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2. Impact of monitoring on detection of arrhythmia recurrences in the ESC-EHRA EORP atrial fibrillation ablation long-term registry

Author

Balabanski T, Brugada-Terradellas J, Arbelo E, Laroche C, Maggioni A, Blomström-Lundqvist C, Kautzner J, Tavazzi L, Tritto M, Kulakowski P, Kalejs O, Forster T, Villalobos FS, Dagres N, and ESC-EHRA Atrial Fibrillation Ablation Long-Term Registry investigators Group

Subjects
Rhythm monitoring, EHRA registry, cardiovascular diseases, Atrial fibrillation, Recurrence, Ablation
Abstract

AIMS: Monitoring of patients after ablation had wide variations in the ESC-EHRA atrial fibrillation ablation long-term (AFA-LT) registry. We aimed to compare four different monitoring strategies after catheter AF ablation. METHODS AND RESULTS: The ESC-EHRA AFA-LT registry included 3593 patients who underwent ablation. Arrhythmia monitoring during follow-up was performed by 12-lead electrocardiogram (ECG), Holter ECG, trans-telephonic ECG monitoring (TTMON), or an implanted cardiac monitoring (ICM) system. Patients were selected to a given monitoring group according to the most extensive ECG tool used in each of them. Comparison of the probability of freedom from recurrences was performed by censored log-rank test and presented by Kaplan-Meier curves. The rhythm monitoring methods were used among 2658 patients: ECG (N = 578), Holter ECG (N = 1874), TTMON (N = 101), and ICM (N = 105). A total of 767 of 2658 patients (28.9%) had AF recurrences during follow-up. Censored log-rank test discovered a lower probability of freedom from relapses, which was detected with ICM compared to TTMON, ECG, and Holter ECG (P < 0.001). The rate of freedom from AF recurrences was 50.5% among patients using the ICM while it was 65.4%, 70.6%, and 72.8% using the TTMON, ECG, and Holter ECG, respectively. CONCLUSION: Comparing all main electrocardiographic monitoring methods in a large patient sample, our results suggest that post-ablation recurrences of AF are significantly underreported by TTMON, ECG, and Holter ECG. The ICM estimates AF ablation recurrences most reliably and should be a preferred mode of monitoring for trials evaluating novel AF ablation techniques.

Published
2019

3. Atrial fibrillation history impact on catheter ablation outcome. Findings from the ESC-EHRA Atrial Fibrillation Ablation Long-Term Registry

