Publications by authors named "Almorad A"
Background: Patients undergoing atrial fibrillation (AF) catheter ablation may require redo procedures involving pulmonary vein (PV) re-isolation and/or ablation of extra-PV sites. Pulsed field ablation (PFA) offers a highly selective energy source for cardiac tissue, with the potential to reduce collateral damage to adjacent structures. This study aimed to evaluate the feasibility and efficacy of redo ablation using a pentaspline PFA system.
View Article and Find Full Text PDFBackground: Catheter ablation is an effective treatment of atrial fibrillation. Pulsed field ablation (PFA) has emerged as a novel energy modality that relies on high-voltage electric fields to achieve cardiac tissue ablation. Data on its efficacy in the elderly are scarce.
View Article and Find Full Text PDFBackground: Left atrial posterior wall isolation (LAPWI) plus pulmonary vein isolation (PVI) can be performed with radiofrequency ablation, cryoballoon ablation (CB-A), or, recently, pulsed field ablation (PFA).
Objective: The aims of this study were to evaluate efficacy and safety of the pentaspline PFA catheter for PVI + LAPWI in patients with persistent AF undergoing an index ablation procedure and to compare 1-year outcomes of PVI + LAPWI with PFA vs CB-A.
Methods: All consecutive patients undergoing an index ablation for persistent atrial fibrillation (AF) at Universitair Ziekenhuis Brussel, Belgium, between 2021 and 2023 were retrospectively screened.
Background: A novel focal lattice-tip catheter allowing the delivery of either pulsed field (PF) or radiofrequency (RF) energy has recently received regulatory approval. The technology features a proprietary 3-dimensional electroanatomic mapping system.
Objective: We describe the first real-world and multicenter experience.
Article Synopsis
- Brugada syndrome (BrS) is linked to dangerous heart rhythms called ventricular fibrillation (VF), and this study explores VF mapping using ECG imaging to understand the relationship between different VF mechanisms.* -
- The researchers focused on patients diagnosed with BrS who experienced VF during a specific heart procedure, analyzing various heart rhythm maps to identify spatial correlations between repolarization gradients and VF triggers.* -
- Results showed that most BrS patients had distinct "repolarization cliffs" that initiated VF, suggesting these cliffs could be important targets for treatment to prevent VF recurrence.*
Article Synopsis
- Pulsed field ablation (PFA) is a new treatment for atrial fibrillation (AF) that shows strong safety and efficacy by specifically targeting heart muscle cells while sparing nearby tissues.
- A meta-analysis comparing PFA with cryoballoon ablation (CRYO) found that PFA had higher procedural success rates and fewer complications, along with shorter procedural and fluoroscopy times.
- However, there were no significant differences in major complications or freedom from atrial tachyarrhythmias after one year between the two techniques.
Article Synopsis
- Pulsed field ablation (PFA) is a new technique for heart tissue treatment that targets heart cells directly without damaging nearby tissues, but using it with mechanical heart valves can be tricky due to potential interference.* -
- This study involved 30 patients with mechanical heart valves undergoing PFA for atrial fibrillation, and it found no major complications, with normal valve function post-procedure.* -
- While PFA seems safe for patients with mechanical valves, careful management of the catheter is crucial to prevent electromagnetic interference that could affect the treatment.*
Article Synopsis
- The peQasus study evaluates the safety and effectiveness of a new temperature-controlled high-power short-duration (HPSD) radiofrequency catheter (QDOT Micro) for pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF).
- Conducted across 15 centers in Europe, the study involved 1,023 patients and compared outcomes between a very HPSD technique and a hybrid approach.
- Results indicated complete PVI success, a mean procedure time of about 98 minutes, and a similar safety profile for both techniques, with 12-month arrhythmia-free survival rates around 77%.
Introduction: Ultrasound-guided (Echo-AVP) and Fluoroscopy-guided Axillary Vein Puncture (Fluoro-AVP) are both acknowledged as safe and effective techniques for transvenous implantation of leads for cardiac implantable electronic devices (CIEDs). Nonetheless, it is still debated which of the two techniques has a better safety and efficacy profile. Therefore, we performed a meta-analysis to evaluate the efficacy and safety of Echo-AVP versus Fluoro-AVP for CIEDs implantation.
View Article and Find Full Text PDFAims: Rhythm control of non-paroxysmal atrial fibrillation (AF) is significantly more challenging, as a result of arrhythmia perpetuation promoting atrial substrate changes and AF maintenance. We describe a tailored ablation strategy targeting multiple left atrial (LA) sites via a pentaspline pulsed field ablation (PFA) catheter in persistent AF sustained beyond 6 months (PerAF > 6 m) and long-standing persistent AF (LSPAF).
Methods And Results: The ablation protocol included the following stages: pulmonary vein antral and posterior wall isolation plus anterior roof line ablation (Stage 1); electrogram-guided substrate ablation (Stage 2); atrial tachyarrhythmia regionalization and ablation (Stage 3).
Focal Pulsed Field Ablation for Premature Ventricular Contractions: A Multicenter Experience.
