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Association between sodium–glucose cotransporter-2 inhibitors and arrhythmic outcomes in patients with diabetes and pre-existing atrial fibrillation EP Europace (IF 6.1) Pub Date : 2024-03-14 Akash Fichadiya, Amity Quinn, Flora Au, Dennis Campbell, Darren Lau, Paul Ronksley, Reed Beall, David J T Campbell, Stephen B Wilton, Derek S Chew
Aims Prior studies suggest that sodium–glucose cotransporter-2 inhibitors (SGLT2is) may decrease the incidence of atrial fibrillation (AF). However, it is unknown whether SGLT2i can attenuate the disease course of AF among patients with pre-existing AF and Type II diabetes mellitus (DM). In this study, our objective was to examine the association between SGLT2i prescription and arrhythmic outcomes
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Prognostic Implications of Premature Ventricular Contractions and Non-sustained Ventricular Tachycardia in Light-Chain Cardiac Amyloidosis EP Europace (IF 6.1) Pub Date : 2024-03-11 Zhongli Chen, Anteng Shi, Hongbin Dong, Natallia Laptseva, Feng Chen, Jiandu Yang, Xiaogang Guo, Firat Duru, Keping Chen, Liang Chen
Background and Aims Premature ventricular contractions (PVC) and non-sustained ventricular tachycardia (NSVT) are commonly observed in light chain cardiac amyloidosis (AL-CA), but their association with prognosis is still unclear. We aimed to evaluate the prognostic value of PVCs and NSVT in patients with moderate-to-advanced AL-CA. Methods We retrospectively included patients with AL-CA at modified
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Aveir VR real-world performance and chronic pacing threshold prediction using mapping and fixation electrical data EP Europace (IF 6.1) Pub Date : 2024-03-08 Mark T K Tam, Yuet-Wong Cheng, Joseph Y S Chan, Chin-Pang Chan, Alex C K Au, Katie W S Fan, Thomas M Y Chim, Wan-Ying Kwok, Fuk-Kei Fong, Angel Lai, Guang-Ming Tan, Bryan P Yan
Aims Aveir VR performance and predictors for its pacing threshold (PCT) in a real-world cohort were investigated. Methods Electrical measurements at various stages of an Aveir VR implant were prospectively collected. Predictors for 3-month PCT were studied. A retrospective cohort of consecutive 139 Micra implants was used to compare the PCT evolution. High PCT was defined as ≥1.5 V, using a pulse width
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Strategies to improve AV synchrony in patients with a Micra AV leadless pacemaker EP Europace (IF 6.1) Pub Date : 2024-03-05 Christophe Garweg, Alexander Breitenstein, Nicolas Clémenty, Carlo De Asmundis, Saverio Iacopino, Jens Brock Johansen, David Sharman, Cathrin Theis, Xavier Viñolas Prat, Stefan Winter, Tobias Reichlin
The second generation of transcatheter pacing systems, called Micra AV, can provide atrio-ventricular (AV) synchronous pacing via a new pacing algorithm relying on sensing mechanical atrial contraction. Several novel programming parameters were introduced to enable AV synchronous pacing, including an A3 and A4 window as well as a conduction and an activity mode switch. In addition to several automated
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Stepping back for good reasons: A reappraisal of the DF-1 connector for defibrillator leads EP Europace (IF 6.1) Pub Date : 2024-02-27 Christian Sticherling, Kenneth A Ellenbogen, Haran Burri
The DF-4 defibrillator standard has been rapidly adopted due to its convenience at implantation. There are however tradeoffs compared to the traditional DF-1 standard which are underappreciated. This viewpoint outlines the advantages and limitations of current defibrillator lead standards which should be kept in mind, as they impact the options which are available to deal with issues which may arise
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The feasibility of population screening for paroxysmal atrial fibrillation using handheld ECGs EP Europace (IF 6.1) Pub Date : 2024-02-27 Jonathan Mant, Rakesh N Modi, Peter Charlton, Andrew Dymond, Efthalia Massou, James Brimicombe, Ben Freedman, Simon J Griffin, F D Richard Hobbs, Gregory Y H Lip, Richard J McManus, Kate Williams
Background and Aims There are few data on the feasibility of population screening for paroxysmal AF using hand-held ECG devices outside a specialist setting or in people over the age of 75. We investigated the feasibility of screening when conducted without face-to-face contact (‘remote’) or via in-person appointments in primary care, and explored impact of age on screening outcomes. Methods People
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In-hospital safety outcomes of left atrial appendage occlusion in octogenarians and nonagenarians EP Europace (IF 6.1) Pub Date : 2024-02-22 Mahmoud Ismayl, Hasaan Ahmed, Andrew M Goldsweig, James V Freeman, Mohamad Alkhouli
Background and Aims Data on safety outcomes of left atrial appendage occlusion (LAAO) in elderly patients are limited. This study aimed to compare the outcomes of LAAO between octogenarians (age 80-89) and nonagenarians (age ≥90) versus younger patients (age ≤79). Methods We conducted a retrospective cohort study using the National Inpatient Sample database to identify patients hospitalized for LAAO
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Long-term outcomes of the pentaspline pulsed field ablation catheter for the treatment of paroxysmal atrial fibrillation: Results of the prospective, multicenter FARA-Freedom Study EP Europace (IF 6.1) Pub Date : 2024-02-22 Andreas Metzner, Martin Fiala, Johan Vijgen, Alexandre Ouss, Melanie Gunawardene, Jim Hansen, Josef Kautzner, Boris Schmidt, Mattias Duytschaever, Tobias Reichlin, Yuri Blaauw, Philipp Sommer, Annelies Vanderper, Anitha B Achyutha, Madeline Johnson, Jonathan D Raybuck, Petr Neuzil
Introduction/Objectives Pulmonary vein isolation (PVI) is well-established strategy for the treatment of paroxysmal atrial fibrillation (PAF). Despite randomized controlled trials and real-world data showing the promise of pulsed-field ablation (PFA) for this treatment, long term efficacy and safety data demonstrating single procedure outcomes off antiarrhythmic drugs remain limited. The aim of the
