Publisher: American Heart Association   (Total: 12 journals)   [Sort by number of followers]

Showing 1 - 12 of 12 Journals sorted alphabetically
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 29, SJR: 3.435, CiteScore: 5)
Circulation     Hybrid Journal   (Followers: 186, SJR: 8.95, CiteScore: 9)
Circulation : Arrhythmia and Electrophysiology     Hybrid Journal   (Followers: 14, SJR: 3.225, CiteScore: 4)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 18, SJR: 3.242, CiteScore: 4)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 23, SJR: 4.228, CiteScore: 5)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 14, SJR: 2.743, CiteScore: 3)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 12, SJR: 2.661, CiteScore: 4)
Circulation : Heart Failure     Hybrid Journal   (Followers: 27, SJR: 4.2, CiteScore: 5)
Circulation Research     Hybrid Journal   (Followers: 32, SJR: 6.813, CiteScore: 9)
Hypertension     Full-text available via subscription   (Followers: 27)
J. of the American Heart Association     Open Access   (Followers: 19, SJR: 2.674, CiteScore: 4)
Stroke     Hybrid Journal   (Followers: 92, SJR: 3.529, CiteScore: 5)
Similar Journals
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Circulation : Arrhythmia and Electrophysiology
Journal Prestige (SJR): 3.225
Citation Impact (citeScore): 4
Number of Followers: 14  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1941-3149 - ISSN (Online) 1941-3084
Published by American Heart Association Homepage  [12 journals]
  • Extreme Left Ventricular Hypertrophy in Pediatric Hypertrophic
           Cardiomyopathy: Good News or Bad News'

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      Authors: Utkarsh Kohli Elizabeth V. Saarel Maully Shah Department of Pediatrics; Division of Pediatric Cardiology, West Virginia University School of Medicine University of Pennsylvania School of Medicine, Philadelphia (M.S.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-05-02T09:00:59Z
      DOI: 10.1161/CIRCEP.122.011033
       
  • Drug Interactions Affecting Antiarrhythmic Drug Use

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      Authors: Philip L. Mar Piotr Horbal Mina K. Chung Jonathan W. Dukes Michael Ezekowitz Dhanunjaya Lakkireddy Gregory Y.H. Lip Mike Miletello Peter A. Noseworthy James A. Reiffel James E. Tisdale Brian Olshansky Rakesh Gopinathannair Department of Medicine, Division of Cardiology, St. Louis University, St. Louis, MO (P.L.M; P.H.). Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic, OH. (M.K.C.) Department of Pharmacy, Cleveland Clinic, OH. (M.M.) Community Memorial Hospital, Ventura, CA (J.W.D.). Lankenau Heart Institute, Bryn Mawr Hospital & Sidney Kimmel Medical College (M.E.). Kansas City Heart Rhythm Institute, KS (D.L, R.G.). Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart & Chest Hospital, Liverpool, United Kingdom (G.Y.H.L.). Department of Clinical Medicine, Aalborg, Denmark (G.Y.H.L.). Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.N.). Division of Cardiology, Department of Medicine, Columbia University, New York, NY (J.A.R.). College of Pharmacy, Purdue University (J.E.T.). School of Medicine, Indiana University, Indianapolis (J.E.T.). Division of Cardiology, Department of Medicine, University of Iowa, Iowa City (B.O.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.
      Antiarrhythmic drugs (AAD) play an important role in the management of arrhythmias. Drug interactions involving AAD are common in clinical practice. As AADs have a narrow therapeutic window, both pharmacokinetic as well as pharmacodynamic interactions involving AAD can result in serious adverse drug reactions ranging from arrhythmia recurrence, failure of device-based therapy, and heart failure, to death. Pharmacokinetic drug interactions frequently involve the inhibition of key metabolic pathways, resulting in accumulation of a substrate drug. Additionally, over the past 2 decades, the P-gp (permeability glycoprotein) has been increasingly cited as a significant source of drug interactions. Pharmacodynamic drug interactions involving AADs commonly involve additive QT prolongation. Amiodarone, quinidine, and dofetilide are AADs with numerous and clinically significant drug interactions. Recent studies have also demonstrated increased morbidity and mortality with the use of digoxin and other AAD which interact with P-gp. QT prolongation is an important pharmacodynamic interaction involving mainly Vaughan-Williams class III AAD as many commonly used drug classes, such as macrolide antibiotics, fluoroquinolone antibiotics, antipsychotics, and antiemetics prolong the QT interval. Whenever possible, serious drug-drug interactions involving AAD should be avoided. If unavoidable, patients will require closer monitoring and the concomitant use of interacting agents should be minimized. Increasing awareness of drug interactions among clinicians will significantly improve patient safety for patients with arrhythmias.
      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-05-02T09:00:47Z
      DOI: 10.1161/CIRCEP.121.007955
       
