David M Harmon, Ojasav Sehrawat, Maren Maanja, John Wight, Peter A Noseworthy
{"title":"Artificial Intelligence for the Detection and Treatment of Atrial Fibrillation.","authors":"David M Harmon, Ojasav Sehrawat, Maren Maanja, John Wight, Peter A Noseworthy","doi":"10.15420/aer.2022.31","DOIUrl":"https://doi.org/10.15420/aer.2022.31","url":null,"abstract":"<p><p>AF is the most common clinically relevant cardiac arrhythmia associated with multiple comorbidities, cardiovascular complications (e.g. stroke) and increased mortality. As artificial intelligence (AI) continues to transform the practice of medicine, this review article highlights specific applications of AI for the screening, diagnosis and treatment of AF. Routinely used digital devices and diagnostic technology have been significantly enhanced by these AI algorithms, increasing the potential for large-scale population-based screening and improved diagnostic assessments. These technologies have similarly impacted the treatment pathway of AF, identifying patients who may benefit from specific therapeutic interventions. While the application of AI to the diagnostic and therapeutic pathway of AF has been tremendously successful, the pitfalls and limitations of these algorithms must be thoroughly considered. Overall, the multifaceted applications of AI for AF are a hallmark of this emerging era of medicine.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e12"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/c0/aer-12-e12.PMC10326669.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauri Holmström, Frank Zijun Zhang, David Ouyang, Damini Dey, Piotr J Slomka, Sumeet S Chugh
{"title":"Artificial Intelligence in Ventricular Arrhythmias and Sudden Death.","authors":"Lauri Holmström, Frank Zijun Zhang, David Ouyang, Damini Dey, Piotr J Slomka, Sumeet S Chugh","doi":"10.15420/aer.2022.42","DOIUrl":"https://doi.org/10.15420/aer.2022.42","url":null,"abstract":"<p><p>Sudden cardiac arrest due to lethal ventricular arrhythmias is a major cause of mortality worldwide and results in more years of potential life lost than any individual cancer. Most of these sudden cardiac arrest events occur unexpectedly in individuals who have not been identified as high-risk due to the inadequacy of current risk stratification tools. Artificial intelligence tools are increasingly being used to solve complex problems and are poised to help with this major unmet need in the field of clinical electrophysiology. By leveraging large and detailed datasets, artificial intelligence-based prediction models have the potential to enhance the risk stratification of lethal ventricular arrhythmias. This review presents a synthesis of the published literature and a discussion of future directions in this field.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e17"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/89/aer-12-e17.PMC10345967.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9828989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frits W Prinzen, Joost Lumens, Jürgen Duchenne, Kevin Vernooy
{"title":"Erratum to: Electro-energetics of Biventricular, Septal and Conduction System Pacing.","authors":"Frits W Prinzen, Joost Lumens, Jürgen Duchenne, Kevin Vernooy","doi":"10.15420/aer.2023.12.er1","DOIUrl":"https://doi.org/10.15420/aer.2023.12.er1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.15420/aer.2021.30.].</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e19"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/05/aer-12-e19.PMC10345947.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiac Resynchronisation with Conduction System Pacing.","authors":"Fatima M Ezzeddine, Isaac G Leon, Yong-Mei Cha","doi":"10.15420/aer.2023.03","DOIUrl":"https://doi.org/10.15420/aer.2023.03","url":null,"abstract":"<p><p>To date, biventricular pacing (BiVP) has been the standard pacing modality for cardiac resynchronisation therapy. However, it is non-physiological, with the activation spreading between the left ventricular epicardium and right ventricular endocardium. Up to one-third of patients with heart failure who are eligible for cardiac resynchronisation therapy do not derive benefit from BiVP. Conduction system pacing (CSP), which includes His bundle pacing and left bundle branch area pacing, has emerged as an alternative to BiVP for cardiac resynchronisation. There is mounting evidence supporting the benefits of CSP in achieving synchronous ventricular activation and repolarisation. The aim of this review is to summarise the current options and outcomes of CSP when used for cardiac resynchronisation in patients with heart failure.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e22"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a2/2d/aer-12-e22.PMC10466271.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10134662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Schaack, Boris Schmidt, Shota Tohoku, Stefano Bordignon, Lukas Urbanek, Ramin Ebrahimi, Jun Hirokami, Tolga Han Efe, Shaojie Chen, Kr Julian Chun
