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4. Very High-Power Ablation for Contiguous Pulmonary Vein Isolation: Results From the Randomized POWER PLUS Trial

Author

O’Neill, Louisa, El Haddad, Milad, Berte, Benjamin, Kobza, Richard, Hilfiker, Gabriela, Scherr, Daniel, Manninger, Martin, Wijnmaalen, Adrianus P., Trines, Serge A., Wielandts, Jean-Yves, Gillis, Kris, Lycke, Michelle, De Becker, Benjamin, Tavernier, Rene, Le Polain De Waroux, Jean-Benoit, Knecht, Sebastien, and Duytschaever, Mattias

Published
2023
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5. Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study

Author

Auer, Johann, Hubauer, Martin, Pandzic, Sead, Preishuber, Eva, Primus-Grabscheit, Carina, Reitgruber, Dietmar, Schmalzer, Florian, Adlbrecht, Christopher, Schober, Andreas, Hajos, Johannes, Keil, Christoph, Schratter, Alexandra, Frick, Matthias, Benda, Magdalena Anna, Mächler, Maximilian, Mutschlechner, Beatrix, Saely, Christoph, Sprenger, Lukas, Lichtenauer, Michael, Eber, Miriam, Hoppe, Uta, Kolbitsch, Tobias, Jirak, Peter Michael, Mirna, Moritz, Schönbauer, Robert, Bergler-Klein, Jutta, Hengstenberg, Christian, Stojkovic, Stefan, Scherr, Daniel, Manninger-Wünscher, Martin, Rohrer, Ursula, Stühlinger, Markus, Schgoer, Wilfried, Schwarzl, Jana, Pürerfellner, Helmut, Derndorfer, Michael, Ebner, Christian, Eder, Veronika, Kollias, Georgios, Sturmberger, Thomas, Sieghartsleitner, Stefan, Vijgen, Johan, Koopman, Peter, Dujardin, Karl, Anné, Wim, De Ceuninck, Michel, Tavernier, Rene, Duytschaever, Mattias, Knecht, Sébastien, Missault, Luc, Vandekerckhove, Yves, Rossenbacker, Tom, Ector, Bavo, Charlier, Filip, Debruyne, Philippe, Dewilde, Willem, Janssens, Luc, Roosen, John, Vankelecom, Bart, Heidbuchel, Hein, Delesie, Michiel, Vervoort, Gert, Rombouts, Hans, Vanassche, Thomas, Engelen, Matthias, Verhamme, Peter, Willems, Rik, Constance, Christian, Pranno, Nicolas, Cox, Jafna, Bata, Iqbal, Macle, Laurent, Aguilar, Martin, Tourigny, Julia Cadrin, Dubuc, Marc, Dyrda, Katia, Guerra, Peter, Khairy, Paul, Mondésert, Blandine, Rivard, Léna, Roy, Denis, Tadros, Rafik, Talajic, Mario, Thibault, Bernard, Nault, Isabelle, Blier, Louis, Champagne, Jean, Molin, Franck, O'Hara, Gilles, Philippon, François, Plourde, Benoit, Sarrazin, Jean-François, Steinberg, Christian, Coufal, Zdenek, Balazsik, David, Mikulica, Michal, Zapeca, Jakub, Cermak, Ondrej, Drasnar, Tomas, Falc, Matej, Hornof, Josef, Racz, Blazej, Weissova, Danica, Linkova, Hana, Paskova, Eva, Petr, Robert, Sirakova, Andrea, Kettner, Jiri, Benak, Ales, Holek, Martin, Podpera, Ivo, Podperova, Monika, Vancura, Vlastimil, Jandik, Tomas, Smid, Jiri, Dedek, Vratislav, Banik, Jan, Durdil, Vaclav, Hnat, Tomas, Lellouche, Nicolas, Rouffiac, Ségolène, Taldir, Guillaume, Bridonneau, Valentin, Couffon, Philippe, Daudin, Magalie, Hamon, Cécile, Lacaze, Jonathan, Quentin, Anne, Thebault, Christophe, Boiffard, Emmanuel, Billon, Olivier, Miette, Fabien, Pouliquen, Hervé, Turlotte, Guillaume, Gorka, Hervé, Albert, Franck, Bayle, Sandrine, Bensaid, Reda, Dasoveanu, Madalina, Demichili, Thibaud, Dutoiu, Teodora, Khalil, Cliff, Loghin, Caterina, Range, Grégoire, Roussel, Laurent, Socié, Pierre, Thuaire, Christophe, Extramiana, Fabrice, Algalarrondo, Vincent, Boughanmi, Haten, El Mansour, Noreddine, Mohammad, Usman, Sellier, Romain, Elbaz, Meyer, Laperche, Clémence, Maury, Philippe, Kiss, Robert, Borsanyi, Tunde, Gingl, Zoltan, Polgar, Balaza, Benczur, Bela, Bodor, Alexandra, Hepp, Tamas, Malati, Eva, Nagy, Laszlo, Erdei, Norbert, Kapus, Jozsef, Kapus, Katalin, Toth, Brigitta, Matoltsy, Andras, Kiss, Tunde, Merkely, Bela, Herczeg, Szilvia, Kiss, Orsolya, Sallo, Zoltan, Toth, Kalman, Habon, Tamas, Rabai, Miklos, Totsimon, Kinga, Zilahi, Zsolt, Bencze, Gabriella, Santa, Janos, Aradi, Daniel, Kelemen, Barbara, Bolognese, Leonardo, Nesti, Martina, Notarstefano, Pasquale Giovanni, D'Orazio, Simona, Cosmi, Franco, Becattini, Cecilia, Agnelli, Giancarlo, Broccatelli, Belinda, Mosconi, Maria