 30-40% of patients requiring advanced heart failure therapies (cardiac transplant or durable left ventricular assist device).

A clinical perspective on surgical and diagnostic strategies for neonatal partial shone complex: Insights from a case report.

Introduction And Clinical Importance: Shone complex (SC) is a rare multilevel congenital heart disease (CHD) characterized by four left-sided heart obstructive lesions: parachute mitral valve, supravalvular mitral ring, subaortic stenosis, and coarctation of the aorta (CoA), accounting for 0.6-0.7 % of CHD cases.

Feasibility of volumetric-modulated arc therapy gating for cardiac radioablation using real-time ECG signal acquisition and a dynamic phantom.

Background: Stereotactic arrythmia radioablation (STAR) is a noninvasive technique to treat ventricular tachycardia (VT). Management of cardiorespiratory motion plays an essential role in VT-STAR treatments to improve treatment outcomes by reducing positional uncertainties and increasing dose conformality. Use of an electrocardiogram (ECG) signal, acquired in real-time, as a surrogate to gate the beam has the potential to fulfil that intent.

A case report of pre-implantation feasibility test for combining leadless pacemaker and subcutaneous implantable cardioverter-defibrillator in adult congenital heart disease.

Unlabelled: New cardiac implantable electronic devices (CIEDs), such as leadless pacemakers and subcutaneous implantable cardioverter defibrillators (S-ICDs), are being used in patients with adult congenital heart disease. The selection of CIEDs often requires careful consideration due to technical challenges posed by a unique heart structure. A 27-year-old man following a surgical tetralogy of Fallot (TOF) repair developed non-sustained ventricular tachycardia, sick sinus syndrome, and complete atrioventricular block.

Dual calcium-voltage optical mapping of regional voltage and calcium signals in intact murine -R2474S hearts.

Unlabelled: Abnormal regional variations in electrical and calcium homeostasis properties have been implicated in catecholaminergic polymorphic ventricular tachycardias (CPVT) attributable to abnormal RyR2-mediated store Ca release, but their underlying mechanism have not been well explored in intact hearts.

Methods: We performed in vivo and ex vivo studies including high throughput mapping of Ca transients (CaT) and transmembrane voltage (V) in murine wild-type (WT) and heterozygous -R2474S/+ hearts, before and during isoprenaline (ISO) challenge.

Results: ISO-challenged -R2474S/+ showed increased incidence of arrhythmia accompanied by abnormal Ca transients compared to WT.

The Utility of Coronary Revascularization to Reduce Ventricular Arrhythmias in Coronary Artery Disease Patients: A Systematic Review.

Ventricular arrhythmias (VA) are a major cause of morbidity and mortality in patients with coronary artery disease (CAD). Current guidelines recommend revascularization of significant CAD to improve survival in patients with ventricular fibrillation (VF), polymorphic ventricular tachycardia (VT), or those who are post-cardiac arrest. However, revascularization is not recommended for CAD patients with suspected scar-mediated monomorphic VT.

An hiPSC-CM approach for electrophysiological phenotyping of a patient-specific case of short-coupled TdP.

Introduction: A healthy young woman, age 26 without prior cardiac complications, experienced an out-of-hospital cardiac arrest caused by ventricular fibrillation (VF), which coincided with a fever. Comprehensive diagnostics including echo, CMR, exercise testing, and genetic sequencing, did not identify any potential cause. This led to the diagnosis of idiopathic VF and installment of an implantable cardioverter defibrillator, which six months later appropriately intervened another VF episode under conditions comparable to the first event.

Evaluation of droperidol use in the emergency department: a retrospective analysis of QTc prolongation and adverse events.

Background: Droperidol is a first-generation antipsychotic medication that has been used for various indications in the emergency department (ED); however, its use has been controversial due to reports of QT prolongation and the risk of torsades de pointes (TdP). The aim of the study is to evaluate the safety of droperidol administration in the ED.

Methods: This was a retrospective study, conducted at an academic level I trauma center.

Guideline-directed medical therapy for heart failure in arrhythmia-induced cardiomyopathy with improved left ventricular ejection fraction.

Aims: No study has analyzed the impact of guideline-directed medical therapy in preventing heart failure (HF) relapse in patients with arrhythmia-induced cardiomyopathy (AiCM) following left ventricular ejection fraction (LVEF) improvement.

Methods And Results: We analyzed data from a single-center cohort of 200 patients admitted for HF, LVEF <50% and cardiac arrhythmia considered by cardiologists to be the precipitating cause of the episode. The primary endpoint was time-to-HF relapse, defined as the composite of readmission for HF, Emergency Department (ED) visit for HF, or significant decline in LVEF.

Rationale and Design of the Personalized Therapy Study: Evaluating Real-World Performance of Two Automated Defibrillation Therapy Algorithms.

Background: Barriers to maximizing patient benefit with implantable defibrillation devices include limited ability to tailor antitachycardia pacing (ATP) therapy in real-time and identify patients at risk of heart failure (HF) events early on. The Personalized Therapy study aims to evaluate the performance of two algorithms, intrinsic ATP (iATP) and TriageHF, to address these barriers in routine clinical practice.

