On top of routine clinical care, daily short-term rhythm strip recordings identified another 13% of elderly hospitalised patients with AF, leading to an overall prevalence of 46% in hospitalised patients. This can have significant therapeutic implications with respect to initiation of anticoagulation.

Seattle criteria reduced the number of abnormal ECGs in athletes and increased agreement in classification. However, variability in ECG interpretation by cardiologists and sport physicians remains high and is a limitation for ECG-based screening programs.

Post-traumatic common carotid artery–internal jugular vein fistula is extremely rare (4% to 7% of all traumatic arteriovenous fistulas). Clinical manifestations depend on the size, duration, and proximity to the heart. This report describes a case where the condition remained undiagnosed for years, and the patient was recently treated with transsternal ligation of the left common carotid artery. ( Level of Difficulty: Advanced. )

Objective of studyTo evaluate the efficacy of radiofrequency ablation (RFA) of ventricular tachycardia (VT) using non-contact electro-anatomic mapping in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C).MethodsFifteen consecutive patients (44 ± 15 years) with ARVD/C and symptomatic VTs were studied. Eight patients had syncopal VTs. Two patients had recurrent VT while on AICD; in three patients, RFA was done prior to AICD implantation, and ten patients refused AICD. After obtaining activation maps, first, the clinical VT was targeted, and then, other VTs were sought.ResultsTwenty-five inducible VTs were mapped, and 22 of them were successfully ablated. In 13 out of 15 patients, all the clinical and inducible VTs were ablated. In two patients, non-clinical inducible VTs could not be ablated. At 25 ± 16 months (2–52 months), all patients remained asymptomatic. Antiarrhythmic medications were discontinued after 6 months. Two patients had recurrence of non-clinical VT on follow-up. There were no episodes of asymptomatic VT recorded in five patients with AICD.ConclusionA majority of induced VT in patients with ARVD/C can be successfully mapped and ablated using the non-contact Ensite Array Mapping system with good long-term VT-free outcome. Ablation can be a useful adjunct to AICD implantation in such patients.

Purpose. We aimed to study long-term outcome after pulmonary vein isolation (PVI) guided by remote magnetic navigation (RMN) and provided comparative data to outcome after manual navigation (MAN). Methods. Three hundred thirty-six patients with symptomatic paroxysmal AF underwent PVI by irrigated point-by-point radiofrequency (RF) ablation (RMN, n = 114 versus MAN, n = 222). Patients were followed up with symptom guided rhythm monitoring for a period up to 43 months. The end point of the study was freedom from repeat ablation after a single procedure and without antiarrhythmic drug treatment (ADT). Results. At the end of follow-up (median 26.3 months), freedom from repeat ablation was comparable between RMN and MAN (70.9% versus 69.5%, p = 0.61). At repeat, mean number of reconnected veins was 2.4 ± 1.2 in RMN versus 2.6 ± 1.0 in MAN (p = 0.08). The majority of repeat procedures occurred during the first year (82.1% in RMN versus 78.5% in MAN; p = 0.74). Conclusion. On the long term (up to 3 years) and in a large cohort of patients with paroxysmal AF, RMN-guided PVI is as effective as MAN guided PVI. In both strategies the majority of repeat procedures occurred during the first year after index procedure.