Heart Rhythm

AimsEarly discharge after electrophysiological procedures has gained increasing attention. However, definition of patient- and procedure-related prerequisites for successful and safe discharge strategies after atrial tachycardia (AT) ablation remains unknown. We therefore evaluated patient characteristics, procedural features, and outcomes according to index length of stay (LOS) following AT ablation. Methods and resultsThe multicenter observational SATELLITE registry enrolled consecutive patie...

BackgroundAcute myocarditis is typically self-limiting and resolves spontaneously in most cases. However, ventricular arrhythmias (VA) complications, which may be life-threatening are associated with higher rates of in-hospital complications and mortality. Catheter ablation is occasionally required for acute myocarditis associated ventricular tachycardia (VT), but data on its procedural use and outcomes, in this setting, remain limited. We aimed to determine the prevalence of VA among patients h...

AimsCatheter ablation using radiofrequency (RF) or pulsed field (PF) energy is an effective treatment method for ventricular arrhythmia (VA). PF offers advantages in lesion formation in anatomically challenging regions. However, its acute effects on ventricular contractility during substrate modification require further elucidation. This study aimed to compare real-time hemodynamic changes associated with PF versus radiofrequency ablation in the left ventricle using stroke volume (SV) as a surro...

Structured AbstractO_ST_ABSBackgroundC_ST_ABSGuideline recommendations for infective endocarditis (IE) prophylaxis have narrowed significantly over the past decade. However, these recommendations are derived from adult data and may not adequately account for the unique risk factors for IE in pediatric and congenital heart disease (CHD) patients with cardiac implantable electronic devices (CIEDs). ObjectiveTo characterize contemporary IE cases and prophylaxis practices among members of the Pedia...

Subclinical rheumatic valvular disease is a significant yet underdiagnosed contributor to the global rheumatic heart disease (RHD) burden. Early detection through population screening is essential to prevent its progression to severe RHD. Rhythm changes and prolongations of PR and QTc intervals in the ECG are described in the advanced RHD cases. However, these parameters were not yet studied in asymptomatic RHD. We aimed to investigate the potential of ECG biomarkers for screening RHD in asympto...

BackgroundNormative pediatric electrocardiographic (ECG) parameters are standardized, but lack temporal resolution for neonates and infants. These values are clinically important, as they support the diagnosis, risk stratification, and management of cardiovascular diseases (CVD). MethodsFive ECG parameters (heart rate (HR), QRS, PR, QT, QTc intervals) were retrospectively analyzed from 7,346 recordings from 6,967 patients at a large pediatric hospital. Patients were only included if their ECG w...

BackgroundArtificial intelligence (AI) has emerged as a promising tool for interpreting 12-lead electrocardiograms (ECGs), with the potential to enhance diagnostic accuracy for arrhythmia detection. However, published studies vary widely in methodology and validation strategy, warranting a quantitative synthesis of diagnostic performance. MethodsA systematic review and meta-analysis was conducted according to the PRISMA-DTA 2018 guidelines and registered in PROSPERO (CRD420251027264). Searches ...

BackgroundEmbolic stroke of undetermined source (ESUS) is associated with a high risk of recurrence. However, randomized trials have not shown superiority of anticoagulation over aspirin in unselected patients. Atrial cardiomyopathy (AtCM) may identify a high-risk ESUS phenotype. We investigated whether multimodal AtCM markers distinguish ESUS from controls and predict adverse clinical outcomes. MethodsIn this prospective single-center study, consecutive ESUS patients and age- and sex-matched c...

BackgroundAdvances in wearable devices and machine-learning-based ECG analysis enable highly accurate detection of atrial fibrillation (AF) outside traditional clinical settings, leading to increasing identification of asymptomatic AF. However, the prognostic significance of AI-detected asymptomatic AF and its implications for downstream cardiovascular risk remain unclear. In contrast to clinically diagnosed AF, evidence guiding risk stratification and further evaluation in this population is li...

BackgroundIn patients with atrial fibrillation (AF) and stable coronary artery disease beyond 1 year after percutaneous coronary intervention (PCI), oral anticoagulant monotherapy is guideline-recommended; however, its efficacy and safety in patients with complex PCI remain uncertain. MethodsWe conducted a post-hoc analysis of the randomized ADAPT AF-DES trial comparing NOAC monotherapy versus NOAC plus clopidogrel in AF patients [≥]12 months after second- or third-generation drug-eluting st...