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Scar Architecture Affects the Electrophysiological Characteristics of Induced Ventricular Arrhythmias in Hypertrophic Cardiomyopathy EP Europace (IF 6.1) Pub Date : 2024-02-20 Pietro Francia, Giulio Falasconi, Diego Penela, Daniel Viveros, José Alderete, Andrea Saglietto, Aldo Francisco Bellido, Julio Marti-Almor, Paula Ocaña-Franco, David Soto-Iglesias, Fatima Zaraket, Dario Turturiello, Antonio Berruezo
Background and aims Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) detects myocardial scarring, a risk factor for ventricular arrhythmias (VA) in hypertrophic cardiomyopathy (HCM). LGE-CMR distinguishes core, borderzone (BZ) fibrosis, and BZ channels, crucial components of reentry circuits. We studied how scar architecture affects inducibility and electrophysiological traits of VA
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Safety of Ventricular Arrhythmia Radiofrequency Ablation with Half-Normal Saline Irrigation EP Europace (IF 6.1) Pub Date : 2024-02-17 Kanae Hasegawa, Zachary T Yoneda, Edward M Powers, Kenichi Tokutake, Masaaki Kurata, Travis D Richardson, Jay A Montgomery, Sharon Shen, Juan C Estrada, Pablo J Saavedra, Amy Emerson, Marilyn L Walker, Harikrishna Tandri, Gregory F Michaud, Arvindh N Kanagasundram, William G Stevenson
Background Failure of radiofrequency (RF) ablation of ventricular arrhythmias is often due to inadequate lesion size. Irrigated radiofrequency ablation with half-normal saline (HNS) has the potential to increase lesion size and reduce sodium delivery to the patient if the same volume of RF irrgant were used for NS and HNS, but could increase risks related to steam pops and lesion size. Aims To assess
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Risk assessment in patients with symptomatic and asymptomatic pre-excitation EP Europace (IF 6.1) Pub Date : 2024-02-16 Anette Jemtrén, Serkan Saygi, Finn Åkerström, Fahd Asaad, Tara Bourke, Frieder Braunschweig, Carina Carnlöf, Nikola Drca, Per Insulander, Göran Kennebäck, Astrid Paul Nordin, Bita Sadigh, Anette Rickenlund, Ott Saluveer, Jonas Schwieler, Emma Svennberg, Jari Tapanainen, Yusuf Turkmen, Hamid Bastani, Mats Jensen-Urstad
Aims Controversy remains as to whether the exercise stress test (EST) is sufficient for risk evaluation in patients with pre-excitation. This study aims to clarify the usefulness of EST in risk stratification in both asymptomatic and symptomatic patients presenting with pre-excitation. Methods and results This prospective study includes consecutive asymptomatic and symptomatic patients with pre-excitation
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Management of ventricular tachycardias: insights on centre settings, procedural workflow, endpoints, and implementation of guidelines—results from an EHRA survey EP Europace (IF 6.1) Pub Date : 2024-02-16 Arian Sultan, Piotr Futyma, Andreas Metzner, Ante Anic, Sergio Richter, Laurent Roten, Patrick Badertscher, Giulio Conte, Julian K R Chun
Ventricular tachycardia (VT), and its occurrence, is still one of the main reasons for sudden cardiac death and, therefore, for increased mortality and morbidity foremost in patients with structural heart [Kahle A-K, Jungen C, Alken F-A, Scherschel K, Willems S, Pürerfellner H et al. Management of ventricular tachycardia in patients with ischaemic cardiomyopathy: contemporary armamentarium. Europace
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Intracardiac Echocardiography in Pediatric and Congenital Cardiac Ablation Shortens Procedure Duration and Improves Success Without Complications EP Europace (IF 6.1) Pub Date : 2024-02-16 Andrew Headrick, Zhining Ou, S Yukiko Asaki, Susan P Etheridge, Benjamin Hammond, Lindsey Gakenheimer-Smith, Thomas Pilcher, Mary Niu
Background and aims Common to adult electrophysiology studies (EPS), intracardiac echocardiography (ICE) use in pediatric and congenital heart disease (CHD) EPS is limited. The purpose of this study was to assess the efficacy of ICE use and incidence of associated complications in pediatric and CHD EPS. Methods This single-center retrospective matched cohort study reviewed EPS between 2013 and 2022
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Temporal relationship between hemodynamic changes and activation of Closed Loop Stimulation during tilt-induced vasovagal syncope EP Europace (IF 6.1) Pub Date : 2024-02-10 Vincenzo Russo, Marco Tomaino, Erika Parente, Angelo Comune, Daniele Giacopelli, Paola Napoli, Alessio Gargaro, Michele Brignole
Aims Dual-chamber pacemaker with Closed Loop Stimulation (CLS) mode is effective in reducing syncopal recurrences in patients with asystolic vasovagal syncope (VVS). In this study we explored hemodynamic and temporal relationship of CLS during tilt-induced vasovagal reflex. Methods Twenty patients underwent tilt test under video recording 3.9 years after CLS pacemaker implantation. Results Three patients
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Area-weighted unipolar voltage to predict heart failure outcomes in patients with ischaemic cardiomyopathy and ventricular tachycardia EP Europace (IF 6.1) Pub Date : 2024-02-03 Robert Rademaker, Yoshi Kimura, Marta de Riva Silva, Hans C Beukers, Sebastiaan R D Piers, Adrianus P Wijnmaalen, Olaf M Dekkers, Katja Zeppenfeld
Aims Patients with ischaemic cardiomyopathy (ICM) referred for catheter ablation of ventricular tachycardia (VT) are at risk for end-stage heart failure (HF) due to adverse remodelling. Local unipolar voltages (UV) decrease with loss of viable myocardium. A UV parameter reflecting global viable myocardium may predict prognosis. We evaluate if a newly proposed parameter, area-weighted unipolar voltage
