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A change in the coronary sinus (CS) activation pattern from an eccentric to a concentric pattern during the ablation of an orthodromic reciprocating tachycardia might falsely suggest the presence of a second (septal) accessory pathway (AP) during tachycardia or the successful ablation of the left lateral AP under ventricular pacing despite persistent and unaffected AP conduction. Complete or partial intra-atrial block should be suspected when an abrupt change in the atrial activation sequence is noted during catheter ablation at the posterolateral and lateral aspects of the mitral annulus. The correct anatomical position of the CS catheter plays a vital role in the differential diagnosis of this situation.

Tachycardia-induced tachycardia, or so-called double tachycardia, appears to be a relatively rare condition. The underlying mechanism for stable beat-to-beat cycle length variability (alternans) in atrial tachycardia has been sparsely reported.

A 58-year-old man with previous inferior myocardial infarction (MI) was referred for cardiac resynchronization therapy pacemaker (CRT-P) for decreased left ventricular ejection fraction (LVEF; 45%) and left bundle branch block (LBBB) (Figure 1). He had New York Heart Association Class I functional classification but palpitation for 3 months. General physical and cardiac examinations were normal. On the admission day, the electrocardiogram showed a narrow QRS rhythm with and without tachycardia (Figures 2 and 3). Would you recommend or consider a CRT-P device or a CRT defibrillator or only an implantable cardioverter defibrillator (ICD) based on these clinical and electrocardiographic findings, or ablation or medical therapy only.

A 78-year-old man suffering from gastric cancer with ischemic cardiomyopathy and recurrent ICD shocks consented to ventricular tachycardia (VT) ablation. He had a previous endocardial VT ablation 1 year ago, and a stereotactic radioablation for his recurrent VT 4 months ago. We planned again left ventricular endocardial mapping for his incessant slow VT suggesting an apical exit site (Figure 1A). However, the activation mapping of LV did not cover the whole VT cycle length, and we decide to map the right ventricular septal side instead of the epicardial access due to the patient's poor frailty. Fortunately, the mid-diastolic potential (MDP) was acquired in an unusual position (Figures 1A and 1B); however, the pericardial location of the mapping catheter was confirmed fluoroscopically (Figures 1C and 1D). An urgent surgical consultation was called for, and operative preparations were initiated. However, since no pericardial tamponade occurred and blood pressure remained stable, we continued the endo-epicardial ablation by ablating the MDP (Video 1).

Objectives Cost-utility modeling informs reimbursement decisions and is based on the premise that health outcome improvements can be expressed as disease-independent utility scores. Previous cost-utility analyses of anti-calcitonin gene-related peptide therapies expressed the utility gain as a function of monthly migraine days (MMDs). Exploring the presence of an additional treatment effect on utility after controlling for MMDs can be insightful. This post hoc analysis of the DELIVER clinical trial (NCT04418765) for the preventive treatment of migraine aims to communicate the impact of eptinezumab on health utility scores. Methods Utility scores were estimated using data from study visits at which the Migraine-Specific Quality of Life Questionnaire (MSQ) was completed. MSQ scores were then mapped to EQ-5D-3L using previously published algorithms. A linear mixed model evaluating the effect of eptinezumab compared to placebo using change from baseline at week 12 and 24, adjusted for MMDs, was generated, and a fixed intercept for each study arm was used to estimate if eptinezumab effected points compared to placebo beyond MMD reduction.

Aim: Diabetic patients have a more severe and widespread coronary atherosclerosis, and their coronary artery diameters(CADs) are widely affected, but this has not been evaluated in prediabetics. This study investigated the effects ofprediabetes on CADs in patients with acute coronary syndrome.Material and Methods: Two hundred and sixty-six patients included in this study were divided into three groups as"normal", "prediabetic" and "diabetic". Patients' CADs were calculated via the quantitative coronary angiography technique.Coronary segments were measured from the designated regions.Results: We found that both prediabetes and diabetes had similar adverse effects on vessels except the proximal RCA,unlike the normal group. We also found that the diameter of the LMCA was the most affected coronary segment, and thediameter of proximal LAD was second segment as affected mostly (p, Amaç: Diyabetik hastalarda daha yaygın ve şiddetli koroner ateroskleroz vardır ve koroner arter çapları (KAÇ) yaygınolarak etkilenir, ancak bu durum prediyabetiklerde değerlendirilmemiştir. Bu çalışma, akut koroner sendromlu hastalardaprediyabetin KAÇ' ları üzerindeki etkilerini araştırdı.Gereç ve Yöntemler: Bu çalışmaya dahil edilen 266 hasta "normal", "prediyabetik" ve "diyabetik" olmak üzere üç gruba ayrıldı.Hastaların KAÇ' ları kantitatif koroner anjiyografi tekniği ile hesaplandı. Koroner segmentler belirlenen bölgelerden ölçüldü.Bulgular: Normal gruptan farklı olarak hem prediyabetin hem de diyabetin proksimal RCA dışında damarlar üzerindebenzer etkileri olduğunu bulduk. Ayrıca LMCA çapının en çok etkilenen koroner segment olduğunu ve proksimal LADçapının en çok etkilenen ikinci segment olduğunu bulduk (her ikisi için p