Publications by authors named "Avi Sabbag"

Aims: Atrial fibrillation (AF), the most common sustained arrhythmia in adults, is increasing in prevalence globally. Catheter ablation (CA), particularly pulmonary vein isolation (PVI), is a key treatment option. Pulmonary vein isolation can be performed using different energy sources, including cryoballoon ablation (CBA), radiofrequency ablation (RFA), or pulse field ablation.

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  • Ventricular arrhythmias (VAs) are uncommon but can occur after electrical cardioversion (ECV) for atrial fibrillation (AF), with an incidence of about 0.2% based on a study of nearly 12,000 ECV procedures.
  • The study involved 23 patients who experienced VAs within 10 days of ECV, with most cases developing 28.5 hours after the procedure, and a significant number had underlying health issues like congestive heart failure.
  • The findings suggest that while VAs post-ECV are rare, they can be life-threatening, especially in patients with certain risk factors, indicating that careful monitoring is essential for these individuals.
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Aim: A recent European Heart Rhythm Association (EHRA) practical guide provides guidance on the use of novel digital devices for heart rhythm analysis using either electrocardiogram (ECG) or photoplethysmography (PPG) technology for the diagnosis of atrial fibrillation (AF). This survey assesses physicians' preferences to use digital devices in patients with possible AF and their impact on clinical decision-making.

Methods And Results: Participants of the DAS-CAM III initiated and distributed an online survey assessing physician preferences in using digital devices for the management of AF in different clinical scenarios.

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Background And Aims: Long-term data on atrial fibrillation (AF) impact on tricuspid regurgitation (TR) progression and its relation to pulmonary pressure are scant. We investigated this association in a study spanning over a decade.

Methods: Adults with echocardiographic evaluation before 2014, free of significant TR, were included.

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  • The study focuses on the diagnostic process of Brugada syndrome (BrS) using ajmaline to expose the Type 1 Brugada pattern in patients, highlighting limited data on different populations.
  • It analyzed 260 patients (average age 43.4, mostly males) who underwent ajmaline tests, revealing a significant number with syncope history and family backgrounds of BrS or sudden cardiac death.
  • Results showed that less than half of the subjects met the current diagnostic criteria for BrS, but the overall rate of serious arrhythmia events was low over a median follow-up period of three years.
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  • Atrial fibrillation (AF) is a common heart rhythm disorder, and this study explores the effectiveness of surgical ablation as a treatment option, especially for patients also undergoing other cardiac surgeries.
  • The research involved 668 patients who underwent this procedure between 2006 and 2022, assessing their outcomes over multiple years, including recurrence of AF and mortality rates.
  • Results showed high success rates for maintaining freedom from AF, with success decreasing slightly over 7 years, while factors like age, female sex, and diabetes were linked to higher risks of recurrence and mortality.
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  • Arrhythmic mitral valve prolapse (AMVP) is a serious heart condition that can cause dangerous heart rhythms, especially in young women.
  • Researchers looked at women with AMVP who had troubling heart rhythms during and after pregnancy to see if being pregnant raised their risk.
  • They found that these women had more dangerous heart rhythms during pregnancy and up to 6 months after giving birth compared to when they weren't pregnant.
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  • Electrical storm (ES) is a serious condition characterized by repeated episodes of dangerous heart rhythms (ventricular arrhythmias) occurring within 24 hours, requiring medical intervention.
  • It mainly affects patients with existing heart issues or those with implantable cardioverter-defibrillators (ICDs), and it poses significant health risks despite advanced treatments.
  • The increasing number of older patients with heart conditions and ICDs suggests that the incidence of ES is likely to rise, prompting the need for comprehensive management strategies and a multi-disciplinary approach.
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  • Permanent pacing is often necessary after tricuspid valve interventions, and leadless pacemakers (LPs) are emerging as a preferred solution due to specific challenges these procedures pose.
  • A study involving 40 patients showed successful LP implantation, with the procedure taking an average of about 58 minutes and no acute complications.
  • Long-term follow-up indicated stable electrical parameters after the procedure, with four deaths occurring during the mean follow-up period of 10 months, unrelated to the LP implantation.
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  • Left atrial appendage (LAA) occluder embolization is a rare but critical complication occurring mostly within the first 24 hours after the procedure, with data collected from 67 centers on 108 patients.
  • The management strategies included attempting percutaneous retrieval in 75% of cases, while 21.3% of patients underwent surgery without prior attempts, highlighting significant mortality rates associated with multiple retrieval attempts.
  • Overall, a major adverse event rate of 43.5% was observed, underscoring the serious risks, including death, particularly following unsuccessful retrievals.
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Background: Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. New-onset post-operative AF may signal an elevated risk of AF and associated outcomes in long-term follow-up. We aimed to estimate the rate of AF recurrence as detected by an implantable loop recorder (ILR) in patients experiencing post-operative AF within 30 days after cardiac surgery.

