Spanish catheter ablation registry. 23rd official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2023).

Introduction And Objectives: We report the results of the 2023 Spanish catheter ablation registry.

Methods: Procedural data were collected and incorporated into the REDCap platform by all participating centers through a specific form.

Results: There were 104 participating centers in 2023 compared with 103 in 2022.

Prognostic value of liver fibrosis assessed by the FIB-4 index in patients with acute coronary syndrome.

Introduction And Objectives: Liver fibrosis is present in nonalcoholic liver disease (NAFLD) and both precede liver failure. Subclinical forms of liver fibrosis might increase the risk of cardiovascular events. The objective of this study was to describe the prognostic value of the FIB-4 index on in-hospital mortality and postdischarge outcomes in patients with acute coronary syndrome (ACS).

Increased Risk of Heart Failure in Elderly Patients Treated with Beta-Blockers After AV Node Ablation.

Introduction: Controversy exists regarding the indication of beta-blockers (BB) in different scenarios in patients with cardiovascular disease. We sought to evaluate the effect of BB on survival and heart failure (HF) hospitalizations in a sample of pacemaker-dependent patients after AV node ablation to control ventricular rate for atrial tachyarrhythmias.

Methods: A retrospective study including consecutive patients that underwent AV node ablation was conducted in a single center between 2011 and 2019.

Comparative Study of Methods for Cycle Length Estimation in Fractionated Electrograms of Atrial Fibrillation.

Atrial cycle length (CL) is an important feature for the analysis of electrogram (EGM) characteristics acquired during catheter ablation (CA) of atrial fibrillation (AF), the commonest cardiac arrhythmia. Nevertheless, a robust ACL estimator requires the precise detection of local activation waves (LAWs), which still remains a challenge. This work aims to compare the performance in (CL) estimation, especially under fractionated EGMs, of three different LAW detection methods relying on different operation strategies.

The Relevance of Heart Rate Fluctuation When Evaluating Atrial Substrate Electrical Features in Catheter Ablation of Paroxysmal Atrial Fibrillation.

Coronary sinus (CS) catheterization is critical during catheter ablation (CA) of atrial fibrillation (AF). However, the association of CS electrical activity with atrial substrate modification has been barely investigated and mostly limited to analyses during AF. In sinus rhythm (SR), atrial substrate modification is principally assessed at a global level through P-wave analysis.

The Dissimilar Impact in Atrial Substrate Modificationof Left and Right Pulmonary Veins Isolation after Catheter Ablation of Paroxysmal Atrial Fibrillation.

Since the discovery of pulmonary veins (PVs) as foci of atrial fibrillation (AF), the commonest cardiac arrhythmia, investigation revolves around PVs catheter ablation (CA) results. Notwithstanding, CA process itself is rather neglected. We aim to decompose crucial CA steps: coronary sinus (CS) catheterization and the impact of left and right PVs isolation (LPVI, RPVI), separately.

Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome.

Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed a prospective, single-center study in all patients discharged after an ACS.

Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A report from the FANTASIIA registry.

Background: Atrial fibrillation (AF) and peripheral artery disease (PAD) are common conditions that increase cardiovascular risk. We determined the association between PAD and prognosis in a cohort of real-world patients receiving oral anticoagulant therapy for nonvalvular AF.

Methods: We prospectively included 1956 patients (mean age 73.

Association of Body Mass Index With Clinical Outcomes in Patients With Atrial Fibrillation: A Report From the FANTASIIA Registry.

Background Obesity and atrial fibrillation (AF) frequently coexist and independently increase mortality. We sought to assess the association between obesity and adverse events in patients receiving oral anticoagulants for AF. Methods and Results Consecutive AF outpatients receiving anticoagulant agents (both vitamin K antagonists and direct oral anticoagulants) were recruited into the FANTASIIA (Atrial fibrillation: influence of the level and type of anticoagulation on the incidence of ischemic and hemorrhagic stroke) registry.

Prognosis and lipid profile improvement by a specialized outpatient clinic for acute coronary syndrome patients.

Background And Aims: Prognosis variations in patients discharged after an acute coronary syndrome (ACS) according to the professionals involved has not been clearly outlined. The aim of our study was to assess the impact on a specific outpatient clinic (SOC).

Methods: We included all consecutive patients admitted for an ACS in a single center.

Time-to-Effect-Based Dosing Strategy for Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation: Results of the plusONE Multicenter Randomized Controlled Noninferiority Trial.

Background: The optimal dosage of cryotherapy during cryoballoon ablation of pulmonary veins is still unclear. This trial tested the noninferiority of a novel, individualized, cryotherapy-dosing strategy for each vein.

Methods And Results: This prospective, randomized, multicenter, noninferiority study included 140 patients with paroxysmal atrial fibrillation, which was refractory to antiarrhythmic drugs.

