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    The Effect of Aggressive Blood Pressure Control on the Recurrence of Atrial Fibrillation After Catheter Ablation: A Randomized, Open Label, Clinical Trial (Substrate Modification with Aggressive Blood Pressure Control: SMAC- AF).
    Circulation 2017 Feb 22. Epub 2017 Feb 22.
    University of Western Ontario, London, Ontario, Canada.
    Background -Radiofrequency catheter ablation for atrial fibrillation has become an important therapy for AF, however recurrence rates remain high. We proposed to determine whether aggressive blood pressure (BP) lowering prevents recurrent atrial fibrillation (AF) after catheter ablation in patients with AF and a high symptom burden. Methods -We randomly assigned 184 patients with AF and a BP greater than 130/80 mmHg to aggressive BP (target <120/80 mm Hg) or standard BP treatment (target <140/90 mmHg) prior to their scheduled AF catheter ablation. Read More

    Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator.
    N Engl J Med 2017 02;376(8):755-764
    From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.).
    Background The presence of a cardiovascular implantable electronic device has long been a contraindication for the performance of magnetic resonance imaging (MRI). We established a prospective registry to determine the risks associated with MRI at a magnetic field strength of 1.5 tesla for patients who had a pacemaker or implantable cardioverter-defibrillator (ICD) that was "non-MRI-conditional" (i. Read More

    Non-vitamin K antagonist oral anticoagulants versus warfarin for cardioversion of atrial fibrillation in clinical practice: A single-center experience.
    J Arrhythm 2017 Feb 1;33(1):7-11. Epub 2016 Jun 1.
    Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
    Background: Anticoagulation therapy with the vitamin K antagonist (VKA) warfarin has been demonstrated to reduce thromboembolic risk after electrical cardioversion (ECV). However, data concerning ECV with non-VKA oral anticoagulants (NOACs) is limited. The objective of this study was to determine the efficacy and safety of NOACs in patients undergoing ECV in a real-world clinical practice at a single center in Japan. Read More

    [Antithrombotic therapy in patients with atrial flutter before planned cardioversion].
    Wiad Lek 2016 ;69(6):742-746
    Introduction: atrium flutter and fibrillation are the heart rhythm disorders that increase the risk of life-dangerous complications, e.g. cardioembolic stroke, pulmonary embolism. Read More

    Early and Late Atrial Arrhythmias After Lung Transplantation - Incidence, Predictive Factors and Impact on Mortality.
    Circ J 2017 Feb 15. Epub 2017 Feb 15.
    Department of Cardiology, University Hospital of Strasbourg.
    Background: Atrial arrhythmias (AAs) are frequent after lung transplantation (LT) and late postoperatively. Several predictive factors of early postoperative AAs after LT have been identified but those of late AAs remain unknown. Whether AA after LT affects mortality is still being debated. Read More

    Concomitant Atrial Fibrillation Surgery for People Undergoing Cardiac Surgery.
    JAMA Cardiol 2017 Feb 8. Epub 2017 Feb 8.
    Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois3Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, Illinois.
    Clinical Question: Should patients with preoperative atrial fibrillation who are undergoing cardiac surgery undergo concomitant atrial fibrillation surgery?

    Bottom Line: There is moderate-quality evidence that concomitant atrial fibrillation surgery approximately doubles the likelihood of freedom from atrial fibrillation, atrial flutter, or atrial tachycardia while not receiving antiarrhythmic medications at least 3 months after the procedure with a small absolute increase in needing a permanent pacemaker. Read More

    Holter-electrocardiogram-monitoring in patients with acute ischaemic stroke (Find-AFRANDOMISED): an open-label randomised controlled trial.
    Lancet Neurol 2017 Feb 8. Epub 2017 Feb 8.
    Clinic for Cardiology and Pneumology, University of Göttingen, Göttingen, Germany.
    Background: Atrial fibrillation is a major risk factor for recurrent ischaemic stroke, but often remains undiagnosed in patients who have had an acute ischaemic stroke. Enhanced and prolonged Holter-electrocardiogram-monitoring might increase detection of atrial fibrillation. We therefore investigated whether enhanced and prolonged rhythm monitoring was better for detection of atrial fibrillation than standard care procedures in patients with acute ischaemic stroke. Read More

