Description: Background— Infarct size (IS) determined by cardiac magnetic resonance (CMR) has proven an additional value, on top of left ventricular ejection fraction (LVEF), in prediction of adverse arrhythmic cardiac events (AACEs) in chronic ischemic heart disease. Its value soon after an acute ST-segment–elevation myocardial infarction remains unknown. Our aim was to determine whether early CMR can improve AACE risk prediction after acute ST-segment–elevation myocardial infarction. Methods and Results— Patients admitted for a first noncomplicated ST-segment–elevation myocardial infarction were prospectively followed up. A total of 440 patients were included. All of them underwent CMR 1 week after admission. CMR-derived LVEF and IS (grams per meter squared) were quantified. AACEs included postdischarge sudden death, sustained ventricular tachycardia, and ventricular fibrillation either documented on ECG or recorded via an implantable cardioverter-defibrillator. Within a median follow-up of 2 years, 11 AACEs (2.5%) were detected: 5 sudden deaths (1.1%) and 6 spontaneous ventricular tachycardia/ventricular fibrillation. In the whole group, AACEs associated with more depressed LVEF (adjusted hazard ratio [95% confidence interval], 0.90 [0.83–0.97]; P 〈0.01) and larger IS (adjusted hazard ratio [95% confidence interval], 1.06 [1.01–1.12]; P =0.01). According to the corresponding area under the receiver operating characteristic curve, LVEF ≤36% and IS ≥23.5 g/m 2 best predicted AACEs. The vast majority of AACEs (10/11) occurred in patients with simultaneous depressed LVEF ≤36% and IS ≥23.5 g/m 2 (n=39). Conclusions— In the era of reperfusion therapies, occurrence of AACEs in patients with an in-hospital noncomplicated first ST-segment–elevation myocardial infarction is low. In this setting, assessment of an early CMR-derived IS could be useful for further optimization of AACE risk prediction.

Description: Aims Electrical storm (ES) is a life-threatening condition that predicts bad prognosis. Treatment includes antiarrhythmic drugs (AAD) and catheter ablation (CA). The present study aims to retrospectively compare prognosis in terms of survival and ES recurrence in 52 consecutive patients experiencing a first ES episode. Methods and results Patients were admitted from 1995 to 2011 and treated for ES by conservative therapy (pharmacological, 29 patients) or by CA (23 patients), according to the physician's preference and time of occurrence, i.e. conservative treatments were more frequently administered during the first years of the study, as catheter ablation became more frequent as the years passed by. After a median follow-up of 28 months, no differences either in survival (32% vs. 29% P = 0.8) or in ES recurrence (38% in ablated vs. 57% in non-ablated patients, P = 0.29) were observed between groups. Low left ventricle ejection fraction (LVEF) was the only variable associated with ES recurrence in ablated patients. When including patients with LVEF 〉 25%, ES recurrence was significantly lower in ablated patients (24 months estimated risk of ES recurrence was 21% vs. 62% in ablated and non-ablated patients, respectively); however, no benefit in survival was observed. Conclusion Our data suggest that in most patients, especially those with an LVEF 〉 25%, catheter ablation following a first ES episode, decreases the risk of ES recurrence, without increasing survival.

Description: Extreme sea level (ESL) events are the phenomena that result in exceptional water level at the coast, which can cause flooding, inundation, and erosion. Recent global scale studies show that relative sea level rise will increase the recurrence of ESL events, by reducing their return period. Also, the compound nature of these events, including the contribution from pluvial, fluvial, and ocean processes, is now understood to affect key processes in estuarine and delta environments. The EOatSEE project (https://eoatsee.eu/), funded by ESA under the Earth Observation Science for Society programmatic line, aims to provide a data-driven description of ESL events as a mean to advance scientific knowledge on this subject matter. It shall foster a community effort, bringing together the EO data provider and the numerical modelling communities, to fully exploit the novel capabilities and synergies offered by the latest advances in EO technology. In this work, a literature review and a collection of needs from the scientific community enabled the identification of current scientific challenges and technical requirements associated with process understanding, predictability and vulnerability & risk assessment of ESL events. Increasing the understanding of the non-linear interactions between oceanic and fluvial processes, and considering coastal morphology response within long-term flooding risk assessments are some examples of the scientific challenges identified, which are to be studied within 9 scientific demonstrators over 6 different coastal regions. Within IUGG2023, a set of preliminary results shall also be presented, as innovative solutions are developed and produced along EOatSEE to address those challenges.