CES Abstracts 2021
B-AB02-02 OUTCOMES OF CORONARY SINUS TEAR DURING EXTRACTION OF ACTIVE FIXATION CORONARY SINUS LEADS
Active fixation coronary sinus (CS) leads provide additional support within the CS via deployable lobes or a side helix. However, adherence to the CS may lead to higher risk of extraction and CS tear during extraction. There is limited data on outcomes of CS tear during active fixation lead extraction.B-AB13-01 TRANS-ANCESTRY GWAS OF 252,730 INDIVIDUALS IDENTIFIES 114 NOVEL LOCI ASSOCIATED WITH THE QT INTERVAL
The QT interval, a marker of ventricular repolarization, is a heritable, independent predictor of risk for ventricular arrhythmias and sudden cardiac death (SCD). Previous genome-wide association studies (GWAS) of the QT interval have highlighted pathways regulating cardiac ion channels, calcium signaling and myocyte internal structure. However, a large proportion of the heritability remains unexplained, suggesting additional mechanisms remain undiscovered.B-AB14-02 INTERMEDIATE TERM PERFORMANCE AND SAFETY OF LEFT BUNDLE BRANCH AREA CONDUCTION SYSTEM PACING LEADS: A MULTICENTER PROSPECTIVE STUDY
Left bundle branch area pacing (LBBAP) has shown to be a reliable alternative to His bundle pacing (HBP) for physiologic pacing. There are limited data on the intermediate term performance of LBBAP leads.B-PO05-210 PREMATURE ATRIAL DEPOLARIZATION WITH ABERRANT CONDUCTION TRIGGERING VENTRICULAR FIBRILLATION
Premature atrial contractions are common and usually benign. However, they are rarely documented to trigger ventricular fibrillation (VF).B-YIA2-01 MECHANO-ARRHYTHMOGENICITY IS ENHANCED IN LATE REPOLARISATION DURING ISCHEMIA AND DRIVEN BY A TRPA1-, CALCIUM-, AND REACTIVE OXYGEN SPECIES-DEPENDENT MECHANISM
Cardiac dyskinesis during ischemia results in arrhythmias via mechanically-induced changes in electrophysiology (‘mechano-arrhythmogenicity’). While cellular mechanisms of mechano-arrhythmogenicity are unknown, ischemic alterations in voltage-Ca2+ dynamics may create a vulnerable period (VP) for mechano-arrhythmogenicity during late repolarisation.B-YIA2-03 A GOVERNING EQUATION TO EXPLAIN THE NUMBER OF WAVELETS AND ROTORS OBSERVED IN HUMAN VENTRICULAR FIBRILLATION
VF is commonly characterised by two mechanisms, multi wavelet reentry and rotors, but no governing equation exists to explain and predict their population dynamics.B-PO01-048 ECG-I PHENOTYPING OF PERSISTENT AF BASED ON DRIVER BURDEN AND DISTRIBUTION TO PREDICT RESPONSE TO PULMONARY VEIN ISOLATION (PHENOTYPE-AF)
It remains unclear which patients with persistent AF will benefit from pulmonary vein Isolation (PVI).B-PO01-076 FEASIBILITY OF LOCAL IMPEDANCE MONITORING IN ATRIAL FIBRILLATION ABLATION WITH HIGH POWER SHORT DURATION LESIONS
High power short duration (HPSD) ablation may improve pulmonary vein isolation (PVI) durability and shorten radiofrequency ablation (RFA) time. Measurement of local impedance (LI) drop on ablation using the DIRECTSENSE software module, an advanced feature of RHYTHMIA mapping system has shown to assess acute lesion durability but has not been clinically studied with HPSD.B-PO01-090 PROSPECTIVE ASSESSMENT OF AN AUTOMATED INTRAPROCEDURAL ECG-BASED SYSTEM FOR LOCALIZING VT EXIT SITES IN PATIENTS WITH STRUCTURAL HEART DISEASE (SHD)
