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Background: The purpose of this meta‐analysis was to evaluate the impact of image integration technique on clinical and procedural outcomes in patients undergoing radiofrequency catheter ablation of atrial fibrillation with a three‐dimensional electroanatomic mapping system. Methods: Randomized controlled trials were identified through a systematic literature search of PubMed and CENTRAL databases from inception to April 2020. The primary outcome was arrhythmia recurrence during the follow‐up period. The secondary outcomes were the difference in total procedural time and fluoroscopy time. Results: Four studies with a total of 749 patients were included. The pooled result showed no statistically significant difference between the groups with respect to arrhythmia recurrence (RR, 0.75; 95% CI, 0.47‐1.21), fluoroscopy time (MD, −6 minutes; 95% CI, −23.4 to 11.3), and total procedural time (MD, 1.1 minutes; 95% CI, −31.8 to 34.1). Conclusion: Image integration to guide radiofrequency catheter ablation for patients with atrial fibrillation does not improve clinical and procedural outcomes. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI) with a reported incidence of 7-18%. Recently, P-wave signal-averaged electrocardiogram (P-SAECG) has been used to assess the risk of paroxysmal AF attacks in some diseases. The aim of this study was to determine prospectively whether patients with AMI at risk for paroxysmal AF would be identified by P-SAECG and other clinical variables.Methods: A total of 100 patients (mean age: 59+/-12, 77 male, 23 female) with ST segment elevation AMI were enrolled in this study. Patients with chronic AF were excluded. At entry, all patients underwent standard 12-lead ECG and in the first 24 hours, P-SAECG was taken, and echocardiography and coronary angiography were performed on the patients. Patients are followed for a month in terms of paroxysmal AF attacks and mortality.Results: AF was determined in 19 patients (19%). In patients with AF, abnormal P-SAECG more frequently occurred than in patients without AF (37% vs 15%, P<0.05). Patients with AF were older (70+/-14 vs 56+/-10, P<0.001) and had lower left ventricular ejection fraction (42%+/-8 vs 49%+/-11, P<0.05). AF was less common in thrombolysis-treated patients (47% vs 74%, P<0.05). Thirty-day mortality was higher in patients with AF (16% vs 2%, P=0.05).Conclusions: An abnormal P-SAECG may be a predictor of paroxysmal AF in patients with AMI. Advanced age and systolic heart failure were detected as two important clinical risk factors for the development of AF. [ABSTRACT FROM AUTHOR]

The precise pathogenetic mechanism(s) of rheumatic fever and rheumatic heart disease have never been defined. C-reactive protein (CRP) is increased in patients with acute rheumatic fever, but it is not known whether plasma levels increase in patients with chronic rheumatic valve disease. The aim of this study was to determine the role of inflammation detected by high sensitivity CRP (hs-CRP) levels in the progression of chronic rheumatic valve disease. A total of 113 patients with chronic rheumatic valve disease (81 women, 32 men; mean age 40±14 years, range 13–70), 51 patients with prosthetic valve(s) (31 women, 20 men; mean age 48±13 years, range 21–71) and 102 healthy subjects (68 women, 34 men, mean age 41±12 years, range 25–73), as a control group, were assessed. Patients with acute rheumatic fever, acute infection, inflammatory disease, malignancy, acute myocardial infarction and trauma were excluded. hs-CRP was determined using latex-enhanced immunonephelometric assays on a BN II analyzer (Behring). Transthoracic echocardiography was performed in all patients in order to evaluate valvular disease. Levels of hs-CRP were significantly higher in patients with chronic rheumatic heart disease than in patients with prosthetic valve(s) and healthy subjects (0.62±0.64 vs. 0.35±0.41 vs. 0.24±0.18 mg/l, P<0.01 and P<0.001 respectively). No correlation was observed between CRP and age, sex or functional capacity. We found that hs-CRP is increased in chronic rheumatic heart disease; this may indicate that inflammatory response still persists in the chronic phase. [Copyright &y& Elsevier]

Presented here is a 39-year-old male patient with no structural heart disease but a ventricular tachycardia with right bundle branch block morphology and right axis deviation, which is responsive to adenosine. The ventricular tachycardia was initiated by ventricular pacing, shown to originate from the mid-anterior free wall region of the left ventricle and terminated by adenosine. Radiofrequency current application at a site where presumed P potentials were recorded eliminated the tachycardia, a finding that suggests that the origin of the tachycardia may be closely related to the anterior fascicle. [ABSTRACT FROM AUTHOR]