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Pulmonary Vein Narrowing after Pulsed Field Versus Thermal Ablation EP Europace (IF 6.1) Pub Date : 2024-02-02 Moussa Mansour, Edward P Gerstenfeld, Chinmay Patel, Andrea Natale, William Whang, Frank A Cuoco, Stavros E Mountantonakis, Douglas N Gibson, John D Harding, Scott K Holland, Anitha B Achyutha, Christopher W Schneider, Andrew S Mugglin, Elizabeth M Albrecht, Kenneth M Stein, John W Lehmann, Vivek Y Reddy
Background When it occurs, pulmonary vein (PV) stenosis after atrial fibrillation (AF) ablation is associated with significant morbidity. Even mild-to-moderate PV narrowing may have long-term implications. Unlike thermal ablation energies such as radiofrequency (RF) or cryothermy, pulsed field ablation (PFA) is a non-thermal modality associated with less fibrotic proliferation. Herein, we compared
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Incidence and patterns of atrial fibrillation after catheter ablation of typical atrial flutter—the FLUTFIB study EP Europace (IF 6.1) Pub Date : 2024-02-01 Philipp Attanasio, Tabea Budde, Paul Kamieniarz, Verena Tscholl, Patrick Nagel, Sebastian Biewener, Abdul Parwani, Leif-Hendrik Boldt, Ulf Landmesser, Gerhard Hindricks, Martin Huemer
Aims In patients with atrial flutter (AFL), ablation of the cavotricuspid isthmus (CTI) is a highly effective procedure to prevent AFL recurrence, but atrial fibrillation (AF) may occur during follow-up. The presented FLUTFIB study was designed to identify the exact incidence, duration, timely occurrence, and associated symptoms of AF after CTI ablation using continuous cardiac monitoring via implantable
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Role of electroanatomical mapping guided superior vena cava isolation in paroxysmal atrial fibrillation patients without provoked superior vena cava trigger: A randomized controlled study EP Europace (IF 6.1) Pub Date : 2024-02-01 Yan Dong, Dongsheng Zhao, Xinguang Chen, Linshen Shi, Qiushi Chen, Haiyan Zhang, Yue Yu, Inam Ullah, Pipin Kojodjojo, Fengxiang Zhang
Aims Data about whether empirical superior vena cava isolation (SVCI) improves the success rate of paroxysmal atrial fibrillation (PAF) is conflicting. This study sought to firstly investigate the characteristics of SVC-triggered AF, and secondly investigate the impact of electroanatomical mapping guided SVCI in addition to circumferential pulmonary vein isolation (CPVI) on the outcome of PAF ablation
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Utilization of and perceived need for simulators in clinical electrophysiology: results from an EHRA physician survey EP Europace (IF 6.1) Pub Date : 2024-01-31 Fleur V Y Tjong, Laura Perrotta, Andreas Goette, David Duncker, Kevin Vernooy, Serge Boveda, K R Julian Chun, Emma Svennberg
Background Simulators training have been recently introduced in EP programs in order to improve catheter manipulation skills without complication risks. Aim To survey the current use of EP simulators and the perceived need of these tools in clinical training and practice. Methods A 20-item online questionnaire developed by the Scientific Initiatives Committee of the European Heart Rhythm Association
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Association between antithrombotic therapy after stroke in patients with atrial fibrillation and the risk of net clinical outcome: an observational cohort study EP Europace (IF 6.1) Pub Date : 2024-01-30 Hyo-Jeong Ahn, So-Ryoung Lee, JungMin Choi, Kyung-Yeon Lee, Soonil Kwon, Eue-Keun Choi, Seil Oh, Gregory Y H Lip
Background and Objectives Data on the optimal use of antithrombotic drugs and associated clinical outcomes in patients with atrial fibrillation (AF) and acute ischemic stroke (IS) are limited. We investigated the prescription patterns of antithrombotics in community practice and long-term clinical prognosis according to early poststroke antithrombotic therapy in patients with AF and acute IS. Methods
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Predicting worsening heart failure hospitalizations in patients with implantable cardioverter defibrillators: Is it all about alerts? A pooled analysis of nine trials EP Europace (IF 6.1) Pub Date : 2024-01-29 Giovanni Luca Botto, Gianfranco Sinagra, Alan Bulava, Alessio Gargaro, Tobias Timmel, Daniele Giacopelli, Antonio D’Onofrio, Laurence Guédon-Moreau
Background and aims To predict worsening heart failure hospitalizations (WHFH) in patients with implantable defibrillators and remote monitoring (RM), the HeartInsight algorithm (Biotronik, Berlin, Germany) calculates a heart failure (HF) score combining seven physiologic parameters: 24-hour heart rate (HR), nocturnal HR, HR variability, atrial tachyarrhythmia, ventricular extrasystoles, patient activity
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Practical Guide on Left Atrial Appendage Closure for the Non-implanting Physician. An International Consensus Paper EP Europace (IF 6.1) Pub Date : 2024-01-29 Tatjana Potpara, Marek Grygier, Karl Georg Haeusler, Jens Erik Nielsen-Kudsk, Sergio Berti, Simonetta Genovesi, Eloi Marijon, Serge Boveda, Apostolos Tzikas, Giuseppe Boriani, Lucas V A Boersma, Claudio Tondo, Tom De Potter, Gregory Y H Lip, Renate B Schnabel, Rupert Bauersachs, Marco Senzolo, Carlo Basile, Stefano Bianchi, Pavel Osmancik, Boris Schmidt, Ulf Landmesser, Wolfram Doehner, Gerhard Hindricks
A significant proportion of patients who suffer from atrial fibrillation and are in need of thromboembolic protection are not treated with oral anticoagulation or discontinue this treatment shortly after its initiation. This undertreatment has not improved sufficiently despite the availability of direct oral anticoagulants which are associated with less major bleeding than vitamin K antagonists. Multiple
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Yield of Molecular Autopsy in Sudden Cardiac Death in Athletes. Data from a Large Registry in the United Kingdom EP Europace (IF 6.1) Pub Date : 2024-01-29 Gherardo Finocchiaro, Davide Radaelli, David Johnson, Raghav T Bhatia, Joseph Westaby, Stefano D’Errico, Michael Papadakis, Sanjay Sharma, Mary N Sheppard, Elijah R Behr
