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Too fast, too furious

Heart BMJ

Clinical introduction A woman in her 30s, a case of rheumatic mitral stenosis status post balloon mitral valvuloplasty 15 years prior, presented to urgent care with palpitations and dyspnoea for 1 week. Echocardiography demonstrated severe calcific mitral stenosis with pulmonary hypertension.

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Long-term risk of right coronary artery injury after catheter ablation of cavotricuspid isthmus–dependent flutter

HeartRhythm

Radiofrequency ablation (RFA) of cavotricuspid isthmus (CTI)dependent atrial flutter requires ablation of the tricuspid annulus overlying the right coronary artery (RCA). Although it is considered safe, reports of acute and subacute RCA injury in human and animal studies raise the possibility of late RCA stenosis.

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Boston Scientific Receives FDA Approval for FARAPULSE Pulsed Field Ablation System

DAIC

Additional real-world data from more than 17,000 patients in the MANIFEST-17K registry demonstrated continued real-world safety of the system, with no reports of permanent phrenic nerve palsy, pulmonary vein stenosis or esophageal injury. director of electrophysiology, Mount Sinai Fuster Heart Hospital , New York.

Ablation 111
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Atrial dilatation in Atrial fibrillation : A query with multiple twists!

Dr. S. Venkatesan MD

The atrial muscle can be entirely normal, or the interstitium can be infiltrated with lipids, fibroblasts, amyloid, etc. We know atrial flutters can be confined to one atrium. Pierre Jaïs Circulation 2000 ) When such flutters transform into fibrillation, how does the spillover of signals occur to the contralateral atrium?

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A man in his 70s with acute chest pain and paced rhythm.

Dr. Smith's ECG Blog

LAFB, atrial flutter, anterolateral STEMI(+) OMI. So the patient was taken for emergent cath, showing: Culprit artery: LAD (100% stenosis, TIMI 0) requiring thrombectomy and stent. South African flag pattern, plus precordial swirl pattern. Queen of Hearts interpretation: Now the cardiologist considered it "STEMI"!

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Multielectrode Radiofrequency Balloon Catheter for Paroxysmal Atrial Fibrillation: Results From the Global, Multicenter, STELLAR Study

Journal of Cardiovascular Electrophysiology

Methods The primary effectiveness endpoint (PEE) was 12-month freedom from documented atrial fibrillation/atrial flutter/atrial tachycardia plus freedom from acute procedural failure, nonstudy catheter failure, repeat ablation failure, direct current cardioversion (DCCV), and Class I/III antiarrhythmic drug (AAD) failure.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. heart auscultation (aortic stenosis); c. Of the 67 patients who underwent targeted tests, suspected diagnoses were confirmed in 49 (73%) patients: aortic stenosis (n = 8, 1%), pulmonary embolism (n = 8, 1%), seizures/stroke (n = 30, 5%), and other diseases (n = 3).