Organization and procedures in contemporary catheter ablation centres: data from the 2018 Italian Catheter Ablation Registry.

AIMS: This report describes the findings of the 2018 Italian Catheter Ablation Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC). METHODS: The Italian Catheter Ablation Registry systematically collects data on the ablation procedures performed in Italy. Data collection was retrospective. A standardized questionnaire was completed by participating centres. RESULTS: We collected data on 15 714 catheter ablation procedures performed in Italy during 2018 in 94 electrophysiology centres. In most centres (75/94, 80%), a single electrophysiology laboratory was available, and a hybrid electrophysiology laboratory was available in 15% (14/94) of centres. In most (93%) centres, at least two electrophysiologists were involved in the catheter ablation procedures. In only 13 out of 94 (14%) electrophysiology laboratories, an anaesthesiologist assists every electrophysiology procedure; in most cases (74/94, 79%), an on-demand anaesthesiology service was available. On-site cardiothoracic surgery was reported in 43 out of 94 (46%) centres.Nonfluoroscopic navigation systems were available in most centres (88/94, 93%). Intracardiac echocardiography was used in 59 out of 94 (63%) electrophysiology laboratories. Atrial fibrillation (31%) was the most frequently treated ablation target, followed by atrioventricular nodal re-entrant tachycardia (20%) and cavo-tricuspid isthmus (15%). In 61.7% of all procedures, a 3D mapping system was used. In about one-third of procedures, a near-zero approach was performed. CONCLUSION: In most Italian electrophysiology centres, a single electrophysiology laboratory was available and at least two electrophysiologists were involved in the ablation procedures. An increasing number of procedures were performed by means of a nonfluoroscopic mapping system with a near-zero approach.

Guidance for rebooting electrophysiology through the COVID-19 pandemic from the Heart Rhythm Society and the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology: Endorsed by the American College of Cardiology.

Coronavirus disease 2019 (COVID-19) has presented substantial challenges to patient care and impacted health care delivery, including cardiac electrophysiology practice throughout the globe. Based upon the undetermined course and regional variability of the pandemic, there is uncertainty as to how and when to resume and deliver electrophysiology services for arrhythmia patients. This joint document from representatives of the Heart Rhythm Society, American Heart Association, and American College of Cardiology seeks to provide guidance for clinicians and institutions reestablishing safe electrophysiological care. To achieve this aim, we address regional and local COVID-19 disease status, the role of viral screening and serologic testing, return-to-work considerations for exposed or infected health care workers, risk stratification and management strategies based on COVID-19 disease burden, institutional preparedness for resumption of elective procedures, patient preparation and communication, prioritization of procedures, and development of outpatient and periprocedural care pathways.

Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic : Latin American Heart Rhythm Society (LAHRS) in collaboration with: Colombian College Of Electrophysiology, Argentinian Society of Cardiac Electrophysiology (SADEC), Brazilian Society Of Cardiac Arrhythmias (SOBRAC), Mexican Society Of Cardiac Electrophysiology (SOMEEC).

COVID-19 is a rapidly evolving public health emergency that has largely impacted the provision of healthcare services around the world. The challenge for electrophysiology teams is double; on one side preventing disease spread by limiting all nonessential face-to-face interactions, but at the same time ensuring continued care for patients who need it. These guidelines contain recommendations regarding triaging in order to define what procedures, device checks and clinic visits can be postponed during the pandemic. We also discuss best practices to protect patients and healthcare workers and provide guidance for the management of COVID-19 patients with arrhythmic conditions.

Restructuring Electrophysiology During the COVID-19 Pandemic: A Practical Guide From a New York City Hospital Network.