    Incidence, type of atrial fibrillation and risk factors for stroke: a population-based cohort study.
    Clin Epidemiol 2017 24;9:53-62. Epub 2017 Jan 24.
    Department of Public Health and Clinical Medicine, Skellefteå Research Unit, Umeå University, Umeå, Västerbotten, Sweden.
    Purpose: The aims of this study were to estimate the incidence of atrial fibrillation and atrial flutter (AF), to assess the presence of provoking factors and risk factors for stroke and systemic embolism, and to determine the type of AF in patients with first-diagnosed AF.

    Patients And Methods: This cohort study was performed in northern Sweden between January 1, 2011 and December 31, 2012. Diagnosis registries were searched for the International Classification of Diseases-10 code for AF (I48) to identify cases of incident AF. Read More

    Compound Heterozygous SCN5A Mutations in a Toddler - Are they Associated with a More Severe Phenotype?
    Arq Bras Cardiol 2017 Jan;108(1):70-73
    Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
    Compound heterozygosity has been described in inherited arrhythmias, and usually associated with a more severe phenotype. Reports of this occurrence in Brugada syndrome patients are still rare. We report a study of genotype-phenotype correlation after the identification of new variants by genetic testing. Read More

    Staged hybrid ablation for persistent and longstanding persistent atrial fibrillation effectively restores sinus rhythm in long-term observation.
    Arch Med Sci 2017 Feb 5;13(1):109-117. Epub 2016 May 5.
    Department of Cardiac Surgery and Transplantology, Silesian Center For Heart Diseases, Zabrze, Poland.
    Introduction: Hybrid ablation (HABL) of atrial fibrillation combining endoscopic, minimally invasive, closed chest epicardial ablation with endocardial CARTO-guided accuracy was introduced to overcome the limitations of current therapeutic options for patients with persistent (PSAF) and longstanding persistent atrial fibrillation (LSPAF). The purpose of this study was to evaluate the procedural safety and feasibility as well as effectiveness of HABL in patients with PSAF and LSPAF 1 year after the procedure.

    Material And Methods: The study is a single-center, prospective clinical registry. Read More

    Angiotensin Receptor Blockade Improves Cardiac Surgical Outcomes in Patients With Metabolic Syndrome.
    Ann Thorac Surg 2017 Jan 25. Epub 2017 Jan 25.
    Division of Cardiothoracic Anesthesiology, Duke University Medical Center, Durham, North Carolina; Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
    Background: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting. Read More

    Catheter ablation for atrial flutter: a survey by the European Heart Rhythm Association and Canadian Heart Rhythm Society.
    Europace 2016 Dec;18(12):1880-1885
    Department of Electrophysiology, University Leipzig - Heart Center, Leipzig, Germany.
    The purpose of this EP wire survey was to examine current practice in the management of both cavotricuspid isthmus (CTI)-dependent and non-CTI-dependent atrial flutter (AFL) ablation amongst electrophysiologists in European and Canadian centres and to understand how current opinions vary from guidelines. The results of the survey were collected from a detailed questionnaire that was created by the European Heart Rhythm Association Research Network and the Canadian Heart Rhythm Society. Responses were received from 89 centres in 12 countries. Read More

    Use of short-term steroids in the prophylaxis of atrial fibrillation after cardiac surgery.
    J Saudi Heart Assoc 2017 Jan 7;29(1):23-29. Epub 2016 Apr 7.
    Department of Cardiac Surgery, Queen Alia Heart Institute, Amman, aJordan.
    Objectives: To assess the effectiveness of corticosteroids in the prophylaxis of postoperative atrial fibrillation (AF) in patients undergoing elective coronary artery bypass grafting or valvular heart surgery in terms of reducing its incidence and decreasing the length of hospital stay.

