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1. Electrophysiological findings in HFpEF patients presenting for AF ablation

Author

J Lee, M Sponder, S Stojkovic, M Riesenhuber, A Hammer, T Hofbauer, P Sulzgruber, S Burger, S Kastl, and R Schoenbauer

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: None. Aims The prevalence of atrial fibrillation (AF) in heart failure with preserved ejection fraction (HFpEF) patients is high. Impaired left atrial (LA) function is a major determinant in HFpEF. The extent of arrhythmogenic left atrial tissue degeneration in HFpEF patients is unknown. Methods and results We prospectively enrolled consecutive patients presenting for first time AF ablation. Each patient underwent baseline laboratory and transthoracic echocardiography assessment. The HFA-PEFF score was utilized to identify HFpEF patients. Bipolar high density voltage mapping [1213 (825 to 1606) mapping points] was created in sinus rhythm prior to PVI to evaluate the general LA bipolar voltage and quantify areas of low voltage, a well known surrogate for fibrosis and arrhythmogenesis. 160 patients were enrolled (55 % male). 42 patients (26 %) suffered from HFpEF. Low voltage areas (LVAs) were present in 84 patients (53 %). HFpEF was associated with generally decreased LA bipolar voltage (0.95 ± 0.45 mV vs. 1.59 ± 0.91 mV respectively; p < 0.001) (Fig. 1) and predictive for the existence of low voltage areas (81 % vs. 45 % low voltage area positive, respectively; p = 0.006). The HFA-PEFF score inversely correlated with LA bipolar voltage (r = - 0.380; p < 0.001) (Fig. 1). Furthermore, the HFA-PEFF score closely correlated to the extent of LVAs (r = 0.275; p = 0.001) and to the low voltage amplitude of atrial myocardium excluding areas of low voltage (r = - 0.403; p < 0.001). Conclusion HFpEF is highly predictive for generally decreased LA bipolar voltage and for the existence of fibrotic and arrhythmogenic left atrial tissue degeneration.

Published
2023
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2. Right atrial function in HFpEF in sinus rhythm vs. atrial fibrillation

Author

R Schoenbauer, F Hana, F Duca, M Koschutnik, C Dona, C Nitsche, M Sponder, M Lenz, C Loewe, D Beitzke, C Hengstenberg, J Mascherbauer, and A A Kammerlander

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Aims We sought to study the prognostic impact of right atrial (RA) size and function in patients with heart failure with preserved ejection fraction (HFpEF) in sinus rhythm (SR) vs. atrial fibrillation (AF). Methods and results Consecutive HFpEF patients were enrolled and indexed RA volumes and emptying fractions (RA-EF) were assessed by cardiac magnetic resonance imaging (CMR). For patients in SR during CMR feature tracking of the RA wall was performed (Figure 1). In addition, all patients underwent right and left heart catheterization, 6 min walk test, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) evaluation. We prospectively followed patients and used Cox regression models to determine the association of RA size and function with a composite endpoint of heart failure hospitalization and cardiovascular death. A total of 188 patients (71% female patients, 70±8 years old) were included of whom 96 (51%) were in SR. Eighty-five patients reached the combined endpoint during a follow-up of 72 (33–101) months. After multivariate cox regression analysis adjusted for age, NT-proBNP level, right ventricular ejection fraction and HF functional class, impaired RA strain (Figure 1A) (HR 0.959; 95% CI [0.924–0.996], P=0.024), RA conduit strain (Figure 1A) (HR 0.944; 95% CI [0.898–0.993], P=0.027) and RA conduit strain rate (Figure 1B) (HR 0.990; 95% CI [0.883–0.998], P=0.013) were significantly associated with adverse outcome for patients in SR (Table 1). In persistent AF, no RA imaging parameter was related to outcome after multivariate regression analysis. Conclusions In HFpEF patients in SR, CMR parameters of impaired RA conduit function show the best association with adverse cardiovascular outcome. In persistent AF, RA parameters lose their prognostic ability. Funding Acknowledgement Type of funding sources: None.

Published
2022
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3. Prognostic impact of left atrial function in heart failure with preserved ejection fraction in sinus rhythm vs. atrial fibrillation

Author

Stefan Aschauer, Christian Nitsche, R Schoenbauer, Andreas A. Kammerlander, Matthias Koschutnik, Christian Hengstenberg, Franz Duca, Julia Mascherbauer, Carolina Donà, and Christian Loewe

Subjects
medicine.medical_specialty, business.industry, Left atrial, Internal medicine, Cardiology, Medicine, Atrial fibrillation, Sinus rhythm, Cardiology and Cardiovascular Medicine, Heart failure with preserved ejection fraction, business, medicine.disease
Abstract

Background Left atrial (LA) function is related with outcome in heart failure with preserved ejection fraction (HFpEF). However, how LA function contributes to outcome in the context of atrial fibrillation (AF) versus sinus rhythm (SR) remains unclear. Purpose To determine the prognostic impact of LA size and phasic function in patients with HFpEF in SR vs. AF. Methods We enrolled consecutive HFpEF patients and assessed indexed LA volumes (LAVi) and emptying fractions (LA-EF) on cardiac magnetic resonance (CMR) imaging. We prospectively followed patients and used Cox regression models to determine the association of LA size and function with a composite endpoint of heart failure hospitalization and cardiovascular death. Results A total of 188 patients (71% female, 70±8 y/o) were included of whom 92 (49%) were in persistent AF (Figure 1A). Patients in persistent AF were older (p=0.017) and had a worse NYHA functional class (p=0.003). Compared to SR, peak and minimal LAVi were increased and LA-EF impaired (each p A total of 65 patients reached the combined endpoint during a follow-up of 31 (9–57) months. Multivariate Cox regression adjusted for established risk factors revealed that LA-EF was significantly associated with outcome in patients in SR (adj.HR 2.14; 95% CI [1.32–3.47] per 1-SD decline, p=0.002). In persistent AF, however, no LA imaging parameter was related to outcome (Figure 1B). By receiver operating characteristic curve and restricted cubic spline- analyses, we identified an LA-EF ≥40% as best indicator for favorable outcomes in patients with HFpEF and SR (Figure 2B). Persistent AF carried a similar risk for adverse outcome compared to impaired LA-EF ( Conclusions In HFpEF patients in SR, impaired LA-EF is independently associated with worse cardiovascular outcome, which is similar to persistent AF. With disease progression including development of persistent AF, LA parameters lose their prognostic ability and thus, are not helpful for further risk stratification. Funding Acknowledgement Type of funding sources: None. Figure 1Figure 2

Published
2021
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4. Influence of diabetes, heart failure, and NT-proBNP on cardiovascular outcomes in patients with atrial fibrillation – insights from a cohort study of 7,412 patients with extended follow-up

Author

Martin Huelsmann, Niema Kazem, Robert P. Giugliano, Patrick Sulzgruber, Lorenz Koller, Christian Gerges, Christian Hengstenberg, Felix Hofer, U Pailer, Michael Gottsauner-Wolf, Max-Paul Winter, Alexander Niessner, R Schoenbauer, and Thomas A Zelniker

Subjects
medicine.medical_specialty, business.industry, Atrial fibrillation, medicine.disease, Heart failure, Diabetes mellitus, Internal medicine, Cardiology, Medicine, In patient, Cardiology and Cardiovascular Medicine, business, Cardiovascular outcomes, Cohort study
Abstract

Background Diabetes and heart failure (HF) promote atrial fibrillation (AF) and are associated with an increased risk of adverse cardiovascular (CV) events in patients with AF. Because of effective anticoagulation options, AF patients are now more likely to develop HF than a stroke or a systemic embolic event. Appropriate risk stratification of patients with AF should therefore not only consider the risk for stroke but also for HF events. Methods Patients with AF admitted to a tertiary academic center between 01/2005 and 07/2019 were identified through a search of electronic health records. The primary outcome of interest was CV death or hospitalization for HF (HHF). We used Cox regression models adjusted for age, sex, estimated glomerular filtration rate, diabetes, HF, body mass index, prior myocardial infarction, hypertension, smoking, C-reactive protein, and LDL-C. To select the most informative variables and overcome the limitations of stepwise regression procedures, we performed a least absolute shrinkage and selection operator logistic regression in a model that incorporated diabetes, HF, NT-proBNP, and the covariates for adjustment in combination with 10-fold cross-validation. Results In total, 7,412 patients (median age 70 years, 39.7% female) were included in the present analysis and followed over a median of 4.6 years. Both diabetes (Adjusted (Adj.) hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.55 to 2.25) and HF (Adj. HR 2.57, 95% CI 2.22 to 2.98) were significantly associated with CV death/HHF after multivariable adjustment. Compared to patients with diabetes, HF patients had a higher risk of HHF but a similar risk of CV and all-cause death. There was a robust relationship between CV death/HHF and NT-proBNP (Adj. HR for 1-unit increase in standardized log-transformed biomarker 1.86, 95% CI 1.67 to 2.07). NT-proBNP showed good discriminatory performance (AUC 0.78, 95% CI 0.77–0.80), and the addition of NT-proBNP to the covariates used for adjustment resulted in a significant AUC improvement (Δ=0.04, P Conclusion These findings suggest that the influence of diabetes and HF expand beyond the risk of stroke and systemic embolic events to CV death/HHF in an unselected AF patient population. NT-proBNP may provide improved risk assessment in AF patients. Funding Acknowledgement Type of funding sources: None. Figure 1. Forest Plot