Background Sudden cardiac death (SCD) may occur in apparently healthy individuals, including athletes. We report the diagnostic role of post-mortem genetic testing, molecular autopsy (MA), in elucidating the cause of SCD in athletes. Methods We reviewed a database of 6860 consecutive cases of SCD referred to our specialist cardiac pathology centre. All cases underwent detailed cardiac autopsy and 748
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Economic analyses in cardiac electrophysiology: From clinical efficacy to cost utility EP Europace (IF 6.1) Pub Date : 2024-01-29 Maria Hee Jung Park Frausing, Jens Cosedis Nielsen, Caroline Louise Westergaard, Christian Gerdes, Jakob Kjellberg, Giuseppe Boriani, Mads Brix Kronborg
Cardiac electrophysiology is an evolving field that relies heavily on costly device- and catheter-based technologies. An increasing number of patients with heart rhythm disorders are becoming eligible for cardiac interventions, not least due to the rising prevalence of atrial fibrillation and increased longevity in the population. Meanwhile, the expansive costs of healthcare face finite societal resources
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Ubiquitin-specific protease 38 promotes inflammatory atrial fibrillation induced by pressure overload EP Europace (IF 6.1) Pub Date : 2024-01-29 Zheng Xiao, Yucheng Pan, Bin Kong, Hong Meng, Wei Shuai, He Huang
Aims Atrial structural and electrical remodelling is a major reason for the initiation and perpetuation of atrial fibrillation (AF). Ubiquitin-specific protease 38 (USP38) is a deubiquitinating enzyme, but its function in the heart remains unknown. The aim of this study was to investigate the effect of USP38 in pressure overload-induced AF. Methods and results Cardiac-specific knockout USP38 and cardiac-specific
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Disturbed atrial metabolism, shear stress, and cardiac load AF after ablation: AXAFA biomolecule study EP Europace (IF 6.1) Pub Date : 2024-01-24 Winnie Chua, Alya Khashaba, Hansel Canagarajah, Jens Cosedis Nielsen, Luigi di Biase, Karl Georg Haeusler, Gerhard Hindricks, Lluis Mont, Jonathan Piccini, Renate B Schnabel, Ulrich Schotten, Ursula-Henrike Wienhues-Thelen, Tanja Zeller, Larissa Fabritz, Paulus Kirchhof
Background Different disease processes can combine to cause to atrial fibrillation (AF). Their contribution to recurrent AF after ablation in patients is not known. Objective Cardiovascular processes associated with recurrent AF after AF ablation were determined by quantifying biomolecules related to inflammation, metabolism, proliferation, fibrosis, shear-stress, atrial pressure, and others in the
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How to assess and treat right ventricular electromechanical dyssynchrony in post-repair tetralogy of Fallot: insights from imaging, invasive studies and computational modelling EP Europace (IF 6.1) Pub Date : 2024-01-24 Miroslav Ložek, Jan Kovanda, Peter Kubuš, Michal Vrbík, Lenka Lhotská, Joost Lumens, Tammo Delhaas, Jan Janoušek
Right bundle branch block (RBBB) and resulting RV electromechanical discoordination are thought to play a role in the disease process of subpulmonary right ventricular (RV) dysfunction that frequently occur post-repair tetralogy of Fallot. We sought to describe this disease entity, the role of pulmonary re-valvulation and the potential added value of RV cardiac resynchronization therapy (RV-CRT). Two
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P2X7 receptor inhibition prevents atrial fibrillation in rodent models of depression EP Europace (IF 6.1) Pub Date : 2024-01-23 Tianxin Ye, Yunping Zhou, Jinxiu Yang, Fangcong Yu, Zhuonan Song, Jiaran Shi, Longbo Wang, Zhouqing Huang, Bo Yang, Xingxiang Wang
Background and Aims Depression, the most prevalent psychiatric disorder, is associated with the occurrence and development of atrial fibrillation (AF). P2X7 receptor (P2X7R) activation participates in the development of depression, but little attention has been given to its role in AF. This study was to investigate the effects of P2X7R on AF in depression models. Methods Lipopolysaccharide (LPS) and
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Noninvasive Detection of Slow Conduction with Cardiac Magnetic Resonance Imaging for VT Ablation EP Europace (IF 6.1) Pub Date : 2024-01-22 Sara Vázquez-Calvo, Judit Mas Casanovas, Paz Garre, Paula Sánchez-Somonte, Pasquale Valerio Falzone, Laura Uribe, Eduard Guasch, José Maria Tolosana, Roger Borras, Rosa M Figueras i Ventura, Elena Arbelo, José T Ortiz-Pérez, Susana Prats, Rosario J Perea, Josep Brugada, Lluís Mont, Andreu Porta-Sanchez, Ivo Roca-Luque
Background Noninvasive myocardial scar characterization with cardiac magnetic resonance (CMR) has been shown to accurately identify conduction channels and can be an important aid for ventricular tachycardia (VT) ablation. A new mapping method based on targeting deceleration zones (DZs) has become one of the most commonly used strategies for VT ablation procedures. Aims To analyze the capability of
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High-risk Brugada Syndrome: Factors Associated with Arrhythmia Recurrence and Benefits of Epicardial Ablation in Addition to ICD implantation EP Europace (IF 6.1) Pub Date : 2024-01-22 Vincenzo Santinelli, Giuseppe Ciconte, Francesco Manguso, Luigi Anastasia, Emanuele Micaglio, Zarko Calovic, Gabriele Vicedomini, Beniamino Mazza, Mattia Vecchi, Valerio Mecarocci, Emanuela T Locati, Antonio Boccellino, Gabriele Negro, Antonio Napolano, Luigi Giannelli, Carlo Pappone
Aims This study aims to evaluate the prognostic impact of the arrhythmogenic substrate size in symptomatic Brugada Syndrome (BrS) as well as to validate the long-term safety and effectiveness of epicardial radiofrequency ablation (RFA) compared to No-RFA group. Methods and Results In this prospective investigational long-term registry study, 257 selected symptomatic BrS patients with ICD implantation
