Introduction: Interventional cardiology procedures (ICPs) have become the mainstay treatments in cardiology diseases and increased rapidly. This study aims to assess the occupational health hazards (OHHs) related to the long-time wearing of lead personal protective equipment and reveal health protection needs in interventional cardiologists. Methods and Results: We invited interventional and non-interventional cardiologists in tertiary III hospitals in China to participate in an online cross-sectional survey on their health status, utilization of personal protective equipment (PPE), and personal health protection (PHP) needs. Propensity score methods were used for comparisons of OHHs between the matched interventional and non-interventional cardiologists. Totally, 642 interventional and 402 non-interventional cardiologists completed the survey. The interventional cardiologists had significantly higher incidence of body pain (56.6% vs. 24.2%, p<0.001), bone and joint disease (21.7% vs. 8.6%, p=0.001), cataract (3.5% vs. 0%, p=0.039), and anxiety (8.1% vs. 2.5%, p=0.029) than the matched non-interventional cardiologists. The risk of back pain was independently associated with female gender, performing percutaneous coronary intervention procedure or ≥2 types of ICP, and the personal annual volume of ICPs. Only 3.3% of interventional cardiologists were satisfied with PPE and 83.0% of them complained of physical toll caused by heavy PPE. 90.7% were willing to conduct ICP without radiation exposure. Conclusions: Body pain was the main OHH in interventional cardiologists likely due to wearing heavy lead PPE for long working hours. Besides training more interventional cardiologists, the adoption of emerging technologies without heavy lead PPE will be a promising way to reduce the OHH burden.

Aims: We aimed to further evaluate the effectiveness and safety between high-power short-duration (HPSD) radiofrequency ablation (RFA) and conventional RFA in patients with atrial fibrillation (AF). Methods: Studies comparing HPSD and conventional applications from inception through December 2021 were searched on Pubmed, Medline, Cochrane and Clinicaltrials.gov. Results: The meta-analysis included seventeen studies with a total of 4934 patients. HPSD group decreased procedure duration [mean difference (MD) -38.28 min, 95% confidence interval (CI) -47.08 to -29.49, P＜0.001], RF duration (MD -20.51 min, 95% CI -25.96 to -15.06, P＜0.001) and fluoroscopy duration (MD -5.19 min, 95% CI -8.02 to -2.37, P＜0.001), while improving the rates of first-pass isolation [Odds Ratio (OR) 8.92, 95% CI 2.40-33.09, P=0.009]. Compared with conventional group, freedom from atrial arrhythmia at 1-year-followup was higher in the HPSD group with a power setting of 40-50W (OR 1.93, 95% CI 1.27-2.91, P=0.002), nevertheless, two groups had similar effectiveness with a power setting of 50W in the HPSD RFA (OR 1.10, 95% CI 0.83-1.46, P=0.52). Acute pulmonary vein reconnection (P＜0.001) was significantly lower in the HPSD group. There was no difference in complications between the two groups (P=0.71). Conclusion: HPSD RFA was associated with shorter procedure duration, higher freedom from atrial arrhythmia and comparable safety when compared with conventional RFA.

Background Nodo-ventricular(NV) fiber-related reentrant tachycardias are so rare that most of them were reported by case, while few reports have summarized their common and individual features. Objectives To clarify the electrophysiological mechanism of supra-ventricular tachycardias (SVT) related to concealed NV fibers. Methods and Results We studied the intra-cardiac electrograms during electrophysiological study of 3 cases of SVT concerning concealed NV fibers. Maneuvers including ventricular entrainments, His bundle refractory period ventricular stimuli, adenosine triphosphate injection and so on were done for differential diagnosis before ablation. Among these patients, one had AVNRT with a bystander NV fiber, the other 2 had NV fiber-mediated orthodromic reentrant tachycardias (NVRT). VA dissociation were observed during SVT in all with antegrade His bundle conduction sequence. His bundle refractory period ventricular stimuli reset tachycardias with resetting of the H-H interval advancing the V-V interval, suggesting the existence of an accessory pathway. The cycle length of an NVRT prolonged during the status of functional right bundle branch block. Multiple QRS fusion morphologies during ventricular entrainments on a fixed site could be observed. Conclusions Concealed NV fibers can mediate orthodromic SVT or be a bystander of AVNRT. V-A dissociation usually occur during such SVTs. An NV fiber not only expresses the characteristics of an AP, but also the characteristics of the AV node. Multiple QRS fusion morphologies during ventricular entrainments or His bundle refractory period ventricular stimuli on a fixed site can discriminate NV fibers from NF fibers.