Ventricular Tachycardia Predicts All-Cause Mortality and Nonsudden Cardiac Death in Nonischemic Cardiomyopathy.

Background: Patients with nonischemic cardiomyopathies (NICMs) are at a risk for end-stage heart failure and death from ventricular arrhythmias. Implanted defibrillators (ICDs) protect against sudden arrhythmic death, but several studies suggest that ventricular arrhythmias are associated with worse outcomes despite ICDs.

Objectives: This study evaluated the relationship of ventricular tachycardia (VT) with total mortality and nonsudden cardiovascular death (NSCVD) in NICM patients with ICDs enrolled in 2 multicentre trials.

Isolated Nonischemic Left Bundle Branch Block Resulting in Heart Failure in Hodgkin Lymphoma Survivors Post-Radiation.

Background: Relatively little is known about the clinical features of left bundle branch block (LBBB) in patients previously treated with chest radiation therapy (RT).

Case Summary: Six long-term Hodgkin lymphoma survivors developed isolated, nonischemic LBBB decades after chest RT. None had prior conduction issues or coronary artery disease on evaluation.

Diagnoses and outcomes of patients referred for FDG PET/CT for suspected cardiac sarcoidosis.

Background: Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging is commonly used to facilitate diagnosis in suspected cardiac sarcoidosis (CS). However, there is a gap in evidence regarding the diagnoses and outcomes of patients who undergo FDG PET/CT.

Objectives: Evaluate the diagnoses and outcomes of patients referred for FDG PET/CT imaging for suspected CS.

Presence of Mid-Myocardial Fibrosis in Ventricular Endocardial Electrograms is Related to Power of Patient-Specific Frequency Bands.

Ventricular tachycardia (VT) is an important cause of morbidity and mortality in patients with structural heart disease. During catheter ablation procedures to control VT, electrograms (EGMs) are acquired from the endocardial surface of the heart. Standard-of-care EGM amplitudes can fail to identify important fibrotic substrate responsible for VT.

Assessment of Intraprocedural Automated Arrhythmia Origin Localization System for Localizing Pacing Sites in 3D Space.

Background: The Automated Arrhythmia Origin Localization (AAOL) algorithm was developed for real-time prediction of early ventricular activation origins on a patient-specific electroanatomic (EAM) surface using a 3-lead electrocardiogram (AAOL-Surface). It has not been evaluated in 3-dimensional (3D) space (AAOL-3D), however, which may be important for predicting the arrhythmia origin from intramural or intracavity sites.

Objectives: This study sought to assess the accuracy of AAOL for localizing earliest ventricular activation in 3D space.

Intrapericardial Corticosteroids and Colchicine Prevent Pericarditis and Atrial Fibrillation After Epicardial Ablation of Ventricular Arrhythmias.

Background: Postprocedural pericarditis (PP) can occur in up to 29.4% of patients undergoing epicardial catheter ablation of ventricular tachycardia (VT). Despite several proposed strategies to mitigate this adverse outcome, rates of PP and pericarditic pain remain high.

Recurrent monomorphic ventricular tachycardia in a patient with myocarditis-Importance of understanding and targeting midmyocardial anatomic substrate.

Introduction: Patients with viral myocarditis can present with challenging life-threatening arrhythmias. Catheter ablation can be a life-saving procedure in some patients with recurrent drug-refractory ventricular arrhythmias.

Methods And Results: A patient with three prior ablations targeting two different monomorphic ventricular tachycardias (MMVTs) presented with recurrent ventricular tachycardia (VT).

Septal late enhancement by cardiac CT is associated with repeat ablation in nonischemic cardiomyopathy patients.

Introduction: Scar substrate in nonischemic cardiomyopathy (NICM) patients is often difficult to identify. Advances in cardiac imaging, especially using late iodine-enhanced computed tomography (LIE-CT), allow better characterization of scars giving rise to ventricular tachycardia (VT). Currently, there are limited data on clinical correlates of CT-derived scar substrates in NICM.

Feasibility, Efficacy, and Safety of Fluoroless Ablation of VT in Patients With Structural Heart Disease.

Background: Catheter ablation of ventricular tachycardia (VT) typically requires radiation exposure with its potential adverse health effects. A completely fluoroless ablation approach is achievable using a combination of electroanatomical mapping and intracardiac echocardiography. Nonetheless, data in patients undergoing VT ablation are limited.

Improved all-cause mortality with left bundle branch area pacing compared to biventricular pacing in cardiac resynchronization therapy: a meta-analysis.

Background: Left bundle branch area pacing (LBBAP) has emerged as a physiological alternative pacing strategy to biventricular pacing (BIVP) in cardiac resynchronization therapy (CRT). We aimed to assess the impact of LBBAP vs. BIVP on all-cause mortality and heart failure (HF)-related hospitalization in patients undergoing CRT.

Intramural needle ablation or repeated standard ablation in patients referred for repeat ablation of scar-related ventricular tachycardia.

Introduction: When ventricular tachycardia (VT) recurs after standard RF ablation (sRFA) some patients benefit from repeat sRFA, whereas others warrant advanced methods such as intramural needle ablation (INA). Our objectives are to assess the utility of repeat sRFA and to clarify the benefit of INA when repeat sRFA fails in patients with VT due to structural heart disease.

Methods: In consecutive patients who were prospectively enrolled in a study for INA for recurrent sustained monomorphic VT despite sRFA, repeat sRFA was considered first.

Safety and Efficacy of Ultrasound-Guided Sympathetic Blockade by Proximal Intercostal Block in Electrical Storm Patients.

Background: Electrical storm (ES) patients who fail standard therapies have a high mortality rate. Previous studies report effective management of ES with bedside, ultrasound-guided percutaneous stellate ganglion block (SGB). We report our experience with sympathetic blockade administered via a novel alternative approach: proximal intercostal block (PICB).