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6. Alcohol dose in septal ablation for hypertrophic obstructive cardiomyopathy

Author

Veselka, J., Faber, L., Liebregts, M., Cooper, R., Januska, J., Kashtanov, M., Dabrowski, M., Hansen, P. R., Seggewiss, H., Bonaventura, J., Polakova, E., Hansvenclova, E., Bundgaard, H., ten, Berg, J., Stables, R. H., Jarkovsky, J., Jensen, M. K., Veselka, J., Faber, L., Liebregts, M., Cooper, R., Januska, J., Kashtanov, M., Dabrowski, M., Hansen, P. R., Seggewiss, H., Bonaventura, J., Polakova, E., Hansvenclova, E., Bundgaard, H., ten, Berg, J., Stables, R. H., Jarkovsky, J., and Jensen, M. K.

Abstract

Background: The aim of this study was to evaluate short- and long-term outcomes related to dose of alcohol administered during alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Current guidelines recommend using 1–3 mL of alcohol administered in the target septal perforator artery, but this recommendation is based more on practical experience of interventionalists rather than on systematic evidence. Methods: We included 1448 patients and used propensity score to match patients who received a low-dose (1.0–1.9 mL) versus a high-dose (2.0–3.8 mL) of alcohol during ASA. Results: The matched cohort analysis comprised 770 patients (n = 385 in both groups). There was a similar occurrence of 30-day post-procedural adverse events (13% vs. 12%; p = 0.59), and similar all-cause mortality rates (0.8% vs. 0.5%; p = 1) in the low-dose group and the high-dose group, respectively. In the long-term follow-up (5.4 ± 4.5 years), a total of 110 (14%) patients died representing 2.58 deaths and 2.64 deaths per 100 patient-years in the low dose and the high dose group (logrank, p = 0.92), respectively. There were no significant differences in the long-term dyspnea and left ventricular outflow gradient between the two groups. Patients treated with a low-dose of alcohol underwent more subsequent septal reduction procedures (logrank, p = 0.04). Conclusions: Matched HOCM patients undergoing ASA with a low-dose (1.0–1.9 mL) or a high-dose (2.0–3.8 mL) of alcohol had similar short- and long-term outcomes. A higher rate of repeated septal reduction procedures was observed in the group treated with a low-dose of alcohol. © 2021 The Authors

Published
2021

21. P2313Outcome of alcohol septal ablation in younger patients with obstructive hypertrophic cardiomyopathy

Author

Liebregts, M., primary, Faber, L., additional, Jensen, M.K., additional, Vriesendorp, P.A., additional, Januska, J., additional, Krejci, J., additional, Hansen, P.R., additional, Seggewiss, H., additional, Horstkotte, D., additional, Adlova, R., additional, Bundgaard, H., additional, Ten Berg, J.M., additional, and Veselka, J., additional

Published
2017
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26. Poster Session 3