Published
2021
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5. P968Impact of contact force sensing catheters on fluoroscopy time in left-sided atrial procedures

Author

Lukas Fiedler, Jedrzej Kosiuk, T De Potter, M. Pfeffer, Clemens Steinwender, Franz X. Roithinger, Thomas Lambert, Alexander Nahler, Hermann Blessberger, Paweł Balsam, S. Hoenig, R. Schoenbauer, D Hrncic, and Piotr Buchta

Subjects
medicine.diagnostic_test, business.industry, Physiology (medical), medicine, Fluoroscopy, Cardiology and Cardiovascular Medicine, business, Nuclear medicine, Left sided, Contact force
Abstract

Funding Acknowledgements None. OnBehalf Go for Zero Fluoroscopy Project investigators Background Contact force sensing catheters provide electrophysiologists with direct feedback and therefore improve safety and help to generate more effective lesions. The use of contact force may also reduce fluoroscopy and procedure times. Purpose The aim of this study was to systematically evaluate the impact of using contact force sensing catheters (CFSCs) on fluoroscopy times and procedure times in left-sided atrial procedures. Methods In this multinational, multicenter study, data from 622 left-sided procedures (142 without and 480 with CFSCs) of 25 participating European centers were prospectively collected with a structured questionnaire. Examinations comprised 393 pulmonary vein isolations (PVIs, group 1[G1]), 122 PVIs with linear lesions (group 2[G2]), 65 left-sided accessory pathway ablations (group 3 [G3]) and 42 ablations for left atrial tachycardia (group 4 [G4]). Fluoroscopy and procedure times were compared with respect to the use of CFSCs, procedure type, and level of operator experience as possible confounders. A Mann-Whitney U-test was applied for comparison, and a p-value Results With the use of CFSCs, fluoroscopy time was significantly reduced when performing pulmonary vein isolations (G1 median [IQR]: 19 [11.0-33.7] vs. 7.2 [4.0-13.0] min., p 15 years: -6.5 min., p 40: -1.5 min., p = 0.346). Conclusion Contact force sensing catheters can help to reduce fluoroscopy times, especially when performing pulmonary vein isolations. This effect could be demonstrated for all career levels. However, it diminished with the operator"s caseload. A shortening of procedure time was found for PVIs with additional linear lesions.

Published
2020
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6. P613Cardiac magnetic resonance imaging derived left ventricular mechanical function in patients with atrial fibrillation and left atrial low voltage zones

Author

J Piorkowski, Julia Mascherbauer, Bettina Kirstein, Y Huo, Julia Mayer, C. Piorkowski, T Gaspar, R Schoenbauer, U Richter, Stefan Ulbrich, and Jakub Tomala

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Atrial fibrillation, medicine.disease, Left atrial, Internal medicine, cardiovascular system, medicine, Cardiology, In patient, cardiovascular diseases, Cardiology and Cardiovascular Medicine, business, Low voltage
Abstract

Background The relation of left atrial low voltage zones (LVZ) to left ventricular function in patients undergoing pulmonary vein isolation (PVI) is not known. Objective To explore the relationship of left atrial low voltage zones (LVZ) on left ventricular function in patients with atrial fibrillation. Methods From June to Nov. 2018, 107 (mean age 67y, 70 men, 73 persistent AF) consecutive patients with symptomatic AF underwent a PVI with LVZ mapping. Before PVI the left ventricular ejection fraction (EF) and stroke volume (SV) were measured by cardiac magnetic resonance imaging (CMR). From feature-tracking of CMR-cine images left ventricular global, systolic and diastolic longitudinal strains (GLS), circumferential strains (GCS) and radial strains (GRS) were calculated. Results Of 59 patients CMR scanning in sinus rhythm was performed, LVZ were present in 24 patients. LVEF was significantly lower in patients with left atrial LVZ (62±9% vs. 55±15%) (p=0,03). Left ventricular stroke volume was significantly decreased by the extent of LVZ (94±23 vs. 72±21ml), (p=0,03). The left ventricular diastolic strains during ventricular filling (caused by atrial contraction) of GLS (r=−0,52), GCS (r=−0,65) and GRS (r=−0,65) were highly signifcantly correlated to the occurence and extent of LVZ (each p The only systolic ventricular strain was GLS, which decreased (r=−0,3, p=0,03) by the occurance of atrial low voltage. Conclusion The active, atrial part of diastolic left ventricular filling properties is impaired by the occurrence and extent of left atrial LVZ. In patients with left atrial LVZ the left ventricular stroke volume and ejection fraction is decreased already in sinus rhythm. It seems possible that atrial mechanical dysfunction and presence of atrial low voltage maybe predicted by LV diastolic strain analysis.

Published
2019
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7. P605Correlation of left atrial phasic transport function and arrhythmogenic substrate in patients with atrial fibrillation: cardiac magnetic resonance feature tracking and bipolar voltage mapping

Author

U Richter, M S Schoenbauer, Lukas Fiedler, R Schoenbauer, C. Piorkowski, Julia Mascherbauer, Jakub Tomala, Franz X. Roithinger, Bettina Kirstein, Y Huo, T Gaspar, Christian Hengstenberg, J Piorkowski, and Stefan Ulbrich

Subjects
medicine.medical_specialty, business.industry, Atrial fibrillation, medicine.disease, Arrhythmogenic substrate, Left atrial, Internal medicine, Cardiology, Medicine, Feature tracking, In patient, Bipolar voltage, Cardiology and Cardiovascular Medicine, business, Cardiac magnetic resonance
Abstract

Background Bipolar voltage mapping is a widely accepted approach to identify areas of arrhythmogenic substrate in patients presenting for atrial fibrillation (AF) ablation. However, until now little is known about the correlation of left atrial (LA) bipolar voltage distribution and LA transport function. Purpose To study the impact of LA low voltage zones (LVZ) on LA transport function. Methods 107 consecutive patients presenting for ablation of symptomatic AF (34 paroxysmal AF, 73 persistent AF) were prospectively enrolled. Each patient underwent cardiac magnetic resonance imaging (CMR) within 24 hours prior to the ablation procedure. 59 patients were in sinus rhythm (SR) and 48 in AF. LA phasic indexed volumes (LAVi) and ejection fractions were calculated using biplane area length formula. In addition LA phasic strains and strain rates were analyzed using dedicated software (Figure 1A & B). LA bipolar voltage mapping was performed prior to beginning of ablation in sinus rhythm using a 3-dimensional mapping system and LVZ were defined as areas of bipolar voltage Results LVZ were present in 47 patients (23 in SR). The area of LVZ was 14.6cm2 (5.3–34.0). For patients in AF at the time of CMR only elevated minimal and maximal LAVi (p=0.001 and p=0.002 respectively) but no LA functional parameter was predictive for the occurrence of LVZ. In contrast for patients in SR all LA phasic volumes (endsystolic, pre atrial contraction and enddiastolic LAVi) and LA function parameters (passive, active and total ejection fraction (EF), reservoir, conduit and booster pump strains and strain rates) were predictive for the occurrence of LVZ. After clustered and pooled multivariate logistic regression only impaired booster pump strain rate was still predictive for occurrence of LVZ (OR 0.974, 95% CI 0.950–0.998, p=0.036). In addition Pearson correlation analysis revealed a strong link between LA booster pump functional parameters and cm2 expansion of LVZ areas: LA active EF, LA booster pump strain and SR (r=−0.42, p=0.044; r=−0.47, p=0.024; r=−0.65, p=0.001 [Figure 1C] respectively). Conclusion For patients in SR LA transport function is closely linked to the occurrence of LA LVZ and outperforms LA volumetric measurements for the prediction of LA LVZ. Furthermore LA booster pump function parameters show robust correlation to the extension of LA LVZ.

