Background
Enlarged left atrium is an established predictor of atrial fibrillation recurrence after pulmonary vein isolation but arrhythmia recurrence is also observed in patients with normal anatomy of the left atrium. The aim of the study is to evaluate arrhythmia recurrence predictors in patients with normal anatomy of the left atrium.
Methods
The study included 182 patients with normal anatomy of the left atrium who underwent pulmonary vein isolation using catheter ablation. Various parameters were also compared, including age, gender, history of arrhythmia, arterial hypertension, concomitant coronary pathology, echocardiography findings, such as mitral valve and tricuspid valve regurgitation and procedure parameters, between patients with and without relapses. Statistical analysis was performed using the IBM SPSS Statistics‐19 software.
Results
Transthoracic echocardiography was performed by independent specialists with extensive experience. Trans‐esophageal echocardiography was performed before each ablation procedure. Standard trans‐septal puncture was performed under fluoroscopic control. Radiofrequency ablation was performed in the ipsilateral pulmonary vein antrum with a wide capture of nearby lung tissue.
Conclusions
It was concluded that the tricuspid valve regurgitation and arterial hypertension correlate with atrial fibrillation recurrence after pulmonary vein isolation in patients with normal left atrial anatomy.
Funding Acknowledgements
Type of funding sources: None.
Background
Leadless pacemakers (L-PM) are a new safe alternative technology for pacing the right ventricle. However, not enough information is available on their potential benefits for quality of life (QoL) in patients with L-PM. The purpose of the study was the quality of life comparison of patients with L-PM and conventional pacemakers (C-PM).
Methods
The study included patients who underwent implantation of a single-chamber pacemaker from December 2018 to March 2022. We used the SF-36 Questionnaire to assess quality of life at baseline and after 6 and 12 months of follow-up. We also used a questionnaire consisting of 10 specific questions related to the implantation procedure.
Results
Total of 32 patients were included (16 L-PM; 16 C-PM). There were no differences in baseline characteristics between groups (L-PM vs. C-PM), except for age (47.5 vs. 57.3 years; P = 0.012) and diabetes 28% vs. 21%; P = 0.021). Baseline SF-36 did not differ between groups. After 6 months of follow-up, patients in the L-PM group showed significantly higher scores on physical function (47 vs 32; P<0.001), physical role (53 vs 37; P=0.004) and mental health (67 vs 52; P=0.017), even after adjusting for covariates. Pacemaker-related discomfort and physical limitations were significantly lower in the L-PM group.
Conclusion
L-PM is associated with a better quality of life than C-PM, both in terms of physical and mental health. Patients who underwent L-PM implantation reported less procedure-related discomfort, physical limitations, and anxiety.
Introduction: Pulmonary vein isolation is the primary goal in treating patients with paroxysmal atrial fibrillation using catheter ablation. This study's purpose is a comparative assessment of the efficacy and safety of two strategies for catheter treatment in patients with persistent atrial fibrillation.
Patients and methods: The study included 127 patients with persistent atrial fibrillation during the last six months before inclusion in the study. The average follow-up period was 24 months.
Results: The primary efficacy endpoint (death, cerebrovascular event, or serious complications associated with treatment) occurred in 15 patients in the cryoballoon ablation group and 14 patients in the radiofrequency ablation group. The Kaplan-Meier survival estimates were 30% and 28%, and the risk ratio 0.96 and 95% of the confidence interval.
Conclusions: The treatment in patients with persistent atria fibrillation, using catheter ablation with contact force control catheter treatment with the pulmonary vein isolation, was more efficient.
The relevance of the study is conditioned by the problem of implantation of an artifi cial cardiac pacemaker in atrial fi brillation in patients with tachy-brady syndrome according to the standard scheme related to the presence of a congenital anomaly, such as persistent left superior vena cava. The purpose of the study is to develop an operative method of implantation of a permanent two-chamber pacemaker in patients with tachybrady syndrome with concomitant pathology of the persistent left superior vena cava. Research methods are the generally accepted clinical and instrumental examination of the patient, including taking anamnesis and a standard cardiological examination, electrocardiography, transthoracic echocardiography, plain radiography, angiocardiographic examination, and multispiral computed tomography, which, along with a general analysis, confi rm the presence of tachy-brady syndrome with atrial fi brillation and congenital anomaly in the form of persistent left superior vena cava in patients. The study presents a developed model of surgical implantation of a permanent two-chamber pacemaker to stabilise the condition of patients with atrial fi brillation related to tachy-brady syndrome with concomitant persistent left superior vena cava; the standard implantation mechanism included the introduction of a radiopaque agent to clarify the anatomical structure of the vascular bed, further, its entry from the subclavian veins into the persistent left superior vena cava and into the cavity of the right atrium through the venous coronary sinus was detected, and then a gradual introduction of an endocardial right ventricular electrode was performed into the subclavian vein through the tricuspid valve along with its further positioning in the apex of the right ventricle; therefore, a permanent two-chamber pacemaker can be successfully installed, creating conditions for restoring sinus rhythm in this group of patients, which is of practical importance for the fi eld of medicine (Tab. 3, Fig. 4, Ref. 20).
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