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Current Management of Atrial Fibrillation in Routine Practice According to Last Esc Guidelines: An Ehra Physician Survey. How are we dealing with controversial approaches? EP Europace (IF 6.1) Pub Date : 2024-01-16 Jose M Guerra, Zoraida Moreno Weidmann, Laura Perrotta, Arian Sultan, Ante Anic, Andreas Metzner, Rui Providencia, Julian Chun
Background and Aims Although guidelines for the management of atrial fibrillation (AF) are regularly published, many controversial issues remain, limiting their implementation. We aim to describe current clinical practice among European Heart Rhythm (EHRA) community according to last guidelines. Methods A 30 multiple-choice questionnaire covering the most controversial topics related to AF management
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Optical Mapping and Optogenetics in Cardiac Electrophysiology Research and Therapy: A State-of-the-Art Review EP Europace (IF 6.1) Pub Date : 2024-01-16 Olivia Baines, Rina Sha, Manish Kalla, Andrew P Holmes, Igor R Efimov, Davor Pavlovic, Christopher O'Shea
State-of-the-art innovations in optical cardiac electrophysiology are significantly enhancing cardiac research. A potential leap into patient care is now on the horizon. Optical mapping, using fluorescent probes and high-speed cameras, offers detailed insights into cardiac activity and arrhythmias by analysing electrical signals, calcium dynamics, and metabolism. Optogenetics utilises light-sensitive
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Posterior wall ablation by pulsed-field ablation – procedural safety, efficacy and findings on redo procedures EP Europace (IF 6.1) Pub Date : 2024-01-16 Thomas Kueffer, Hildegard Tanner, Antonio Madaffari, Jens Seiler, Andreas Haeberlin, Jens Maurhofer, Fabian Noti, Claudia Herrera, Gregor Thalmann, Nikola A Kozhuharov, Tobias Reichlin, Laurent Roten
Background The left atrial posterior wall is a potential ablation target in patients with recurrent atrial fibrillation despite durable pulmonary vein isolation or in patients with roof-dependent atrial tachycardia (AT). Pulsed-field ablation (PFA) offers efficient and safe posterior wall ablation (PWA), but available data is scarce. Methods Consecutive patients undergoing PWA using PFA were included
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Three-Dimensional Intracardiac Echocardiography for Left Atrial Appendage Sizing and Percutaneous Occlusion Guidance EP Europace (IF 6.1) Pub Date : 2024-01-12 Domenico G Della Rocca, Michele Magnocavallo, Carola Gianni, Sanghamitra Mohanty, Amin Al-Ahmad, Mohamed Bassiouny, Marialessia Denora, Vincenzo Mirco La Fazia, Carlo Lavalle, Gerald J Gallinghouse, Pasquale Santangeli, Marco Polselli, Andrea Sarkozy, Giampaolo Vetta, Adnan Ahmed, Javier E Sanchez, Luigi Pannone, Gian-Battista Chierchia, David R Tschopp, Carlo de Asmundis, Luigi Di Biase, Dhanunjaya
Background Left atrial appendage (LAA) imaging is critical during percutaneous occlusion procedures. 3D-intracardiac echocardiography (ICE) features direct visualization of LAA from multiple cross-sectional planes at a time. We aimed at reporting procedural success of 3D-ICE-guided LAA occlusion and the correlation between pre-procedural transesophageal echocardiography (TEE) and intraprocedural 3D-ICE
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Performance and safety of temperature- and flow-controlled radiofrequency ablation for ventricular arrhythmia EP Europace (IF 6.1) Pub Date : 2024-01-09 Richard Kobza, Gabriela Hilfiker, Sophie Rissotto, Saagar Mahida, Christian Grebmer, Firat Duru, Helmut Pürerfellner, Benjamin Berte
Aims High-power ablation is effective for ventricular arrhythmia ablation; however, it increases the risk of steam pops. The aim of this study was to define the safety and efficacy of QMODE ablation in the ventricle and the risk of steam pop. Methods and results Consecutive patients undergoing ventricular ablation using QDOT were included in a prospective single-centre registry. Procedural data, complications
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Cardiac radiotherapy transiently alters left ventricular electrical properties and induces cardiomyocyte specific ventricular substrate changes in heart failure EP Europace (IF 6.1) Pub Date : 2024-01-09 Felix Mehrhof, Judith Hüttemeister, Radu Tanacli, Matthias Bock, Markus Bögner, Felix Schoenrath, Volkmar Falk, Daniel Zips, Gerhard Hindricks, Jin-Hong Gerds-Li, Felix Hohendanner
Background Ongoing clinical trials investigate the therapeutic value of stereotactic cardiac radioablation (cRA) in heart failure patients with ventricular tachycardia. Animal data indicate an effect on local cardiac conduction properties. However, the exact mechanism of cRA in patients remains elusive. Methods High-density 3D electroanatomic mapping in sinus rhythm was performed in a patient with
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A cross-sectional nationwide survey of guideline based syncope units in the Netherlands. The SU-19 score: a novel validation for best practices EP Europace (IF 6.1) Pub Date : 2024-01-08 Steven van Zanten, Jelle S Y de Jong, Mike G Scheffer, Evert C A Kaal, Joris R de Groot, Frederik J de Lange
Aims We aimed to identify all syncope units (SUs) in the Netherlands and assess the extent to which these SUs fulfil the essential requirements outlined by the consensus statements of the European Heart Rhythm Association and the European Society of Cardiology syncope guidelines. For this, we developed the SU-19 score, a novel guideline based validation tool for best practice. Methods All outpatient
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Electrophysiological characteristic and ablation of ventricular arrhythmias originating from the intramural basal inferior septum EP Europace (IF 6.1) Pub Date : 2024-01-05 Jie Yang, Mengmeng Li, Chenxi Jiang, Ribo Tang, Caihua Sang, Wei Wang, Xin Zhao, Changyi Li, Songnan Li, Xueyuan Guo, Changqi Jia, Man Ning, Li Feng, Dan Wen, Hui Zhu, Yuexin Jiang, Tong Liu, Fang Liu, Deyong Long, Jianzeng Dong, Changsheng Ma