Published
2019
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8. 131Left atrial phasic function in heart failure with preserved ejection fraction: cardiac magnetic resonance myocardial feature tracking, invasive hemodynamics and outcome

Author

Julia Mascherbauer, Andreas A. Kammerlander, Lukas Fiedler, Franz Duca, Caroline Zotter-Tufaro, Stefan Aschauer, Franz X. Roithinger, Christian Hengstenberg, Christian Nitsche, Diana Bonderman, Christian Loewe, Christoph J. Binder, and R Schoenbauer

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Myocardial feature, Cardiology, Invasive hemodynamics, Medicine, Cardiology and Cardiovascular Medicine, business, Heart failure with preserved ejection fraction, Cardiac magnetic resonance, Tracking (particle physics)
Abstract

Background Global left atrial (LA) size and function have been shown to be associated with adverse events in heart failure with preserved ejection fraction (HFpEF). The machanism of coupling from left heart failure to pulmonary circulation is still controversially discussed. Purpose To study the prognostic most relevant determinant of LA size and function and its backward and forward interplay. Methods 188 HFpEF patients were prospectively enrolled and underwent baseline clinical assessment, cardiac magnetic resonance imaging (CMR) and invasive hemodynamic assessment. Coronary artery disease was ruled out by coronary angiography. 92 patients were in atrial fibrillation (AF), 96 in sinus rhythm. LA size and function were assessed by CMR including LA strain imaging by myocardial feature tracking (Figure 1A & B). Results Patients in AF had more pronounced dilatation of all phasic LA volumes and reduction of all phasic LA functions when compared to sinus rhythm (each p After 31 (9–57) months 66 patients reached the combined endpoint defined as combination from hospitalization due to heart failure and cardiovascular death. In AF no atrial functional or volume parameter was correlated to outcome. In contrast in sinus rhythm several phasic LA volume and functional parameters were associated with outcome. After multivariate cox regression analysis only reduced total LA ejection fraction and conduit strain rate were still predictive for worse outcome (p=0.031 and Conclusion Total LA ejection fraction plays a key role in the prognosis of HFpEF. This effect seems to be mainly related to its LA conduit function but not to LA booster pump function. LA conduit function correlates to impaired 6MWD, sPAP and PVR.

Published
2019
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9. 336Left atrial function in heart failure with preserved ejection fraction: backward and forward coupling and prognostic relevance

Author

Christoph J. Binder, Stefan Aschauer, Diana Bonderman, Lukas Fiedler, Caroline Zotter-Tufaro, Andreas A. Kammerlander, Christian Nitsche, Franz Duca, Christian Loewe, Julia Mascherbauer, Franz X. Roithinger, R Schoenbauer, and Christian Hengstenberg

Subjects
Coupling (electronics), Nuclear magnetic resonance, business.industry, Medicine, Radiology, Nuclear Medicine and imaging, General Medicine, Function (mathematics), Cardiology and Cardiovascular Medicine, business, Heart failure with preserved ejection fraction
Published
2019
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10. 227Correlation of left atrial transport function and bipolar voltage maps in patients with atrial fibrillation

Author

Lukas Fiedler, Julia Mascherbauer, M S Schoenbauer, Jakub Tomala, Christian Hengstenberg, U Richter, C Piorkowski, R Schoenbauer, Franz X. Roithinger, Bettina Kirstein, T Gaspar, Y Huo, J Piorkowski, and Stefan Ulbrich

Subjects
medicine.medical_specialty, business.industry, Atrial fibrillation, General Medicine, medicine.disease, Left atrial, Internal medicine, Cardiology, Medicine, Radiology, Nuclear Medicine and imaging, In patient, Bipolar voltage, Cardiology and Cardiovascular Medicine, business
Published
2019
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11. P6506Prognostic impact of left atrial function in heart failure with preserved ejection fraction

Author

Julia Mascherbauer, Franz X. Roithinger, Stefan Aschauer, Christoph J. Binder, Franz Duca, Andreas A. Kammerlander, Christian Nitsche, Diana Bonderman, Lukas Fiedler, Christian Loewe, Christian Hengstenberg, Caroline Zotter-Tufaro, and R Schoenbauer

Subjects
medicine.medical_specialty, Left atrial, business.industry, Internal medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, Heart failure with preserved ejection fraction, business
Published
2018
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12. P1460Persistent atrial fibrillation and heart failure with preserved ejection fraction a prospective observational study on extracellular volume accumulation, invasive hemodynamics, and outcome

Author

Stefan Aschauer, Julia Mascherbauer, Andreas A. Kammerlander, R Schoenbauer, Franz X. Roithinger, Caroline Zotter-Tufaro, Franz Duca, Lukas Fiedler, Christoph J. Binder, Matthias Koschutnik, and D Bondermann

Subjects
medicine.medical_specialty, Ejection fraction, business.industry, Invasive hemodynamics, Atrial fibrillation, medicine.disease, Internal medicine, Extracellular fluid, Cardiology, Medicine, Observational study, Cardiology and Cardiovascular Medicine, business, Heart failure with preserved ejection fraction
Published
2017
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13. P1372Prognostic impact of persistent atrial fibrillation in heart failure patients with preserved ejection fraction a prospective observational study

Author

Caroline Zotter-Tufaro, Lukas Fiedler, Julia Mascherbauer, Stefan Aschauer, Matthias Koschutnik, Christoph J. Binder, D. Bondermann, Aa. Kammerlander, Fx. Roithinger, Franz Duca, and R Schoenbauer

Subjects
medicine.medical_specialty, Ejection fraction, business.industry, Physiology (medical), Internal medicine, Heart failure, Persistent atrial fibrillation, medicine, Cardiology, Observational study, Cardiology and Cardiovascular Medicine, business, medicine.disease
Published
2017
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14. Role of the coronary sinus ostium musculature in reentrant formation

Author

R. Schoenbauer, Gerd Hindricks, Thomas Gaspar, Andreas Bollmann, Arash Arya, Christopher Piorkowski, Sergio Richter, Y. Huo, and P. Sommer

Subjects
Tachycardia, Male, medicine.medical_specialty, Radiofrequency ablation, medicine.medical_treatment, Action Potentials, Sensitivity and Specificity, law.invention, law, Heart Conduction System, Physiology (medical), Internal medicine, medicine, Humans, Tachycardia, Atrioventricular Nodal Reentry, Sinus rhythm, Atrial tachycardia, Aged, business.industry, Body Surface Potential Mapping, Coronary Sinus, Reproducibility of Results, Atrial fibrillation, Reentry, Anatomy, Ablation, medicine.disease, cardiovascular system, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Entrainment (chronobiology)
Abstract

Radiofrequency ablation of focal atrial tachycardias (AT) is a validated technique with high success rates. However, electrophysiological (EP) characteristics and ablation strategy of localized reentrant AT originating from the coronary sinus ostium (CSo) have not been reported in detail so far. From January 2009 to July 2010, 1,453 patients underwent clinically motivated EP studies. Four patients were diagnosed with localized reentrant AT originating from the CSo. P wave morphology and consistency of tachycardia cycle length were studied. Subsequently, if reentry was suggested as an underlying mechanism for AT, color-coded 3-dimensional (3D) entrainment mapping was performed to localize the reentrant circuit or differentiate a localized reentrant AT from macroreentant AT, and also confirm reentry as an underlying mechanism of AT by evaluating consistency of return cycles after entrainment at multiple sites in both atria. Finally, activation mapping was performed to localize the earliest activation site. The P wave morphologies and isoelectric line between the P waves suggested most likely an AT originating from the CSo with a centrifugal activation pattern, which was confirmed by activation mapping. Consistency of return cycles and continuously fragmented local electrograms at successful ablation sites suggested reentry as an underlying AT mechanism. Color-coded 3D entrainment mapping in all 4 patients located the reentrant circuit in the CSo. There were also two specific features observed. One was fragmented and/or double potentials recorded in the CSo with prominent prolonged electrogram duration compared to those during sinus rhythm. The other is a significant conduction delay within the CS. The myocardium of the CSo was suggested as a part of the critical isthmus within the reentrant circuit, while the rest of atria distal to the CSo and myocardial coat of the distal CS were not involved in the tachycardia circuit, which was confirmed by entrainment mapping. Although CSo myocardium has been implicated to be a part of atrioventricular nodal reentrant tachycardia, to the best of our knowledge, this is the first report showing the localized reentrant AT confined to the CSo. Three of our patients (75%) had concomitant atrial fibrillation (AF). Further studies should be warranted to clarify the role of AT from the CS in triggering AF.