Author

Fabbri, G. M. T., primary, Baldasseroni, S., additional, Panuccio, D., additional, Zoni Berisso, M., additional, Scherillo, M., additional, Lucci, D., additional, Di Pasquale, G., additional, Mathieu, G., additional, Burazor, I., additional, Burazor, M., additional, Perisic, Z., additional, Atanaskovic, V., additional, Erakovic, V., additional, Stojkovic, A., additional, Vogtmann, T., additional, Schoebel, C., additional, Sogorski, S., additional, Sebert, M., additional, Schaarschmidt, J., additional, Fietze, I., additional, Baumann, G., additional, Penzel, T., additional, Mornos, C., additional, Ionac, A., additional, Cozma, D., additional, Dragulescu, D., additional, Mornos, A., additional, Petrescu, L., additional, Pescariu, L., additional, Brembilla-Perrot, B., additional, Khachab, H., additional, Lamberti, F., additional, Bellini, C., additional, Remoli, R., additional, Cogliandro, T., additional, Nardo, R., additional, Bellusci, F., additional, Mazzuca, V., additional, Gaspardone, A., additional, Aguinaga Arrascue, L. E., additional, Bravo, A., additional, Garcia Freire, P., additional, Gallardo, P., additional, Hasbani, E., additional, Quintana, R., additional, Dantur, J., additional, Inoue, K., additional, Ueoka, A., additional, Tsubakimoto, Y., additional, Sakatani, T., additional, Matsuo, A., additional, Fujita, H., additional, Kitamura, M., additional, Wegrzynowska, M., additional, Konduracka, E., additional, Pietrucha, A. Z., additional, Mroczek-Czernecka, D., additional, Paradowski, A., additional, Bzukala, I., additional, Nessler, J., additional, Igawa, O., additional, Adachi, M., additional, Atarashi, H., additional, Kusama, Y., additional, Kodani, E., additional, Okazaki, R., additional, Nakagomi, A., additional, Endoh, Y., additional, Baez-Escudero, J. L., additional, Dave, A. S., additional, Sasaridis, C. M., additional, Valderrabano, M., additional, Tilz, R., additional, Bai, R., additional, Di Biase, L., additional, Gallinghouse, G. J., additional, Gibson, D., additional, Pisapia, A., additional, Wazni, O., additional, Natale, A., additional, Arujuna, A., additional, Karim, R., additional, Rinaldi, A., additional, Cooklin, M., additional, Rhode, K., additional, Razavi, R., additional, O'neill, M., additional, Gill, J., additional, Kusa, S., additional, Komatsu, Y., additional, Kakita, K., additional, Takayama, K., additional, Taniguchi, H., additional, Otomo, K., additional, Iesaka, Y., additional, Ammar, S., additional, Reents, T., additional, Fichtner, S., additional, Wu, J., additional, Zhu, P., additional, Kolb, C., additional, Hessling, G., additional, Deisenhofer, I., additional, Gilbert, G., additional, Mohanty, P., additional, Cunningham, J., additional, Metz, T., additional, Horton, R., additional, Tao, S., additional, Yamauchi, Y., additional, Okada, H., additional, Maeda, S., additional, Obayashi, T., additional, Isobe, M., additional, Chan, J., additional, Johar, S., additional, Wong, T., additional, Markides, V., additional, Hussain, W., additional, Konstantinidou, M., additional, Wissner, E., additional, Fuernkranz, A., additional, Yoshiga, Y., additional, Metzner, A., additional, Kuck, K.- H., additional, Ouyang, F., additional, Kettering, K., additional, Gramley, F., additional, Mollnau, H., additional, Weiss, C., additional, Bardeleben, S., additional, Biasco, L., additional, Scaglione, M., additional, Caponi, D., additional, Di Donna, P., additional, Sergi, D., additional, Cerrato, N., additional, Blandino, A., additional, Gaita, F., additional, Fiala, M., additional, Wichterle, D., additional, Sknouril, L., additional, Bulkova, V., additional, Chovancik, J., additional, Nevralova, R., additional, Pindor, J., additional, Januska, J., additional, Choi, J. I., additional, Ban, J. E., additional, Yasutsugu, N., additional, Park, J. S., additional, Jung, J. S., additional, Lim, H. E., additional, Park, S. W., additional, Kim, Y. 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E., additional, Yaegashi, T., additional, Furusho, H., additional, Kato, T., additional, Chikata, A., additional, Takashima, S., additional, Usui, S., additional, Takamura, M., additional, Kaneko, S., additional, Chudzik, M., additional, Mitkowski, P., additional, Przybylski, A., additional, Lewek, J., additional, Smukowski, T., additional, Maciag, A., additional, Castrejon Castrejon, S., additional, Perez-Silva, A., additional, Estrada, A., additional, Doiny, D., additional, Ortega, M., additional, Lopez-Sendon, J. L., additional, Merino, J. L., additional, O'mahony, C., additional, Coats, C., additional, Cardona, M., additional, Garcia, A., additional, Calcagnino, M., additional, Lachmann, R., additional, Hughes, D., additional, Elliott, P. M., additional, Conti, S., additional, Pruiti, G. P., additional, Puzzangara, E., additional, Romano, S. A., additional, Di Grazia, A., additional, Ussia, G. 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E., additional, Williams, R., additional, Mcnicoll, S., additional, Silvetti, M. S., additional, Drago, F., additional, Penela, D., additional, Bijnens, B., additional, Doltra, A., additional, Silva, E., additional, Berruezo, A., additional, Mont, L., additional, Sitges, M., additional, Mcintosh, R., additional, Baumann, O., additional, Raju, P., additional, Gurunathan, S., additional, Furniss, S., additional, Patel, N., additional, Sulke, N., additional, Lloyd, G., additional, Mor, M., additional, Dror, S., additional, Tsadok, Y., additional, Bachner-Hinenzon, N., additional, Katz, A., additional, Liel-Cohen, N., additional, Etzion, Y., additional, Mlynarski, R., additional, Mlynarska, A., additional, Wilczek, J., additional, Sosnowski, M., additional, Sinha, A. M., additional, Sinha, D., additional, Noelker, G., additional, Brachmann, J., additional, Weidemann, F., additional, Ertl, G., additional, Jones, M., additional, Searle, N., additional, Cocker, M., additional, Ilsley, E., additional, Foley, P., additional, Khiani, R., additional, Nelson, K. E., additional, Turley, A. J., additional, Owens, W. A., additional, James, S. A., additional, Linker, N. 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X., additional, Mutch, E., additional, Brashaw-Smith, J., additional, Ball, L., additional, Leyva, F., additional, Kim, D. H., additional, Lee, M. J., additional, Lee, W. S., additional, Park, S. D., additional, Shin, S. H., additional, Woo, S. I., additional, Kwan, J., additional, Park, K. S., additional, Munetsugu, Y., additional, Tanno, K., additional, Kikuchi, M., additional, Ito, H., additional, Miyoshi, F., additional, Kawamura, M., additional, Kobayashi, Y., additional, Man, S., additional, Algra, A. M., additional, Schreurs, C. A., additional, Van Der Wall, E. E., additional, Cannegieter, S. C., additional, Swenne, C. A., additional, Iitsuka, K., additional, Kondo, T., additional, Goebbert, K., additional, Karossiene, Z., additional, Goldman, D., additional, Kallen, B., additional, Kerpi, E., additional, Sardo, J., additional, Arsenos, P., additional, Gatzoulis, K., additional, Manis, G., additional, Dilaveris, P., additional, Tsiachris, D., additional, Mytas, D., additional, Asimakopoulos, S., additional, Stefanadis, C., additional, Sideris, S., additional, Kartsagoulis, E., additional, Barbosa, O., additional, Marocolo Junior, M., additional, Silva Cortes, R., additional, Moraes Brandolis, R. A., additional, Oliveira, L. F., additional, Pertili Rodrigues De Resende, L. A., additional, Vieira Da Silva, M. A., additional, Dias Da Silva, V. J., additional, Hegazy, R. A., additional, Sharaf, I. A., additional, Fadel, F., additional, Bazaraa, H., additional, Esam, R., additional, Deshko, M. S., additional, Snezhitsky, V. A., additional, Stempen, T. P., additional, Kuroki, K., additional, Igawa, M., additional, Kuga, K., additional, Ferreira Santos, L., additional, Dionisio, T., additional, Nunes, L., additional, Machado, J., additional, Castedo, S., additional, Henriques, C., additional, Matos, A., additional, Oliveira Santos, J., additional, Kraaier, K., additional, Olimulder, M. A. G. M., additional, Galjee, M. A., additional, Van Dessel, P. F. H. M., additional, Van Der Palen, J., additional, Wilde, A. A. M., additional, Scholten, M. F., additional, Chouchou, F., additional, Poupard, L., additional, Philippe, C., additional, Court-Fortune, I., additional, Barthelemy, J.- C., additional, Roche, F., additional, Dolgoshey, T. S., additional, Madekina, G. A., additional, Sugiura, S., additional, Fujii, E., additional, Senga, M., additional, Dohi, K., additional, Sugiura, E., additional, Nakamura, M., additional, Ito, M., additional, Eitel, C., additional, Mendell, J., additional, Lasseter, K., additional, Shi, M., additional, Urban, L., additional, Hatala, R., additional, Hlivak, P., additional, De Melis, M., additional, Garutti, C., additional, Corbucci, G., additional, Mlcochova, H., additional, Maxian, R., additional, Arbelo, E., additional, Dogac, A., additional, Luepkes, C., additional, Ploessnig, M., additional, Chronaki, C., additional, Hinterbuchner, L., additional, Guillen, A., additional, Bun, S. S., additional, Latcu, D. G., additional, Franceschi, F., additional, Prevot, S., additional, Koutbi, L., additional, Ricard, P., additional, Saoudi, N., additional, Nazari, N., additional, Alizadeh, A., additional, Sayah, S., additional, Hekmat, M., additional, Assadian, M., additional, Ahmadzadeh, A., additional, Wnuk, M., additional, Jedrzejczyk-Spaho, J., additional, Kruszelnicka, O., additional, Piwowarska, W., additional, Fedorowski, A., additional, Burri, P., additional, Juul-Moller, S., additional, Melander, O., additional, Mitro, P., additional, Murin, P., additional, Kirsch, P., additional, Habalova, V., additional, Slaba, E., additional, Matyasova, E., additional, Barlow, M. A., additional, Blake, R. J., additional, Rostoff, P., additional, Wojewodka Zak, E., additional, Froidevaux, L., additional, Sarasin, F. P., additional, Louis-Simonet, M., additional, Hugli, O., additional, Yersin, B., additional, Schlaepfer, J., additional, Mischler, C., additional, Pruvot, E., additional, Occhetta, E., additional, Frascarelli, F., additional, Burali, A., additional, and Dovellini, E., additional

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2011
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27. Poster Session 1