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Background And Aims: Available data on continuous rhythm monitoring by implantable loop recorders (ILRs) in patients with Brugada syndrome (BrS) are scarce. The aim of this multi-centre study was to evaluate the diagnostic yield and clinical implication of a continuous rhythm monitoring strategy by ILRs in a large cohort of BrS patients and to assess the precise arrhythmic cause of syncopal episodes.

Methods: A total of 370 patients with BrS and ILRs (mean age 43.

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Introduction: Atrioventricular block may be idiopathic or a secondary manifestation of an underlying systemic disease. Cardiac sarcoidosis is a significant underlying cause of high-grade atrioventricular block, posing diagnostic challenges and significant clinical implications. This study aimed to assess the prevalence and clinical characteristics of cardiac sarcoidosis among younger patients presenting with unexplained high-grade atrioventricular block.

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Background: Levetiracetam is widely used in post-stroke epilepsy. However, it is suspected to possess P-glycoprotein (P-gp) induction properties, and therefore, a potentially significant interaction with direct oral anticoagulants (DOACs). We aimed to search for ischemic stroke signals with levetiracetam and the DOACs.

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This article will discuss the past, present, and future of ventricular tachycardia ablation and the continuing contribution of the Europace journal as the platform for publication of milestone research papers in this field of ventricular tachycardia ablation.

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Article Synopsis
  • Mitral valve prolapse (MVP) is the most common valve disorder but is complex, especially concerning its association with arrhythmias (AMVP) and risks of sudden cardiac death.
  • Recent studies reveal that MVP isn't always benign and can be linked to serious ventricular arrhythmias, necessitating a deeper understanding of AMVP and its characteristics.
  • The review suggests a risk assessment strategy for managing patients with MVP by exploring mitral annular disjunction (MAD) and its implications, advocating for updated research and clinical guidelines.
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Background: Hypertrophic cardiomyopathy (HCM) carries an increased risk of sudden cardiac death. Ventricular fibrillation (VF) is thought to be the common culprit arrhythmia.

Objective: The purpose of this study was to describe the incidence and predictors of sustained ventricular arrhythmias (VTAs) in HCM patients.

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  • Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, linked to higher mortality and complications, but the long-term recurrence rate is not well-understood.
  • The study followed 22 patients with POAF, using either an implanted loop recorder or ECG monitoring to track AF recurrence over two years, finding about 35.7% experienced recurrence.
  • Results showed no significant difference between monitoring methods, with patients receiving anticoagulation treatment, and no major adverse events like mortality or strokes reported, indicating a need for further research on monitoring methods in this patient group.*
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Even after a successful ventricular tachycardia ablation (VTA), some patients have recurrent ventricular tachycardia (VT) during their follow-up. We assessed the long-term predictors of recurrent VT after having a successful VTA. The patients who underwent a successful VTA (defined as the non-inducibility of any VT at the procedure's end) in 2014-2021 at our center in Israel were retrospectively analyzed.

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Brugada syndrome (BrS) is a primary electrical disease predisposing to ventricular tachyarrhythmias and sudden cardiac death [...

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  • * Patients with baseline AF (2% of the total) tended to be older, predominantly male, and had more comorbidities, while male sex, age, obesity, and heart-related issues were identified as strong predictors of AF.
  • * Among those without baseline AF, 85 new cases were identified during follow-up, with age, heart failure, and congenital heart disease being significant risk factors; the CHARGE-AF risk score proved to be a better predictor of AF than the CHADS-VAS
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