We present the case of a 14-year-old male patient referred to paediatric cardiology for the incidental finding of a cardiac murmur and initially diagnosed with asymmetric septal hypertrophic cardiomyopathy. Due to deterioration in his functional class (NYHA II/IV), he was admitted to our institution for further evaluation. A hyperechoic mass measuring 35.7 mm × 39.4 mm was identified in the interventricular septum, with central vascularisation and a significant obstructive gradient in the right ventricular outflow tract (112 mmHg). Cardiac magnetic resonance imaging confirmed a highly vascularised lesion, hyperintense on HASTE, T1, and T2 sequences, with an extracellular volume of 67%, consistent with a cardiac haemangioma. Coronary CT angiography demonstrated perfusion by a septal branch of the left anterior descending artery. Given the anatomical involvement and the low feasibility of surgical management, cardiac catheterisation with embolisation of the septal branch using an Interlock Coil occlusion device was performed. Post-procedure angiography confirmed complete occlusion. Cardiac tumours in paediatrics are rare and generally benign, with haemangiomas being one of the least common neoplasms. Diagnosis relies on non-invasive imaging techniques, with echocardiography and magnetic resonance imaging playing crucial roles. In this case, the combination of echocardiography, coronary CT angiography, and catheterisation allowed for a comprehensive characterisation of the lesion and the development of a therapeutic strategy while minimising risks. The patient remains stable under follow-up. This multidisciplinary approach optimises the management of paediatric cardiac tumours, enabling individualised therapeutic options.

The precise preprocedural localization of outflow tract premature ventricular contractions (OT-PVCs) remain essential yet challenging, owing to the region's complex and variable anatomy, particularly for left-sided origins. Although numerous electrocardiographic localization algorithms have been proposed, most are constrained by a trade-off between diagnostic accuracy and clinical practicality. QRS notching is a frequently observed but largely overlooked feature in OT-PVCs, and it remains understudied in the context of idiopathic ventricular arrhythmias. This study aims to move beyond a simple analysis of notch distribution across leads by leveraging QRS notching as a functional marker of ventricular activation to enhance site of origin localization. This retrospective observational study included 105 patients who underwent successful catheter ablation for symptomatic OT-PVCs. The cohort consisted of 57 right ventricular outflow tract (RVOT) and 48 left ventricular outflow tract (LVOT) PVCs. All PVCs exhibited a left bundle branch block morphology with an inferior axis, defined by a dominant R-wave in the inferior leads and a QS complex in leads aVL and aVR. Furthermore, each PVC demonstrated a single, reproducible notch with a duration of ≤20ms. Notch Timing (NT) was defined as the interval from the earliest onset of the global PVC QRS complex to the nadir of the identifiable notch. When notches were asynchronous across the 12 leads, the timing of the latest-occurring notch was recorded for analysis. The diagnostic performance of the NT criterion for differentiating RVOT from LVOT origins was evaluated and compared against the V2S/V3R index using receiver operating characteristic (ROC) curve analysis, with the area under the curve (AUC) serving as the primary metric of comparison. Of 105 patients (45.6±13.4years, 55% male), 57 had RVOT and 48 had LVOT PVCs. NT robustly differentiated origins, with RVOT PVCs demonstrating significantly later notches than LVOT PVCs (94.3±15.0ms vs. 74.5±15.6ms, p<0.001). An NT >80ms favored an RVOT origin with 87.7% sensitivity and 68.8% specificity (PPV=76,9%, NPV=78,1%, AUC 0.838). The diagnostic performance of NT was comparable to the established V2S/V3R index (AUC 0.828). Characteristic lead distribution patterns augmented localization, though extensive notching across both the inferior and lateral precordial leads was not specific for a free-wall RVOT origin. This study introduces the first structured framework for QRS notch analysis-defining its characteristics, timing, and distribution-to improve arrhythmia localization. This represents a shift from descriptive morphology to mechanistic interpretation, where a novel notch timing metric robustly discriminates RVOT from LVOT origins by quantifying delayed transeptal conduction.

