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1. Electrophysiology of living organs from first principles

Author

Scharf, Günter and Scharf, Christoph

Subjects
Physics - Biological Physics, Quantitative Biology - Quantitative Methods
Abstract

Based on the derivation of the macroscopic Maxwell's equations by spatial averaging of the microscopic equations, we discuss the electrophysiology of living organs. Other methods of averaging (or homogenization) like the bidomain model are not compatible with Maxwell's theory. We also point out that modeling the active cells by source currents is not a suitable description of the situation from first principles. Instead, it turns out that the main source of the measured electrical potentials is the polarization charge density which exists at the membranes of the active cells and adds up to a macroscopic polarization. The latter is the source term in the Laplace equation, the solution of which gives the measured far-field potential. As a consequence it is the polarization or dipole density which is best suited for localization of cardiac arrhythmia., Comment: 11 pages, no figure

Published
2010

3. Paroxysmal and persistent atrial fibrillation ablation outcomes with the pulmonary vein ablation catheter GOLD duty-cycled phased radiofrequency ablation catheter: quality of life and 12-month efficacy results from the GOLD Atrial Fibrillation Registry

Author

Boersma, Lucas, primary, Koźluk, Edward, primary, Maglia, Giampiero, primary, de Sousa, João, primary, Grebe, Olaf, primary, Eckardt, Lars, primary, Hokanson, Robert B, primary, Hemingway, Lauren A, primary, Ostern, Ekaterina, primary, Park, Hyoung-Seob, primary, Rovaris, Giovanni, primary, Arribas, Fernando, primary, Scharf, Christoph, primary, Csanádi, Zoltán, primary, Arenal, Ángel, primary, Laurenzi, Francesco, primary, Klaver, Martijn, primary, and Goette, Andreas, primary

Published
2020
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4. Cardiac Interventions in Symptomatic Patients ≥ 90-Years-Old (Nonagenarians): A Single-Center Retrospective Analysis of Spectrum and Outcome

Author

Bertel Osmund, Levis Pierre, Naegeli Barbara, Straumann Edwin, Amann Franz Wolfgang, Seifert Burkhardt, Franzen Olaf, Müller Philippe N, Scharf Christoph, Maurer Dominik, and Jost Christine H Attenhofer

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Cardiac interventions, Retrospective analysis, Medicine, business, Single Center, Outcome (game theory)
Published
2019

8. Effects of AV delay programming on ventricular resynchronisation: role of radionuclide ventriculography

Author

Siegrist, Patrick, Comte, Nathalie, Holzmeister, Johannes, Sütsch, Gabor, Koepfli, Pascal, Namdar, Mehdi, Duru, Firat, Brunckhorst, Corinna, Scharf, Christoph, Kaufmann, Philipp, Siegrist, Patrick, Comte, Nathalie, Holzmeister, Johannes, Sütsch, Gabor, Koepfli, Pascal, Namdar, Mehdi, Duru, Firat, Brunckhorst, Corinna, Scharf, Christoph, and Kaufmann, Philipp

Abstract

Purpose: Optimal atrioventricular delay (AVD) setting for cardiac resynchronisation therapy, i.e. biventricular pacing in patients with heart failure, remains a formidable challenge. Thus, the purpose of this study was to evaluate the effects of different AVD on inter- and intra-ventricular resynchronisation using phase histograms of radionuclide ventriculography (RNV). Methods: In 17 consecutive patients (mean age 64 ± 6years), RNV was performed 236 ± 350days after pacemaker implantation for cardiac resynchronisation therapy. Images were acquired during atrial pacing at 80bpm and during biventricular pacing with AVD ranging from 80 to 160ms. Inter-ventricular dyssynchrony was measured by the delay between the mean phase angles of the left and right ventricles. Intra-ventricular dyssynchrony was measured by the standard deviation (SD) of left ventricular phase histograms. Results: Left ventricular (LV) ejection fraction (EF) was inversely correlated to LV dyssynchrony (SD of LV phase histogram, R = −0.82, p < 0.0001). However, the increase in LVEF by biventricular pacing (mean +4.4 ± 4%) showed only modest correlation to the resulting resynchronisation effect (characterised by a −13 ± 8° decrease in LV phase histogram SD, R = −0.38, p < 0.0001). Conclusion: RNV is helpful in optimising pacing parameters for resynchronisation therapy. Varying AVD did not have a major impact on intra- or inter-ventricular resynchronisation. Thus, the benefit of AVD-based LVEF optimisation seems to result from atrioventricular resynchronisation

