Heart rhythm : the official journal of the Heart Rhythm Society
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Comparative Study
Different characteristics of complex fractionated atrial electrograms in acute paroxysmal versus long-standing persistent atrial fibrillation.
Complex fractionated atrial electrograms (CFAEs) may represent a phenomenon associated with sources of atrial fibrillation (AF) and are being used increasingly as targets of catheter ablation. However, current methods have limited efficacy for characterizing CFAEs important to substrate arrhythmogenicity and do not measure electrogram morphology. ⋯ A novel method for quantifying CFAEs, independent of activation rate, has been developed. The method demonstrates greater significance in the difference between CFAE morphology in paroxysmal and long-standing AF compared with mean interval between CFAE deflections. The differences identified suggest that CFAE morphology may evolve as AF persists.
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Comparative Study
A Heart Rhythm Society Electrophysiology Workforce study: current survey analysis of physician workforce trends.
Recent economic trends influenced by healthcare reform, an aging population, changes in physician reimbursement, and increasing competition will have a significant impact on the electrophysiology workforce. Therefore, there is an important need to obtain information about the EP workforce to assess training of arrhythmic healthcare providers in order the meet the requisite societal need. This report summarizes the data collected by the HRS Workforce Study Task Force in relation to physician workforce issues. ⋯ Based on findings from this study, the task force identified specific workforce (supply) trends and the key drivers of current and future challenges. Although specific areas will require further analysis, overall, the current EP workforce is stable, with the exception of geographic dispersion. However, the workforce must adapt to the key economic drivers (demand) and address future recruitment challenges.
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Indications for cardiac implantable electronic devices (CIEDs) are increasing. Although CIED infections occur infrequently, the impact of this outcome is expected to be substantial. ⋯ CIED infections are most often caused by Staphylococcus species, half of which are methicillin resistant. Percutaneous lead and device removal along with antibiotic therapy are effective as primary interventions. The overall relapse rate is 1.9%, and the relapse rate among patients who had reimplantation during the same hospitalization is 2.6%.
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Approximately 10% of sudden infant death syndrome (SIDS) cases may stem from potentially lethal cardiac channelopathies, with approximately half of channelopathic SIDS involving the Na(V)1.5 cardiac sodium channel. Recently, Na(V) beta subunits have been implicated in various cardiac arrhythmias. Thus, the 4 genes encoding Na(V) beta subunits represent plausible candidate genes for SIDS. ⋯ This study provides the first molecular and functional evidence to implicate the Na(V) beta subunits in SIDS pathogenesis. Altered Na(V)1.5 sodium channel function due to beta-subunit mutations may account for the molecular pathogenic mechanism underlying approximately 1% of SIDS cases.