ObjectivePremature Ventricular Contractions (PVC) is a common arrhythmia. Accurate localization is crucial for effective treatment and prognosis. Current Electrocardiography (ECG) methods face inherent limitations in localizing PVC precisely. This study aimed to develop a robust PVC localization model using radiomics and machine learning.MethodsData was collected from 304 PVC patients who underwent catheter radiofrequency ablation at the First Affiliated Hospital of Dalian Medical University between November 2015 and May 2023. Coronary Computed Tomography Angiography and clinical baseline data were used to extract 980 radiomic features. Least Absolute Shrinkage and Selection Operator regression identified the most valuable features. The dataset was divided into training and testing sets in a 7:3 ratio. Fifteen machine learning algorithms were used for model construction and evaluation, with SHapley Additive exPlanations analysis to assess feature importance. The results were compared with traditional ECG localization diagnostics and previously-studied articles.ResultsGradient Boosting (GB), LightGBM, and Random Forest models performed well, with the area under the receiver operating characteristic curve (AUC) exceeding 0.8515, showing competitive performance compared to reported metrics of ECG-based methods. The GB model achieved an AUC of 0.9897 in distinguishing the left ventricular outflow tract from the right ventricular outflow tract. SHAP analysis revealed that radiomics features such as original_glszm_HighGrayLevelZoneEmphasis and clinical features such as B-type natriuretic peptide and left ventricular ejection fraction all emerged as important contributors to the predictive capacity.ConclusionCombining radiomics and machine learning techniques offers a robust, data-driven framework that complements traditional diagnostic approaches for PVC localization. This method enhances diagnostic precision and aids in developing personalized treatment plans for PVC patients.

Surgical myectomy (SM), performed to relieve dynamic left ventricular outflow tract obstruction (LVOTO) in symptomatic obstructive hypertrophic cardiomyopathy (oHCM) patients provides improved quality of life and symptoms and excellent long-term survival. Guidelines recommend SM in symptomatic oHCM patients refractory to optimal medical therapy. We sought to assess whether SM in patients with fewer symptoms at initial referral is associated with improved long-term outcomes in oHCM. Baseline symptom burden at the time of referral emerged as a powerful prognostic discriminator among 3,546 HCM patients undergoing SM. Our findings suggest that earlier surgical referral before advanced decompensation may be associated with more favorable long-term outcomes. Women were more likely to present with advanced symptoms and had higher adjusted risk. These results underscore the need to determine whether a proactive therapeutic strategy, including an earlier intervention, can modify long-term survival in oHCM.

The optimal post-repair pulmonary valve annulus (PVA) diameter in tetralogy of Fallot (TOF) may be far smaller than anticipated. Therefore, selected patients can undergo repair without manipulating the PV structure. Of the 347 patients who underwent TOF repair with PVA preservation (AP) from January 2016 to December 2023, 100 had AP while leaving the PV structure untouched. Median age, weight, and PVA (Z) at repair were 125 days (interquartile range [IQR], 96.5-167.5), 6.3kg (IQR, 5.1-7.1), and -0.8 (IQR, -1.8 to 0.3), respectively. One non-cardiac late death occurred 9 months after repair. During a median 46.2 months follow-up, 14 patients (14%) required reinterventions for significant right ventricular outflow tract obstruction (RVOTO): balloon pulmonary valvuloplasty (BPV) in 6, surgical RVOTO relief in 4, and BPV followed by surgery in 4 (including 1 who received a right ventricle to pulmonary artery conduit to bypass a left anterior descending coronary artery crossing the RVOT). Except for the conduit recipient, only 2 patients showed significant RVOTO (n = 1) and significant pulmonary regurgitation (PR) (n = 1) at the last follow-up. On Cox regression, neonatal repair (hazard ratio [HR], 5.12, P = 0.02) and a higher PRV/LV (post-repair pressure ratio of the right ventricle to the left ventricle) (HR 1.61 per 0.1 increase, P = 0.04) were risk factors for decreased time to reintervention. The post-repair PRV/LV cutoff predicting reintervention was 0.52. Preserving an intact PV during TOF repair is feasible in a subset. Post-repair RVOTO, when it occurs, can be relieved by a timely reintervention without inducing significant PR.

