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JACC. Clinical Electrophysiology

Jonathan M Behar, Tom Jackson, Eoin Hyde, Simon Claridge, Jaswinder Gill, Julian Bostock, Manav Sohal, Bradley Porter, Mark O'Neill, Reza Razavi, Steve Niederer, Christopher Aldo Rinaldi
OBJECTIVES: The purpose of this study was to identify the optimal pacing site for the left ventricular (LV) lead in ischemic patients with poor response to cardiac resynchronization therapy (CRT). BACKGROUND: LV endocardial pacing may offer benefit over conventional CRT in ischemic patients. METHODS: We performed cardiac magnetic resonance, invasive electroanatomic mapping (EAM), and measured the acute hemodynamic response (AHR) in patients with existing CRT systems...
December 2016: JACC. Clinical Electrophysiology
Fu Siong Ng, Jeremy M Kalindjian, Simon A Cooper, Rasheda A Chowdhury, Pravina M Patel, Emmanuel Dupont, Alexander R Lyon, Nicholas S Peters
OBJECTIVES: The purpose of this study was to investigate the effects of enhancing gap junction (GJ) coupling during acute myocardial infarction (MI) on the healed infarct scar morphology and late post-MI arrhythmia susceptibility. BACKGROUND: Increased heterogeneity of myocardial scarring after MI is associated with greater arrhythmia susceptibility. We hypothesized that short-term enhancement of GJ coupling during acute MI can produce more homogeneous infarct scars, reducing late susceptibility to post-MI arrhythmias...
October 2016: JACC. Clinical Electrophysiology
Francesca Brun, Judith A Groeneweg, Kathleen Gear, Gianfranco Sinagra, Jeroen van der Heijden, Luisa Mestroni, Richard N Hauer, Mark Borgstrom, Frank I Marcus, Trina Hughes
OBJECTIVES: The primary objective of this study is risk stratification of patients with arrhythmic right ventricular cardiomyopathy (ARVC). BACKGROUND: There is a need to identify those who need an automatic implantable defibrillator (ICD) to prevent sudden death. METHODS: This is an analysis of 88 patients with ARVC from three centers who were not treated with an ICD. RESULTS: Risk factors for subsequent arrhythmic deaths were pre-enrollment sustained or nonsustained ventricular tachycardia (VT) and decreased left ventricular function...
October 2016: JACC. Clinical Electrophysiology
Olujimi A Ajijola, David Hamon
No abstract text is available yet for this article.
June 2016: JACC. Clinical Electrophysiology
David Filgueiras-Rama, José Jalife
Evidence accumulated over the last 25 years suggests that, whether in the atria or ventricles, fibrillation may be explained by the self-organization of the cardiac electrical activity into rapidly spinning rotors giving way to spiral waves that break intermittently and result in fibrillatory conduction. The dynamics and frequency of such rotors depend on the ion channel composition, excitability and refractory properties of the tissues involved, as well as on the thickness and respective three-dimensional fiber structure of the atrial and ventricular chambers...
February 1, 2016: JACC. Clinical Electrophysiology
Kyndaron Reinier, Kumar Narayanan, Audrey Uy-Evanado, Carmen Teodorescu, Harpriya Chugh, Wendy J Mack, Karen Gunson, Jonathan Jui, Sumeet S Chugh
OBJECTIVES: To assess potential improvement in SCD risk prediction by adding selected risk markers from the 12-lead ECG to measurement of the left ventricular ejection fraction (LVEF). BACKGROUND: Novel strategies to improve risk stratification for sudden cardiac death (SCD) are needed. Given the modest odds associated with most individual risk markers, combining multiple markers may be a useful approach. METHODS: From the ongoing Oregon Sudden Unexpected Death Study, SCD cases with pre-event LVEF available were compared to matched control subjects with coronary artery disease...
December 1, 2015: JACC. Clinical Electrophysiology
Stephanie E Chiuve, Qi Sun, Roopinder K Sandhu, Usha Tedrow, Nancy R Cook, JoAnn E Manson, Christine M Albert
BACKGROUND: Sudden cardiac death (SCD) is often the first manifestation of coronary heart disease (CHD) among women. Data regarding BMI and risk of SCD are limited and conflicting. OBJECTIVES: We examined the association of BMI repeatedly measured over 32 years and BMI during early and mid-adulthood with risk of SCD in the Nurses' Health Study. METHODS: We prospectively followed 72,484 women free of chronic disease from 1980-2012. We ascertained adult height, current weight, and weight at age 18 at baseline and updated weight biennially...
December 1, 2015: JACC. Clinical Electrophysiology
Adam B Greenbaum, Toby Rogers, Gaetano Paone, Shawn E Flynn, Mayra E Guerrero, William W O'Neill, Robert J Lederman
OBJECTIVES: The purpose of this study was to test whether a microcatheter can safely be advanced across the right atrial appendage to access the pericardium and then withdrawn despite subsequent high-intensity anticoagulation. We also tested whether transatrial pericardial insufflation of carbon dioxide (CO2) would enhance the safety of subxiphoid needle access to the empty pericardium by separating the heart from the anterior pericardium. BACKGROUND: Subxiphoid needle access to the empty pericardium, required for left atrial suture ligation and epicardial ablation for rhythm disorders, risks myocardial or coronary laceration...
