Heart rhythm : the official journal of the Heart Rhythm Society
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Comparative Study
The impact of risk score (CHADS2 versus CHA2DS2-VASc) on long-term outcomes after atrial fibrillation ablation.
Risk stratification tools are needed to select the right candidates for catheter ablation of atrial fibrillation (AF). Both the CHADS2 and CHA2DS2-VASc scores have utility in predicting AF-related outcomes and guiding anticoagulation treatment. ⋯ Both the CHADS2 and CHA2DS2-VASc scores were excellent in stratifying patients for 5-year outcomes after AF ablation. However, the CHA2DS2-VASc score was superior to the CHADS2 score in predicting AF recurrence and AF-related morbidities.
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Automated external defibrillator rescues among children with diagnosed and treated long QT syndrome.
Long QT syndrome (LQTS) is a potentially lethal yet highly treatable cardiac channelopathy. A comprehensive LQTS-directed treatment program often includes an automated external defibrillator (AED). ⋯ An AED should seldom be necessary in an appropriately treated child with LQTS. Nevertheless, despite only 3 AED rescues in more than 1700 patient-years, an AED can be a lifesaving and cost-effective part of an LQTS patient's comprehensive sudden death prevention program.
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Atrial fibrillation (AF) is highly associated with obstructive sleep apnea (OSA) in which AF is triggered by hyperactivity of the cardiac autonomic nervous system. Previous studies showed that low-level vagosympathetic trunk stimulation (LLVS), at voltages not slowing sinus rate or AV conduction, inhibits AF by suppressing the cardiac autonomic nervous system. ⋯ LLVS is capable of suppressing ERP shortening and AF induced by OSA. LLVS may serve as a new therapeutic approach to treat OSA-induced AF.
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Distinguishing orthodromic atrioventricular reciprocating tachycardia (ORT) using a retrograde septal accessory pathway (AP) from atypical atrioventricular nodal reentrant tachycardia (AVNRT) may be challenging. Specifically, excluding the presence and participation of an AP may require multiple diagnostic maneuvers. ⋯ RV pacing maneuvers are useful to exclude an AP in patients with AVNRT having concentric atrial activation sequence and a septal ventriculoatrial interval >70 ms; however, none are consistently diagnostic. When observed in this patient population, anterograde His-bundle or septal ventricular capture during RV entrainment was diagnostic for ORT using a septal AP.
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Multicenter Study Clinical Trial
Thoracic Spinal Cord Stimulation for Heart Failure as a Restorative Treatment (SCS HEART study): first-in-man experience.
Preclinical studies suggest that neuromodulation with thoracic spinal cord stimulation (SCS) improves left ventricular (LV) function and remodeling in systolic heart failure (HF). ⋯ The results of this first-in-human trial suggest that high thoracic SCS is safe and feasible and potentially can improve symptoms, functional status, and LV function and remodeling in patients with severe, symptomatic systolic HF.