Published
2012

15. Atrial Arrhythmias following contemporary Surgical AF Ablation: electrophysiological findings, ablation strategies and clinical outcome

Author

R. Schoenbauer, Friedrich-Wilhelm Mohr, Nico Doll, A. Rastan, Y. Huo, C. Piorkowski, Arash Arya, Andreas Bollmann, G. Hindricks, and T Gaspar

Subjects
Tachycardia, medicine.medical_specialty, business.industry, medicine.medical_treatment, Atrial fibrillation, Atrial arrhythmias, medicine.disease, Ablation, Surgery, Electrophysiology, medicine.anatomical_structure, Internal medicine, medicine, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Af ablation, Coronary sinus, Interatrial septum
Published
2013
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16. Complications, procedure-related and in-hospital mortality after catheter ablation for ventricular tachycardia in ischemic and non-ischemic dilated cardiomyopathy

Author

G. Hindricks, Lukas Fiedler, Livio Bertagnolli, B. Dinov, Andreas Bollmann, Arash Arya, Sascha Rolf, and R. Schoenbauer

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Cardiogenic shock, Ischemia, Catheter ablation, Dilated cardiomyopathy, Cardiac Ablation, medicine.disease, Ablation, Ventricular tachycardia, Internal medicine, Heart failure, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business
Published
2013
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17. Poster Session 1

Author

A. Deshmukh, S. S. Sharma, F. G. Gobal, S. S. Singla, P. H. Hebbar, H. P. Paydak, M. Igarashi, H. Tada, Y. Sekiguchi, H. Yamasaki, K. Kuroki, T. Machino, K. Yoshida, K. Aonuma, J. Shavadia, H. Otieno, G. Yonga, A. Jinah, J. F. Qvist, P. H. Soerensen, U. Dixen, M. A. Ramirez-Marrero, B. Perez-Villardon, D. Gaitan-Roman, M. Jimenez-Navarro, J. L. Delgado-Prieto, E. De Teresa-Galvan, M. De Mora-Martin, P. B. Hebbar, W. X. Wei, S. Bardari, M. Zecchin, R. Salame', L. Vitali Serdoz, A. Di Lenarda, N. Guerrini, G. Barbati, G. Sinagra, K. Hanazawa, K. Kaitani, Y. Nakagawa, I. Lenaerts, R. Driesen, N. Hermida, H. Heidbuchel, S. Janssens, J. L. Balligand, K. R. Sipido, R. Willems, R. Sehra, D. Krummen, C. Briggs, S. Narayan, Y. Tanaka, K. Hirao, T. Nakamura, O. Inaba, A. Yagishita, K. Higuchi, H. Hachiya, M. Isobe, E. Kallergis, E. M. Kanoupakis, H. E. Mavrakis, C. A. Goudis, N. E. Maliaraki, P. E. Vardas, K. Kiuchi, C. Piorkowski, S. Kircher, T. Gaspar, N. Watanabe, A. Bollmann, G. Hindricks, K. Wauters, A. Grosse, S. Raffa, M. Brunelli, J. C. Geller, A. P. Maggioni, L. Gonzini, G. Gussoni, G. Vescovo, M. Gulizia, S. Pirelli, G. Mathieu, G. Di Pasquale, R. Salame, S. Magnani, T. Sakamoto, K. Kumagai, E. Fuke, S. Nishiuchi, T. Hayashi, Y. Miki, S. Naito, S. Oshima, I. E. Hof, E. Vonken, B. K. Velthuis, M. Meine, R. N. W. Hauer, K. P. Loh, J. O. Na, C. U. Choi, E. J. Kim, S. W. Rha, C. G. Park, H. S. Seo, D. J. Oh, H. E. Lim, D. Wichterle, V. Bulkova, M. Fiala, J. Chovancik, J. Simek, P. Peichl, R. Cihak, J. Kautzner, A. Glick, S. Viskin, B. Belhassen, A. Navarrete, F. Conte, A. Ishti, D. Sai, M. Moran, Z. Chitovova, H. Ahmed, K. Mares, J. Skoda, L. Sediva, J. Petru, V. Y. Reddy, P. Neuzil, M. Schmidt, U. Dorwarth, A. Leber, M. Wankerl, J. Krieg, F. Straube, S. Reif, E. Hoffmann, E. Mikhaylov, V. Tikhonenko, D. Lebedev, S. Y. Shin, H. S. Yong, J. I. Choi, S. H. Kim, S. Matsuo, T. Yamane, M. Hioki, K. Ito, R. Narui, T. Date, K. Sugimoto, M. Yoshimura, S. Rolf, P. Sommer, R. Batalov, S. Popov, I. Antonchenko, T. Suslova, S. Fichtner, U. Czudnochowsky, H. L. Estner, S. Ammar, T. Reents, C. Jilek, G. Hessling, I. Deisenhofer, E. Pokushalov, A. Romanov, G. Corbucci, S. Artemenko, D. Losik, V. Shabanov, A. Turov, D. Elesin, M. Abramov, P. Sanders, P. Jais, K. Roberts-Thomson, K. Fukumoto, S. Takatsuki, T. Kimura, N. Nishiyama, Y. Aizawa, T. Sato, S. Miyoshi, K. Fukuda, Y. Roux, J. Tenkorang, P. Carroz, J. Schlaepfer, P. Pascale, A. Forclaz, M. Fromer, E. Pruvot, L. Sknouril, R. Nevralova, M. Dorda, J. Januska, R. Santi, C. Geller, K. Nakamura, K. Kasseno, K. Taniguchi, A. Wutzler, M. Huemer, A. Parwani, L. H. Boldt, D. Blaschke, R. Dietz, W. Haverkamp, B. Coutu, R. Malanuk, M. Ait Said, A. Vicentini, S. Schade, K. Ando, A. Rousseauplasse, T. Deering, B. C. Picarra, A. R. Santos, P. Dionisio, P. Semedo, R. Matos, M. Leitao, A. Jacinto, M. Trinca, C. Wan, J. Glad, S. Szymkiewicz, M. Habibovic, H. Versteeg, A. J. M. Pelle, D. A. M. J. Theuns, L. Jordaens, S. S. Pedersen, S. Pakarinen, L. Toivonen, J. Taggeselle, A. Frey, A. Birkenhagen, S. Kohler, S. K. G. Maier, N. Lobitz, S. Paule, J. Becher, G. Mustafa, A. Ibrahim, G. King, B. Foley, B. Wilkoff, R. Freedman, D. Hayes, S. Kalbfleisch, S. Kutalek, R. Schaerf, I. A. Fazal, M. Tynan, C. J. Plummer, J. M. Mccomb, A. Oto, K. Aytemir, H. Yorgun, U. Canpolat, E. B. Kaya, L. Tokgozoglu, G. Kabakci, H. Ozkutlu, S. Greenberg, F. Hamati, R. Styperek, J. Alonso, D. Peress, O. Bolanos, R. Augostini, M. Pelini, S. Zhang, S. Stoycos, S. Witsaman, K. Mowrey, J. Bremer, A. Oza, G. Ciconte, P. Mazzone, G. Paglino, A. Marzi, P. Vergara, N. Sora, S. Gulletta, P. Della Bella, M. Nagashima, M. Goya, Y. Soga, K. Hiroshima, K. Andou, K. Hayashi, Y. An, M. Nobuyoshi, A. Kutarski, B. Malecka, R. Pietura, P. Osmancik, D. Herman, P. Stros, V. Kocka, P. Tousek, H. Linkova, M. Bortnik, E. Occhetta, G. Dell'era, A. Degiovanni, L. Plebani, P. N. Marino, M. V. Gorev, D. G. Alimov, P. Raju, S. Kully, S. 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Macinnis, M. Horacek, B. Dinov, R. Schoenbauer, F. Braunschweig, A. Arya, D. Andreu, A. Berruezo, J. T. Ortiz, E. Silva, T. M. De Caralt, J. Fernandez-Armenta, A. Perez-Silva, M. Ortega, J. L. Lopez-Sendon, F. Regoli, F. Faletra, G. Nucifora, E. Pasotti, T. Moccetti, C. Klersy, M. Casella, A. Dello Russo, M. Moltrasio, M. Zucchetti, G. Fassini, L. Di Biase, A. Natale, C. Tondo, N. Matsuhashi, H. J. Weig, G. Kerst, S. Weretk, P. Seizer, M. P. Gawaz, J. Schreieck, G. Sarquella-Brugada, F. Prada, C. M. Salling, C. Kolb, M. Pytkowski, A. Maciag, M. Farkowski, A. Jankowska, I. Kowalik, A. Kraska, H. Szwed, P. Maury, A. Duparc, P. Mondoly, A. Rollin, R. Pap, M. Kohari, G. Bencsik, A. Makai, L. Saghy, T. Forster, E. Ebrille, M. Scaglione, C. Raimondo, D. Caponi, P. Di Donna, A. Blandino, S. D. L. Delcre, F. Gaita, I. Roca Luque, L. D. S. Dos, N. R. G. Rivas, A. P. D. Pijuan, J. Perez, J. Casaldaliga, D. G. D. Garcia-Dorado, A. M. M. Moya, H. Sato, T. Yagi, T. Yambe, F. Streitner, C. Dietrich, E. Mahl, N. Schoene, C. Veltmann, M. Borggrefe, J. Kuschyk, P. P. Sadarmin, K. C. K. Wong, K. Rajappan, Y. Bashir, T. R. Betts, C. Leclercq, R. Martins, J. C. Daubert, P. Mabo, M. Koide, G. Hamano, T. Taniguchi, M. Yamato, N. Sasaki, K. Hirooka, Y. Ikeda, Y. Yasumura, W. Dichtl, T. Wolber, U. Paoli, S. Bruellmann, T. Berger, M. Stuehlinger, F. Duru, F. Hintringer, E. Kanoupakis, H. Mavrakis, E. Koutalas, I. Saloustros, C. Goudis, G. Chlouverakis, P. Vardas, J. M. Herre, M. Saeed, L. Saberi, S. Neuman, K. Yamaji, M. Iwabuchi, A. Baranchuk, F. Femenia, R. Miranda Hermosilla, J. C. Lopez Diez, J. L. Serra, M. Valentino, E. Retyk, N. Galizio, W. Kwasniewski, A. Filipecki, W. Orszulak, D. Urbanczyk-Swic, M. Trusz - Gluza, O. Piot, B. Degand, A. Donofrio, P. Scanu, A. Quesada, A. Kloppe, D. Mijic, H. Bogossian, M. Zarse, B. Lemke, J. Tyler, G. Comfort, T. F. Deering, A. E. Epstein, S. M. G. Greenberg, D. S. Goldman, J. Rhude, J. P. Majewski, J. Lelakowski, I. Tomala, C. M. 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Morichelli, A. D'onofrio, D. Vaccari, L. Calo', G. Buja, N. Rovai, A. Gargaro, J. Sperzel, G. Speca, L. Santini, J. Haarbo, K. Dubin, M. Carlson, A. Garcia Quintana, H. Mendoza-Lemes, L. Garcia Perez, S. Led Ramos, E. Caballero Dorta, M. Matinez De Espronceda, V. Piro Mastracchio, L. Serrano Arriezu, L. Sciarra, M. Marziali, E. Marras, M. Rebecchi, G. Allocca, E. Lioy, P. Delise, V. E. Santobuono, M. Iacoviello, F. Nacci, G. Luzzi, A. Puzzovivo, M. Memeo, F. Quadrini, S. Favale, M. E. Trucco, M. Arce, J. Palazzolo, W. Uribe, R. Maggi, T. Furukawa, F. Croci, A. Solano, M. Brignole, A. Lebreiro, A. Sousa, A. S. Correia, P. Lourenco, S. Oliveira, M. Paiva, J. Freitas, M. J. Maciel, N. Linker, G. Rieger, C. Garutti, N. Edvardsson, R. Salguero Bodes, M. De Riva Silva, A. Fontenla Cerezuela, M. Lopez Gil, E. Mejia Martinez, A. Jurado Roman, S. Garcia Alvarez, F. Arribas Ynsaurriaga, N. R. Petix, A. Del Rosso, V. Guarnaccia, A. Zipoli, F. Rabajoli, G. Foglia Manzillo, C. Tolardo, C. Checchinato, S. Chiaravallotti, M. Santarone, M. T. Spinnler, C. Podoleanu, A. Frigy, D. Dobreanu, C. Ginghina, and E. Carasca

