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PWI is definitely not appropriate for all patients with persistent AF. It has been shown to be effective in some cases (low/fractionated voltage, high burden of spatiotemporal dispersion) but in select trials without replication. Persistent AF is an area ripe for continued investigation w/ #AI and advanced signal/vector analysis. We will almost certainly find that a ‘tailored’ / individualized approach is better than one size fits all.
@VoltaMedical@VektorMedical
PVI is the one area where RCTs have been unable to supercede anecdotes – because operator bias is so powerful.
Only two randomized trials have shown efficacy beyond PVI (CONVERGE and VENUS), yet only a minority have adopted. And multiple PWI studies show no systematic benefit when applied widely, yet the majority continue to do so in persistent patients.
The time is ripe for personalization targeting individual mechanisms, as one size has been proven to not fit all.
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Journal of Cardiovascular Electrophysiology retweeted
PVI is the one area where RCTs have been unable to supercede anecdotes – because operator bias is so powerful.
Only two randomized trials have shown efficacy beyond PVI (CONVERGE and VENUS), yet only a minority have adopted. And multiple PWI studies show no systematic benefit when applied widely, yet the majority continue to do so in persistent patients.
The time is ripe for personalization targeting individual mechanisms, as one size has been proven to not fit all.
🚀New on @JCardioEP
🎓"Adverse Effect of Ventricular Rate Regularization Pacing in Biventricular Cardiac Resynchronization Therapy" by Chu-Pak Lau et al
onlinelibrary.wiley.com/doi/…
A 72 y.o. man with a CRT-D developed acute HF due to biventricular pacing tachycardia > 100/min. Frequent ventricular ectopics activated ventricular rate stabilisation for rate smoothing which paradoxically worsened heart failure.
#Epeeps
With cannabis use on the rise, what are the cardiac risks? This large multicenter study reveals cannabis users face higher rates of atrial & ventricular arrhythmias compared to matched controls.
#Epeeps
🚀 New in @JCardioEP
🎓 "Right Ventricular Septal Pacing-Derived V6 R-Wave Peak Time Predicts Successful Left Bundle Branch Area Pacing in Patients With Heart Failure and Left Bundle Branch Block" by Mengxing Cai et al
onlinelibrary.wiley.com/doi/…
V6 R-wave peak time during right ventricular septal pacing predicts successful LBBAP implantation in heart failure patients with LBBB. This simple ECG marker correlates with scar burden and guides intra-operative CRT strategy.
#LBBAP#CRT#EPeeps
🚀Check out in the @JCardioEP
🎓 "Long-Term Outcome of Radiofrequency Versus Pulsed-Field Ablation in Atrial Fibrillation Patients Aged More Than 60 Years Undergoing Their First Catheter Ablation" by @PamelaH33 et al
@natale_md
📷 onlinelibrary.wiley.com/doi/…
Findings from this single-center analysis show that PFA is beneficial in AF patients regardless of their age by being associated with either significantly higher arrhythmia-free survival or longer time to recurrence compared to similar age-group patients undergoing thermal CA
📜 Sudden Death in the Young A nationwide prospective epidemiological study of sudden death in young people aged 1-35 years in the Mediterranean island of Cyprus
🔗 pubmed.ncbi.nlm.nih.gov/4076…
✒️@LoizosA@DrAntoniadesC
✅In Cyprus, sudden death affects 1 in 46,000 people aged 1–35 years annually, mostly due to cardiomyopathies. >25% occur during sports. This 11-year national epidemiological study provides key data on sudden deaths, highlighting the need for early screening and genetic testing.