Article
Medicine, General & Internal
Tomasz Jadczyk, Jiri Wolf, Martin Pesl, Filip Soucek, Frantisek Lehar, Jiri Jez, Tomas Kulik, Bohdan Tyshchenko, Silvie Belaskova, Petr Ourednicek, Guido Caluori, Miroslav Novak, Zdenek Starek
Summary: This study developed and validated low-dose CT scanning protocols of the left atrium for radiofrequency catheter ablation (RFA) guidance. Optimized scanning protocols significantly reduced radiation dose without affecting contrast media and signal-to-noise ratio.
Article
Medicine, General & Internal
Gregory F. Michaud, William G. Stevenson
Summary: A 63-year-old healthy male with atrial fibrillation presents with symptoms of dyspnea and irregular heartbeat. Physical examination reveals high blood pressure, irregular pulse, and ECG confirms atrial fibrillation. Further evaluation and treatment plan are needed.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Letter
Medicine, General & Internal
Isaac W. Leon-acuna, Takeki Suzuki
Summary: Andrade et al. found that initial catheter cryoballoon ablation strategy resulted in lower incidence of persistent atrial fibrillation and lower arrhythmia burden compared to antiarrhythmic drug therapy in patients with paroxysmal atrial fibrillation during 3 years of follow-up. The study builds upon the findings of the EARLY-AF trial and the STOP AF First trial. Due to the relatively small sample size (303 patients) and short follow-up period, it may be difficult to detect mortality benefits of cryoballoon ablation.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Florian Baptiste, Jerome Kalifa, Cyril Durand, Edouard Gitenay, Michel Bremondy, Anis Ayari, Nicolas Maillot, Antonio Taormina, Aicha Fofana, Guillaume Penaranda, Sabrina Siame, Clement Bars, Julien Seitz
Summary: This study aimed to investigate the prevalence and electrophysiological characteristics of atrial fibrillation (AF) drivers arising from the right atrial appendage (RAA). The results showed that 7% of patients had RAA drivers, which were associated with the termination of AF.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Medicine, General & Internal
Oussama M. Wazni, Gopi Dandamudi, Nitesh Sood, Robert Hoyt, Jaret Tyler, Sarfraz Durrani, Mark Niebauer, Kevin Makati, Blair Halperin, Andre Gauri, Gustavo Morales, Mingyuan Shao, Jeffrey Cerkvenik, Rachelle E. Kaplon, Steven E. Nissen
Summary: In this multicenter trial, cryoballoon ablation as initial therapy was found to be superior to drug therapy in preventing atrial arrhythmia recurrence in patients with paroxysmal atrial fibrillation. Serious procedure-related adverse events were uncommon.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Medicine, General & Internal
J. G. Andrade, M. W. Deyell, L. Macle, G. A. Wells, M. Bennett, V Essebag, J-F Roux, D. Yung, A. Skanes, Y. Khaykin, C. Morillo, U. Jolly, P. Novak, E. Lockwood, G. Amit, P. Angaran, J. Sapp, S. Wardell, S. Lauck, J. Cadrin-Tourigny, S. Kochhaeuser, A. Verma
Summary: This study evaluated the treatment effect of catheter cryoballoon ablation versus antiarrhythmic drug therapy for initial paroxysmal atrial fibrillation. The results showed that in the 3-year follow-up period, the catheter ablation group had a lower incidence of persistent atrial fibrillation and recurrent atrial tachyarrhythmia compared to the drug therapy group. Additionally, the proportion of time in atrial fibrillation was also lower in the ablation group. Therefore, catheter ablation is recommended as the initial treatment for initial paroxysmal atrial fibrillation.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Jason G. Andrade, Oussama M. Wazni, Malte Kuniss, Nathaniel M. Hawkins, Marc W. Deyell, Gian-Battista Chierchia, Steven Nissen, Atul Verma, George A. Wells, Ricky D. Turgeon