    Methods: This prospective double blinded randomized study was conducted at Queen Alia Heart Institute (Amman, Jordan) from June 2014 to June 2015 on 340 patients who underwent their first on-pump elective coronary artery bypass grafting (CABG) alone or combined with valvular surgery. Inclusion criteria consisted of elective first time CABG or combined with valvular surgery, use of β-adrenergic blockade, and normal sinus rhythm. Read More

    Repeat ablation and hospitalization following cryoballoon ablation of atrial fibrillation at a single tertiary medical center.
    Proc (Bayl Univ Med Cent) 2017 Jan;30(1):3-6
    Baylor Soltero Cardiovascular Research Center (East), Baylor Jack and Jane Hamilton Heart and Vascular Hospital (East, Franklin, Donsky, Wheelan, Kowal), and Baylor Scott & White Health Care System (East, Phan, Filardo, Franklin, Donsky, Wheelan, Kowal), Dallas, Texas.
    Cryoablation for atrial fibrillation (AF) has rapidly become a mainstream treatment for AF. In this report, 163 patients who had undergone a cryoablation procedure at one clinical center were contacted by telephone 33.1 ± 3. Read More

    No decline in risk of heart failure after incident atrial fibrillation: A community study assessing trends overall and by ejection fraction.
    Heart Rhythm 2017 Jan 21. Epub 2017 Jan 21.
    Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
    Background: Patients with atrial fibrillation (AF) experience an increased risk of heart failure (HF). However, data are lacking on current trends in the risk of HF after AF.

    Objective: The purpose of this study was to describe the temporal trends in HF occurrence after AF in a community cohort of patients with incident AF from 2000 to 2013. Read More

    Flecainide as first-line treatment for fetal supraventricular tachycardia.
    J Matern Fetal Neonatal Med 2017 Jan 23:1-15. Epub 2017 Jan 23.
    a Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
    Objective: The aim of this study was to evaluate utilization, efficacy and side effects of flecainide treatment as first-line agent in patients with fetal supraventricular tachycardia (SVT).

    Method: This retrospective review was conducted on 23 consecutive fetal tachyarrhythmia cases that met inclusion criteria. If the treatment was necessary, flecainide was used as first-line treatment in all cases. Read More

    Outcomes for Emergency Department Patients With Recent-Onset Atrial Fibrillation and Flutter Treated in Canadian Hospitals.
    Ann Emerg Med 2017 Jan 19. Epub 2017 Jan 19.
    University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
    Study Objective: Recent-onset atrial fibrillation and flutter are the most common arrhythmias managed in the emergency department (ED). We evaluate the management and 30-day outcomes for recent-onset atrial fibrillation and flutter patients in Canadian EDs, where cardioversion is commonly practiced.

    Methods: We conducted a prospective cohort study in 6 academic hospital EDs and enrolled patients who had atrial fibrillation and flutter onset within 48 hours. Read More

    Excess of exercise increases the risk of atrial fibrillation.
    Scand J Med Sci Sports 2017 Jan 16. Epub 2017 Jan 16.
    Department of Electrophysiology, University of Leipzig, Heart Centre, Leipzig, Germany.
    An interesting and still not well-understood example for old medical wisdom "Sola dosis facit venenum" is the increased prevalence of atrial fibrillation (AF) in athletes. Numerous studies have shown a fourfold to eightfold increased risk of AF in athletes compared to the normal population. Analysis of the existing data suggests a dose-dependent effect of exercise. Read More