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Deshmukh, A., primary, Sharma, S. S., additional, Gobal, F. G., additional, Singla, S. S., additional, Hebbar, P. H., additional, Paydak, H. P., additional, Igarashi, M., additional, Tada, H., additional, Sekiguchi, Y., additional, Yamasaki, H., additional, Kuroki, K., additional, Machino, T., additional, Yoshida, K., additional, Aonuma, K., additional, Shavadia, J., additional, Otieno, H., additional, Yonga, G., additional, Jinah, A., additional, Qvist, J. F., additional, Soerensen, P. H., additional, Dixen, U., additional, Ramirez-Marrero, M. A., additional, Perez-Villardon, B., additional, Gaitan-Roman, D., additional, Jimenez-Navarro, M., additional, Delgado-Prieto, J. L., additional, De Teresa-Galvan, E., additional, De Mora-Martin, M., additional, Deshmukh, A., additional, Hebbar, P. B., additional, Wei, W. X., additional, Bardari, S., additional, Zecchin, M., additional, Salame', R., additional, Vitali Serdoz, L., additional, Di Lenarda, A., additional, Guerrini, N., additional, Barbati, G., additional, Sinagra, G., additional, Hanazawa, K., additional, Kaitani, K., additional, Nakagawa, Y., additional, Lenaerts, I., additional, Driesen, R., additional, Hermida, N., additional, Heidbuchel, H., additional, Janssens, S., additional, Balligand, J. L., additional, Sipido, K. R., additional, Willems, R., additional, Sehra, R., additional, Krummen, D., additional, Briggs, C., additional, Narayan, S., additional, Tanaka, Y., additional, Hirao, K., additional, Nakamura, T., additional, Inaba, O., additional, Yagishita, A., additional, Higuchi, K., additional, Hachiya, H., additional, Isobe, M., additional, Kallergis, E., additional, Kanoupakis, E. M., additional, Mavrakis, H. E., additional, Goudis, C. A., additional, Maliaraki, N. E., additional, Vardas, P. E., additional, Kiuchi, K., additional, Piorkowski, C., additional, Kircher, S., additional, Gaspar, T., additional, Watanabe, N., additional, Bollmann, A., additional, Hindricks, G., additional, Wauters, K., additional, Grosse, A., additional, Raffa, S., additional, Brunelli, M., additional, Geller, J. C., additional, Maggioni, A. P., additional, Gonzini, L., additional, Gussoni, G., additional, Vescovo, G., additional, Gulizia, M., additional, Pirelli, S., additional, Mathieu, G., additional, Di Pasquale, G., additional, Salame, R., additional, Magnani, S., additional, Sakamoto, T., additional, Kumagai, K., additional, Fuke, E., additional, Nishiuchi, S., additional, Hayashi, T., additional, Miki, Y., additional, Naito, S., additional, Oshima, S., additional, Hof, I. E., additional, Vonken, E., additional, Velthuis, B. K., additional, Meine, M., additional, Hauer, R. N. W., additional, Loh, K. P., additional, Na, J. O., additional, Choi, C. U., additional, Kim, E. 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B., additional, Jenni, R., additional, Brugada, P., additional, Bakos, Z., additional, Medvedev M, M. M., additional, Jonas Carlsson, J. C., additional, Fredrik Holmqvist, F. H., additional, Pyotr Platonov, P. P., additional, Nurbaev, T., additional, Pirnazarov, M., additional, Nikishin, A., additional, Aagaard, P., additional, Sahlen, A., additional, Bergfeldt, L., additional, Simeonidou, E., additional, Kastellanos, S., additional, Varounis, C., additional, Michalakeas, C., additional, Koniari, C., additional, Nikolopoulou, A., additional, Anastasiou-Nana, M., additional, Furukawa, Y., additional, Yamada, T., additional, Morita, T., additional, Tanaka, K., additional, Iwasaki, Y., additional, Kawasaki, M., additional, Kuramoto, Y., additional, Fukunami, M., additional, Blanche, C., additional, Tran, N., additional, Rigamonti, F., additional, Zimmermann, M., additional, Okisheva, E., additional, Tsaregorodtsev, D., additional, Sulimov, V., additional, Novikova, D., additional, Popkova, T., additional, Udachkina, E., additional, Korsakova, Y., additional, Volkov, A., additional, Novikov, A., additional, Alexandrova, E., additional, Nasonov, E., additional, Arsenos, P., additional, Gatzoulis, K., additional, Manis, G., additional, Dilaveris, P., additional, Gialernios, T., additional, Kartsagoulis, E., additional, Asimakopoulos, S., additional, Stefanadis, C., additional, Marocolo, M., additional, Barbosa Neto, O., additional, Carvalho, A. C., additional, Marques Neto, S. R., additional, Mota, G. R., additional, Barbosa, P. R. B., additional, Fernandez-Fernandez, A., additional, Manzano Fernandez, S., additional, Pastor-Perez, F. J., additional, Barquero-Perez, O., additional, Goya-Esteban, R., additional, Salar, M., additional, Rojo-Alvarez, J. L., additional, Garcia-Alberola, A., additional, Takigawa, M., additional, Kawamura, M., additional, Aiba, T., additional, Sakaguchi, T., additional, Itoh, H., additional, Horie, M., additional, Igarashi, T., additional, Negishi, J., additional, Toyota, N., additional, Yamada, O., additional, Papavasileiou, M., additional, Cabrera Bueno, F., additional, Molina Mora, M. J., additional, Alzueta Rodriguez, J., additional, Barrera Cordero, A., additional, De Teresa Galvan, E., additional, Revishvili, A. S., additional, Dzhordzhikiya, T., additional, Sopov, O., additional, Simonyan, G., additional, Lyadzhina, O., additional, Fetisova, E., additional, Kalinin, V., additional, Balt, J. C., additional, Steggerda, R. C., additional, Boersma, L. V. A., additional, Wijffels, M. C. E. F., additional, Wever, E. F. D., additional, Ten Berg, J. M., additional, Ricci, R. P., additional, Morichelli, L., additional, D'onofrio, A., additional, Vaccari, D., additional, Calo', L., additional, Buja, G., additional, Rovai, N., additional, Gargaro, A., additional, Sperzel, J., additional, Speca, G., additional, Santini, L., additional, Haarbo, J., additional, Dubin, K., additional, Carlson, M., additional, Garcia Quintana, A., additional, Mendoza-Lemes, H., additional, Garcia Perez, L., additional, Led Ramos, S., additional, Caballero Dorta, E., additional, Matinez De Espronceda, M., additional, Piro Mastracchio, V., additional, Serrano Arriezu, L., additional, Sciarra, L., additional, Marziali, M., additional, Marras, E., additional, Rebecchi, M., additional, Allocca, G., additional, Lioy, E., additional, Delise, P., additional, Santobuono, V. E., additional, Iacoviello, M., additional, Nacci, F., additional, Luzzi, G., additional, Puzzovivo, A., additional, Memeo, M., additional, Quadrini, F., additional, Favale, S., additional, Trucco, M. E., additional, Arce, M., additional, Palazzolo, J., additional, Uribe, W., additional, Maggi, R., additional, Furukawa, T., additional, Croci, F., additional, Solano, A., additional, Brignole, M., additional, Lebreiro, A., additional, Sousa, A., additional, Correia, A. S., additional, Lourenco, P., additional, Oliveira, S., additional, Paiva, M., additional, Freitas, J., additional, Maciel, M. J., additional, Linker, N., additional, Rieger, G., additional, Garutti, C., additional, Edvardsson, N., additional, Salguero Bodes, R., additional, De Riva Silva, M., additional, Fontenla Cerezuela, A., additional, Lopez Gil, M., additional, Mejia Martinez, E., additional, Jurado Roman, A., additional, Garcia Alvarez, S., additional, Arribas Ynsaurriaga, F., additional, Petix, N. R., additional, Del Rosso, A., additional, Guarnaccia, V., additional, Zipoli, A., additional, Rabajoli, F., additional, Foglia Manzillo, G., additional, Tolardo, C., additional, Checchinato, C., additional, Chiaravallotti, S., additional, Santarone, M., additional, Spinnler, M. T., additional, Podoleanu, C., additional, Frigy, A., additional, Dobreanu, D., additional, Ginghina, C., additional, and Carasca, E., additional

Published
2011
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28. Poster Session 1: Ablation of atrial fibrillation