Giulia, Paciaroni, Maurizio, Urbini, Chiara, Parato, Vito Maurizio, Notaristefani, Camilla, Scarano, Michele, Ameri, Pietro, Ghigliotti, Giorgio, Guglielmi, Giulia, Lotti, Roberta, Merlo, Andrea Carlo, Muiesan, Maria Lorenza, Abondio, Andrea, Berasi, Caterina, Mattiuzzo, Elena, Mutti, Claudio, Salvetti, Massimo, Pignatelli, Pasquale, Menichelli, Danilo, Pastori, Daniele, Tamiya, Eiji, Matsumoto, Takahiro, Takabe, Tomosato, Yamamoto, Shoichi, Yamashita, Haruyo, Higashiue, Shinichi, Furuya, Onichi, Hiramatsu, Norihiko, Kasuga, Kensuke, Kojima, Saburo, Komooka, Masatoshi, Kuroyanagi, Satoshi, Matsuura, Makoto, Takemoto, Tetsushi, Yamamoto, Shuji, Saito, Katusmi, Abe, Takuro, Ishida, Issei, Iwanami, Yuji, Kataoka, Shohei, Moriyama, Tetsu, Murohashi, Akira, Sasaki, Akihito, Nakamura, Yuichiro, Ueno, Tetsuya, Shimane, Akira, Hamana, Tomoyo, Ichibori, Hirotoshi, Inoue, Tomohiro, Itoh, Mitsuaki, Iwane, Seigo, Kawai, Hiroya, Kokawa, Tatsuya, Masumoto, Akiko, Matsuo, Koki, Miyata, Taishi, Nakano, Shinsuke, Oishi, Shogo, Onishi, Tetsuari, Sawada, Takahiro, Saito, Takayuki, Shoda, Mitsuhiko, Takahashi, Nobuyuki, Takaya, Tomofumi, Taniguchi, Yasuyo, Tsukamoto, Shota, Tsukishiro, Yasue, Tsukiyama, Yoshiro, Tsunamoto, Hiroshi, Uzu, Kenzo, Yamamoto, Hiroyuki, Yamamoto, Tetsuya, Yokoi, Kiminobu, Yoshida, Chiaki, Watanabe, Nobuhiro, Betsuyaku, Tetsuo, Adachi, Kumiko, Awane, Kouichi, Goto, Daisuke, Sakakibara, Mamoru, Watanabe, Masashi, Ueno, Hideki, Hiroe, Yoshitaka, Matsuo, Koshi, Ayata, Kenji, Fukuda, Ko, Hata, Yoshiki, Hashimoto, Katsushi, Matsumi, Hiroaki, Nikaido, Akira, Okamoto, Shuichi, Sime, Iveta, Stirna, Valters, Reinholde, Ilze, Hansone, Silvija, Kozlovska, Anita, Romanova, Janina, Klincare, Dace, Pontaga, Natalja, Dirmans, Igors, Kalnins, Artis, Upite, Dana, Gersamija, Arcils, Teleznikovs, Arturs, Rozkova, Nadezda, Safro, Jelena, Anguera Camós, Ignasi, Domenico Dallaglio, Paolo, Salguero Bodes, Rafael, Arnbas, Fernando, Borrego, Luis, Marco, Alvaro, Jimenez, Javier Ramos, Gómez-Doblas, Juan José, Pérez Cabeza, Alejandro, Ferreira Gonzålez, Ignacio, Limeres Freire, Javier, Lopez Grau, Merce, Viñolas Prat, Xavier, Moreno Weidmann, Zoraida, Guerra Ramos, Jose Maria, Alonso Martin, Maria Concepcion, Campos Garcia, Bieito, Mogro Carranza, Javier Mauricio, Mendez Zurita, Francisco Javier, Rodriguez Font, Enrique, Gonzales Matos, Carlos Eduardo, García Hernando, Víctor, Lindholm, Carl-Johan, Thulin, Jörgen, Wallén, Håkan, Hagwall, Kristina, Eliasson, Ken, Lundvall, Martin, Olsson, Jens, Kjellman, Björn, Lind, Markus, Johansson, Lars, Svedberg, Niclas, Berglund, Stefan, Söderberg, Julia, Zedigh, Christer, Mooe, Thomas, Axelsson, Mattias, Binsell, Emil, Huber, Daniel, Müller, Christian, Danier, Isabelle, Kühne, Michael, Okamura, Bernhard, Schoepfer, Hadrien, Simmen, Cornelia, Reichlin, Tobias, Chollet, Laurève, Lam, Anna, Wittmer, Severin, Rickli, Hans, Gall, Christian, Hametner, Greta, Intorp, Stephanie, Luescher, Daniel, Haegeli, Laurent, Berg, Jan Christopher, Ebrahimi, Ramin, Auricchio, Angelo, Crljenica, Carmela, Moccetti, Tizziano, Monti, Cristina, Pasotti, Elena, Petrova, Iveta, Rossi, Mariagrazia, Mach, François, Namdar, Mehdi, de Groot, Joris, Proost, Virginnio, Neefs, Joline, Linz, Dominik, van Stipdonk, Twan, den Uijl, Dennis, Alings, Marco, Schaap, Jeroen, Segers, Dolf, Wouters, Noemi, Bartels, Louis, Tieleman, Robert, Pisters, Ron, de Vries, Tim, Selig, Jaap, Kuijper, Aaf, Bot, Pieter, Keijzers, Mitran, Verdel, Gerardus, Tukkie, Raymond, van den Bos, Ewout, Kauer, Floris, Oemrawsingh, Rohit, Stevenhagen, Jeroen, van Es, Jan, Lip, Gregory, Gupta, Dhiraj, Kotalczyk, Agnieszka, Gunstone, Anthony, Brixey, Richard David, Gorog, Diana, Dinarvand, Danial, Gue, Ying, Kanji, Rahim, Memtsas, Vassilios, Senior, Roxy, Bioh, Gabriel, Wong, Yuk-Ki, Child, Nick, Piccini, Jonathan P, Caso, Valeria, Connolly, Stuart J, Fox, Keith A A, Oldgren, Jonas, Jones, W Schuyler, Gorog, Diana A, Durdil, Václav, Viethen, Thomas, Neumann, Christoph, Mundl, Hardi, and Patel, Manesh R