    Stroke as the Initial Manifestation of Atrial Fibrillation: The Framingham Heart Study.
    Stroke 2017 Feb 12;48(2):490-492. Epub 2017 Jan 12.
    From the Cardiovascular Research Center (S.A.L., L.-C.W., P.T.E.) and Cardiac Arrhythmia Service (S.A.L., P.T.E.), Massachusetts General Hospital, Boston; Boston University and National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA (X.Y., J.R.R., P.A.W., S.S., E.J.B.); Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester (D.D.M.); Boston University School of Medicine, MA (H.J.A., J.R.R., P.A.W., S.S., E.J.B.); Department of Neurology, Boston Medical Centre, MA (H.J.A., J.R.R., C.S.K., S.S.); Pulmonary Center and the Section of Pulmonary and Critical Care Medicine, Department of Medicine (A.J.W.) and Preventive Medicine Section, Department of Medicine (E.J.B.), Boston University School of Medicine, MA; and Section of Cardiovascular Medicine and Department of Epidemiology, School of Public Health, Boston University, MA (E.J.B.).
    Background And Purpose: To prevent strokes that may occur as the first manifestation of atrial fibrillation (AF), screening programs have been proposed to identify patients with undiagnosed AF who may be eligible for treatment with anticoagulation. However, the frequency with which patients with AF present with stroke as the initial manifestation of the arrhythmia is unknown.

    Methods: We estimated the frequency with which AF may present as a stroke in 1809 community-based Framingham Heart Study participants with first-detected AF and without previous strokes, by tabulating the frequencies of strokes occurring on the same day, within 30 days before, 90 days before, and 365 days before first-detected AF. Read More

    Study design for control of HEART rate in inFant and child tachyarrhythmia with heart failure Using Landiolol (HEARTFUL): A prospective, multicenter, uncontrolled clinical trial.
    J Cardiol 2017 Jan 7. Epub 2017 Jan 7.
    Ono Pharmaceutical Co. Ltd., Osaka, Japan.
    Background: Persistent tachycardia in pediatric patients after congenital heart surgery further deteriorates their hemodynamic condition, and may become fatal. Therefore, immediate control of the tachycardia is mandatory in these patients. For this purpose, quick-acting, short-acting, titratable intravenous agents are required. Read More

    Atrial fibrillation inducibility during cavotricuspid isthmus-dependent atrial flutter ablation as a predictor of clinical atrial fibrillation. A meta-analysis.
    J Interv Card Electrophysiol 2017 Jan 9. Epub 2017 Jan 9.
    Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.
    Background: Atrial fibrillation (AF) and cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) are two separate entities that coexist in a significant percentage of patients. We sought to investigate whether AF inducibility during CTI AFL ablation predicted the occurrence of AF at follow-up after successful AFL ablation.

    Methods: A systemic review of Medline, Cochrane, and Embase was done for all the clinical studies in which assessment of AF inducibility in patients undergoing ablation for CTI AFL was performed. Read More

    Incidence of new-onset atrial fibrillation after cavotricuspid isthmus ablation for atrial flutter.
    Europace 2017 Jan 8. Epub 2017 Jan 8.
    Department of Cardiology, University Hospital Basel, Petersgraben 4 CH-4031, Basel, Switzerland
    Aims: In patients with cavotricuspid isthmus (CTI) ablation for atrial flutter (AFL), the decision to hold oral anticoagulation (OAC) often becomes an issue. The purpose of this study was to describe the incidence of the development of atrial fibrillation (AF) after CTI ablation in patients with documented AFL with and without a previous history of AF and to identify risk predictors for the occurrence of AF after CTI.

    Methods And Results: We included 364 consecutive patients undergoing successful CTI ablation. Read More

    Emergency department presentations for atrial fibrillation and flutter in Alberta: a large population-based study.
    BMC Emerg Med 2017 Jan 10;17(1). Epub 2017 Jan 10.
    Women & Children's Health Research Institute, Edmonton, Canada.
    Background: Atrial fibrillation or flutter (AFF) are not infrequent presenting problems in Emergency Departments (ED); however, little is known of the pattern of these presentations. This study provides a description of AFF presentations and outcomes after ED discharge in Alberta.