  • Relationship Between Maximal Left Ventricular Wall Thickness and Sudden
           Cardiac Death in Childhood Onset Hypertrophic Cardiomyopathy

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      Authors: Gabrielle Norrish Tao Ding Ella Field Elena Cervi Lidia Ziółkowska Iacopo Olivotto Diala Khraiche Giuseppe Limongelli Aris Anastasakis Robert Weintraub Elena Biagini Luca Ragni Terrence Prendiville Sophie Duignan Karen McLeod Maria Ilina Adrian Fernandez Chiara Marrone Regina Bökenkamp Anwar Baban Peter Kubus Piers E.F. Daubeney Georgia Sarquella-Brugada Sergi Cesar Sabine Klaassen Tiina H. Ojala Vinay Bhole Constancio Medrano Orhan Uzun Elspeth Brown Ferran Gran Gianfranco Sinagra Francisco J. Castro Graham Stuart Gabriele Vignati Hirokuni Yamazawa Roberto Barriales-Villa Luis Garcia-Guereta Satish Adwani Katie Linter Tara Bharucha Pablo Garcia-Pavia Ana Siles Torsten B. Rasmussen Margherita Calcagnino Caroline B. Jones Hans De Wilde Toru Kubo Tiziana Felice Anca Popoiu Jens Mogensen Sujeev Mathur Fernando Centeno Zdenka Reinhardt Sylvie Schouvey Costas O’Mahony Rumana Z. Omar Perry M. Elliott Juan Pablo Kaski Centre for Inherited Cardiovascular Diseases; Great Ormond Street Hospital, London, United Kingdom (G.N., E.F., E.C., J.P.K.). Institute of Cardiovascular Sciences, University College London, United Kingdom. (G.N., C.O., P.M.E., J.P.K.) Department of Statistical Science, University College London, United Kingdom. (T.D., R.Z.O.) The Children’s Memorial Health Institute, Warsaw, Poland (L.Z.). Careggi University Hopsital, Florence, Italy (I.O.). Necker–Enfants Malades Hospital, Paris, France (D.K.). Monaldi Hospital, Naples, Italy (G.L.). Onassis Cardiac Surgery Center, Athens, Greece (A.A.). Royal Children’s Hospital, Melbourne, Australia (R.W.). Cardiology Unit, S. Orsola-Malpighi Hospital, IRCCS Azienda Ospedalierao-Universitaria di Bologna, Italy (E.B., L.R.). Our Lady’s Children’s Hospital, Dublin, Ireland (T.P., S.D.). Royal Hospital for Children, Glasgow, United Kingdom (K.M., M.I.). Fundación Favaloro University Hospital, Buenos Aires, Argentina (A.F.). Papa Giovanni XXIII Hospital, Bergamo (C.M.). Fondazione Toscana G. Monasterio, Massa-Pisa, Italy (C.M.). Leiden University Medical Center, the Netherlands (R.B.). Bambino Gesu Hospital, Rome, Italy (A.B.). University Hospital Motol, Prague, Czech Republic (P.K.). Royal Brompton Pharmacy “Victor Babes” Timisoara, Children’s Hospital ‘Louis Turcanu,’ Romania (A.P.). Aalborg University Hospital, Denmark (J.M.). Evelina Children’s Hospital, London, United Kingdom (S.M.). Rio Hortega University Hospital, Valladolid, Spain (F.C.). The Freeman Hospital, Newcastle, United Kingdom (Z.R.). Hospital Saint Joseph, Marseille, France (S.S.). St Bartholomew’s Centre for Inherited Cardiovascular Diseases, St Bartholomew’s Hospital, West Smithfield, London, United Kingdom (C.O., P.M.E.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.
      Background:Maximal left ventricular wall thickness (MLVWT) is a risk factor for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). In adults, the severity of left ventricular hypertrophy has a nonlinear relationship with SCD, but it is not known whether the same complex relationship is seen in childhood. The aim of this study was to describe the relationship between left ventricular hypertrophy and SCD risk in a large international pediatric HCM cohort.Methods:The study cohort comprised 1075 children (mean age, 10.2 years [±4.4]) diagnosed with HCM (1–16 years) from the International Paediatric Hypertrophic Cardiomyopathy Consortium. Anonymized, noninvasive clinical data were collected from baseline evaluation and follow-up, and 5-year estimated SCD risk was calculated (HCM Risk-Kids).Results:MLVWTZscore was <10 in 598 (58.1%), ≥10 to <20 in 334 (31.1%), and ≥20 in 143 (13.3%). Higher MLVWTZscores were associated with heart failure symptoms, unexplained syncope, left ventricular outflow tract obstruction, left atrial dilatation, and nonsustained ventricular tachycardia. One hundred twenty-two patients (71.3%) with MLVWTZscore ≥20 had coexisting risk factors for SCD. Over a median follow-up of 4.9 years (interquartile range, 2.3–9.3), 115 (10.7%) had an SCD event. Freedom from SCD event at 5 years for those with MLVWTZscores <10, ≥10 to <20, and ≥20 was 95.6%, 87.4%, and 86.0, respectively. The estimated SCD risk at 5 years had a nonlinear, inverted U-shaped relationship with MLVWTZscore, peaking atZscore +23. The presence of coexisting risk factors had a summative effect on risk.Conclusions:In children with HCM, an inverted U-shaped relationship exists between left ventricular hypertrophy and estimated SCD risk. The presence of additional risk factors has a summative effect on risk. While MLVWT is important for risk stratification, it should not be used either as a binary variable or in isolation to guide implantable cardioverter defibrillator implantation decisions in children with HCM.
      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-05-02T09:00:02Z
      DOI: 10.1161/CIRCEP.121.010075
       