Author

Marti Almor, J., primary, Bazan, V., additional, Matiello, M., additional, Cian, D., additional, Oliva, X., additional, Altaba, C., additional, Guijo, M. A., additional, Bruguera, J., additional, Fiala, M., additional, Sknouril, M., additional, Dorda, M., additional, Chovancik, J., additional, Nevralova, R., additional, Jiravsky, O., additional, Jiravska-Godula, B., additional, Branny, M., additional, Elvan, A., additional, Beukema, W. P., additional, Smit, J. J. J., additional, Delnoy, P. P. H. M., additional, Ramdat Misier, A. R., additional, Tuan, J., additional, Chung, I., additional, Jeilan, M., additional, Kundu, S., additional, Osman, F., additional, Stafford, P., additional, Ng, G. A., additional, Vergara, P., additional, Mazzone, P., additional, Paglino, G., additional, Saviano, M., additional, Crisa, S., additional, Maida, G., additional, Vicedomini, G., additional, Pappone, C., additional, Miyazaki, S., additional, Wright, M., additional, Hocini, M., additional, Jais, P., additional, Haissaguerre, M., additional, Yoshitani, K., additional, Kaitani, K., additional, Hanazawa, K., additional, Nakagawa, Y., additional, Yokokawa, M., additional, Tada, H., additional, Naito, S., additional, Oshima, S., additional, Taniguchi, K., additional, Romanov, A., additional, Pokushalov, E., additional, Shugaev, P., additional, Artemenko, S., additional, Turov, A., additional, Gindele, F. M., additional, Wiedemann, M., additional, Ewertsen, C., additional, Heiderfazel, S., additional, Andresen, D., additional, Miyake, M., additional, Motooka, M., additional, Izumi, T., additional, Izumi, C., additional, Sunthorn, H., additional, Burri, H. B., additional, Gentil, P. G., additional, Shah, D. S., additional, Sugiura, S., additional, Fujii, E., additional, Senga, M., additional, Yamazato, S., additional, Nakamura, M., additional, Ito, M., additional, Den Uijl, D. W., additional, Delgado, V., additional, Tops, L. F., additional, Trines, S. A. I. P., additional, Zeppenfeld, K., additional, Van Der Wall, E. E., additional, Schalij, M. J., additional, Bax, J. J., additional, Pappalardo, A., additional, Forleo, G. B., additional, Avella, A., additional, Bencardino, G., additional, De Girolamo, P. G., additional, Dello Russo, A., additional, Laurenzi, F., additional, Tondo, C., additional, Mueller, H., additional, Burri, H., additional, Gentil-Baron, P., additional, Lerch, R., additional, Shah, D., additional, Shirokova, N., additional, Pedrote Martinez, A. A., additional, Arana, E., additional, Garcia-Riesco, L., additional, Urbano-Moral, J. A., additional, Frutos-Lopez, M., additional, Sanchez-Brotons, J. A., additional, Torres-Llergo, J., additional, Martinez-Martinez, A., additional, Matsuda, H., additional, Harada, T., additional, Nakano, E., additional, Takai, M., additional, Fujita, S., additional, Sasaki, T., additional, Mizuno, K., additional, Miyake, F., additional, Doshi, A., additional, Hummel, J., additional, Daoud, E., additional, Augostini, R., additional, Weiss, R., additional, Hart, D., additional, Houmsse, M., additional, Kalbfleisch, S., additional, Gorzolka, J., additional, Bulkova, V., additional, Wojnarova, D., additional, Neuwirth, R., additional, Januska, J., additional, Cerrato, E., additional, Amellone, C., additional, Tizzani, E., additional, Antolini, M., additional, Massa, R., additional, Golzio, P. G., additional, Comoglio, C., additional, Rinaldi, M., additional, El-Domiaty, H. A., additional, Kamal, H. M., additional, Moubarak, A. M., additional, Mansy, M. M., additional, El-Kerdawy, H., additional, Ahmed, S., additional, Klinkenberg, T. J., additional, Ten Hagen, A., additional, Wiesfeld, A. C. P., additional, Tan, E. S., additional, and Van Gelder, I. C., additional

Published
2009
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30. Septal ventricular tachycardia with alternating LBBB-RBBB morphology in isolated ventricular noncompaction.

Author

Fiala M, Januska J, Bulková V, and Pleva M

Abstract

Alternating VT Morphology in IVNC. Knowledge on ventricular tachycardia (VT) in isolated ventricular noncompaction (IVNC) is limited. We report on a patient with IVNC who presented with cardiogenic shock due to an incessant drug-resistant VT that was cured by radiofrequency ablation. The VT had characteristics of a deep septal focal arrhythmia, which was distinctive by ablation-induced alternation of the rightward and leftward exits, and was difficult to ablate from either side of the ventricular septum. [ABSTRACT FROM AUTHOR]

Published
2010
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31. Pulmonary vein isolation using segmental versus electroanatomical circumferential ablation for paroxysmal atrial fibrillation: over 3-year results of a prospective randomized study.

Author

Fiala M, Chovancík J, Nevralová R, Neuwirth R, Jiravsky O, Nykl I, Sknouril L, Dorda M, Januska J, Branny M, Fiala, Martin, Chovancík, Jan, Nevralová, Renáta, Neuwirth, Radek, Jiravský, Otakar, Nykl, Igor, Sknouril, Libor, Dorda, Miloslav, Januska, Jaroslav, and Branny, Marian

Abstract

Purpose: We tested the hypothesis that electroanatomic pulmonary vein (PV) antra encircling for the PV isolation will improve the outcome in treatment of paroxysmal atrial fibrillation (PAF), compared with segmental PV isolation.Methods: Fifty-four patients underwent segmental PV isolation (group 1) and 56 patients circumferential PV isolation (group 2) for symptomatic PAF in a randomized study.Results: Following single ablation procedure, at the 48 +/- 8 month follow-up, 30 (56%) and 32 (57%) patients in groups 1 and 2 remained free of arrhythmia (P = 0.41). After repeat ablation, 43 (80%) and 45 (80%) patients in groups 1 and 2 were free of arrhythmia without antiarrhythmic drugs (AADs); 48 (89%) and 51 (91%) patients in groups 1 and 2 did not have arrhythmia recurrences without or with AADs.Conclusion: This study demonstrates no advantage in long-term arrhythmia-free clinical outcome after circumferential PV isolation in patients with frequent PAF. [ABSTRACT FROM AUTHOR]

Published
2008
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35. Outcomes of Alcohol Septal Ablation in Patients With Severe Left Ventricular Outflow Tract Obstruction: A Propensity Score Matching Analysis.

