Ashok Shah

Noninvasive Electrocardiomapping Facilitates Previously Failed Ablation of Right Appendage Diverticulum Associated Life‐Threatening Accessory Pathway

Combination of structural (CT‐scan) and functional (3D electrocardiomapping) imaging methods helped successfully accomplish ablation of a life‐threatening manifest accessory pathway in association with a complex right atrial anomaly after previous unsuccessful attempts of endo‐epicardial ablation guided by the invasive electroanatomic system in an adolescent female. Such a system has a potential to facilitate the ablation procedure and impact its outcome through accurate localization of the arrhythmogenic substrate. (J Cardiovasc Electrophysiol, Vol. 24, pp. 583–585, May 2013)

Early Repolarization Syndrome: Epidemiology, Genetics, and Risk Stratification

Early repolarization (ER) involving the inferolateral leads, previously considered a benign electrocardiographic (ECG) phenomenon, has recently been associated with sudden cardiac death. Although the mechanisms underlying early repolarization are unknown, ER is the latest of the primary electrical cardiac disease discovered to have significantly high prevalence in SCD cases and contribute to increased risk of death from cardioarrhythmic cause. Population-based studies have demonstrated an association between early repolarization and sudden death, primarily when the ECG demonstrates ≥0.2 mV of ST elevation. Risk stratification, especially for asymptomatic patient, remains challenging. However, clinical features as personal history of syncope, familial history of sudden cardiac death and characteristics of the J-wave (>0.2 mV, wide distribution, horizontal/descending ST segment) should be considered at higher risk.