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4. Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study

Author

Ekanem, Emmanuel, Neuzil, Petr, Reichlin, Tobias, Kautzner, Joseph, van der Voort, Pepijn, Jais, Pierre, Chierchia, Gian-Battista, Bulava, Alan, Blaauw, Yuri, Skala, Tomas, Fiala, Martin, Duytschaever, Mattias, Szeplaki, Gabor, Schmidt, Boris, Massoullie, Grégoire, Neven, Kars, Thomas, Olivier, Vijgen, Johan, Gandjbakhch, Estelle, Scherr, Daniel, Johannessen, Arne, Keane, David, Boveda, Serge, Maury, Philippe, García-Bolao, Ignacio, Anic, Ante, Hansen, Peter Steen, Raczka, Franck, Lepillier, Antoine, Guyomar, Yves, Gupta, Dhiraj, Van Opstal, Jurren, Defaye, Pascal, Sticherling, Christian, Sommer, Philipp, Kucera, Pavel, Osca, Joaquin, Tabrizi, Fariborz, Roux, Antoine, Gramlich, Michael, Bianchi, Stefano, Adragão, Pedro, Solimene, Francesco, Tondo, Claudio, Russo, Antonio Dello, Schreieck, Jürgen, Luik, Armin, Rana, Obaida, Frommeyer, Gerrit, Anselme, Frédéric, Kreis, Ingo, Rosso, Raphael, Metzner, Andreas, Geller, Laszlo, Baldinger, Samuel H., Ferrero, Angel, Willems, Stephan, Goette, Andreas, Mellor, Greg, Mathew, Shibu, Szumowski, Lukasz, Tilz, Roland, Iacopino, Saverio, Jacobsen, Peter Karl, George, Andrikopoulos, Osmancik, Pavel, Spitzer, Stefan, Balasubramaniam, Richard, Parwani, Abdul Shokor, Deneke, Thomas, Glowniak, Andrzej, Rossillo, Antonio, Pürerfellner, Helmut, Duncker, David, Reil, Peter, Arentz, Thomas, Steven, Daniel, Olalla, Juan José, de Jong, Jonas S. S. G., Wakili, Reza, Abbey, Selim, Timo, Gottschling, Asso, Antonio, Wong, Tom, Pierre, Bertrand, Ewertsen, Niels Christian, Bergau, Leonard, Lozano-Granero, Cristina, Rivero, Maximo, Breitenstein, Alexander, Inkovaara, Jaakko, Fareh, Samir, Latcu, Decebal Gabriel, Linz, Dominik, Müller, Patrick, Ramos-Maqueda, Javier, Beiert, Thomas, Themistoclakis, Sakis, Meininghaus, Dirk Grosse, Stix, Günter, Tzeis, Stylianos, Baran, Jakub, Almroth, Henrik, Munoz, Daniel Rodriguez, de Sousa, João, Efremidis, Michalis, Balsam, Pawel, Petru, Jan, Küffer, Thomas, Peichl, Petr, Dekker, Lukas, Della Rocca, Domenico G., Moravec, Ondrej, Funasako, Moritoshi, Knecht, Sebastien, Jauvert, Gael, Chun, Julian, Eschalier, Romain, Füting, Anna, Zhao, Alexandre, Koopman, Pieter, Laredo, Mikael, Manninger, Martin, Hansen, Jim, O’Hare, Daniel, Rollin, Anne, Jurisic, Zrinka, Fink, Thomas, Chaumont, Corentin, Rillig, Andreas, Gunawerdene, Melanie, Martin, Claire, Kirstein, Bettina, Nentwich, Karin, Lehrmann, Heiko, Sultan, Arian, Bohnen, Jan, Turagam, Mohit K., and Reddy, Vivek Y.

Abstract

Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for ~1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.

Published
2024
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5. Dual energy for pulmonary vein isolation using dual-energy focal ablation technology integrated with a three-dimensional mapping system: SmartfIRE 3-month results.