Published
2018

11. Leadless pacing using the transcatheter pacing system (Micra TPS) in the real world: initial Swiss experience from the Romandie region.

Author

Valiton, Valérian, Graf, Denis, Pruvot, Etienne, Carroz, Patrice, Fromer, Martin, Bisch, Laurence, Tran, Vân Nam, Cook, Stéphane, Scharf, Christoph, and Burri, Haran

Abstract

Aims: Leadless pacemakers are implanted in Switzerland since June 2015. Large worldwide registries have shown high implant success, low complication rates, and good electrical parameters up to 12 months' follow-up. However, data are scarce outside the investigational setting. The purpose of this study is to assess the real-world experience regarding clinical safety and efficacy of Micra TPS (transcatheter pacing system) leadless pacemakers.Methods and Results: Retrospective observational, multi-centre study designed to assess initial safety and efficacy of the Micra TPS in the Swiss Romande region. A total of 92 patients were included from four different centres with an implantation success rate of 97.8% (90 of 92). Thresholds were overall low at implantation (median 0.38 V/0.24 ms, ranging from 0.13 to 2.88 V/0.24 ms) and remained stable over 1-year follow-up. The perioperative serious adverse event rate was 6.5% in six patients which lead to prolonged hospitalization in five patients and death in one patient. In addition, three further major events (3.3%) occurred during an average follow-up of 1 year, requiring implantation of a standard transvenous pacemaker in two patients, and surgical explantation of the Micra TPS in one patient due to intractable ventricular tachycardia.Conclusion: Leadless pacemakers are a valuable adjunct for treating selected patients requiring single-chamber pacing. However, in this initial experience, major complication rates were high (9.8%). The implant procedure requires proper training and should be performed in an adequate setting. [ABSTRACT FROM AUTHOR]

Published
2019
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13. Left Ventricular Cardiomyopathy in Mitral Valve Prolapse: Fact or Fiction?

Author

Attenhofer Jost, Christina, primary, Greutmann, Matthias, additional, Connolly, Heidi M., additional, Naegeli, Barbara, additional, Faeh-Gunz, Anja, additional, Scharf, Christoph, additional, Candinas, Reto, additional, Valsangiacomo Buechel, Emanuela, additional, Weber, Roland, additional, Binggeli, Christian, additional, Franzen, Olaf, additional, and Medeiros-Domingo, Argelia, additional

Published
2015
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19. Catheter Ablation for Paroxysmal Atrial Fibrillation

Author

Oral, Hakan, primary, Scharf, Christoph, additional, Chugh, Aman, additional, Hall, Burr, additional, Cheung, Peter, additional, Good, Eric, additional, Veerareddy, Srikar, additional, Pelosi, Frank, additional, and Morady, Fred, additional

Published
2003
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25. Pulmonary Vein Isolation for Paroxysmal and Persistent Atrial Fibrillation

Author

Oral, Hakan, primary, Knight, Bradley P., additional, Tada, Hiroshi, additional, Özaydın, Mehmet, additional, Chugh, Aman, additional, Hassan, Sohail, additional, Scharf, Christoph, additional, Lai, Steve W.K., additional, Greenstein, Radmira, additional, Pelosi, Frank, additional, Strickberger, S. Adam, additional, and Morady, Fred, additional

Published
2002
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27. Clinical significance of residual pulmonary vein potentials after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

