EUROPEAN JOURNAL OF ARRHYTHMIA & ELECTROPHYSIOLOGY – VOLUME 2 ISSUE 1 – SUMMER 2016

This edition of European Journal of Arrhythmia & Electrophysiology features several illuminating case reports. Right ventricular (RV) perforation due to pacemaker insertion is a rare though potentially fatal complication. It has been thought that this complication is more common with active fixation leads than with passive fixation leads. However, in the study reported by Ayati […]

Since enalapril was shown to reduce the risk of all-cause death in the CONSENSUS1and SOLVD-T trials,2angiotensin-converting enzyme inhibitors (ACEIs) have been the mainstay of treatment for patients with heart failure (HF) and a reduced ejection fraction (HFrEF). In the SOLVD-T trial there was a relative risk reduction (RRR) of 16% in all-cause death and of […]

The prevalence of congestive heart failure (HF) increases with age: HF is implicated in 20% of hospital admissions in those aged >65, and octogenarians are 20 times more likely to be hospitalised for HF than younger patients.1As a consequence, elderly patients currently represent a larger portion of patients with HF, but they substantially differ from […]

The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a disruptive technological change in our approach to ICD implantation avoiding the Achilles’ heel of the transvenous lead impantation in patients without pacing indications. The evidence base has been significantly expanded over the past 12 months with growing experience and longer-term follow-up. In 2015, a pooled analysis of the […]

Advances in surgical technique over the last two decades have heralded a dramatic improvement in survival rates in those born with congenital heart disease (CHD). With current methods, more than 85% of paediatric patients undergoing surgical repair survive into adulthood,1and there are now at least 1.2 million people living in Europe with CHD,2 of whom […]

Catheter ablation has been consistently shown to provide improved freedom from atrial fibrillation (AF) compared to medical management but, nevertheless, success rates following a single procedure remain relatively poor and are significantly lower than those for ablation procedures for most other supraventricular arrhythmias.1,2Recurrence of atrial tachyarrhythmias (AT; comprising AF, atrial flutter or atrial tachycardia), either […]

Current use of QRS duration in cardiac resynchronization therapy Cardiac resynchronization therapy (CRT) is an established therapeutic option in patients with symptomatic systolic heart failure concomitant with electrical dyssynchrony.1–3 Patients with a wide QRS (≥120 ms), especially those with a left bundle branch block (LBBB) morphology, derive the most benefit from biventricular pacing in terms […]

Premature ventricular contractions (PVCs) arising from the Purkinje network are rare causes of idiopathic ventricular fibrillation (IVF).1–4Van Herendael and colleagues recently highlighted the importance of triggers from the papillary muscles (PM) and the left ventricular outflow tract in the initiation of ventricular fibrillation.4 In their study, eight of 30 patients had PM triggers which were […]

The purpose of this report is to describe an unusual case of arrhythmogenic cardiomyopathy, involving the left ventricle (LV), with an atypical standard electrocardiogram (ECG) pattern. Sustained ventricular arrhythmias in a middle-aged subject are usually related to ischemic heart disease. A latent or overt cardiomyopathy is probably the second cause of a rhythm disturbance especially. […]

The use of implantable cardiac rhythm management (CRM) devices has been on the rise worldwide with approximately one million implant per year.1 The two common complications of CRM device implants are infection and pneumothorax with the prevalence of 1.2% and 0.6% respectively.2 Despite the use of techniques to reduce pneumothorax, such as cephalic vein cutdown, […]

Pacemaker (PM) insertion is one of the most common invasive procedures in cardiology. This routine procedure may be associated with unfortunate complications such as myocardial perforation. Although this is a welldescribed but rare complication in symptomatic patients, subclinical perforation is even rarer and the diagnosis remains a challenge. In subclinical and late manifestation, it is […]