Summary: Cryoballoon catheter ablation has been shown to significantly improve arrhythmia outcomes, produce clinically meaningful improvements in patient-reported outcomes, reduce subsequent health care resource use, and not increase the risk of serious adverse events compared with initial antiarrhythmic drug therapy in patients with treatment-naive AF.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Medicine, General & Internal
Fabien Squara, Didier Scarlatti, Sok-Sithikun Bun, Pamela Moceri, Emile Ferrari, Olivier Meste, Vicente Zarzoso
Summary: This study found that Fibrillatory Wave Amplitude (FWA) is unrelated to the complexity of atrial fibrillation (AF) but is mainly determined by the amount of viable atrial myocytes. Therefore, FWA should only be referred as a marker of atrial tissue pathology.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Medicine, General & Internal
Leonard Bergau, Philipp Bengel, Vanessa Sciacca, Thomas Fink, Christian Sohns, Philipp Sommer
Summary: Atrial fibrillation is the most common sustained arrhythmia worldwide and is strongly associated with heart failure. Two therapeutic strategies, rhythm control and rate control, are accepted as the standard of care in AF patients with heart failure. Recent important studies have investigated the optimal therapeutic strategy in HF patients.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
Jason G. Andrade, George A. Wells, Marc W. Deyell, Matthew Bennett, Vidal Essebag, Jean Champagne, Jean-Francois Roux, Derek Yung, Allan Skanes, Yaariv Khaykin, Carlos Morillo, Umjeet Jolly, Paul Novak, Evan Lockwood, Guy Amit, Paul Angaran, John Sapp, Stephan Wardell, Sandra Lauck, Laurent Macle, Atul Verma
Summary: In patients with symptomatic, paroxysmal atrial fibrillation, catheter cryoballoon ablation was associated with a significantly lower rate of atrial fibrillation recurrence compared to antiarrhythmic drug therapy. The ablation group also had better outcomes in terms of atrial tachyarrhythmia occurrence and atrial fibrillation burden.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Review
Medicine, General & Internal
Riyaz A. Kaba, Aziz Momin, John Camm
Summary: Atrial fibrillation is a global disease associated with various serious complications, making treatment complex and challenging. A large proportion of patients have persistent or long-standing persistent AF, posing greater treatment challenges.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Federico. T. T. Magni, Bart. A. A. Mulder, Hessel. F. F. Groenveld, Ans C. P. Wiesfeld, Robert. G. G. Tieleman, Moniek. G. G. Cox, Isabelle. C. C. Van Gelder, Tom Smilde, Eng. S. S. Tan, Michiel Rienstra, Yuri Blaauw
Summary: Our initial experience shows that the use of the PFA catheter for pulmonary vein isolation (PVI) is safe, fast, and easy to learn.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Jonathan M. Kalman, Ahmed M. Al-Kaisey, Ramanathan Parameswaran, Joshua Hawson, Robert D. Anderson, Michael Lim, David Chieng, Stephen A. Joseph, Alex McLellan, Joseph B. Morton, Paul B. Sparks, Geoffrey Lee, Prashanthan Sanders, Peter M. Kistler
Summary: This study aimed to determine if the timing of catheter ablation for atrial fibrillation (AF) affects arrhythmia outcomes. The results showed that there was no significant difference in the atrial arrhythmia free survival at 12 months post-ablation between patients who underwent early ablation and those who underwent delayed ablation. Other secondary outcomes also showed no significant difference. Therefore, delaying AF ablation by 12 months for antiarrhythmic drug management does not reduce the efficacy of ablation.
