Deep Learning Can Unmask Conduction Tissue Disease From an Ambulatory ECG.

Background: Bradyarrhythmia is a common and potentially serious cause of syncope, often difficult to detect due to its intermittent nature. Traditional ECG monitoring methods either provide low diagnostic accuracy or delay diagnosis, increasing the risk of recurrence. We hypothesized that a deep learning-enabled, 24-hour, single-lead ECG could detect past episodes of bradyarrhythmia.

Near-term prediction of sustained ventricular arrhythmias applying artificial intelligence to single-lead ambulatory electrocardiogram.

Background And Aims: Accurate near-term prediction of life-threatening ventricular arrhythmias would enable pre-emptive actions to prevent sudden cardiac arrest/death. A deep learning-enabled single-lead ambulatory electrocardiogram (ECG) may identify an ECG profile of individuals at imminent risk of sustained ventricular tachycardia (VT).

Methods: This retrospective study included 247 254, 14 day ambulatory ECG recordings from six countries.

Temporal trends in population characteristics and type of device among primary prevention implantable cardioverter defibrillator recipients: The DAI-PP programme.

Background: Patient characteristics, technology and clinical practice surrounding primary prevention implantable cardioverter defibrillators have evolved continuously over time.

Aim: To explore the temporal changes in patient characteristics, pharmacological therapy and device types among implantable cardioverter defibrillator recipients implanted for the primary prevention of sudden cardiac death over the last two decades in France.

Methods: Characteristics of participants and type of device from the retrospective DAI-PP Pilot Study (2002-2012) were compared with those from the ongoing prospective DAI-PP Consortium (2018 onwards).

Comparison of patient radiation exposure in coronary angiography via the trans-radial versus trans-femoral approach.

Background: Cardiac catheterization via the trans-radial approach (TRA) has shown several advantages over the trans-femoral approach (TFA) but with a concern of higher radiation exposure. Considering the growing experience with TRA, this study compares patient's radiation during coronary angiography using TRA versus TFA.

Methods: This study included consecutive patients undergoing coronary angiogram over a year at tertiary hospital performed by experienced operators through radial or femoral access.

Personalized screening before subcutaneous cardioverter-defibrillator implantation: Usefulness and outcomes in clinical practice-the S-ICD screening SIS prospective study.

Background: Electrocardiographic screening before subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation is unsuccessful in around 10% of cases. A personalized screening method, by slightly moving the electrodes, to obtain a better R/T ratio has been described to overcome traditional screening failure.

Objective: The objectives of the SIS study were to assess to what extent a personalized screening method improves eligibility for S-ICD implantation and to evaluate the inappropriate shock rate after such screening success.

Dynamic changes in nocturnal heart rate predict short-term cardiovascular events in patients using the wearable cardioverter-defibrillator: from the WEARIT-France cohort study.

Aims: While elevated resting heart rate measured at a single point of time has been associated with cardiovascular outcomes, utility of continuous monitoring of nocturnal heart rate (NHR) has never been evaluated. We hypothesized that dynamic NHR changes may predict, at short term, impending cardiovascular events in patients equipped with a wearable cardioverter-defibrillator (WCD).

Methods And Results: The WEARIT-France prospective cohort study enrolled heart failure patients with WCD between 2014 and 2018.

Incidence of Cardiac Arrest During Sports Among Women in the European Union.

Background: Women represent a growing proportion of sports participants. Still, few original data regarding sudden cardiac arrest during sports (Sr-SCA) in women are available.

Objectives: The authors sought to assess the incidence, characteristics, and outcomes of women presenting with Sr-SCA.

Ventricular fibrillation in acute myocardial infarction: 20-year trends in the FAST-MI study.

Aims: Sudden cardiac arrest remains a major complication of acute myocardial infarction (AMI) and is frequently related to ventricular fibrillation (VF). Incidence and impact of VF among patients hospitalized for AMI were evaluated.