The coronavirus disease 2019 crisis is a global pandemic of a novel infectious disease with far-ranging public health implications. With regard to cardiac electrophysiology (EP) services, we discuss the "real-world" challenges and solutions that have been essential for efficient and successful (1) ramping down of standard clinical practice patterns and (2) pivoting of workflow processes to meet the demands of this pandemic. The aims of these recommendations are to outline: (1) essential practical steps to approaching procedures, as well as outpatient and inpatient care of EP patients, with relevant examples, (2) successful strategies to minimize exposure risk to patients and clinical staff while also balancing resource utilization, (3) challenges related to redeployment and restructuring of clinical and support staff, and (4) considerations regarding continued collaboration with clinical and administrative colleagues to implement these changes. While process changes will vary across practices and hospital systems, we believe that these experiences from 4 different EP sections in a large New York City hospital network currently based in the global epicenter of the coronavirus disease 2019 pandemic will prove useful for other EP practices adapting their own practices in preparation for local surges.

Coronovirus Disease-2019 (COVID-19) Pandemic and Cardiac Electrophysiology: Guidance Protocol From a UK Tertiary Cardiac Center.

Since December 2019, the coronovirus disease-2019 (COVID-19) pandemic has resulted in more than 2,160,000 positive cases and more than 145,000 deaths until April 18, 2020. The pressure to the health services worldwide has been unprecedented. The redeployment of staff and resources to treat more efficiently COVID-19 cases along with the need to reduce disease transmission has affected the field of electrophysiology among many others. Amendments to clinical pathways are obligatory in this perspective to continue to provide the necessary health services to the people who need them, although at the same time, infection control and prevention are not compromised by inadvertent disease transmission or unnecessary use of resources. We aim to provide a guide of the logistic aspects of electrophysiology procedures derived from our tertiary cardiac center during the current COVID-19 pandemic.

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias.

Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta-analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow-up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias.

Overview of the current electrophysiology (EP) state of affairs in Russia.

Russia is the largest country in the world based on the landmass, covering more than one-eighth of the earth's inhabited area. Russia faces challenges in electrophysiology (EP) care including insufficient and uneven financing, complicated system for identifying optimal treatment for individual patients, relative paucity of reasonable educational and certification scope for electrophysiologists, suboptimal national statistical data gathering regarding heart rhythm disorders and EP devices in use, and weak networking of medical information. In comparison with the average level of EP utilization in ESC countries, Russia utilizes around 50% in pacemaker; 10% in ICD; 8% in cardiac resynchronization therapy; 55% in ablations; and 45% in AF ablations. As projected, Russia has the biggest unmet demand in EP procedures, so-called developmental potential in the European region. Nearly 37% of implanted single-chamber and 63% dual-chamber devices are manufactured outside of Russia. The price of the Russian devices is slightly (by 10-20%) lower than the one imported and they are readily provided for patients by the Russian Ministry of Health. Based on the analysis of the data available, we suggest some strategies for the improvement of the EP care in Russia. Solutions include the institution of formal EP education and standardization of it, development of international educational, and scientific collaboration; implementation quality-assessment tools for professional knowledge and skills; wide application of national medical databases and collection of heart rhythm disorders' statistics; growth of financial support of electrophysiology and transparent distribution of financing between state/municipal and private medical centers; enhancement of medical care accessibility countrywide; development of technologies for local EP devices production; and collection of data regarding usage and effectiveness of it.

Updated Survey on Interventional Electrophysiology: 5-Year Follow-Up of Infrastructure, Procedures, and Training Positions in Germany.

OBJECTIVES: This study provides an update and comparison to a 2010 nationwide survey on cardiac electrophysiology (EP), types and numbers of interventional electrophysiological procedures, and training opportunities in 2015. BACKGROUND: In 2010, German cardiology centers performing interventional EP were identified and contacted to provide a survey on cardiac EP. METHODS: German cardiology centers performing interventional EP in 2015 were identified from quality reports and contacted to repeat the 2010 questionnaire. RESULTS: A majority of 131 centers (57%) responded. EP (ablation procedures and device therapy) was mainly part of a cardiology department (89%) and only independent (with its own budget) in 11%. The proportion of female physicians in EP training increased from 26% in 2010 to 38% in 2015. In total, 49,356 catheter ablations (i.e., 81% of reported ablations in 2015) were performed by the responding centers, resulting in a 44% increase compared with 2010 (the median number increased from 180 to 297 per center). Atrial fibrillation (AF) was the most common arrhythmia interventionally treated (47%). At 66% of the centers, (at least) 2 physicians were present during most catheter ablations. A minimum of 50 (75) AF ablations were performed at 80% (70%) of the centers. Pulmonary vein isolation with radiofrequency point-by-point ablation (62%) and cryoablation (33%) were the preferred ablation strategies. About one-third of centers reported surgical AF ablations, with 11 centers (8%) performing stand-alone surgical AF ablations. Only one-third of the responding 131 centers fulfilled all requirements for training center accreditation. CONCLUSIONS: Comparing 2010 with 2015, an increasing number of EP centers and procedures in Germany are registered. In 2015, almost every second ablation was for therapy for AF. Thus, an increasing demand for catheter ablation is likely, but training opportunities are still limited, and most centers do not fulfil recommended requirements for ablation centers.