Author

Duytschaever, Mattias, Račkauskas, Gediminas, Potter, Tom De, Hansen, Jim, Knecht, Sebastian, Phlips, Thomas, Vijgen, Johan, Scherr, Daniel, Szeplaki, Gabor, Herendael, Hugo Van, Kronborg, Mads Brix, Berte, Benjamin, Pürerfellner, Helmut, and Lukac, Peter

Abstract

Aims Contact force (CF)–sensing radiofrequency (RF) catheters with an ablation index have shown reproducible outcomes for the treatment of atrial fibrillation (AF) in large multicentre studies. A dual-energy (DE) focal CF catheter to deliver RF and unipolar/biphasic pulsed field ablation (PFA), integrated with a three-dimensional (3D) mapping system, can provide operators with additional flexibility. The SmartfIRE study assessed the safety and efficacy of this novel technology for the treatment of drug-refractory, symptomatic paroxysmal AF. Results at 3 months post-ablation are presented here. Methods and results Pulmonary vein isolation (PVI) was performed using a DE focal, irrigated CF-sensing catheter with the recommendation of PFA at posterior/inferior and RF ablation at the anterior/ridge/carina segments. Irrespective of energy, a tag size of 3 mm; an inter-tag distance ≤6 mm; a target index of 550 for anterior, roof, ridge, and carina; and a target index of 400 for posterior and inferior were recommended. Cavotricuspid isthmus ablation was permitted in patients with documented typical atrial flutter. The primary effectiveness endpoint was acute procedural success. The primary safety endpoint was the rate of primary adverse events (PAEs) within 7 days of the procedure. A prespecified patient subset underwent oesophageal endoscopy (EE; 72 h post-procedure), neurological assessment (NA; pre-procedure and discharge), and cardiac computed tomography (CT)/magnetic resonance angiogram (MRA) imaging (pre-procedure and 3 months post-procedure) for additional safety evaluation, and a mandatory remapping procedure (Day 75 ± 15) for PVI durability assessment. Of 149 patients enrolled between February and June 2023, 140 had the study catheter inserted (safety analysis set) and 137 had ablation energy delivered (per-protocol analysis set). The median (Q1/Q3) total procedure and fluoroscopy times were 108.0 (91.0/126.0) and 4.2 (2.3/7.7) min (n = 137). The acute procedural success rate was 100%. First-pass isolation was achieved in 89.1% of patients and 96.8% of veins. Cavotricuspid isthmus ablations were successfully performed in 12 patients [pulsed field (PF) only: 6, RF only: 5, and RF/PF: 1]. The PAE rate was 4.4% [6/137 patients; 2 pulmonary vein (PV) stenoses, 2 cardiac tamponades/perforations, 1 stroke, and 1 pericarditis]. No coronary artery spasm was reported. No oesophageal lesion was seen in the EE subset (0/31, 0%). In the NA subset (n = 30), microemboli lesions were identified in 2 patients (2/30, 6.7%), both of which were resolved at follow-up; only 1 was symptomatic (silent cerebral lesion, 3.3%). In the CT/MRA subset (n = 30), severe PV narrowing (of >70%) was detected in 2 patients (2/30, 6.7%; vein level 2/128, 1.6%), of whom 1 underwent dilatation and stenting and 1 was asymptomatic; both were associated with high index values and a small inter-tag distance. In the PV durability subset (n = 30), 100/115 treated PVs (87%) were durably isolated and 18/30 patients (60.0%) had all PVs durably isolated. Conclusion A DE focal CF catheter with 3D mapping integration showed a 100% acute success rate with an acceptable safety profile in the treatment of paroxysmal AF. Prespecified 3-month remapping showed notable PVI durability. Clinical trial registration ClinicalTrials.gov Identifier: NCT05752487. [ABSTRACT FROM AUTHOR]