Background and Aims The electrocardiographic and electrophysiological characteristics of ventricular arrhythmia (VA) arising from intramural basal inferior septum (BIS) have not been specifically addressed. The current study was to characterize intramural BIS VA from those with endocardial origins and clarify the anatomical configurations of pyramidal space. Methods Fifty-five consecutive patients
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Severe acute kidney injury related to hemolysis after pulsed field ablation for atrial fibrillation EP Europace (IF 6.1) Pub Date : 2024-01-04 Sandrine Venier, Nathan Vaxelaire, Peggy Jacon, Adrien Carabelli, Antoine Desbiolles, Frederic Garban, Pascal Defaye
Background and Aims Pulsed-field ablation (PFA) has been proposed as a novel alternative to radiofrequency and cryoablation in the treatment of atrial fibrillation (AF). Following the occurrence of two cases of acute kidney injury secondary to hemolysis after PFA procedure, we evaluated hemolysis in a cohort of consecutive patients. Methods and Results Two cases of AKI occurred in last May and June
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Improved Diagnostic Performance of Insertable Cardiac Monitors by an Artificial Intelligence-Based Algorithm EP Europace (IF 6.1) Pub Date : 2024-01-03 Eliot Crespin, Arnaud Rosier, Issam Ibnouhsein, Alexandre Gozlan, Arnaud Lazarus, Gabriel Laurent, Aymeric Menet, Jean-Luc Bonnet, Niraj Varma
Background The increasing use of insertable cardiac monitors (ICM) produces a high rate of false positive (FP) diagnoses. Their verification results in a high workload for caregivers. Objective We evaluated the performance of an artificial intelligence (AI)-based ILR ECG Analyzer™ (ILR-ECG-A). This machine learning algorithm that reclassifies ICM-transmitted events to minimize the rate of FP diagnoses
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Respiratory Control Minimizes Diaphragmatic Contraction and Dry Cough during Pulsed Field Ablation of Atrial Fibrillation EP Europace (IF 6.1) Pub Date : 2024-01-02 Ruhong Jiang, Qiang Liu, Laite Chen, Shiquan Chen, Yunhe Wang, Hui Cheng, Xia Sheng, Yaxun Sun, Lu Yu, Pei Zhang, Jianwei Lin, Zuwen Zhang, Xueyan Ding, Michael Shehata, Guosheng Fu, Chenyang Jiang
Background and Aims Pulsed-field ablation (PFA) is a promising new ablation modality to treat atrial fibrillation. However, PFA can cause varying degrees of diaphragmatic contraction and dry cough, especially under conscious sedation. This prospective study presents a method to minimize the impact of PFA on diaphragmatic contraction and dry cough during the procedure. Methods 28 patients underwent
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Prevention and treatment of pericardial tamponade in the electrophysiology laboratory - an European Heart Rhythm Association Survey EP Europace (IF 6.1) Pub Date : 2024-01-02 Andreas Metzner, Arian Sultan, Piotr Futyma, Sergio Richter, Laura Perrotta, K R Julian Chun
Background Pericardial tamponade (PT) is the most frequent severe complication during EP procedures and requires immediate, coordinated and effective treatment. However, multiple aspects of PT treatment are not standardized or under ongoing debate. Methods An online questionnaire consisting of 26 multiple-choice questions was sent out to the European Heart Rhythm (EHRA) Research Network and also distributed
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Redo Procedures after Sinus Node Sparing Hybrid ablation for Inappropriate Sinus Tachycardia/Postural Orthostatic Sinus Tachycardia EP Europace (IF 6.1) Pub Date : 2023-12-28 Carlo de Asmundis, Lorenzo Marcon, Luigi Pannone, Domenico Giovanni Della Rocca, Dhanunjaya Lakkireddy, Thomas M Beaver, Chad R Brodt, Cinzia Monaco, Antonio Sorgente, Charles Audiat, Giampaolo Vetta, Robbert Ramak, Ingrid Overeinder, Rani Kronenberger, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Andrea Sarkozy, Pedro Brugada, Gian Battista Chierchia, Mark La Meir
Aims A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/Postural Orthostatic Tachycardia Syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug-resistant IST/POTS. The aim of this study was to evaluate the long-term rate of redo procedures after hybrid IST ablation and procedural strategy, outcomes
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Conventional biventricular pacing is still preferred to conduction system pacing for atrioventricular block in patients with reduced ejection fraction and narrow QRS EP Europace (IF 6.1) Pub Date : 2023-12-28 Michael Glikson, Marek Jastrzebski, Michael R Gold, Kenneth Ellenbogen, Haran Burri
It is well established that right ventricular pacing is detrimental in patients with reduced cardiac function who require ventricular pacing (VP), and alternatives nowadays are comprised of biventricular pacing (BiVP) and conduction system pacing (CSP). The latter modality is of particular interest in patients with a narrow baseline QRS as it completely avoids, or minimizes, ventricular desynchronization
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Association of vectorcardiographic T-wave area with clinical and echocardiographic outcomes in cardiac resynchronization therapy EP Europace (IF 6.1) Pub Date : 2023-12-26 Muhammet Dural, Mohammed A Ghossein, Willem Gerrits, Fenna Daniels, Mathias Meine, Alexander H Maass, Michiel Rienstra, Frits W Prinzen, Kevin Vernooy, Antonius M W van Stipdonk
Background and Aims Data on repolarization parameters in CRT is scarce. We investigated the association of baseline T-wave area, with both clinical and echocardiographic outcomes of CRT in a large, multi-center cohort of CRT recipients. Also, we evaluated the association between baseline T-wave area and QRS area. Methods In this retrospective study, 1.355 consecutive CRT recipients were evaluated.