Methods And Results: The Personalized Therapy Study was designed as a prospective, multicenter, post-market registry study expected to enroll approximately 2,200 patients meeting the following criteria: (1) implanted with a study-eligible device regardless of procedure type; (2) Medtronic CareLink® Network enrolled; (3) TriageHF enabled within CareLink and High Risk Alert notifications turned ON; and (4) iATP enabled.

[A 38 YEARS-OLD YOUNG MALE WITH CHEST PAIN AND ECG CHANGES].

Coronary vasospasm is a well-known condition causing acute chest syndrome and can lead to myocardial infarction, ventricular arrhythmias, and even sudden cardiac death. While there are extensive case series showing the association of coronary vasospasm with drugs like cocaine, the association of marijuana with coronary vasospasm has not been reported frequently. When smoked, marijuana results in a rapid, dose-dependent tachycardia, an increase in blood pressure, and an increase in cardiac output.

Re-arrest immediately after return of spontaneous circulation: A retrospective observational study of in-hospital cardiac arrest.

Background: Patients who achieve return of spontaneous circulation (ROSC) after in-hospital cardiac arrest (IHCA) may re-arrest. This phenomenon has not been sufficiently investigated. The aim of this study was to examine the immediate (1-min) and short-term (20-min) risks of re-arrest in IHCA.

Life-Saving Cooperative Function of a Subcutaneous Cardioverter-Defibrillator and a Pacemaker in Dextrocardia With Heart Failure.

A 47-year-old man with congenitally corrected transposition of the great arteries, dextrocardia, heart failure, and pacemaker-dependency presented with nonsustained ventricular tachycardia. He underwent a right-sided transmuscular cardioverter-defibrillator insertion after appropriate testing. One year later, life-saving antiarrhythmic therapy was applied by the subcutaneous defibrillator while the appropriate pacemaker functioning supported heart rhythm.

Conditional ablation of MCU exacerbated cardiac pathology in a genetic arrhythmic model of CPVT.

Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a genetic arrhythmic syndrome caused by mutations in the calcium (Ca) release channel ryanodine receptor (RyR2) and its accessory proteins. These mutations make the channel leaky, resulting in Ca-dependent arrhythmias. Besides arrhythmias, CPVT hearts typically lack structural cardiac remodeling, a characteristic often observed in other cardiac conditions (heart failure, prediabetes) also marked by RyR2 leak.

Infiltrative Myocardial T-Cell Lymphoma.

We report a unique case involving cardiac manifestation of T-cell lymphoma and associated risk management of ventricular arrhythmia and sudden cardiac death. A 39-year-old woman presented with a syndrome consistent with fever in a returned traveler, ultimately diagnosed with stage IV peripheral T-cell lymphoma involving the myocardium with ventricular tachycardia. Management of risk of sudden cardiac death was complicated by hematological management with an antibody-drug conjugate chemotherapy regimen and later autologous stem cell transplant.

Exploring cardiac vector propagation in acute myocardial infarction: a spatial velocity perspective.

Aims: To objectively characterize the spatial-velocity dynamics of the QRS-loop in the vectorcardiogram (VCG) of patients with acute myocardial infarction (AMI).

Methods: VCG was constructed as a space curve directly with three quasi-orthogonal leads I, aVF and V2 recorded by conventional ECG of 25 healthy individuals and 50 AMI patients. Spatial velocity (SV) of the dynamic QRS loop, spatial distance (SD), and spatial magnitude (SM) were recorded, along with axis-specific component attributes of vector magnitude such as ΔX, ΔY, and ΔZ.

Recreational and Occupational Physical Activity and Risk of Adverse Events in Truncating Founder Variant Carriers.

Background: founder variants cause hypertrophic cardiomyopathy leading to heart failure and malignant ventricular arrhythmias. Exercise is typically regarded as a risk factor for disease expression although evidence is conflicting. Stratifying by type of exercise may discriminate low- from high-risk activities in these patients.

From bits to bedside: entering the age of digital twins in cardiac electrophysiology.

This State of the Future Review describes and discusses the potential transformative power of digital twins in cardiac electrophysiology. In this 'big picture' approach, we explore the evolution of mechanistic modelling based digital twins, their current and immediate clinical applications, and envision a future where continuous updates, advanced calibration, and seamless data integration redefine clinical practice of cardiac electrophysiology. Our aim is to inspire researchers and clinicians to embrace the extraordinary possibilities that digital twins offer in the pursuit of precision medicine.

CT-guided Left Stellate Ganglion Cryoneurolysis for Refractory Ventricular Arrhythmias.

Background Ventricular arrhythmias (VAs), including ventricular tachycardia and ventricular fibrillation, present substantial therapeutic challenges due to their high morbidity, mortality, and increasing prevalence. Current treatments often prove infeasible or inadequate in patients with refractory VAs. Purpose To evaluate the safety and effectiveness of CT-guided left stellate ganglion cryoneurolysis (SGC) in the treatment of refractory VAs.