Published
2024
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14. PO-06-166 VERY HIGH-POWER SHORT-DURATION RADIOFREQUENCY ABLATION RESULTS IN IMPROVED CATHETER STABILITY AND LARGER IMPEDANCE DROP COMPARED TO CONVENTIONAL RADIOFREQUENCY ABLATION: A CLOUD-BASED ANALYSIS OF SECURE STUDY

Author

Vijgen, Johan M., Gallagher, Mark M., Pürerfellner, Helmut, De Potter, Tom, Ng, Andre, Rosso, Raphael, Szeplaki, Gabor, Deneke, Thomas, Deisenhofer, Isabel, Amos, Yariv - Avraham, Postilnik, Ravit, Tsoref, Liat, and Grimaldi, Massimo

Published
2024
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16. Clinical effectiveness of primary prevention implantable cardioverter-defibrillators: results of the EU-CERT-ICD controlled multicentre cohort study

Author

Zabel, Markus, Willems, Rik, Lubinski, Andrzej, Bauer, Axel, Brugada, Josep, Conen, David, Flevari, Panagiota, Hasenfuß, Gerd, Svetlosak, Martin, Huikuri, Heikki V, Malik, Marek, Pavlović, Nikola, Schmidt, Georg, Sritharan, Rajevaa, Schlögl, Simon, Szavits-Nossan, Janko, Traykov, Vassil, Tuinenburg, Anton E, Willich, Stefan N, Harden, Markus, Friede, Tim, Svendsen, Jesper Hastrup, Sticherling, Christian, Merkely, Béla, Perge, Peter, Sallo, Zoltan, Szeplaki, Gabor, Szegedi, Nandor, Nagy, Klaudia Vivien, Lüthje, Lars, Sritharan, R, Haarmann, Helge, Bergau, Leonard, Seegers, Joachim, Munoz- Exposito, Pascal, Tichelbäcker, Tobias, Kirova, Aleksandra, Hnatkova, Katerina, Vos, Marc A, Reinhold, Thomas, Vandenberk, Bert, Klinika, Magdalena, Rotkvić, L, Flevari, Panayota, Katsimardos, Andreas, Katsaras, Dimitrios, Hatala, Robert, Kuczejko, Tomasz, Hansen, Jim, Manola, Šime, Vinter, Ozren, Benko, Ivica, Tuinenburg, Anton, Sprenkeler, David, Smoczynska, A, Vos, M A, Meyer-Zürn, Christine, Eick, Christian, Arbelo, Elena, Kaliska, Gabriela, Martinek, Jozef, Dommasch, Michael, Steger, Alexander, Kääb, Stefan, Sinner, Moritz F, Rizas, Konstantinos D, Hamm, Wolfgang, Traykov, V, Cygankiewicz, Iwona, Ptaszyński, Pawel, Kaczmarek, K, Poddebska, I, Iovev, Svetoslav, Novotný, Tomáš, Kozak, Milan, Huikuri, Heikki, Kenttä, Tuomas, Pelli, Ari, Kasprzak, Jaroslaw D, Qavoq, Dariusz, Brusich, Sandro, Avdovic, Ervin, Klasan, Marina, Galuszka, Jan, Taborsky, Milos, Velchev, Vasil, Dissmann, Rüdiger, Shalganov, T, Guzik, P, Krauze, T, Bimmel, Dieter, Lieberz, Christiane, Ludwigsburg, Klinikum, Stefanow, Stefan, Rüb, Norman, Wolpert, Christian, Meier, Lars S, Behrens, Steffen, Jurisic, Zrinka, Braunschweig, Frieder, Blaschke, Florian, Pieske, Burkert, Bakotic, Zoran, Anic, Ante, Weiden, Klinikum, Schwinger, Robert H G, Platonov, Pyotr, Grönefeld, Gerian, Klingenheben, Thomas, and EU-CERT-ICD Study Investigators