EUROPEAN HEART JOURNAL
(2023)
Review
Cardiac & Cardiovascular Systems
Louisa O'Neill, Benjamin De Becker, Maarten De Smet, Jean-Benoit Le Polain De Waroux, Rene Tavernier, Mattias Duytschaever, Sebastien Knecht
Summary: Recurrent atrial tachycardia is a common phenomenon after catheter ablation for AF, with gap-related macro re-entrant atrial tachycardia being the dominant mechanism. The optimal ablation strategy and procedural endpoint for multiple inducible ATs after ablation of the clinical AT are still unclear, but ensuring durable linear block and PV isolation may be sufficient for preventing further AT.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Florian Straube, Janis Pongratz, Alexander Kosmalla, Benedikt Brueck, Lukas Riess, Stefan Hartl, Christian Tesche, Ullrich Ebersberger, Michael Wankerl, Uwe Dorwarth, Ellen Hoffmann
Summary: Cryoballoon ablation is a reasonable strategy for symptomatic persistent AF in the initial AF ablation procedure, with a high acute isolation success rate. Although there are potential complications and recurrence risks, Cryoballoon ablation has shown good outcomes in the treatment of persistent AF.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Andrea Saglietto, Fiorenzo Gaita, Carina Blomstrom-Lundqvist, Elena Arbelo, Nikolaos Dagres, Josep Brugada, Aldo Pietro Maggioni, Luigi Tavazzi, Josef Kautzner, Gaetano Maria De Ferrari, Matteo Anselmino
Summary: This study aimed to develop a machine-learning scoring system based on easily accessible clinical variables from the ESC-EHRA Atrial Fibrillation Ablation Long-Term Registry to predict the probability of 1-year arrhythmic recurrence after catheter ablation for AF patients. Among four different supervised machine-learning models, the random forest model achieved the best performance with a 19-variable version, outperforming existing scores. The final calibrated model, available as a web calculator, showed significantly better predictive performance.
Article
Cardiac & Cardiovascular Systems
Emanuele Bertaglia, Saverio Iacopino, Roberto Verlato, Giuseppe Arena, Paolo Pieragnoli, Claudio Tondo, Giulio Molon, Massimiliano Manfrin, Giovanni B. Perego, Giovanni Rovaris, Francesco Rivezzi, Massimo Mantica, Umberto Startari, Luigi Sciarra
Summary: This study evaluated the efficacy and safety of cryoballoon pulmonary vein isolation (CB-PVI) in young and middle-aged patients with atrial fibrillation (AF). The results showed that CB-PVI had similar acute procedural results, complication rates, and AF recurrence rates in young and middle-aged patients.
CLINICAL CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Carlo Pappone, Giuseppe Ciconte, Luigi Anastasia, Fiorenzo Gaita, Edward Grant, Emanuele Micaglio, Emanuela T. Locati, Zarko Calovic, Gabriele Vicedomini, Vincenzo Santinelli
Summary: This study investigates the electroanatomical arrhythmogenic substrate in high-risk LQTS patients and finds that abnormal electrical activities in the epicardium of the right ventricle contribute to malignant ventricular arrhythmia. Catheter ablation successfully eliminates these abnormalities and prevents recurrences.
Article
Cardiac & Cardiovascular Systems
Giovanna Rodio, Saverio Iacopino, Ennio C. Pisano, Valeria Calvi, Giovanni Rovaris, Massimiliano Marini, Massimo Giammaria, Fabrizio Caravati, Giampiero Maglia, Gabriele Zanotto, Paolo Della Bella, Mauro Biffi, Antonio Curnis, Massimiliano Maines, Daniela Orsida, Matteo Santamaria, Giovanni Bisignani, Matteo Baroni, Fabio Lissoni, Antonio Duca, Giovanni B. Forleo, Carlo Piemontese, Alberto De Salvia, Gennaro Miracapillo, Eduardo Celentano, Massimo Zecchin, Giovanni Luzzi, Daniele Giacopelli, Alessio Gargaro, Antonio D'Onofrio
