Prevention of cerebral thromboembolism by oral anticoagulation with dabigatran after pulmonary vein isolation for atrial fibrillation: the ODIn-AF trial.

Background And Objectives: Long-term oral anticoagulation (OAC) following successful catheter ablation of atrial fibrillation (AF) remains controversial. Prospective data are missing. The ODIn-AF study aimed to evaluate the effect of OAC on the incidence of silent cerebral embolic events and clinically relevant cardioembolic events in patients at intermediate to high risk for embolic events, free from AF after pulmonary vein isolation (PVI).

Safety and feasibility of a 1 frame-per-second X-ray framerate in cardiac electrophysiology.

Background: We investigated the feasibility and safety of a framerate of 1 frame per second ("fps") for fluoroscopy and cine-angiography, to lower radiation exposure for patients and personnel in cardiac electrophysiology ("EP").

Method: Analysis of 2521 EP procedures, 899 (36%) with the lowest available conventional framerate (3.75 fps) and 1622 (64%) procedures performed with a framerate lowered further to 1.

Sex differences of resource utilisation and outcomes in patients with atrial arrhythmias and heart failure.

Objective: Atrial fibrillation or atrial flutter (AF) and heart failure (HF) often go hand in hand and, in combination, lead to an increased risk of death compared with patients with just one of both entities. Sex-specific differences in patients with AF and HF are under-reported. Therefore, the aim of this study was to investigate sex-specific catheter ablation (CA) use and acute in-hospital outcomes in patients with AF and concomitant HF in a retrospective cohort study.

In-hospital mortality of patients with atrial arrhythmias: insights from the German-wide Helios hospital network of 161 502 patients and 34 025 arrhythmia-related procedures.

Aims: Atrial fibrillation (AFib) and atrial flutter (AFlut) are common arrhythmias with increased use of invasive procedures. A steady re-evaluation of relevant safety endpoints is recommended and both quality management and pay-for-performance programs are evolving. Therefore, the aims of this study were (i) to investigate and report overall in-hospital mortality and mortality of invasive arrhythmia-related procedures and (ii) to identify mortality predictors in a German-wide hospital network.

Cardiac tamponade in catheter ablation of atrial fibrillation: German-wide analysis of 21 141 procedures in the Helios atrial fibrillation ablation registry (SAFER).

Aims: Catheter ablation is an established therapy in patients with symptomatic atrial fibrillation (AF) with increasing popularity. Pericardial effusion requiring intervention (PE) is one of the most threatening adverse outcomes. The aim of this study was to examine rates of PE after catheter ablation in a large 'real-world' data set in a German-wide hospital network.

Intraprocedural reduction of the veno-arterial norepinephrine gradient correlates with blood pressure response after renal denervation.

Aims: No intraprocedural assessment is currently available to evaluate the extent of nerve ablation by renal denervation (RDN). We prospectively evaluated the association of intraprocedural reduction of renal veno-arterial norepinephrine gradient with blood pressure (BP) response after RDN.

Methods And Results: In 46 consecutive RDN patients, the periprocedural norepinephrine veno-arterial difference was defined as veno-arterial norepinephrine gradient.

Metabolic syndrome with or without diabetes contributes to left ventricular diastolic dysfunction.

Objective: Left ventricular diastolic dysfunction (LVDD) is considered a precursor of diabetic cardiomyopathy, while the metabolic syndrome (MetS) is associated with an increased risk of cardiovascular morbidity and mortality. This study aimed to evaluate the association between LVDD, MetS and glucose metabolism disturbances classified by oral glucose tolerance testing (oGTT).

Methods And Results: The presence of LVDD was evaluated in 166 subjects with normal ejection fraction, 43 (26%) of whom had type 2 diabetes at inclusion.

Limiting esophageal temperature in radiofrequency ablation of left atrial tachyarrhythmias results in low incidence of thermal esophageal lesions.

Background: Atrio-esophageal fistula formation following radiofrequency ablation of left atrial tachyarrhythmias is a rare but devastating complication. Esophageal injuries are believed to be precursors of fistula formation and reported to occur in up to 47% of patients. This study investigates the incidence of esophageal lesions when real time esophageal temperature monitoring and temperature limitation is used.

Soluble P-selectin and matrix metalloproteinase 2 levels are elevated in patients with diastolic dysfunction independent of glucose metabolism disorder or coronary artery disease.

Objective: The development of diastolic dysfunction (DDF) is multifactorial. Possible mechanisms include metabolic disturbances, myocardial fibrosis, chronic inflammation and endothelial dysfunction. Recognizing early stages of DDF may help to identify patients at risk of developing symptomatic DDF.

[Catheter ablation of ventricular outflow tract arrhythmias using an electroanatomic mapping system].

Background: In some patients with arrhythmias originating from the ventricular outflow tract, catheter ablation may be considered for curative treatment. The conventional ablation procedure may be limited particularly in cases with nonsustained arrhythmias. Only little information is available about three-dimensional electroanatomic mapping combined with the cooled radiofrequency (RF) catheter ablation technique in the treatment of such arrhythmias.

Circumferential pulmonary vein ablation for treatment of atrial fibrillation using an irrigated-tip catheter.

In this study, a series of 52 consecutive patients with atrial fibrillation from 1 institution underwent circumferential pulmonary vein ablation using an irrigated-tip catheter. The technique was safe, and 81% of the patients maintained sinus rhythm at 6 months. However, 1/3 of them required additional antiarrhythmic drug therapy.