Published
2022
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8. Evaluation of posterior mitral isthmus ablation in the absence of a vein of Marshall.

Author

François, Clara, Haddad, Milad El, Becker, Benjamin De, Smet, Maarten De, Waroux, Jean-Benoît Le Polain de, Tavernier, René, Duytschaever, Mattias, and Knecht, Sébastien

Abstract

Aims Achieving acute and durable mitral isthmus (MI) block remains challenging using radiofrequency (RF) catheter ablation alone. Vein of Marshall (VoM) ethanolization results in chemical damage along the MI resulting in the creation of a durable transmural lesion with a very high rate of procedural block. However, no studies have systematically assessed the efficacy of MI ablation alone when no anatomical VoM is present. Methods and results Thirty seven patients without VoM evidenced after careful angiographic examination were included. Ablation parameters and result were compared with a matched control group in whom the posterior MI line was performed without assessing the presence of the VoM. Mitral isthmus block was achieved in 36 out of 37 patients without VoM (97%), with endocardial ablation only in 5/37 (14%) and combined endocardial and coronary sinus ablation in 32/37 patients (86%). There was a significant difference in the occurrence of block between patients without a VoM and the control group (97.3% vs. 65% respectively, P < 0.01), with a trend towards less needed RF {26 [interquartile range (IQR) 20–38] vs. 29 [IQR 19–40] tags [ P = 0.8], 611 [IQR 443–805] vs. 746 [IQR 484–1193] seconds [ P = 0.08]}. Conclusion The absence of a VoM is associated with a very high rate of procedural block during posterior MI ablation. The higher rate of MI block in this specific population would also suggest the crucial role of the VoM (when present) in resistant MI block. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Prospective Screening for Transthyretin Cardiac Amyloidosis in Spinal Stenosis Surgery Patients