Circ Arrhythm Electrophysiol
September 2024
Background: Pulsed field ablation (PFA) is a novel technology for catheter-based atrial arrhythmia treatment. Evidence of its application for ventricular arrhythmia ablation is still limited. In this study, we describe the feasibility and efficacy of focal PFA for premature ventricular contraction (PVC) ablation.
View Article and Find Full Text PDFAims: Previous clinical studies on pulmonary vein isolation (PVI) with a radiofrequency balloon (RFB) reported safe and effective procedures using conventional ablation settings with 20/60 s RF delivery via posterior/anterior (PST/ANT) electrodes. The latest evidence suggests that reducing the application time to 15 s (s) on the posterior wall when facing the oesophageal region is as effective as applying 20 s. To prospectively assess whether reducing RF time on PST/ANT segments to 15/45 s can ensure sufficient quality of lesion metrics and compare the new shortened ablation settings with the conventional one in terms of safety, and effectiveness at 1-year.
View Article and Find Full Text PDFDistance-dependent neuromodulation effect during thermal ablation for atrial fibrillation.
J Cardiovasc Electrophysiol
October 2024
Article Synopsis
- The study investigates how thermal atrial fibrillation (AF) ablation impacts the cardiac autonomic nervous system (CANS) by focusing on the effects during the ablation of the right superior pulmonary vein (RSPV) and its influence on the heart rate (HR) post-ablation.
- Researchers evaluated 97 patients undergoing first-time thermal ablation, analyzing HR changes and anatomical factors through pre- and post-procedural electrocardiograms and cardiac CT measurements.
- Results showed that 38.1% of patients experienced a significant HR increase after the procedure, with key predictors being the distance between the RSPV and superior vena cava (SVC) and the patient's age,
Catheter ablation as an adjunctive therapy to ICD implantation in Brugada Syndrome.
Eur Heart J Qual Care Clin Outcomes
November 2024
Background: Brugada Syndrome (BrS) is a life-threatening cardiac arrhythmia disorder associated with an increased risk of ventricular arrhythmias (VAs) and sudden cardiac death. Current management primarily relies on implantable cardioverter-defibrillators (ICDs), but patients may experience ICD shocks. Catheter ablation (CA) has emerged as a potential intervention to target the arrhythmogenic substrate.
View Article and Find Full Text PDFCatheter ablation of septal ventricular tachycardia (VT) is challenging. Pulsed field ablation is a promising technology, potentially reaching deep substrates. We report the first sequential unipolar biventricular pulsed field ablation targeting refractory septal VT.
View Article and Find Full Text PDFArticle Synopsis
- Brugada syndrome (BrS) is linked to sudden cardiac death, with drug-induced cases making up a significant portion, and this study focuses on developing a deep learning model called BrS-Net to recognize and predict BrS diagnosis.
- The research included 1,188 patients undergoing ajmaline testing, showing that BrS-Net effectively identified a BrS type I pattern during ajmaline with high accuracy (AUC-ROC of 0.945) and had moderate prediction accuracy from baseline ECG (AUC-ROC of 0.805).
- The study concludes that BrS-Net demonstrates strong performance in both recognizing and predicting BrS type I patterns, presenting a potential tool for monitoring at-risk populations.
Article Synopsis
- This study looked at how well an automatic program can check if certain veins in the heart are isolated during a procedure called pulmonary vein isolation (PVI), which is used to treat a heart condition called atrial fibrillation.
- The researchers compared this program's results to expert doctors' opinions by gathering data from 89 patients across four hospitals.
- The program performed really well, with scores showing it was accurate over 86% of the time in confirming if the veins were isolated properly.
Article Synopsis
- A rare gene variant in SCN5A is present in about 20%-25% of patients with Brugada syndrome (BrS), impacting their clinical outcomes.
- A systematic review of 17 studies with 3568 BrS patients revealed that those with SCN5A variants have worse clinical features, such as more frequent syncope and abnormal ECG readings.
- The analysis showed that patients with the SCN5A variant had a doubled risk of major arrhythmic events compared to those without the variant.
Seismocardiography (SCG), a method for measuring heart-induced chest vibrations, is gaining attention as a non-invasive, accessible, and cost-effective approach for cardiac pathologies, diagnosis, and monitoring. This study explores the integration of SCG acquired through smartphone technology by assessing the accuracy of metrics derived from smartphone recordings and their consistency when performed by patients. Therefore, we assessed smartphone-derived SCG's reliability in computing median kinetic energy parameters per record in 220 patients with various cardiovascular conditions.
View Article and Find Full Text PDFArticle Synopsis
- Pericarditis is a common complication after hybrid sinus node-sparing ablation for inappropriate sinus tachycardia (IST) and postural orthostatic tachycardia syndrome (POTS).
- The study aimed to assess whether prophylactic therapy with acetylsalicylic acid and colchicine reduced the risk of symptomatic pericarditis after the procedure.
- Results showed that patients receiving prophylaxis had a significantly lower incidence of symptomatic pericarditis (81.9% vs 47.2%) and few complications related to pericarditis, indicating prophylaxis is beneficial.