Publications by authors named "Jakub Sroubek"
Background: Catheter ablation is an effective therapy in the management of atrial fibrillation (AF). Left atrial appendage closure (LAAC) is an alternative to anticoagulation for stroke prevention in patients with bleeding risks.
Objectives: The purpose of this study was to assess the safety and efficacy of combining AF ablation and LAAC in a single procedure.
Article Synopsis
- Current epicardial ablation methods struggle to create deep lesions and can damage nearby structures, motivating the study of a new cryoablation catheter designed to address these issues.
- The study involved ten healthy pigs, where researchers used both surgical and percutaneous approaches to create epicardial lesions while measuring the effectiveness and safety of a low-temperature cryoablation system called HeartPad.
- Results showed that lesion depth increased significantly with longer exposure times, suggesting that the new catheter design may improve ablation outcomes while potentially protecting surrounding tissues.
Article Synopsis
- Vascular access complications are common in catheter ablation procedures for ventricular arrhythmias, and the impact of vascular closure devices (VCDs) on these complications is unclear.
- This study analyzed 1,016 catheter ablation procedures over four years, categorizing cases based on the use of VCDs: none (manual compression), partial use, or complete use.
- Results showed that the use of VCDs, especially complete VCDs, significantly reduced the rate of vascular complications compared to manual compression and partial use of VCDs.
Outcomes of Atrial Fibrillation Ablation in Heart Failure Subtypes.
Circ Arrhythm Electrophysiol
September 2024
Background: Catheter ablation (CA) improves clinical outcomes in patients with atrial fibrillation (AF) and heart failure (HF) with reduced ejection fraction (HFrEF). We aimed to evaluate the impact of CA on clinical and quality-of-life outcomes across HF subtypes.
Methods: All patients undergoing AF ablation at a tertiary center were enrolled in a prospective registry and included in this study (2013-2021).
Background: The risk of ventricular arrhythmias (VAs) after cardiac resynchronization therapy (CRT) has been associated with ischemic disease/scar, sex, and possibly left ventricular mass (LVM).
Objective: The purpose of this study was to evaluate sex differences and baseline/postimplant change in LVM on VA risk after CRT implantation in patients with nonischemic cardiomyopathy and left bundle branch block.
Methods: In patients meeting the criteria, baseline and follow-up echocardiographic images were obtained for LVM assessment.
Article Synopsis
- The study investigates the effectiveness of post-ablation ventricular tachycardia (VT) inducibility through programmed ventricular stimulation (PVS) as a predictor for recurrence and survival outcomes in high-risk patients undergoing VT ablation.
- A retrospective analysis was conducted on 123 high-risk patients who underwent VT ablation, revealing no significant differences in long-term outcomes between those with no VT inducibility and other response groups.
- The findings suggest that post-ablation PVS results do not reliably predict survival or recurrence in high-risk VT ablation patients, challenging its current use as a procedural endpoint.
Background: Comparative efficacy and safety data on radiofrequency ablation (RFA) versus pulsed field ablation (PFA) for common idiopathic left ventricular arrhythmia (LV-VAs) locations are lacking.
Objectives: This study sough to compare RFA with PFA of common idiopathic LV-VAs locations.
Methods: Ten swine were randomized to PFA or RFA of LV interventricular septum, papillary muscle, LV summit via distal coronary sinus, and LV epicardium via subxiphoid approach.
Impact of Contact Force on Pulsed Field Ablation Outcomes Using Focal Point Catheter.
Circ Arrhythm Electrophysiol
June 2024
Background: Conventional focal radiofrequency catheters may be modified to enable multiple energy modalities (radiofrequency or pulsed field [PF]) with the benefit of contact force (CF) feedback, providing greater flexibility in the treatment of arrhythmias. Information on the impact of CF on lesion formation in PF ablations remains limited.
Methods: An in vivo study was performed with 8 swine using an investigational dual-energy CF focal catheter with local impedance.
Background: Data are lacking on patient-reported outcomes (PRO) following cryoballoon ablation (CBA) versus radiofrequency ablation (RFA). We sought to evaluate QoL and clinical outcomes of cryoballoon pulmonary vein isolation only (CRYO-PVI-ONLY) versus RFA with PVI and posterior wall isolation (RF-PVI+PWI) in a large prospective PRO registry.
Methods: Patients who underwent AF ablation (2013-2016) at our institution were enrolled in an automated, prospectively maintained PRO registry.
Ventricular Tachycardia Ablation Endpoints: Moving Beyond Noninducibility.
JACC Clin Electrophysiol
May 2024
In patients with structural heart disease and ventricular tachycardia (VT) undergoing catheter ablation, the response to programmed electrical stimulation (PES) at the end of the procedure has been traditionally used to evaluate the acute success and predict long-term outcomes. Although noninducibility at PES has been extensively investigated and validated in clinical trials and large multicenter registries, its performance in predicting long-term freedom from VT is suboptimal. In addition, PES has inherent limitations related to the influence of background antiarrhythmic drug therapy, periprocedural use of anesthesia, and the heterogeneity in PES protocols.
