Heart rhythm : the official journal of the Heart Rhythm Society
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Comparative Study
Autonomic nerve activity and the short-term variability of the Tpeak-Tend interval in dogs with pacing-induced heart failure.
In congestive heart failure (CHF), autonomic nervous system (ANS) activity is known to modulate arrhythmic risk through its effects on myocardial repolarization. An increased interval between the peak and the end of the T wave (T(peak)-T(end)) has been reported to increase the incidence of sudden cardiac death. However, the ANS influence on the T(peak)-T(end) interval remains unclear. ⋯ In a canine model of pacing-induced CHF, iSGNA correlates positively while iVNA correlates negatively with T(peak)-T(end)STV(T). These findings suggest that SGNA increases while VNA decreases the dispersion of ventricular repolarization in ambulatory dogs with CHF.
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The risk of cerebrovascular embolic events with atrial fibrillation (AF) is potentially linked to an increased risk of cognitive decline and dementia. However, epidemiologic studies exploring the association between AF and incident dementia have reported conflicting results. ⋯ AF is independently associated with increased risk of dementia. Patients with AF should be periodically screened for dementia, which should be included among the outcomes assessed in AF treatment trials.
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Randomized Controlled Trial Multicenter Study Comparative Study
Investigation of a novel algorithm for synchronized left-ventricular pacing and ambulatory optimization of cardiac resynchronization therapy: results of the adaptive CRT trial.
In patients with sinus rhythm and normal atrioventricular conduction, pacing only the left ventricle with appropriate atrioventricular delays can result in superior left ventricular and right ventricular function compared with standard biventricular (BiV) pacing. ⋯ The aCRT algorithm is safe and at least as effective as BiV pacing with comprehensive echocardiographic optimization.
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Antitachycardia pacing (ATP) can reduce implantable cardioverter-defibrillator shocks, but its use in children and patients with congenital heart disease (CHD) is not well described. ⋯ ATP is highly efficacious for VT in children and patients with CHD. In addition to reducing appropriate shocks, inappropriate shocks due to sinus or supraventricular tachycardia can be significantly reduced with ATP.
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Despite the informative nature of atrial fibrillation (AF) electrograms, electrophysiological aspects of predicting reversal of structural remodeling of the left atrium (LA) have not been evaluated. ⋯ Electrogram organization was a robust predictor of reverse remodeling of the enlarged LA after sinus rhythm restoration by catheter ablation in patients with persistent AF.