Author

Veselka J, Liebregts M, Cooper R, Faber L, Januska J, Tesarkova KH, Hansen PR, Seggewiss H, Hansvenclova E, Bonaventura J, Vejtasova V, Ten Berg J, Stables RH, and Jensovsky M

Subjects
Humans, Female, Propensity Score, Dyspnea etiology, Treatment Outcome, Retrospective Studies, Ventricular Outflow Obstruction, Left, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic diagnosis, Cardiomyopathy, Hypertrophic surgery, Cardiac Surgical Procedures, Ventricular Outflow Obstruction surgery
Abstract

Background: The current ACC/AHA guidelines on hypertrophic cardiomyopathy (HCM) caution that alcohol septal ablation (ASA) might be less effective in patients with left ventricular outflow tract obstruction (LVOTO) ≥ 100 mm Hg., Methods: We used a multinational registry to evaluate the outcome of ASA patients according to baseline LVOTO., Results: A total of 1346 ASA patients were enrolled and followed for 5.8 ± 4.7 years (7764 patient-years). The patients with baseline LVOTO ≥ 100 mm Hg were significantly older (61 ± 14 years vs 57 ± 13 years; P < 0.01), more often women (60% vs 45%; P < 0.01), and had a more pronounced HCM phenotype than those with baseline LVOTO < 100 mm Hg. There were no significant differences in the occurrences of 30-day major cardiovascular adverse events in the 2 groups. After propensity score matching (2 groups, 257 pairs of patients), the long-term survival was similar in both groups (P = 0.10), the relative reduction of LVOTO was higher in the group with baseline LVOTO ≥ 100 mm Hg (82 ± 21% vs 73 ± 26%; P < 0.01), but the residual resting LVOTO remained higher in this group (23 ± 29 mm Hg vs 13 ± 13 mm Hg; P < 0.01). Dyspnoea (NYHA functional class) at the most recent clinical check-up was similar in the 2 groups (1.7 ± 0.7 vs 1.7 ± 0.7; P = 0.85), and patients with baseline LVOTO ≥ 100 mm Hg underwent more reinterventions (P = 0.02)., Conclusions: After propensity matching, ASA patients with baseline LVOTO ≥ 100 mm Hg had similar survival and dyspnoea as patients with baseline LVOTO < 100 mm Hg, but their residual LVOTO and risk of repeated procedures were higher., (Copyright © 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Published
2023
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37. Prediction of Sudden Cardiac Arrest After Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy: ASA-SCARRE Risk Score.

Author

Veselka J, Liebregts M, Cooper R, Faber L, Januska J, Kashtanov M, Tesarkova KH, Hansen PR, Seggewiss H, Shloydo E, Popov K, Hansvenclova E, Polakova E, Ten Berg J, Stables RH, Jarkovsky J, and Bonaventura J

Subjects
Male, Humans, Adult, Middle Aged, Aged, Female, Ethanol therapeutic use, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac etiology, Death, Sudden, Cardiac prevention & control, Risk Factors, Treatment Outcome, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic surgery, Cardiac Surgical Procedures, Ablation Techniques
Abstract

This study aimed to derive a new score, the Alcohol Septal Ablation-Sudden Cardiac ARREst (ASA-SCARRE) risk score, that can be easily used to evaluate the risk of sudden cardiac arrest events (sudden cardiac death, resuscitation, or appropriate implantable cardioverter-defibrillator discharge) after alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy. We analyzed 1,834 patients from the Euro-ASA registry (49% men, mean age 57 ± 14 years) who were followed up for 5.0 ± 4.3 years (9,202 patient-years) after ASA. A total of 65 patients (3.5%) experienced sudden cardiac arrest events, translating to 0.72 events per 100 patient-years. The independent predictors of sudden cardiac arrest events were septum thickness before ASA (hazard ratio 1.09 per 1 mm, 95% confidence interval 1.04 to 1.14, p <0.001) and left ventricular outflow tract (LVOT) gradient at the last clinical checkup (hazard ratio 1.01 per 1 mm Hg, 95% confidence interval 1.01 to 1.02, p = 0.002). The following ASA-SCARRE risk scores were derived and independently predicted long-term risk of sudden cardiac arrest events: "0" for both LVOT gradient <30 mmHg and baseline septum thickness <20 mm; "1" for LVOT gradient ≥30 mm Hg or baseline septum thickness ≥20 mm; and "2" for both LVOT gradient ≥30 mm Hg and baseline septum thickness ≥20 mm. The C statistic of the ASA-SCARRE risk score was 0.684 (SE 0.030). In conclusion, the ASA-SCARRE risk score may be a useful and easily available clinical tool to predict risk of sudden cardiac arrest events after ASA in patients with hypertrophic obstructive cardiomyopathy., Competing Interests: Disclosures The authors have no conflict of interests to declare., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2022
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38. Outcomes of Patients With Hypertrophic Obstructive Cardiomyopathy and Pacemaker Implanted After Alcohol Septal Ablation.

Author

Veselka J, Liebregts M, Cooper R, Faber L, Januska J, Kashtanov M, Tesarkova KH, Hansen PR, Seggewiss H, Shloydo E, Popov K, Hansvenclova E, Bonaventura J, Berg JT, Stables RH, and Polakova E

Subjects
Ethanol adverse effects, Heart Septum diagnostic imaging, Heart Septum surgery, Humans, Retrospective Studies, Treatment Outcome, Ablation Techniques adverse effects, Atrioventricular Block diagnosis, Atrioventricular Block etiology, Atrioventricular Block therapy, Cardiomyopathy, Hypertrophic diagnostic imaging, Cardiomyopathy, Hypertrophic surgery, Pacemaker, Artificial
Abstract

Background: Atrioventricular block is a frequent major complication after alcohol septal ablation (ASA)., Objectives: The aim of this study was to evaluate the outcomes of patients with implanted permanent pacemaker (PPM) related to a high-grade atrioventricular block after ASA for hypertrophic obstructive cardiomyopathy., Methods: We used a multinational registry (the Euro-ASA registry) to evaluate the outcome of patients with PPM after ASA., Results: A total of 1,814 patients were enrolled and followed up for 5.0 ± 4.3 years (median = 4.0 years). A total of 170 (9.4%) patients underwent PPM implantation during the first 30 days after ASA. Using propensity score matching, 139 pairs (n = 278) constituted the matched PPM and non-PPM groups. Between the matched groups, there were no long-term differences in New York Heart Association functional class (1.5 ± 0.7 vs 1.5 ± 0.9, P = 0.99) and survival (log-rank P = 0.47). Patients in the matched PPM group had lower long-term left ventricular (LV) outflow gradient (12 ± 12 mm Hg vs 17 ± 19 mm Hg, P < 0.01), more pronounced LV outflow gradient decrease (81% ± 17% vs 72% ± 35%, P < 0.01), and lower LV ejection fraction (64% ± 8% vs 66% ± 8%, P = 0.02) and were less likely to undergo reintervention (re-ASA or myectomy) (log-rank P = 0.02)., Conclusions: Patients with hypertrophic obstructive cardiomyopathy treated with ASA have a 9% probability of PPM implantation within 30 days after ASA. In long-term follow-up, patients with PPM had similar long-term survival and New York Heart Association functional class but lower LV outflow gradient, a more pronounced LV outflow gradient decrease, a lower LV ejection fraction, and a lower likelihood of reintervention compared with patients without PPM., Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Published
2022
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39. Depression and anxiety among College Students in Slovakia - Comparison of the Year 2018 and during COVID-19 pandemic.

