Predictors of early and late left atrial tachycardia and left atrial flutter after catheter ablation of atrial fibrillation: long-term follow-up.

Background: The aim of the study was identification of the predictors of left atrial tachycardia and left atrial flutter (LATAFL) after radiofrequency catheter ablation of atrial fibrillation (CAAF).

Methods: We followed 598 patients (71% male, 41% paroxysmal AF; median follow-up: 36 months) after a single step-wise CAAF procedure. The time to first documented LATAFL lasting longer than 30 s, documented in any kind of electrocardiography (ECG), was defined as an end-point.

Cryoballoon ablation of atrial fibrillation: How important is the proper selection of patients?

Background: Relation between pre-procedural selection of patients and the success rate after a single cryoballoon ablation (CAB) procedure is unknown.

Methods: CAB was performed in 378 (65% male, median age 58 years, 85% paroxysmal atrial fibrillation [AF]) consecutive patients with symptomatic and drug refractory AF. The combined ALARMEc (Atrial fibrillation type, Left Atrium size, Renal insufficiency, Metabolic syndrome, cardiomyopathy) risk score was calculated for each individual patient.

Cryoballoon ablation in young patients with lone paroxysmal atrial fibrillation.

Introduction And Objectives: Long-term efficacy following cryoballoon ablation of lone paroxysmal atrial fibrillation remains unknown. We describe long-term follow-up results of the single cryoballoon ablation procedure.

Methods: Pulmonary vein isolation was performed in 103 patients (72 male; median age 52 years) with symptomatic lone paroxysmal atrial fibrillation.

Learning curve in cryoballoon ablation of atrial fibrillation: eight-year experience.

Background: We analyzed the procedural experience cryoballoon ablation (CBA) of atrial fibrillation (AF) gained over 8 years in a high-volume centre to understand the influence of the learning curve on feasibility, safety and clinical outcome.

Methods And Results: In 424 patients (62% male) with drug-refractory AF, CBA was performed between 2005 and 2012. The analyzed period was divided into 8 calendar years.

Score associated with the outcome after multiple ablation procedures in patients with atrial fibrillation.

Background: Catheter ablation (CA) of atrial fibrillation (AF) is now established therapeutic option. Multiple procedures (MPs) are often needed to achieve the satisfactory outcome. The aim of the study was to assess the outcome after MPs in AF patients categorized to risk-score groups.

Ipsilateral circumferential radiofrequency ablation of atrial fibrillation with irrigated tip catheter: long-term outcome and pre-procedural predictors.

Background: Predictors of long-term outcome of atrial fibrillation (AF) ablation are unknown. The predictors of 5-year follow-up (FU) after single ipsilateral circumferential antrum pulmonary vein isolation (PVI) with irrigated tip catheter were investigated.

Methods And Results: In 356 patients (74% male) with AF (44% paroxysmal AF [PAF]) PVI was performed.

Repeated catheter ablation of atrial fibrillation: how to predict outcome?

Background: Pre-procedural predictors (PP) of atrial fibrillation (AF) recurrence (AFR) after repeated catheter ablation of AF (RCAF) are unknown. The aim of this study was identification of PP of outcome after RCAF.

Methods And Results: In 213 patients (73% male) with drug-refractory AF (47% paroxysmal AF; PAF) RCAF was performed.

Cryoballoon ablation of paroxysmal atrial fibrillation: 5-year outcome after single procedure and predictors of success.

Aims: Long-term efficacy following cryoballoon (CB) ablation of atrial fibrillation (AF) remains unknown. This study describes 5 years follow-up results and predictors of success of CB ablation in patients with paroxysmal atrial fibrillation (PAF).

Methods And Results: In total, 163 patients were enrolled with symptomatic, drug refractory PAF.

Differences in clinical and echocardiographic parameters between paroxysmal and persistent atrial flutter in the AURUM 8 study: targets for prevention of persistent arrhythmia?

Purpose: Cavotricuspid isthmus-dependent atrial flutter (AFL) can occur in a paroxysmal or persistent pattern. The aim of this study was to identify clinical, echocardiographic, and electrophysiological risk factors independently associated with persistence of AFL.

