Eric N. Prystowsky

Venice Chart International Consensus Document on Atrial Fibrillation Ablation

Venice Chart International Consensus Document on Atrial Fibrillation Ablation ANDREA NATALE, M.D.,∗ ANTONIO RAVIELE, M.D.,† THOMAS ARENTZ, M.D.,‡ HUGH CALKINS, M.D.,¶ SHIH-ANN CHEN, M.D.,∗∗ MICHEL HAISSAGUERRE, M.D.,†† GERHARD HINDRICKS, M.D.,‡‡ YEN HO, M.D.,¶¶ KARL HEINZ KUCK, M.D.,∗∗∗ FRANCIS MARCHLINSKI, M.D.,††† CARLO NAPOLITANO, M.D.,‡‡‡ DOUGLAS PACKER, M.D.,¶¶¶ CARLO PAPPONE, M.D.,∗∗∗∗ ERIC N. PRYSTOWSKY, M.D.,†††† RICHARD SCHILLING, M.D.,‡‡‡‡ DIPEN SHAH, M.D.,¶¶¶¶ SAKIS THEMISTOCLAKIS, M.D.,† and ATUL VERMA, M.D.,∗∗∗∗∗ for the Venice Chart members From the ∗Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, USA; †Department of Cardiology, Arrhythmologic Section, Umberto I Hospital, Venice-Mestre, Italy; ‡Arrhythmia Service, Herz-Zentrum, Bad Krozingen, Germany; ¶Department of Cardiology, The Johns Hopkins Hospital, Baltimore, USA; ∗∗Division of Cardiology, Department of Medicine, National Yang-Ming University School of Medicine and Taipei Veterans General Hospital, Taipei, Taiwan; ††Hospital du Haut Leveque, CHU Bordeaux, Bordeaux, France; ‡‡University Leipzig, Heart Center, Department of Cardiology, Leipzig, Germany; ¶¶National Heart and Lung Institute, Imperial College and Royal Brompton & Harefield Hospitals, London, UK; ∗∗∗Second Medical Department, St Georg General Hospital, Hamburg, Germany; †††Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, USA; ‡‡‡Molecular Cardiology Laboratory, University of Pavia, Salvatore Maugeri Foundation, Pavia, Italy; ¶¶¶Department of Clinical Cardiac Electrophysiology and Internal Medicine, Mayo Clinic, Rochester, USA; ∗∗∗∗Department of Cardiology, Electrophysiology and Cardiac Pacing Unit, San Raffaele University Hospital, Milan, Italy; ††††St. Vincent Hospital and Health Care Center Program, Indianapolis, USA; ‡‡‡‡St. Bartholomew’s Hospital, London, UK; ¶¶¶¶Cardiology Cantonal Hospital of Geneva, Geneva, Switzerland; ∗∗∗∗∗University of Toronto, Toronto, Canada.

Report of the NASPE Policy Conference on Arrhythmias and the Athlete

Arrhythmias and the Athlete. Introduction: This consensus statement summarizes the proceedings of The Expert Consensus Conference on Arrhythmias in the Athlete of the North American Society of Pacing and Electrophysiology (NASPE) on detecting, evaluating, and treating athletes with cardiovascular disorders that predispose to cardiac arrhythmias.

The History of Atrial Fibrillation: The Last 100 Years

Atrial fibrillation (AF) has had a rich history that has touched the careers of many of the great clinicians and investigators of the 20th century. More recently, there has been an explosion of research into various aspects of the mechanisms and therapy for AF, as evidenced by over 8,000 publications on AF from 2000 to 2007. A century of research and clinical observations, coupled with modern investigative technologies, has enabled modern investigators to have their own “fantastic voyage” as they travel beyond the cell borders into the ionic mechanisms responsible for AF and its many atrial perturbations. One can only imagine the satisfaction of Wenckebach, MacKenzie, and Lewis if they could see how their seeds of wisdom have grown into such sturdy ideas, or how delighted Scherf would be to learn that his ectopic focus theory for AF has been given new life.

Late occurrence of heart block after radiofrequency catheter ablation of the septal region: clinical follow-up and outcome.

Late Occurrence of Heart Block. Introduction: There are few data regarding the occurrence of delayed heart block at least 24 hours after radiofrequency catheter ablation (RFCA) of AV nodal reentry or posteroseptal accessory pathways (APs). We investigated the late occurrence of heart block in this population, the clinical outcome, and whether findings at electrophysiologic study could have predicted its development.

Case Studies with the Experts: Management Decisions in Atrial Fibrillation

Atrial fibrillation (AF) is the most common outpatient arrhythmia. The recent ACC/AHA/ESC guidelines outline a variety of approaches to the management of AF, but their implementation into clinical practice requires multi‐faceted patient evaluations and assessments for optimizing patient care. Using a case‐based approach, issues such as rate versus rhythm control, anticoagulation, cardioversion, pharmacological and catheter ablation for maintenance of sinus rhythm, and the pathophysiology of AF are discussed. These data were originally presented at a satellite symposium titled Case Studies with the Experts: Management Decisions in AF, held on May 10, 2007, during the annual Heart Rhythm Society meeting.

Mechanism of induction of atrioventricular node reentry by simultaneous anterograde conduction over the fast and slow pathways.

Introduction: AV node reentry (AVNRT) is typically induced with anterograde (Ant) block over the fast pathway (FP) and conduction over the slow pathway (SP), with subsequent retrograde (Ret) conduction over the FP. Rarely, a premature atrial complex (PAC) conducts simultaneously over the FP and SP to induce AVNRT (2 for 1). This study investigates the mechanism of 2 for 1 induction.

Hyperventilation Facilitates Induction of Supraventricular Tachycardia: A Novel Method and the Possible Mechanism

Hyperventilation and Supraventricular Tachycardia. Introduction: Hyperventilation has been demonstrated to alter autonomic function. Sympathomimetic drugs (isoproterenol) and parasympatholytic drugs (atropine) may be needed to facilitate induction of supraventricular tachycardia (SVT). The aim of this study was to test the clinical utility and mechanisms of hyperventilation to facilitate SVT initiation.

New Antiarrhythmic Agents for the Prevention and Treatment of Atrial Fibrillation

Rhythm control could become the preferred treatment strategy for atrial fibrillation (AF) if the available antiarrhythmic agents were more effective and safe. A subanalysis of the AFFIRM trial data suggested that rhythm control, if achieved without the adverse effects related to antiarrhythmic medications, may offer a significant survival advantage over rate control. This article reviews the new investigational pharmacologic and dietary agents being considered for the prevention and treatment of AF. Dronederone is a benzofurane similar to amiodarone, but without the iodine component, and is devoid of many of the amiodarone systemic toxicities. Azimilide is a delayed rectifier potassium channel blocker with use‐dependent effects. Agents that target the ultra rapid component of the delayed rectifier potassium current (IKur) have atrial myocyte specific properties and may be devoid of QT prolongation and torsade de pointes in clinical usage. Newer agents being studied also include fish oil, gap junction modulators, 5HT4 receptor antagonists, angiotensin‐converting enzyme inhibitors, angiotensin II receptor blockers, and HMG CoA reductase inhibitors. There is considerable hope that at least some of these agents will ultimately be available for more effective and safe clinical treatment and prevention of AF.

Unknown Intracardiac Electrogram

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