Subjects
medicine.medical_specialty, medicine.medical_treatment, Implantable cardioverter-defibrillator, Risk factors, Mortality, Sudden cardiac death, 030204 cardiovascular system & hematology, Ventricular Function, Left, Cohort Studies, EU-CERT-ICD Study Investigators, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, Internal medicine, medicine, Clinical endpoint, Humans, AcademicSubjects/MED00200, Prospective Studies, 030212 general & internal medicine, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, 1102 Cardiorespiratory Medicine and Haematology, Aged, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, Heart Failure, Ejection fraction, Ischemic cardiomyopathy, business.industry, Hazard ratio, Stroke Volume, 1103 Clinical Sciences, Dilated cardiomyopathy, medicine.disease, Confidence interval, Defibrillators, Implantable, 3. Good health, Europe, Primary Prevention, Death, Sudden, Cardiac, Treatment Outcome, Cardiovascular System & Hematology, Implantable cardioverter-defibrillator, Risk factors, Mortality, Sudden cardiac death, Cardiology and Cardiovascular Medicine, business, Cohort study
Abstract

Aims The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter-Defibrillators (EU-CERT-ICD), a prospective investigator-initiated, controlled cohort study, was conducted in 44 centres and 15 European countries. It aimed to assess current clinical effectiveness of primary prevention ICD therapy. Methods and results We recruited 2327 patients with ischaemic cardiomyopathy (ICM) or dilated cardiomyopathy (DCM) and guideline indications for prophylactic ICD implantation. Primary endpoint was all-cause mortality. Clinical characteristics, medications, resting, and 12-lead Holter electrocardiograms (ECGs) were documented at enrolment baseline. Baseline and follow-up (FU) data from 2247 patients were analysable, 1516 patients before first ICD implantation (ICD group) and 731 patients without ICD serving as controls. Multivariable models and propensity scoring for adjustment were used to compare the two groups for mortality. During mean FU of 2.4 ± 1.1 years, 342 deaths occurred (6.3%/years annualized mortality, 5.6%/years in the ICD group vs. 9.2%/years in controls), favouring ICD treatment [unadjusted hazard ratio (HR) 0.682, 95% confidence interval (CI) 0.537–0.865, P = 0.0016]. Multivariable mortality predictors included age, left ventricular ejection fraction (LVEF), New York Heart Association class Conclusion In contemporary ICM/DCM patients (LVEF ≤35%, narrow QRS), primary prophylactic ICD treatment was associated with a 27% lower mortality after adjustment. There appear to be patients with less survival advantage, such as older patients or diabetics.

Published
2020

29. Appropriate Shocks and Mortality in Patients With Versus Without Diabetes With Prophylactic Implantable Cardioverter Defibrillators