Author

Oral, Hakan, primary, Tada, Hiroshi, additional, Ozaydin, Mehmet, additional, Hassan, Sohail, additional, Scharf, Christoph, additional, Chugh, Aman, additional, Greenstein, Radmira, additional, Pelosi, Frank, additional, Knight, Bradley P., additional, Strickberger, S.Adam, additional, and Morady, Fred, additional

Published
2002
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30. A prospective analysis of changes stored intracardiac electrogram morphologies after implantable cardioverter defibrillators shocks

Author

Pelosi, Frank, primary, Hsu, William, additional, McCauley, Al, additional, Greenstein, Radmira, additional, Chugh, Arnan, additional, Hassan, Sohail A., additional, Scharf, Christoph, additional, Oral, Hakan, additional, Knight, Bradley P., additional, Morady, Fred, additional, and Strickberger, S.Adam, additional

Published
2002
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32. Effect of pulmonary vein isolation on atrial fibrillation cycle length

Author

Ozaydin, Mehmet, primary, Hsu, William, additional, Tada, Hiroshi, additional, Chugh, Aman, additional, Scharf, Christoph, additional, Greenstein, Radmira, additional, Pelosi, Frank, additional, Knight, Bradley P., additional, Strickbarger, S.Adam, additional, Morady, Fred, additional, and Oral, Hakan, additional

Published
2002
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33. Segmental isolation of pulmonary veins during atrial fibrillation

Author

Oral, Hakan, primary, Knight, Bradley P., additional, Tada, Hiroshi, additional, Ozaydin, Mehmet, additional, Greenstein, Radmira, additional, Chugh, Aman, additional, Scharf, Christoph, additional, Hassan, Sohail, additional, Pelosi, Frank, additional, Strickberger, S.Adam, additional, and Morady, Fred, additional

Published
2002
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36. Abstract 16379: QTc Prolongation in Connective Tissue Disorders

Author

Ibrahimi, Burbuqe, Attenhofer Jost, Christine H, Voegele, Jolanda, Molitor, Nadine, Despotovic, Dragan, Scharf, Christoph, Duru, Firat, Breitenstein, Alexander, Roland, Weber, Oxenius, Angela, and Matthias, Greutmann

Abstract

Introduction:Sudden cardiac (SCD) was described in connective tissue disorders (CTD) such as Marfan syndrome (MFS), Loews Dietz syndrome, TGFBetaR2 mutations as well as in mitral valve prolapse. The etiology of SCD in CTD is unknown however, although increased ventricular arrhythmias and ventricular repolarization abnormalities have been descrbed.Hypothesis:CTD patients (pt) may have a higher incidence of abnormal ventricular repolarization (AVR), early depolarization (ER) and longer QT c intervalsMethods:The CTD population of 3 referral centers was analysed for ECG findings, history of ventricular tachycardia (VT) and syncope. The ECGs were analyzed by 2 electrophysiologists (EP) for AVR, ER and QT interval and classified as normal/abnormal, in the case of discrepancy, a 3rd EP made the final decision. Results of genetic testing were collected. QTcprolongation defined as >460ms in children <16 years, respectively 480s in men, and 490ms in women.Results:There were 119 pt, age 35 years (range 2 -79 years), 67 men (56%) . In 64 pt, genetic testing revealed a mutation (45 FBN1, 2 FBN1 plus another mutation, 5 SMAD 3 mutation, 4 ACTA2 mutation, 1 COL3A1, 3 TGFB2, 1 LDS 1/2mutation, 3 EDS IV mutation)- A history of syncope was present in 6 pt. SCD occurred in 1 pt (12 years old, SMAD 3 mutation, death 1 week after aortic root surgery wit. no explanation at autopsy but Qtc prolongation, see Figure). VT was described in 7 pt. Average heart rate was 69 (14)bpm, PR interval 172 (151), QRS 107 (26), QTc421 (30ms). The ECG was abnormal in 35 patients(29%). AVR was present in 34 pt, QTc prolongation was present in 4 of 119 patents (4%). QTcprolongation could not be predicted by the genetic results. Ventricular tachycardia was described in 7 patients (7%, ECG normal in 3, AVR in 2, QTc prolongation in 1). A Holter ECG was done in 35 pt.Conclusions:Analysis of the resting ECG is important in pt CTD. In the presence of repolarisation anomalies and Qtc prolongation, careful surveillance is recommended.