{"title":"Pulsed Field Ablation for Atrial Fibrillation.","authors":"David Schaack, Boris Schmidt, Shota Tohoku, Stefano Bordignon, Lukas Urbanek, Ramin Ebrahimi, Jun Hirokami, Tolga Han Efe, Shaojie Chen, Kr Julian Chun","doi":"10.15420/aer.2022.45","DOIUrl":"https://doi.org/10.15420/aer.2022.45","url":null,"abstract":"<p><p>Catheter ablation is a widely used, effective and safe treatment for AF. Pulsed field ablation (PFA), as a novel energy source for cardiac ablation, has been shown to be tissue selective and is expected to decrease damage to non-cardiac tissue while providing high efficacy in pulmonary vein isolation. The FARAPULSE ablation system (Boston Scientific) follows the idea of single-shot ablation and is the first device approved for clinical use in Europe. Since its approval, multiple high-volume centres have performed increasing numbers of PFA procedures in patients with AF and have published their experiences. This review summarises the current clinical experience regarding the use of PFA for AF using the FARAPULSE system. It provides an overview of its efficacy and safety.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e11"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/d0/aer-12-e11.PMC10326665.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9815179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin L Freedman, Timothy R Maher, Madison Tracey, Pasquale Santangeli, Andre d'Avila
{"title":"Procedural Adaptations to Avoid Haemodynamic Instability During Catheter Ablation of Scar-related Ventricular Tachycardia.","authors":"Benjamin L Freedman, Timothy R Maher, Madison Tracey, Pasquale Santangeli, Andre d'Avila","doi":"10.15420/aer.2022.24","DOIUrl":"https://doi.org/10.15420/aer.2022.24","url":null,"abstract":"<p><p>Classically, catheter ablation for scar-related ventricular tachycardia (VT) relied upon activation and entrainment mapping of induced VT. Advances in post-MI therapies have led to VTs that are faster and haemodynamically less stable, because of more heterogeneous myocardial fibrosis patterns. The PAINESD score is one means of identifying patients at highest risk for haemodynamic decompensation during attempted VT induction, who may, therefore, benefit from alternative ablation strategies. One strategy is to use temporary mechanical circulatory support, although this warrants formal assessment of cost-effectiveness. A second strategy is to minimise or avoid VT induction altogether by employing a family of 'substrate'-based approaches aimed at identifying VT isthmuses during sinus or paced rhythm. Substrate mapping techniques are diverse, and focus on the timing, morphology and amplitude of local ventricular electrograms - sometimes aided by advanced non-invasive cardiac imaging modalities. In this review, the evolution of VT ablation over time is discussed, with an emphasis on procedural adaptations to the challenge of haemodynamic instability.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e20"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/75/aer-12-e20.PMC10350657.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manyoo A Agarwal, Aadhavi Sridharan, Rhea C Pimentel, Steven M Markowitz, Lynda E Rosenfeld, Michael G Fradley, Eric H Yang
{"title":"Ventricular Arrhythmia in Cancer Patients: Mechanisms, Treatment Strategies and Future Avenues.","authors":"Manyoo A Agarwal, Aadhavi Sridharan, Rhea C Pimentel, Steven M Markowitz, Lynda E Rosenfeld, Michael G Fradley, Eric H Yang","doi":"10.15420/aer.2023.04","DOIUrl":"https://doi.org/10.15420/aer.2023.04","url":null,"abstract":"<p><p>Cardiovascular disease and cancer are the leading causes of morbidity and mortality in the US. Despite the significant progress made in cancer treatment leading to improved prognosis and survival, ventricular arrhythmias (VA) remain a known cardiovascular complication either exacerbated or induced by the direct and indirect effects of both traditional and novel cancer treatments. Although interruption of cancer treatment because of VA is rarely required, knowledge surrounding this issue is essential for optimising the overall care of patients with cancer. The mechanisms of cancer-therapeutic-induced VA are poorly understood. This review will discuss the ventricular conduction (QRS) and repolarisation abnormalities (QTc prolongation), and VAs associated with cancer therapies, as well as existing strategies for the identification, prevention and management of cancer-treatment-induced VAs.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e16"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/89/aer-12-e16.PMC10345968.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma Kealaher, Parin Shah, Tharindra Dissanayake, Dewi E Thomas, James Barry, Andrei D Margulescu
