Background: Recent evidence showed that the characteristics and outcome of those with de novo heart failure (HF) and acutely decompensated chronic heart failure (ADCHF) were different. We aimed to perform a comprehensive search on the clinical characteristics and outcome of patients with de novo HF and ADCHF. Methods: We performed a comprehensive search on de novo/new onset acute HF vs ADCHF from inception up until December 2019. Results: There were 38320 patients from 15 studies. De novo HF were younger and, had less prevalent hypertension, diabetes mellitus, ischaemic heart disease, chronic obstructive pulmonary disease, atrial fibrillation, and history of stroke/transient ischaemic attack compared to ADCHF. Five studies showed a lower NT-proBNP in de novo HF patients, while one study showed no difference. Valvular heart disease as aetiology of heart failure was less frequent in de novo HF, and upon sensitivity analysis, hypertensive heart disease was more frequent in de novo HF. As for precipitating factors, ACS (OR 2.42; I²:89%) was more frequently seen in de novo HF, whereas infection was less frequently (OR 0.69; I²:32%) in ADCHF. De novo HF was associated with a significantly lower 3-month mortality (OR 0.63; I²:91%) and 1-year (OR 0.59; I²:59%) mortality. Meta-regression showed that 1-year mortality did not significantly vary with age (p = .106), baseline ejection fraction (p = .703), or HF reduced ejection fraction (p = .262). Conclusion: Risk factors, aetiology, and precipitating factors of HF in de novo and ADCHF differ. De novo HF also had lower 1-year mortality and 3-month mortality compared to ADCHF.

Prevalence of atrial fibrillation (AF) in patients with congenital heart disease (CHD) is on the rise. Anti-arrhythmic drugs are usually the first line of treatment in CHD, however, it is often ineffective and poorly tolerated. We aimed to perform a systematic review to assess the efficacy and safety of catheter ablation for AF in CHD. We performed a comprehensive search on catheter ablation for atrial fibrillation in congenital heart disease up until July 2019 through several electronic databases. Ablation of AF in patients with CHD had a modest 12 months AF freedom ranging from 32.8% to 63%, which can be increased by subsequent/repeat ablation. The complexity of CHD appears to have a significant effect on a study but not in others. Catheter ablation in ASD and persistent left superior vena cava had a high success rate. Overall, catheter ablation is safe whichever the type of CHD is. Catheter ablation for AF in CHD had modest efficacy that can be increased by subsequent/repeat ablation and it also has an excellent safety profile. Ablation in complex CHD could also have similar efficacy, however, it is preferably done by experts in a high volume tertiary center.

Background: Basic life support (BLS) performed by general population improves outcomes in cardiorespiratory collapse. This community-based study aims to measure the general population's eagerness in learning BLS, knowledge regarding early recognition, and use an automated external defibrillator. Methods: This was a cross-sectional community-based study in Jakarta using questionnaire. Numerous questions asked through a questionnaire in order to evaluate the general population's eagerness and knowledge about basic life support. Results: There were 303 respondents in this study. Most respondents stated that knowledge about BLS is important and was eager to learn; however, only 39.6% of respondents have ever done BLS training. 59.4% of respondents have ever looked for information or read about BLS. 63.6% of respondents chose to call an ambulance for the first reaction, while 36,5% of respondents preferred to look for a pulse. Most of the respondents know to check the carotid pulse in the neck. 77.4% of respondents know that chest compression was done on mid-chest. 81.5% of respondents agreed that CPR was preferably done repeatedly in a specific rhythm, but giving one despite the method is better than none. Only 49.5% of respondents wanted to give mouth-to-mouth ventilation. Most respondents thought that they are not allowed to use AED, and only a small proportion had seen AED in public. Conclusion: Most of the respondents agreed that BLS is important. Respondents have satisfying knowledge about how to react while encountering an unconscious person. Most respondents have not seen AED and most likely didn't know how to use it.

Is T-Wave Alternans a Repolarization Abnormality Marker in COVID-19? An Investigation on the Potentialities of Portable Electrocardiogram Device