We have previously developed an intraprocedural automatic arrhythmia origin localization (AAOL) system to localize idiopathic ventricular arrhythmia origins onto patient-specific electroanatomic (EAM) surface in real time using a 3-lead ECG.B-PO01-092 USING PULSED ELECTRIC FIELDS TO CAUSE FOCAL FIBROSIS IN THE INTERVENTRICULAR SEPTUM
Pulse electric fields (PEF) are being investigated as an alternative ablation modality to traditional radiofrequency ablation for modification of myocardial substrate.B-PO01-108 ATRIAL TACHYCARDIA ABLATION AT THE PULMONIC VALVE IN A PATIENT WITH CONGENITALLY CORRECTED TRANSPOSITION OF GREAT ARTERIES
Patients with congenitally-corrected transposition of great arteries (ccTGA) have anatomical differences with clinical ramifications for catheter ablation.B-PO02-012 USE OF STORED DEFIBRILLATOR ELECTROGRAMS AND EXTRA STIMULUS MAPPING FOR IDENTIFICATION OF VENTRICULAR ECTOPY TRIGGERING VENTRICULAR FIBRILLATION
Ablation using activation or pace mapping of PVCs from Purkinje tissue triggering VF; is associated with high success rates. However, sometimes PVCs are not observed during ablation.B-PO02-015 ENHANCING MUTANT IKSCHANNEL ACTIVITY BY ALTERING ENDOGENOUS PIP2 LEVELS AND ITS INTERACTION WITH PKA SIGNALLING PATHWAY
Phosphatidylinositol-4,5-biphosphate (PIP2) is implicated in the regulation and modulation of the IKS channel.B-PO02-021 INCREASED MICROTUBULE DETYROSINATION ENHANCES MECHANO-ARRHYTHMOGENICITY THROUGH TRPA1 IN VENTRICULAR MYOCYTES
In hypertension, there is an increased risk of sudden cardiac death, which is associated with acute hemodynamic fluctuations in the presence of ventricular structural remodelling. Increased microtubule network (MTN) density (via polymerisation) or stability (via post-translational modifications, such as detyrosination or acetylation) may enhance mechano-transduction in this setting and increase the incidence of mechanically-triggered arrhythmias (‘mechano-arrhythmogenicity’) mediated by TRPA1.B-PO02-025 NON-INVASIVE ELECTRICAL IMAGING OF REPOLARIZATION ABNORMALITIES TO PREDICT ARRHYTHMIC RISK
Repolarization gradients can provide the substrate for reentry. Limitations have been reported in clinical identification of abnormal substrates using electrocardiographic techniques.B-PO02-027 RIGHT PREDOMINANT ELECTRICAL REMODELING IN A PURE MODEL OF PULMONARY HYPERTENSION PROMOTES REENTRANT ARRHYTHMIAS
Electrophysiological (EP) properties have been studied mainly in the monocrotaline (MCT) model of pulmonary arterial hypertension (PAH). Findings from these studies however are confounded by major extra-pulmonary toxicities, including liver failure and direct myocardial damage. This has precluded the ability to draw definitive conclusions regarding the role of PAH per se in EP remodeling.B-PO02-129 AN EFFICIENT WORKFLOW TO INCREASE THE PRECISION OF NONINVASIVE RADIO-ABLATION OF VENTRICULAR TACHYCARDIA USING COMPUTERIZED ECG MAPPING AND RESPIRATORY GATING
Non-invasive stereotactic radiotherapy (SAbR) is an emerging therapy for refractory ventricular tachycardia. However, the precision of SAbR may be limited by respiratory motion, and the current workflow is time intensive.B-PO02-029 REDUCED ATRIAL FIBRILLATION DRIVERS IN RESPONSE TO REACTIVE OXYGEN SCAVENGING - A NOVEL THERAPEUTIC TARGET IN ATRIAL FIBRILLATION?