{"title":"Hypersensitivity Reactions to Components of Cardiac Implantable Electronic Devices and Their Treatment: A Systematic Review.","authors":"Emma Kealaher, Parin Shah, Tharindra Dissanayake, Dewi E Thomas, James Barry, Andrei D Margulescu","doi":"10.15420/aer.2022.23","DOIUrl":"https://doi.org/10.15420/aer.2022.23","url":null,"abstract":"<p><p><b>Background:</b> Hypersensitivity reactions (HSRs) to components of cardiac implantable electronic devices (CIEDs) are rare but difficult to differentiate from device infection. Data on best management strategies of HSRs to CIEDs are lacking. The aims of this systematic review are to summarise the available literature on the aetiology, diagnosis and management of HSR in CIED patients and to provide guidance on best management strategies for these patients. <b>Methods and results:</b> A systematic search for publications on HSR to CIED in PubMed from January 1970 to November 2022 was conducted, resulting in 43 publications reporting on 57 individual cases. The quality of data was low. The mean age was 57 ± 21 years, and 48% of patients were women. The mean time from implant to diagnosis was 29 ± 59 months. Multiple allergens were identified in 11 patients (19%). In 14 cases (25%) no allergen was identified. Blood tests were mostly normal (55%), but eosinophilia (23%), raised inflammatory markers (18%) and raised immunoglobulin E (5%) were also encountered. Symptoms included local reactions, systemic reactions or both in 77%, 21% and 7% of patients, respectively. Explantation of CIED and reimplantation of another CIED coated with a non-allergenic material was usually successful. Use of topical or systemic steroids was associated with high failure rates. <b>Conclusion:</b> Based on the limited data available, the treatment of choice for HSRs to CIEDs is full CIED removal, reassessment of CIED indication and reimplantation of devices coated in non-allergenic materials. Steroids (topical/systemic) have limited efficiency and should not be used. There is an urgent need for further research in this field.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e08"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/35/aer-12-e08.PMC10326667.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9815180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardioneuroablation for Treating Vasovagal Syncope: Current Status and Future Directions.","authors":"Le Li, Sunny Po, Yan Yao","doi":"10.15420/aer.2023.02","DOIUrl":"https://doi.org/10.15420/aer.2023.02","url":null,"abstract":"<p><p>Syncope is defined by transient and spontaneous loss of consciousness with rapid recovery. Vasovagal syncope (VVS) is the most common form of syncope and is strongly associated with hypervagotonia. There is, however, a lack of effective therapies for VVS. Cardioneuroablation (CNA) is an emerging and promising intervention for VVS with favourable outcomes. CNA has been shown to suppress excessive excitation of vagal activity through ablating the cardiac ganglionated plexi. CNA in the management of VVS requires more structured and comprehensive studies and several issues concerning patient selection, selection of ablation targets, ablation endpoints and the long-term effect of CNA are yet to be determined. This review describes its clinical applications and future directions based on current research data and the authors' own experiences.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e18"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/d2/aer-12-e18.PMC10345939.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mario D Bassi, Juan M Farina, Jorge Bombau, Mario Fitz Maurice, Guillermo Bortman, Elaine Nuñez, Manlio Márquez, Norberto Bornancini, Adrian Baranchuk
{"title":"Sudden Cardiac Arrest in Basketball and Soccer Stadiums, the Role of Automated External Defibrillators: A Review. For the BELTRAN Study (BaskEtbaLl and soccer sTadiums: Registry on Automatic exterNal defibrillators).","authors":"Mario D Bassi, Juan M Farina, Jorge Bombau, Mario Fitz Maurice, Guillermo Bortman, Elaine Nuñez, Manlio Márquez, Norberto Bornancini, Adrian Baranchuk","doi":"10.15420/aer.2022.30","DOIUrl":"https://doi.org/10.15420/aer.2022.30","url":null,"abstract":"<p><p>Sudden cardiac arrest (SCA) during sports events has a dramatic impact on stadium-goers and the public and is often associated with poor outcomes unless treated with an automated external defibrillator (AED). Despite this, stadiums vary in AED use. This review aims to identify the risks and incidences of SCA, and the use of AEDs in soccer and basketball stadiums. A narrative review of all relevant papers was conducted. Athletes across all sports face an SCA risk of 1:50,000 athlete-years, with the greatest risk of SCA in young male athletes (1:35,000 person-years) and black male athletes (1:18,000 person-years). Africa and South America have the poorest soccer SCA outcomes at 3% and 4% survival. AED use on-site improves survival greater than defibrillation by emergency services. Many stadiums do not have AEDs implemented into medical plans and the AEDs are often unrecognisable or are obstructed. Therefore, AEDs should be used on-site, use clear signalling, have certified trained personnel, and be incorporated into stadiums' medical plans.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e03"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/7b/aer-12-e03.PMC9945480.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10793682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}