    Methods: Provincial administrative databases were used to obtain all primary ED encounters for AFF during 1999 to 2011 for patients aged >35 years. Read More

    Catheter ablation for atrial flutter: a survey by the European Heart Rhythm Association and Canadian Heart Rhythm Society.
    Europace 2017 Jan 5. Epub 2017 Jan 5.
    Department of Electrophysiology, University Leipzig-Heart Center, Leipzig, Germany.
    The purpose of this EP wire survey was to examine current practice in the management of both cavotricuspid isthmus : CTI)-dependent and non-CTI-dependent atrial flutter (AFL) ablation amongst electrophysiologists in European and Canadian centres and to understand how current opinions vary from guidelines. The results of the survey were collected from a detailed questionnaire that was created by the European Heart Rhythm Association Research Network and the Canadian Heart Rhythm Society. Responses were received from 89 centres in 12 countries. Read More

    Results of Cryoablation for Atrial Fibrillation Concomitant With Video-Assisted Minimally Invasive Mitral Valve Surgery.
    Semin Thorac Cardiovasc Surg 2016 Summer;28(2):271-280. Epub 2016 Apr 21.
    Department of Surgical Sciences, Città della Salute e della Scienza di Torino Hospital, University of Turin, Turin, Italy; Department of Medical Sciences, Città della Salute e della Scienza di Torino Hospital, University of Turin, Turin, Italy.
    Interest in minimally invasive video-assisted mitral valve surgery (MIMVS) is rapidly growing. Data on concomitant atrial fibrillation (AF) ablation to MIMVS are still lacking. The present study investigates the long-term results of AF cryoablation concomitant to MIMVS. Read More

    Association of Rate-Dependent Conduction Block Between Eccentric Coronary Sinus to Left Atrial Connections With Inducible Atrial Fibrillation and Flutter.
    Circ Arrhythm Electrophysiol 2017 Jan;10(1)
    From the Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, China (D.H., J.-b.L.); Section for Cardiac Electrophysiology, Department of Medicine/Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (D.H., J.E.M., T.Z., E.G.I., S.S., D.D.S., H.A., R.D.B., H.C., S.N.); Section for Cardiac Electrophysiology, Department of Medicine/Cardiology, University of Pennsylvania Perelman School of Medicine, Philadelphia (S.N.).
    Background: We sought to describe the prevalence and variability of coronary sinus (CS) and left atrial (LA) myocardium connections, their susceptibility to rate-dependent conduction block, and association with atrial fibrillation (AF) and flutter induction.

    Methods And Results: The study cohort included 30 consecutive AF patients (age 63.3±10. Read More

    Cardiovascular Magnetic Resonance-Guided Electrophysiological Interventions: Radiofrequency Ablation of Typical Atrial Flutter.
    Circ Cardiovasc Imaging 2017 Jan;10(1)
    From the Department of Electrophysiology, HELIOS Heart Center Leipzig, Germany (I.P., C.J., S.H., G.H., P.S.); Philips Research Laboratories, Best, The Netherlands, and Hamburg, Germany (S.K., S.W., J.S., B.S.); and Imricor Medical Systems, Burnsville, MN (T.L.).

    Towards personalized computational modelling of the fibrotic substrate for atrial arrhythmia.
    Europace 2016 Dec;18(suppl 4):iv136-iv145
    Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins University, 3400 N Charles St, 208 Hackerman Hall, Baltimore, MD 21218, USA
    : Atrial arrhythmias involving a fibrotic substrate are an important cause of morbidity and mortality. In many cases, effective treatment of such rhythm disorders is severely hindered by a lack of mechanistic understanding relating features of fibrotic remodelling to dynamics of re-entrant arrhythmia. With the advent of clinical imaging modalities capable of resolving the unique fibrosis spatial pattern present in the atria of each individual patient, a promising new research trajectory has emerged in which personalized computational models are used to analyse mechanistic underpinnings of arrhythmia dynamics based on the distribution of fibrotic tissue. Read More