Pediatric & Congenital Electrophysiology Society: building an international paediatric electrophysiology organisation.

The Pediatric and Congenital Electrophysiology Society (PACES) is a non-profit organisation comprised of individuals dedicated to improving the care of children and young adults with cardiac rhythm disturbances. Although PACES is a predominantly North American-centric organisation, international members have been a part of PACES for the last two decades. This year, PACES expanded its North American framework into a broadly expansive international role. On May 12, 2015, paediatric electrophysiology leaders from within the United States of America and Canada met with over 30 international paediatric electrophysiologists from 17 countries and five continents discussing measures to (1) expand PACES' global vision, (2) address ongoing challenges such as limited resource allocation that may be present in developing countries, (3) expand PACES' governance to include international representation, (4) promote joint international sessions at future paediatric EP meetings, and (5) facilitate a global multi-centre research consortium. This meeting marked the inception of a formal international collaborative spirit in PACES. This editorial addresses some solutions to breakdown the continental silos paediatric electrophysiologists have practiced within; however, there remain ongoing limitations, and future discussions will be needed to continue to move the PACES global international vision forward.

Registro Español de Desfibrilador Automático Implantable. XI Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2014) / Spanish Implantable Cardioverter-defibrillator Registry. Eleventh Official Report of the Spanish Society of Cardiology Electrophysiology and Arrhythmias Section (2014)

Introducción y objetivos. Se presentan los resultados del Registro Español de Desfibrilador Automático Implantable de 2014, elaborado por la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología. Métodos. Se envió de forma prospectiva a la Sociedad Española de Cardiología la hoja de recogida de datos cumplimentada voluntariamente por cada equipo implantador. Resultados. El número de implantes comunicados fue 4.911 (el 82% del total de implantes estimado). La tasa de implantes fue 106 por millón de habitantes y la estimada, 128. Los primoimplantes fueron el 72,2%. Se obtuvieron datos de 162 hospitales (8 más que en 2013). La mayoría de los implantes (82%) se realizaron en varones. La media de edad fue 61,8 ± 13,7 años. La mayoría de los pacientes presentaban una disfunción ventricular grave o grave-moderada y clase funcional II de la New York Heart Association. La cardiopatía más frecuente fue la isquémica, seguida de la dilatada. Las indicaciones por prevención primaria han sido el 58,5%. Los implantes realizados por electrofisiólogos fueron el 85,6%. Conclusiones. El Registro Español de Desfibrilador Automático Implantable de 2014 recoge información del 82% de los implantes realizados en España. El número de implantes ha crecido respecto a los datos de los últimos años. El porcentaje de indicación por prevención primaria ha aumentado con respecto al registro anterior (AU)

