Heart rhythm : the official journal of the Heart Rhythm Society
-
For patients with symptomatic, sustained atrial fibrillation (AF), a "pill-in-the-pocket" antiarrhythmic drug (PIP-AAD) strategy has been proposed to reduce emergency department (ED) use. ⋯ Out-of-hospital PIP-AAD can be an effective for highly selected patients; however, the rates of treatment failure and adverse events are clinically relevant, which limits the widespread application of a PIP-AAD approach.
-
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.
-
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.
-
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.
-
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.