Circulation. Arrhythmia and electrophysiology
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Circ Arrhythm Electrophysiol · Oct 2010
Multicenter Study Comparative StudySafety and efficacy of pulmonary vein antral isolation in patients with obstructive sleep apnea: the impact of continuous positive airway pressure.
Obstructive sleep apnea (OSA) may be associated with pulmonary vein antrum isolation (PVAI) failure. The aim of the present study was to investigate if treatment with continuous positive airway pressure (CPAP) improved PVAI success rates. ⋯ OSA was an independent predictor for PVAI failure. Treatment with CPAP improved PVAI success rates. Patients not treated with CPAP in addition to having higher prevalence of non-PV triggers were 8 times more likely to fail the procedure.
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Circ Arrhythm Electrophysiol · Aug 2010
J wave, QRS slurring, and ST elevation in athletes with cardiac arrest in the absence of heart disease: marker of risk or innocent bystander?
QRS-ST changes in the inferior and lateral ECG leads are frequently observed in athletes. Recent studies have suggested a potential arrhythmogenic significance of these findings in the general population. The aim of our study was to investigate whether QRS-ST changes are markers of cardiac arrest (CA) of unexplained cause or sudden death in athletes. ⋯ J wave and/or QRS slurring was found more frequently among athletes with cardiac arrest/sudden death than in control athletes. Nevertheless, the presence of this ECG pattern appears not to confer a higher risk for recurrent malignant ventricular arrhythmias.
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Circ Arrhythm Electrophysiol · Jun 2010
Randomized Controlled Trial Comparative StudyCircumferential pulmonary vein ablation with additional linear ablation results in an increased incidence of left atrial flutter compared with segmental pulmonary vein isolation as an initial approach to ablation of paroxysmal atrial fibrillation.
There has been growing concern that linear ablation is associated with an increased risk of iatrogenic arrhythmias in patients undergoing ablation for atrial fibrillation (AF). Therefore, we compared circumferential pulmonary vein ablation plus left atrial linear ablation (CPVA+LALA) with segmental pulmonary vein isolation (PVI)in patients with paroxysmal AF. ⋯ As an initial ablation approach in patients with paroxysmal AF, more LAFL occurred after CPVA+LALA and fluoroscopy times were longer compared with segmental PVI.
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Circ Arrhythm Electrophysiol · Apr 2010
Clinical TrialUtility of treadmill testing in identification and genotype prediction in long-QT syndrome.
The clinical diagnosis of long-QT syndrome (LQTS) remains challenging when ECG abnormalities are borderline or intermittent. Despite issues with access, cost, and heterogeneity of LQTS mutations, genetic testing remains the diagnostic gold standard for diagnosis of LQTS. We sought to develop a provocative testing strategy to unmask the LQTS phenotype and relate this to the results of genetic testing. ⋯ The presence and genotype of LQTS can be predicted by a combination of postural and exercise changes in the QT/RR relationship. beta-Blockade normalized these changes. Routine exercise testing is useful in predicting and directing genetic testing in LQTS.