  • Intramural Needle Ablation for Refractory Premature Ventricular
           Contractions

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      Authors: Srinivas R. Dukkipati Tomofumi Nakamura Ikutaro Nakajima Connor Oates Ryohsuke Narui Shinichi Tanigawa Tatjana Sljapic William Whang Jacob S. Koruth Subbarao Choudry Benjamin Schaeffer Akira Fujii Usha B. Tedrow John L. Sapp William G. Stevenson Vivek Y. Reddy Helmsley Electrophysiology Center; Department of Cardiology, Icahn School of Medicine at Mount Sinai, NY (S.R.D., C.O., T.S., W.W., J.S.K., S.C., V.Y.R.). Cardiovascular Division, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (T.N., I.N., R.N., W.G.S.). Cardiovascular Division, Department of Medicine, Brigham Women’s Hospital, Boston, MA (S.T., B.S., A.F., U.B.T.). Heart Rhythm Service, Division of Cardiology, Department of Medicine, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada (J.L.S.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.
      Background:Frequent premature ventricular contractions (PVCs) are often amenable to catheter ablation. However, a deep intramural focus may lead to failure due to inability of standard ablation techniques to penetrate the focus. We sought to assess the efficacy and safety of infusion needle ablation (INA) for PVCs that are refractory to standard radiofrequency ablation.Methods:Under 2 Food and Drug Administration approved protocols, INA was evaluated in patients with frequent PVCs that were refractory to standard ablation. Initial targets for ablation were selected by standard mapping techniques. INA was performed with a deflectable catheter equipped with an extendable/retractable needle at the tip that can be extended up to 12 mm into the myocardium and is capable of pacing and recording. After contrast injection for location assessment, radiofrequency ablation was performed with the needle tip using a temperature-controlled mode (maximum temperature 60 °C) with saline infusion from the needle. The primary end point was a decrease in PVC burden to <5000/24 hours at 6 months. The primary safety end point was incidence of procedure- or device-related serious adverse events.Results:At 4 centers, 35 patients (age 55.3±16.9 years, 74.2% male) underwent INA. The baseline median PVC burden was 25.4% (interquartile range, 18.4%–33.9%) and mean left ventricular ejection fraction was 37.7±12.3%. Delivering 10.3±8.0 INA lesions/patient (91% had adjunctive standard radiofrequency ablation also) resulted in acute PVC elimination in 71.4%. After a mean follow-up of 156±109 days, the primary efficacy end point was met in 73.3%. The median PVC burden decreased to 0.8% (interquartile range, 0.1%–6.0%;P<0.001). The primary safety end point occurred in 14.3% consisting of 1 (2.9%) heart block, 1 (2.9%) femoral artery dissection, and 3 (8.6%) pericardial effusions (all treated percutaneously).Conclusions:INA is effective for the elimination of frequent PVCs that are refractory to conventional ablation and is associated with an acceptable safety profile.REGISTRATION:URL:https://www.clinicaltrials.gov; Unique identifier: NCT01791543 and NCT03204981.
      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-04-27T04:00:17Z
      DOI: 10.1161/CIRCEP.121.010020
       
  • New-Onset Atrial Fibrillation in Patients Hospitalized With COVID-19:
           Results From the American Heart Association COVID-19 Cardiovascular
           Registry

