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Journal Heart Rhythm

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Prophylactic (hydroxy)chloroquine in COVID-19: potential relevance for cardiac arrhythmia risk.

Joost A Offerhaus, Arthur A M Wilde, Carol Ann Remme,

(Hydroxy)chloroquine ((H)CQ) is being investigated as treatment for COVID-19, but studies have so far demonstrated either no or a small benefit. However, these studies have been mostly performed in patients admitted to hospital and hence likely already (severely) affected. Another suggested approach employs prophylactic (H)CQ treatment aimed at preventing either ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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INCIDENCE OF ARRHYTHMIAS AND ELECTROCARDIOGRAPHIC ABNORMALITIES IN SYMPTOMATIC PEDIATRIC PATIENTS WITH PCR POSITIVE SARS-CoV-2 INFECTION INCLUDING DRUG INDUCED CHANGES IN THE CORRECTED QT INTERVAL (QTc).

Sharmeen Samuel, Richard A. Friedman, Chetan Sharma, Madhusudan Ganigara, Elizabeth Mitchell, Charles Schleien, Andrew D. Blaufox,

BackgroundThere is limited data regarding the electrophysiological abnormalities and arrhythmias in children with COVID-19, including those associated with treatment using potentially pro-arrhythmic Hydroxychloroquine (HCQ) and Azithromycin (AZN).ObjectivesTo describe the electrophysiologic findings and arrhythmias associated with pediatric COVID-19 and its treatment.MethodsA single center retrospective chart review was undertaken and included all ... Read more >>

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INCIDENCE OF ARRHYTHMIAS AND ELECTROCARDIOGRAPHIC ABNORMALITIES IN SYMPTOMATIC PEDIATRIC PATIENTS WITH PCR POSITIVE SARS-CoV-2 INFECTION INCLUDING DRUG INDUCED CHANGES IN THE CORRECTED QT INTERVAL (QTc).

Sharmeen Samuel, Richard A Friedman, Chetan Sharma, Madhusudan Ganigara, Elizabeth Mitchell, Charles Schleien, Andrew D Blaufox,

BACKGROUND:There is limited data regarding the electrophysiological abnormalities and arrhythmias in children with COVID-19, including those associated with treatment using potentially pro-arrhythmic Hydroxychloroquine (HCQ) and Azithromycin (AZN). OBJECTIVES:To describe the electrophysiologic findings and arrhythmias associated with pediatric COVID-19 and its treatment. METHODS:A single center retrospective chart review was undertaken and ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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A fast irregular tachycardia with changing QRS configuration in a 29-year-old man.

Hein J Wellens,

Heart Rhythm (Heart rhythm)
[2020, 17(7):1198-1199]

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His Bundle and Left Bundle Pacing with Optimised Atrio-ventricular Delay Achieve Superior Electrical Synchrony over Endocardial and Epicardial Pacing in Left Bundle Branch Block Patients.

Marina Strocchi, Angela W C Lee, Aurel Neic, Julien Bouyssier, Karli Gillette, Gernot Plank, Mark K Elliott, Justin Gould, Jonathan M Behar, Baldeep Sidhu, Vishal Mehta, Martin J Bishop, Edward J Vigmond, Christopher A Rinaldi, Steven A Niederer,

BACKGROUND:His bundle pacing (HBP) and left bundle pacing (LBP) are emerging as novel delivery methods for cardiac resynchronisation therapy (CRT) in heart failure patients with left bundle branch block (LBBB). HBP and LBP have never been compared to biventricular endocardial (BiV-endo) pacing. Furthermore, there are indications of negative effects of ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Simultaneous epicardial-endocardial mapping of the sinus node in humans with structural heart disease: Impact of overdrive suppression on sino-atrial exits.

Ramanathan Parameswaran, Geoffrey Lee, Gwilym M Morris, Alistair Royse, John Goldblatt, Marco Larobina, Troy Watts, Chrishan J Nalliah, Geoffrey Wong, Ahmed M Al-Kaisey, Robert D Anderson, Aleksandr Voskoboinik, Hariharan Sugumar, David Chieng, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman,

BACKGROUND:The 3-dimensional nature of sino-atrial node (SAN) function has not previously been characterised in the intact human heart. OBJECTIVE:To characterize the 3-dimensional nature of SAN function in patients with structural heart disease (SHD) using simultaneous endocardial-epicardial phase mapping. METHODOLOGY:Simultaneous intra-op endo-epicardial SAN mapping was performed during sinus rhythm at baseline ... Read more >>

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[2020, :]

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Common and rare susceptibility genetic variants predisposing to Brugada Syndrome in Thailand.