Author

Stabile, G., Trines, S.A., Arbelo, E., Dagres, N., Brugada, J., Kautzner, J., Pokushalov, E., Maggioni, A.P., Laroche, C., Anselmino, M., Beinart, R., Traykov, V., Lundqvist, C.B., Steinwender, C., Chasnoits, A., Mairesse, G., Balabanski, T., Riahi, S., Nawar, M., Maaty, M.A. el, Raatikainen, P., Anselme, F., Lewalter, T., Brodherr, T., Efremidis, M., Geller, L., Glover, ben, Glikson, M., Gaita, F., Rekvava, R., Kalejs, O., Trines, S., Kalarus, Z., Oliveira, M.M., Adra-Gao, P., Ciudin, R., Mikhaylov, E., Sinkovec, M., Villacastin, J.P., Blomstrom-Lundqvist, C., Sychov, O., Roberts, P., Scherr, G.D.D., Manninger, M., Mastnak, B., Pachinger, O., Hintringer, F., Stuhlinger, M., Steinwender, L.C., Xhaet, Y.O., Shalganov, S.T., Stoyanov, M., Protich, M., Traykov, S.V., Marchov, D., Kaninski, G., Chasnoits, M.A., Cihak, R., Haman, K.L., Schmidt, B., Chun, K.R.J., Perrotta, L., Bordignon, S., Tilz, R., Willems, S., Hindricks, G., Koutsouraki, I.S., Sorensen, B.G., Galal, C.W., AbdelWahab, A., Mokhtar, C.S.S., Ortega, I.G., Martinez, J.G.M., Calatrava, M.D., Sabate, R.V., Girbau, L.M., Arcocha, M.F., Gaztanaga, L., Zamarreno, E., Alvarez, M., Macias, R., Villalobos, F.S., Perez, J.C.R., Castellano, N.P., Canadas, V., Ferrer, J.J.G., Filgueiras, D., Campal, J.M.R., Sanchez-Borque, P., Benezet-Mazuecos, J., Ramos, J.T., Lozano, F., Urda, V.C., Cordero, A.B., Palomo, C.M., Ruiz-Salas, A., Alzueta, J., Peinado, R., Filqueiras-Rama, D., Gallanti, A.G., Garofalo, D., Calvo, N., Antolin, J.J.O., Pedrote, A., Arana-Rueda, E., Garcia-Riesco, L., Lund, J., Defaye, P., Jacon, P., Venier, S., Dugenet, F., Piot, O., Copie, X., Paziaud, O., Lepillier, A., Costa, A. da, Romeyer-Bouchard, C., Boveda, S., Albenque, J.P., Combes, N., Combes, S., Ferracci, A., Pisapia, A., Katritsis, D., Letsas, K., Vlachos, K., Lioni, L., Vassilikos, V.P., Szegedi, N., Szeplaki, G., Tahin, T., Csanadi, Z., Sandorfi, G., Kiss, A., Nagy-Balo, E., Saghy, L., Glover, B.M., Galvin, J., Keelan, E., Nof, E., Grimaldi, M., Quadrini, F., Monaco, A. di, Troisi, F., Tritto, M., Renzullo, E., Sanzo, A., Zagari, D., Pappone, C., Agricola, P.M.G., Bella, P. della, Iuliano, A., Bongiorni, M.G., Calo, L., Ruvo, E. de, Sciarra, L., Ferraris, F., Ponti, R. de, Marazzi, R., Doni, L.A., Kim, A., Molhoek, S., Gelder, I. van, Rienstra, M., Compier, M.G., Pison, L., Crijns, H.J., Vernooy, K., Luermans, J., Jordaens, L., Groot, N. de, Szili-Torok, T., Bhagwandien, R., Elvan, Z.A., Buist, T., Gal, P., Lubinski, A., Krolak, T., Nowak, S., Mizia-Stec, K., Wnuk-Wojnar, A.M., Lelakowski, J., Kazmierczak, J., Kulakowski, P., Baran, J., Opolski, G., Kiliszek, M., Lodzinski, P., Borodzicz, S., Balsam, P., Blaszyk, K., Pytkowski, M., Kuteszko, R., Ciszewski, J., Fuglewicz, A., Wozniak, A., Adamczyk, K., Adragao, P., Cunha, P., Grecu, I.M., Tinica, G., Muresan, L., Rosu, R., Khomenko, E., Romanov, A., Bayramova, S., Mikhaylov, E.N., Lebedev, D.S., Patsouk, A.V., Yashin, S., Kryzhanovskiy, D., Bazayev, S.V., Morgunov, D., Silin, I., Popov, S., Kuznetsov, V., Jonsson, A., Platonov, P., Holmqvist, F., Kongstad, O., Yuan, S., Hoglund, N., Malmborg, H., Mortsell, D., Pernat, A., Morgan, J., Greenwood, E.F., Fletcher, L.L., Kravchenko, D.T., Doronin, A., Meshkova, M., Karpenko, I., Goryatchiy, A., Abramova, A., and ESC-EHRA Atrial Fibrillation Abla

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Catheter ablation, 030204 cardiovascular system & hematology, recurrence predictors, Coronary artery disease, 03 medical and health sciences, mid-term outcome, 0302 clinical medicine, Recurrence, Internal medicine, Atrial Fibrillation, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Registries, atrial fibrillation duration, business.industry, Hypertrophic cardiomyopathy, atrial fibrillation, catheter ablation, Cardiology and Cardiovascular Medicine, Atrial fibrillation, General Medicine, Middle Aged, medicine.disease, Ablation, Log-rank test, Outcome and Process Assessment, Health Care, Cohort, Cardiology, Catheter Ablation, Female, business, Kidney disease
Abstract

Background Atrial fibrillation (AF) promotes atrial remodeling that in turn promotes AF perpetuation. The aim of our study is to investigate the impact of AF history length on 1-year outcome of AF catheter ablation in a cohort of patients enrolled in the Atrial Fibrillation Ablation Registry. Methods We described the real-life clinical epidemiology, therapeutic strategies, and the short- and mid-term outcomes of 1948 patients (71.9% with paroxysmal AF) undergoing AF ablation procedures, stratified according to AF history duration (= 2 years). Results The mean AF history duration was 46.2 +/- 57.4 months, 592 patients had an AF history duration = 2 years (mean 75.5 +/- 63.5 months) (P < 0.001). Patients with AF history duration = 2 years (34.0%) (P = 0.037). AF history duration >= 2 years, overall ablation procedure duration, hypertension, and chronic kidney disease were all predictors of recurrences after the blanking period. Conclusions In this multicenter registry, performing catheter ablation in patients with an AF history >= 2 years was associated with higher rates of AF recurrences at 1 year. Since cumulative time in AF in not necessarily equivalent to AF history, its role remains to be clarified.