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      Authors: Anna G. Rosenblatt Colby Ayers Anjali Rao Stacey J. Howell Nicholas S. Hendren Ronit H. Zadikany Joseph E. Ebinger James D. Daniels Mark S. Link James A. de Lemos Sandeep R. Das University of Texas Southwestern, Dallas (A.G.R; C.A, A.R, N.S.H, J.D.D, M.S.L, J.A.d.L, S.R.D.). University of San Francisco, CA (S.J.H.). Cedars-Sinai Medical Center, Los Angeles, CA (R.H.Z, J.E.E.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.
      Background:New-onset atrial fibrillation (AF) in patients hospitalized with COVID-19 has been reported and associated with poor clinical outcomes. We aimed to understand the incidence of and outcomes associated with new-onset AF in a diverse and representative US cohort of patients hospitalized with COVID-19.Methods:We used data from the American Heart Association COVID-19 Cardiovascular Disease Registry. Patients were stratified by the presence versus absence of new-onset AF. The primary and secondary outcomes were in-hospital mortality and major adverse cardiovascular events (MACE; cardiovascular death, myocardial infarction, stroke, cardiogenic shock, and heart failure). The association of new-onset AF and the primary and secondary outcomes was evaluated using Cox proportional-hazards models for the primary time to event analyses.Results:Of the first 30 999 patients from 120 institutions across the United States hospitalized with COVID-19, 27 851 had no history of AF. One thousand five hundred seventeen (5.4%) developed new-onset AF during their index hospitalization. New-onset AF was associated with higher rates of death (45.2% versus 11.9%) and MACE (23.8% versus 6.5%). The unadjusted hazard ratio for mortality was 1.99 (95% CI, 1.81–2.18) and for MACE was 2.23 (95% CI, 1.98–2.53) for patients with versus without new-onset AF. After adjusting for demographics, clinical comorbidities, and severity of disease, the associations with death (hazard ratio, 1.10 [95% CI, 0.99–1.23]) fully attenuated and MACE (hazard ratio, 1.31 [95% CI, 1.14–1.50]) partially attenuated.Conclusions:New-onset AF was common (5.4%) among patients hospitalized with COVID-19. Almost half of patients with new-onset AF died during their index hospitalization. After multivariable adjustment for comorbidities and disease severity, new-onset AF was not statistically significantly associated with death, suggesting that new-onset AF in these patients may primarily be a marker of other adverse clinical factors rather than an independent driver of mortality. Causality between the MACE composites and AF needs to be further evaluated.
      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-04-27T03:59:53Z
      DOI: 10.1161/CIRCEP.121.010666
       
  • Voltage Map Guided Nonocclusive Balloon Cryoablation to Achieve Antral
           Pulmonary Vein Isolation

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      Authors: Kristie Coleman Gourg Atteya Dimitrios Varrias Elliot Wolf Amarbir Bhullar Nikhil Sharma Moussa Saleh Kabir Bhasin Neil Bernstein Nicholas Skipitaris Stavros Mountantonakis Department of Cardiac Electrophysiology; Northwell Health- Lenox Hill Heart & Lung, NY.
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-04-26T02:16:54Z
      DOI: 10.1161/CIRCEP.122.010895
       
  • Concomitant Spatiotemporal Electrogram Dispersion and Low Voltage During
           Atrial Fibrillation Is Associated With Refractory Atrial Fibrillation
           After Catheter Ablation

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      Authors: Tetsuma Kawaji Takanori Aizawa Shun Hojo Akihiro Kushiyama Hidenori Yaku Kenji Nakatsuma Kazuhisa Kaneda Masashi Kato Takafumi Yokomatsu Shinji Miki Department of Cardiology, Mitsubishi Kyoto Hospital (T.K; S.H, A.K, H.Y, K.N, K.K, M.K, T.Y, S.M.). Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Japan (T.K, T.A.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-04-26T02:15:48Z
      DOI: 10.1161/CIRCEP.121.010707
       
  • Association Between Apixaban Concentration and Clinical Outcomes in Asians
           With Atrial Fibrillation

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      Authors: Shin-Yi Lin Ching-Hua Kuo Li-Ting Ho Yen-Bin Liu Chih-Fen Huang Sung-Chun Tang Jiann-Shing Jeng Department of Pharmacy; National Taiwan University, Taipei. (S.-Y.L., C.-F.H.) Cardiovascular Center Department of Neurology, National Taiwan University Hospital, National Taiwan University, Taipei. (S.-C.T.) School of Pharmacy, College of Medicine, National Taiwan University, Taipei. (S.-Y.L., C.-H.K., C.-F.H.)
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-04-26T02:13:42Z
      DOI: 10.1161/CIRCEP.121.010693
       
  • Plumbing the Depths of Intramural Ventricular Arrhythmias: The Surface May
           Not Always Reveal What Lies Below

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      Authors: Travis D. Richardson Arvindh N. Kanagasundram William G. Stevenson Cardiac Electrophysiology Section; Vanderbilt University Medical Center, Nashville, TN.
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-04-26T02:12:06Z
      DOI: 10.1161/CIRCEP.122.011032
       
  • 90 vs 50-Watt Radiofrequency Applications for Pulmonary Vein Isolation:
           Experimental and Clinical Findings

