Heart Rhythm : the Official Journal of the Heart Rhythm Society

BACKGROUND: Atrial fibrillation (AF) is the most common heart arrhythmia and considered to be a progressive chronic disease associated with an increased morbidity and mortality. Recent data suggests a link between inflammation, oxidative stress and AF, although the underlying mechanisms are not fully understood. As oxidized lipoproteins cause structural damage and electrophysiologic changes in cardiomyocytes, it is feasible that the transformation of atheroprotective high-density lipoprotein (HDL) into dysfunctional HDL contributes to the development of AF...

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BACKGROUND: Cardioneuroablation (CNA) is a promising therapy for reflex asystolic syncope, however, convincing data on the mid-term safety and efficacy of this procedure are still lacking. OBJECTIVE: To assess mid-term safety, efficacy and patient's acceptance of CNA. METHODS: This prospective observational single-center study included 115 consecutive patients (mean 39±13 years, 58% females) treated between 2016 and 2022 who completed at least one-year follow-up...

BACKGROUND: Pulsed field ablation (PFA) is a nonthermal energy source for ablation of cardiac arrhythmias. This study investigated the prospective outcomes of a novel PFA generator in conjunction with a commercially available, contact force-sensing, focal ablation catheter. OBJECTIVE: We sought to assess the feasibility, safety, and lesion characteristics of point-by-point PFA in consecutive patients undergoing repeat ablation of atrial fibrillation (AF). METHODS: The study involved reisolation of pulmonary veins (PV) with electrical reconnection and the creation of an anterior line (AL) in patients with anterior substrate or durable pulmonary vein isolation (PVI)...

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BACKGROUND: Pulsed field ablation (PFA) is a nonthermal method to achieve selective cell death with little inflammation response. However, there are no reports in septal reduction therapy (SRT). OBJECTIVE: The study was aimed to investigate the effectiveness and safety of PFA for SRT. METHODS: A novel transvenous intra-septal PFA method with 3-dimensional (3D) guidance was introduced in Yorkshire pigs. Electrocardiographic parameters, transthoracic echocardiography and histopathology were used to evaluated...

BACKGROUND: Brugada syndrome (BrS) is an inherited cardiac arrhythmogenic disease that predisposes patients to sudden cardiac death. It is associated with mutations in SCN5A, encoding the cardiac sodium channel alpha subunit (NaV 1.5). BrS-related mutations have incomplete penetrance and variable expressivity within families. OBJECTIVE: To determine the role of patient-specific genetic background on the cellular and clinical phenotype among carriers of NaV 1.5_p...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Congenital complete heart block (CCHB) is seen in 1:15,000-1:20,000 live births, with risk of left ventricular (LV) dysfunction or dilated cardiomyopathy in 7-23% of subjects. OBJECTIVE: We investigated serial changes in LV size and systolic function in paced CCHB subjects to examine effect of time from pacemaker on echocardiographic parameters. METHODS: Single center retrospective cohort analysis of paced CCHB subjects was performed...

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No abstract text is available yet for this article.

Arrhythmogenic role of epicardial adipose tissue (EAT) in atrial arrhythmias is well established, but its effect on ventricular arrhythmias has been significantly less investigated. Since ventricular arrhythmias are thought to cause 75% to 80% of cases of sudden cardiac death, this is not a trivial issue. We provide an overview of clinical data as well as experimental and molecular data linking EAT to ventricular arrhythmias, attempting to dissect possible mechanisms and indicate future directions of research and possible clinical implications...

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BACKGROUND: In 2022 and 2023 Medtronic recalled implantable defibrillators because they may deliver less than full energy shocks. The 2022 problem truncates the 2nd phase of the waveform (SCP-T2), resulting in ∼32J shocks, and is mitigated by downloadable software; the 2023 malfunction truncates the 1st phase of the waveform, resulting in 0-12J shocks due to a glassed feedthrough problem (GFT-T1) that might be avoided by programming B>AX shock polarity. OBJECTIVE: 1) Assess the consequences of GFT-T1 and SCP-T2 shocks in the FDA MAUDE database; 2) estimate the incidences of GFT-T1 and SCP-T2...

BACKGROUND: Efficacy of beta blocker treatment in type 3 long QT syndrome (LQT3) remains debated. OBJECTIVES: To test the hypothesis that beta-blocker use is associated with cardiac events in a French cohort of LQT3 patients. METHODS: All the patients with a likely pathogenic/pathogenic variant in the SCN5A gene (linked to LQT3) were included and followed up. Documented ventricular tachycardia/ventricular fibrillation, torsade de pointes, aborted cardiac arrest, sudden death, and appropriate shocks were considered as severe cardiac events (SCEs)...

BACKGROUND: In arrhythmogenic right ventricular cardiomyopathy (ARVC), risk of atrial arrhythmias (AA) persists after ventricular tachycardia (VT) ablation. OBJECTIVE: We sought to determine the type, prevalence, outcome, and risk correlates of AA in ARVC in patients undergoing VT ablation. METHODS: Prospectively collected procedural and clinical data on ARVC patients undergoing VT ablation were analyzed. Risk score for typical atrial flutter was determined from univariate logistic regression analysis...

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BACKGROUND: Left bundle branch (LBB) pacing (LBBP) is a physiological pacing. However, the accuracy of current ECG criteria for LBBP remains inadequate. OBJECTIVE: To establish a novel individualized criterion to improve the accuracy of LBBP determination in patients with a narrow QRS complex. METHODS: Patients in whom both LBBP and left ventricular septal pacing (LVSP) were acquired during operation were enrolled. LBB conduction time (LBBCT) was measured from LBB potential (LBBpo ) to intrinsic QRS onset...