Published
2019
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37. Der Politische Staat des Churfürstenthum Braunschweig-Lüneburg samt dazu gehörigen Herzogthümern, und Grafschaften in welchem dessen Stædte, Flecken, Dörfer, Adeliche Güther, und einzelne Höfe nach ihren Gerichts-Obrigkeiten und Einpfarrungen aus privat Nachrichten zusammengetragen und in Alphabetischer Ordung entworfen

Author

Scharf, Christoph Barthold and Scharf, Christoph Barthold

Abstract

von Christoph Barthold Scharf Königl-Gross-Britannischen, und Churfürstlich-Braunschweig-Luneburgischen Amtmann zu Danneberg ..., Fingerprint nach Ex. der Bibliothek des Herzog Anton Ulrich-Museums Braunschweig, der Dombibliothek Hildesheim und der ULB Sachsen-Anhalt, Vorlageform des Erscheinungsvermerks: Lauenburg, Gedruckt bey Johann Georg Berenberg, 1777.

38. Der Politische Staat des Churfürstenthum Braunschweig-Lüneburg samt dazu gehörigen Herzogthümern, und Grafschaften in welchem dessen Stædte, Flecken, Dörfer, Adeliche Güther, und einzelne Höfe nach ihren Gerichts-Obrigkeiten und Einpfarrungen aus privat Nachrichten zusammengetragen und in Alphabetischer Ordung entworfen

Author

Scharf, Christoph Barthold and Scharf, Christoph Barthold

Abstract

von Christoph Barthold Scharf Königl-Gross-Britannischen, und Churfürstlich-Braunschweig-Luneburgischen Amtmann zu Danneberg ..., Fingerprint nach Ex. der Bibliothek des Herzog Anton Ulrich-Museums Braunschweig, der Dombibliothek Hildesheim und der ULB Sachsen-Anhalt, Vorlageform des Erscheinungsvermerks: Lauenburg, Gedruckt bey Johann Georg Berenberg, 1777.

39. Effects of AV delay programming on ventricular resynchronisation: role of radionuclide ventriculography

Author

Siegrist, Patrick, Comte, Nathalie, Holzmeister, Johannes, Sütsch, Gabor, Koepfli, Pascal, Namdar, Mehdi, Duru, Firat, Brunckhorst, Corinna, Scharf, Christoph, Kaufmann, Philipp, Siegrist, Patrick, Comte, Nathalie, Holzmeister, Johannes, Sütsch, Gabor, Koepfli, Pascal, Namdar, Mehdi, Duru, Firat, Brunckhorst, Corinna, Scharf, Christoph, and Kaufmann, Philipp

Abstract

Purpose: Optimal atrioventricular delay (AVD) setting for cardiac resynchronisation therapy, i.e. biventricular pacing in patients with heart failure, remains a formidable challenge. Thus, the purpose of this study was to evaluate the effects of different AVD on inter- and intra-ventricular resynchronisation using phase histograms of radionuclide ventriculography (RNV). Methods: In 17 consecutive patients (mean age 64 ± 6years), RNV was performed 236 ± 350days after pacemaker implantation for cardiac resynchronisation therapy. Images were acquired during atrial pacing at 80bpm and during biventricular pacing with AVD ranging from 80 to 160ms. Inter-ventricular dyssynchrony was measured by the delay between the mean phase angles of the left and right ventricles. Intra-ventricular dyssynchrony was measured by the standard deviation (SD) of left ventricular phase histograms. Results: Left ventricular (LV) ejection fraction (EF) was inversely correlated to LV dyssynchrony (SD of LV phase histogram, R = −0.82, p < 0.0001). However, the increase in LVEF by biventricular pacing (mean +4.4 ± 4%) showed only modest correlation to the resulting resynchronisation effect (characterised by a −13 ± 8° decrease in LV phase histogram SD, R = −0.38, p < 0.0001). Conclusion: RNV is helpful in optimising pacing parameters for resynchronisation therapy. Varying AVD did not have a major impact on intra- or inter-ventricular resynchronisation. Thus, the benefit of AVD-based LVEF optimisation seems to result from atrioventricular resynchronisation