Published
2018

4. Guidelines for the management of atrial fibrillation The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)

Author

Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, Le Heuzey JY, Ponikowski P, Rutten FH, Vahanian A, Auricchio A, Bax J, Ceconi C, Dean V, Filippatos G, Funck Brentano C, Hobbs R, Kearney P, McDonagh T, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Vardas PE, Widimsky P, Agladze V, Aliot E, Balabanski T, Blomstrom Lundqvist C, Capucci A, Crijns H, Dahlöf B, Folliguet T, Glikson M, Goethals M, Gulba DC, Ho SY, Klautz RJ, Kose S, McMurray J, PERRONE FILARDI, PASQUALE, Raatikainen P, Salvador MJ, Schalij MJ, Shpektor A, Sousa J, Stepinska J, Uuetoa H, Zamorano JL, Zupan I, European Heart Rhythm Association, European Association for Cardio Thoracic Surgery, ESC Committee for Practice Guidelines, Document Reviewers, Camm, Aj, Kirchhof, P, Lip, Gy, Schotten, U, Savelieva, I, Ernst, S, Van Gelder, Ic, Al Attar, N, Hindricks, G, Prendergast, B, Heidbuchel, H, Alfieri, O, Angelini, A, Atar, D, Colonna, P, De Caterina, R, De Sutter, J, Goette, A, Gorenek, B, Heldal, M, Hohloser, Sh, Kolh, P, Le Heuzey, Jy, Ponikowski, P, Rutten, Fh, Vahanian, A, Auricchio, A, Bax, J, Ceconi, C, Dean, V, Filippatos, G, Funck Brentano, C, Hobbs, R, Kearney, P, Mcdonagh, T, Popescu, Ba, Reiner, Z, Sechtem, U, Sirnes, Pa, Tendera, M, Vardas, Pe, Widimsky, P, Agladze, V, Aliot, E, Balabanski, T, Blomstrom Lundqvist, C, Capucci, A, Crijns, H, Dahlöf, B, Folliguet, T, Glikson, M, Goethals, M, Gulba, Dc, Ho, Sy, Klautz, Rj, Kose, S, Mcmurray, J, PERRONE FILARDI, Pasquale, Raatikainen, P, Salvador, Mj, Schalij, Mj, Shpektor, A, Sousa, J, Stepinska, J, Uuetoa, H, Zamorano, Jl, Zupan, I, European Heart Rhythm, Association, European Association for Cardio Thoracic, Surgery, ESC Committee for Practice, Guideline, Document, Reviewers, Alfieri, Ottavio, Ponikowski, P., Fysiologie, Cardiologie, RS: CARIM School for Cardiovascular Diseases, Camm, A. J, Lip, G, Van Gelder, I. C, Hohloser, S. H, and Le Heuzey, J. Y.

Subjects
Lung Diseases, Male, Rate control, Heart Valve Diseases, Management of atrial fibrillation, Angiotensin-Converting Enzyme Inhibitors, Comorbidity, Upstream therapy, Hyperthyroidism, law.invention, Cardiac Resynchronization Therapy, Electrocardiography, Ventricular Dysfunction, Left, Postoperative Complications, Atrial fibrillation European Society of Cardiology Guidelines Anticoagulation Rate control Rhythm control Upstream therapy Pulmonary vein isolation Left atrial ablation randomized controlled-trial congestive-heart-failure parkinson-white-syndrome cardiac resynchronization therapy angiotensin-converting enzyme polyunsaturated fatty-acids antiarrhythmic-drug therapy long-term survival radiofrequency catheter ablation placebo-controlled trial, Randomized controlled trial, Heart Rate, Pregnancy, Recurrence, law, Prevalence, Secondary Prevention, Medicine, Angioplasty, Balloon, Coronary, Precision Medicine, Mineralocorticoid Receptor Antagonists, Middle Aged, Congestive-Heart-Failure, Left atrial ablation, Primary Prevention, Stroke, Catheter Ablation, Cardiology, Female, Rhythm control, Cardiology and Cardiovascular Medicine, Risk assessment, Anti-Arrhythmia Agents, Sports, Radiofrequency Catheter Ablation, Adult, medicine.medical_specialty, Point-of-Care Systems, Angiotensin-Converting Enzyme, Antiarrhythmic-Drug Therapy, Placebo-Controlled Trial, Electric Countershock, MEDLINE, Hemorrhage, Guidelines, Parkinson-White-Syndrome, Risk Assessment, Pulmonary vein isolation, European Society of Cardiology, Anticoagulation, Fibrinolytic Agents, Thromboembolism, Internal medicine, Diabetes Mellitus, Humans, Polyunsaturated Fatty-Acids, International Normalized Ratio, Acute Coronary Syndrome, Randomized Controlled-Trial, Long-Term Survival, Aged, Heart Failure, Intraoperative Care, business.industry, Conflict of interest, Anticoagulants, Evidence-based medicine, Cardiomyopathy, Hypertrophic, Precision medicine, Atrial fibrillation, Athletes, CHA2DS2–VASc score, Quality of Life, Wolff-Parkinson-White Syndrome, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, Platelet Aggregation Inhibitors
Abstract

