Publications by authors named "Julian K R Chun"
Aims: Sodium-glucose co-transporter inhibitors (SGLTis) have cardiovascular protective effects. We aimed to assess the effects of SGLTis on individual hard clinical endpoints and quality of life (QoL) in patients with cardiovascular risk factors.
Methods And Results: Data was searched in PubMed, Embase, Cochrane Library and clinicaltrials.
Article Synopsis
- Advanced bipolar radiofrequency catheter ablation (Bi-RFA) is being studied as a new treatment for patients with ventricular tachycardia (VT) and premature ventricular contractions (PVC) that do not respond to standard unipolar radiofrequency ablation (Uni-RFA).
- A multicenter registry conducted in Europe showed that out of 91 patients treated with Bi-RFA, 74% achieved elimination of clinical VT/PVC, and 78% experienced a significant reduction in PVC burden during follow-up.
- The procedure was found to be generally safe and feasible, though there were some major complications reported, indicating that Bi-RFA could be a valid option for managing refractory VT/PVC
Article Synopsis
- Management of atrial fibrillation (AF) in severely obese patients is complex, but cryoballoon ablation (CBA) shows encouraging results despite certain risks.
- In a study involving 72 severely obese patients (BMI ≥ 40 kg/m) compared to 129 normal-weight patients (BMI < 25 kg/m), similar procedural times were observed, but severely obese patients had higher radiation exposure and more complications.
- Although outcomes for paroxysmal and persistent AF were slightly lower in severely obese patients, CBA is still a viable treatment option with relatively good success rates.
Article Synopsis
- Ventricular tachycardia (VT) is a major cause of sudden cardiac death, especially in patients with structural heart conditions, highlighting the need for effective management.
- Catheter ablation has emerged as a safe and effective treatment option for patients experiencing recurrent VT, with existing guidelines outlining when and how to perform the procedure.
- A recent survey by the European Heart Rhythm Association aims to provide insights into various practical aspects of VT management, including procedural techniques and technologies, to establish a clearer understanding of current practices in different medical centers.
Article Synopsis
- Limited data on venous thromboembolism (VTE) risk after right-sided electrophysiological (EP) studies and ablations exist, with no guidelines for managing DVT and PE, unlike left-sided procedures.
- An EHRA survey of 244 participants aimed to assess current anticoagulation practices and VTE prevention during right-sided EP procedures, highlighting that the right femoral vein is the most common access point.
- Findings revealed that most respondents do not routinely use intravenous heparin or prescribe VTE prophylaxis, with only a minority continuing preventive measures post-discharge, despite some operators reporting instances of DVT and PE in the past year.
Article Synopsis
- This study investigates device-related thrombus (DRT) occurrences after left atrial appendage closure (LAAC), focusing on how often it persists or recurs.
- It found that about 29% of DRT cases persist, with being female and having a larger initial thrombus size being significant predictors.
- Unfavorable DRT evolution is linked to a higher rate of thromboembolic events, emphasizing the importance of monitoring thrombus size post-LAAC.
Article Synopsis
- The study explores young electrophysiology (EP) professionals’ concerns about radiation exposure and its effects on reproduction and pregnancy, showing a significant level of apprehension among participants.
- A survey conducted with 252 EP personnel revealed that a large percentage were worried about radiation's impact on reproductive health and were mostly unaware of existing safety guidelines.
- The findings indicate a need for better communication and adherence to safety measures, as many women in EP labs face restrictions during pregnancy, with zero-fluoroscopy being favored for safety.
Article Synopsis
- The study aimed to uncover regional differences in characteristics and satisfaction levels among patients with implantable cardioverter-defibrillators (ICDs) across Europe.
- Data was collected from 1,809 ICD patients through an online questionnaire in 10 European countries, revealing that Central/Eastern European patients reported higher satisfaction and feelings of being well-informed compared to their Western and Southern European counterparts.
- The findings suggest that Southern European physicians need to address quality of life concerns, while Western European physicians should work on enhancing the information they provide to patients, highlighting the need for targeted strategies to address these regional disparities.
Article Synopsis
- - A study was conducted to evaluate the efficacy and safety of a new irrigated radiofrequency (RF) balloon technology for isolating pulmonary veins in patients, with data collected from two high-volume centers in Germany.
- - Among 140 patients, the RF balloon achieved a remarkable 99.1% success rate in isolating pulmonary veins, with 60% of these isolated successfully on the first application, and median procedure time was 77 minutes.
- - Although there were a few safety concerns, including a low incidence of serious events like cardiac tamponade and strokes, these were mainly observed in the early stages of the procedure, emphasizing the importance of monitoring for potential oesophageal injuries during treatment.
Implantable Cardioverter-Defibrillators in Poland Compared with other European Countries from the Patient's Perspective: Insights from the EHRA Patient Survey.
Łukasz Januszkiewicz Marcin Grabowski Michał Mirosław Farkowski Paweł Życiński Tomasz Jędrychowski Julian K R Chun
Int J Environ Res Public Health
March 2023
Article Synopsis
- The study compares Polish ICD recipients with those from other European countries regarding quality of life, information before implantation, and end-of-life issues.
- Polish patients reported a higher improvement in quality of life (51.0%) versus 44.3% in other countries, but less frequent use of remote monitoring (21.0% in Poland vs. 66.8% elsewhere).
- Despite being well-informed before implantation (78.1% in Poland), Polish patients were less familiar with the ICD deactivation process compared to their European counterparts.