Author

Junttila, M. Juhani, Pelli, Ari, Kenttä, Tuomas V., Friede, Tim, Willems, Rik, Bergau, Leonard, Malik, Marek, Vandenberk, Bert, Vos, Marc A., Schmidt, Georg, Merkely, Bela, Lubinski, Andrzej, Svetlosak, Martin, Braunschweig, Frieder, Harden, Markus, Zabel, Markus, Huikuri, Heikki V., Sticherling, Christian, Seegers, Joachim, Hasenfuß, Gerd, Munoz-Exposito, Pascal, Tichelbäcker, Tobias, Kirova, Aleksandra, Schlögl, Simon, Sritharan, Rajevaa, Jörß, Katharina, Macken, Jessica, Misdaq, Misbah, Rudolph, Kornelia, Bauer, Axel, Meyer-Zürn, Christine, Eick, Christian, rechts der Isar, Klinikum, Schmidt, Goerg, Müller, Alexander, Dommasch, Michael, Sinnecker, Daniel, Kääb, Stefan, Sinner, Moritz F., Dissmann, Rüdiger, Burmester, Ute, Behrens, Steffen, Gregor, Martina, Stefanow, Stefan, Rüb, Norman, Wolpert, Christian, Bimmel, Dieter, Lieberz, Christiane, Maier, Lars S., Schwinger, Robert H.G., Blaschke, Florian, Pieske, Burkert, Grönefeld, Gerian, Klein, Gunnar, Gardiwal, Ajmal, Szeplaki, Gabor, Perge, Peter, Szavits Nossan, Janko, Rotkvić, Luka, Pavlovic, Nikola, Manola, Sime, Vinter, Ozren, Benko, Ivica, Brusic, Sandro, Avdovic, Ervin, Klasan, Marina, Bakotic, Zoran, Anic, Ante, Jurisic, Zrinka, Kowalczyk, Emilia, Kucejko, Tomasz, Czechowska, Agnieszka, Wybor, Katarina, Cygankiewicz, Iwona, Ptaszyński, Pawel, Kasprzak, Jaroslaw, Qavoq, Dariusz, Guzik, Przemyslaw, Krauze, Tomasz, Sterlinski, Maciej, Hatala, Robert, Kaliska, Gabriela, Martinek, Jozef, Hastrup Svendsen, Jesper, Thamsborg, Karen, Hansen, Jim, Schloett-Hyldelund, Ida-Maria, Laage-Petersen, Julie, van Soest, Sofie, Flevari, Panayota, Katsaras, Dimitrios, Katsimardos, Andreas, Leftheriotis, Dionyssios, Papangelopoulou, Konstantinia, Varlamos, Charalambos, Traykov, Vassil, Velchev, Vasil, Iovev, Svetoslav, Shalganov, Tchavdar, Conen, David, Giesebart, Sarah, Novotny, Tomas, Kozak, Milan, Taborsky, Milos, Galuszka, Jan, Tuinenburg, Anton E., Wijers, Sofieke, Dunnink, Albert, Sprenkeler, David, Brugada, Josep, Arbelo, Elena, Trucco, Emilce, Vidorreta, Silvia, Kenttä, Tuomas, Huikuri, Pirkko, Koski, Päivi, Karlsson, Helena, Ersgaard, David, Platonov, Pyotr, Klingenheben, Thomas, and EU-CERT-ICD Investigators

Subjects
Male, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Ventricular Function, Left, DISEASE, Sudden cardiac death, Endocrinology, 0302 clinical medicine, Tachycardia, Medicine, FIBROSIS, Advanced and Specialised Nursing, 030212 general & internal medicine, Registries, 11 Medical and Health Sciences, RISK, Electroshock, OUTCOMES, Incidence (epidemiology), Incidence, Hazard ratio, ASSOCIATION, Middle Aged, Implantable cardioverter-defibrillator, 3. Good health, Defibrillators, Implantable, Diabetes and Metabolism, Primary Prevention, PRESERVED EJECTION FRACTION, Cardiology, Female, VENTRICULAR-FIBRILLATION, Life Sciences & Biomedicine, medicine.medical_specialty, 030209 endocrinology & metabolism, Lower risk, Sudden death, 03 medical and health sciences, Endocrinology & Metabolism, Diabetes mellitus, Internal medicine, Journal Article, Internal Medicine, Diabetes Mellitus, Humans, Aged, Retrospective Studies, Advanced and Specialized Nursing, Science & Technology, business.industry, Retrospective cohort study, medicine.disease, Death, Sudden, Cardiac, MYOCARDIAL-INFARCTION, ICD sudden death cardiomyopathy, business, SUDDEN CARDIAC DEATH, Diabetic Angiopathies, Follow-Up Studies
Abstract

