Publications by authors named "Dominique Pavin"

Background: Following implantation/replacement of an implantable cardioverter-defibrillator, patients are legally subjected to variable lengths of driving restrictions based on the indication (1 and 3 months after primary and secondary prevention, respectively; 1 week after device replacement).

Aim: To assess the incidence of ventricular arrhythmia during the theoretical driving restriction period in a large cohort of patients.

Methods: Patients who underwent implantable cardioverter-defibrillator implantation for primary or secondary prevention or device replacement between 2015 and 2021 were included retrospectively.

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Article Synopsis
  • The study introduces a new technique called multielectrode catheter-induced ectopy mapping (MECIE mapping) to help locate the origins of infrequent premature ventricular complexes (PVCs) for effective ablation treatment.
  • Researchers enrolled 29 patients with infrequent PVCs and used MECIE mapping to create a detailed local activation time map, achieving high concordance with the clinical PVCs.
  • After an average follow-up of about 13 months, 93.1% of the patients experienced an 80% or greater reduction in PVCs, indicating that MECIE mapping is a promising strategy for successful PVC ablation.
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Background: Electrical storm (ES) is a life-threatening condition, associated with substantial early and subacute mortality. Catheter ablation (CA) is a well-established therapy for ES. However, data regarding the impact of CA on the short-term and midterm survival of patients admitted for ES remain unclear.

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Quinidine, the first antiarrhythmic drug, was widely used during the 20th century. Multiple studies have been conducted to provide insights into the pharmacokinetics and pleiotropic effects of Class Ia antiarrhythmic drugs. However, safety concerns and the emergence of new drugs led to a decline in their use during the 1990s.

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Background: Recurrences of atrial fibrillation (AF) after pulmonary vein isolation (PVI) are mainly due to pulmonary vein reconnection. However, a growing number of patients have AF recurrences despite durable PVI. The optimal ablative strategy for these patients is unknown.

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Background: Catheter ablation is a first-line treatment for symptomatic right ventricular outflow tract (RVOT) premature ventricular complexes (PVCs). There is evidence of displacement of the ablation target site during PVCs relative to the location in sinus rhythm (SR).

Aim: To analyse the extent of displacement induced by RVOT PVCs and its effect on the ablation sites and the mid-term efficacy of ablation.

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Introduction And Objectives: Ablation of multifocal premature ventricular complexes (PVCs) is challenging. Activation mapping can be performed for the predominant morphology, but may be useless for other less prevalent ones. We aimed to describe the efficacy of an automated pace-mapping software-based ablation strategy for ablating the site of origin of multiple PVC locations.

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The clinical efficacy of the inhibitors of the renin-angiotensin-aldosterone system (RAAS) as an upstream therapy for atrial fibrillation (AF) prevention is controversial. No study has itemized so far the role of RAAS inhibitors in AF prevention after atrial flutter (AFL) ablation. This trial aims to investigate the effect of ramipril compared with placebo on AF occurrence in patients hospitalized for AFL ablation without structural heart disease.

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Background: Although less common, typical atrial flutter shares similar pathophysiological roots with atrial fibrillation. Following successful cavo-tricuspid isthmus ablation using radiofrequency, many patients, however, develop atrial fibrillation in the mid-to-long-term. This study sought to assess whether pulmonary vein isolation conducted at the same time as cavo-tricuspid isthmus ablation would significantly modify the atrial fibrillation burden upon follow-up in patients suffering from typical atrial flutter.

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Introduction: The distance from the descending aorta (DA) to the posterior wall of the left atrium (LA) is variable. We aimed to determine whether the proximity between the DA and the left inferior pulmonary vein (LIPV) ostium has an impact on biophysical parameters and cryoballoon (CB) ablation efficacy during LIPV freezing.

Methods: Patients referred for CB-ablation of atrial fibrillation (AF) in two high-volume centers were included.

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Conduction disturbances remain common following transcatheter aortic valve implantation (TAVI). Aside from high-degree atrioventricular block (HAVB), their optimal management remains elusive. Invasive electrophysiological studies (EPS) may help stratify patients at low or high risk of HAVB allowing for an early discharge or permanent pacemaker (PPM) implantation among patients with conduction disturbances.

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Background: Cryoballoon ablation is widely used for pulmonary vein isolation in patients with atrial fibrillation. There are no data regarding the clinical efficacy of cryoballoon ablation in patients with atypical right pulmonary vein anatomy.

Aim: We aimed to evaluate the impact of right pulmonary vein anatomy on the safety and efficacy of cryoballoon ablation.

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Aims: Although cryoballoon pulmonary vein isolation is a well-established treatment for paroxysmal atrial fibrillation (AF), it's role in persistent AF is unclear. We examined procedural success and long-term outcomes of cryoablation in persistent and longstanding persistent AF.

Methods And Results: International multicentre registry from three UK and eight European centres.

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Background: Pulmonary vein isolation (PVI) using cryoballoon ablation is widely used for rhythm control in patients with paroxysmal atrial fibrillation. This technique has a steep learning curve, and PVI can be achieved quickly in most patients. However, the right inferior pulmonary vein (RIPV) is often challenging to occlude and isolate.

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Ablation of atrial fibrillation (AF) is the cornerstone therapy for patients with symptomatic AF resistant to anti-arrhythmic drugs or as first-line therapy, and is based on permanent pulmonary vein (PV) isolation. The presence of a conduction gap in a wide antral circumferential ablation lesion around PVs is often sufficient to transform an initially successful ablation into a procedural failure, thus necessitating a redo intervention. The strategy during a redo procedure is based on the detection and ablation of the reconnection gap.

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Objectives: This study hypothesized that the association of D-dimer blood level and several clinical items in a new risk score could predict the absence of atrial thrombus.

Background: Symptomatic and drug resistant atrial fibrillation (AF) can be treated by catheter ablation. The procedure-related risk of thromboembolism is limited by the pre-operative use of transesophageal echocardiography (TEE) to detect atrial thrombi.

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Aims: Ventricular tachycardia (VT) ablation has been proven to be effective and safe to avoid arrhythmia recurrences in patients with repaired congenital heart disease (CHD). However, some of these patients may present right ventricular (RV) access issues [agenesia or thrombosis of inferior vena cava (IVC)], making impossible to access the right ventricle through an inferior approach. In such patients, only a superior approach would theoretically be feasible.

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Background: Atrial fibrillation ablation is often performed by achieving pulmonary vein isolation using the "wide antral circumferential ablation" (WACA) technique, but many pulmonary veins remain connected because of conduction gaps in the ablation line.

Aim: To analyse the efficacy of a novel technique based on pacing manoeuvres to detect gaps in an initial WACA lesion.

Methods: Patients referred for radiofrequency atrial fibrillation ablation were enrolled prospectively.

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Aims: Intensive endurance sport practice is associated with an increased risk of atrial fibrillation (AF) in male veteran athletes. Paroxysmal AF (PAF) is the very beginning step of this disease. The description of atrial remodelling occurring at this early stage might enable to depict predictive factors of AF in veteran athletes in order to give them personalized recommendation according to their sport practice.

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