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‘Single-shot’ pulmonary vein isolation using a novel lotos pulsed field ablation catheter: a preclinical evaluation of the feasibility, safety and 30-day efficacy EP Europace (IF 6.1) Pub Date : 2023-12-16 Sijia Pu, Fangzhou Liu, Yuhan Chen, Cihua Luo, Peng Li, Yanlin Chen, Lu Fu, Huiyi Liu, Xingdong Ye, Shulin Wu, Yumei Xue, Weidong Lin
Aims Pulsed field ablation (PFA) is emerging as a nonthermal, tissue-specific technique for pulmonary vein isolation (PVI) in atrial fibrillation therapy. This preclinical study aimed to investigate the feasibility and safety of PVI using a novel PFA system including a nanosecond-scale PFA generator, a novel lotos PFA catheter, and a customized 12-French steerable sheath. Methods and Results A total
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Transcoronary Mapping with an Over-the-wire Multielectrode Catheter in Scar-related Ventricular Tachycardia Patients EP Europace (IF 6.1) Pub Date : 2023-12-14 Takuro Nishimura, Masahiko Goya, Miho Negishi, Takashi Ikenouchi, Tasuku Yamamoto, Iwanari Kawamura, Kentaro Goto, Takatoshi Shigeta, Tomomasa Takamiya, Susumu Tao, Masateru Takigawa, Taishi Yonetsu, Shinsuke Miyazaki, Tetsuo Sasano
Background and Aims The usefulness of coronary venous system mapping has been reported for assessing intramural and epicardial substrates in patients with scar-related ventricular tachycardia (VT). However, there has been little data on mapping from coronary arteries. We investigated the safety and utility of mapping from coronary arteries with a novel over-the-wire multielectrode catheter in scar-related
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Ablation for atrial fibrillation improves the outcomes in patients with heart failure with preserved ejection fraction EP Europace (IF 6.1) Pub Date : 2023-12-13 Zhonglei Xie, Baozhen Qi, Zimu Wang, Fuhai Li, Chaofeng Chen, Chaofu Li, Shuai Yuan, Shun Yao, Jingmin Zhou, Junbo Ge
Background and Aims Patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) have worse clinical outcomes than those with sinus rhythm (SR). We aim to investigate whether maintaining SR in patients with HFpEF through a strategy such as AF ablation would improve outcomes. Methods This is a cohort study that analyzed 1034 patients (median age 69 [63-76] years
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Major In-Hospital Complications after Catheter Ablation of Cardiac Arrhythmias - Individual Case Analysis of 43,031 Procedures EP Europace (IF 6.1) Pub Date : 2023-12-13 Lars Eckardt, Florian Doldi, Omar Anwar, Nele Gessler, Katharina Scherschel, Ann-Kathrin Kahle, Aenne S von Falkenhausen, Raffael Thaler, Julian Wolfes, Andreas Metzner, Christian Meyer, Stephan Willems, Julia Köbe, Philipp Sebastian Lange, Gerrit Frommeyer, Karl-Heinz Kuck, Stefan Kääb, Gerhard Steinbeck, Moritz F Sinner
Objective and Background In-hospital complications of catheter ablation for atrial fibrillation (AF), atrial flutter (AFL), and ventricular tachycardia (VT) may be overestimated by analyses of administrative data. Methods We determined the incidences of in-hospital mortality, major bleeding, and stroke around AF, AFL, and VT ablations in four German tertiary centers between 2005-2020. All cases were
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Prevention of venous thromboembolism after right heart-sided electrophysiological procedures: results of an EHRA survey EP Europace (IF 6.1) Pub Date : 2023-12-13 Giacomo Mugnai, Michal Farkowski, Luca Tomasi, Laurent Roten, Federico Migliore, Carlo de Asmundis, Giulio Conte, Serge Boveda, Julian K R Chun
Introduction Limited data are available regarding venous thromboembolism (VTE), specifically deep vein thrombosis (DVT) and pulmonary embolism (PE), following right-sided ablations and electrophysiological (EP) studies. Compared to left-sided procedures, no guidelines on antithrombotic management strategies for the prevention of DVT and PE are available. The main purpose of the present European Heart
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Single-lead ECG AI model with risk factors detects Atrial Fibrillation during Sinus Rhythm EP Europace (IF 6.1) Pub Date : 2023-12-10 Stijn Dupulthys, Karl Dujardin, Wim Anné, Peter Pollet, Maarten Vanhaverbeke, David McAuliffe, Pieter-Jan Lammertyn, Louise Berteloot, Nathalie Mertens, Peter De Jaeger
Background and Aims Guidelines recommend opportunistic screening for atrial fibrillation (AF), using a 30-second single-lead electrocardiogram (ECG) recorded by a wearable device. Since many patients have paroxysmal AF, identification of patients at high risk presenting in sinus rhythm may increase the yield of subsequent long-term cardiac monitoring. The aim is evaluating an AI-algorithm trained on
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Coronary artery disease in atrial fibrillation ablation: impact on arrhythmic outcomes EP Europace (IF 6.1) Pub Date : 2023-12-07 Ida Anna Cappello, Luigi Pannone, Domenico Giovanni Della Rocca, Antonio Sorgente, Alvise Del Monte, Sahar Mouram, Giampaolo Vetta, Rani Kronenberger, Robbert Ramak, Ingrid Overeinder, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Mark La Meir, Dries Belsack, Andrea Sarkozy, Pedro Brugada, Kaoru Tanaka, Gian Battista Chierchia, Ali Gharaviri, Carlo de Asmundis