Author

Debonnaire, Philippe, primary, Claeys, Mathias, additional, De Paepe, Pascale, additional, Christiaen, Emma, additional, Geerts, Bert, additional, De Geeter, Frank, additional, Trenson, Sander, additional, Hoste, Davy, additional, Van Droogenbroeck, Jan, additional, Verhoeven, Kristof, additional, Vantomme, Nikolaas, additional, and Tavernier, René, additional

Published
2023
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20. Evaluation of a standardized approach using optimized and contiguous RF applications for electrical isolation of the superior vena cava

Author

Hilfiker, Gabriela, primary, De Becker, Benjamin, additional, Haddad, Milad El., additional, O'Neill, Louisa, additional, Gillis, Kris, additional, Wielandts, Jean‐Yves, additional, Tavernier, René, additional, De Waroux, Jean‐Benoit Le Polain, additional, Duytschaever, Mattias, additional, and Knecht, Sébastien, additional

Published
2022
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25. Safety of very high-power short-duration radiofrequency ablation for pulmonary vein isolation: a two-centre report with emphasis on silent oesophageal injury

Author

Halbfass, Philipp, primary, Wielandts, Jean-Yves, additional, Knecht, Sébastien, additional, Le Polain de Waroux, Jean-Benoît, additional, Tavernier, René, additional, De Wilde, Vincent, additional, Sonne, Kai, additional, Nentwich, Karin, additional, Ene, Elena, additional, Berkovitz, Artur, additional, Mueller, Julian, additional, Lehmkuhl, Lukas, additional, Reichart, Amelie, additional, Lüsebrink, Ulrich, additional, Duytschaever, Mattias, additional, and Deneke, Thomas, additional

Published
2021
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27. Biosense Webster’s QDOT Micro™ radiofrequency ablation catheter

Author

Wielandts, Jean-Yves, primary, Almorad, Alexandre, additional, Hilfiker, Gabriela, additional, Gillis, Kris, additional, Haddad, Milad El, additional, Vijgen, Johan, additional, Berte, Benjamin, additional, Le Polain de Waroux, Jean-Benoît, additional, Tavernier, René, additional, Duytschaever, Mattias, additional, and Knecht, Sébastien, additional

Published
2021
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28. Predictors of recurrence after durable pulmonary vein isolation for paroxysmal atrial fibrillation

Author

Lycke, Michelle, Kyriakopoulou, Maria, El Haddad, Milad, Wielandts, Jean Yves, Hilfiker, Gabriela, Almorad, Alexandre, Strisciuglio, Teresa, De Pooter, Jan, Wolf, Michael, Unger, Philippe, Vandekerckhove, Yves, Tavernier, René, de Waroux, Jean Benoît Le Polain J.B.E.P., Duytschaever, Mattias, Knecht, Sébastien, Lycke, Michelle, Kyriakopoulou, Maria, El Haddad, Milad, Wielandts, Jean Yves, Hilfiker, Gabriela, Almorad, Alexandre, Strisciuglio, Teresa, De Pooter, Jan, Wolf, Michael, Unger, Philippe, Vandekerckhove, Yves, Tavernier, René, de Waroux, Jean Benoît Le Polain J.B.E.P., Duytschaever, Mattias, and Knecht, Sébastien

