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Effects of fibroblast-myocyte coupling on cardiac conduction and vulnerability to reentry: A computational study. (33/71)

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Dose-dense adjuvant Doxorubicin and cyclophosphamide is not associated with frequent short-term changes in left ventricular ejection fraction. (34/71)

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Prospective evaluation of diagnostic work-up in syncope patients: results of the PL-US registry. (35/71)

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An "aggressive" protocol of programmed ventricular stimulation for selecting post-myocardial infarction patients with a low ejection fraction who may not require implantation of an automatic defibrillator. (36/71)

BACKGROUND: The predictive value of electrophysiologic studies depends on the aggressiveness of the programmed ventricular stimulation protocol. OBJECTIVES: To assess if non-inducibility with an "aggressive" protocol of PVS identifies post-infarction patients with low ejection fraction (EF < or = 30%) who may safely be treated without implantable cardioverter defibrillator. METHODS: We studied 154 patients during a 9 year period. Our aggressive PVS protocol included: a) stimulus current five times the diastolic threshold (< or = 3 mA) and b) repetition of double and triple extrastimulation at the shortest coupling intervals that capture the ventricle. RESULTS: Sustained ventricular tachyarrhythmias were induced in 116 patients (75.4%) and 112 (97%) of them received an ICD (EPS+/ICD+ group). Of the 38 non-inducible patients, 34 (89.5%) did not receive an ICD (EPS-/ICD-group). In comparison to the EPS+/ICD+ group, EPS-/ICD-group patients were older (69 +/- 10 vs. 65 +/- 10 years, P < 0.05), had a lower EF (23 +/- 5% vs. 25 +/- 5%, P < 0.05) and a higher prevalence of left bundle branch block (45.5% vs. 20.2%, P < 0.005). Follow-up was longer for EPS+/ICD+ patients (40 +/- 26 months) than for EPS-/ICD- patients (27 +/- 22 months) (P = 0.011). Twelve EPS+/ICD+ patients (10.7%) and 5 EPS-/ICD-patients (14.7%) died during follow-up (P = 0.525). Kaplan-Meier survival curves did not show a significant difference between the two groups (P = 0.18). CONCLUSIONS: The mortality rate in patients without inducible VTAs using an aggressive PVS protocol and who did not undergo subsequent ICD implantation is not different from that of patients with inducible arrhythmias who received an ICD. Using this protocol, as many as one-fourth of primary prevention ICD implants could be spared without compromising patient prognosis.  (+info)

A novel near-infrared voltage-sensitive dye reveals the action potential wavefront orientation at increased depths of cardiac tissue. (37/71)

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Genetic fate mapping demonstrates contribution of epicardium-derived cells to the annulus fibrosis of the mammalian heart. (38/71)

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Impact of genetic discoveries on the classification of lone atrial fibrillation. (39/71)

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A conformal, bio-interfaced class of silicon electronics for mapping cardiac electrophysiology. (40/71)

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