Introduction and objectives. We present the results of the Spanish Implantable Cardioverter-defibrillator Registry for 2014, as compiled by the Electrophysiology and Arrhythmia Section of the Spanish Society of Cardiology. Methods. Data collection sheets were voluntarily completed by each implantation team and prospectively sent to the Spanish Society of Cardiology. Results. The number of reported implantations was 4911 (82% of the estimated total number of implantations). The implantation rate was 106 per million population while the estimated rate was 128. First implantations comprised 72.2%. Data were obtained from 162 hospitals (8 more than in 2013). Most implantations (82%) were performed in men. The mean patient age was 61.8 ± 13.7 years. Most patients showed severe or moderate-to-severe ventricular dysfunction and were in New York Heart Association functional class II. The most frequent cardiac condition was ischemic heart disease, followed by dilated cardiomyopathy. Implantations for primary prevention indications comprised 58.5%. Electrophysiologists performed 85.6% of the implantations. Conclusions. The 2014 Spanish Implantable Cardioverter-defibrillator Registry received information on 82% of the implantations performed in Spain. The number of implantations has increased from previous years and the percentage of implantations for primary prevention indications has increased from the previous year (AU)

Registro Español de Trasplante Cardiaco. XXVI Informe Oficial de la Sección de Insuficiencia Cardiaca y Trasplante Cardiaco de la Sociedad Española de Cardiología (1984-2014) / Spanish Heart Transplantation Registry. 26th Official Report of the Spanish Society of Cardiology Working Group on Heart Failure and Heart Transplantation (1984-2014)

Introducción y objetivos. Se presentan las características y resultados del trasplante cardiaco en España desde que empezó su actividad en mayo de 1984. Métodos. Se realiza un análisis descriptivo de las características de los receptores, los donantes, el procedimiento quirúrgico y los resultados de los trasplantes cardiacos realizados en España hasta el 31 de diciembre de 2014. Resultados. Durante 2014 se han realizado 266 procedimientos, con lo que la serie histórica consta de 7.289 trasplantes. El análisis temporal confirma un empeoramiento significativo del perfil clínico de los receptores (mayor porcentaje de pacientes añosos, con insuficiencia renal grave, diabetes insulinodependiente, cirugía cardiaca previa y ventilación mecánica), de los donantes (mayor porcentaje de donantes añosos y con mayor discordancia de peso) y del procedimiento (mayor porcentaje de trasplante urgente, que en 2014 alcanza el 41,4%, y con tiempo de isquemia > 240 min). El uso de dispositivos de asistencia mecánica ha disminuido respecto a 2013, y en 2014 supone el 18,8% del total de pacientes. La supervivencia a 1, 5, 10 y 15 años es del 76, el 65, el 52 y el 38% respectivamente, y permanece estable desde 1995. Conclusiones. La actividad de trasplante cardiaco en España permanece estable en los últimos años, con alrededor de 250 procedimientos al año. A pesar del claro empeoramiento de las características de donantes, receptores y tiempos quirúrgicos, se mantienen unos resultados en mortalidad comparables a los del entorno y se confirma un uso creciente de los dispositivos de asistencia circulatoria antes del trasplante (AU)

Introduction and objectives. We present the characteristics and outcomes of heart transplantation in Spain since it was first performed in 1984. Methods. A descriptive analysis of the characteristics of recipients, donors, the surgical procedure, and the outcomes of heart transplantations performed in Spain until 31 December 2014. Results. In 2014, 266 procedures were performed, making a time series of 7289 transplantations. The temporal analysis confirmed a significant worsening of the clinical profile of recipients (higher percentage of older patients, patients with severe renal failure, insulin-dependent diabetes, previous cardiac surgery, and previous mechanical ventilation), of donors (higher percentage of older donors and greater weight mismatch), and of the procedure (higher percentage of emergency transplantations, reaching 41.4% in 2014, and ischemia time > 240 min). Mechanical assist devices were used less than in 2013; in 2014 they were used in 18.8% of all transplant recipients. Survival at 1, 5, 10, and 15 years was 76%, 65%, 52%, and 38%, respectively, and has remained stable since 1995. Conclusions. Cardiac transplantation activity in Spain has remained stable in recent years, at around 250 procedures per year. Despite a clear deterioration in donor and recipient characteristics and surgical times, the mortality outcomes have remained comparable to those of previous periods in our environment. The growing use of circulatory assist devices before transplantation is also confirmed (AU)

Snapshot of adult invasive cardiac electrophysiology in Canada: results of the web-based registry.