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      Authors: Agustín Bortone Jean-Paul Albenque F. Daniel Ramirez Michel Haïssaguerre Stéphane Combes Marion Constantin Guillaume Laborie Guillaume Brault-Noble Éloi Marijon Pierre Jaïs Thomas Pambrun ELSAN, Service de Cardiologie, Hôpital Privé Les Franciscaines, Nîmes (A.B; G.L.). Département de Rythmologie, Clinique Pasteur, Toulouse (J.-P.A, S.C.). L’Institut de RYthmologie et modélisation Cardiaque (LIRYC), Université de Bordeaux (F.D.R, M.H, M.C, P.J, T.P.). Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France (F.D.R, M.H, M.C, P.J, T.P.). Division of Cardiology, University of Ottawa Heart Institute, Ontario, Canada (F.D.R.). ELSAN, Service d’Anesthésie et de Réanimation, Hôpital Privé Les Franciscaines, Nîmes (G.B.-N.). Département de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France (É.M.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.
      BACKGROUND:Fifty-watt radiofrequency applications have proven to be safe and efficient for pulmonary vein isolation (PVI). However, as PV reconnection still occurs and ablation catheter instability significantly contributes to suboptimal lesion formation, a new ablation catheter capable of delivering 90 W for 4 seconds only has been developed with the aim of improving PVI outcomes. In this setting, we sought to determine whether 90 W applications create transmural lesions without collateral damage experimentally and whether they can safely improve PVI procedures clinically compared with 50 W settings.METHODS:Experimentally, individual lesions were created in vivo in the right atrium of 6 swine with 90 W-4 seconds applications using the SmartTouch-SF catheter in a power-controlled mode (3 animals) or the QDOT-MICRO catheter in a temperature-controlled mode (3 animals). Clinically, PVI was performed in a homogenous population of 150 consecutive paroxysmal atrial fibrillation patients using CARTO and the QDOT-MICRO catheter in a temperature-controlled mode (75 patients 50 W-ablation index-guided and 75 patients 90 W-4 seconds).RESULTS:Mostly, (94.9%) experimental lesions were transmural in the thin-walled right atrium of swine. However, collateral damage was observed with both catheters in 17.9% of lesions. Clinically, 90 W procedures had a lower first-pass PVI rate (49% versus 81%,P<10−4) and a higher acute PV reconnection rate (21% versus 5%,P=0.004) than 50 W procedures, whereas total procedural duration (62 versus 66 minutes,P=0.09), 1-year sinus rhythm maintenance (88% versus 90%,P=0.6) and safety (1 tamponade per group) were similar in both groups.CONCLUSIONS:Experimentally, using the QDOT-MICRO catheter, 90 W-4 seconds lesions are mostly transmural in the thin-walled right atrium of swine (median depth 1.87 mm) with a moderate lesion diameter of 6.62 mm but retain the potential for collateral damage. Clinically, 90 W-4 seconds applications are associated with a lower first-pass PVI rate and a higher acute PV reconnection rate than 50 W applications but similar safety outcomes and effectiveness at 1 year.
      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-04-01T01:40:57Z
      DOI: 10.1161/CIRCEP.121.010663
       
  • Electrocardiographic Findings, Arrhythmias, and Left Ventricular
           Involvement in Familial ST-Depression Syndrome