Methods: Patients of the recently published AURUM 8 study with paroxysmal versus persistent AFL were compared with respect to clinical and echocardiographic baseline characteristics as well as procedural parameters.

Major determinants of myocardial injury after pulmonary vein isolation with radiofrequency ablation.

Background: Radiofrequency (RF) current is used as a common energy source to perform pulmonary vein isolation (PVI) in patients with atrial fibrillation. We applied measurements of the blood concentration of cTnI as a surrogate parameter for the injured cell mass.

Aim: To clarify which parameters are major determinants of myocardial injury, estimated by cTnI, after PVI with RF ablation.

Which standard biomarkers are useful for the evaluation of myocardial injury after pulmonary vein isolation with cryoballoon?

Background: Many studies have used creatinine kinase (CK), myocardial bound for CK (CK-MB), and cardiac troponin I (cTnI) and T (cTnT) to evaluate myocardial cells injury after ablation. We applied measurements of the blood concentration of cardio-specific biomarkers as surrogates for the injured cell mass.

Aim: To clarify which of the standard biomarkers are useful in the evaluation and quantification of lesions produced by cryoballoon ablation (CBA) during pulmonary vein isolation.

Gold vs. platinum-iridium tip catheter for cavotricuspid isthmus ablation: the AURUM 8 study.

Aims: Gold electrodes have the theoretical advantage of creating bigger lesions than platinum-iridium (Pt-Ir) electrodes. We performed a prospective randomized study to compare the clinical efficacy of standard 8 mm Pt-Ir tip catheter (control) and 8 mm gold-tip catheters in the ablation of the cavotricuspid isthmus (CTI)-dependent atrial flutter.

Methods And Results: A total of 463 patients undergoing CTI ablation in 19 clinical centres were randomized to receive the treatment by gold-tip or control catheter.

Therapy with renin-angiotensin system blockers after pulmonary vein isolation in patients with atrial fibrillation: who is a responder?

Aims: The data on anti-arrhythmic effect of renin-angiotensin-aldesteron system blockers (RASB) in patients with atrial fibrillation (AF) are controversially discussed. The goal of this analysis was to identify cohort of patients with AF and hypertension, who may have benefit from RASB therapy after pulmonary vein isolation (PVI).

Methods: A total of 284 patients with AF and hypertension (paroxysmal AF [PAF]= 218, male = 185, age = 61 years, left ventricular ejection fraction = 60%, coronary artery disease = 42) considered for PVI were included.

Pulmonary vein antrum isolation and terminal part of the P wave.

Background: Delayed interatrial conduction, manifested on the electrocardiogram as a P wave >or=110 ms (interatrial block, IAB), is highly prevalent and associated with atrial fibrillation (AF). It is correlated with P-terminal force (Ptf; product of the duration and amplitude of the negative terminal phase of the P wave in lead V1). Our purpose was to describe the modifications of the P-wave duration and Ptf after pulmonary vein antrum isolation (PVAI) in patients with paroxysmal AF.

Electrocardiographic and further predictors for permanent pacemaker requirement after transcatheter aortic valve implantation.

The objective of this study was to identify electrocardiographic (ECG) and further predictors for atrioventricular (AV) block with a need for pacemaker (PM) implantation after transcatheter aortic valve implantation (TAVI). Pre- and post-procedural ECGs of patients with severe aortic stenosis and ongoing TAVI were investigated in a prospective study. From 50 consecutive patients enrolled in the study (mean age 80 +/- 6 years, 46% men), 17 (34%) experienced an AV block with subsequent requirement of a permanent PM [16 of 36 (44.

Acute and long-term results of PVI at antrum using a novel high-density mapping catheter without help of 3D electro-anatomic mapping in patients with paroxysmal and chronic atrial fibrillation.

Purpose: Multi-electrode circumferential mapping catheters have been developed by several manufacturers to facilitate catheter ablation procedures for atrial fibrillation (AF). We tested the effectiveness and safety of a conventional, fully endocardial electrogram-guided circumferential antrum isolation (PVI) with a novel mapping device.

