Publications by authors named "Duytschaever M"
Introduction: Repetitive focal and rotational activation patterns are currently used as additional ablation targets for atrial fibrillation (AF). However, there is no evidence that all these detected targets are actual sources of AF. In this paper, we present an approach that detects and ranks AF activation patterns not only based on the degree of pattern repetitiveness but also on the extent to which they are able to entrain their vicinity.
View Article and Find Full Text PDFBackground: Sudden cardiac death (SCD) is generally associated with life-threatening ventricular arrhythmias. Supraventricular arrhythmias are an accepted cause of SCD in Wolff-Parkinson-White syndrome and complex congenital heart disease. However, the role of atrial tachyarrhythmias (ATAs) in SCD in patients with structurally normal hearts is unclear.
View Article and Find Full Text PDFIn the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017.
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- 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%.
Atrial Topology for a Unified Understanding of Typical and Atypical Flutter.
Circ Arrhythm Electrophysiol
November 2024
Article Synopsis
- Macroreentry is the main cause of typical and atypical flutter, but many questions about it remain unanswered, prompting a study that uses topology to investigate atrial tachycardia activation patterns.
- Researchers utilized a computational model resembling a closed sphere with holes to analyze cases of tachycardia, focusing on activation maps and ablation responses in 131 clinical cases.
- The study's findings suggest that reentrant activity on closed surfaces consistently shows paired rotation, and through mathematical principles, they established a framework to better understand flutter and its treatment outcomes.
Article Synopsis
- - Atrial fibrillation is the most common heart arrhythmia in adults, significantly contributing to heart-related health issues and deaths.
- - The EAST-AFNET 4 trial shows that early rhythm control, particularly through catheter ablation, improves cardiovascular outcomes more than standard care, especially in patients with multiple health issues.
- - Research from studies like STOP-AF First and Cryo-FIRST indicates that catheter ablation is more effective than drugs in maintaining normal heart rhythm, prompting a shift towards prioritizing this approach in treatment.
Radiofrequency ablation is a promising technique for arrhythmia treatment in horses. Due to the thicker myocardial wall and higher blood flow in horses, it is unknown if conventional radiofrequency settings used in human medicine can be extrapolated to horses. The study aim is to describe the effect of ablation settings on lesion dimensions in equine myocardium.
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- Achieving effective mitral isthmus (MI) block using only radiofrequency (RF) catheter ablation is often difficult, but using vein of Marshall (VoM) ethanolization creates more durable lesions that improve results.
- A study of 37 patients without VoM showed a 97% success rate for achieving MI block compared to only 65% in a control group with VoM assessed, indicating a significant effectiveness difference.
- The findings imply that the presence of VoM might play a critical role in the challenges faced when trying to achieve MI block through traditional methods.
Catheter Ablation of Persistent AF-Where are We Now?
Rev Cardiovasc Med
December 2023
Persistent atrial fibrillation (AF) is a diverse condition that includes various subtypes and underlying causes of arrhythmia. Progress made in catheter ablation technology in recent years has significantly enhanced the durability of ablation. Despite these advances however, the effectiveness of ablation in treating persistent AF is still relatively modest.
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- Pulsed field ablation (PFA) is a new method for treating atrial fibrillation (AF) that focuses on ablating heart tissue while minimizing harm to nearby structures.
- In the MANIFEST-17K study, data from 106 centers involved 17,642 patients and showed no serious complications like esophageal damage, with only a 1% major complication rate.
- The results suggest that PFA has a strong safety profile and may change how AF is treated, compared to traditional thermal ablation methods.
Background: Idiopathic ventricular fibrillation (IVF) can be associated with undetected distinct conditions such as microstructural cardiomyopathic alterations (MiCM) or Purkinje (Purk) activities with structurally normal hearts.
Objectives: This study sought to evaluate the characteristics of recurrent VF recorded on implantable defibrillator electrograms, associated with these substrates.
Methods: This was a multicenter collaboration study.
Introduction: Esophageal safety following radiofrequency (RF) left atrial (LA) linear ablation has not been established. To determine the esophageal safety profile of LA linear RF lesions, we performed systematic esophagogastroduodenoscopy in all patients with intraesophageal temperature rise (ITR) ≥ 38.5°C.