Abstract

AIMS: Catheter ablation of paroxysmal atrial fibrillation (AF) reduces AF recurrence, AF burden, and improves quality of life. Data on clinical and procedural predictors of arrhythmia recurrence are scarce and are flawed by the high rate of pulmonary vein reconnection evidenced during repeat procedures after pulmonary vein isolation (PVI). In this study, we identified clinical and procedural predictors for AF recurrence 1 year after CLOSE-guided PVI, as this strategy has been associated with an increased PVI durability. METHODS AND RESULTS: Patients with paroxysmal AF, who received CLOSE-guided PVI and who participated in a prospective trial in our centre, were included in this study. Uni- and multivariate models were plotted to find clinical and procedural predictors for AF recurrence within 1 year. Three hundred twenty-five patients with a mean age of 63 years (CHA2DS2VASc 1 [1-3], left atrium diameter 41 ± 6 mm) were included. About 60.9% were male individuals. After 1 year, AF recurrence occurred in 10.5% of patients. In a binary logistic regression analysis, the diagnosis-to-ablation time (DAT) was found to be the strongest predictor of AF recurrence (P = 0.011). Diagnosis-to-ablation time ≥1 year was associated with a nearly two-fold increased risk for developing AF recurrence. CONCLUSION: The DAT is the most important predictor of arrhythmia recurrence in low-risk patients treated with durable pulmonary vein isolation for paroxysmal AF. Whether reducing the DAT could improve long-term outcomes should be investigated in another trial., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2021

29. Prospective Randomized Evaluation of High Power During CLOSE-Guided Pulmonary Vein Isolation: The POWER-AF Study

Author

Wielandts, Jean Yves, Kyriakopoulou, Maria, Almorad, Alexandre, Hilfiker, Gabriela, Strisciuglio, Teresa, Phlips, Thomas, El Haddad, Milad, Lycke, Michelle, Unger, Philippe, Le Polain De Waroux, Jean Benoît, Vandekerckhove, Yves, Tavernier, René, Duytschaever, Mattias, Knecht, Sébastien, Wielandts, Jean Yves, Kyriakopoulou, Maria, Almorad, Alexandre, Hilfiker, Gabriela, Strisciuglio, Teresa, Phlips, Thomas, El Haddad, Milad, Lycke, Michelle, Unger, Philippe, Le Polain De Waroux, Jean Benoît, Vandekerckhove, Yves, Tavernier, René, Duytschaever, Mattias, and Knecht, Sébastien

Abstract

BACKGROUND: CLOSE-guided atrial fibrillation (AF) ablation is based on contiguous (intertag distance ≤6 mm), optimized (Ablation Index >550 anteriorly and >400 posteriorly) point-by-point radiofrequency lesions. The optimal radiofrequency power remains unknown. METHODS: The POWER-AF study is a prospective, randomized controlled monocentric study including patients with paroxysmal AF, planned for first CLOSE-guided pulmonary vein isolation using a contact force radiofrequency catheter (Thermocool SmartTouch, Biosense Webster, Inc, Irvine, CA). A total of 100 patients were randomized into 2 groups (1:1). The control group received AF ablation using the standard CLOSE protocol (35 W), whereas in the experimental group, pulmonary vein isolation was performed using high power (45 W). Endoscopic evaluation was performed in patients with intraesophageal temperature rise >38.5 °C. RESULTS: The resulting sample size was 96 (48+48) patients. In the high power group, shorter procedure time (80 versus 102 minutes, P<0.001), shorter total radiofrequency application time (16 versus 26 minutes, P<0.001), and radiofrequency time per application (26 versus 37 s anteriorly, P<0.001 and 13 versus 17 s posteriorly, P<0.001) were observed. Endoscopic evaluation (performed in 19/48 versus 25/48 patients respectively, P=0.31) showed an ulcerative perforation in a high power group patient (treated by endoscopic stenting and normalization after ≈4 months) and a superficial ulcerative lesion in a control group patient (conservative treatment). Both occurred following excessive Ablation Index applications (up to 460 and 480, respectively) with excessive contact force (30 g on average, with peaks up to 50 g). Six-months AF recurrence was not significantly different (10% in high power versus 8% in control, P=0.74). CONCLUSIONS: This randomized controlled study shows that a 45 W radiofrequency power CLOSE protocol in patients with paroxysmal AF significantly increases the global procedural effic, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2021

31. Repositioning and extraction of stylet‐driven pacing leads with extendable helix used for left bundle branch area pacing

Author

le Polain de Waroux, Jean‐Benoit, primary, Wielandts, Jean‐Yves, additional, Gillis, Kris, additional, Hilfiker, Gabriela, additional, Sorgente, Antonio, additional, Capulzini, Lucio, additional, Geerts, Bert, additional, Knecht, Sébastien, additional, Duytschaever, Mattias, additional, and Tavernier, René, additional