View Article and Find Full Text PDFBackground: Atrial fibrillation (AF) catheter ablation has become an increasingly effective and safe strategy for the management of AF. With increased safety of catheter ablation, same-day discharge (SDD) is a potential way to minimize health care resource utilization and improve patient experience.
Objective: To evaluate the safety and patient satisfaction of SDD after contemporary AF ablation.
Background: The efficacy of pulsed field ablation (PFA) for redo procedures is unknown.
Objectives: In this study, the authors aimed to evaluate the effectiveness of PFA when performing PFA over chronic RFA (redo environment).
Methods: This was a 3-step in vivo study.
Background: Atrial fibrillation (AF) risk increases with age. We aim to assess the efficacy and safety of catheter ablation in the older population.
Methods: All patients undergoing AF ablation (2013-2021) at our institution were enrolled in a prospectively maintained registry.
Background: Monomorphic ventricular tachycardia (VT) electrical storm (ES) in patients with coronary artery disease is dependent on scarred myocardium. The role of routine ischemic or coronary evaluations before ablation in patients presenting with monomorphic VT storm, without acute coronary syndrome (ACS), remains unknown.
Objectives: This study sought to assess the impact of ischemic or coronary evaluations on procedural outcomes and post-ablation mortality in monomorphic VT storm patients.
Background: Patients with ventricular tachycardia (VT) who require VT ablation are at high risk for readmission. This study aimed to identify the causes and outcomes of 30-day readmission after VT ablation and to analyze the predictors of recurrent VT that required rehospitalization.
Methods: Using the Nationwide Readmission Database, our study included patients aged ≥ 18 years who underwent VT catheter ablation between 2017 and 2020.
Article Synopsis
- The study focuses on the use of Left Ventricular Assist Devices (LVAD) in advanced heart failure patients, particularly those with a history of ventricular tachyarrhythmia (VTA), and aims to improve outcomes through a new intra-operative ablation protocol.
- Researchers designed a randomized clinical trial involving 100 LVAD candidates, comparing those receiving intra-operative VTA ablation against those receiving standard medical management.
- The trial will track various outcomes for an average of 18 months post-surgery, assessing VTA recurrence, adverse events, right heart function, healthcare utilization, and quality of life.
Introduction: Obesity is a well-known risk factor for atrial fibrillation (AF). We aim to evaluate the effect of baseline obesity on procedural complications, AF recurrence, and symptoms following catheter ablation (CA).
Methods: All consecutive patients undergoing AF ablation (2013-2021) at our center were enrolled in a prospective registry.
Catheter-Based Electroporation: A Novel Technique for Catheter Ablation of Cardiac Arrhythmias.
JACC Clin Electrophysiol
September 2023
Catheter ablation of arrhythmias is now standard of care in invasive electrophysiology. Current ablation strategies are based on the use of thermal energy. With continuous efforts to optimize thermal energy delivery, effectiveness has greatly improved; however, safety concerns persist.
View Article and Find Full Text PDFBackground: Ablation is used for both rhythm control and improved quality of life (QoL) in atrial fibrillation (AF). It has been suggested that young adults may experience high recurrence rates after ablation and data remain lacking regarding QoL benefits. We aimed to investigate AF ablation outcomes and QoL benefits in young adults undergoing AF ablation using a large prospectively maintained registry and automated patient-reported outcomes (PRO).
View Article and Find Full Text PDFTrends and disparities in ventricular tachycardia mortality in the United States.
J Cardiovasc Electrophysiol
February 2023
We aimed to evaluate trends and disparities in mortality from ventricular tachycardia in patients with underlying cardiovascular disease. We performed cross-sectional analyses using publicly available data from the Center for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. We identified a total of 7025 deaths from ventricular tachycardia between the years 2007 and 2020.
View Article and Find Full Text PDFArticle Synopsis
- Catheter ablation for atrial fibrillation (AF) is effective for improving patients' quality of life (QoL), but many need repeat procedures, prompting a study on QoL outcomes from redo ablation.
- The study involved 848 patients, who showed significant improvements in QoL and reduction in AF symptoms after redo ablation, with 70% reporting substantial symptom improvement.
- Moreover, the frequency of AF episodes and healthcare usage decreased after 6 months, and fewer patients required ongoing anticoagulant or antiarrhythmic medications.
Background: Pulsed-field ablation (PFA) is a nonthermal energy with higher selectivity to myocardial tissue in comparison to radiofrequency ablation (RFA). We compared the effects of PFA and RFA on heterogeneous ventricular scar in a swine model of healed infarction.
Methods: In 9 swine, myocardial infarction was created by balloon occlusion of the left anterior descending artery.