    Atrial fibrillation following aortic valve replacement: impact of perioperative use of intravenous β-blocker.
    Gen Thorac Cardiovasc Surg 2016 Dec 20. Epub 2016 Dec 20.
    Department of Cardiovascular Surgery, Osaka Police Hospital, 10-31, Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan.
    Objectives: Despite recent advances in perioperative management, postoperative atrial fibrillation/flutter (POAF) remains the most common complication after cardiac surgery. Therefore, it is important to determine related risk factors to establish effective management. However, most studies have focused on patients undergoing coronary artery bypass grafting and little is known about POAF in those who receive aortic valve replacement (AVR). Read More

    Nadolol for Treatment of Supraventricular Tachycardia in Infants and Young Children.
    Pediatr Cardiol 2016 Dec 19. Epub 2016 Dec 19.
    University of Michigan, Ann Arbor, MI, USA.
    Supraventricular tachycardia (SVT) is a common infant arrhythmia, for which beta-blockers are frequently chosen as therapy. Propranolol is a common choice though it is dosed every 6-8 h. We reviewed the clinical results of treating infant SVT with an extemporaneous preparation of nadolol. Read More

    Arrhythmias in Adults with Congenital Heart Disease: What are Risk Factors for Specific Arrhythmias?
    Pacing Clin Electrophysiol 2016 Dec 16. Epub 2016 Dec 16.
    Children's Hospital of Wisconsin/ Medical College of Wisconsin, Milwaukee, Wisconsin.
    Introduction: An increasing number of patients with congenital heart disease are now surviving into adulthood. This has also led to the emergence of complications from the underlying congenital heart disease, related surgical interventions, and associated combordities. While the prevalence of particular arrhythmias with specific congenital heart disease has been previously described, a detailed analysis of all lesions and a large number of comorbidities has not been previously published. Read More

    Anatomic characteristics of the mitral isthmus region: The left atrial appendage isthmus as a possible ablation target.
    Ann Anat 2017 Mar 13;210:103-111. Epub 2016 Dec 13.
    Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland; HEART-Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, Cracow, Poland.
    The mitral isthmus is a part of the postero-inferior area of the lateral left atrial wall located between the mitral annulus and the left inferior pulmonary vein ostium. Linear ablation lesions are created within the mitral isthmus for the invasive treatment of left atrial arrhythmias. However, the anatomy of this region is not fully understood. Read More

    Development and impact of arrhythmias after the Norwood procedure: A report from the Pediatric Heart Network.
    J Thorac Cardiovasc Surg 2017 Mar 16;153(3):638-645.e2. Epub 2016 Nov 16.
    Division of Cardiovascular Sciences, The National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md.
    Objectives: The study objective was to determine the predictors of new-onset arrhythmia among infants with single-ventricle anomalies during the post-Norwood hospitalization and the association of those arrhythmias with postoperative outcomes (ventilator time and length of stay) and interstage mortality.

    Methods: After excluding patients with preoperative arrhythmias, we used data from the Pediatric Heart Network Single Ventricle Reconstruction Trial to identify risk factors for tachyarrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, junctional ectopic tachycardia, and ventricular tachycardia) and atrioventricular block (second or third degree) among 544 eligible patients. We then determined the association of arrhythmia with outcomes during the post-Norwood hospitalization and interstage period, adjusting for identified risk factors and previously published factors. Read More

    Alcohol and Atrial Fibrillation: A Sobering Review.
    J Am Coll Cardiol 2016 Dec;68(23):2567-2576
    Alfred Heart Centre, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Research Institute, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia. Electronic address:
    Alcohol is popular in Western culture, supported by a perception that modest intake is cardioprotective. However, excessive drinking has detrimental implications for cardiovascular disease. Atrial fibrillation (AF) following an alcohol binge or the "holiday heart syndrome" is well characterized. Read More

    Detection of sequential activation of left atrium and coronary sinus musculature in the general population.
    J Arrhythm 2016 Dec 1;32(6):449-455. Epub 2016 Jun 1.
    Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
    Background: The direction of impulse propagation across the coronary sinus (CS) musculature (CSM) is an important piece of the mechanistic puzzle underlying atrial tachyarrhythmias. We hypothesized that in the general population, the sequence of left atrial (LA) to CSM electrograms recorded in the CS reflects the direction of impulse propagation over the CSM.