PURPOSE: Interventional cardiac electrophysiology (EP) has experienced a significant growth in Canada. Our aim is to establish a periodic registry as a nationwide initiative. METHODS: The registry is designed to collect information regarding EP laboratory infrastructure, human resources, and the spectrum and volumes of EP procedures. Respective administrative staff were contacted electronically. RESULTS: Out of 25 identified Canadian EP centers, 19 centers (76%) have participated in the registry. Responding centers have access on average to 5.3 lab days per week to perform EP studies/ablations; average lab time per full- and part-time (prorated to 0.5) EP physician is 0.8 day per week. Diagnostic EP studies and radio-frequency ablations are performed in all (19) centers; cryoablation is available in 83% of centers. Two centers have remote magnetic navigation systems. EnSite NavX is the most widely available 3D mapping system utilized in 15 (83%) centers, followed by CARTO and intracardiac echo which are each available in 14 (78%) centers; LocaLisa is actively used in one center. The number of full-time physicians ranges between 0 and 7, with a mean of 3.5 full-time physicians per center. The ratio of staff to trainees is 1.6:1. A total of 8,041 EP procedures are performed in the 19 centers per annum. On an annual average, 104 procedures per one operator and 159 procedures per trainee are performed. CONCLUSIONS: This registry provides contemporary information on invasive EP lab resources and procedures in Canada. It also demonstrates that Canadian EP procedural intensities of practice and training are comparable to international standards.

Registro Español de Ablación con Catéter. XII Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2012) / Spanish Catheter Ablation Registry. 12th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2012)

Introducción y objetivos. Se detallan los resultados del Registro Nacional de Ablación del año 2012. Métodos. La recogida de datos se llevó a cabo mediante dos sistemas. De manera retrospectiva con la cumplimentación de un formulario y de manera prospectiva a través de una base de datos común. La elección de una u otra fue voluntaria para cada uno de los centros. Resultados. Se recogieron datos de 74 centros. El número total de procedimientos de ablación fue 11.042, con una media de 149 ± 103 procedimientos. Los tres sustratos abordados con más frecuencia fueron la taquicardia intranodular (n = 2.842; 25,7%), la ablación del istmo cavotricuspídeo (n = 2.485; 23%) y las vías accesorias (n = 1.999; 18%). El cuarto sustrato fue la ablación de fibrilación auricular (n = 1.852; 17%), que mostró un incremento del 21% con respecto a los datos de 2011. La ablación de arritmias ventriculares ha permanecido estable, pero han disminuido los procedimientos sobre las asociadas a cicatriz tras infarto. La tasa total de éxito fue del 94,9%; la de complicaciones mayores, del 1,9% y la de mortalidad, del 0,04%. Conclusiones. El registro del año 2012 mantiene una línea de continuidad ascendente en el número de ablaciones realizadas y muestran, en líneas generales, una elevada tasa de éxito y bajo número de complicaciones. Continúa el aumento del abordaje de sustratos más complejos, especialmente de la fibrilación auricular (AU)

Introduction and objectives. This article presents the findings of the 2012 Spanish Catheter Ablation Registry. Methods. Data were collected in 2 ways: retrospectively using a standardized questionnaire, and prospectively using a central database. Each participating center selected its own preferred method of data collection. Results. Seventy-four Spanish centers voluntarily contributed data to the survey. A total of 11 042 ablation procedures were analyzed, averaging 149 (103) per center. The 3 main conditions treated were atrioventricular nodal reentrant tachycardia (n=2842; 25.7%), cavotricuspid isthmus (n=2485; 23%), and accessory pathways (n=1999; 18%). Atrial fibrillation was the fourth most common substrate treated (n=1852; 17%), representing a slight increase. The number of ventricular arrhythmia ablation procedures was similar to that of 2011, but there was a decrease in procedures for ventricular tachycardia associated with postinfarction scarring. The overall success rate was 94.9%, major complications occurred in 1.9%, and the overall mortality rate was 0.04%. Conclusions. Data from the 2012 registry show that the number of ablations performed continued to increase. Overall, they also show a high success rate and a low number of complications. Ablation of complex substrates continued to increase, particularly in the case of atrial fibrillation (AU)

