Typical dynamic electrocardiographic changes in Takotsubo syndrome.

Aims: Negative T waves and QTc prolongation often occur in patients with Takotsubo syndrome. Description of typical electrocardiographic changes could be a diagnosis element of this syndrome. This study aimed to clarify on the one hand the more preciously possible the typical electrocardiographic changes, and on the other hand, the timing of occurrence of these abnormalities compared to the trigger occurrence, the symptoms onset and the hospital admission.

A circular mapping catheter is not mandatory for isolating pulmonary veins during paroxysmal atrial fibrillation ablation with radiofrequency.

Purpose: In this study, we evaluated the feasibility, efficacy, and safety of radiofrequency ablation of paroxysmal atrial fibrillation (AF) with the use of an ablation catheter only (non-CMC group) by retrospectively comparing its procedural success and recurrence rates at 1 year to ablation performed with the help of a circular mapping catheter (CMC group).

Methods: We compared the success and recurrence rates between 226 patients and 251 patients who underwent index ablation with and without the use of CMC, respectively.

Results: Freedom from recurrence was defined as a 1-year absence of AF/atrial tachycardia (AT) episodes > 30 s, beyond the 3-month blanking period.

Late diagnosis of a congenitally corrected transposition of the great arteries discovered at pacemaker implantation in a patient previously diagnosed with dextrocardia and situs solitus.

Congenitally corrected transposition of the great arteries (CCTGA) should not be missed in patients with dextrocardia and situs solitus. We report a case of a 56-year-old man with late diagnosis of CCTGA after ventricular lead replacement. Free LV wall pacing may be favorable in these patients so to prevent deterioration of the systemic RV function.

New insights into the clinical signs of supraventricular tachycardia: The "sign of lace-tying".

Background: Supraventricular tachycardias (SVT) are a common arrhythmia therefore an accurate diagnosis is of clinical importance. Although an ECG performed during tachycardia greatly aids diagnosis, patient history and predisposing factors also improve diagnostic accuracy.

Methods: This prospective study included 100 consecutive patients undergoing electrophysiological study for SVT with the aim to reassess their clinical characteristics and describe frequent predisposing factors, such as the "sign of lace-tying" that to our knowledge has not previously been reported.

Integrity of the Ganglionated Plexi Is Essential to Parasympathetic Innervation of the Atrioventricular Node by the Right Vagus Nerve.

Introduction: Radiofrequency isolation of pulmonary vein can be accompanied by transient sinus bradycardia or atrioventricular nodal (AVN) block, suggesting an influence on vagal cardiac innervation. However, the importance of the atrial fat pads in relation with the vagal innervation of AVN in humans remains largely unknown. The aim of this study was to evaluate the role of ganglionated plexi (GP) in the innervation of the AVN by the right vagus nerve.

Vasovagal syncope initiating ventricular fibrillation in a healthy subject.

A 62-year-old man with cured lymphoma as only significant medical history experienced a first reflex syncope after prolonged orthostatic posture, with cardiac arrest. Prolonged asystole was followed by ventricular fibrillation needing external defibrillation. The defibrillator provided complete recordings.

Predictive value of thromboembolic risk scores before an atrial fibrillation ablation procedure.

Introduction: It is not clear whether transesophageal echocardiography (TEE) should be performed prior to a planned atrial fibrillation (AF) ablation in all patients.

Methods And Results: The objectives of this study were to determine in 681 consecutive patients: (i) the relationship between the CHADS2 and CHA2DS2-VASc scores, the presence of a thrombogenic milieu and left atrial (LA) volume; (ii) the need for TEE in patients with low and intermediate thromboembolic risk assessed; and (iii) the predictive accuracy of the these 2 scores for the presence of thrombi in the LA/LAA (LA appendage) before a planned AF ablation. The prevalence of thrombi was 1%.

Assessment of left atrial shape and volume in structural remodeling secondary to atrial fibrillation.

Purpose: Assessment of volume in relation with left atrial (LA) shape alteration before and after PV isolation.

Methods: We compared trapezoidal modification of LA using echocardiography with the ellipsoid formula (EEL: ) and CT, with both ellipsoid (CTEL: ) and truncated cone formulas (CTTR: ), in 40 patients, before and +/-3 months after AF ablation.

Results: A trapezoidal shape was present in 76.

Variable morphologies of preexcitation due to a concomitant Brugada pattern.

Since the first publication of the Brugada syndrome in 1992 several variants of this ECG pattern have been described. We report a very unusual case of preexcitation with changing electrocardiographic morphologies which appeared to be an association of a variable Brugada pattern with a persistent antegrade preexcitation.