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      Authors: Alex Hørby Christensen Christoffer Rasmus Vissing Adrian Pietersen Jacob Tfelt-Hansen Thomas Hartvig Lindkær Jensen Steen Pehrson Finn Lund Henriksen Niels Christian Foldager Sandgaard Kasper Karmark Iversen Henrik Kjærulf Jensen Morten Salling Olesen Henning Bundgaard The Unit for Inherited Cardiac Diseases, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark & Department of Clinical Medicine, The Heart Centre, Rigshospitalet, University of Copenhagen. (A.H.C; C.R.V, J.T.-H, S.P, H.B.) Department of Forensic Medicine, Faculty of Medical Sciences, The Heart Centre, Rigshospitalet, University of Copenhagen. (J.T.-H.) Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen. (M.S.O.) Department of Cardiology, Herlev-Gentofte Hospital. Copenhagen University Hospital. (A.H.C, A.P, K.K.I.) Department of Pathology, Rigshospitalet, Copenhagen University Hospital. (T.H.L.J.) Department of Cardiology, Odense University Hospital (F.L.H, N.C.F.S.). Department of Cardiology, Aarhus University Hospital (H.K.J.). Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark (H.K.J.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.
      BACKGROUND:Familial ST-depression syndrome is an inherited disease characterized by persistent, nonischemic ST-deviations, and risk of arrhythmias and heart failure. We aimed at further characterizing the ECG, arrhythmias, and structural characteristics associated with this novel syndrome.METHODS:Retrospective analysis of data from consecutive families with familial ST-depression Syndrome in Denmark. ECG features, prevalence and type of arrhythmias, occurrence of systolic dysfunction, and medium-term outcome were analyzed.RESULTS:Forty affected individuals (43% men; mean age at diagnosis 49.1 years) from 14 apparently unrelated families with ≥2 affected members were included. Autosomal dominant inheritance was observed in all families. The ECG phenotype seemed to develop in prepuberty and the ST-deviations were persistent and most pronounced in leads V4/V5/II, respectively. Serial ECG analyses showed stable to slow progression of the ECG phenotype. Exercise accentuated the ST-deviations with a maximum difference between rest/stress (mean) of −117 μV in lead V5. During a mean follow-up of 9.3±7.1 years 5 (13%) patients developed sustained ventricular arrhythmias or (aborted) sudden cardiac death, 10 (25%) developed atrial fibrillation, 2 (5%) other supraventricular arrhythmias, and 10 (25%) were diagnosed with left ventricular ejection fraction ≤50%. The ventricular arrhythmias were polymorphic with relatively short-coupled premature ventricular contractions at onset (300–360 ms); no QT prolongation was observed. Seven patients had at least one catheter ablation; 5 for supraventricular arrhythmias and 2 for ventricular arrhythmias. Males experienced more arrhythmic end points than females (P<0.01).CONCLUSIONS:The familial ST-depression ECG phenotype is stable to slowly progressive after medium-term follow-up. Clinically, both supra- and ventricular arrhythmias are common; as are some degree of left ventricular systolic dysfunction. Familial ST-depression represent a novel inherited cause of polymorphic ventricular tachycardia.
      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-03-31T03:05:34Z
      DOI: 10.1161/CIRCEP.121.010688
       
  • Feasibility of a Randomized Clinical Trial of Cardiac Resynchronization
           Therapy With or Without an Implantable Defibrillator in Older Patients

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      Authors: Andrew Althouse Sandeep Jain Alaa Shalaby Madhurmeet Singh Raul Weiss Larissa Myaskovsky Sana M. Al-Khatib Samir Saba Center for Research on Health Care Data Center; University of Pittsburgh, PA (A.A.). Heart Vascular Institute at the University of Pittsburgh Medical Center, PA (S.J., M.S., S.S.). Cardiology Division, Department of Medicine at the VA Pittsburgh Healthcare, PA (A.S.). Cardiology Division, Ohio State University, Columbus (R.W.). Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque (L.M.). Cardiology Division, Duke University Medical Center, Durham, NC (S.M.A.-K.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-03-31T03:02:31Z
      DOI: 10.1161/CIRCEP.121.010795
       
  • GENESIS: Gene-Specific Machine Learning Models for Variants of Uncertain
           Significance Found in Catecholaminergic Polymorphic Ventricular
           Tachycardia and Long QT Syndrome-Associated Genes

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      Authors: Rachel L. Draelos Jordan E. Ezekian Farica Zhuang Mary E. Moya-Mendez Zhushan Zhang Michael B. Rosamilia Perathu K.R. Manivannan Ricardo Henao Andrew P. Landstrom Department of Computer Science; Trinity College of Arts Bioinformatics, Duke University School of Medicine, Durham, NC. (R.H.) Department of Cell Biology, Duke University School of Medicine, Durham, NC. (A.P.L.)
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.
      BACKGROUND:Cardiac channelopathies such as catecholaminergic polymorphic tachycardia and long QT syndrome predispose patients to fatal arrhythmias and sudden cardiac death. As genetic testing has become common in clinical practice, variants of uncertain significance (VUS) in genes associated with catecholaminergic polymorphic ventricular tachycardia and long QT syndrome are frequently found. The objective of this study was to predict pathogenicity of catecholaminergic polymorphic ventricular tachycardia-associatedRYR2VUS and long QT syndrome-associated VUS inKCNQ1,KCNH2, andSCN5Aby developing gene-specific machine learning models and assessing them using cross-validation, cellular electrophysiological data, and clinical correlation.METHODS:The GENe-specific EnSemble grId Search framework was developed to identify high-performing machine learning models forRYR2,KCNQ1,KCNH2, andSCN5Ausing variant- and protein-specific inputs. Final models were applied to datasets of VUS identified from ClinVar and exome sequencing. Whole cell patch clamp and clinical correlation of selected VUS was performed.RESULTS:The GENe-specific EnSemble grId Search models outperformed alternative methods, with area under the receiver operating characteristics up to 0.87, average precisions up to 0.83, and calibration slopes as close to 1.0 (perfect) as 1.04. Blinded voltage-clamp analysis of HEK293T cells expressing 2 predicted pathogenic variants inKCNQ1each revealed an ≈80% reduction of peak Kv7.1 current compared with WT. Normal Kv7.1 function was observed in KCNQ1-V241I HEK cells as predicted. Though predicted benign, loss of Kv7.1 function was observed for KCNQ1-V106D HEK cells. Clinical correlation of 9/10 variants supported model predictions.CONCLUSIONS:Gene-specific machine learning models may have a role in post-genetic testing diagnostic analyses by providing high performance prediction of variant pathogenicity.
      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-03-31T03:01:37Z
      DOI: 10.1161/CIRCEP.121.010326
       