40. Safety and efficacy of the nMARQ catheter for paroxysmal and persistent atrial fibrillation

Author

Christine H. Attenhofer-Jost, Hans-Peter Brunner-La Rocca, Gabor Sütsch, Lam Dang, Martin Vurma, Christoph Scharf, Firat Duru, University of Zurich, Scharf, Christoph, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: CARIM - R2.05 - Clinical heart failure, MUMC+: MA Cardiologie (9), and RS: CARIM - R2.02 - Cardiomyopathy

Subjects
Male, Fatal outcome, Radiofrequency ablation, medicine.medical_treatment, 030204 cardiovascular system & hematology, Ablation, law.invention, Esophageal Fistula, 0302 clinical medicine, 2737 Physiology (medical), law, Atrial Fibrillation, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Atrial fibrillation, Equipment Design, Middle Aged, Catheter, Treatment Outcome, Pulmonary Veins, Persistent atrial fibrillation, Cardiology, 10209 Clinic for Cardiology, Catheter Ablation, Female, Cardiology and Cardiovascular Medicine, Atrio-oesophageal fistula, Anti-Arrhythmia Agents, Switzerland, Medical Device Recalls, medicine.medical_specialty, Operative Time, Catheter ablation, 610 Medicine & health, Pulmonary vein isolation, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, Physiology (medical), Internal medicine, medicine, Humans, Aged, business.industry, Proton Pump Inhibitors, medicine.disease, Surgery, Logistic Models, nMARQ, business, Follow-Up Studies
Abstract

Aims Circular irrigated radiofrequency ablation using the nMARQ catheter has recently been introduced for the treatment of atrial fibrillation (AF). The aim of this study is to report the safety and efficacy of catheter ablation using this technology in patients with paroxysmal and persistent AF. Methods and results The data of a prospective registry describing the experience of a single operator using this technology on 327 consecutive patients were analysed. The mean procedure time was 69 ± 22 min for paroxysmal AF ( n = 228) and 75 ± 23 min for persistent AF ( n = 97). Follow-up was available for 206 (63%) patients for 6 ± 5 months (range 1–23, median 3.3). Single procedure success off antiarrhythmic drugs was 75% in paroxysmal AF and 52% in persistent AF. Including the 5% redo cases and those on antiarrhythmic medication, freedom from AF was documented in 90 and 83% of paroxysmal and persistent AF patients, respectively. There were no serious complications in the first 325 patients, but the last two consecutive patients (0.6%) developed atrio-oesophageal fistulas and had a fatal outcome. The catheter has been recalled from market. Conclusion The nMARQ catheter is a highly effective tool for treatment of paroxysmal and persistent AF. Nevertheless, the occurrence of life-threatening oesophageal fistulas is of major concern and requires further investigation. [10.1093/europace/euw134][1] [1]: /lookup/doi/10.1093/europace/euw134

Published
2015

41. Paroxysmal and persistent atrial fibrillation ablation outcomes with the pulmonary vein ablation catheter GOLD duty-cycled phased radiofrequency ablation catheter: quality of life and 12-month efficacy results from the GOLD Atrial Fibrillation Registry.