The presystolic wave (PSW), a late-diastolic Doppler flow signal in the left ventricular outflow tract, reflects atrial contraction and atrioventricular coupling. Although its presence is considered a physiological finding in healthy individuals, alterations in PSW characteristics may indicate impaired atrial or ventricular compliance. This study aimed to evaluate the relationship between PSW and cerebrovascular events (CVE) in patients with paroxysmal atrial fibrillation (PAF). In this retrospective study, 380 patients diagnosed with PAF by 24-hour Holter monitoring between January 2019 and January 2025 were analyzed. Transthoracic echocardiography was performed to assess PSW presence, left ventricular systolic and diastolic functions. Patients were divided according to PSW presence and history of CVE (stroke or transient ischemic attack). Clinical, laboratory, and echocardiographic variables were compared, and multivariate logistic regression was used to identify independent predictors of CVE. PSW was identified in 284 (74.7%) patients. Those without PSW were older, had greater left atrial volume index (LAVI) and left ventricular mass index (LVMI), and more frequently had previous CVE (45.8% vs. 16.9%, p < 0.001). In multivariate analysis, high CHA₂DS₂-VASc score, increased LAVI, and absence of PSW were independent predictors of CVE. ROC analysis showed that a PSW peak velocity < 0.30m/s was associated with the presence of CVE, with 81% sensitivity and 67% specificity (AUC = 0.783, p < 0.001). Absence or reduction of the PSW is independently associated with CVE in PAF patients. PSW assessment provides a simple, reproducible, and noninvasive measure of atrioventricular mechanical function that may be associated with increased thromboembolic vulnerability.

The aim of this study is to provide an up-to-date synthesis of hypertrophic cardiomyopathy (HCM), integrating progress in imaging, genetics, and therapeutics (especially cardiac myosin inhibitors) while emphasizing individualized care for obstructive and nonobstructive disease. This narrative review discusses contemporary literature on HCM, including epidemiology, mechanisms, diagnostic tools, and management. Particular emphasis is placed on multimodality imaging (echocardiography and cardiac magnetic resonance), risk stratification methods, and trial evidence for mavacamten and aficamten. Over the past two decades, earlier diagnosis and better risk assessment have helped reduce HCM-related mortality. In obstructive HCM, cardiac myosin inhibitors have shown consistent benefits on symptoms, LV outflow tract gradients, and functional capacity. By contrast, nonobstructive HCM remains harder to treat, and some patients progress to advanced heart failure. Biomarkers, strain parameters, and CMR fibrosis quantification may support longitudinal monitoring. Myosin inhibition has changed the therapeutic landscape for obstructive HCM and may extend beyond symptom relief, but long-term safety and broader applicability remain unclear. The expanding use of advanced imaging and biomarkers is key to individualized decision-making and risk assessment. HCM is not static; with careful follow-up and multidisciplinary care, outcomes are increasingly favorable. Integrating newer biologic therapies with established management remains a priority, while access and unmet needs (particularly in non-obstructive HCM) still require attention.

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (PMAIVF) is a rare, life-threatening complication typically associated with infective endocarditis (IE) and prior cardiac surgery. Here, we report an unusual case of a 28-year-old woman with a congenital bicuspid aortic valve (BAV) who experienced an exceptionally rapid progression to PMAIVF within just two months of IE onset. While transthoracic echocardiography (TTE) showed ambiguous perivalvular abnormalities, transesophageal echocardiography (TEE) clearly delineated the pseudoaneurysm, demonstrating its dynamic systolic expansion and diastolic collapse, as well as its communication with the left ventricular outflow tract. To better understand the clinical profile of this rare entity, we comprehensively reviewed 64 cases from 32 core literatures. The review confirms that PMAIVF predominantly affects young adults (median age 35years) and is strongly driven by the coexistence of BAV and IE (accounting for ~ 85% of cases). This case and our literature review underscore the diagnostic limitations of TTE and highlight the indispensability of TEE for early identification, accurate anatomical mapping, and prompt surgical intervention (such as aortic valve replacement and patch repair) to prevent fatal complications like cardiac tamponade.

A recent discussion that highlighted the differences between the reported effective orifice area and corresponding incidence of prosthesis-patient mismatch within the 1- and 7-year results of the PERIcardial SurGical AOrtic Valve ReplacemeNt (PERIGON) Trial of the Avalus valve has once again emphasized the instability of such measurements. The effective orifice area, calculated using the continuity equation through measurements of the left ventricular outflow tract diameter, is highly susceptible to measurement variability, as previously demonstrated in literature through both intra- and interobserver variability. To illustrate this problem a simulation was performed in which the left ventricular outflow tract diameter was systematically altered by -2 mm, -1 mm, 0 mm, +1 mm, and +2 mm. Subsequently, the proportion of severe prosthesis-patient mismatch was recalculated and varied between 13.3%, 6.2%, 3.1% (original), 1.2%, and 0.3%, respectively. These findings demonstrate that small but clinically realistic variability in left ventricular outflow tract measurements can significantly affect the presence of prosthesis-patient mismatch. A measurement variability of 1 mm can nearly double or halve the prevalence of severe prosthesis-patient mismatch. This illustrates that prosthesis-patient mismatch, in its current form, is highly unstable and that indexed effective orifice area-based prosthesis-patient mismatch should not be used in isolation.

