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Background: Previous studies have reported the presence of subtle abnormalities in the right ventricular outflow tract (RVOT) in patients with apparently normal hearts and ventricular arrhythmias (VAs) from the RVOT, including the presence of low voltage areas (LVAs). This LVAs seem to be associated with the presence of ST‐segment elevation in V1 or V2 leads at the level of the 2nd intercostal space (ICS). Objective: Our aim was to validate an electrocardiographic marker of LVAs in the RVOT in patients with idiopathic outflow tract VAs. Methods: A total of 120 patients were studied, 84 patients referred for ablation of idiopathic VAs with an inferior axis by the same operator, and a control group of 36 patients without VAs. Structural heart disease including arrhythmogenic right ventricular cardiomyopathy was ruled out in all patients. An electrocardiogram was performed with V1–V2 at the 2nd ICS, and ST‐segment elevation ≥1 mm and T‐wave inversion beyond V1 were assessed. Bipolar voltage map of the RVOT was performed in sinus rhythm (0.5–1.5 mV color display). Areas with electrograms <1.5 mV were considered LVAs, and their presence was assessed. We compared three groups, VAs from the RVOT (n = 66), VAs from the LVOT (n = 18) and Control group (n = 36). ST‐elevation, T‐wave inversion and left versus right side of the VAs were tested as predictors of LVAs, respective odds ratio (ORs) (95% confidence interval [CI]) and p values, were calculated with univariate logist regression. Variables with a p <.005 were included in the multivariate analysis. Results: ST‐segment elevation, T‐wave inversion and LVAs were present in the RVOT group, LVOT group and Control group as follows: (62%, 17%, and 6%, p <.0001), (33%, 29%, and 0%, p =.001) and (62%, 25%, and 14%, p <.0001). The ST‐segment elevation, T‐wave inversion and right‐sided VAs were all predictors of LVAs, respective unadjusted ORs (95% CI), p values were, 32.31 (11.33–92.13), p <.0001, 4.137 (1.615–10.60), p =.003 and 8.200 (3.309–20.32), p <.0001. After adjustment, the only independent predictor of LVAs was the ST‐segment elevation, with an adjusted OR (95% CI) of 20.94 (6.787–64.61), p <.0001. Conclusion: LVAs were frequently present in patients with idiopathic VAs. ST‐segment elevation was the only independent predictor of their presence. [ABSTRACT FROM AUTHOR]

Background: Silent atrial fibrillation is a frequent etiology of cryptogenic stroke. Spontaneous conversion of atrial fibrillation to sinus rhythm results in atrial stunning. Objective: To evaluate if the presence of a lower left atrial appendage peak emptying velocity (LAAV) after a cryptogenic stroke is associated with the occurrence of atrial fibrillation (AF). Methods: We retrospectively selected consecutive patients with an acute ischemic stroke that had a transoesophageal echocardiogram (TEE) performed in the first 30 days of the acute event. Documented AF or potential cardioembolic sources in the TEE were considered exclusion criteria. We assessed the LAAV. During follow‐up, we evaluated the occurrence of new‐onset AF and the combined endpoint of death or new ischemic stroke. Results: We studied 73 consecutive patients, during a mean follow‐up period of 54.9 ± 19.3 months. Seven developed AF, and 13 had the combined endpoint. LAAV was independently associated with AF occurrence (HR: 0.93, 95% CI: 0.88–0.99; P = .016). Patients with a LAAV ≤ 46.5 cm/s (AUC: 0.766, 95% CI: 0.579–0.954; P = .021) had a lower survival rate free from AF occurrence (Log‐rank, P < .001) and free from the combined endpoint of death or ischemic stroke (Log‐rank, P = .010). Conclusion: A lower LAAV was associated with AF occurrence and the combined endpoint of death or ischemic stroke after an initial episode of cryptogenic stroke. Patients with this finding could eventually benefit from long‐term cardiac rhythm monitoring. [ABSTRACT FROM AUTHOR]