Methods: The study enrolled 250 consecutive patients with paroxysmal or chronic AF.

Evaluation of atrial fibrillation burden before catheter ablation predicts outcome after pulmonary vein isolation.

Background: Paroxysmal atrial fibrillation (PAF) is defined as recurrent AF terminating spontaneously within 7 days. This definition allows the consideration of any AF occurrence lasting < 7 days as paroxysmal, irrespective of the frequency and duration of episodes. The aim of this study was to investigate symptomatic AF burden (AFB) defined as total duration of symptomatic AF episodes within 3 months prior to abalation, for prediction of outcome after pulmonary vein isolation (PVI).

Pulmonary vein stenting for the treatment of acquired severe pulmonary vein stenosis after pulmonary vein isolation: clinical implications after long-term follow-up of 4 years.

Introduction: Severe pulmonary vein stenosis (PVS) after catheter ablation of atrial fibrillation (AF) is a well-recognized complication with a further reported incidence of 1.3%. The preferred therapy for symptomatic PVS is pulmonary vein (PV) angioplasty, but this treatment modality is followed by restenosis in 44-70%.

Acute success and persistence of bidirectional conduction block in the cavotricuspid isthmus one month post cryocatheter ablation of common atrial flutter.

Introduction: Cryoablation is successful in the treatment of common atrial flutter. Long-term clinical success is mainly dependent on persistence of bidirectional conduction block (BCB) in the inferior cavotricuspid isthmus (CTI). Only few data on persistence of BCB post cryoablation with the reported technique are available.

Effects of atropine and pirenzepine on heart rate turbulence.

Background: It has been shown that mortality risk in patients after myocardial infarction could be estimated by heart rate turbulence (HRT), a short-term change in heart rate after ventricular premature beat (VPB), presumably caused by baroreceptor mechanism. We sought to determine whether pharmacological blockade with atropine, or augmentation of vagal tone with pirenzepine given in small doses would influence HRT.

Methods: In 30 patients with normal echocardiogram, and without signs or symptoms of coronary artery disease, after electrophysiologic examination or radiofrequency ablation for supraventricular arrhythmias was completed, turbulence onset (TO) and turbulence slope (TS) in basal state, after 1.

Usefulness of atrial fibrillation burden as a predictor for success of pulmonary vein isolation.

Background: The definition of symptomatic improvement after pulmonary vein isolation (PVI) is controversial. We assessed primarily the usefulness and predictive accuracy (PA) of AF (atrial fibrillation) burden (AFB) within the first 3 months after the procedure as an early predictor for curative success as well as reduction of symptoms.

Methods: We studied 100 pts (62 men, mean age: 54 +/- 9 years, LVEF: 57 +/- 9%, paroxysmal AF, 85, persistent AF, 15) who underwent PVI.

Percutaneous pulmonary vein stenting for the treatment of severe stenosis after pulmonary vein isolation.

Introduction: Pulmonary vein stenosis (PVS) is a potential complication of pulmonary vein isolation (PVI) using radiofrequency energy. The aim of our study was the evaluation of the severity and long-term outcome of primary angioplasty and angioplasty with pulmonary vein stenting for PVS.

Methods And Results: Twelve patients with 15 PVS (greater than 70% stenosis) were prospectively evaluated.

The value of magnetic resonance imaging for the diagnosis of arrhythmogenic right ventricular cardiomyopathy.

This study evaluated the diagnostic significance of a magnetic resonance imaging (MRI) based scoring model for identification of arrhythmogenic right ventricular cardiomyopathy (ARVC) in patients with MRI evidence of RV abnormalities. Fifty-three patients with RV myocardial abnormalities on MRI were divided into a group with ARVC 1 (n=17) and a group with other RV arrhythmias (n=37). Decision tree learning (DTL) and linear classification (based on a modified ARVC scoring model of major and minor criteria) were used to identify and assess MRI criterion information value, and to induce ARVC diagnostic rules.