Summary: This study aimed to assess the temporal association of decreasing thoracic impedance (TI) trends with ventricular tachycardia/fibrillation (VT/VF) episodes through a longitudinal analysis of daily remote monitoring data from implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-Ds). The study found that only in ICD patients, a decrease in TI was associated with VT/VF episodes, while there was no such association in CRT-D patients.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Federico Migliore, Raimondo Pittorru, Pietro Bernardo Dall'Aglio, Manuel De Lazzari, Giovanni Rovaris, Elena Piazzi, Alessia Dentico, Alessandra Ferrieri, Giuseppe D'Angelo, Alessandra Marzi, Basma El Sawaf, Emanuele Bertaglia, Sabino Iliceto, Gino Gerosa, Vincenzo Tarzia, Domenico Carretta, Patrizio Mazzone
Summary: This multicenter study demonstrates that the use of bidirectional rotational TLE mechanical sheaths combined with different mechanical tools and the femoral approach can achieve reasonable success and safety in patients with extremely old leads.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
Article
Clinical Neurology
Alvise Del Monte, Francesco Rivezzi, Enrico Giacomin, Francesco Peruzza, Maurizio Del Greco, Massimiliano Maines, Federico Migliore, Alessandro Zorzi, Federica Viaro, Alessio Pieroni, Andrea La Licata, Claudio Baracchini, Emanuele Bertaglia
Summary: This study evaluated the frequency of subclinical atrial fibrillation (SCAF) detected by implantable cardiac monitors (ICM) in patients with embolic stroke of undetermined source (ESUS). It identified several predictors of SCAF, including abnormal P wave terminal force in lead V1, left atrial end-systolic indexed volume > 34 ml/m(2), and BMI > 25 kg/m(2). A multiparametric evaluation using these predictors has the best accuracy to predict SCAF in ESUS patients.
NEUROLOGICAL SCIENCES
(2023)
Article
Cardiac & Cardiovascular Systems
Tobias Toennis, Emanuele Bertaglia, Axel Brandes, Wolfgang Dichtl, Nina Fluschnik, Joris R. de Groot, Eloi Marijon, Lluis Mont, Carina Blomstrom Lundqvist, Nuno Cabanelas, G. Andrei Dan, Andrzej Lubinski, Bela Merkely, Kim Rajappan, Andrea Sarkozy, Vasil Velchev, Dan Wichterle, Paulus Kirchhof
Summary: Atrial high-rate episodes (AHRE) are atrial tachyarrhythmias detected by continuous rhythm monitoring. The presence of AHRE increases the risk of stroke compared with patients without AHRE. It remains unclear whether anticoagulation is effective and safe in patients with AHRE, but two clinical trials are expected to provide more information soon.
Article
Cardiac & Cardiovascular Systems
Fiorenzo Gaita, Natascia Cerrato, Andrea Saglietto, Domenico Caponi, Leonardo Calo, Carla Giustetto
Summary: Thirty years after its description, the understanding of Brugada syndrome has significantly increased. The spontaneous type 1 ECG pattern is a well-established prognostic marker in asymptomatic patients, with double the risk of arrhythmic events compared to drug-induced ECG pattern. Careful monitoring, including periodic ECGs and 12-lead 24-hour Holter monitoring, is necessary due to the variability of the ECG pattern over time. Additional electrocardiographic markers, such as AV block and increased QRS duration, have been associated with increased arrhythmic risk.
EUROPEAN HEART JOURNAL SUPPLEMENTS
(2023)
Article
Cardiac & Cardiovascular Systems
Fiorenzo Gaita, Federico Ferraris, Matteo Anselmino, Leonardo Calo
Summary: Atrial fibrillation is a common and harmful arrhythmia. Coumel's Triangle can help understand its complex pathogenesis, with substrate, trigger, and catalyst factor playing a role. Anti-arrhythmic drugs have limited efficacy, while interventional therapy is more effective, especially in early stages of the disease, and can reduce mortality in certain populations. Ablation procedures may vary depending on the type of AF and presence of atrial dilation.
EUROPEAN HEART JOURNAL SUPPLEMENTS
(2023)
Article
Cell Biology
Michele Golino, Francesco Moroni, Marco Giuseppe Del Buono, Justin M. M. Canada, Azita H. H. Talasaz, Sebastian Pinel, James Mbualungu, Alessandra Vecchie, Ai-Chen (Jane) Ho, Georgia K. Thomas, Salvatore Carbone, Hayley E. Billingsley, Jeremy Turlington, Roshanak Markley, Cory Trankle, Roberto De Ponti, Benjamin Van Tassell, Antonio Abbate
Summary: Anakinra treatment leads to a transient increase in eosinophils in patients with heart failure, which is associated with injection site reactions and improvement in cardiorespiratory fitness.
