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(Circulation. 2007;116:2235.)
© 2007 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	CATHETER ABLATION OF VENTRICULAR TACHYCARDIA AFTER REPAIR OF CONGENITAL HEART DISEASE: ELECTROANATOMIC IDENTIFICATION OF THE CRITICAL RIGHT VENTRICULAR ISTHMUS, by Zeppenfeld et al.

 
Ventricular tachycardia (VT) is an important source of morbidity and mortality after repair of congenital heart disease, particularly tetralogy of Fallot. VT is often inducible and attributed to reentry. Zeppenfeld and coworkers characterized VT during catheter ablation procedures in 11 patients and related the findings to detailed anatomic study of autopsy specimens. Surgical incisions and scars created isthmuses for conduction that defined portions of reentry circuits that are consistent with anatomic studies. Isthmuses can be identified during catheter mapping and can be transected with ablation. In this selected series, ablation through 1 of these isthmuses was frequently effective in controlling VT. The findings provide guidance for catheter ablation in this patient population and suggest surgical procedures that might reduce the risk of late VT. See p 2241. (editorial p 2236).

	ACUTE MYOCARDIAL INFARCTION AND CONGESTIVE HEART FAILURE OUTCOMES AT SPECIALTY CARDIAC HOSPITALS, by Nallamothu et al.

 
Specialty cardiac hospitals have arisen over the past few years purportedly to homogenize processes of care and improve outcomes by focusing on specific disease states and procedures. Controversy has followed, as accusations have been leveled that these hospitals focus on lower-risk patients and profitable procedures, as well as that they shift the burden of sicker, higher-risk patients to more general hospitals. The controversy resulted in a 2003 moratorium on federal payments to new specialty facilities while these issues were assessed. To date, studies of outcomes in specialty versus general hospitals have focused only on procedural outcomes. In this issue of Circulation, Nallamothu and colleagues advance the debate substantially by assessing disease-based outcomes for acute myocardial infarction and heart . . . [Full Text of this Article]