Author

Hajduk M, Dancik D, Januska J, Strakova A, Turcek M, Heretik A, and Pecenak J

Subjects
Anxiety epidemiology, Cross-Sectional Studies, Depression epidemiology, Female, Humans, Male, Mental Health, SARS-CoV-2, Slovakia epidemiology, Stress, Psychological, Students, COVID-19, Pandemics
Abstract

Objectives: The study aimed to estimate the prevalence of depression and anxiety among university students during the peak of COVID‑19 pandemic in the Slovak Republic in December 2020. The secondary goal was to compare results with a study from 2018 at the same university., Methods: A web-based cross-sectional study was administered at the Comenius University in Bratislava. The final sample consisted of 1,786 participants (approx. 80 % females) with the mean age and standard deviation of M=21.15 and SD=3.53. An online battery of self-report measures of depression, anxiety, perceived stress, loneliness, and resilience was administered., Results: The prevalence rates of moderately severe to‑severe depression and anxiety were 34.3 % and 20.1 %, respectively. Depression and anxiety were associated with younger age, higher perception of stress, higher loneliness, and lower resilience. In comparison with 2018, we found a two-fold increase in depression and anxiety. The increase was present across most of the depression and anxiety symptoms., Conclusion: The result of the study revealed elevated rates of depression and anxiety during the second wave of COVID-19 pandemic in Slovakia. Various demographic and psychological factors were associated with more severe depression and anxiety among university students. Some subgroups of students are at the higher risk of mental health problems (Tab. 4, Ref. 26).

Published
2022
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40. Addressing the role of edaravone in the management of amyotrophic lateral sclerosis and gaps in care and access: expert panel recommendations.

Author

Barrington CJ, Burruano M, Carney C, Choi J, Januska J, Lachuk L, Oskarsson B, Rodriguez C, Speicher L, and Tereso G

Subjects
Edaravone, Free Radical Scavengers, Humans, Managed Care Programs, Specialization, United States, Amyotrophic Lateral Sclerosis drug therapy
Abstract

A virtual key opinion leader (KOL) and payer discussion was held on December 5, 2020. In attendance were 2 KOLs, both specialists in amyotrophic lateral sclerosis (ALS) at leading clinics in the United States, and 6 managed care executives from US regional health plans. The objective of this panel was to share opinions, ideas, and information around the treatment of ALS with edaravone, gaps in management and guidelines, and potential solutions. The panel concluded that coverage criteria for edaravone may need to be reassessed and treatment guidelines could be revisited to include a determination of place in therapy for edaravone.

Published
2021
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41. Alcohol dose in septal ablation for hypertrophic obstructive cardiomyopathy.

Author

Veselka J, Faber L, Liebregts M, Cooper R, Januska J, Kashtanov M, Dabrowski M, Hansen PR, Seggewiss H, Bonaventura J, Polakova E, Hansvenclova E, Bundgaard H, Ten Berg J, Stables RH, Jarkovsky J, and Jensen MK

Subjects
Ethanol, Heart Septum diagnostic imaging, Heart Septum surgery, Humans, Retrospective Studies, Treatment Outcome, Ablation Techniques, Cardiomyopathy, Hypertrophic diagnostic imaging, Cardiomyopathy, Hypertrophic surgery, Catheter Ablation
Abstract

Background: The aim of this study was to evaluate short- and long-term outcomes related to dose of alcohol administered during alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Current guidelines recommend using 1-3 mL of alcohol administered in the target septal perforator artery, but this recommendation is based more on practical experience of interventionalists rather than on systematic evidence., Methods: We included 1448 patients and used propensity score to match patients who received a low-dose (1.0-1.9 mL) versus a high-dose (2.0-3.8 mL) of alcohol during ASA., Results: The matched cohort analysis comprised 770 patients (n = 385 in both groups). There was a similar occurrence of 30-day post-procedural adverse events (13% vs. 12%; p = 0.59), and similar all-cause mortality rates (0.8% vs. 0.5%; p = 1) in the low-dose group and the high-dose group, respectively. In the long-term follow-up (5.4 ± 4.5 years), a total of 110 (14%) patients died representing 2.58 deaths and 2.64 deaths per 100 patient-years in the low dose and the high dose group (logrank, p = 0.92), respectively. There were no significant differences in the long-term dyspnea and left ventricular outflow gradient between the two groups. Patients treated with a low-dose of alcohol underwent more subsequent septal reduction procedures (logrank, p = 0.04)., Conclusions: Matched HOCM patients undergoing ASA with a low-dose (1.0-1.9 mL) or a high-dose (2.0-3.8 mL) of alcohol had similar short- and long-term outcomes. A higher rate of repeated septal reduction procedures was observed in the group treated with a low-dose of alcohol., Competing Interests: Declaration of Competing Interest The authors report no relationships that could be construed as a conflict of interest., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Published
2021
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43. Alcohol septal ablation in patients with severe septal hypertrophy.

Author

Veselka J, Jensen M, Liebregts M, Cooper RM, Januska J, Kashtanov M, Dabrowski M, Hansen PR, Seggewiss H, Hansvenclova E, Bundgaard H, Ten Berg J, Hilton Stables R, and Faber L

Subjects
Adult, Aged, Female, Humans, Hypertrophy therapy, Male, Middle Aged, Retrospective Studies, Severity of Illness Index, Time Factors, Treatment Outcome, Cardiomyopathy, Hypertrophic therapy, Ethanol, Hypertrophy, Left Ventricular therapy, Ventricular Septum pathology
Abstract

Objective: The current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement., Methods: We compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness <30 mm Hg to those with ≥30 mm Hg treated using ASA in nine European centres., Results: A total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS <30 mm group and the IVS ≥30 mm group (p=0.047), respectively. There were no differences in dyspnoea (New York Heart Association class III/IV 12% vs 16%), residual left ventricular outflow tract gradient (16±20 vs 16±16 mm Hg) and repeated septal reduction procedures (12% vs 18%) in the IVS <30 mm group and IVS ≥30 mm group, respectively (p=NS for all)., Conclusions: The short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS <30mm. However, long-term all-cause and cardiac mortality rates are worse in the ≥30 mm group., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2020
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44. Effect of impaired cardiac conduction after alcohol septal ablation on clinical outcomes: insights from the Euro-ASA registry.

Author

Jensen MK, Faber L, Liebregts M, Januska J, Krejci J, Bartel T, Cooper RM, Dabrowski M, Hansen PR, Almaas VM, Seggewiss H, Horstkotte D, Adlova R, Berg JT, Bundgaard H, and Veselka J

Subjects
Adult, Aged, Female, Humans, Male, Middle Aged, Registries, Survival Rate, Treatment Outcome, Bundle-Branch Block etiology, Bundle-Branch Block therapy, Cardiomyopathy, Hypertrophic therapy, Defibrillators, Implantable, Ethanol administration & dosage, Ethanol adverse effects, Pacemaker, Artificial
Abstract

Aims: We analysed the impact of bundle branch block (BBB) and pacemaker (PM) implantation on symptoms and survival after alcohol septal ablation (ASA) in patients with hypertrophic cardiomyopathy (HCM)., Methods and Results: Among 1416 HCM patients from the Euro-ASA registry, 58 (4%) patients had a PM and 64 (5%) patients had an implantable cardioverter-defibrillator (ICD) before ASA. At latest follow-up (5.0 ± 4.0 years) after ASA, 118 (8%) patients had an ICD and 229 (16%) patients had a PM. In patients without an implantable device prior to ASA 13% had a PM and 5% had an ICD implanted following ASA. New onset BBB was present in 44% (right BBB in 31%) of patients without previous BBB. At latest follow-up, we found no associations between BBB and New York Heart Association (NYHA) Class 3-4 [odds ratio (OR) 0.98, 95% confidence interval (CI) 0.63-1.51; P = 0.91] or Canadian Cardiovascular Society (CCS) Class 3-4 (OR 1.5, CI 0.32-6.7; P = 0.62), respectively, and no associations between PM and NYHA Class 3-4 (OR 1.2, CI 0.70-2.0; P = 0.52) or CCS 3-4 (OR 1.3, CI 0.24-6.6; P = 0.79), respectively. The survival after ASA was not reduced in patients with BBB [hazard ratio (HR) 0.73, CI 0.53-1.01; P = 0.06] or PM (HR 0.78, CI 0.52-1.17; P = 0.24)., Conclusions: Development of BBB or need for a PM after ASA in patients with obstructive HCM was not associated with inferior symptomatic outcome or reduced survival, thus concerns for the negative impact of impaired cardiac conduction on the clinical outcome after ASA were not confirmed., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.)

