dimitrios lypourlis

@ALFIEEP1 @drjohnm What about the pressure for LAAO ?

Not all that glitters is gold… It seems that point-by-point radiofrequency ablation in atrial fibrillation is now considered old-fashioned, despite having some of the best catheters on the market. I have never witnessed such pressure and lobbying in EP. cc @drjohnm

MELOS RELOADED adds more weight to a growing question in pacing: In patients with AV block, preserved or mildly reduced EF, and a high expected pacing burden, should right ventricular pacing still be the default? After propensity matching, 3,382 patients were studied. At 4 years, LBBAP showed an absolute survival advantage of 11.8%. Mortality was lower with LBBAP: HR 0.53. HF hospitalization or CRT upgrade was also lower: 4.6% vs 11.2%. And one more key point: Not all “LBBAP” is equal. Failure to confirm true left bundle capture carried higher mortality. Lead position is not the endpoint. Physiologic capture is. @Marek_Jastrz_EP @HaranBurri @ZacharyWhinnett #Electrophysiology #CardioTwitter #Pacing

Another beautiful study on PVCs Transcutaneous Electrical Vagus Nerve Stimulation to Suppress Ventricular Premature Complexes [was no better than sham] Proves my long-time contention for PVC Rx —> Voltaire approach. Do nothing. Reassure. Wait. jacc.org/doi/10.1016/j.…

Debate summary highlighting limitations of argument against LAA occlusion #HRS2026

Thank you to @Abbott and @RKutieleh for a great evening in the Field Museum in Chicago

Thank you to @MRazminia, @Abbott and @RKutieleh for an incredible learning experience yesterday at Northwestern Hospital in Chicago

Characteristics, Clinical Course, and Cardiac Events of Patients with Previously Asymptomatic Long QT Syndrome @MJAckermanMDPhD @EllianaRudquist heartrhythmjournal.com/article/S1547-…

⚡ Brugada syndrome is not just a sodium channel disease. For years, we simplified Brugada as: 👉 SCN5A 👉 sodium current 👉 channelopathy But here’s the problem: 👉 This explains only 20–30% of patients 🧠 So what about the rest? This paper pushes the field forward: 👉 Brugada = a multi-layer disease 🔬 New insight: proteomics Using Mendelian randomization across large cohorts, they identify novel protein pathways linked to BrS: • Cytoskeletal regulation • Stress-response signaling • Extracellular matrix remodeling ➡️ Not random findings ➡️ A coherent biological network 💥 Key players: • MMP1 → fibrosis / structural substrate • HSPB1 → protein folding / stress response • MAPKAPK2 → inflammation + signaling • PDLIM4 → cytoskeletal organization 🔥 Translation: 👉 The problem is not only the ion channel 👉 It’s the environment where the channel lives ⚡ This explains what we already see clinically: • Epicardial substrate • Fibrosis in RVOT • Inflammatory signals • Success of substrate ablation 👉 Hard to reconcile with a “pure channelopathy” 🧬 New concept: 👉 Structural + molecular dysfunction → leads to an “acquired channelopathy” Even normal channels can behave abnormally in a diseased substrate ⚠️ And this changes everything: • Risk stratification • Biomarkers (plasma proteins?) • Patient selection for ablation • Future targeted therapies 🎯 Take-home message Brugada is evolving from: ⚡ channel disease ➡️ 🫀 substrate-based cardiomyopathy 💬 Are we ready to stop calling Brugada a “pure channelopathy”? #Cardiology #BrugadaSyndrome #Arrhythmia #Genetics #PrecisionMedicine #EPeeps #CardioTwitter ⚡🫀 doi.org/10.1016/j.hrth…

Prevalence, Spectrum and Outcomes in Patients with Non-Penetrant Long QT Syndrome @EllianaRudquist @MJAckermanMDPhD heartrhythmjournal.com/article/S1547-…

CAAN-AF Trial #CHRD @adelaide87018 Our previous meta-analysis of observational studies suggested CRT patients with AF had a significant 58% reduction in all-cause mortality with AV node ablation - jacc.org/doi/10.1016/j.… We designed the CAAN AF Trial supported by the @nhmrc and critical industry partners - in order of support @bostonsci @AbbottNews @Medtronic @MicroPort - Methodology paper - heartrhythmopen.com/article/S2666-… CAAN AF Trial: doi.org/10.1093/eurhea… RCT showing no benefit in the routine use of AV node ablation

Another negative RCT for PWI in perAF! Will CORNERSTONE AF finally dampen EP obsession with PW? #EHRA2026

Clinical Profile and Mode of Initiation of Spontaneous Ventricular Tachyarrhythmias in Patients With Brugada Syndrome (START-BrS) | JACC: Clinical Electrophysiology jacc.org/doi/10.1016/j.…

JACC case reportsにノドベンのケースレポートが掲載されました！ オープンアクセスとなっています！🙇‍♂️ jacc.org/doi/10.1016/j.…

Electrophysiological Predictors of Super-response to Left Bundle Branch Area Pacing in Non-ischemic Cardiomyopathy: The PRECISION LBBAP 🫀Conduction system **capture** matters Confirmed LBB capture conferred 7.4-fold higher odds of super-response heartrhythmjournal.com/article/S1547-…

Major bleeding after left atrial appendage occlusion was most frequent in the first 6 months, and associated with older age, diabetes, prior bleeding, kidney disease, and increased risk of stroke and mortality. ja.ma/4d4rTDi

@drjohnm @bmorecardiology 😅

In my three decades of medicine I’ve never had industry reps bring free lunch BEFORE a trial was presented Here’s the flyer BSX passed out “Is your practice ready?” Wow! No mention of CLOSURE AF???

Surgical isolation of the left atrium - presented by Dr Cox Fascinating ECG - looks like heart block. His EGM shows sinus conduction - wow! I did not expect that

Line of Block: A simple pacing maneuver to distinguish AV nodal from accessory pathway ventriculoatrial conduction @Ahmed__Mokhtar heartrhythmjournal.com/article/S1547-…

Temporal Variability of the Electromechanical Window in Long-QT Syndrome and Drug-Induced QT Prolongation: Value for Enhanced Arrhythmia-Risk Assessment - Heart Rhythm heartrhythmjournal.com/article/S1547-…

Atrial Fibrillation Progression in Patients with Device-Detected Subclinical Atrial Fibrillation: Insights from the ARTESiA Trial @BorianiGiuseppe heartrhythmjournal.com/article/S1547-…