Author

Boersma L, Koźluk E, Maglia G, de Sousa J, Grebe O, Eckardt L, Hokanson RB, Hemingway LA, Ostern E, Park HS, Rovaris G, Arribas F, Scharf C, Csanádi Z, Arenal Á, Laurenzi F, Klaver M, and Goette A

Subjects
Catheters, Female, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Recurrence, Registries, Treatment Outcome, Atrial Fibrillation diagnosis, Atrial Fibrillation surgery, Catheter Ablation adverse effects, Pulmonary Veins surgery
Abstract

Aims: The GOLD AF Registry has been designed to prospectively assess the population, indications, and outcomes using second-generation phased radiofrequency (RF) ablation (pulmonary vein ablation catheter GOLD) in a global examination of standard-of-care use for the treatment of paroxysmal and persistent atrial fibrillation (AF)., Methods and Results: GOLD AF (NCT02433613) is a prospective, observational, multi-centre registry designed to characterize efficacy and safety of phased RF ablation in patients with AF. The primary endpoint was freedom from AF recurrence at 12-month follow-up after a 90-day blanking period. Ancillary objectives include safety, procedural efficiency, and quality of life (QoL). The QoL assessment using the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) and the European Heart Rhythm Association (EHRA) Score of AF-related symptoms was collected at baseline and 12 months. In total, 1054 patients were included in this analysis (age 60.6, 67.6% male, 26.5% PersAF). Kaplan-Meier estimate of freedom from AF recurrence was 77.7% at 12 months. Peri-procedural device or procedure-related complications were observed in 26 (2.5%) patients, with a low stroke rate of 0.3%. One-year post-ablation, the EHRA AF Symptom score decreased in 68% of patients. The AFEQT score improvement was observed in 88.4% and 90.4% of patients who completed the questionnaire in-person or interviewed by phone at 12 month follow-up, respectively., Conclusion: Phased RF ablation for the treatment of paroxysmal and persistent AF demonstrated a 77.7% freedom from AF recurrence at 12 months in addition to a significant reduction in arrhythmia symptoms and clinically meaningful improved QoL. Low peri-procedural complication rate of <3% was reported., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2020
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42. Leadless pacing using the transcatheter pacing system (Micra TPS) in the real world: initial Swiss experience from the Romandie region.

Author

Valiton V, Graf D, Pruvot E, Carroz P, Fromer M, Bisch L, Tran VN, Cook S, Scharf C, and Burri H

Subjects
Action Potentials, Adult, Aged, Aged, 80 and over, Arrhythmias, Cardiac diagnosis, Arrhythmias, Cardiac mortality, Arrhythmias, Cardiac physiopathology, Device Removal, Equipment Design, Female, Heart Rate, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Switzerland, Time Factors, Treatment Outcome, Young Adult, Arrhythmias, Cardiac therapy, Cardiac Catheterization adverse effects, Cardiac Catheterization mortality, Cardiac Pacing, Artificial adverse effects, Cardiac Pacing, Artificial mortality, Pacemaker, Artificial
Abstract

Aims: Leadless pacemakers are implanted in Switzerland since June 2015. Large worldwide registries have shown high implant success, low complication rates, and good electrical parameters up to 12 months' follow-up. However, data are scarce outside the investigational setting. The purpose of this study is to assess the real-world experience regarding clinical safety and efficacy of Micra TPS (transcatheter pacing system) leadless pacemakers., Methods and Results: Retrospective observational, multi-centre study designed to assess initial safety and efficacy of the Micra TPS in the Swiss Romande region. A total of 92 patients were included from four different centres with an implantation success rate of 97.8% (90 of 92). Thresholds were overall low at implantation (median 0.38 V/0.24 ms, ranging from 0.13 to 2.88 V/0.24 ms) and remained stable over 1-year follow-up. The perioperative serious adverse event rate was 6.5% in six patients which lead to prolonged hospitalization in five patients and death in one patient. In addition, three further major events (3.3%) occurred during an average follow-up of 1 year, requiring implantation of a standard transvenous pacemaker in two patients, and surgical explantation of the Micra TPS in one patient due to intractable ventricular tachycardia., Conclusion: Leadless pacemakers are a valuable adjunct for treating selected patients requiring single-chamber pacing. However, in this initial experience, major complication rates were high (9.8%). The implant procedure requires proper training and should be performed in an adequate setting.

Published
2019
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