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3 years ago
Brugada syndrome (BrS) is a cardiac disease caused by an inherited ion channelopathy. It was first described by the Brugada brothers in 19921 and is associated with a propensity to develop ventricular fibrillation (VF). Brugada syndrome is characterised by prominent J waves appearing as an ST segment elevation in the right precordial leads. In the latest guidelines, diagnosis of BrS constitutes…
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3 years ago
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia observed in clinical practice, occurring in approximately 2 % of the general population.1–3 A progressive increase in both the prevalence and incidence of AF has been demonstrated in recent years, defining AF as a major economic and public health issue.1
The identification of sites of AF initiation and/or maintenance within…
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3 years ago
AF is the most common sustained arrhythmia, and carries an increased risk of cardiovascular and cerebrovascular complications. The latest estimates on the prevalence of AF portray an alarming scenario, with a steep increase in the number of people developing AF and prediction that the number affected will more than double in the next 40 years.1 Among the strategies to restore and maintain sinus…
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3 years ago
The best clinical approach to managing asymptomatic patients with ventricular pre-excitation has yet to be established. The clinical benefit of identifying and treating asymptomatic patients at risk of sudden cardiac death (SCD) has been debated since catheter ablation became effective and safe for the treatment of accessory pathways (APs). Data supporting current recommendations are mostly…
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3 years ago
Catheter ablation (CA) is a widely used first-line treatment for AF. Randomised controlled trials (RCTs) have shown its superiority to pharmacological treatment in terms of symptom control, rhythm control and mortality in selected patients; observational studies have also suggested a decreased risk of stroke.1,2 Pulmonary vein isolation (PVI) is the standard endpoint, but studies have reported…
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3 years ago
Early repolarisation (ER) is defined as J-point elevation of ≥0.1 mV in two adjacent leads with either a slurred or notched morphology (Figures 1 to 4).1,2 Numerous studies have established an association with ER and increased risk of death and idiopathic ventricular fibrillation (VF).1–5 Clinicians face questions such as patient and family counselling, quantitifying the risk of sudden cardiac…
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3 years ago
Atrial fibrillation (AF) is the most prevalent arrhythmia in the world and a leading cause of hospitalisation and death.1 Current therapy for AF remains suboptimal, in large part because its mechanisms are uncertain. However, recent advances in our understanding of human AF, from meticulous mapping in patients and insights from animal models, are providing new therapeutic options for patients.
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3 years ago
Ventricular arrhythmias are designated idiopathic when demonstrable structural heart disease, significant coronary disease including coronary spasm or genetic arrhythmia syndromes are absent.1 These arrhythmias may be benign but are also a recognised cause of sudden cardiac death. The common form of idiopathic ventricular tachycardia (VT) originates in the ventricular outflow tracts, manifest…
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3 years ago
Although the exact circuit of atrioventricular nodal re-entrant tachycardia (AVNRT) still eludes us, AVNRT is the most common regular arrhythmia in humans, and therefore the most commonly encountered during ablation attempts for regular tachycardias.1–4 Catheter ablation for AVNRT is the current treatment of choice in symptomatic patients. It reduces arrhythmia-related hospitalisations and costs,…
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3 years ago
An estimated 180,000–300,000 sudden cardiac deaths (SCD) occur in the US annually.1,2 Worldwide, sudden and unexpected cardiac death is the most common cause of death,2 accounting for 17 million deaths every year with SCD accounting for 25% of these. The accepted definition of SCD is death that occurs within one hour of onset of symptoms in witnessed cases, and within 24 hours of last being seen…
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