BackgroundLeft atrial (LA) remodeling, a hallmark of chronically elevated LA pressure, is characterized by enlargement and functional impairment. While global and reservoir LA functions are well described, the role of LA booster function and its failure remains poorly defined. ObjectivesTo characterize LA booster function using cardiac computed tomography angiography (CCTA) and to evaluate the relationship between LA preload, booster performance, remodeling, and clinical outcomes. MethodsWe re...

BACKGROUNDDilated cardiomyopathy (DCM) presents a highly heterogeneous spectrum, including a familial subset with elevated arrhythmic risk. Traditional demographic and imaging markers, such as late gadolinium enhancement, have been inadequate for identifying high-risk patients before arrhythmic events. Remodelling of the interventricular septum--central to ventricular mechanics and conduction--may offer improved risk stratification. OBJECTIVESTo identify differences in left ventricular (LV) mor...

ObjectiveTo analyze the experience of the last six years with ECMO in Uncontrolled Donation after Circulatory Death (uDCD), assessing the clinical and logistical factors that determine donation effectiveness and the viability of retrieved organs, with the nurse perfusionist as the central figure in organ perfusion. MethodsRetrospective observational study of uDCD procedures performed at Hospital Clinic de Barcelona between June 2019 and October 2025. ResultsOf 184 out-of-hospital ECMO-CPR acti...

IntroductionAtrial fibrillation (AF), a common arrhythmia, is associated with impaired quality of life (QoL) and increased stroke risk and mortality. Clinical guidelines recommend leveraging digital technologies to support patient education and AF self-management. Conversational artificial intelligence (AI) technologies may support patient engagement with self-management by enabling human-like conversations. This study aims to evaluate the effectiveness of a conversational AI intervention (Conve...

AimsWe aimed to develop and evaluate fully automated artificial intelligence (AI) system. for detection of mitral valve prolapse (MVP) and mitral regurgitation (MR) from echocardiographic studies. Methods and ResultsWe used a dataset of 24,869 echocardiographic studies from the University of California San Francisco (UCSF) to train a multi-view deep neural network (DNN) to detect MVP using apical 4-chamber, 2-chamber, and parasternal long-axis views. A separate dataset of 27,906 studies from UC...

BackgroundElevated resting heart rate (HR) and atrial cardiopathy are each linked to higher mortality risk, yet their interrelationship and joint prognostic value remain unclear. MethodsWe analyzed 7,326 adults (mean age 59 {+/-} 13 years) without cardiovascular disease from the Third National Health and Nutrition Examination Survey with available electrocardiograms. Atrial cardiopathy was defined by electrocardiogram as abnormal P-wave axis or deep terminal P-wave negativity in V1. Multivariab...

AimsCardiac myosin inhibitors (CMIs) have emerged as an alternative to septal reduction therapy (SRT) for obstructive hypertrophic cardiomyopathy (oHCM). However, comparative data on the time-trajectory of myocardial functional adaptation after septal myectomy (SM), alcohol septal ablation (ASA), and CMI are lacking. We compared temporal changes in echocardiographic parameters including LV global longitudinal strain (LVGLS) and LA reservoir strain (LASr) across these treatment strategies. Metho...

ObjectiveTo validate case number correctness and time interval agreement in the Swedish Registry of Cardiopulmonary Resuscitation (SRCR) for out-of-hospital cardiac arrest (OHCA) by linkage to Emergency Medical Dispatch Centre (EMDC) data between 2015 and 2024. MethodsIn this retrospective validation study, OHCA records reported to the SCRC were linked with EMDC-indexed OHCA for validation and correction of EMS case numbers. We quantified the proportion of correct EMS case numbers reported as a...

BackgroundEchocardiography (echo) is a cornerstone of pediatric cardiology, yet access to expert interpreters is limited worldwide, particularly in low-resource and rural settings. Artificial intelligence (AI) offers a mechanism to broadly deliver expert-level precision and standardize measurements, yet AI for comprehensive automated measurements in pediatric and congenital heart disease (CHD) echo remains underdeveloped. MethodsWe created EchoFocus-Measure, an AI platform that automatically ex...

BackgroundThe molecular drivers distinguishing valvular heart disease-associated atrial fibrillation (VHD-AF) from other AF etiologies remain poorly defined, with prior transcriptomic studies largely focused on non-valvular AF. MethodsWe performed RNA sequencing on peripheral blood mononuclear cells (PBMCs) from 15 patients with VHD-AF and 15 age- and sex-matched healthy controls. Bioinformatic analyses identified differentially expressed genes (DEGs), enriched pathways, and protein-protein int...