Published
2021
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33. Predictors of recurrence after durable pulmonary vein isolation for paroxysmal atrial fibrillation

Author

Lycke, Michelle, primary, Kyriakopoulou, Maria, additional, El Haddad, Milad, additional, Wielandts, Jean-Yves, additional, Hilfiker, Gabriela, additional, Almorad, Alexandre, additional, Strisciuglio, Teresa, additional, De Pooter, Jan, additional, Wolf, Michael, additional, Unger, Philippe, additional, Vandekerckhove, Yves, additional, Tavernier, René, additional, de Waroux, Jean-Benoît e Polain, additional, Duytschaever, Mattias, additional, and Knecht, Sébastien, additional

Published
2020
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36. Safety of very high-power short-duration radiofrequency ablation for pulmonary vein isolation: a two-centre report with emphasis on silent oesophageal injury.

Author

Halbfass, Philipp, Wielandts, Jean-Yves, Knecht, Sébastien, Waroux, Jean-Benoît Le Polain de, Tavernier, René, Wilde, Vincent De, Sonne, Kai, Nentwich, Karin, Ene, Elena, Berkovitz, Artur, Mueller, Julian, Lehmkuhl, Lukas, Reichart, Amelie, Lüsebrink, Ulrich, Duytschaever, Mattias, Deneke, Thomas, Le Polain de Waroux, Jean-Benoît, and De Wilde, Vincent

Subjects
ATRIAL fibrillation diagnosis, CLINICAL trials, ATRIAL fibrillation, CATHETER ablation, TREATMENT effectiveness, PULMONARY veins
Abstract

Aims: Very high-power short-duration (vHPSD) via temperature-controlled ablation (TCA) is a new modality to perform radiofrequency pulmonary vein isolation (PVI), conceivably at the cost of a narrower safety margin towards the oesophagus. In this two-centre trial, we aimed to determine the safety of vHPSD-based PVI with specific emphasis on silent oesophageal injury.Methods and Results: Ninety consecutive patients with atrial fibrillation (AF) underwent vHPSD-PVI (90 W, 3-4 s, TCA) using the QDOT MICRO catheter, in conjunction with the nGEN (Bad Neustadt, n = 45) or nMARQ generator (Bruges, n = 45). All patients underwent post-ablation oesophageal endoscopy. Procedural parameters and complications were recorded. A subgroup of 21 patients from Bad Neustadt underwent cerebral magnetic resonance imaging (cMRI) to detect silent cerebral events (SCEs). Mean age was 67 ± 9 years, 59% patients were male, and 66% patients had paroxysmal AF. Pulmonary vein isolation was obtained in all cases after 96 ± 29 min. No steam pop, cardiac tamponade, stroke, or fistula was reported. None of the 90 patients demonstrated oesophageal ulceration (0%). Charring was not observed in the nMARQ cohort (0% vs. 11% in the nGEN group). In 5 out of 21 patients (24%), cMRI demonstrated SCE (exclusively nGEN cohort).Conclusion: Temperature-controlled vHPSD catheter ablation allows straightforward PVI without evidence of oesophageal ulcerations or symptomatic complications. Catheter tip charring and silent cerebral lesions when using the nGEN generator have led to further modification. [ABSTRACT FROM AUTHOR]

Published
2022
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38. Evaluation of higher power delivery during RF pulmonary vein isolation using optimized and contiguous lesions

Author

Kyriakopoulou, Maria, Wielandts, Jean Yves, Strisciuglio, Teresa, El Haddad, Milad, Pooter, Jan De, Almorad, Alexandre, Hilfiker, Gabriela, Phlips, Thomas, Unger, Philippe, Lycke, Michelle, Vandekerckhove, Yves, Tavernier, René, Duytschaever, Mattias, Knecht, Sébastien, Kyriakopoulou, Maria, Wielandts, Jean Yves, Strisciuglio, Teresa, El Haddad, Milad, Pooter, Jan De, Almorad, Alexandre, Hilfiker, Gabriela, Phlips, Thomas, Unger, Philippe, Lycke, Michelle, Vandekerckhove, Yves, Tavernier, René, Duytschaever, Mattias, and Knecht, Sébastien