Subjects
Lv function, medicine.medical_specialty, business.industry, Physiology (medical), Internal medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Predictive value, Value (mathematics), Surgery
Abstract

was higher in the NRG (p 0.70 was the more accurate RT-MCE value to predict LV regional recovery with positive predictive value of 70% and negative predictive value of 56% (p

Published
2011
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18. Poster Session 2

Author

T. Andersson, A. Magnusson, I.- L. Bryngelsson, O. Frobert, K. M. Henriksson, N. Edvardsson, D. Poci, M. Polovina, T. Potpara, M. Licina, N. Mujovic, A. Kocijancic, D. Simic, M. C. Ostojic, R. A. Providencia, A. Botelho, J. Trigo, J. Nascimento, N. Quintal, P. Mota, A. M. Leitao-Marques, R. F. Bosch, W. Kirch, L. Rosin, S. N. Willich, D. Pittrow, H. Bonnemeier, M. C. Valenza, L. Martin, T. Munoz Casaubon, G. Valenza, M. Botella, M. Serrano, B. Valenza, I. Cabrera, K. Anderson, B. S. Benzaquen, N. Koziolova, J. Nikonova, Y. Shilova, D. Scherr, S. Narayan, M. Wright, D. Krummen, A. Jadidi, P. Jais, M. Haissaguerre, M. Hocini, R. Hunter, Y. Liu, Y. Lu, W. Wang, R. J. Schilling, S. Bernstein, B. Wong, R. Rooke, C. Vasquez, R. Shah, S. Rosenberg, L. Chinitz, G. Morley, M. Bashir Choudhary, F. Holmqvist, J. Carlson, H.- J. Nilsson, P. G. Platonov, A. S. Jadidi, H. Cochet, S. Miyazaki, A. J. Shah, N. Marrouche, N. Calvo, M. Nadal, D. Andreu, D. Tamborero, F. E. Diaz, A. Berruezo, J. Brugada, L. Mont, S. Fichtner, G. Hessling, H. L. Estner, C. Jilek, T. Reents, S. Ammar, J. Wu, I. Deisenhofer, H. Nakanishi, K. Kashiwase, A. Hirata, M. Wada, Y. Ueda, J. Skoda, P. Neuzil, J. Popelova, J. Petru, L. Sediva, V. Y. Reddy, L. Uldry, A. Forclaz, N. Virag, J.- M. Vesin, L. Kappenberger, R. Sehra, C. Briggs, W.- J. Rappel, M. Janotka, M. Chovanec, K. Yamashiro, K. Takami, Y. Sakamoto, K. Satoh, T. Suzuki, H. Nakagawa, A. Romanov, E. Pokushalov, S. Artemenko, V. Shabanov, I. Stenin, D. Elesin, A. Turov, A. Yakubov, M. Hioki, S. Matsuo, K. Ito, R. Narui, S. Yamashita, K. Sugimoto, M. Yoshimura, T. Yamane, L. Di Biase, J. D. Gallinghouse, K. Rajappan, J. Kautzner, A. Dello Russo, C. Tondo, F. Lorgat, A. Natale, O. Balta, K. Buenz, M. Paessler, H. Anders, M. Horlitz, T. Deneke, L. Lickfett, I. Liberman, M. Linhart, R. Andrie, E. Mittmann-Braun, F. Stockigt, G. Nickenig, J. Schrickel, R. Tilz, A. Rillig, B. Feige, A. Metzner, A. Fuernkranz, A. Burchard, E. Wissner, F. Ouyang, T. R. Betts, M. A. Jones, K. C. K. Wong, N. Qureshi, Y. Bashir, G. Corbucci, D. Losik, V. Selina, M. A. Crandall, C. Daniels, E. Daoud, S. Kalbfleisch, H. Yamaji, T. Murakami, H. Kawamura, M. Murakami, K. Hina, S. Kusachi, G. Dakos, V. Vassilikos, S. Paraskevaidis, A. Mantziari, S. Theophylogiannakos, I. Chouvarda, I. Chatzizisis, I. Styliadis, T. Kimura, K. Fukumoto, N. Nishiyama, Y. Aizawa, Y. Fukuda, T. Sato, S. Miyoshi, S. Takatsuki, A. J. Navarrete Casas, I. Ali, F. C. Conte, M. Moran, B. G. Graham, O. Kalejs, R. Lacis, P. Stradins, A. Koris, I. Putnins, M. Vikmane, A. Lejnieks, A. Erglis, A. Estrada, A. Perez Silva, S. Castrejon, D. Doiny, J. L. Merino, A. Baranchuk, I. Greiss, C. S. Simpson, H. Abdollah, D. P. Redfearn, M. Buys-Topart, R. Nitzsche, B. Thibault, S. Kathan, C. Kolb, S. Reif, S. Schade, J. Taggeselle, A. Frey, A. Birkenhagen, S. Kohler, M. Schmidt, O. Cano Perez, F. Buendia, B. Igual, J. M. Osca, J. M. Sanchez, M. J. Sancho-Tello, J. M. Olague, A. Salvador, J. M. Tolosana, J. Fernandez-Armenta, M. Matas, M. C. Barbarin, M. Habibovic, K. C. Van Den Broek, D. A. M. J. Theuns, L. Jordaens, M. Alings, P. H. Van Der Voort, S. S. Pedersen, G. Pupita, S. Molini, M. Brambatti, A. Capucci, S. Molodykh, E. M. Idov, O. V. Belyaev, L. Segreti, E. Soldati, G. Zucchelli, A. Di Cori, S. Viani, L. Paperini, R. De Lucia, M. G. Bongiorni, L. Binner, M. Taborsky, D. Bello, H. Heuer, B. Ramza, I. Jenniskens, W. B. Johnson, M. S. Silvetti, L. Rava', M. S. Russo, C. Di Mambro, A. Ammirati, G. Gimigliano, M. Prosperi, F. Drago, A. R. Santos, B. Picarra, P. Semedo, P. Dionisio, R. Matos, M. Leitao, A. Jacinto, M. Trinca, P. Mazzone, G. Ciconte, A. Marzi, G. Paglino, P. Vergara, N. Sora, S. Gulletta, P. Della Bella, P. Koppitz, A. Fach, S. Hobbiesiefken, E. Fiehn, R. Hambrecht, J. Sperzel, M. Jung, J. Schmitt, D. Pajitnev, H. Burger, G. Goebel, W. Ehrlich, T. Walther, T. Ziegelhoeffer, V. Vancura, D. Wichterle, V. Melenovsky, M. Glikson, G. Goldenberg, A. Segev, D. Dvir, J. Kuzniec, A. Finkelstein, I. Hay, V. Guetta, W. K. Choo, S. Gupta, R. Kirkfeldt, J. Johansen, E. Nohr, M. Moller, P. Arnsbo, J. Nielsen, M. Banha, P. Stojanov, S. Raspopovic, D. Vasic, D. Savic, G. Nikcevic, V. Jovanovic, P. Defaye, B. Mondesert, A. Mbaye, R. Cassagneau, V. Gagniere, J. Jacon, V. Sanfins, H. R. Reis, J. N. Nobre, V. M. Martins, L. D. Duarte, C. M. Morais, J. C. Conceicao, M. Hero, J. L. Rey, A. Ducharme, C. Simpson, C. Stuglin, L. Blier, M. Senaratne, Y. Khaykin, A. Pinter, A. Mlynarska, R. Mlynarski, M. Sosnowski, J. Wilczek, C. Iorgulescu, S. Bogdan, D. Constantinescu, C. Caldararu, M. Dorobantu, A. Radu, R.- G. Vatasescu, S. Yusu, T. Ikeda, H. Mera, Y. Miwa, A. Abe, M. Miyakoshi, T. Tsukada, H. Yoshino, V. Nayar, P. Cantelon, A. Rawling, M. R. D. Belham, P. J. Pugh, J. Osca Asensi, O. Cano, D. Tejada, B. Munoz, M. Rodriguez, J. Olague, L. Wecke, A. Van Hunnik, T. Thompson, L. Di Carlo, M. Zdeblick, A. Auricchio, F. Prinzen, A. Doltra Magarolas, B. Bijnens, E. Silva, D. Penela, M. Sitges, P. Ofman, L. Navaravong, J. Leng, A. Peralta, P. Hoffmeister, R. Levine, J. Cook, M. Stoenescu, M. E. Tettamanti, A. Revilla Orodea, J. Lopez Diaz, L. De La Fuente Galan, R. Arnold, E. Garcia Moran, J. A. San Roman Calvar, I. Gomez Salvador, K. Nakamura, M. Takami, T. Keida, A. Mesato, S. Higa, M. Shimabukuro, H. Masuzaki, R. Proietti, A. Sagone, G. Domenichini, H. Burri, C. Valzania, M. Biffi, H. Sunthorn, G. Gavaruzzi, H. Foulkes, G. Boriani, S. Koh, W. Hou, J. Snell, J. Poore, N. Dalal, G. Bornzin, A. Kloppe, D. Mijic, H. Bogossian, I. Ninios, M. Zarse, B. Lemke, L. Guedon-Moreau, C. Kouakam, D. Klug, C. Marquie, F. Ziglio, S. Kacet, H. Mohamed Fereig Hamed, A. M. A. L. Hamdy, A. H. M. E. D. Abd El Aziz, M. R. V. A. T. Nabih, R. E. H. A. B. Hamdy, A. Yaminisaharif, G. H. Davoudi, A. Kasemisaeid, S. Sadeghian, A. Vasheghani