Hypertrophic cardiomyopathy (HCM) is one of the oldest known causes of sudden death. It was first described in 1958. It has been called HOCM (hypertrophic obstructive cardiomyopathy) and also IHSS (idiopathic hypertrophic subaortic stenosis), despite the fact that some patients do not have a sizeable resting outflow gradient. It is a relatively common genetic cause of sudden death, particularly in young athletes.

Epidemiology
Hypertrophic cardiomyopathy is actually the most common genetically-associated form of sudden cardiac death. It is estimated that 1 in 500 people (0.2% of th

From 2004, Vol. 4, No. 8:
At the University of Florida, they are a referral center for ablation of complex arrhythmias, lead extractions, and biventricular pacing. They perform almost equal amounts of ablations and device implants.

From 2004, Vol. 4, No. 7:
At Lenox Hill Hospital in New York, their lab is unique in that two very busy private practice EP groups manage to work together to perform over 2,000 cases in a single laboratory with a fixed schedule. They write that their EP lab staff is composed of motivated, dedicated, experienced and hard-working nurses who make th

AF is characterized by uncoordinated atrial activation with consequent deterioration of atrial mechanical function.⁴ Thromboembolic disease and ischemic stroke are the most important complications of AF, and their occurrence is increased in both paroxysmal (intermittent) and chronic forms of AF.³ The rate of ischemic stroke among patients with nonrheumatic AF averages 5% per year, which is 2-7 times the rate for individuals without AF.⁴ One of every six strokes occurs in patients with AF.⁴ In the Framingham Heart Study, patients with rheumatic heart disease and AF had a striking 17-fold increased risk of stroke compared to age-matched controls.⁵ Most importantly, ischemic stroke associated with AF is nearly twice as likely to be fatal as non-AF stroke.⁵ In addition, stroke recurrence is more frequent and functional deficits following an AF-related stroke are more likely to be severe with persisting neurological de

Femoral Sheaths
Our EP nurses are going to start putting the femoral venous sheaths in for the electrophysiology cases. There does not seem to be any other centre in the United Kingdom that is doing this; could anyone help with information/protocols/policies, etc.?
J. Mudd

Post Procedure
Does your lab transport patients back to their room post RFA procedure monitored or unmonitored? Also, do all of your RFA patients post procedure go directly back to their room, or are they monitored for a short period of time in a CCL/EP holding area/recovery room?
M. Arenas

What are the current pharmacological options available for AF patients?
The current pharmacological options available to treat patients with AF are often directed at antithrombotic therapy and efforts to optimally control the ventricular response. With particular reference to individuals who would benefit from drugs designed to suppress the arrhythmia, the selection of a drug typically hinges on which agent the patient will be best able to tolerate. Underlying conditions such as left ventricular hypertrophy, poor ventricular systolic function, and congestive heart failure, as well as n

I have the difficult task to talk about t-wave alternans on a cellular level to a crew of clinical electrophysiologists. I will try to make it simple.
This is a developing story, and it started back in the early 1900s, when visible alternans was described on an EKG on an every-other-beat level in the t-wave (negative, positive, negative, positive, negative, positive...). In this EKG rhythm strip, the alternation is followed by a PVC and then ventricular fibrillation. This is clearly macroscopic t-wave alternans which can be seen on the surface EKG. In later years, it was described in severa

When did the HeartStart Home Defibrillator first become available on the market?
The HeartStart Home Defibrillator received FDA clearance in November 2002. This was for prescription-use only. It was the first of a new generation of defibrillators specifically designed for home use.

When was the EP lab started at your institution?
Dr. Jeremy Ruskin is the founder and director of the MGH Cardiac Arrhythmia Service and Clinical Electrophysiology Laboratory, the first subspecialty service dedicated to the care of patients with cardiac arrhythmias in New England. Since its inception in 1978, this service has been dedicated to excellence in clinical care, the training of fellows in clinical cardiac electrophysiology, and research on the mechanisms of and innovative therapies for the treatment of cardiac arrhythmias.