BackgroundCongenital aortic valve stenosis (AVS) is the most common cause of ventricular outflow tract obstruction. Surgical aortic valvuloplasty (SAV) and balloon aortic valvuloplasty (BAV) are the most common primary interventions, with conflicting data regarding their long-term outcomes. We aimed to study the long-term clinical outcomes of patients allocated to BAV or SAV.MethodsWe searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL through August 2025 for relevant studies reporting long-term outcomes of SAV versus BAV in patients with congenital AVS. The primary outcome was the 10-year rate of aortic valve replacement (AVR). Subgroup analysis was performed for all clinical outcomes according to the age of the included children.ResultsA total of nine trials including 1704 patients (67%, [1136/1704]) males; median follow-up of 10 years) were included. The pooled estimate showed that SAV was associated with lower long-term reintervention rates (risk ratio 0.76, 95% confidence interval (CI): 0.6 to 0.96, P = .02), and a significant reduction in peak aortic gradient pressure (PAGP) (mean difference (MD) -11.53 mm Hg, 95% CI: -18.66 to -4.41, P < .001) in patients more than 1 year of age. In addition, SAV was associated with a longer time to first reintervention in patients younger than 1 year of age (MD 2.43 years, 95% CI: 0.68 to 4.19, P = .01). There was no significant difference regarding the primary outcome or other studied outcomes.ConclusionIn patients with congenital aortic valve stenosis, SAV showed the greatest benefit in children older than 1 year of age with similar AVR and mortality rates; but superior durability, lower reintervention rates, and greater reductions in peak aortic pressure gradient when compared with BAV.

Pulmonary sinus cusp-inclusive mapping and ablation for paediatric right ventricular outflow tract ventricular arrhythmias.

It is not clear whether septal myectomy with secondary chordal resection (SM-SCR) can achieve similar postoperative outcomes among hypertrophic obstructive cardiomyopathy (HOCM) patients exhibiting different severity of septal hypertrophy. This was a single-center retrospective cohort study with a nested case-control study. HOCM patients received SM-SCR between 2014 and 2023 were retrospectively included and were grouped based on their septal thickness. The main outcome was the relief of the left ventricular outflow tract (LVOT) obstruction. Besides, predictors for recurrent mitral regurgitation (MR) were also explored. A total of 88 patients were included, with 63 in the significant hypertrophy group (SH group) and 25 in the mild hypertrophy group (MH group). The overall median follow-up time was 54.0 (33.0-79.0) months. Before adjusting the covariates, The LVOT gradients at the last follow-up were similar between groups [SH group vs. MH group: 10.0 (6.0-14.0) mmHg vs. 8.0 (6.0-11.5) mmHg, P = 0.556], while the interventricular septum (IVS) was thicker for the SH group [15.0 (12.0-17.0) mm vs. 13.0 (11.0-14.0) mm, P = 0.016]. In the fully adjusted model, both the LVOT gradients and the IVS thickness were comparable (P = 0.606 and 0.520 respectively). The risk of recurrent MR was similar between groups (7.9% vs. 8.0%, log-rank P = 0.879), while no predictors for recurrent MR were identified. According to our single-center data, the mid-term outcomes after SM-SCR were comparable for HOCM patients with different severity of septal hypertrophy. However, further investigations with larger sample sizes and longer follow-up durations are needed. The study was approved by the Institutional Review Board [2023(2408)], and patients' consents were waived due to the retrospective nature of the study.