Farahani, P. Yazdanifard, A. Shafiee, C. Alonso, C. Grimard, G. Jauvert, A. Lazarus, L. L. Mont, J. Ortiz-Perez, T. Caralt, J. Escudero, F. Perez, K. M. Griffith, R. Ferreyra, P. Urena, M. Demas, C. Muratore, H. Mazzetti, J. Guardado, M. Fernandes, V. H. Pereira, F. Canario-Almeida, F. Ferreira, B. Rodrigues, J. Almeida, A. Sokal, E. Jedrzejczyk, R. Lenarczyk, S. Pluta, O. Kowalski, P. Pruszkowska, A. Swiatkowski, Z. Kalarus, M. Heinke, B. Ismer, H. Kuehnert, T. Heinke, R. Surber, N. Osypka, D. Prochnau, H. R. Figulla, S. Iacopino, M. Landolina, A. Proclemer, L. Padeletti, V. Calvi, A. Pierantozzi, P. Di Stefano, A. Bauer, F. Bode, F. Le Gal, J. C. Deharo, M. Delay, J. Clementy, M. Kawamura, Y. Munetsugu, K. Tanno, Y. Kobayashi, D. Cannom, J. Hosoda, T. Ishikawa, K. Andoh, M. Nobuyoshi, S. Fujii, S. Shizuta, T. Isshiki, M. A. Castel, F. Perez-Villa, B. Vidal, P. Pruszkowska-Skrzep, M. Szulik, T. Kukulski, L. Gianfranchi, K. Bettiol, F. Pacchioni, P. Alboni, R. Abu Sham'a, J. Buber, E. Nof, R. Kuperstein, M. Feinberg, D. Luria, M. Eldar, K. Parks, J. R. Stone, J. P. Singh, E. Hatzinikolaou-Kotsakou, M. Kotsakou, T. H. Beleveslis, G. Moschos, E. Reppas, P. Latsios, K. Tsakiridis, A. Kazemisaeid, G. Davoodi, A. Yamini Sharif, M. Sheikhvatan, M. Toniolo, G. Zanotto, A. Rossi, L. Tomasi, C. Vassanelli, H. Versteeg, P. M. C. Mommersteeg, G. Vergara, J. Blauer, R. Ranjan, S. Vijayakumar, E. Kholmovski, N. Volland, R. Macleod, L. E. Aguinaga Arrascue, A. Bravo, P. Garcia Freire, P. Gallardo, E. Hasbani, J. Dantur, R. Quintana, P. P. Adragao, D. Cavaco, L. Parreira, K. Reis Santos, P. Carmo, R. Miranda, S. Marcelino, D. Cabrita, P. Sommer, T. Gaspar, S. Rolf, A. Arya, C. Piorkowski, G. Hindricks, E. Valles Gras, V. Bazan, L. Portillo, F. Suarez, J. Bruguera, J. Marti, Y. Huo, S. Richter, R. Schoenbauer, N. Rivas, J. Casaldaliga, I. Roca, L. Dos, J. Perez-Rodon, A. Pijuan, D. Garcia-Dorado, A. Moya, H. B. Carter, A. Garg, J. Hegrenes, H. J. Sih, L. R. Teplitsky, K. Kuroki, H. Tada, Y. Seo, T. Ishizu, M. Igawa, Y. Sekiguchi, K. Kuga, K. Aonuma, C. Rodriguez A, J. Mejias, P. Hidalgo, J. A. Hidalgo L, M. Orczykowski, P. Derejko, F. Walczak, E. Szufladowicz, P. Urbanek, R. Bodalski, K. Bieganowska, L. Szumowski, P. Peichl, R. Cihak, I. Skalsky, P. Kubus, P. Vit, L. Zaoral, R. A. Gebauer, M. Fiala, J. Janousek, K. Hiroshima, M. Goya, M. Ohe, K. Hayashi, Y. Makihara, M. Nagashima, Y. An, M. Schloesser, T. Lawrenz, D. Meyer Zu Vilsendorf, C. Strunk-Mueller, C. Stellbrink, J. Papagiannis, D. Avramidis, C. Kokkinakis, G. Kirvassilis, G. Eidelman, A. Arenal, T. Datino, F. Atienza, E. Gonzalez Torrecilla, A. Miracle, J. Hernandez, F. Fernandez Aviles, E. Ene, P. Insulander, H. Bastani, F. Braunschweig, N. Drca, G. Kenneback, J. Schwieler, J. Tapanainen, M. Jensen-Urstad, B. Andrea, E. M. A. Andrea, W. M. Maciel, L. S. Siqueira, R. C. Cosenza, F. M. Mittidieri, S. F. Farah, J. A. Atie, E. Kanoupakis, E. Kallergis, H. Mavrakis, C. Goudis, I. Saloustros, N. Malliaraki, G. Chlouverakis, P. Vardas, J. L. Bonnes, J. Jaspers Focks, S. W. Westra, M. A. Brouwer, J. L. R. M. Smeets, G. Inama, C. Pedrinazzi, F. Oliva, M. Senni, M. Zoni Berisso, S. Mostov, M. Haim, R. Nevzorov, D. Hasadi, B. Starsberg, A. Porter, J. Kuschyk, A. Schoene, F. Streitner, C. G. Veltmann, R. Schimpf, M. Borggrefe, U. Luesebrink, A. Gardiwal, H. Oswald, T. Koenig, D. Duncker, G. Klein, R. Bastiaenen, V. Batchvarov, O. Atty, J. H. Cheng, E. R. Behr, M. M. Gallagher, A. H. Starrenburg, K. Kraaier, M. F. Scholten, J. Van Der Palen, S. Adhya, L. A. Smith, T. Zhao, C. Bannister, R. H. Kamdar, M. Martinelli, S. Siqueira, R. Greco, S. A. D. Nishioka, A. A. A. Pedrosa, R. Alkmim-Teixeira, G. L. Peixoto, R. Costa, J. C. Nielsen, P. T. Mortensen, J. B. Johansen, W. Kwasniewski, A. Filipecki, D. Urbanczyk-Swic, W. Orszulak, M. Trusz - Gluza, J. Jimenez-Candil, J. Morinigo, C. Ledesma, C. Martin-Luengo, T. Vogtmann, M. Gomer, S. Stiller, V. Kuehlkamp, G. Zach, S. Loescher, S. Kespohl, G. Baumann, J. D. Snell, N. Korsun, J. R. Snell, B. Morley, R. Bharmi, Y. Nabutovsky, M. Mollerus, L. Naslund, A. Meyer, M. Lipinski, B. Libey, K. Dornfeld, A. Martin, M. Gallego, M. K. De Bie, J. B. Van Rees, C. J. Borleffs, J. Thijssen, J. W. Jukema, M. J. Schalij, L. Van Erven, E. T. Van Der Velde, T. A. Witteman, H. Foeken, T. Szili-Torok, F. Akca, K. Caliskan, F. Ten Cate, M. Michels, D. C. Cozma, L. Petrescu, C. Mornos, S. I. Dragulescu, J. A. Groeneweg, B. K. Velthuis, M. G. P. J. Cox, P. Loh, D. Dooijes, M. J. Cramer, J. M. T. De Bakker, R. N. W. Hauer, S. D. Park, S. H. Shin, S. I. Woo, J. Kwan, K. S. Park, D. H. Kim, A. Iorio, L. Vitali Serdoz, F. Brun, E. Daleffe, M. Zecchin, M. Dal Ferro, S. Santangelo, G. F. Sinagra, S. Ouali, R. Hammemi, S. Hammas, S. Kacem, R. Gribaa, E. Neffeti, F. Remedi, E. Boughzela, P. Korantzopoulos, K. Letsas, Z. Christogiannis, K. Kalantzi, A. Ntorkos, J. Goudevenos, P. W. X. Foley, L. Yung, E. Barnes, M. Kikuchi, H. Ito, F. Miyoshi, R. Pecini, J. M. Marott, G. B. Jensen, J. Theilade, T. Mine, T. Kodani, T. Masuyama, I. M. Mozos, C. Serban, C. Costea, L. Susan, P. Barthel, A. Mueller, M. Malik, G. Schmidt, O. Karakurt, H. Kilic, D. R. Munevver Sari, D. Mroczek-Czernecka, A. Z. Pietrucha, A. Borowiec, M. Wnuk, I. Bzukala, O. Kruszelnicka, E. Konduracka, J. Nessler, Y. Kikuchi, A. Meireles, C. Gomes, D. Anjo, C. Roque, A. Pinheiro Vieira, V. Lagarto, A. Hipolito Reis, S. Torres, L. Miller, G. Vedrenne, E. Bruguiere, A. Redheuil, T. Lavergne, J. Y. Le Heuzey, E. Mousseaux, A. Hersi, K. Alhabib, H. Alfaleh, K. Sulaiman, W. Almahmeed, J. Alsuwidi, H. Amin, A. Almotarreb, H. W. K. Pang, K. Michael, E. J. Pereira, P. W. Munt, M. F. Fitzpatrick, A. S. Revishvili, G. Simonyan, T. Dzhordzhikiya, O. Sopov, V. Kalinin, E. T. Locati, A. M. Vecchi, G. Cattafi, A. Sachero, M. Lunati, S. Sayah, A. Alizadeh, N. Nazari, M. Hekmat, M. Moradi, M. Zeighami, H. Ghanji, K. Suzuki, M. Takagi, K. Maeda, H. Tatsumi, P. Vieira, H. Reis, A. Toth, H. Vago, P. Takacs, E. Edes, A. Marki, G. Y. Balazs, K. Huttl, B. Merkely, F. Lainis, M. M. Buckley, E. J. Johns, C. M. Seifer, L. Daba, K. Liebrecht, W. Piwowarska, J. Toquero Ramos, E. Perez Pereira, C. Mitroi, V. Castro Urda, J. M. Fernandez Villanueva, A. Corona Figueroa, L. Hernandez Reina, I. Fernandez Lozano, A. Bartoletti, P. Bocconcelli, S. Giuli, R. Massa, C. Svetlich, G. Tarsi, F. Tronconi, E. Vitale, P. Stryjewski, M. Wegrzynowska, A. Lousinha, J. Labandeiro, E. Antunes, S. Silva, S. Alves, A. Timoteo, M. Oliveira, R. Cruz Ferreira, and J. Jedrzejczyk-Spaho