    Methods: We studied 19 patients with atrioventricular (AV) reentrant tachycardia (RT) utilizing a left-sided accessory pathway (AP) and 21 patients with typical counterclockwise atrial flutter (AFL). Read More

    Postoperative atrial tachycardias after mitral valve surgery: Mechanisms and outcomes of catheter ablation.
    Heart Rhythm 2016 Dec 3. Epub 2016 Dec 3.
    Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:
    Background: Atrial tachycardias (ATs) including atrial fibrillation are common arrhythmias occurring late after mitral valve (MV) surgery, and their management is challenging.

    Objective: The purpose of this study was to determine the electrophysiological mechanisms of ATs in patients with prior MV surgery and the long-term outcomes of catheter ablation.

    Methods: We studied 67 consecutive patients (mean age 59. Read More

    Radiofrequency catheter ablation of accessory pathways in patients with Ebstein's anomaly: At 8 years of follow-up.
    Cardiol J 2016 Dec 2. Epub 2016 Dec 2.
    Institute of Cardiology, Arrhythmia Department, Warsaw, Poland.
    Background: Data regarding long-term follow-up of radiofrequency catheter ablation (RFCA) of accessory pathways (APs) in patients with Ebstein's anomaly (EA) are limited. The procedures are challenging due to multiple or wide APs.

    Methods: Analysis was performed on clinical and periprocedural data of patients with EA referred to the centre in order to perform catheter ablation of accessory pathway (AP). Read More

    Right Ventricular Pacing for Assessment of Cavo-Tricuspid Isthmus Block.
    J Atr Fibrillation 2016 Aug-Sep;9(2):1454. Epub 2016 Aug 31.
    INOVA Heart and Vascular Institute, Electrophysiology, INOVA Fairfax Hospital, Fairfax, VA.
    Background: Cavo-tricuspid isthmus (CTI) dependent atrial flutter is typically treated with cardiac ablation. Standard techniques to assess CTI block after ablation can be technically challenging. Right ventricular (RV) pacing may allow for another technique to assess CTI block after ablation. Read More

    Achieving Bidirectional Long Delays In Pulmonary Vein Antral Lines Prior To Bidirectional Block In Patients With Paroxysmal Atrial Fibrillation (The Bi-Bi Technique For Atrial Fibrillation Ablation).
    J Atr Fibrillation 2016 Aug-Sep;9(2):1224. Epub 2016 Aug 31.
    Unity Point Health Methodist, Peoria, IL.
    Background: Pulmonary Vein Antral isolation (PVAI) is currently the standard of care for both paroxysmal and persistent atrial fibrillation ablation. Reconnection to the pulmonary vein is the most common cause of recurrence of atrial fibrillation. Achieving the endpoint of bidirectional block (BDB) for cavotricuspid isthmus dependant flutter has improved our outcomes for atrial flutter ablation. Read More

    Assessment Of Sinoatrial Node Function In Patients With Persistent And Long-Standing Persistent Forms Of Atrial Fibrillation After Maze III Procedure Combined With Mitral Valve operation.
    J Atr Fibrillation 2016 Jun-Jul;9(1):1408. Epub 2016 Jun 30.
    A.N. Bakoulev Scientific Center for Cardiovascular Surgery.
    Research Objective: Assessment of sinoatrial node function after Maze III procedure combined with a mitral valve operation.