Pattarapong Makarawate, Charlotte Glinge, Apichai Khongphatthanayothin, Roddy Walsh, John Mauleekoonphairoj, Montawatt Amnueypol, Somchai Prechawat, Wanwarang Wongcharoen, Rungroj Krittayaphong, Alisara Anannab, Peter Lichtner, Thomas Meitinger, Fleur V Y Tjong, Krystien V V Lieve, Ahmad S Amin, Dujdao Sahasatas, Tachapong Ngarmukos, Duangdao Wichadakul, Sanchai Payungporn, Boosamas Sutjaporn, Pharawee Wandee, Yong Poovorawan, Jacob Tfelt-Hansen, Michael W T Tanck, Rafik Tadros, Arthur A M Wilde, Connie R Bezzina, Gumpanart Veerakul, Koonlawee Nademanee,

BACKGROUND:Mutations in SCN5A are rarely found in Thai patients with Brugada syndrome (BrS). Recent evidence suggested that common genetic variation may underlie BrS in a complex inheritance model. OBJECTIVE:To find common and rare/low frequency genetic variants predisposing to BrS in Thailand. METHODS:We conducted a genome-wide association study (GWAS) to explore ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Percutaneous Recanalization of Superior Vena Cava Occlusions for Cardiac Implantable Electronic Device Implantation - Tools and Techniques.

Naga Venkata K Pothineni, C Anwar A Chahal, David S Frankel, Fermin C Garcia, Jay Giri, Joshua M Cooper, Robert D Schaller,

Heart Rhythm (Heart rhythm)
[2020, :]

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Transvenous Phrenic Nerve Stimulation for Central Sleep Apnea is Safe and Effective in Patients with Concomitant Cardiac Devices.

Hemal M Nayak, Raj Patel, Scott McKane, Kristofer J James, Timothy E Meyer, Robin E Germany, Christoph Stellbrink, Maria Rosa Costanzo, Ralph Augostini,

BACKGROUND:Central sleep apnea is common in heart failure patients. Transvenous phrenic nerve stimulation (TPNS) requires placing a lead to stimulate the phrenic nerve and activate the diaphragm. Data are lacking concerning the safety and efficacy of TPNS in patients with concomitant cardiovascular implantable electronic devices (CIEDs). OBJECTIVE:The objective is to ... Read more >>

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[2020, :]

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Follow-Up Imaging after Left Atrial Appendage Closure.

Kenji Kuroki, Shephal K Doshi, William Whang, Sarina Vanderzee, Crystal B Ducharme, Yoshinari Enomoto, Sam Hanon, Jacob S Koruth, Marc A Miller, Subbarao Choudry, Aamir Sofi, Noelle Langan, Betsy Ellsworth, Srinivas R Dukkipati, Vivek Y Reddy,

BACKGROUND:Because device-related thrombus (DRT) portends a poor prognosis after left atrial appendage closure with the Watchman device, surveillance transesophageal echocardiograms (TEEs) are recommended at 45 days and 1 year. However, oral anticoagulants are just stopped at 45 days, rendering this early TEE unlikely to detect DRT. Indeed, DRT is most ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Macro-reentrant Biatrial Tachycardia Relevant to Interatrial Septal Incisions after Mitral Valve Surgery: Electrophysiological Characteristics and Ablation Strategy.

Jinlin Zhang, Wei Hu, Anquan Zhao, Gang Yang, Qingyong Zhang, Xi Su, Minglong Chen,

BACKGROUND:Macroreentrant biatrial tachycardia (BiAT) relevant to interatrial septal incisions following MV surgery has been rarely reported. OBJECTIVE:We aimed to assess the mapping and ablation strategy of this special category of atrial tachycardia (AT). METHODS:We identified 10BiATs in a total of 84 ATs after MV surgery performed at three institutions. Activation ... Read more >>

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[2020, :]

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Effects of Hydroxychloroquine Treatment on QT Interval.

Matthew Hooks, Bradley Bart, Orly Vardeny, Anders Westanmo, Selçuk Adabag,

BACKGROUND:Hydroxychloroquine (HCQ) has been promoted as a potential treatment for COVID-19 but there are safety concerns. OBJECTIVES:To determine the effect of HCQ treatment on QT interval METHODS: We retrospectively studied the electrocardiograms of 819 patients treated with HCQ for rheumatologic diseases from 2000 to 2020. The primary outcome was corrected ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Diagnostic yield and long-term outcome of non-ischemic sudden cardiac arrest survivors and their relatives - results from a tertiary referral center.

