Background Catheter radiofrequency ablation for typical atrial flutter is considered to be safe and effective. However, atrial fibrillation (AF) following cavotricuspid isthmus ablation for atrial flutter has been reported in patients without a previous history of AF, which has implications for the decision to use oral anticoagulation. This retrospective study at a single center aimed to evaluate the occurrence of AF in patients after successful cavotricuspid isthmus ablation of typical atrial flutter and to determine the incidence and associations with AF during follow-up. Material/Methods Between January 2011 and July 2017, of 110 consecutive patients who underwent cavotricuspid isthmus ablation for typical atrial flutter, 67 patients had no previous history of AF, of which 40 patients underwent follow-up. The 40 patients included in this retrospective clinical study included 34 men and 6 women, with a mean age of 67±10 years. Results Forty patients underwent post-ablation follow-up for 46±23 months, and 12 patients (30%) developed AF; six patients (15%) experienced recurrent of atrial flutter. More than half of the patients with post-ablation AF were asymptomatic with a European Heart Rhythm Association (EHRA) score of 1, and univariate analysis showed the absence of variables associated with the prevalence of AF. Conclusions Following cavotricuspid isthmus ablation for atrial flutter, recurrence of atrial flutter was found in 15% of cases, and asymptomatic AF occurred in 30%. These findings have implications for the use of post-ablation oral anticoagulation treatment, which is often discontinued following ablation therapy and before patient follow-up.

The patient's laboratory findings were as follows: neutrophil -to -lymphocyte ratio higher than 3 (reference range, 1-3), elevated levels of high -sensitivity cardiac troponin T, from 72 ng/l to 102 ng/l (reference range <14 ng/l), dynamically evolving C -reactive protein levels, from 1.2 mg/l to 1.8 mg/l and 94 mg/l (reference range <6 mg/l), elevated levels of N -terminal fragment of the prohormone brain natriuretic peptide, 2451 ng/l (reference range <125 ng/l), lactic acid dehydrogenase, 369 U/l (reference range, 80-240 U/l), D -dimers, 1.39 mg/l (reference range <0.5 mg/l), aspartate aminotransferase, 159 U/l (reference range <45 U/l), alanine aminotransferase, 163 U/l (reference range <35 U/l), but procalcitonin levels (reference range <0.05 ng/ml) were normal. Due to suggestive laboratory results, particularly in the light of the COVID -19 outbreak, 2,4 a reverse transcription-polymerase chain reaction test for SARS -CoV -2 was performed on the sixth day of hospitalization and yielded a positive result. Consequently, the patient received a single 500 -mg dose of azithromycin and a single 75--mg dose of oseltamivir. On day 7, he was transferred in good general condition to a COVID--19 -specialized hospital for further treatment. On day 17, the patient's pharyngeal swab specimen was still positive for SARS -CoV -2 after the reverse transcription-polymerase chain reaction test, and the man presented no respiratory symptoms.Cardiac magnetic resonance imaging, performed with a 1.5 Tesla scanner, revealed left atrial enlargement and global left ventricular hypokinesia with ejection fraction of 20%. The T2 -weighted sequence did not show myocardial edema (Figure 1A -1C). In contrast, imaging with the use of late gadolinium enhancementThe emerging outbreak of coronavirus disease 2019 (COVID -19) was declared a pandemic by the World Health Organization on March 11, 2020. 1 So far, there have been scarce data concerning cardiovascular involvement due to COVID -19. 2 Even though respiratory tract signs mostly characterize the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS -CoV -2) infection, cardiac complications, such as myocarditis, may also occur alone. 3 In this article, we present a patient whose clinical presentation raised our suspicion for underlying myocarditis.A 74 -year -old man with a recent history of normal left ventricular ejection fraction of 55% was admitted to the hospital due to hemodynamically unstable new -onset ventricular tachycardia (VT) lasting 12 hours (Supplementary material, Figure S1A and S1B). After unsuccessful self -administration of metoprolol, 200 mg orally, arrhythmia was managed with electrical cardioversion. Subsequently, symptomatic bradycardia and hypotension were observed. The patient did not present with fever or any symptoms of respiratory infection.The patient had a history of atrial fibrillation, catheter ablation performed 3 times, arterial hypertension, type 2 diabetes, and hypothyroidism. As a medical professional, the patient might have been ex...

Atrial fibrillation is the most commonly reported arrhythmia and, if undiagnosed or untreated, may lead to thromboembolic events. It is therefore desirable to provide screening to patients in order to detect atrial arrhythmias. Specific mobile apps and accessory devices, such as smartphones and smartwatches, may play a significant role in monitoring heart rhythm in populations at high risk of arrhythmia. These apps are becoming increasingly common among patients and professionals as a part of mobile health. The rapid development of mobile health solutions may revolutionize approaches to arrhythmia screening. In this viewpoint paper, we assess the availability of smartphone and smartwatch apps and evaluate their efficacy for monitoring heart rhythm and arrhythmia detection. The findings obtained so far suggest they are on the right track to improving the efficacy of early detection of atrial fibrillation, thus lowering the risk of stroke and reducing the economic burden placed on public health.

Background: Cardiac resynchronization therapy (CRT) is a valuable intracardiac device-based treatment option for a subgroup of patients with advanced heart failure (HF) and QRS prolongation. However, still a significant proportion of patients do not benefit from CRT implantation, labeled as non-responders. Objectives: The aim of the present study was to evaluate the N-terminal prohormone of brain natriuretic peptide (NT-pro BNP) and high sensitivity troponin T (cTnThs) value as predictors of CRT response in a 12-month observation. Materials and Methods: The study included 46 patients with HF and implanted CRT-D. Levels of NT-pro BNP and cTnThs were assessed during a 12 month follow up. Results: 46 consecutive patients (76% men) with a mean age of 64±8 were observed for 12 months. The CRT response criteria was met by 26 patients (56,5%). A significant decline in the NT-pro BNP concentrations was documented in responders (p=0.001). Moreover, ΔNT-pro BNP by at least 579 pg/ml had high sensitivity and specificity for identifying the CRT responders. There were no statistically significant differences in the results of cTnThs between the two study groups. Conclusion: The relative change in the level of NT-pro BNP by at least 43,5% allows to identify the responders to CRT after 12 months of follow-up. Serial measurements of NT-pro BNP can be a valuable tool for monitoring the effectiveness of CRT.

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