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Journal: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing


The optimal radiofrequency (RF) power and lesion duration using contact force (CF) sensing catheters for atrial fibrillation (AF) ablation are unknown. We evaluate 50 W RF power for very short durations using CF sensing catheters during AF ablation.

Concepts: Atrial fibrillation, Force


Catheter ablation of premature ventricular complexes (PVC) improves left ventricular (LV) systolic performance in certain patients; however, the effect on diastolic function and left atrial (LA) remodeling is unclear. We assessed the effects of catheter ablation of PVCs on parameters of LV diastolic function and LA remodeling.

Concepts: Improve, Effect, Blood pressure, Effectiveness, Ventricle, Effects unit, Premature ventricular contraction


Differentiation between atrioventricular nodal reentry tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) can be sometimes challenging. Apical right ventricular (RV) entrainment can help in differentiation; however, it has some fallacies. We thought to compare the accuracy of anteroseptal basal RV entrainment to RV apical entrainment in identifying the mechanism of supraventricular tachycardia (SVT).

Concepts: Supraventricular tachycardia, Adenosine, Tachycardia, AV nodal reentrant tachycardia


OBJECTIVE: This study aimed to reveal individual variations in Koch’s triangle using NavX and to evaluate the efficacy of the NavX-guided slow pathway ablation. METHODS: A regional geometry around Koch’s triangle was constructed in 42 consecutive patients with atrioventricular nodal reentrant tachycardia (AVNRT), and a bipolar electrogram map was created with 72 ± 30 sampling points during sinus rhythm to identify sites with Haissaguerre’s slow potentials (SPs) and His bundle electrograms (HBEs) to examine the anatomical and electrical variations. Radiofrequency ablation was performed at the most prominent SP recording site. The acute results and long-term outcome were examined in comparison to another 42 consecutive patients who underwent a conventional fluoroscopy-guided slow pathway ablation in the previous months. RESULTS: The size of Koch’s triangle and the coronary sinus ostium varied over a wide range of 132 to 490 and 69 to 346 mm(2), respectively. HBEs were recorded linearly along the antero-septal right atrium (n = 29) or deviated downward toward the midseptum (n = 13, 31 %). The SPs were always distributed below the lowest HBE recording site. The NavX-guided ablation eliminated AVNRT with a median of 1 radiofrequency pulse, 9.1 ± 4.6 min of fluoroscopy, and 49 ± 14 min of procedure time, all of which were significantly smaller than those in fluoroscopy-guided ablation. No procedure-related complications or long-term recurrence was noted in either group. CONCLUSION: Koch’s triangle varies in terms of the size and electrogram distribution, and the NavX-guided slow pathway ablation overcomes the diversity and seems more effective than fluoroscopy-guided ablation.

Concepts: Cardiology, Heart, Atrial fibrillation, Cardiac electrophysiology, Supraventricular tachycardia, Sinus venosus, AV nodal reentrant tachycardia, Coronary sinus


The postural tachycardia syndrome (POTS) is a heterogeneous group of disorders that results in symptoms of orthostatic intolerance. Excess blood pooling has been observed to cause low effective circulating volume in the central vasculature. Consequently, acute volume loading with IV saline has emerged as a potential strategy for clinical intervention. We evaluated the impact of acute volume loading on both the signs and symptoms of patients suffering from POTS.

Concepts: Cardiology, The Canon of Medicine, Effectiveness, Neurology, Syndromes, Orthostatic hypotension, Postural orthostatic tachycardia syndrome, Orthostatic intolerance


Atrial fibrillation (AF) is the most common cardiac dysrhythmia. Appropriate detection of AF and early initiation of oral anticoagulation therapy are critical to reduce the risk of stroke. Patients with implantable cardioverter defibrillators (ICD) are at high risk of developing AF. The purpose of the Dx-AF study is to demonstrate that a novel single-lead VDD-ICD system (Linox smart S DX) will facilitate adequate recognition of sub-clinical AF and ultimately stroke prevention with a comparable safety profile in comparison to VVI-ICD.

Concepts: Heart, Randomized controlled trial, Stroke, Atrial fibrillation, Implantable cardioverter-defibrillator, Cardiac electrophysiology, Defibrillation, Fibrillation


Prior studies report permanent pacemaker (PPM)-induced tricuspid regurgitation (TR) in up to one third of cases late post-implantation. We sought to assess the extent of immediate PPM-induced TR.

Concepts: Cardiology, Tricuspid valve


Recent data suggests that high burden of premature atrial complexes after pulmonary vein isolation predicts recurrences of atrial arrhythmias. The present study sought to assess the role of premature atrial complexes burden in predicting atrial arrhythmias recurrences in patients with atrial fibrillation (AF) who have undergone second-generation cryoballoon ablation (CB-Adv).

Concepts: Present, Time, Blood, Heart, Atrial fibrillation, Future, Cardiac electrophysiology, Premature atrial contraction


Pulmonary vein isolation is now widely accepted for the treatment of symptomatic atrial fibrillation refractory to antiarrhythmic drugs. However, multiple procedures are often required to significantly reduce atrial fibrillation (AF) recurrence. In the present study, we analyzed the acute results and the midterm clinical outcome of a second-generation cryoballoon ablation (CB-A) performed during repeat procedures for recurrence of AF after an initial procedure performed with conventional radiofrequency (RF).

Concepts: Blood, Heart, Atrial fibrillation, Digoxin


Catheter ablation is proven to be an effective strategy for drug refractory ventricular tachycardia (VT) in ischemic cardiomyopathy. However, the appropriate timing of VT ablation and identifying the group of patients that may receive the greatest benefit remains uncertain. There is limited data on the effect on prophylactic catheter ablation (PCA) in the prevention of implantable cardioverter defibrillator (ICD) therapy, electrical storm, and mortality.

Concepts: Epidemiology, Cardiology, Systematic review, Randomized controlled trial, Implantable cardioverter-defibrillator, Ventricular tachycardia, Meta-analysis, Ventricular fibrillation