OBJECTIVE Diabetes increases the risk of all-cause mortality and sudden cardiac death (SCD). The exact mechanisms leading to sudden death in diabetes are not well known. We compared the incidence of appropriate shocks and mortality in patients with versus without diabetes with a prophylactic implantable cardioverter defibrillator (ICD) included in the retrospective EU-CERT-ICD registry. RESEARCH DESIGN AND METHODS AND RESULTS A total of 3,535 patients from 12 European EU-CERT-ICD centers with a mean age of 63.7 ± 11.2 years (82% males) at the time of ICD implantation were included in the analysis. A total of 995 patients (28%) had a history of diabetes. All patients had an ICD implanted for primary SCD prevention. End points were appropriate shock and all-cause mortality. Mean follow-up time was 3.2 ± 2.3 years. Diabetes was associated with a lower risk of appropriate shocks (adjusted hazard ratio [HR] 0.77 [95% CI 0.62–0.96], P = 0.02). However, patients with diabetes had significantly higher mortality (adjusted HR 1.30 [95% CI 1.11–1.53], P = 0.001). CONCLUSIONS All-cause mortality is higher in patients with diabetes than in patients without diabetes with primary prophylactic ICDs. Subsequently, patients with diabetes have a lower incidence of appropriate ICD shocks, indicating that the excess mortality might not be caused primarily by ventricular tachyarrhythmias. These findings suggest a limitation of the potential of prophylactic ICD therapy to improve survival in patients with diabetes with impaired left ventricular function.

Published
2020

36. Standardized pulmonary vein isolation workflow to enclose veins with contiguous lesions: the multicentre VISTAX trial

Author

Duytschaever, Mattias, primary, Vijgen, Johan, additional, De Potter, Tom, additional, Scherr, Daniel, additional, Van Herendael, Hugo, additional, Knecht, Sebastien, additional, Kobza, Richard, additional, Berte, Benjamin, additional, Sandgaard, Niels, additional, Albenque, Jean-Paul, additional, Szeplaki, Gabor, additional, Stevenhagen, Yorick Jeroen, additional, Taghji, Philippe, additional, Wright, Matthew, additional, Macours, Nathalie, additional, and Gupta, Dhiraj, additional

Published
2020
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39. Prediction of mortality benefit based on periodic repolarisation dynamics in patients undergoing prophylactic implantation of a defibrillator: a prospective, controlled, multicentre cohort study

Author

Bauer, Axel, primary, Klemm, Mathias, additional, Rizas, Konstantinos D, additional, Hamm, Wolfgang, additional, von Stülpnagel, Lukas, additional, Dommasch, Michael, additional, Steger, Alexander, additional, Lubinski, Andrezej, additional, Flevari, Panagiota, additional, Harden, Markus, additional, Friede, Tim, additional, Kääb, Stefan, additional, Merkely, Bela, additional, Sticherling, Christian, additional, Willems, Rik, additional, Huikuri, Heikki, additional, Malik, Marek, additional, Schmidt, Georg, additional, Zabel, Markus, additional, Merkely, Béla, additional, Perge, Peter, additional, Sallo, Zoltan, additional, Szeplaki, Gabor, additional, Lüthje, Lars, additional, Schlögl, Simon, additional, Haarmann, Helge, additional, Bergau, Leonard, additional, Seegers, Joachim, additional, Hasenfuß, Gerd, additional, Munoz-Exposito, Pascal, additional, Tichelbäcker, Tobias, additional, Kirova, Aleksandra, additional, Hnatkova, Katerina, additional, Vos, Marc, additional, Willich, Stefan N., additional, Reinhold, Thomas, additional, Vandenberk, Bert, additional, Klinika, Magdalena, additional, Toplice, Krapinske, additional, Flevari, Panayota, additional, Katsimardos, Andreas, additional, Katsaras, Dimitrios, additional, Hatala, Robert, additional, Svetlosak, Martin, additional, Lubinski, Andrzej, additional, Kuczejko, Tomasz, additional, Hansen, Jim, additional, Conen, David, additional, Milosrdnice, Sestre, additional, Pavlović, Nikola, additional, Manola, Šime, additional, Vinter, Ozren, additional, Benko, Ivica, additional, Tuinenburg, Anton, additional, Bauer, Axel, additional, Meyer-Zürn, Christine, additional, Eick, Christian, additional, Hastrup, Jesper, additional, Brugada, Josep, additional, Arbelo, Elena, additional, Kaliska, Gabriela, additional, Martinek, Jozef, additional, Sinner, Moritz F., additional, Rizas, Konstantinos D., additional, Vdovin, Nikolay, additional, Cygankiewicz, Iwona, additional, Ptaszynski, Pawel, additional, Kaczmarek, Krzysztof, additional, Poddebska, Izabela, additional, Iovev, Svetoslav, additional, Novotný, Tomáš, additional, Kozak, Milan, additional, Kenttä, Tuomas, additional, Pelli, Ari, additional, Kasprzak, Jaroslaw D., additional, Qavoq, Dariusz, additional, Brusich, Sandro, additional, Avdovic, Ervin, additional, Klasan, Marina, additional, Galuszka, Jan, additional, Taborsky, Milos, additional, Velchev, Vasil, additional, Dissmann, Rüdiger, additional, Guzik, Przemysław, additional, Bimmel, Dieter, additional, Lieberz, Christiane, additional, Stefanow, Stefan, additional, Rüb, Norman, additional, Wolpert, Christian, additional, Maier, Lars S., additional, Behrens, Steffen, additional, Jurisic, Zrinka, additional, Braunschweig, Frieder, additional, Blaschke, Florian, additional, Pieske, Burkert, additional, Bakotic, Zoran, additional, Anic, Ante, additional, Schwinger, Robert H.G., additional, and Platonov, Pyotr, additional

