Regional disparities in the care and outcomes of atrial fibrillation patients in a universal health care system: a population-based cohort study.

Introduction: While prior studies have shown regional disparities in patients with myocardial infarction and heart failure within a universal health care, there are limited data on the association between different regions within a universal health care system and outcomes after an atrial fibrillation (AF) diagnosis. In this context, we aimed to assess variations in processes of care and outcomes among patients with the diagnosis of AF presenting to the emergency department (ED).

Methods: We conducted a population-based retrospective cohort study of all adult patients (≥ 18 years) with their first presentation to the ED with AF between April 1, 2012, and March 31, 2022 in Ontario, Canada.

Feasibility study: Characterizing acute lesion dimensions in patients with and without devices using noncontrast (native T-weighted) magnetic resonance imaging after ventricular tachycardia/premature ventricular complex radiofrequency ablation.

Background: Late gadolinium enhancement magnetic resonance imaging (MRI) has been shown to reliably locate radiofrequency ablation (RFA) lesions with microvascular obstruction (MVO) as a broadly accepted signature. However, MVO volume depends on the time elapsed after gadolinium contrast injection. Native T1-weighted (Tw) MRI has recently been shown to accurately characterize RFA lesions in preclinical models.

Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cine.

Background: Implantable cardioverter-defibrillators (ICDs) cause banding artifacts around areas of B inhomogeneity in conventional steady-state free precession (SSFP) cine sequences. Alternatively, high-bandwidth gradient-recalled echo (GRE) cine sequences can be used to minimize artifacts in the myocardium. In this study, we assessed the bias and interobserver variability in cardiac volumes and ejection fractions between GRE cines in acquired in the presence of ICDS and ground-truth SSFP cines (without ICDs present) in a population of healthy volunteers.

Relationship Between Social Deprivation and Access to Catheter Ablation for Atrial Fibrillation: A Population-Level Study.

Background: Access to catheter ablation for atrial fibrillation (AF) may vary due to social deprivation.

Objectives: This study sought to characterize the correlation between our outcomes of interest (rates of AF diagnoses, ablation referrals, and procedures) and the association between social deprivation and our outcomes.

Methods: Rates and correlations of AF diagnoses, ablation referrals, and procedures were reported across 49 census divisions in Ontario, Canada.

Applying Artificial Intelligence for Phenotyping of Inherited Arrhythmia Syndromes.

Inherited arrhythmia disorders account for a significant proportion of sudden cardiac death, particularly among young individuals. Recent advances in our understanding of these syndromes have improved patient diagnosis and care, yet certain clinical gaps remain, particularly within case ascertainment, access to genetic testing, and risk stratification. Artificial intelligence (AI), specifically machine learning and its subset deep learning, present promising solutions to these challenges.

Relationship between wait times and postatrial fibrillation ablation outcomes: A population-based study.

Background: Rhythm control is a cornerstone of atrial fibrillation (AF) management. Shorter time between diagnosis of AF and receipt of catheter ablation is associated with greater rates of therapy success. Previous work considered diagnosis-to-ablation time as a binary or categorical variable and did not consider the unique risk profile of patients after a referral for ablation was made.

Surviving the Shocks: A Contemporary of Short-coupled Ventricular Fibrillation.

A young man presented following successful cardiac resuscitation after an out-of-hospital cardiac arrest. During his admission, he had multiple runs of short-coupled ventricular fibrillation with a similar morphology premature ventricular complex (PVC) trigger. He was brought to the electrophysiology laboratory, and, with a high dose of isoprenaline, the PVC was localised to the moderator band.

Deep Learning-Augmented ECG Analysis for Screening and Genotype Prediction of Congenital Long QT Syndrome.

Importance: Congenital long QT syndrome (LQTS) is associated with syncope, ventricular arrhythmias, and sudden death. Half of patients with LQTS have a normal or borderline-normal QT interval despite LQTS often being detected by QT prolongation on resting electrocardiography (ECG).

Objective: To develop a deep learning-based neural network for identification of LQTS and differentiation of genotypes (LQTS1 and LQTS2) using 12-lead ECG.

Association of admission serum sodium and outcomes following out-of-hospital cardiac arrest.

Background: The prognostic association between dysnatremia and outcomes in out-of-hospital cardiac arrest (OHCA) is not well understood. Given hypernatremia is associated with poor outcomes in critical illness and hyponatremia may exacerbate cerebral edema, we hypothesized that dysnatremia on OHCA hospital admission would be associated with worse neurological outcomes.

Methods: We studied adults (≥19 years) with non-traumatic OHCA between 2009 and 2016 who were enrolled in the British Columbia Cardiac Arrest Registry and survived to hospital admission at 2 quaternary urban hospitals.

Canadian Cardiovascular Society 2023 Guidelines on the Fitness to Drive.

Cardiovascular conditions are among the most frequent causes of impairment to drive, because they might induce unpredictable mental state alterations via diverse mechanisms like myocardial ischemia, cardiac arrhythmias, and vascular dysfunction. Accordingly, health professionals are often asked to assess patients' fitness to drive (FTD). The Canadian Cardiovascular Society previously published FTD guidelines in 2003-2004; herein, we present updated FTD guidelines.

The Prevalence and Characteristics of Arrhythmic Mitral Valve Prolapse in Patients With Unexplained Cardiac Arrest.

Background: There is growing evidence that mitral valve prolapse (MVP) is associated with otherwise unexplained cardiac arrest (UCA). However, reports are hindered by the absence of a systematic ascertainment of alternative diagnoses.

Objectives: This study reports the prevalence and characteristics of MVP in a large cohort of patients with UCA.

Iatrogenic Atrioventricular Block.

Iatrogenic atrioventricular (AV) block can occur in the context of cardiac surgery, percutaneous transcatheter, or electrophysiologic procedures. In cardiac surgery, patients undergoing aortic and/or mitral valve surgery are at the highest risk for developing perioperative AV block requiring permanent pacemaker implantation. Similarly, patients undergoing transcatheter aortic valve replacement are also at increased risk for developing AV block.