Heart rhythm : the official journal of the Heart Rhythm Society
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Review Meta Analysis
An updated meta-analysis of novel oral anticoagulants versus vitamin K antagonists for uninterrupted anticoagulation in atrial fibrillation catheter ablation.
Catheter ablation is recommended as a first- or second-line rhythm control therapy for selected patients with atrial fibrillation (AF). There is a wide variability in the periprocedural management of oral anticoagulation in patients undergoing AF ablation. ⋯ In patients undergoing AF ablation, uninterrupted periprocedural NOACs are associated with a low incidence of stroke or TIA and a significant reduction in major bleeding as compared with uninterrupted VKAs.
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Ventricular arrhythmias (VAs) of the right coronary cusp (RCC) are not fully characterized. ⋯ RCC-VAs are not uncommon and have unique electrocardiographic and electrophysiological characteristics that distinguish an RCC origin of VA from RVOT and LCC origins. Most RCC-VAs were ablated successfully in the anterior and upper aspects of the RCC.
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Multicenter Study
Long-term outcomes of prophylactic placement of an endovascular balloon in the vena cava for high-risk transvenous lead extractions.
Many clinicians use the strategy of prophylactically placing an endovascular balloon before transvenous lead extraction, yet there are no data regarding this practice. ⋯ During the study period, we observed no acute or long-term adverse outcomes associated with prophylactic placement of an endovascular balloon in the venae cavae of patients undergoing transvenous lead extraction.
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Observational Study
Predictors of ventricular arrhythmia after left ventricular assist device implantation: A large single-center observational study.
Ventricular arrhythmias (VAs) are common in patients after left ventricular assist device (LVAD) implantation. ⋯ Pre-LVAD VAs and AF predict the occurrence of VAs after LVAD implantation. According to the latest data on the negative impact of post-LVAD VAs on all-cause mortality, further studies should clarify the reasonability of maintaining sinus rhythm in patients with AF and/or prophylactic catheter ablation of ventricular tachycardias before LVAD implantation.
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Transvenous lead extraction (TLE) carries a significant risk of intraprocedural complications. Phased-array intracardiac echocardiography (ICE) is widely used during cardiac procedures; however, its utility during TLE has not been well described. ⋯ ICE imaging during TLE can be used to assess the presence of lead binding sites, LAEs, and procedural complications. LAEs were found in the majority of patients, mostly in the absence of bacteremia. The presence of ICE-detected lead binding sites is predictive of a more complex extraction procedure.