Published
2019
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45. Short- and long-term outcomes of alcohol septal ablation for hypertrophic obstructive cardiomyopathy in patients with mild left ventricular hypertrophy: a propensity score matching analysis.

Author

Veselka J, Faber L, Liebregts M, Cooper R, Januska J, Kashtanov M, Dabrowski M, Hansen PR, Seggewiss H, Hansvenclova E, Bundgaard H, Ten Berg J, Stables RH, and Jensen MK

Subjects
Aged, Female, Heart Septum pathology, Heart Septum surgery, Humans, Male, Middle Aged, Postoperative Complications epidemiology, Propensity Score, Retrospective Studies, Treatment Outcome, Ablation Techniques adverse effects, Ablation Techniques methods, Ablation Techniques statistics & numerical data, Cardiomyopathy, Hypertrophic mortality, Cardiomyopathy, Hypertrophic pathology, Cardiomyopathy, Hypertrophic surgery, Hypertrophy, Left Ventricular complications, Hypertrophy, Left Ventricular mortality
Abstract

Aims: Based on European guidelines, alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM) is indicated only in patients with interventricular septum (IVS) thickness >16 mm. The aim of this study was to evaluate the short- and long-term outcomes in ASA patients with mild hypertrophy (IVS ≤ 16 mm)., Methods and Results: We retrospectively evaluated 1505 consecutive ASA patients and used propensity score to match 172 pairs (344 patients) in groups IVS ≤ 16 mm or IVS > 16 mm. There was no occurrence of post-ASA ventriculoseptal defect in the whole cohort (n = 1505). Matched patients had 30-day mortality rate 0% in IVS ≤ 16 mm group and 0.6% in IVS > 16 mm group (P = 1). Patients in IVS ≤ 16 mm group had more ASA-attributable early complications (16% vs. 9%; P = 0.049), which was driven by higher need for pacemaker implantation (13% vs. 8%; P = 0.22). The mean follow-up was 5.4 ± 4.3 years and the annual all-cause mortality rate was 1.8 and 3.2 deaths per 100-patient-years in IVS ≤ 16 group and IVS > 16 group, respectively (log-rank test P = 0.04). There were no differences in symptom relief and left ventricular (LV) gradient reduction. Patients with IVS ≤ 16 mm had less repeated septal reduction procedures (log-rank test P = 0.03)., Conclusion: Selected patients with HOCM and mild hypertrophy (IVS ≤ 16 mm) had more early post-ASA complications driven by need for pacemaker implantation, but their long-term survival is better than in patients with IVS >16 mm. While relief of symptoms and LV obstruction reduction is similar in both groups, a need for repeat septal reduction is higher in patients with IVS > 16 mm., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)

Published
2019
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46. Comparison of two modes of long-term ECG monitoring to assess the efficacy of catheter ablation for paroxysmal atrial fibrillation.

Author

Chovancik J, Bulkova V, Wichterle D, Toman O, Rybka L, Januska J, Spinar J, and Fiala M

Subjects
Aged, Anti-Arrhythmia Agents, Atrial Fibrillation diagnosis, Female, Humans, Male, Middle Aged, Postoperative Complications diagnosis, Prospective Studies, Recurrence, Time Factors, Treatment Outcome, Atrial Fibrillation physiopathology, Atrial Fibrillation surgery, Catheter Ablation adverse effects, Electrocardiography, Ambulatory, Postoperative Complications physiopathology
Abstract

Aims: Optimal ECG monitoring in detecting recurrences of atrial fibrillation (AF) or atrial tachycardia (AT) after catheter ablation has not been well established. The purpose of this prospective study was to compare the utility of daily ECG monitoring with episodic card recorder (ECR) vs. periodic monitoring with episodic loop recorder (ELR) for the detection of post-blanking AF/AT recurrences during early (Months 4-6) and late (Months 7-12) periods after catheter ablation for paroxysmal AF., Methods: The study included 105 consecutive patients, who received ECR for 12 months and were instructed to send at least 2 random ECG recordings daily with extra-recordings during symptoms. The patients were simultaneously monitored for one week with ELR at the end of each period (Months 6 and 12)., Results: Thirty-one and 12 patients with AF/AT recurrence were identified by means of ECR and ELR, respectively. In patients with complete and valid data, ELR technology was inferior to ECR by detecting AF/AT in 5 (31%) of 16 and 5 (26%) of 19 patients with arrhythmia identified by ECR in the early and late period, respectively. Overall, ELR had a sensitivity of 8/23 (35%) for detecting AF/AT recurrence. There was no single patient with AF/AT recurrence on ELR that would not be known from ECR monitoring. Only 2 patients with arrhythmia recurrence were completely asymptomatic throughout the study period., Conclusion: Daily ECG monitoring with ECR was better than periodic monitoring with ELR in detecting AF/AT recurrences during the follow-up periods. Entirely asymptomatic patients with AF/AT recurrences were rare.

Published
2019
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47. [An elderly patient with severe peripheral vascular disease].

Author

Evenboer J, Wille J, and van Asselt KM

Subjects
Age Factors, Aged, 80 and over, Fatal Outcome, Female, Foot Ulcer therapy, Humans, Ischemia diagnosis, Ischemia therapy, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease therapy, Quality of Life, Conservative Treatment, Foot Ulcer physiopathology, Ischemia physiopathology, Peripheral Arterial Disease physiopathology
Abstract

Background: Peripheral arterial disease is a common condition in elderly patients. Cases of severe peripheral vascular disease can be treated with endovascular revascularization or bypass surgery. An amputation may be necessary if revascularization treatments fail., Case Description: A 94-year-old woman with dementia, living in a nursing home, was referred to the vascular surgery team for a painful ulcer on the left foot. Revascularization fails and due to the infectious status, an above-the-knee amputation seems necessary. Family and physicians, however, opt for a conservative, palliative policy and in the next few weeks the infectious ulcer develops into mummification. The patient nonetheless experiences a good quality of life until she becomes bedridden because of pneumonia. She dies 11 months after she was diagnosed with critical limb ischaemia., Conclusion: Adopting a conservative approach in elderly patients with severe peripheral arterial disease and dementia is a worthwhile alternative to amputation, and can achieve a reasonably good quality of life. Diaries maintained by family members can provide insight into the patient's quality of life.

