For the first clinical application of the MG technology in an interventional electrophysiology we found a stable system enabling excellent 3D orientation for spatial catheter positioning on the basis of underlying pre-recorded cine loops. Clinically, the MG technology allowed successful procedures with short fluoroscopy times, even though a sensor-equipped ablation catheter was not yet available for use in the study.
A b s t r a c tBackground: Frequent premature ventricular complexes (PVC) are related to reversible tachycardia-induced cardiomyopathy. However, the role of arrhythmia burden on the outcome of the catheter ablation has not been fully recognised.
Aim:The aim of this study was to assess the effect of catheter ablation and PVC burden in patients with and without structural heart disease (SHD) on left ventricular ejection fraction (LVEF).
Methods:Transthoracic echocardiography was done before and six months after radiofrequency catheter ablation in 109 consecutive patients (61 men, age 55 ± 17 years) with frequent PVCs. Sixty-five (59.6%) patients had underlying SHD.
Results:The catheter ablation procedure was successful in 93 (85.3%) patients. Baseline PVC burden was higher in patients with SHD (22,267 ± 12,934) compared to those without concomitant SHD (15,546 ± 7888), p = 0.005. Nevertheless, patients with LVEF ≤ 50% at baseline presented greater LVEF recovery (from 44% to 56%) than those with LVEF > 50% at baseline after catheter ablation. In both groups, the LVEF improved (p < 0.001); however, no difference was observed between patients with SHD (5.7% ± 1.37%) and without (4.6% ± 0.96%) SHD; p = 0.89. PVC burden was higher in patients with (24,350 ± 2776 PVC/day) compared to those without (17,588 ± 1970 PVC/day) improvement of LVEF. In multivariate regression analysis PVC burden > 20,000/day (but not age, p = 0.95; gender, p = 0.89; presence of SHD, p = 0.53; QRS complex width of the treated PVC, p = 0.21, LVEF before ablation, p = 0.19; and site of origin, p = 47) predicted improvement in LVEF after successful catheter ablation (odds ratio: 3.53; 95% confidence interval: 1.15-10.75; p = 0.023).
Conclusions:Catheter ablation of frequent PVCs improves left ventricular function in multivariate analysis predicted improvement of LVEF within six months after the successful catheter ablation procedure in patients with PVC burden exceeding 20,000/24 h.
BACKGROUND Catheter ablation is an effective treatment for patients with atrial fibrillation (AF). Despite the increasing availability of the procedure, current treatment patterns of invasive AF treatment in Poland are unknown. AIMS The aim of the study was to assess data on the contemporary approaches to AF ablation in Poland, such as: target population, patients' characteristics, ablation techniques, procedural results, and complication rates. METHODS The survey including 36 questions was conducted among 38 representatives of Polish electrophysiology centers performing AF catheter ablation to test the methods and outcomes in their laboratories. RESULTS The survey was conducted among 38 out of 69 Polish electrophysiology centers performing AF ablation. There were 88 ablation laboratories in 2018 in Poland. They have performed 16 566 ablations, of which 6680 were AF ablations, according to the Polish National Health Fund data. Therefore, 3745 AF ablations analyzed in this study constituted 22.6% of all ablations and 56% of AF ablations performed in Poland in 2018. Paroxysmal AF was the most common type of AF in all surveyed centers. In 69% of the centers, the preferred method was cryoballoon ablation and in 31%, radiofrequency point -by -point circumferential pulmonary vein isolation. The reported complication rate was low (6.4%), with local adverse events being the most frequent. The mean reported incidence of atrial flutter or tachycardia after ablation was low (5%). Repeated procedures were performed mainly with radiofrequency ablation (89%). Procedural techniques and the type of venous access did not vary between the centers. CONCLUSIONS Paroxysmal AF was the most common indication for percutaneous ablation of that arrhythmia in Polish electrophysiology laboratories. The preferred method was cryoballoon ablation.
BACKGROUND Premature ventricular contractions (PVCs) are associated with tachycardiomyopathy and high mortality rate. The treatment depends on the engaged ventricle. For PVCs originating from the right outflow tract (OT), radiofrequency catheter ablation (RFCA) is recommended (class IB-R recommendation) in preference to pharmacotherapy. In those originating from the left ventricle, ablation is a class IIa B-NR recommendation. AIMS The aim of the study was to assess the success of RFCA of PVCs based on arrhythmia origin. METHODS A total of 110 consecutive patients with monomorphic PVCs referred for ablation were enrolled and divided according to the site of ablation to the OT group and the ventricles (VENT) group. Holter electrocardiography and echocardiography were performed before the procedure and at 6-month follow-up. RESULTS Long-term RFCA success was achieved in 93 (85%) patients (89% in the OT group and 82% in the VENT group; P = 0.39). The PVC reduction was similar in both groups (median [interquartile range] 99.55% [14] and 99.88% [6], respectively; P = 0.56). The OT group presented greater left ventricle (LV) recovery than the VENT group (odds ratio, 2.01; 95% CI, 1.15-10.75; P = 0.015). The procedure in the VENT group was longer, required additional access, the complication rate was similar, and 1 serious adverse event (aortic dissection) was observed in a patient with arrhytmia originating in the LV outflow tract. CONCLUSIONS The origin of PVCs does not determine the success of arrhythmia elimination. The OT origin may predict LV improvement. The duration of RFCA in the VENT group was longer. The outflow tract origin may predict reversal of LV deterioration.
We describe a case of Vasospastic angina and early repolarisation syndrome, which induced polymorphic Ventricular tachycardia episodes. Surprisingly, the angina episodes dissapeared only after atrial arrhythmias treatment and percutaneous atrial fibrillation ablation.
Leopard syndrome is an autosomal dominant inherited disease manifested by numerous cutaneous birthmarks, heart electrical conduction disorders, hypertelorism, pulmonary valve stenosis, deafness and hypertrophic cardiomyopathy. The disease may be accompanied by symptomatic ventricular tachycardia. In patients without the need for cardiac pacing and indications for a cardioverter-defibrillator (ICD) implantation, a completely subcutaneous system (S-ICD) may become an efficient option.
We present the case report of a 28 year-old man with postmyocarditis cardiomyopathy and cardioverter-defibrillator (ICD) implantation in secondary prevention. He survived an episode of circulatory arrest due to ventricular fibrillation/ /polymorphic ventricular tachycardia. All high energy therapy delivered by ICD was unsuccessful. The reason for the failure of the therapy was an increase in the defibrillation threshold. The implantation of an additional subcutaneous lead lowered the defibrillation threshold.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.