Maternal adult congenital heart disease (ACHD) has been associated with increased offspring congenital heart disease (CHD), but evidence from resource-limited regions remains scarce. The association between maternal acquired heart disease (AHD) and offspring CHD is unknown. To quantify the overall and subtype-specific CHD risk in offspring associated with maternal ACHD and AHD, examine the association of maternal ACHD and AHD with outcomes in offspring with CHD, and identify maternal factors that may modify the associations between maternal cardiac diseases and offspring CHD risk. This prospective birth cohort study enrolled pregnant women receiving prenatal care between August 1, 2011, and December 31, 2021, at a major cardiac referral center in China. Participants included pregnant women with ACHD, with AHD, or without cardiac disease and were followed up through delivery; their offspring were followed up until 1 year of age. All follow-ups were completed by December 15, 2023. Data were analyzed from April 1, 2024, through April 31, 2025. Maternal ACHD and AHD, confirmed via the center's electronic medical records. The main outcome was offspring CHD, which was diagnosed using echocardiography. Log-binomial regression was used to estimate relative risks (risk ratios [RRs]) and 95% CIs. Adverse outcomes were compared using pairwise tests. Stratification analyses identified potential effect modifiers. A total of 14 336 pregnant women with 15 677 offspring (8480 males [54.1%]) were included. The mean (SD) maternal age and gestational age at enrollment were 31.4 (4.5) years and 16.4 (6.4) weeks, respectively. Both maternal ACHD and AHD were associated with higher CHD risk in offspring (RR, 1.71 [95% CI, 1.26-2.31] and 1.38 [95% CI, 1.02-1.87], respectively). Minor CHDs, particularly septal defects, were the subtypes with the greatest magnitude of associations with maternal ACHD (RR, 2.95; 95% CI, 1.97-4.43) and AHD (RR, 2.28; 95% CI, 1.50-3.45). Right ventricular outflow tract obstruction (RR, 6.17; 95% CI, 3.59-10.60) and valvular heart disease (RR, 1.65; 95% CI, 1.11-2.45) were the key contributors to offspring CHD risk. Preterm birth had higher rates among offspring with CHD and mothers with ACHD as well as offspring with CHD and mothers without ACHD compared with offspring without CHD and mothers without cardiac disease (12 of 39 [30.8%] and 121 of 780 [15.5%] vs 1287 of 14 088 [9.1%]; all P < .001). Higher rates of chromosomal (5 of 39 [12.8%] and 38 of 780 [4.9%] vs 75 of 14 088 [0.5%]; all P < .001) and genetic aberrations (3 of 39 [7.7%] and 16 of 780 [2.1%] vs 57/14 088 [0.4%]; all P < .001) were found among offspring with CHD and mothers with AHD as well as offspring with CHD and mothers without AHCD compared with offspring without CHD and mothers without cardiac disease. Associations between maternal cardiac disease and offspring CHD were robust in primiparous women (ACHD: RR, 2.15 [95% CI, 1.48-3.11], P for interaction < .001; AHD: RR, 1.73 [95% CI, 1.17-2.56], P for interaction = .02) and those with periconceptional exposure to hazardous substances (ACHD: RR, 2.22 [95% CI, 1.56-3.16], P for interaction < .001; AHD: RR, 1.57 [95% CI, 1.05-2.36], P for interaction = .02). In this cohort study, maternal ACHD and AHD were associated with increased risks and adverse outcomes of offspring CHD. Targeted modification of identified maternal factors could help mitigate offspring CHD risk in this high-risk population.

A challenge of studying mammalian cardiac embryogenesis is the limited ability to perform experimental manipulations in animal models. The avian embryo is widely accepted as a model for mammalian heart developmental studies. In this study, we establish the methodology and protocols for studying the Japanese quail (Coturnix japonica) heart at embryonic day 10 (HH38) using the FUJIFILM VisualSonics Vevo 3100 ultrasound system equipped with a MX550D small animal cardiology transducer. These protocols were designed to measure right ventricular wall thickness, pulmonary artery diameter, and the outflow velocities of the right ventricular outflow tract (RVOT) and the pulmonary artery (PA), thereby establishing baseline parameters of the normally developing quail morphology. Quail embryos are an ideal model for cardiovascular research due to their short incubation period (16–17 days), experimental accessibility, and strong similarities to mammalian heart development. These developmental similarities include, but are not limited to, looping, chamber septation, and the development of a true four-chamber heart. High-resolution imaging modalities, including ultrasound and optical coherence tomography, enable noninvasive, real-time visualization of cardiac morphology and function throughout development. Echocardiography allows for quantitative and qualitative assessments of myocardial structure and cardiac hemodynamics. The similarity to the mammalian heart, combined with rapid embryogenesis, makes quail embryos a valuable model for investigating congenital heart defects, genetic modifications, and fundamental cardiac developmental processes. In this study, we describe reproducible incubation protocols and baseline echocardiographic parameters used to evaluate morphological and physiological changes in the developing embryonic quail heart on embryonic day 10.