Guidelines summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategy for an individual patient suffering from a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes for textbooks. The legal implications of medical guidelines have been discussed previously. A large number of Guidelines have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice, quality criteria for development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines can be found on the ESC Web Site (http://www.escardio.org/guidelines-surveys/esc-guidelines/about/Pages/rules-writing.aspx). In brief, experts in the field are selected and undertake a comprehensive review of the published evidence for management and/or prevention of a given condition. A critical evaluation of diagnostic and therapeutic procedures is performed, including assessment of the risk–benefit ratio. Estimates of expected health outcomes for larger societies are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to pre-defined scales, as outlined in Tables 1 and 2 . View this table: Table 1 Classes of recommendations View this table: Table 2 Levels of evidence The experts of the writing panels have provided disclosure statements of all relationships they may have that might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. Any changes in conflict of interest that arise during the writing period must be notified to the ESC. The Task Force report received its entire financial support from …

Published
2010

5. Guidelines for the management of atrial fibrillation: the Task Force for theManagement of Atrial Fibrillation of the European Society of Cardiology (ESC)

Author

EUROPEAN HEART RHYTHM ASSOCIATION, EUROPEAN ASSOCIATION FOR CARDIO THORACIC, Surgery, Camm, Aj, Kirchhof, P, Lip, Gy, Schotten, U, Savelieva, I, Ernst, S, Van, Gelder, Ic, AL ATTAR, N, Hindricks, G, Prendergast, B, Heidbuchel, H, Alfieri, O, Angelini, Annalisa, Atar, D, Colonna, P, DE CATERINA, R, DE SUTTER, J, Goette, A, Gorenek, B, Heldal, M, Hohloser, Sh, Kolh, P, LE HEUZEY JY, Ponikowski, P, Rutten, Fh, Esc, COMMITTEE FOR PRACTICE GUIDELINES, Vahanian, A, Auricchio, A, Bax, J, Ceconi, C, Dean, V, Filippatos, G, FUNCK BRENTANO, C, Hobbs, R, Kearney, P, Mcdonagh, T, Popescu, Ba, Reiner, Z, Sechtem, U, Sirnes, Pa, Tendera, M, Vardas, Pe, Widimsky, P, Document, Reviewers, Agladze, V, Aliot, E, Balabanski, T, BLOMSTROM LUNDQVIST, C, Capucci, A, Crijns, H, Dahlã–f, B, Folliguet, T, Glikson, M, Goethals, M, Gulba, Dc, Sy, Ho, Klautz, Rj, Kose, S, Mcmurray, J, PERRONE FILARDI, P, Raatikainen, P, Salvador, Mj, Schalij, Mj, Shpektor, A, Sousa, J, Stepinska, J, Uuetoa, H, Zamorano, Jl, and Zupan, I.

Published
2010

14. Inhibition of atrial electrical activity by ventricular pacing mediated by vagal stimulation.

Author

Batchvarov V, Balabanski T, Velichkov P, Daskalov T, and Katova T

Subjects
Adolescent, Adult, Electrocardiography, Electrophysiology, Female, Heart Block therapy, Humans, Male, Pacemaker, Artificial, Arrhythmia, Sinus physiopathology, Atrioventricular Node physiopathology, Bradycardia physiopathology, Cardiac Pacing, Artificial methods, Heart Block physiopathology, Sinoatrial Node physiopathology, Vagus Nerve physiology
Abstract

In the absence of retrograde (VA) conduction, ventricular pacing does not exert any appreciable effect upon atrial electrical activity. We report three patients (2 with complete AV block and 1 with preserved AV conduction) in which, during EP study, no VA conduction was present and, in spite of that, excessive suppression (for more than 15 secs in the first patient) of sinus (atrial) electrical activity during RV pacing was observed. The sinus node suppression was reproducible in two patients. In all patients the suppression phenomenon was not observed after intravenous administration of atropine, which suggests that it was mediated by enhanced vagal tone.

Published
1995
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