Heart rhythm : the official journal of the Heart Rhythm Society
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The relationship between shocks, device programming, and atrial fibrillation (AF) with a rapid ventricular rate (AF + RVR) using continuous daily monitoring has not been studied in large number of patients with implantable cardioverter-defibrillators (ICDs). ⋯ Faster VT/VF detection thresholds, longer detection durations, use of SVT discriminators, and delivery of ATP reduces all-cause ICD shocks. Continuous monitoring of AF + RVR identifies patients at the highest risk of future ICD shocks.
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Randomized Controlled Trial
Does cardiac resynchronization therapy provide unrecognized benefit in patients with prolonged PR intervals? The impact of restoring atrioventricular synchrony: an analysis from the COMPANION Trial.
The influence of PR prolongation on outcomes after cardiac resynchronization therapy (CRT) is uncertain. ⋯ PR prolongation may affect mortality and heart failure hospitalizations in patients with systolic dysfunction, heart failure, and wide QRS complexes. The effect of PR prolongation may be attenuated by CRT.
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Risk stratification strategies employing sarcomere gene mutational analysis have proved imprecise in identifying high-risk patients with hypertrophic cardiomyopathy (HCM). Therefore, additional genetic risk markers that reliably determine which patients are predisposed to sudden death are needed. ⋯ These observations support the emerging hypothesis that double (or compound) mutations detected by genetic testing may confer a gene dosage effect in HCM, thereby predisposing patients to adverse disease progression. In 3 families, multiple sarcomere mutations were associated with a risk of sudden death, even in the absence of conventional risk factors.