The COMPASSION S3 trial (Congenital Multicenter Trial of Pulmonic Valve Dysfunction Studying the SAPIEN 3 Interventional Transcatheter Heart Valve) was designed to evaluate the safety and effectiveness of the SAPIEN 3 transcatheter heart valve (THV) for transcatheter pulmonic valve replacement in patients with a dysfunctional right ventricular outflow tract (RVOT) conduit or previously implanted valve in the pulmonic position. Here, 5-year clinical and hemodynamic outcomes for patients in the main cohort and the continued access protocol are reported. The COMPASSION S3 trial was a single-arm, multicenter study enrolling patients with either moderate-to-severe pulmonic regurgitation, a mean RVOT gradient ≥35 mm Hg, or both. The primary end point was THV dysfunction at 1 year, a nonhierarchical composite of RVOT reintervention, ≥moderate total pulmonic regurgitation, and mean RVOT gradient >40 mm Hg. Clinical and echocardiographic outcomes were assessed at baseline, discharge, 30 days, 6 months, 1 year, and then annually to 5 years. Between 2016 and 2020, 69 patients were enrolled and successfully implanted with the SAPIEN 3 THV. The mean patient age was 32.1 years, and most patients (70.8%) had a conduit as the most recent prior intervention. At 5 years, the rate of THV dysfunction was 12.0%: 3 patients required reintervention, 2 patients had ≥moderate pulmonic regurgitation, and 1 patient had a mean gradient >40 mm Hg. There were 3 cases of device-related endocarditis (4.4%). One death occurred on postoperative day 560 due to cardiogenic shock. No cases of tricuspid valve injury, stent fractures, or valve malposition were reported. Post-transcatheter pulmonic valve replacement, mean gradients were low and stable through 5-year follow-up. Through 5 years, >95% of patients had ≤mild total pulmonic regurgitation, and 97.9% of patients had none/trace paravalvular regurgitation. Five-year results from the COMPASSION S3 trial demonstrate that the SAPIEN 3 THV provides durable RVOT relief with low rates of reintervention or endocarditis, supporting the device as a safe and versatile option for transcatheter pulmonic valve replacement across diverse anatomies and clinical scenarios. URL: https://www.clinicaltrials.gov; Unique identifier: NCT02744677.

Hypertrophic cardiomyopathy (HCM) is an inherited heart disease characterized by unexplained left ventricular hypertrophy with or without outflow tract obstruction. Conventional therapies may relieve symptoms associated with left ventricular outflow tract (LVOT) obstruction; however, they do not act directly on the contractile cell, and refractory patients may require septal reduction therapy. Allosteric cardiac myosin inhibitors (CMIs) represent a novel therapeutic approach directly targeting sarcomeric hypercontractility. Mavacamten and aficamten have demonstrated significant clinical and haemodynamic benefits in obstructive HCM (oHCM). The MAPLE-HCM trial revealed that aficamten significantly improved peak oxygen uptake, NYHA functional class, quality of life, and reduced LVOT gradients compared with metoprolol, with a favourable safety profile. Encouraged by these findings, CMIs have been investigated in non-obstructive HCM (nHCM). The ODYSSEY-HCM trial evaluated mavacamten in patients with symptomatic nHCM. While the primary endpoints of exercise capacity and patient-reported health status were not met, secondary analyses showed favourable effects on NT-proBNP, high-sensitivity troponin I, left ventricular diastolic function, and hypertrophy parameters. In conclusion, CMIs offer substantial benefits in oHCM, improving symptoms and cardiac haemodynamics. In nHCM, despite limited impact on functional capacity, CMIs demonstrate biological activity and favourable cardiac remodelling, supporting further research into their potential role in modulating disease pathophysiology.

Intraseptal Mapping of Premature Ventricular Complexes Using Multipolar Catheters.

Outcomes and Sex Differences in Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy-Insights from a Japanese Nationwide Registry.

A short right ventricular outflow tract represents an anatomical limitation for transcatheter self-expandable pulmonary valve placement. In this report, we present an innovative modification of the HarmonyTM transcatheter pulmonary valve to accommodate the short right ventricular outflow tract anatomy in an 11-year-old boy in a setting in which an appropriately-sized balloon expandable valve was unavailable.

Cardiac MR Imaging of Flow Abnormalities in Hypertrophic Cardiomyopathy Phenotypes.