October 2015: JACC. Clinical Electrophysiology
Faisal F Syed, Christopher V DeSimone, Elisa Ebrille, Prakriti Gaba, Dorothy J Ladewig, Susan B Mikell, Scott H Suddendorf, Emily J Gilles, Andrew J Danielsen, Markéta Lukášová, Jiří Wolf, Pavel Leinveber, Miroslav Novák, Zdeněk Stárek, Tomas Kara, Charles J Bruce, Paul A Friedman, Samuel J Asirvatham
INTRODUCTION: Epicardial cardiac resynchronization therapy (CRT) permits unrestricted electrode positioning. However, this requires surgical placement of device leads and the risk of unwanted phrenic nerve stimulation. We hypothesized that shielded electrodes can capture myocardium without extracardiac stimulation. METHODS: In 6 dog and 5 swine experiments, we used a percutaneous approach to access the epicardial surface of the heart, and deploy novel leads housing multiple electrodes with selective insulation...
August 2015: JACC. Clinical Electrophysiology
Kongkiat Chaikriangkrai, Soma Jyothula, Hye Yeon Jhun, Su Min Chang, Edward A Graviss, Mossaab Shuraih, Tapan G Rami, Amish S Dave, Miguel Valderrábano
OBJECTIVE: To investigate incidence and timing, risk factors, prognostic significance, and electrophysiological mechanisms of atrial arrhythmia (AA) after lung transplantation. BACKGROUND: Although new-onset AA is common after thoracic surgery and is associated with poorer outcomes, prognostic and mechanistic data is sparse in lung transplant populations. METHOD: A total of 293 consecutive isolated lung transplant recipients without known AA were retrospectively reviewed...
August 1, 2015: JACC. Clinical Electrophysiology
Thomas A Dewland, Eric Vittinghoff, Tamara B Harris, Jared W Magnani, Yongmei Liu, Fang-Chi Hsu, Suzanne Satterfield, Christina Wassel, Gregory M Marcus
BACKGROUND: Despite a lower prevalence of established atrial fibrillation (AF) risk factors, Whites exhibit substantially higher rates of this arrhythmia compared to Blacks. The mechanism underlying this observation is not known. Both inflammation and obesity are risk factors for AF, and adipose tissue is a known contributor to systemic inflammation. OBJECTIVES: We sought to determine the degree to which racial differences in AF risk are explained by differences in inflammation and adiposity...
August 2015: JACC. Clinical Electrophysiology
Shadi Al Halabi, Mohammed Qintar, Ayman Hussein, M Chadi Alraies, David G Jones, Tom Wong, Michael R MacDonald, Mark C Petrie, Daniel Cantillon, Khaldoun G Tarakji, Mohamed Kanj, Mandeep Bhargava, Niraj Varma, Bryan Baranowski, Bruce L Wilkoff, Oussama Wazni, Thomas Callahan, Walid Saliba, Mina K Chung
BACKGROUND: Rhythm control with antiarrhythmic drugs (AADs) is not superior to rate control in patients with heart failure (HF) and atrial fibrillation (AF), but AF ablation may be more successful at achieving rhythm control than AADs. However, risks for both ablation and AADs are likely higher and success rates lower in patients with HF. OBJECTIVE: To compare rate control versus AF catheter ablation strategies in patients with AF and HF. METHODS: We conducted a meta-analysis of trials which randomized HF patients (LVEF<50%) with AF to a rate control or AF catheter ablation strategy and reported change in LVEF, quality of life, 6-minute walk test, or peak oxygen consumption...
June 1, 2015: JACC. Clinical Electrophysiology
Peter F Aziz, Tammy Sweeten, Ramon L Vogel, William J Bonney, Jacqueline Henderson, Akash R Patel, Maully J Shah
OBJECTIVE: The study sought to examine the prevalence and outcomes of sports participation (both competitive and recreational) in our single-center LQTS genotype positive pediatric population. BACKGROUND: The risks of sports participation in patients with long QT syndrome (LQTS) are not clearly elucidated. METHODS: A retrospective review was performed on genotype positive patients referred for the evaluation and management of LQTS between 1998 and 2013 at the Children's Hospital of Philadelphia...
March 2015: JACC. Clinical Electrophysiology
Stavros Stavrakis, Hiroshi Nakagawa, Sunny S Po, Benjamin J Scherlag, Ralph Lazzara, Warren M Jackman
Recent experimental and clinical studies have shown that the epicardial autonomic ganglia play an important role in the initiation and maintenance of atrial fibrillation (AF). In this review, we present the current data on the role of the autonomic ganglia in the pathogenesis of AF and discuss potential therapeutic implications. Experimental studies have demonstrated that acute autonomic remodeling may play a crucial role in AF maintenance in the very early stages. The benefit of adding ablation of the autonomic ganglia to the standard pulmonary vein (PV) isolation procedure for patients with paroxysmal AF is supported by both experimental and clinical data...
March 2015: JACC. Clinical Electrophysiology
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