Subjects
medicine.medical_specialty, Voltage-dependent calcium channel, business.industry, medicine.drug_class, Umbilical artery, 030204 cardiovascular system & hematology, Cyclase, 3. Good health, Low testosterone levels, 03 medical and health sciences, 0302 clinical medicine, Bkca channel, Endocrinology, Physiology (medical), Internal medicine, medicine.artery, Natriuretic peptide, Medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Ionic Channels
Abstract

Inthelastdecadesseveralinvestigatorshavesuggestedtheassociationofandrogenswithhypertension. Recently, some studies have shown that the incidence of cardiovascular diseases is increased in men with low testosterone levels, suggesting a protective role of androgens. Hypertension is one of the mostcommonproblemsinpregnancythatcomplicates5-10 %ofpregnancies.Anincreaseofmorbidity wasobservedinbabiesfrompregnantwomenwithhypertension.However,thepathogenesisremains unclearandthislimitstheabilitytopreventandtreatthispathology.Thebeneficialeffectsofandrogens for vascular system are associated with their ability to cause vasorelaxation. Inhuman vessels, this non genomiceffectofandrogensappeartobeduetoactivationoflargeconductancecalcium-activatedpotassiumchannels(BKCa)andvoltagegatedpotassiumchannels(KV)whichisinducedbycGMPincrease andaconsequentactivationofcGMP-dependentproteinkinase(PKG).Ontheotherhand,thegenomic effects of androgens concerning ionic channels are almost unknown. Our previous studies suggested that androgens increase the expression of BKCa channels and decrease expression of L-type calcium channels (LTCC). The aim of this work was to analyze the genomic effects of androgens on theexpressionofotherproteinsinvolvedintheregulationofvascularcontractility,suchassolubleguanylate cyclase (sGC), the natriuretic peptide receptor-A (NPRA) and PKG. This study also aimed to compare the expression levels of these proteins in human umbilical artery (HUA) from normotensive andhypertensivepregnantwomen.ToachievethesegoalsrealtimePCRwasperformedusingsmooth

Published
2011
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26. [Fractures of the patella]

Author

H R, SCHOENBAUER

Subjects
Fractures, Bone, Gastropoda, Animals, Humans, Infant, Knee Injuries, Patella, Child
Published
1959

37. Bioimpedance Spectroscopy Reveals Important Association of Fluid Status and T 1 -Mapping by Cardiovascular Magnetic Resonance.