View Article and Find Full Text PDFBackground: Left ventricular (LV) summit arrhythmias account for up to 14% of LV arrhythmias. The ablation of LV summit arrhythmias is challenging, as testified by the fact that radiofrequency (RF) catheter ablation failure is frequent. Retrograde coronary venous ethanol infusion has been proposed as an alternative approach for the ablation of LV summit arrhythmias.
View Article and Find Full Text PDFAims: Contact force (CF)-sensing radiofrequency (RF) catheters with an ablation index have shown reproducible outcomes for the treatment of atrial fibrillation (AF) in large multicentre studies. A dual-energy (DE) focal CF catheter to deliver RF and unipolar/biphasic pulsed field ablation (PFA), integrated with a three-dimensional (3D) mapping system, can provide operators with additional flexibility. The SmartfIRE study assessed the safety and efficacy of this novel technology for the treatment of drug-refractory, symptomatic paroxysmal AF.
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- 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
- * The ligament of Marshall is identified as a source of AF triggers and has nerve fibers that maintain AF, suggesting it plays a critical role in the condition's persistence.
- * Ethanol infusion into the Vein of Marshall shows promise in reducing arrhythmia recurrence post-ablation, but further randomized trials are necessary to evaluate its long-term effectiveness.
Background: We previously presented the safety and early efficacy of the inspIRE study (Study for Treatment of Paroxysmal Atrial Fibrillation [PAF] by Pulsed-field Ablation [PFA] System With Irreversible Electroporation [IRE]). With the study's conclusion, we report the outcomes of the full pivotal study cohort, with an additional analysis of predictors of success.
Methods: InspIRE was a prospective, multicenter, single-arm clinical trial of drug-refractory paroxysmal atrial fibrillation.
Article Synopsis
- Ablation of atrial fibrillation (AF) has become a widely accepted and effective treatment for managing this common heart rhythm disorder over the last 30 years.
- Since the initial consensus document in 2007, new research and technologies have significantly changed AF ablation practices, necessitating updates in 2012 and 2017.
- A new consensus document was recently created by various cardiac societies to provide a current framework for selecting and managing patients for catheter or surgical AF ablation, reflecting the evolving nature of the field.
Article Synopsis
- * The first expert guidelines for AF ablation were published in 2007, and updates were necessary in 2012 and 2017 due to advancements in research and technology.
- * A new consensus document is now being released to provide updated guidelines for healthcare professionals on selecting and managing patients for AF ablation, created by various international cardiac societies.
Article Synopsis
- Atrial fibrillation (AF) ablation has become a well-established treatment method in the last 30 years, supported by evidence showing it is safe and effective.
- In response to advancements in research and technology, new guidelines have been released over the years, the latest being necessary to provide updated recommendations for patient care.
- This revised consensus involves collaboration among major cardiac electrophysiology societies from Europe, Asia-Pacific, and Latin America to ensure comprehensive guidelines for AF treatment.
Aims: Pulsed field ablation (PFA) is a promising ablation technique for pulmonary vein isolation (PVI) with appealing advantages over radiofrequency (RF) including speed, tissue selectivity, and the promise of enhanced durability. In this study, we determine the procedural performance, efficacy, safety, and durability of PFA and compare its performance with a dataset of optimized RF ablation.
Methods And Results: After propensity score matching, we compared 161 patients who received optimized RF-guided PVI in the PowerPlus study (CLOSE protocol) with 161 patients undergoing PFA-guided PVI for paroxysmal or persistent atrial fibrillation (AF; pentaspline basket catheter).
Article Synopsis
- * The introduction of high-power and very high-power short-duration procedures using the QDOT MICRO catheter marks a significant shift in ablation technology and methods.
- * Recommendations for three structured workflows using the QDOT MICRO catheter are presented, allowing for adaptable strategies based on individual patient needs and operator preferences.
Aims: Pulmonary vein isolation (PVI) is a well-established strategy for the treatment of paroxysmal atrial fibrillation (PAF). Despite randomized controlled trials and real-world data showing the promise of pulsed-field ablation (PFA) for this treatment, long-term efficacy and safety data demonstrating single-procedure outcomes off antiarrhythmic drugs remain limited. The aim of the FARA-Freedom Study was to evaluate the long-term efficacy and safety of PFA using the pentaspline catheter for PAF.
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