Ventricular arrythmias have a significant prognostic impact in patients with LVAD. Catheter ablation in patients with LVAD is a feasible option when first line therapy fails. Mapping can be challenging due to mechanical and electromagnetic limitations. Complications can be reduced through a careful pre-procedural planning.

In this review, we have performed a literature search and attempt to provide the readership with a comprehensive overview of ST segment elevation during ablations and its mechanism and guidance for physicians on what to do when faced with such situations.

Meta-analysis of four randomized controlled trials showed that integration of preprocedural CT or MRI images with real-time electroanatomic maps to guide pulmonary vein isolation does not improve clinical and procedural outcomes.

To achieve first-pass pulmonary vein isolation (PVI) and to avoid the acute pulmonary vein reconnections is sometimes difficult even with the lesion size index (LSI)-guided radiofrequency ablation. We focused on the relationship between the optimized -LSI (o-LSI) (LSI/bipolar voltage within the PV-encircling lines, which were defined by the Advisor™ HD Grid catheter) and the sufficient ablation sites and found that was strongly associated with acute PV reconnection. The o-LSI may potentially be novel strategies for durable PVI.

Utility of the novel measurement of the local impedance during initial atrial fibrillation ablation was investigated. The local impedance drop during radiofrequency applications was higher than the generator impedance drop, both of which were positively correlated.

With a target VS value of 375-425, ITDs of 4 mm was sufficient for durable PVI.

This is a retrospective clinical study comprising 72 patients who underwent mitral isthmus (MI) ablation either as part of an atrial fibrillation ablation strategy, or to treat reentrant AT. The MI block was acutely achieved in 69/72 patients. However, five patients, despite showing MI block based on conventional pacing maneuvers, developed perimitral atrial flutter through a gap in previous ablation lesions with extremely low impulse conduction velocity as shown by high density mapping.

A greater incidence of recurrence was observed in the presence of RA structural remodeling regardless of the AF type. RA structural remodeling was a useful predictor of clinical outcomes after PVI.

The patients who were administered bisoprolol transdermal patches (BTPs) immediately after atrial fibrillation (AF) ablation showed significant reductions in the incidence of early recurrence of atrial arrhythmias (ERAAs) compared with the patients who were not administered BTPs. The efficacy of BTPs at preventing ERAAs was confirmed not only immediately after ablation, but also during the short period after AF ablation.

Electronic monitoring demonstrated that the proportions of NVAF patients with ≥80% adherence did not differ between those taking DOACs once or twice daily in either the full analysis set (FAS) or per-protocol set (PSS). However, the group taking apixaban twice daily had a lower proportion of patients with ≥90% adherence than the group taking edoxaban once daily.

The mid-term success rate of pulmonary vein isolation by means of second-generation cryoballoon in persistent atrial fibrillation is significantly lower in older patients (>75 years) compared with the younger cohort. There is no difference in the complication rate of pulmonary vein isolation by means of second-generation cryoballoon of between younger and older patients.

Our meta-analysis included 14 studies, involving 28 319 participants. We demonstrated that postimplantation pocket hematoma significantly increases overall risk of infection (OR = 6.30, 95% CI: 3.87-10.24, I² = 49.3%).

The extraction of cardiac implantable electronic device leads due to infections, malfunctions, and recalls is common, and can lead to complications such as lead break resulting in incomplete lead removal and cardiac tamponade. We found that older lead age, co-radial leads, passive leads, and non-polyurethane leads were independent predictors of lead break during extraction. These findings will guide clinicians to make appropriate choices of procedure and take greater care when these risk factors are present.

It is a real-world registry to evaluate the long-term effect of CRT on LV reverse remodeling assessed by repeat LV structural and functional measurements. Left ventricular reverse remodeling is maintained after the first year of CRT implantation throughout the entire follow-up in a real-world registry. Repeat measurements of LVEF improve the risk of individual mortality after adjusting by age and sex during long-term follow-up compared with a only measurement of LVEF after CRT.

Normal function and the most common problems that occur during pacemaker operation while performing physical exercise are discussed

Bedrest might not prevent cardiovascular events or device complications in patients with a temporary pacemaker for bradyarrhythmias during the waiting period for permanent pacemaker implantation.

In our study, we used a pigtail catheter to orient radiographic angle during leadless pacemaker implantation such that the interventricular septum would be on edge in the LAO projection. Employing this angle made it very easy for even our cardiology fellows in training to implant leadless pacemakers at the optimal site on the septum. To the best of our knowledge, this is the first time a right ventricular pigtail catheter has ever been used in this manner, and we feel that both physicians and patients would benefit from this simple maneuver, which we found to be safe and effective.

We performed computer simulations of antegrade accessory pathway (AP) conduction using a simplied wall model. We found that high AP conductivity blocked antegrade conduction. This finding suggests the involvement of an electrotonic effect.

Sudden cardiac arrest is uncommon among young adults. Inherited cardiomyopathies and channelopathies are the most frequently identified cardiac etiologies. However, assessment of coronary artery anatomy is mandatory in order to rule out coronary artery anomalies.

We report for the first time a sudden rise in the pacing threshold of the left ventricular lead due to myocardial ischemia after cardiac resynchronization therapy with defibrillator implantation, and its recovery to the baseline after the revascularization.

A 12 lead electrocardiogram provides an important diagnostic tool for atrial flutter recognition. However, rarely, atrial flutter waves can cause diagnostic challenges by producing ST segment abnormalities mimicking ST segment elevation and result in unnecessary workup and treatment.

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Presentation, Investigation and Management of Coronary fistula and its arrhythmic complications.

Our interesting electrocardiogram has two qRS morphology without features of preexcitation suggesting two atrio ventricular node conduction system. All cardiologists should be aware of this feature in heterotaxy syndrome as reentrant supraventricular tachycardia may develop in these patients.

Pilot study evaluating the feasibility and impact of real-time transthoracic echocardiogram during cardiac implantable electronic device (CIED) right ventricular lead placement.