Author

Donà C, Nitsche C, Anegg O, Poschner T, Koschutnik M, Duca F, Aschauer S, Dannenberg V, Schneider M, Schoenbauer R, Beitzke D, Loewe C, Hengstenberg C, Mascherbauer J, and Kammerlander A

Subjects
Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Contrast Media, Magnetic Resonance Imaging methods, Magnetic Resonance Spectroscopy, Myocardium pathology, Predictive Value of Tests, Prospective Studies, Reproducibility of Results, Heart, Heart Failure
Abstract

Background: Extracellular matrix expansion is a key pathophysiologic feature in heart failure and can be quantified noninvasively by cardiac magnetic resonance T 1 -mapping. Free water within the interstitial space of the myocardium, however, may also alter T 1 -mapping results., Purpose: To investigate the association between systemic fluid status and T 1 -mapping by cardiac magnetic resonance., Study Type: Prospective, observational single-center study., Population: Two-hundred eighty-five consecutive patients (44.4% female, 70.0 ± 14.9 years old) scheduled for cardiac MR due to various cardiac diseases., Sequence and Field Strength: 1.5-T scanner (Avanto Fit, Siemens Healthineers, Erlangen, Germany). For T 1 -mapping, electrocardiographically triggered modified-Look-Locker inversion (MOLLI) recovery sequence using a 5(3)3 prototype on a short-axis mid-cavity slice and with a four-chamber view was performed., Assessments: MR parameters including native myocardial T 1 -times using MOLLI and extracellular volume (MR-ECV) were assessed, and additionally, we performed bioimpedance analysis (BIA). Furthermore, demographic data and comorbidities were assessed., Statistics: Wilcoxon's rank-sum test, chi-square tests, and for correlation analysis, Pearson's correlation coefficients were used. Regression analyses were performed to investigate the association between patients' fluid status and T 1 -mapping results. A P-value <0.05 was considered statistically significant., Results: The mixed cohort presented with a mean overhydration (OH) of +0.2 ± 2.4 liters, as determined by BIA. By MR, native T 1 -times were 1038 ± 51 msec and MR-ECV was 31 ± 9%. In the multivariable regression analysis, only OH was significantly associated with MR-ECV (adj. beta: 0.711; 95% CI: 0.28 to 1.14) along with male sex (adj. beta: 2.529; 95% CI: 0.51 to 4.55). In linear as well as multivariable analysis, only OH was significantly associated with native T 1 times (adj. beta: 3.750; 95% CI: 1.27 to 6.23)., Conclusion: T 1 -times and MR-ECV were significantly associated with the degree of OH on BIA measurement. These effects were independent from age, sex, body mass index, and hematocrit. Patients' volume status may thus be an important factor when T 1 -time and MR-ECV values are interpreted., Level of Evidence: 2 TECHNICAL EFFICACY STAGE: 3., (© 2022 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Published
2022
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38. Landiolol for refractory tachyarrhythmias in the intensive care unit: case reports.

Author

Gangl C, Krychtiuk KA, Schoenbauer R, and Speidl WS

Abstract

Tachyarrhythmias are common complications of critically ill patients treated on intensive care units. Landiolol is an ultra-short acting beta-blocker with a very high beta1-selectivity. Therefore, landiolol effectively reduces heart rate with only minimal negative effects on blood pressure and inotropy. This article describes two cases of successful treatment of supraventricular and ventricular tachycardias with landiolol in critically ill patients., (© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology.)

Published
2022
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39. Atrial arrhythmias following surgical AF ablation: electrophysiological findings, ablation strategies, and clinical outcome.

Author

Huo Y, Schoenbauer R, Richter S, Rolf S, Sommer P, Arya A, Rastan A, Doll N, Mohr FW, Hindricks G, Piorkowski C, and Gaspar T

Subjects
Adult, Aged, Atrial Fibrillation diagnosis, Atrial Fibrillation etiology, Atrial Fibrillation physiopathology, Atrial Flutter diagnosis, Atrial Flutter etiology, Atrial Flutter physiopathology, Electrophysiologic Techniques, Cardiac, Female, Humans, Image Interpretation, Computer-Assisted, Imaging, Three-Dimensional, Intraoperative Care, Male, Middle Aged, Pulmonary Veins physiopathology, Pulmonary Veins surgery, Recurrence, Retrospective Studies, Tachycardia, Supraventricular diagnosis, Tachycardia, Supraventricular etiology, Tachycardia, Supraventricular physiopathology, Time Factors, Treatment Outcome, Atrial Fibrillation surgery, Atrial Flutter surgery, Cardiac Surgical Procedures adverse effects, Catheter Ablation adverse effects, Tachycardia, Supraventricular surgery
Abstract

Background: Intraoperative atrial fibrillation (AF) ablation during cardiac surgery is a well-established treatment. However, tachycardia mechanisms, ablation strategies, and long-term follow-up of atrial arrhythmias (AA) following intraoperative AF ablation (AFA) have not been previously studied in a large cohort of patients., Objective: Eighty-two patients (48 male, median age of 65 years) with symptomatic recurrence of AA following intraoperative AFA underwent radiofrequency catheter ablation., Methods: Regular atrial tachycardias (AT) were mapped using 3-dimensional (3D) color-coded entrainment/activation mapping and eliminated by linear ablation. Pulmonary vein (PV)-isolation (PVI) was achieved in patients with left atrium-PV (LAPV) conduction after AT elimination., Results: In 85 (83%) out of a total of 103 regular ATs, the entire reentrant circuits were localized perimitrally (n = 27), around PVs (left PV [LPV] or right PV [RPV]; n = 9), around left atrial appendage (LAA; n = 1), on left-sided atrial septum (n = 8), on atrioventricular nodal area (n = 1), on the posterior wall of LA (n = 1), along roof-septum-inferoposterior wall (n = 8), at coronary sinus ostium (n = 2), upper loop in RA (n = 1), and as cavotricuspid isthmus-dependent reentrant ATs (n = 27). Sixty-five (79%) patients received PVI. Noninducibility of any AT was reached at the end of all procedures. During a median follow-up time of 18 months, 69 patients (87%) were free of AA., Conclusion: Reentrant AT appears in the majority of patients with recurrence of AA following intraoperative AFA. Detailed 3D color-coded entrainment mapping was successfully obtained in the majority of patients suffering from reentrant AT after intraoperative AFA, facilitated the accurate identification of the entire reentrant circuit and selection of optimal ablation lines., (© 2014 Wiley Periodicals, Inc.)

Published
2014
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40. Role of the coronary sinus ostium musculature in reentrant formation.

Author

Huo Y, Arya A, Gaspar T, Richter S, Schoenbauer R, Sommer P, Bollmann A, Hindricks G, and Piorkowski C

Subjects
Aged, Female, Humans, Male, Reproducibility of Results, Sensitivity and Specificity, Action Potentials, Body Surface Potential Mapping, Coronary Sinus physiopathology, Heart Conduction System physiopathology, Tachycardia, Atrioventricular Nodal Reentry physiopathology
Abstract

Background: Radiofrequency ablation of focal atrial tachycardias (AT) is a validated technique with high success rates. However, electrophysiological (EP) characteristics and ablation strategy of localized reentrant AT originating from the coronary sinus ostium (CSo) have not been reported in detail so far., Methods: From January 2009 to July 2010, 1,453 patients underwent clinically motivated EP studies. Four patients were diagnosed with localized reentrant AT originating from the CSo. P wave morphology and consistency of tachycardia cycle length were studied. Subsequently, if reentry was suggested as an underlying mechanism for AT, color-coded 3-dimensional (3D) entrainment mapping was performed to localize the reentrant circuit or differentiate a localized reentrant AT from macroreentant AT, and also confirm reentry as an underlying mechanism of AT by evaluating consistency of return cycles after entrainment at multiple sites in both atria. Finally, activation mapping was performed to localize the earliest activation site., Results: The P wave morphologies and isoelectric line between the P waves suggested most likely an AT originating from the CSo with a centrifugal activation pattern, which was confirmed by activation mapping. Consistency of return cycles and continuously fragmented local electrograms at successful ablation sites suggested reentry as an underlying AT mechanism. Color-coded 3D entrainment mapping in all 4 patients located the reentrant circuit in the CSo. There were also two specific features observed. One was fragmented and/or double potentials recorded in the CSo with prominent prolonged electrogram duration compared to those during sinus rhythm. The other is a significant conduction delay within the CS. The myocardium of the CSo was suggested as a part of the critical isthmus within the reentrant circuit, while the rest of atria distal to the CSo and myocardial coat of the distal CS were not involved in the tachycardia circuit, which was confirmed by entrainment mapping., Conclusion: Although CSo myocardium has been implicated to be a part of atrioventricular nodal reentrant tachycardia, to the best of our knowledge, this is the first report showing the localized reentrant AT confined to the CSo. Three of our patients (75%) had concomitant atrial fibrillation (AF). Further studies should be warranted to clarify the role of AT from the CS in triggering AF.

Published
2012
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41. Two completely separated arrhythmias in one single heart chamber.

Author

Schoenbauer R, Huo Y, Hindricks G, and Piorkowski C

Subjects
Atrial Flutter surgery, Catheter Ablation, Comorbidity, Electrocardiography, Humans, Male, Middle Aged, Mitral Valve surgery, Tachycardia surgery, Treatment Outcome, Atrial Flutter diagnosis, Atrial Flutter epidemiology, Tachycardia diagnosis, Tachycardia epidemiology
Abstract

A 61-year-old male patient underwent an electrophysiological study and ablation for symptomatic atypical atrial flutter which was most likely related to previous intraoperative cryoablation for treatment of paroxysmal atrial fibrillation during open heart surgery. During the procedure, a tachycardia was induced in the electrically isolated left inferior pulmonary vein (PV). With the routine induction protocol, perimitral flutter was induced, whereas, independently, the PV tachycardia was still maintained. After ablation of the mitral isthmus, no tachycardias were inducible anymore.

Published
2011
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