Heart Rhythm

BackgroundHuman induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) represent a highly promising approach for cell-based replacement therapy in heart failure. However, the development of graft-related ventricular arrhythmias immediately following transplantation impedes its clinical translation. To date, there have been no reports worldwide characterizing the features of engraftment arrhythmias after hiPSC-CMs transplantation in human. Consequently, this study aims to analyze the ch...

BackgroundWhile various reports described the characteristics and catheter ablation strategies for para-Hisian premature ventricular contraction (PVC), the patient population were limited in previous literatures and optimal approach remain unknown. This study sought to comprehensively assess the safety and outcomes of catheter ablation for para-Hisian PVC, with a particular focus on the safety and efficacy of ablation from aortic coronary cusps. MethodsA total of 122 para-Hisian PVC cases were ...

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...

BackgroundThe optimal timing and efficacy of pharmacological rhythm control in patients with preoperative atrial fibrillation (AF) undergoing cardiopulmonary bypass (CPB) surgery remain unclear. We aimed to evaluate the effectiveness of intravenous amiodarone administration during rewarming on early cardioversion and short-term outcomes, and to develop a predictive model for postoperative AF recurrence. MethodsThis retrospective cohort study included adult patients with preoperative atrial fibr...

BackgroundThere are controversies about whether atrial fibrillation (AF) type, paroxysmal (PaAF) vs persistent (PeAF), affects stroke risk. The type of AF is still not included in most risk stratification tools. ObjectiveWe aim to assess differences in stroke outcomes between PaAF and PeAF patients in both low- and high-CHA2DS2-VASc groups. MethodsWe conducted an epidemiological study of all patients admitted to Tulane Medical Center with the diagnosis of AF from January 2010 to March 2020. Da...

BackgroundCatheter ablation is an established rhythm control therapy for atrial fibrillation. However, as the extent of ablation increases, the risk of complications may also rise. This has motivated strategies that achieve pulmonary vein isolation with less lesion creation while preserving safety and effectiveness. MethodsIn this prospective, multicenter, randomized non-inferiority trial, 130 patients undergoing first-time ablation for paroxysmal or non-paroxysmal atrial fibrillation were assi...

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...

AO_SCPLOWBSTRACTC_SCPLOWO_ST_ABSAimsC_ST_ABSWe aim to develop a patient-specific computational model to predict the risk of Ventricular Tachycardia (VT) in patients with Biventricular Cardiac Resynchronization Therapy (BiV-CRT) device. Patients are indeed at risk of developing arrhythmias due to BiV-CRT pacing, a known potential complication that puts the cardiologist on guard against its prevention. Materials and MethodsWe consider three non-ischemic fibrotic patients. Patient-specific left ve...

BackgroundEarly identification of arrhythmias in the intensive care unit (ICU) is important to prevent ICU morbidity and mortality. Timely arrhythmia detection relies on bedside providers telemetry interpretation. Machine learning (ML) models can function as clinical support tools to facilitate diagnoses. ML model development requires well-curated training data. The differential performance between labelers of different roles and experience is currently unknown. MethodsThis was a prospective ob...

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...

BackgroundGenetic testing is now recommended for select patients with early-onset atrial fibrillation (AF). Hemochromatosis is an autosomal recessive syndrome that occurs in patients who carry two pathogenic or likely-pathogenic (P/LP) variants in HFE. HFE is included on some genetic testing panels used for patients with AF. Hemochromatosis causes cardiomyopathy due to iron overload in the ventricle; however, it is unknown whether AF can be an early manifestation that is identified by genetic te...

BackgroundGuideline-directed medical therapy (GDMT) has been shown to improve mortality and/or symptoms in heart failure with reduced ejection fraction (HFrEF). Medical devices also play an important role in improved quality of life and overall symptom relief for HFrEF patients. Baroreflex Activation Therapy (BAT) increases parasympathetic nervous system activity by stimulating the carotid baroreceptors, thereby reducing symptoms. Herein, we analyzed the effects of BAT on hospitalization, atrial...

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 ...

BackgroundPericardial effusion can progress to life-threatening cardiac tamponade when large or rapidly accumulating, yet early diagnosis is frequently delayed without sufficient clinical vigilance. Echocardiography is the gold standard but is not always accessible in emergency or resource-limited settings. Electrocardiographic (ECG) findings, including low QRS voltage and electrical alternans, may prompt clinical suspicion; however, their diagnostic value remains constrained by poor quantitativ...

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...

BackgroundHypertrophic cardiomyopathy (HCM) is a common inherited cardiovascular disease associated with increased risks of heart failure, sudden cardiac death (SCD), and stroke. Over 1,400 pathogenic variants, primarily in MYH7 and MYBPC3, have been identified, yet the prognostic significance of genetics remains unclear. Recent studies suggest genotype-positive (G+) HCM is linked to earlier diagnosis, greater disease severity, and poorer outcomes, necessitating further research to clarify the r...

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...