Article
Cardiac & Cardiovascular Systems
Fiorenzo Gaita, Natascia Cerrato, Carla Giustetto, Annamaria Martino, Laura Bergamasco, Michele Millesimo, Lorella Barbonaglia, Paula Carvalho, Domenico Caponi, Andrea Saglietto, Giacomo Bonacchi, Francesca Bianchi, Elisa Silvetti, Cinzia Crescenzi, Stefano Canestrelli, Melissa De Maio, Gaetano Maria De Ferrari, Giuseppe Musumeci, Francesco Rametta, Marco Scaglione, Leonardo Calo
Summary: The study evaluated the long-term prognosis of a large cohort of asymptomatic patients with Brugada ECG pattern. The entire population of asymptomatic patients with BrECG exhibited a relatively low event rate per year, with those having spontaneous type-1 BrECG and positive EPS showing higher risk. Asymptomatic patients with drug-induced-only BrECG had minimal arrhythmic risk, but ongoing follow-up was recommended to detect the appearance of spontaneous type-1 BrECG pattern.
Review
Cardiac & Cardiovascular Systems
Massimiliano Marini, Luigi Pannone, Stefano Branzoli, Silvia Quintarelli, Alessio Coser, Fabrizio Guarracini, Roberto Bonmassari, Mark La Meir, Carlo de Asmundis
Summary: Video-assisted thoracoscopic surgery (VATS) has revolutionized the management of pulmonary and cardiac diseases and has expanded its applications in the last two decades. It has emerged as a valuable technique for electrophysiological procedures, including pacemaker implantations. This paper provides a thorough review of the existing literature on VATS-based pacing procedures, focusing on the detailed description of implantation techniques.
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
(2023)
Letter
Cardiac & Cardiovascular Systems
Michele Golino, Francesco Moroni, Salvatore Carbone, Giuliana Corna, Cory Trankle, Hayley E. Billingsley, Marco G. Del Buono, Azita H. Talasaz, Georgia K. Thomas, Roberto De Ponti, Jeremy Turlington, Roshanak Markley, Ross Arena, Justin M. Canada, Benjamin Van Tassell, Antonio Abbate
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Review
Medicine, General & Internal
Fabrizio Guarracini, Eleonora Bonvicini, Sofia Zanon, Marta Martin, Giulia Casagranda, Marianna Mochen, Alessio Coser, Silvia Quintarelli, Stefano Branzoli, Patrizio Mazzone, Roberto Bonmassari, Massimiliano Marini
Summary: Electrical storm is a medical emergency characterized by recurrent ventricular arrhythmia that can cause hemodynamic instability. Its incidence is increasing, especially in patients with implantable cardioverter defibrillators, and the prognosis is usually poor. Early recognition, management, and treatment are crucial in reducing mortality and improving the quality of life. In emergency situations, different approaches can be used, such as anti-arrhythmic drugs, deep sedation, catheter ablation, neuraxial modulation, and mechanical hemodynamic support. This review aims to provide practical guidelines for the management of electrical storm in acute settings.
MEDICINA-LITHUANIA
(2023)
Article
Medicine, General & Internal
Roberto De Ponti, Carlo Arno, Andrea Piemonti, Paola Centineo, Paola Genoni, Michele Golino, Simone Savastano, Guido Garzena, Sabina Campi
Summary: This study analyzes the data on out-of-hospital cardiac arrest (OHCA) in a limited territory, focusing on survival to hospital admission. The results show that factors such as occurrence near a public building, presence of witnesses, shockable rhythm, and bystander AED shock were associated with better survival. However, the occurrence of OHCA during pandemic waves was linked to longer intervention time and worse survival.
JOURNAL OF CLINICAL MEDICINE
(2023)
