Risk stratification scheme. Risk stratification aiming at assessing the risk of VAs and SCD in patients with MVP, involving two phases based on the clinical and imaging context and the uncovered arrhythmia. In the absence of ventricular tachycardia, phenotypic risk features will trigger the intensity of screening for arrhythmia. Green boxes indicate green heart consensus statements and yellow boxes indicate yellow heart consensus statements. High risk -sustained VT, polymorphic NSVT, fast (>180 bpm) NSVT, VT/NSVT resulting in syncope. ICD = implantable cardioverter defibrillator; LA = left atrium; LGE = late gadolinium enhancement; LV-EF = left ventricular ejection fraction; MAD = mitral annular disjunction; MV = mitral valve; PVCs = premature ventricular contractions; TWI = T-wave inversion; VT = ventricular tachycardia. #Additional ECG monitoring method may be used such as loop recorders.

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Objective: To investigate the relation between temporal artery biopsy (TAB) length and diagnostic sensitivity for giant cell arteritis. Methods: Histological TAB reports generated from four hospital pathology departments were reviewed for demographics, histological findings, and formalin fixed TAB lengths. A biopsy was considered positive for giant cell arteritis if there was a mononuclear cell infiltrate predominating at the media-intima junction or in the media. Results: Among 1821 TAB reports reviewed, 287 (15.8%) were excluded because of missing data, sampling errors, or age ,50 years. Mean TAB length of the 1520 datasets finally analysed (67.2% women; mean (SD) age, 73.1 (10.0) years) was 1.33 (0.73) cm. Histological evidence of giant cell arteritis was found in 223 specimens (14.7%), among which 164 (73.5%) contained giant cells. Statistical analyses, including piecewise logistic regression, identified 0.5 cm as the TAB length change point for diagnostic sensitivity. Compared with TAB length of ,0.5 cm, the respective odds ratios for positive TAB without and with multinucleated giant cells in samples >0.5 cm long were 5.7 (95% confidence interval, 1.4 to 23.6) and 4.0 (0.97 to 16.5). Conclusions: A fixed TAB length of at least 0.5 cm could be sufficient to make a histological diagnosis of giant cell arteritis.T he diagnosis of giant cell arteritis is most solidly established by the demonstration of granulomatous inflammation in a temporal artery biopsy (TAB). For between 7% and 44% of cases of giant cell arteritis, however, TAB examination is unremarkable 1 and it is unclear to what extent these non-informative specimens reflect false negative histological findings. One of several factors that has been advanced to explain false negative TAB results is that, because of the ''skipping'' nature of the inflammatory involvement in giant cell arteritis, 2 3 histological changes may be missed in a TAB taken in an arteritis-free segment.The resultant widely accepted dogma is that a long TAB segment should be excised to maximise the chance of visualising disease components. Although it is most commonly recommended that samples of 2-3 cm 4 or 3-5 cm 5 length be taken, the TAB length yielding optimal diagnostic sensitivity remains unknown. We therefore undertook this study in an attempt to determine the relation between TAB length and diagnostic sensitivity for giant cell arteritis. METHODSWe reviewed the written histological TAB reports from four pathology departments in three university hospitals (centres 1-3), each having internal medicine, rheumatology, and ophthalmology units, and one public ophthalmology hospital (centre 4). These departments customarily measured the lengths of formalin fixed TAB samples on macroscopic examination and recorded them in their reports. Using those departments' computerised databases, we retrieved all consecutive TAB reports that had been generated during well defined periods. Selected time periods covered either the entire interval from computerisation of histological reports unti...

Anatomic, dynamic, and perfusion imaging using contrast-enhanced CT allows characterization of left ventricular anatomy and 3D scar and BZ substrate. Integration of reconstructed 3D data sets into clinical mapping systems supplements information of voltage mapping and may enable new image approaches for substrate-guided ventricular tachycardia ablation.