Oxidative Stress (OS) is thought to be a mediator of atrial fibrillation (AF), but the precise role of OS in AF is unknown. We assessed reactive oxygen species (ROS) scavenging on slow conduction and maintenance of rotational drivers.B-PO03-018 CLINICAL CHARACTERISTICS AND ELECTROPHYSIOLOGIC PROPERTIES OF SCN5A VARIANTS IN FEVER-INDUCED BRUGADA SYNDROME
Brugada syndrome (BrS) is a severe inherited arrhythmia syndrome which can be unmasked by fever.B-PO03-028 BIPOLAR PULSED ELECTRIC FIELD ABLATION OF THE INTERVENTRICULAR SEPTUM
Ablation of deep septal substrate with thermal energy sources conveys many challenges including inadequate lesion depth, inadvertent steam pops, and conduction system injury.B-PO03-045 LEFT BUNDLE BRANCH AREA PACING IN PATIENTS WITH AV NODAL AND INFRA NODAL DISEASE: A MULTICENTER PROSPECTIVE STUDY
The reported success rates of His bundle pacing (HBP) in patients with AV nodal disease is over 90% and in infra nodal disease is only about 50-75%. The success rates of left bundle branch area pacing (LBBAP) in this cohort is not well studied.B-PO03-119 ATRIAL FIBRILLATION ABLATION SAME-DAY DISCHARGE AUGMENTATION: A PROSPECTIVE QUALITY IMPROVEMENT PROJECT
Ablation is an increasingly prevalent treatment for atrial fibrillation. Hospital resource limitations, including bed availability, a barrier to utilization. Strategies to facilitate same-day discharge (SDD) following ablation has become increasingly relevant.B-PO04-147 TRENDS IN EARLY STROKE AND MORTALITY IN EPICARDIAL VERSUS ENDOCARDIAL LEFT ATRIAL APPENDAGE CLOSURE IN ATRIAL FIBRILLATION: NATIONWIDE READMISSIONS DATABASE 2016-2018
Percutaneous left atrial appendage closure (LAAC) devices have emerged as an important alternative to anticoagulation for stroke prevention in patients with atrial fibrillation. National data on recent trends and early complication rates associated with endocardial (endo) LAAC and epicardial (epi) LAAC procedures are limited.B-PO04-190 A NOVEL VISUAL DIAGNOSTIC ASSESSMENT OF EXPERT AND NOVICE GAZE PATTERNS ON PEDIATRIC ELECTROCARDIOGRAMS USING EYE TRACKING TECHNOLOGY
Pediatric electrocardiogram (ECG) interpretation is difficult to master. Understanding how experienced pediatric electrophysiologists (EPs) visually process ECGs using eye tracking technology (ETT) may allow for development of novel educational tools.B-PO05-002 DIFFERENTIAL GENE EXPRESSION BY AGE AND ATRIAL FIBRILLATION IN THE HUMAN LEFT ATRIUM
The incidence of atrial fibrillation (AF) increases with age. Identification of genes differentially expressed by age and AF may improve our understanding of AF pathogenesis.B-PO05-010 REMOVING THE VENTRICULAR FAR FIELD FROM UNIPOLAR ATRIAL ELECTROGRAMS IN A CLINICALLY FEASIBLE SETUP WITH A PHYSICALLY MOTIVATED MODEL YIELDS HIGH QUALITY RESULTS
While bipolar electrograms have dominated electrophysiological studies of the atria in the past, unipolar electrograms come with advantages in undistorted morphology but pose undesirable interference with the ventricular far field (VFF). Blanking or template building are common approaches to alleviate this drawback but tremendously reduce data or prolong the procedure. None of the approaches is clinically satisfactory.B-PO05-019 THE ATRIAL-PULMONARY VEIN JUNCTION CONSTITUTES AN ARRHYTHMOGENIC SUBSTRATE
Ablative pulmonary vein isolation (PVI) is ineffective in atrial fibrillation (AF) prevention in 40% of AF patients. The role of the atrial-pulmonary vein (A-PV) junction in arrhythmogenesis is poorly understood since incomplete PVI can be curative. We aimed to test the hypothesis that the A-PV junction constitutes a structural and functional arrhythmogenic substrate.B-011-02 KIR2.1 CHANNELS IN A NOVEL SARCOPLASMIC RETICULUM MICRODOMAIN CONTROL INTRACELLULAR CA2+ DYNAMICS