Elisabeth Mütze Jacobsen, Benjamin Lautrup Hansen, Amalie Kjerrumgaard, Jacob Tfelt-Hansen, Christian Hassager, Jesper Kjaergaard, Alex Hørby Christensen, Henning Bundgaard, Bo Gregers Winkel,

BACKGROUND:Cardiac arrest may be the first manifestation in the majority of inherited cardiac diseases. International guidelines recommend screening of relatives of Sudden Cardiac Arrest (SCA) survivors if an inherited cardiac disorder is suspected. OBJECTIVE:To assess the prevalence and spectrum of inherited cardiac diseases and the long-term outcome in a consecutive ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Bipolar radiofrequency ablation for ventricular tachycardias originating from the interventricular septum: safety and efficacy in a pilot cohort study.

Paolo Della Bella, Giovanni Peretto, Gabriele Paglino, Caterina Bisceglia, Andrea Radinovic, Simone Sala, Francesca Baratto, Luca Limite, Manuela Cireddu, Alessandra Marzi, Giuseppe D'Angelo, Pasquale Vergara, Simone Gulletta, Patrizio Mazzone, Antonio Frontera,

BACKGROUND:Interest has grown in recent years for bipolar radiofrequency ablation (B-RFA). However, indications and outcome in patients with ventricular tachycardia (VT) are still to be defined. OBJECTIVE:To describe patient selection, safety and effectiveness of B-RFA, in a pilot cohort study of patients with nonischemic dilated cardiomyopathy (NIDCM) and drug-refractory VT. ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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COVID-19 and Cardiac Arrhythmias.

Anjali Bhatla, Michael M Mayer, Srinath Adusumalli, Matthew C Hyman, Eric Oh, Ann Tierney, Juwann Moss, Anwar A Chahal, George Anesi, Srinivas Denduluri, Christopher M Domenico, Jeffrey Arkles, Benjamin S Abella, John R Bullinga, David J Callans, Sanjay Dixit, Andrew E Epstein, David S Frankel, Fermin C Garcia, Ramanan Kumareswaram, Saman Nazarian, Michael P Riley, Pasquale Santangeli, Robert D Schaller, Gregory E Supple, David Lin, Francis Marchlinski, Rajat Deo,

BACKGROUND:Early studies suggest that coronavirus disease 2019 (COVID-19) is associated with a high incidence of cardiac arrhythmias. SARS-CoV-2 infection may cause injury to cardiac myocytes and increase arrhythmia risk. OBJECTIVE:To evaluate the risk of cardiac arrest and arrhythmias including incident atrial fibrillation (AF), bradyarrhythmias, and nonsustained ventricular tachycardia (NSVT) in ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Signature Signal Strategy: Electrogram Based Ventricular Tachycardia Mapping Nayyar et al. Signature electrogram based VT ablation.

Sachin Nayyar, Eugene Downar, Abhishek P Bhaskaran, Stéphane Massé, Kumaraswamy Nanthakumar,

Multiple decades of work have recognized complexities of substrate responsible for ventricular tachycardia (VT). There is enough evidence that three critical components of a re-entrant VT circuit, namely region of slow conduction, zone of unidirectional block and exit site, are located in spatial vicinity to each other in the ventricular ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Skin sympathetic nerve activity in patients with obstructive sleep apnea.

Wenbo He, Yuzhu Tang, Guannan Meng, Danning Wang, Johnson Wong, Gloria A Mitscher, David Adams, Thomas H Everett, Peng-Sheng Chen, Shalini Manchanda,

BACKGROUND:Obstructive sleep apnea (OSA) is associated with increased cardiac arrhythmia and sudden cardiac death. We recently developed a new method (neuECG) to non-invasively measure electrocardiogram and skin sympathetic nerve activity (SKNA). OBJECTIVES:To test the hypothesis that the SKNA measured during sleep study is higher in patients with OSA than without ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Cryoballoon Ablation of Pulmonary Veins for Persistent Atrial Fibrillation: Results From the Multicenter STOP Persistent AF Trial.

Wilber W Su, Vivek Y Reddy, Kabir Bhasin, Jean Champagne, Robert M Sangrigoli, Kendra M Braegelmann, Fred J Kueffer, Paul Novak, Sanjaya K Gupta, Teiichi Yamane, Hugh Calkins, ,

BACKGROUND:Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation to treat patients with symptomatic drug-refractory atrial fibrillation (AF). OBJECTIVES:To assess the safety and efficacy of PVI using the cryoballoon catheter to treat patients with persistent AF. METHODS:STOP Persistent AF (NCT03012841) was a prospective, multicenter, single-arm, FDA-regulated trial designed to ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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In-Hospital and Long-term Outcomes among Patients with Spontaneous Coronary Artery Dissection presenting with Ventricular Tachycardia/Fibrillation.