Published
2019

48. Newly designed 11-gene panel reveals first case of hereditary amyloidosis captured by massive parallel sequencing.

Author

Chyra Kufova Z, Sevcikova T, Januska J, Vojta P, Boday A, Vanickova P, Filipova J, Growkova K, Jelinek T, Hajduch M, and Hajek R

Subjects
Adult, Aged, Aged, 80 and over, Amyloidosis, Familial diagnosis, Cardiomyopathy, Hypertrophic diagnosis, Computational Biology, Czech Republic, Female, Gene Frequency, Genetic Markers, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Phenotype, Pilot Projects, Predictive Value of Tests, Reproducibility of Results, Risk Factors, Amyloidosis, Familial genetics, Cardiomyopathy, Hypertrophic genetics, DNA Mutational Analysis methods, Gene Expression Profiling methods, High-Throughput Nucleotide Sequencing, Mutation, Polymorphism, Single Nucleotide, Transcriptome
Abstract

Aims: Amyloidosis is caused by deposition of abnormal protein fibrils, leading to damage of organ function. Hereditary amyloidosis represents a monogenic disease caused by germline mutations in 11 amyloidogenic precursor protein genes. One of the important but non-specific symptoms of amyloidosis is hypertrophic cardiomyopathy. Diagnostics of hereditary amyloidosis is complicated and the real cause can remain overlooked. We aimed to design hereditary amyloidosis gene panel and to introduce new next-generation sequencing (NGS) approach to investigate hereditary amyloidosis in a cohort of patients with hypertrophic cardiomyopathy of unknown significance., Methods: Design of target enrichment DNA library preparation using Haloplex Custom Kit containing 11 amyloidogenic genes was followed by MiSeq Illumina sequencing and bioinformatics identification of germline variants using tool VarScan in a cohort of 40 patients., Results: We present design of NGS panel for 11 genes ( TTR , FGA , APOA1 , APOA2 , LYZ , GSN , CST3 , PRNP , APP , B2M , ITM2B ) connected to various forms of amyloidosis. We detected one mutation, which is responsible for hereditary amyloidosis. Some other single nucleotide variants are so far undescribed or rare variants or represent common polymorphisms in European population., Conclusions: We report one positive case of hereditary amyloidosis in a cohort of patients with hypertrophic cardiomyopathy of unknown significance and set up first panel for NGS in hereditary amyloidosis. This work may facilitate successful implementation of the NGS method by other researchers or clinicians and may improve the diagnostic process after validation., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Published
2018
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49. Effect of Institutional Experience on Outcomes of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy.

Author

Veselka J, Faber L, Jensen MK, Cooper R, Januska J, Krejci J, Bartel T, Dabrowski M, Hansen PR, Almaas VM, Seggewiss H, Horstkotte D, Adlova R, Bundgaard H, Ten Berg J, and Liebregts M

Subjects
Ablation Techniques adverse effects, Age Factors, Cardiac Output, Low, Cardiomyopathy, Hypertrophic mortality, Cardiovascular Diseases mortality, Dyspnea etiology, Electric Countershock statistics & numerical data, Europe epidemiology, Female, Heart Rate, Humans, Male, Middle Aged, Pacemaker, Artificial statistics & numerical data, Registries, Retreatment, Retrospective Studies, Stroke Volume, Ablation Techniques statistics & numerical data, Cardiomyopathy, Hypertrophic surgery, Ethanol administration & dosage, Heart Septum surgery
Abstract

Background: The current American College of Cardiology Foundation/American Heart Association guidelines on hypertrophic cardiomyopathy state that institutional experience is a key determinant of successful outcomes and lower complication rates of alcohol septal ablation (ASA). The aim of this study was to evaluate the safety and efficacy of ASA according to institutional experience with the procedure., Methods: We retrospectively evaluated 1310 patients with symptomatic obstructive hypertrophic cardiomyopathy who underwent ASA and were divided into 2 groups. The first-50 group consisted of the first consecutive 50 patients treated at each centre, and the over-50 group consisted of patients treated thereafter (patients 51 and above)., Results: In the 30-day follow-up, there was a significant difference in the occurrence of major cardiovascular adverse events (21% in the first-50 group vs 12% in the over-50 group; P < 0.01), which was driven by the occurrence of cardiovascular deaths (2.1% vs 0.4%; P = 0.01) and implanted pacemakers (15% vs 9%; P < 0.01). In the long-term follow-up (5.5 ± 4.1 years), the first-50 group was associated with a significantly higher occurrence of major adverse events (P < 0.01) and higher cardiovascular mortality (P < 0.01). Also, patients in the first-50 group were more likely to self-report dyspnea of New York Heart Association class III/IV (16% vs 10%), to have a left ventricular outflow gradient > 30 mm Hg (16% vs 10%) at the last clinical check-up (P < 0.01 for both), and a probability of repeated septal reduction therapy (P = 0.03)., Conclusions: An institutional experience of > 50 ASA procedures was associated with a lower occurrence of ASA complications, better cardiovascular survival, better hemodynamic and clinical effect, and less need for repeated septal reduction therapy., (Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Published
2018
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50. Outcomes of Alcohol Septal Ablation in Younger Patients With Obstructive Hypertrophic Cardiomyopathy.

Author

Liebregts M, Faber L, Jensen MK, Vriesendorp PA, Januska J, Krejci J, Hansen PR, Seggewiss H, Horstkotte D, Adlova R, Bundgaard H, Ten Berg JM, and Veselka J

Subjects
Ablation Techniques adverse effects, Ablation Techniques mortality, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Arrhythmias, Cardiac etiology, Arrhythmias, Cardiac therapy, Cardiac Pacing, Artificial, Cardiomyopathy, Hypertrophic diagnostic imaging, Cardiomyopathy, Hypertrophic mortality, Disease-Free Survival, Ethanol adverse effects, Europe, Female, Heart Septum diagnostic imaging, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Pacemaker, Artificial, Patient Selection, Retrospective Studies, Risk Assessment, Risk Factors, Sex Factors, Time Factors, Treatment Outcome, Ventricular Outflow Obstruction diagnostic imaging, Ventricular Outflow Obstruction mortality, Young Adult, Cardiomyopathy, Hypertrophic surgery, Ethanol therapeutic use, Heart Septum surgery, Ventricular Outflow Obstruction surgery
Abstract

Objectives: The aim of this study was to describe the safety and outcomes of alcohol septal ablation (ASA) in younger patients with obstructive hypertrophic cardiomyopathy., Background: The American College of Cardiology Foundation/American Heart Association guidelines reserve ASA for older patients and patients with serious comorbidities. Data on long-term age-specific outcomes after ASA are scarce., Methods: A total of 1,197 patients (mean age 58 ± 14 years) underwent ASA for obstructive hypertrophic cardiomyopathy. Patients were divided into young (≤50 years), middle-age (51 to 64 years), and older (≥65 years) groups., Results: Thirty-day mortality and pacemaker implantation rates were lower in young compared with older patients (0.3% vs. 2% [p = 0.03] and 8% vs. 16% [p < 0.001], respectively). Ninety-five percent of young patients were in New York Heart Association functional class I or II at last follow-up. During a mean follow-up period of 5.4 ± 4.2 years, 165 patients (14%) died. Annual mortality rates of young, middle-age, and older patients were 1%, 2%, and 5%, respectively (p < 0.01). Annual adverse arrhythmic event rates were similar in the 3 age groups at about 1% (p = 0.90). Independent predictors of mortality in young patients were age, female sex, and residual left ventricular outflow tract gradient. Additionally, young patients treated with ≥2.5 ml alcohol had a higher all-cause mortality rate (0.6% vs. 1.4% per year in patients treated with <2.5 ml, p = 0.03)., Conclusions: ASA in younger patients with obstructive hypertrophic cardiomyopathy was safe and effective for relief of symptoms at long-term follow-up. The authors propose that the indication for ASA can be broadened to younger patients., (Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Published
2017
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