Abstract

Aims: “CLOSE”-guided pulmonary vein isolation (PVI) is based on contiguous (≤6 mm) and optimized radiofrequency (RF) ablation lesions (ablation index [AI] ≥ 400 posteriorly and ≥ 550 anteriorly]. However, the optimal RF power to reach the desired AI is unknown. Therefore we evaluated the efficiency of an ablation strategy using higher power (40 W) during a first “CLOSE”-guided PVI. Methods: Eighty consecutive patients undergoing “CLOSE”-guided PVI for symptomatic paroxysmal atrial fibrillation were ablated with 40 W (group A). Results were compared with 105 consecutive patients enrolled in the “CLOSE to CURE”-study and were ablated using the same protocol with 35 W (group B). Results: In group A, ablation was associated with shorter ablation procedure time (91 vs 111 minutes; P <.001), shorter fluoroscopy time (5 vs 11 minutes; P <.001), shorter PVI time (48 vs 64 minutes; P <.001), shorter RF time (20 vs 28 minutes; P <.001), lower RF time per application (22 vs 29 seconds; P <.001), less RF applications (52 vs 58; P <.001), and less catheter dislocations (1 vs 2; P =.002). The impedance drop (12 vs 13 Ω; P =.192), first-pass isolation rate (99% vs 93%; P =.141) and acute reconnection rate (6% vs 4%; P >.733) were similar in both groups (groups A and B, respectively). No complications occurred. In group A, a gastroscopy—performed in five patients with esophageal temperature rise more than 42°C—did not reveal any esophageal lesion. Postprocedural recurrence of atrial tachyarrhythmia at 1 year was not significantly different between both groups. Conclusions: Using the “CLOSE”-protocol, increased power increases the efficiency of PVI without compromising patients' safety., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2020

39. Left bundle branch area pacing as alternative to his bundle pacing for cardiac resynchronisation therapy: a case report.

Author

UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Wielandts, Jean-Yves, Almorad, Alexandre, Hilfiker, Gabriela, Gauthey, Anais, Knecht, Sébastien, Duytschaever, Mattias, Vandekerckhove, Yves, Tavernier, René, Le Polain De Waroux, Jean-Benoît, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Wielandts, Jean-Yves, Almorad, Alexandre, Hilfiker, Gabriela, Gauthey, Anais, Knecht, Sébastien, Duytschaever, Mattias, Vandekerckhove, Yves, Tavernier, René, and Le Polain De Waroux, Jean-Benoît

Abstract

Case description : A 74-year-old man suffering from severe heart failure (NYHA III – LVEF 28%) associated with left bundle branch block (LBBB) (Figure 1(A)) and uncontrolled permanent atrial fibrillation (AF) despite optimal medical treatment was referred for His ablation and rescue physiological pacing after a first unsuccessful LV lead implantation through the coronary sinus (CS). Careful review of the occluded CS angiogram indeed revealed no side branches. Concordantly, the patient was offered a ‘rescue’ HBP procedure. Using the SelectSecure lead (model 3830) and a C315 His sheath (Both Medtronic, Inc. MN), His mapping (HV ¼ 106ms) and recruitment were easily obtained, unfortunately without LBBB correction.

Published
2020

40. Evaluation of a standardized approach using optimized and contiguous RF applications for electrical isolation of the superior vena cava.

Author

Hilfiker, Gabriela, De Becker, Benjamin, Haddad, Milad El., O'Neill, Louisa, Gillis, Kris, Wielandts, Jean‐Yves, Tavernier, René, De Waroux, Jean‐Benoit Le Polain, Duytschaever, Mattias, and Knecht, Sébastien

Subjects
VENA cava superior, RADIO frequency therapy, ATRIAL fibrillation, CATHETER ablation, TREATMENT effectiveness, ELECTROPHYSIOLOGY, HEART atrium, TACHYCARDIA, PULMONARY veins
Abstract

The superior vena cava (SVC) is well described as one of the most common non‐pulmonary vein (PV)—triggers for atrial tachyarrhythmias (ATA). In our study we evaluated a standardized approach for electrical isolation of the SVC from the right atrium using a horseshoe‐shaped lesion set with optimized and contiguous ostial RF lesions. The results are promising, demonstrating a very high rate of acute SVC isolation in a safe and time efficient manner (mostly less than 10 min). [ABSTRACT FROM AUTHOR]

Published
2023
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41. Left bundle branch area pacing guided by continuous uninterrupted monitoring of unipolar pacing characteristics.