Methods And Results: Data from the FAST-MI programme consisting of 5 French nationwide prospective cohort studies between 1995 and 2015 were analysed, totally including 14 423 patients with AMI (66 ± 14 years, 72% males, 59% ST-elevation myocardial infarction).

Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators.

Background: Women with congenital heart disease at high risk for sudden cardiac death have been poorly studied thus far.

Objectives: The aim of this study was to assess sex-related differences in patients with tetralogy of Fallot (TOF) and implantable cardioverter-defibrillators (ICDs).

Methods: Data were analyzed from the DAI-T4F (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator) cohort study, which has prospectively enrolled all patients with TOF with ICDs in France since 2010.

Sports-related sudden cardiac arrest in young adults.

Aims: Data on sports-related sudden cardiac arrest (SrSCA) among young adults in the general population are scarce. We aimed to determine the overall SrSCA incidence, characteristics, and outcomes in young adults.

Methods And Results: Prospective cohort study of all cases of SrSCA between 2012 and 2019 in Germany and Paris area, France, involving subjects aged 18-35 years.

Evaluation of an Ambulatory ECG Analysis Platform Using Deep Neural Networks in Routine Clinical Practice.

Background Holter analysis requires significant clinical resources to achieve a high-quality diagnosis. This study sought to assess whether an artificial intelligence (AI)-based Holter analysis platform using deep neural networks is noninferior to a conventional one used in clinical routine in detecting a major rhythm abnormality. Methods and Results A total of 1000 Holter (24-hour) recordings were collected from 3 tertiary hospitals.

Incidence, Characteristics, and Outcomes of Ventricular Fibrillation Complicating Acute Myocardial Infarction in Women Admitted Alive in the Hospital.

Background Little data are available in women presenting with ventricular fibrillation (VF) in the setting of acute myocardial infarction (AMI). We assessed frequency, predictors of VF, and outcomes, with a special focus on women compared with men. Methods and Results Data were analyzed from the FAST-MI (French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction) program, which prospectively included 14 406 patients admitted to French cardiac intensive care units ≤48 hours from AMI onset between 1995 and 2015 (mean age, 66±14 years; 72% men; mean left ventricular ejection fraction, 52±12%; 59% with ST-segment-elevation myocardial infarction).

Characteristics and factors associated to patients discharging from hospital without an implantable cardioverter defibrillator after out-of-hospital cardiac arrest.

Aims: Guidelines recommend that in the absence of reversible cause for sudden cardiac arrest (SCA), implantable cardioverter defibrillator (ICD) should be performed to prevent further fatal event. We sought to describe the frequency and characteristics of patients discharged from the hospital without ICD after the SCA in the daily practice.

Methods And Results: From 2011 to 2018, all SCAs related to a cardiac cause admitted alive across the 48 hospitals of Great Paris Area were prospectively enrolled.

Cardiac implantable electronic device dysfunctions in patients undergoing radiotherapy: A prospective cohort study.

Background: Increasing numbers of patients with cardiac implantable electronic devices (CIEDs) are undergoing radiotherapy (RT) for cancer. The aim of the study was to prospectively evaluate the incidence, characteristics, and associated factors of CIED dysfunctions related to RT.

Methods: Between April 2013 and March 2020, all patients with a CIED who underwent ≥1 RT session were enrolled.

Fighting against sudden cardiac death: need for a paradigm shift-Adding near-term prevention and pre-emptive action to long-term prevention.

More than 40 years after the first implantable cardioverter-defibrillator (ICD) implantation, sudden cardiac death (SCD) still accounts for more than five million deaths worldwide every year. Huge efforts in the field notwithstanding, it is now increasingly evident that the current strategy of long-term prevention based on left ventricular ejection fraction as the key selection criterion is actually of very limited impact, also because the largest absolute numbers of SCD are encountered in the general population not known to be at risk. It has been recently reemphasized that SCD is often not so sudden, with almost half of the victims experiencing typical warning symptoms preceding the event.