    Methods: 100 patients were included in the research with persistent and long-standing persistent forms of atrial fibrillation (AF) and need of operative treatment concerning valve disease. The following preoperative preparation methods were executed to all patients: Electrocardiogram in 12 standard assignments;Two-dimensional echocardiographic with assessment of systolic and diastolic functions of the left ventricle, size of the left atrium and grade of valve disease;Transesophageal echocardiography for exclusion of blood clots in the left atrium and left atrial appendage;Coronary angiography for exclusion of coronary heart disease;Computer tomography for examination of cardiac chambers and anatomic characteristics of pulmonary veins. Read More

    Persistent Atrial Fibrillation And Atrial Flutter Complicated By Tachycardiomyopathy Because Of Intermittent Conduction Through Accessory Pathway.
    J Atr Fibrillation 2016 Apr-May;8(6):1379. Epub 2016 Apr 30.
    Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
    The term tachycardiomyopathy refers to a specific form of tachycardia-related cardiomyopathy caused by supraventricular or ventricular tachyarrhytmias that are both associated with ventricular rates higher than 120 bpm. The arrhythmias which are most frequently associated with these forms of heart disease are atrial fibrillation and atrial flutter, particularly found in the elderly population. The most frequent clinical manifestation is heart failure. Read More

    Antiarrhythmic Effect Of Antioxidants In Patients With Atrial Fibrillation.
    J Atr Fibrillation 2016 Apr-May;8(6):1360. Epub 2016 Apr 30.
    "Dagestan State Medical Academy" Russian Ministry of Health, Department of outpatient therapy, cardiology and general practice, 36700, Republic of Dagestan, Makhachkala, pl. Lenin.
    Resume In accordance with modern concepts, one of the leading roles in the development of paroxysmal atrial fibrillation and flutter, belongs - the restructuring of the myocardium, in second place - sick sinus syndrome and in third place - the presence of accessory pathways and hormonal disorders. The development of atrial fibrillation and flutter in the structural pathology, primarily begins with of drugs if it does not work, we have to carry out ablation. Providing proper, effective and important combination therapy - is the main challenge in cardiology. Read More

    A Comparison Between Dabigatran and Warfarin on Time to Elective Cardioversion.
    J Atr Fibrillation 2016 Apr-May;8(6):1355. Epub 2016 Apr 30.
    Central Texas Veterans Health Care System, Department of Veterans Affairs, Temple, TX, USA.
    Objective: To evaluate the use of dabigatran versus warfarin on time to elective direct current cardioversion (DCCV).

    Methodology: This retrospective observational study was conducted at a single Veterans Affairs hospital in the Southwestern region of the U.S. Read More

    Lyme Arrhythmia in an Avid Golfer: A Diagnostic Challenge and a Therapeutic Dilemma.
    J Atr Fibrillation 2016 Feb-Mar;8(5):1378. Epub 2016 Feb 29.
    James J. Peter VA Medical Center/The Mount Sinai Hospital.
    Lyme disease is a multisystem disorder affecting dermatologic, cardiac, nervous and musculoskeletal systems. Cardiac manifestations occur in about 5% of Lyme infections and stem from the involvement of the cardiac conduction system, resulting in varying degrees of sino-atrioventricular block. Occasionally, Lyme infection may also present with myopericarditis. Read More

    A Case of Wide Complex Tachycardia in a Patient with a Biventricular Assist Device.
    J Atr Fibrillation 2016 Feb-Mar;8(5):1364. Epub 2016 Feb 29.
    1NewYork Presbyterian Hospital - Columbia University Medical Center, Department of Medicine , 177 Fort Washington Ave New York.
    This case report highlights the variety of wide complex tachycardias, and the need for their prompt management, in the growing population of patients with circulatory support devices. We present a case that demonstrates how a wide complex supraventricular tachycardia in a patient with a biventricular assist device can be safely and effectively targeted for treatment using percutaneous radiofrequency catheter ablation, allowing for clinical improvement, weaning of RVAD treatment, and discharge home with LVAD alone. Read More

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