Sudden cardiac death (SCD) is the leading cause of death in adults worldwide. Coronary heart disease is the underlying reason for most of the patients with SCD, including acute coronary syndrome and chronic ischemic heart disease. Revascularization is an important treatment technology for coronary heart disease, which includes percutaneous coronary intervention and surgical coronary artery bypass grafting. However, according to the recommended guidelines, even with the use of secondary prevention strategies such as medication treatment and a complete revascularization, there are still a great number of patients who have reduced left ventricular ejection fraction, heart failure, and ventricular arrhythmia at different stages in the course of disease. SCD remains to be a serious challenge in the long-term management of ischemic heart disease patients who have had revascularization. Here, we focus on broader issues of concerns to provide more insights by comprehensive recommendations for the clinical treatment of coronary artery disease after revascularization for SCD prevention.

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Scientific growth in the field of magnetic resonance imaging (MRI) and cardiac devices has been exponential in recent decades. Cardiac implantable electronic devices due to their ferromagnetic constituents in leads and device body have always been an issue if patients need MRI. MRI is relatively safe. Recent introduction of changes in leads and device body constituents renders them less ferromagnetic, making MRI less frightening to a certain extent. Simultaneously, there is increasing research interest in MRI. Not only anatomy and pathology but also physiology of cardiac and nervous structures can be imaged. It is estimated that 53%–64% of intracardiac defibrillator (ICD) patients will require an MRI determination over a 10-year time horizon, highlighting the importance of MRI-conditional devices for this patient population. In this article, we briefly describe evolution and current status of conditioning of cardiac devices to make them MRI-friendly and briefly discuss where we are in terms of our physician role with respect to MRI-conditional devices.

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The need for transvenous lead extraction (TVL) is increasing. Unfortunately, many patients with indications for extraction go without appropriate care. There are multiple barriers to patients receiving TVL. These include a knowledge deficit, a lack of adequate training, a lack of appropriate tools, and a lack of resources. In this paper, we will review these barriers and offer some potential solutions. Hopefully, in the near future, all patients that require TVL will be appropriately referred and the resources and training will allow safe and effective treatment.

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Cryoballoon (CB) has emerged as a reasonable alternative to radiofrequency for treatment of paroxysmal atrial fibrillation (AF) due to simple operation, short learning curve, less patient discomfort, shorter ablation time, etc., However, the second-generation CB had a higher probability than the first-generation CB in the phrenic nerve injury (PNI) mostly observed in freezing the right superior pulmonary vein. Few reports on the CB ablation for a refractory AF originating from superior vena cava.what's more,It is rare to publish Phrenic Nerve Injury(PNI) is occurred in CB ablation for AF from SVC,the case is about it.

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Background: Mean platelet volume (MPV) is a new biomarker for left atrial appendage (LAA) thrombus or thromboembolic event with great potential. Considering its applicability and cost, it can be the chosen examination for the detection of LAA thrombus in patients with nonvalvular atrial fibrillation. This study aimed to evaluate MPV as a new biomarker for left atrial thrombus or thromboembolic events in comparison with transesophageal echocardiography. Methods: We did electronic searches on PubMed, ScienceDirect, and SpringerLink databases. Appraisal of studies was performed using critical appraisal sheets provided by the Centre for Evidence-Based Medicine. Test characteristic was extracted from the literature. Meanwhile, sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were calculated based on the test characteristic. Results: Two studies met the selection criteria. Different cutoff was used in the studies (>10.5 fL and >9.4 fL) which showed significant differences in sensitivity, specificity, and positive predictive value. However, both the studies have fairly high NPV (78.95% and 72.65%, respectively). Conclusion: Currently, the best MPV cutoff value in determining the absence of thrombus in the left atrium is 10.5 fL. Although the clinical application of MPV remains limited, it can be further improved by more studies to obtain the optimal cutoff value and to increase the value of MPV by combining with other biomarkers and clinical prediction tools.

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