Author

Gillis, Kris, O'Neill, Louisa, Wielandts, Jean‐Yves, Hilfiker, Gabriela, Vlase, Alina, Knecht, Sébastien, Duytschaever, Mattias, Tavernier, René, and le Polain de Waroux, Jean‐Benoît

Subjects
ELECTRODES, ARTIFICIAL implants, CARDIAC pacing, COMPARATIVE studies, ELECTROCARDIOGRAPHY, DESCRIPTIVE statistics, HIS bundle
Abstract

Introduction: During left bundle branch area pacing (LBBAP) lead implantation, intermittent monitoring of unipolar pacing characteristics confirms LBB capture and can detect septal perforation. We aimed to demonstrate that continuous uninterrupted unipolar pacing from an inserted lead stylet (LS) is feasible and facilitates LBBAP implantation. Methods: Thirty patients (mean age 76 ± 14 years) were implanted with a stylet‐driven pacing lead (Biotronik Solia S60). In 10 patients (comparison‐group) conventional implantation with interrupted unipolar pacing was performed, with comparison of unipolar pacing characteristics between LS and connector‐pin (CP)‐pacing after each rotation step. In 20 patients (uninterrupted‐group) performance and safety of uninterrupted implantation during continuous pacing from the LS were evaluated. Results: In the comparison group, LS and CP‐pacing impedances were highly correlated (R2 = 0.95, p <.0001, bias 12 ± 37 Ω) with comparable sensed electrograms and paced QRS morphologies. In the uninterrupted group, continuous LS‐pacing allowed beat‐to‐beat monitoring of impedance and QRS morphology to guide implantation. This resulted in successful LBBAP in all patients, after a mean of 1 ± 0 attempts, with mean threshold 0.81 ± 0.4 V, median sensing 6.5 mV [IQR 4.4–9.5], and mean impedance 624 ± 101 Ω. Positive LBBAP‐criteria were seen in all patients with median paced QRS duration of 120 ms [IQR 112–152 ms] and median pLVAT 73 ms [IQR 68–80.5 ms]. No septal perforation occurred. Conclusion: Unipolar pacing from the LS allows accurate determination of pacing impedance and generates similar paced QRS morphologies and sensed electrograms to CP pacing. Continuous LS pacing allows real‐time monitoring of impedance and paced QRS morphology, which facilitates safe and successful LBBAP lead implantation. [ABSTRACT FROM AUTHOR]

Published
2022
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44. Identification of repetitive atrial activation patterns in persistent atrial fibrillation by direct contact high‐density electrogram mapping

Author

Wolf, Michael, primary, Tavernier, René, additional, Zeidan, Ziad, additional, El Haddad, Milad, additional, Vandekerckhove, Yves, additional, Pooter, Jan De, additional, Phlips, Thomas, additional, Strisciuglio, Teresa, additional, Almorad, Alexandre, additional, Kyriakopoulou, Maria, additional, Lycke, Michelle, additional, Duytschaever, Mattias, additional, and Knecht, Sébastien, additional

Published
2019
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45. Evaluation of a simple technique aiming at optimizing point-by-point isolation of the left pulmonary veins: a randomized study

Author

Kyriakopoulou, Maria, primary, Strisciuglio, Teresa, additional, El Haddad, Milad, additional, De Pooter, Jan, additional, Almorad, Alexandre, additional, Van Beeumen, Katarina, additional, Unger, Philippe, additional, Vandekerckhove, Yves, additional, Tavernier, René, additional, Duytschaever, Mattias, additional, and Knecht, Sébastien, additional

Published
2019
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46. Identification of repetitive atrial activation patterns in persistent atrial fibrillation by direct contact high‐density electrogram mapping

Author

Wolf, Michael, Tavernier, René, Zeidan, Ziad, El Haddad, Milad, Vandekerckhove, Yves, Pooter, Jan De, Phlips, Thomas, Strisciuglio, Teresa, Almorad, Alexandre, Kyriakopoulou, Maria, Lycke, Michelle, Duytschaever, Mattias, Knecht, Sébastien, Wolf, Michael, Tavernier, René, Zeidan, Ziad, El Haddad, Milad, Vandekerckhove, Yves, Pooter, Jan De, Phlips, Thomas, Strisciuglio, Teresa, Almorad, Alexandre, Kyriakopoulou, Maria, Lycke, Michelle, Duytschaever, Mattias, and Knecht, Sébastien

Abstract

DecretOANoAutActif, info:eu-repo/semantics/published

Published
2019

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