The strong inward rectifier K+ channel, Kir2.1, is known to localize at the sarcolemma to control the resting potential and the final phase of ventricular repolarization. K+ channels have been suggested to contribute countercurrent to calcium flux across the sarcoplasmic reticulum (SR) membrane, but their identity and function remain controversial.B-011-03 SGK1 DEFICIENCY IS PROTECTIVE IN A MODEL OF SEPSIS-RELATED ATRIAL FIBRILLATION
Sepsis is associated with new onset atrial fibrillation (AF), and AF in septic patients is associated with worse outcomes. Serum glucocorticoid kinase 1 (SGK1), a serine/threonine kinase in the PI-3 kinase pathway, is involved in cardiac inflammation. Prior work has suggested a potential therapeutic role for SGK1 inhibition in cardiac arrhythmias, which we investigated in a model of bacterial sepsis-induced AF.B-011-04 ABLATION SCAR IN A SINGLE PULMONARY VEIN CAUSES PROARRHYTHMIC MECHANICAL DESTABILIZATION IN HEALTHY SHEEP ATRIA
Atrial and pulmonary vein (PV) stretch is proarrhythmic, but the mechanical effect of PV ablation scar on atrial fibrillation (AF) arrhythmogenesis is unknown. We hypothesize that discontinuous PV ablation scars are proarrhythmic because they create heterogeneous stretch.B-011-05 PANORAMIC OPTICAL MAPPING AND MICRO COMPUTED TOMOGRAPHY FOR IN-DEPTH 3D CHARACTERIZATION OF THE ARRHYTHMOGENIC SUBSTRATE IN MURINE HEARTS
Optical mapping of murine hearts is currently limited to the epicardium. Action potential duration (APD) heterogeneity is a key driver for initiation and persistence of reentry. When combined with micro CT, optical mapping can provide data on anatomical alterations and structural remodeling contributing to arrhythmogenesis.B-011-06 USING MACHINE LEARNING TO IDENTIFY PATIENTS LIKELY TO REQUIRE REPEAT CATHETER ABLATION FOR ATRIAL FIBRILLATION: INSIGHTS FROM THE UC SAN DIEGO AF ABLATION REGISTRY
Catheter ablation is superior to pharmacologic therapy in maintaining normal sinus rhythm in select patients with atrial fibrillation (AF). However, this procedure is not without risks, and many often require a repeat ablation.B-011-20 EVALUATION OF THE 3-DIMENSIONAL SUBSTRATE OF VENTRICULAR TACHYCARDIA IN A LANGENDORFF PERFUSED HUMAN HEART
The underlying mechanisms of ventricular tachycardia (VT) are not well understood. Most models for VT propagation are based on animal studies or single surface recordings which have limited utility. Human based investigations of VT are often limited by hemodynamic collapse and lack viable ways to assess the myocardial electrical propagation.B-011-21 CARDIAC MAGNETIC RESONANCE PREDICTORS OF VENTRICULAR TACHYCARDIA RECURRENCE AFTER SUBSTRATE BASED ABLATION
Ventricular tachycardia (VT) substrate-based ablation has become increasingly important in patients with structural heart disease-related VT.B-011-22 MACHINE LEARNING TO PREDICT RECURRENT EVENTS FOLLOWING UNEXPLAINED CARDIAC ARREST
Patients who suffer an unexplained cardiac arrest (UCA) are at risk for recurrence.B-011-23 QRS CHARACTERISTICS DURING LEFT BUNDLE BRANCH PACING WITH AND WITHOUT BIDIRECTIONAL LEFT INTRAHISIAN BLOCK
LBB (left bundle branch) pacing has been proposed as a novel modality to achieve cardiac resynchronization. However, selective capture of the left bundle is physiologically expected to produce a wide QRS, with variability based on the integrity of retrograde right bundle conduction.