  • Trends and Outcomes of Catheter Ablation of Ventricular Tachycardia in
           Patients With Ischemic and Nonischemic Cardiomyopathy

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      Authors: Christopher T. Sciria Edward V. Kogan James E. Ip George Thomas Christopher F. Liu Steven M. Markowitz Bruce B. Lerman Luke K. Kim Jim W. Cheung Division of Cardiology; Department of Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital the Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, NY.
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-03-28T02:47:40Z
      DOI: 10.1161/CIRCEP.121.010742
       
  • High-Frequency, Low-Tidal-Volume Mechanical Ventilation Safely Improves
           Catheter Stability and Procedural Efficiency During Radiofrequency
           Ablation of Atrial Fibrillation

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      Authors: Jose Osorio Allyson Varley Omar Kreidieh Brigham Godfrey Gunther Schrappe Anil Rajendra Josh Silverstein Jorge Romero Daniel Rodriguez Gustavo Morales Paul Zei Arrhythmia Institute at Grandview; Birmingham, AL (J.O., B.G., A.R., G.M.). Heart Rhythm Clinical Vascular Care, Albert Einstein College of Medicine, Bronx, NY (J.R., D.R.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-03-25T03:44:03Z
      DOI: 10.1161/CIRCEP.121.010722
       
  • New-Onset Atrial Fibrillation in Left Bundle Branch Area Pacing Compared
           With Right Ventricular Pacing

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      Authors: Venkatesh Ravi Parikshit S. Sharma Neil R. Patel Sujitraj Dommaraju Dipen V. Zalavadia Varun Garg Timothy R. Larsen Angela M. Naperkowski Jeremiah Wasserlauf Kousik Krishnan Wilson Young Parash Pokharel Jess W. Oren Randle H. Storm Richard G. Trohman Henry D. Huang Faiz A. Subzposh Pugazhendhi Vijayaraman Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL (V.R; P.S.S, V.G, T.R.L, J.W, K.K, R.G.T, H.G.H.). Wright Center for GME, Scranton, PA (N.R.P, S.D.). Geisinger Heart Institute, Wilkes Barre, PA (D.V.Z, A.M.N, F.A.S, P.V.). Geisinger Heart Institute, Scranton, PA (W.Y.). Geisinger Heart Institute, Danville, PA (P.P, J.W.O, R.H.S.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-03-25T03:43:14Z
      DOI: 10.1161/CIRCEP.121.010710
       
  • P-Wave Parameters and Indices: A Critical Appraisal of Clinical Utility,
           Challenges, and Future Research—A Consensus Document Endorsed by the
           International Society of Electrocardiology and the International Society
           for Holter and Noninvasive Electrocardiology