Christopher C Cheung, Andrew Starovoytov, Ashkan Parsa, Jason G Andrade, Andrew D Krahn, Matthew Bennett, Jacqueline Saw,

BACKGROUND:Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction (MI) in young to middle-aged women. Ventricular tachycardia/ventricular fibrillation (VT/VF) may complicate acute SCAD presentations and the long-term outcomes are unknown. OBJECTIVE:To report the outcomes in SCAD patients presenting with VT/VF. METHODS:We analyzed our prospective Canadian SCAD registries ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Reconsidering the Multiple Wavelet Hypothesis of Atrial Fibrillation.

Seungyup Lee, Celeen M Khrestian, Jayakumar Sahadevan, Albert L Waldo,

BACKGROUND:Moe/Abildskov proposed the multiple wavelet hypothesis of atrial fibrillation (AF) based on observations in the canine vagal nerve stimulation (VNS) AF model. Data from mapping studies in in vitro canine AF model by Allessie et al. evaluated the Moe/Abildskov hypothesis, concluding that a critical number of wavelets sustained AF. OBJECTIVE:To ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Evidence of two conduction exits of moderator band: Findings from activation and pace mapping study.

Chen-Xi Jiang, De-Yong Long, Meng-Meng Li, Cai-Hua Sang, Ri-Bo Tang, Wei Wang, Song-Nan Li, Xue-Yuan Guo, Rong Bai, Xin Du, Jian-Zeng Dong, Chang-Sheng Ma,

BACKGROUND:The moderator band (MB) is an endocavitary structure with only 2 exits to the bulk of ventricular myocardium. Whether this may lead to specific electrophysiological characteristics remains unknown. OBJECTIVE:To investigate electrocardiographic (ECG), activation and pace mapping characteristics of MB-originated ventricular arrhythmias (VAs). METHODS:Mapping and ablation of MB-VAs were performed in ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Drivers of Hospitalization in Atrial Fibrillation: A Contemporary Review.

Aditya Bhat, Shaun Khanna, Henry H L Chen, Gary C H Gan, C Raina MacIntyre, Timothy C Tan,

Atrial fibrillation (AF) related hospitalization has risen over the last two decades and is the most influential determinant of total disease-related expenditure. In this review article, we describe several identified drivers for hospitalization from several registries and large-scale clinical trials, including key cardiovascular and non-traditional risk factors. We also discuss ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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Behavior of the PR Interval with Increasing Heart Rate in Patients with COVID-19.

Behzad B Pavri, Juergen Kloo, Darius Farzad, Joshua M Riley,

BACKGROUND:Myriad manifestations of cardiovascular involvement are described in Coronavirus disease 2019 (COVID-19) but there have been no reports of COVID-19 affecting the cardiac conduction system. The PR interval on the electrocardiogram (ECG) normally shortens with increasing heart rate (HR). We encountered a COVID-19 patient manifesting Mobitz 1 atrioventricular (AV) block ... Read more >>

Heart Rhythm (Heart rhythm)
[2020, :]

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European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population.

Jens Cosedis Nielsen, Yenn-Jiang Lin, Marcio Jansen de Oliveira Figueiredo, Alireza Sepehri Shamloo, Alberto Alfie, Serge Boveda, Nikolaos Dagres, Dario Di Toro, Lee L Eckhardt, Kenneth Ellenbogen, Carina Hardy, Takanori Ikeda, Aparna Jaswal, Elizabeth Kaufman, Andrew Krahn, Kengo Kusano, Valentina Kutyifa, Han S Lim, Gregory Y H Lip, Santiago Nava-Townsend, Hui-Nam Pak, Gerardo Rodríguez Diez, William Sauer, Anil Saxena, Jesper Hastrup Svendsen, Diego Vanegas, Marmar Vaseghi, Arthur Wilde, T Jared Bunch, , Alfred E Buxton, Gonzalo Calvimontes, Tze-Fan Chao, Lars Eckardt, Heidi Estner, Anne M Gillis, Rodrigo Isa, Josef Kautzner, Philippe Maury, Joshua D Moss, Gi-Byung Nam, Brian Olshansky, Luis Fernando Pava Molano, Mauricio Pimentel, Mukund Prabhu, Wendy S Tzou, Philipp Sommer, Janice Swampillai, Alejandro Vidal, Thomas Deneke, Gerhard Hindricks, Christophe Leclercq,

Heart Rhythm (Heart rhythm)
[2020, :]

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Entrainment of a wide QRS complex tachycardia with progressive atrial delay: What is the mechanism?

Taihei Itoh, Masaomi Kimura, Kimitaka Nishizaki, Hirofumi Tomita,

Heart Rhythm (Heart rhythm)
[2020, :]

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