Periaortitis fibrosa con infiltración en las válvulas aórtica y mitral / Fibrotic periaortitis infiltrating into the aortic and mitral valves

No disponible

Diagnóstico diferencial entre doble respuesta ventricular y extrasistolia hisiana bigeminada. Respuesta / Differential diagnosis between dual ventricular response and bigeminy arising from the bundle of his. Response

No disponible

Evaluación de la complejidad de la activación miocárdica durante la fibrilación ventricular. Estudio experimental / Evaluation of the complexity of myocardial activation during ventricular fibrillation. An experimental study

Introducción y objetivos. Analizar en un modelo experimental las características de la fibrilación ventricular en situaciones con distintos grados de complejidad y establecer la relación existente entre los datos aportados por distintos métodos de análisis de la arritmia. Métodos. En 27 preparaciones de corazón aislado de conejo estudiadas bajo la acción de fármacos (propranolol y KB-R7943) o procedimientos físicos (estiramiento) que causan distintos grados de variación de la complejidad de la activación miocárdica durante la arritmia, se han utilizado técnicas espectrales, morfológicas y cartográficas para procesar los registros obtenidos con multielectrodos epicárdicos. Resultados. La complejidad de la fibrilación ventricular objetivada mediante procedimientos cartográficos se ha relacionado con la frecuencia dominante, la energía normalizada del espectro, el índice de regularidad de las señales, sus coeficientes de variación y el área de las regiones de interés identificadas a partir de estos parámetros. En el análisis multivariable, se han aceptado como variables independientes el área de las regiones de interés relacionadas con la energía espectral y el coeficiente de variación de la energía (índice de complejidad = -0,005 × área de las regiones de la energía espectral -2,234 × coeficiente de variación de la energía +1,578; p = 0,0001; r = 0,68). Conclusiones. Los indicadores espectrales, morfológicos y, de manera independiente, los derivados del análisis de las regiones de interés de la energía normalizada permiten aproximarse de manera fiable a la evaluación de la complejidad de la fibrilación ventricular como una alternativa a los complejos procedimientos cartográficos (AU)

Introduction and objectives. An experimental model is used to analyze the characteristics of ventricular fibrillation in situations of variable complexity, establishing relationships among the data produced by different methods for analyzing the arrhythmia. Methods. In 27 isolated rabbit heart preparations studied under the action of drugs (propranolol and KB-R7943) or physical procedures (stretching) that produce different degrees of change in the complexity of myocardial activation during ventricular fibrillation, use was made of spectral, morphological, and mapping techniques to process the recordings obtained with epicardial multielectrodes. Results. The complexity of ventricular fibrillation assessed by mapping techniques was related to the dominant frequency, normalized spectral energy, signal regularity index, and their corresponding coefficients of variation, as well as the area of the regions of interest identified on the basis of these parameters. In the multivariate analysis, we used as independent variables the area of the regions of interest related to the spectral energy and the coefficient of variation of the energy (complexity index = -0.005 × area of the spectral energy regions -2.234 × coefficient of variation of the energy +1.578; P=.0001; r=0.68). Conclusions. The spectral and morphological indicators and, independently, those derived from the analysis of normalized energy regions of interest provide a reliable approach to the evaluation of the complexity of ventricular fibrillation as an alternative to complex mapping techniques (AU)

Novedades en alteraciones del ritmo cardiaco: electrofisiología cardiaca, arritmias y estimulación cardiaca / Innovations in heart rhythm disturbances: cardiac electrophysiology, arrhythmias, and cardiac pacing

En este artículo se revisan los trabajos más relevantes en el campo de las arritmias publicados en 2012, incluyendo aritmología clínica, técnicas de ablación, estimulación cardiaca y genética de la muerte súbita (AU)

This article reviews the most relevant articles published in 2012 in the field of arrhythmias, on subjects that include clinical arrhythmology, ablation, cardiac pacing, and the genetics of sudden cardiac death (AU)