Published
2019
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46. Comparison of the Effects of Epicardial and Endocardial Cardiac Resynchronization Therapy on Transmural Dispersion of Repolarization

Author

Molnar, Levente, Szilagyi, Szabolcs, Osztheimer, Istvan, Szeplaki, Gabor, ÖZCAN, EMİN EVREN, Sallo, Zoltan, Geller, Laszlo, Merkely, Bela, Zima, Endre, and Ozturk, Ali

Abstract

BackgroundDespite significant improvements in cardiac output and functional capacity with cardiac resynchronization therapy (CRT), incidence of sudden cardiac death still remains high. Reversal of physiological myocardial activation sequence during epicardial pacing increases the transmural dispersion of repolarization (TDR). The aim of this study was to compare the effects of endocardial and epicardial biventricular pacing on repolarization parameters in the same patient group.

Published
2015

47. Reszinkronizációs terápia Primer implantáció és upgrade

Author

Nagy, Klaudia Vivien, Szegedi, Nandor, Szeplaki, Gabor, Kovacs, Atilla, Nemeth, Tamas, Valentina, Kutyifa, Molnar, Levente, Bela, Merkely, ÖZCAN, EMİN EVREN, Istvan, Osztheimer, Endre, Zima, Szilagyi, Szabolcs, and Geller, Laszlo

Published
2015

48. Sex differences in rate and rhythm control for atrial fibrillation.

Author

Weberndörfer, Vanessa, Beinart, Roy, Ricciardi, Danilo, Ector, Joris, Mahfoud, Mohanad, Szeplaki, Gabor, Hemels, Martin, and DAS-CAM participants 2017/2018

Abstract

Atrial fibrillation (AF), is the most common sustained arrhythmia and is associated with a substantial increase in morbidity and mortality. Several studies have demonstrated sex-related differences in various aspects, including age at diagnosis, clinical manifestations, management and prognosis. These dissimilarities may dictate different approaches to management and could translate to differences in outcomes. However, similarly to other cardiovascular therapies, there may be a tendency to treat females more conservatively and less aggressively than male patients. The use of oral anticoagulants, for example, is lower in female patients with AF. Electrical cardioversion is less often used. Likewise, despite higher rates of adverse reactions to antiarrhythmic drugs in women, they are less likely to undergo catheter ablations, a well-established therapeutic approach to symptomatic patients with recurrences of AF. In this article, we review sex related dissimilarities in patients with AF. In addition, we discuss various treatment options, and specifically refer to differences in access of treatment, success rates, and potential treatment-related complications. [ABSTRACT FROM AUTHOR]

Published
2019
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