Aims Catheter ablation (CA) is an established treatment for atrial fibrillation (AF). A computed tomography (CT) may be performed before ablation to evaluate the anatomy of pulmonary veins. The aim of this study is to investigate the prevalence of patients with coronary artery disease (CAD) detected by cardiac CT scan pre-ablation and to evaluate the impact of CAD and revascularization on outcomes
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Efficacy of a web-based healthcare innovation to advance the quality of life and care of patients with an implantable cardioverter defibrillator (ACQUIRE-ICD): a randomized controlled trial EP Europace (IF 6.1) Pub Date : 2023-12-07 Ole Skov, Jens Brock Johansen, Jens Cosedis Nielsen, Charlotte E Larroudé, Sam Riahi, Thomas M Melchior, Michael Vinther, Søren Jensen Skovbakke, Nina Rottmann, Uffe Kock Wiil, Carl Joakim Brandt, Kim G Smolderen, John A Spertus, Susanne S Pedersen
Aims Modern clinical management of patients with an implantable cardioverter defibrillator (ICD) largely consists of remote device monitoring, although a subset is at risk of mental health issues post-implantation. We compared a 12-month web-based intervention consisting of goal setting, monitoring of patients’ mental health—with a psychological intervention if needed—psychoeducational support from
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Enhancement of Bicycle Exercise Capacity in Patients with Chronotropic Incompetence Through Closed Loop Stimulation: A Randomized Crossover Trial EP Europace (IF 6.1) Pub Date : 2023-12-01 Su-Kiat Chua, Wen-Ling Chen, Lung-Ching Chen, Kou-GI Shyu, Huei-Fong Hung, Shih-Huang Lee, Tzu-Lin Wang, Wei-Ting Lai, Kuan-Jen Chen, Zhen-Yu Liao, Cheng-Yen Chuang, Ching-Yao Chou
Background This study aimed to investigate the effectiveness of closed-loop stimulation (CLS) pacing compared to the traditional DDD mode in patients with chronotropic incompetence (CI) using bicycle-based cardiopulmonary exercise testing (CPET). Methods This single-center, randomized crossover trial involved 40 patients with CI. Patients were randomized to receive either DDD-CLS or DDD mode pacing
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Autothreshold algorithm feasibility and safety in left bundle branch pacing EP Europace (IF 6.1) Pub Date : 2023-12-01 Elena Sola-García, Manuel Molina-Lerma, Juan Jiménez-Jáimez, Rosa Macías-Ruiz, Pablo J Sánchez-Millán, Luis Tercedor, Miguel Álvarez
Background and Aims Autothreshold algorithms enable remote monitoring of patients with conventional pacing, but there is limited information on their performance in left bundle branch pacing (LBBP). Our objective was to analyze the behavior of the autothreshold algorithm in LBBP and compare it with conventional pacing and manual thresholds during initial device programming (acute phase), after 1-7
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Efficacy and Safety of Pulmonary Vein Isolation with Pulsed Field Ablation versus Novel Cryoballoon Ablation System for Atrial Fibrillation EP Europace (IF 6.1) Pub Date : 2023-12-01 Patrick Badertscher, Simon Weidlich, Sven Knecht, Niklas Stauffer, Philipp Krisai, Gian Voellmin, Stefan Osswald, Christian Sticherling, Michael Kühne
Background Pulsed-field ablation (PFA) has emerged as a novel treatment technology for patients with atrial fibrillation (AF). Cryoballoon (CB) is the most frequently used single shot technology. A direct comparison to a novel CB system is lacking. Objective To compare pulmonary vein isolation (PVI) using PFA versus a novel CB system regarding efficiency, safety, myocardial injury, and outcomes. Methods
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Comparison of automated subcutaneous defibrillator screening between different pacing sites in cardiac pacing device carriers EP Europace (IF 6.1) Pub Date : 2023-11-29 Manuel Molina-Lerma, Eva Cabrera-Borrego, Ricardo Rivera-Lopez, Pablo Sánchez-Millán, Jesús Peña Mellado, Antonio Arriaga Jiménez, Miguel Álvarez
Background and Aims The compatibility of cardiac pacing with the presence of a subcutaneous implantable cardioverter-defibrillator (S-ICD) has been investigated, but S-ICD screening test results have not been compared among different pacing sites. The objective was to compare S-ICD screening results among different cardiac pacing sites and to assess the electrocardiographic predictors of success. Methods
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Impact of maintenance anaesthetics on total emissions of an atrial fibrillation catheter ablation procedure: authors' reply. EP Europace (IF 6.1) Pub Date : 2023-11-28 Geoffroy Ditac,Rémi Schweizer,Pierre-Jean Cottinet,Francis Bessière
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Correspondence on 'Risk of myocardial infarction and ischemic stroke in individuals with first-diagnosed paroxysmal vs. non-paroxysmal atrial fibrillation under anticoagulation". EP Europace (IF 6.1) Pub Date : 2023-11-28 An-Ping Huo,Pui-Ying Leong,James Cheng-Chung Wei
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Association Between Accelerometer-derived Physical Activity and Incident Cardiac Arrest EP Europace (IF 6.1) Pub Date : 2023-11-28 Shuangfa Qiu, Zhenhua Xing
Background Studies on objectively measured physical activity (PA) have investigated acute cardiovascular outcomes but not cardiac arrest (CA). Our study aimed to investigate the dose-response relationship between accelerometer-measured PA and CA by intensity of PA. Methods This prospective cohort study included 98,893 UK Biobank participants whose PA data were measured using wrist-worn accelerometers