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      Authors: Lin Yee Chen Antonio Luiz Pinho Ribeiro Pyotr G. Platonov Iwona Cygankiewicz Elsayed Z. Soliman Bulent Gorenek Takanori Ikeda Vassilios P. Vassilikos Jonathan S. Steinberg Niraj Varma Antoni Bayés-de-Luna Adrian Baranchuk Lillehei Heart Institute & Cardiovascular Division; Department of Medicine, University of Minnesota Medical School, Minneapolis (L.Y.C.). Centro de Telessaúde, Hospital das Clínicas, & Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (A.L.P.R.). Department of Cardiology, Clinical Sciences, Lund University, Sweden (P.G.P.). Department of Electrocardiology, Medical University of Lodz, Poland (I.C.). Institute of Global Health & Human Ecology, American University in Cairo, Cairo, Egypt (E.Z.S.). Epidemiological Cardiology Research Center (EPICARE), Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.). Department of Cardiology, Eskişehir Osmangazi University, Eskisehir, Turkey (B.G.). Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Japan (T.I.). Third Cardiology Department, Hippokrateio General Hospital, Medical School, Aristotle University of Thessaloniki, Greece (V.P.V.). Clinical Cardiovascular Research Center, Univ of Rochester School of Medicine & Dentistry, Rochester, NY (J.S.S.). Cardiac Electrophysiology, Heart & Vascular Institute, Cleveland Clinic, OH (N.V.). Cardiovascular Research Foundation. Cardiovascular ICCC-Program, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain (A.B.-d.-L.). Division of Cardiology, Kingston Health Science, Center, Queen’s University, Kingston, Ontario, Canada (A.B.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.
      Atrial cardiomyopathy, characterized by abnormalities in atrial structure and function, is associated with increased risk of adverse cardiovascular and neurocognitive outcomes, independent of atrial fibrillation. There exists a critical unmet need for a clinical tool that is cost-effective, easy to use, and that can diagnose atrial cardiomyopathy. P-wave parameters (PWPs) reflect underlying atrial structure, size, and electrical activation; alterations in these factors manifest as abnormalities in PWPs that can be readily ascertained from a standard 12-lead ECG and potentially be used to aid clinical decision-making. PWPs include P-wave duration, interatrial block, P-wave terminal force in V1, P-wave axis, P-wave voltage, P-wave area, and P-wave dispersion. PWPs can be combined to yield an index (P-wave índex), such as the morphology-voltage-P-wave duration ECG risk score. Abnormal PWPs have been shown in population-based cohort studies to be independently associated with higher risks of atrial fibrillation, ischemic stroke, sudden cardiac death, and dementia. Additionally, PWPs, either individually or in combination (as a P-wave índex), have been reported to enhance prediction of atrial fibrillation or ischemic stroke. To facilitate translation of PWPs to routine clinical practice, additional work is needed to standardize measurement of PWPs (eg, via semiautomated or automated measurement), confirm their reliability and predictive value, leverage novel approaches (eg, wavelet analysis of P waves and machine learning algorithms), and finally, define the risk-benefit ratio of specific interventions in high-risk individuals. Our ultimate goal is to repurpose the ubiquitous 12-lead ECG to advance the study, diagnosis, and treatment of atrial cardiomyopathy, thus overcoming critical challenges in prevention of cardiovascular disease and dementia.
      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-03-25T03:42:23Z
      DOI: 10.1161/CIRCEP.121.010435
       
  • On the Electrophysiology and Mapping of Intramural Arrhythmic Focus

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      Authors: Robert D. Anderson Jairo Rodriguez Padilla Christian Joens Stephane Masse Abhishek Bhaskaran Karl Magtibay Ahmed Niri John Asta Patrick Lai Mohammed Ali Azam Edward Vigmond Kumaraswamy Nanthakumar Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology, University Health Network, Toronto General Hospital, Ontario, Canada (R.D.A; C.J, S.M, A.B, K.M, A.N, J.A, P.L, M.A.A, K.N.). IHU Liryc, Hôpital Xavier Arnozan, Pessac Cedex, France (J.R.P, E.V.).
      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.
      Background:Conventional mapping of focal ventricular arrhythmias relies on unipolar electrogram characteristics and early local activation times. Deep intramural foci are common and associated with high recurrence rates following catheter-based radiofrequency ablation. We assessed the accuracy of unipolar morphological patterns and mapping surface indices to predict the site and depth of ventricular arrhythmogenic focal sources.Methods:An experimental beating-heart model used Langendorff-perfused, healthy swine hearts. A custom 56-pole electrode array catheter was positioned on the left ventricle. A plunge needle was placed perpendicular in the center of the grid to simulate arrhythmic foci at variable depths. Unipolar electrograms and local activation times were generated. Simulation models from 2 human hearts were also included with grids positioned simultaneously on the endocardium-epicardium from multiple left ventricular, septal, and outflow tract sites.Results:A unipolar Q or QS complex lacks specificity for superficial arrhythmic foci, as this morphology pattern occupies a large surface area and is the predominant pattern as intramural depth increases without developing a R component. There is progressive displacement from the arrhythmic focus to the surface exit as intramural focus depth increases. A shorter total activation time over the overlying electrode array, larger surface area within initial 20 ms activation, and a dual surface breakout pattern all indicate a deep focus.Conclusions:Displacement from the focal intramural origin to the exit site on the mapping surface could lead to erroneous lesion delivery strategies. Traditional unipolar electrogram features lack specificity to predict the intramural arrhythmic source; however, novel endocardial-epicardial mapping surface indices can be used to determine the depth of arrhythmic foci.
      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2022-03-24T02:53:27Z
      DOI: 10.1161/CIRCEP.121.010384
       
  • Correction to: Evolving Cardiac Electrical Therapies for Advanced Heart
           Failure Patients

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      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2021-06-15T09:00:04Z
      DOI: 10.1161/HAE.0000000000000077
      Issue No: Vol. 14, No. 6 (2021)
       
  • Correction to: Novel Mutation in the α-Myosin Heavy Chain Gene Is
           Associated With Sick Sinus Syndrome

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      Abstract: Circulation: Arrhythmia and Electrophysiology, Ahead of Print.

      Citation: Circulation: Arrhythmia and Electrophysiology
      PubDate: 2021-05-18T09:00:07Z
      DOI: 10.1161/HAE.0000000000000075
      Issue No: Vol. 14, No. 5 (2021)
       
 
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