Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Jun 2021
Direct oral anticoagulants to treat left ventricular thrombus-A systematic review and meta-analysis: ELECTRAM investigators.
Though current guidelines currently recommend using warfarin, there is also a growing interest in the utilization of direct oral anticoagulants (DOACs) to treat left ventricular (LV) thrombus. ⋯ Our study demonstrates no significant difference in SEE, major bleeding, or failure of LV thrombus resolution between the two groups, thus demonstrating that DOACs are an efficacious and safe alternative for the treatment of LV thrombus compared to VKAs. However, further well-designed prospective trials are needed to answer important clinical questions-optimal dosing/duration of DOACs and its safety in the background of antiplatelet therapy.
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J. Cardiovasc. Electrophysiol. · Mar 2021
Comparison of clinical and procedural outcomes between high-power short-duration, standard-power standard-duration, and temperature-controlled noncontact force guided ablation for atrial fibrillation.
High-power short-duration (HPSD) ablation is a novel strategy using contact force-sensing catheters optimized for power-controlled radiofrequency ablation for atrial fibrillation (AF). This study investigates the outcomes of HPSD (50 W delivered for up to 15 s, Lesion Size Index of 5-6) compared to standard-power standard-duration (SPSD) (20-25 W until 400-500 gram seconds, up to 60 s) and temperature-controlled noncontact (TCNC) (20-40 W up to 60 s of ablation) settings. ⋯ AF ablation with HPSD reduced procedure times with similar sinus rhythm maintenance compared to SPSD and TCNC.
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J. Cardiovasc. Electrophysiol. · Mar 2021
Case ReportsVentricular fibrillation in a left ventricular assist device patient: Can the echocardiogram be misleading?
Sustained ventricular tachycardia and ventricular fibrillation (VF) are life-threatening arrhythmias which remain highly prevalent in patients with advanced heart failure. These ventricular arrhythmias may impair the support provided by continuous-flow left ventricular assist devices (CF-LVADs) and lead to frequent hospitalizations, antiarrhythmic medication use, external defibrillations, and need for heart transplantation. We report a case in which a patient with a CF-LVAD and an implantable cardioverter defibrillator at end of life presented with asymptomatic low-flow alarms and was found to have VF of unknown duration. Unique in our case was the presence of apparent organized contractility and rhythmic opening of the mitral valve on echocardiogram despite VF on electrocardiogram.
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J. Cardiovasc. Electrophysiol. · Mar 2021
Catheter ablation of atrial fibrillation using ablation index-guided high-power technique: Frankfurt AI high-power 15-month follow-up.
Radiofrequency (RF) high-power ablation appears to be a novel concept in treating atrial fibrillation (AF). The ablation-index (AI) has been linked with the durability of pulmonary vein isolation (PVI). To report the midterm clinical results of a new ablation strategy using AI-guided high-power (50 W) ablation (AI-HP). ⋯ The AI-HP (50 W) appears as an efficient ablation technique in treating AF and leads to a high single-procedure arrhythmia-free survival at 15 months.
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J. Cardiovasc. Electrophysiol. · Jan 2021
The Impact of the COVID-19 Pandemic on Cardiac Electrophysiology Training: A Survey Study.
The coronavirus disease 2019 (COVID-19) pandemic has resulted in a significant decrease in volume of electrophysiology (EP) procedures. There has been concern that trainees may not achieve the procedural numbers required to graduate as independent electrophysiologists within the usual timeline. We sought to determine the impact of the COVID-19 pandemic on the percentage of clinical cardiac EP (CCEP) fellows in jeopardy of not meeting procedural volume requirements and overall sentiments regarding preparedness of fellows for independent practice. ⋯ The COVID-19 pandemic has resulted in a decrease in procedural volume for CCEP trainees, but the majority of fellows and program directors do not anticipate major barriers to timely graduation. This may change with COVID-19 resurgence and further interruptions in training.