Geographic and clinical patterns of left atrial appendage occlusion utilization across the United States.

Background: Left Atrial Appendage Occlusion (LAAO) has become a more common procedure designed to reduce stroke risk in patients who are intolerant of systemic anticoagulation. The speed of adoption and broader application to patients outside of the narrow trial patients motivates an assessment to understand whether specific operator characteristics affect procedural volume.

Methods: Using US CMS and Open Payments datasets, we explored LAAO procedural volumes, including temporal and geographical trends.

Fat, fib, and forgetfulness: The interplay between adiposity, atrial fibrillation, and dementia.

Atrial Fibrillation, dementia, and obesity are prevalent and interconnected pathologic states with significant morbidity and mortality and increasing global incidence. This review examines the current literature regarding the known and hypothesized relationships between these three conditions, their risk factors, and treatment strategies. We aim to highlight a stepwise and potentially causative interplay between them.

Leveraging a randomized trial to assess relationships between transeptal puncture, brain emboli, and migraine symptoms.

Background: Catheter ablation procedures with transseptal punctures (usually for atrial fibrillation) are often associated with migraine-related visual auras, but the mechanism remains unknown. Whether this phenomenon is mediated by the creation of an atrial septal defect from transseptal puncture or by silent acute brain emboli detected on magnetic resonance imaging related to the procedure remains to be investigated.

Objective: This study aimed to evaluate whether randomization to a transseptal puncture during catheter ablation for ventricular arrhythmias is associated with postprocedural visual auras and assess the relationship between occipital and parietal lobes acute brain emboli and migraine-related visual auras.

Radiation induces diffuse extracellular remodeling of healthy myocardium in a dose- and time-dependent manner without a dense ablative effect.

Background: Although early studies of cardiac stereotactic body radiotherapy (cSBRT) show promise as a therapy to treat drug-refractory ventricular tachycardia, there remain knowledge gaps in its application, including the ideal doses to apply, which radiation source to use, which substrates to target, and the structural and electrophysiological effects seen after cSBRT.

Objective: Here, we examine doses up to 50 Gy to assess lesion formation by longitudinally following healthy myocardium after photon radiation using cardiac magnetic resonance (CMR) imaging and correlating those findings with histologic analysis.

Methods: Eight healthy canines underwent stereotactic photon beam cSBRT targeting healthy cardiac tissue.