Article Synopsis
- The study evaluated how well ICD patients received information about their device and its implications, highlighting gaps in knowledge.
- About 71.5% of participants felt adequately informed, yet many lacked critical information regarding complications, driving restrictions, and end-of-life options.
- Notably, women reported feeling less informed and involved in decision-making compared to men, indicating a need for improved communication in this area.
Article Synopsis
- Catheter Ablation (CA) is an effective treatment for atrial fibrillation (AF), significantly reducing symptoms and improving clinical outcomes.
- Early intervention in AF is crucial, as starting rhythm control sooner is linked to better cardiovascular health and reduced hospital readmissions.
- Although CA shows limited success in persistent AF cases, patients with early persistent AF tend to have better outcomes, and new ablation techniques may enhance treatment effectiveness.
Article Synopsis
- Pulsed field ablation (PFA) is a new method for treating atrial fibrillation (AF) using high-voltage electrical energy, but is rarely used as a first-line treatment.
- A case study involved a patient with a pacemaker (PM) who underwent successful PFA for AF, achieving pulmonary vein isolation quickly and without complications.
- After six months, the patient showed a significant reduction in AF episodes, and there was no impact on pacemaker function.
Aims: Cryoballoon (CB)-based pulmonary vein isolation (PVI) is an effective treatment for atrial fibrillation (AF). The most frequent complication during CB-based PVI is right-sided phrenic nerve injury (PNI) which is leading to premature abortion of the freeze cycle. Here, we analysed reconnection rates after CB-based PVI and PNI in a large-scale population during repeat procedures.
View Article and Find Full Text PDFArticle Synopsis
- Atrial fibrillation (AF) presents significant challenges in healthcare, and the effective treatment of pulmonary vein isolation shows varying definitions of success among studies.
- An online survey, conducted with support from the European Heart Rhythm Association, gathered insights from 107 clinicians regarding their practices in monitoring and defining successful AF ablation outcomes.
- Most clinicians (82%) routinely monitor AF recurrences post-ablation, with a majority defining success as a combination of absence of symptoms and recorded AF, and considering anticoagulation cessation primarily for patients with paroxysmal AF.
Article Synopsis
- The healthcare sector contributes nearly 5% of global greenhouse gas emissions, prompting a need for environmental sustainability in technology-heavy fields like cardiac electrophysiology (EP).
- A survey of 278 physicians across 42 European centers revealed that 62% are motivated to lower the environmental impact of EP procedures, but current practices are wasteful, with significant numbers of catheters being discarded rather than reused.
- Barriers to implementing sustainable practices include a lack of support from institutions and challenges in changing behaviors, while solutions cited by physicians include regulatory changes, education, and improved product recommendations after use.
Article Synopsis
- A survey conducted by the European Heart Rhythm Association found that early recurrences of atrial tachyarrhythmias (ERATs) occur in about 25% of patients post-atrial fibrillation ablation, particularly in persistent atrial fibrillation (persAF) cases.
- The common practice among electrophysiologists is to apply a blanking period (BP) of around 90 days, with some preferring shorter durations for patients with paroxysmal atrial fibrillation (PAF).
- While most ERATs are managed conservatively, a notable percentage of doctors consider repeat ablation during the BP for patients experiencing multiple ERATs or organized atrial tachyarrhythmias.
Article Synopsis
- Ablation for atrial fibrillation (AF) primarily focuses on isolating the pulmonary veins (PVs) to treat symptomatic cases effectively.
- Innovative ablation systems utilizing various energy sources, like cryo and radiofrequency, aim to enhance the durability of PV isolation to improve outcomes.
- The manuscript discusses the evolution of pulmonary vein isolation techniques, their importance in treating AF, and explores additional strategies to boost clinical success rates in ablation procedures.
Article Synopsis
- This study assessed whether adding left atrium posterior wall isolation (PWI) to pulmonary vein isolation (PVI) helps prevent the recurrence of atrial fibrillation (AF).
- Among 3,287 patients, PWI showed no significant benefits for those with paroxysmal AF but did reduce AF recurrence in patients with persistent AF, especially in older individuals or those with larger left atria.
- Both radiofrequency and cryoballoon techniques for PWI were effective, but radiofrequency might lead to more atrial tachycardia; the procedure was generally safe with low complication rates, although it required more time compared to PVI alone.
Article Synopsis
- The study analyzed how living with an implantable cardioverter-defibrillator (ICD) affects patients' quality of life (QoL), surveying 1809 patients across 10 European countries.
- Nearly half of the respondents reported an improved QoL, especially those with a cardiac resynchronization therapy-defibrillator (CRT-D), while about 10% experienced significant declines, primarily due to device-related complications like inappropriate shocks.
- Overall, most patients view ICD therapy positively, but complications are linked to lower QoL and highlight the need for thorough patient education and involvement in treatment decisions.
Article Synopsis
- A survey conducted by the European Heart Rhythm Association gathered responses from 202 cardiologists and electrophysiologists to assess the management of idiopathic monomorphic PVCs in Europe.
- The most reported symptoms in patients were palpitations (87%), fatigue (29%), and dizziness (18%), with essential blood tests including thyroid function and electrolytes being commonly requested.
- The survey revealed a preference for beta-blockers and antiarrhythmic drugs for treatment, and there was significant interest in using catheter ablation, particularly for patients with a high frequency of PVCs or related cardiomyopathy.