Heart rhythm : the official journal of the Heart Rhythm Society
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Observational Study
Risk of stroke and intracranial hemorrhage in 9727 Chinese with atrial fibrillation in Hong Kong.
Current risk schemes to predict ischemic stroke and intracranial hemorrhage (ICH) in atrial fibrillation (AF) are derived primarily using a Caucasian population. ⋯ Chinese AF patients are at high risk for ischemic stroke. Analysis of the net clinical benefit favors the use of warfarin over aspirin or no therapy for stroke prevention in a broad range of Chinese AF patients.
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Myotonic dystrophy type 1 (DM1), a muscular dystrophy due to CTG expansion in the DMPK gene, can cause cardiac conduction disorders and sudden death. These cardiac manifestations are similar to those observed in loss-of-function SCN5A mutations, which are also responsible for Brugada syndrome (BrS). ⋯ Our study is the first to describe the deleterious effect of DM1 on clinical expression of a loss-of-function SCN5A mutation and to show a provoked BrS phenotype in a DM1 patient. The modification of the ECG pattern by ajmaline supports the hypothesis of a link between DM1 and Nav1.5 loss of -function.
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Because the His bundle is intrinsic to the circuit in orthodromic reciprocating tachycardia and remote from that of atrioventricular nodal reentrant tachycardia (AVNRT), pacing the His bundle during supraventricular tachycardia (SVT) may be useful to distinguish these arrhythmias. ⋯ HOP during SVT is a novel technique for distinguishing orthodromic reciprocating tachycardia from AVNRT. It can reliably distinguish between these arrhythmias with high sensitivity and specificity.
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Randomized Controlled Trial
A prospective randomized controlled trial on the incidence and predictors of late-phase postoperative atrial fibrillation up to 30 days and the preventive value of biatrial pacing.
Postoperative atrial fibrillation (POAF) is considered to be a transient arrhythmia in the first week after cardiac surgery. ⋯ POAF is not limited to the first week after cardiac surgery but also occurs frequently in the postoperative month. It is desirable to regularly follow patients with POAF for atrial fibrillation recurrences after discharge.
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Hemodynamic support using percutaneous left ventricular assist devices (pLVADs) during catheter mapping and ablation of unstable ventricular tachycardia (VT) can provide effective end-organ perfusion. However, its effect on procedural and clinical outcomes remains unclear. ⋯ In this nonrandomized retrospective study, catheter ablation of unstable VT supported by a pLVAD was associated with shorter ablation times and reduced hospital length of stay. While pLVAD support did not affect VT recurrence, it was associated with a lower composite end point of 30-day rehospitalization, redo-VT ablation, recurrent implantable cardioverter-defibrillator therapies, and 3-month mortality.