Comparison of Long-Term Mortality for Cardiac Diseases in Patients With Versus Without Diabetes Mellitus.

Diabetes mellitus confers the highest mortality risk in primary and secondary cardiovascular prevention, but long-term prognosis differences between different forms of cardiovascular disease have not been assessed. We hypothesized that acute heart failure (HF) could have poorer outcomes than acute coronary heart disease (CHD) in patients with diabetes. We performed a prospective study of all consecutive patients admitted in a single year.

Etiology and Programming Effects on Shock Efficacy in ICD Recipients.

Background: We sought to assess the efficacy of high-energy shocks to restore rhythm and predictors of success in patients with sustained ventricular arrhythmias and implantable cardioverter defibrillator (ICD).

Methods And Results: Data from 162 patients included in the UMBRELLA study that experienced one or more episodes of ventricular tachycardia (VT) for which ICD shocks of at least 30 Joules were delivered (appropriate high-energy shocks) were analyzed. In total, 456 ventricular arrhythmia episodes were registered.

Choice of New Oral Anticoagulant Agents Versus Vitamin K Antagonists in Atrial Fibrillation: FANTASIIA Study.

Introduction: Atrial fibrillation (AF) is associated with an increased risk of thromboembolic events. Many patients with AF receive chronic anticoagulation, either with vitamin K antagonists (VKAs) or with non-VKA oral anticoagulants (NOACs). We sought to analyze variables associated with prescription of NOAC.

[Electrical storm in patients with prophylactic defibrillator implantation].

Introduction: Little is known about the prevalence of electrical storm, baseline characteristics and mortality implications of patients with implantable cardioverter defibrillator in primary prevention versus those patients without electrical storm. We sought to assess the prevalence, baseline risk profile and survival significance of electrical storm in patients with implantable defibrillator for primary prevention.

Methods: Retrospective multicenter study performed in 15 Spanish hospitals.

Analyses of inappropriate shocks in a Spanish ICD primary prevention population: Predictors and prognoses.

Background: ICDs have been demonstrated to be highly effective in the primary prevention of sudden death, but inappropriate shocks (IS) occur frequently and represent one of the most important adverse effects of ICDs. The aim of this study was to analyze IS and identify the clinical predictors and prognostic implications of ISs in a real-world primary prevention ICD population.

Methods: This multicenter retrospective study was performed in 13 centers with experience in the field of ICD implantation (at least 30 per year) and ICD follow-up in Spain.

Quality of Anticoagulation With Vitamin K Antagonists.

Background: Vitamin K antagonists (VKA) have a narrow therapeutic range, and literature analysis reveals poor quality of anticoagulation control. We sought to assess the prevalence of poor anticoagulant control in patients under VKA treatment in the prevention of stroke for atrial fibrillation (AF).

Hypothesis: Control of anticoagulation with VKA is inadequate in a high percentage of patients with AF.

Trends in clinical profile and medical treatments of atrial fibrillation patients over the last 10 years.

Aim: We sought to define trends in AF prevalence and its medical management using recent data based on data from two cross-sectional studies performed in a European country in 1999 and 2009.

Methods: CARDIOTENS 1999 and CARDIOTENS 2009 were two observational, cross-sectional, multicenter studies. Patients were recruited in from primary care and cardiology outpatient clinics.

Low levels of high-density lipoproteins cholesterol are independently associated with acute coronary heart disease in patients hospitalized for chest pain.

Introduction And Objectives: The role of high-density lipoproteins in the context of acute chest pain has not been well characterized. The objective of this study was to determine the relative contribution of lipid profile to the risk of acute coronary syndrome in patients admitted to a cardiology ward for chest pain.

Methods: We included all consecutive admissions in a single cardiology department over a period of 10 months and 1-year follow-up was performed.

Differential effect of β-blockers for heart rate control in coronary artery disease.

Background: Resting heart rate is an independent risk factor for cardiovascular disease and is mainly controlled by β-blockers (BBs). BBs are part of the optimal medical treatment for coronary artery disease (CAD), and their benefit correlates with resting heart rate (RHR) reduction.

Hypothesis: RHR is poorly controlled in daily practice among patients with stable cardiovascular disease, and control is only achieved by some BBs.

Burden of systemic hypertension in patients admitted to cardiology hospitalization units.

Hypertension is 1 of the most prevalent cardiovascular risk factors; nevertheless, some studies have reported that the antecedent of hypertension does not impair prognosis in patients with established cardiovascular disease. The objective of this study was to describe the impact of hypertension on readmission and 1-year mortality in patients admitted to a single cardiology hospitalization unit. All consecutive hospitalizations in a single cardiology department through 10 months were included, and 1-year follow-up was performed.