Publications by authors named "Kautzner Josef"

Article Synopsis
  • - The study investigates the effectiveness of a new ECG technique called CineECG, which visualizes heart electrical activity, in improving cardiac resynchronization therapy (CRT) for patients who don't respond well to standard treatments.
  • - Researchers analyzed CineECG data from 15 patients with heart conditions under different pacing settings and found that specific movement directions in the heart's electrical signals correlate with better immediate heart performance (measured as dP/dt max).
  • - The results indicate that the direction of the ST-T segment during repolarization can predict a significant improvement in heart function during CRT, suggesting that CineECG could help optimize treatment plans for patients.
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Introduction: Atrial fibrillation (AF) can cause or aggravate heart failure (HF). Catheter ablation (CA) is an effective treatment for AF. This study focused on the feasibility and outcomes of emergent AF ablation performed during hospitalization for acute HF.

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Aims: Catheter ablation is an effective treatment method for recurrent ventricular tachycardias (VTs). However, at least in part, procedural and clinical outcomes are limited by challenges in generating an adequate lesion size in the ventricular myocardium. We investigated procedural and clinical outcomes of VT ablation using a novel 'large-footprint' catheter that allows the creation of larger lesions either by radiofrequency (RF) or by pulsed field (PF) energy.

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Article Synopsis
  • Pulsed electric field (PEF) energy shows potential as an effective method for catheter ablation in atrial fibrillation (AF), but its impact on red blood cells (erythrocytes) is not well understood.
  • A study involving 60 AF patients found that PEF ablation significantly increased levels of free hemoglobin, lactate dehydrogenase, and bilirubin, indicating intravascular hemolysis after the procedure.
  • The results suggested that the extent of hemolysis correlates strongly with the number of PEF applications, with more than 74 applications being linked to significant damage to red blood cells.
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  • This study looks at how well doctors can predict sudden cardiac death after someone has a heart attack using a measurement called left ventricular ejection fraction (LVEF).
  • They combined information from over 140,000 heart attack patients to see if LVEF alone is good enough for deciding who should get a heart device called a defibrillator.
  • The results showed that LVEF didn't do a great job at predicting sudden cardiac death, which means doctors need better ways to tell who is at risk.
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  • Cardiac myosin-specific T cells are important in causing heart problems when treated with certain cancer medications.
  • Researchers studied mouse hearts to see how these T cells act and found that they change when there's heart damage.
  • They discovered that after recovering from heart injuries, mice became more likely to develop heart issues when given these cancer drugs, and they also found similar T cells in human patients with heart problems.
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  • 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
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  • A study evaluated the effectiveness of stellate ganglion block (SGB) as a treatment for refractory ventricular arrhythmias, focusing on patient characteristics and success predictors.
  • The analysis involved 117 patients from the Czech Republic and the US, with results showing that age negatively impacted SGB success, while a higher left ventricular ejection fraction hinted at improved outcomes.
  • Overall, SGB was effective across different types of arrhythmias and cardiomyopathy causes, but elderly patients saw less benefit in arrhythmia suppression within 24 hours post-treatment.
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Stereotactic arrythmia radioablation (STAR) is a novel, non-invasive and promising treatment option for ventricular arrythmias (VA). It has been applied in highly selected patients mainly as bail-out procedure, when (multiple) catheter-ablations, together with anti-arrhythmic drugs, were unable to control the VAs. Despite the increasing clinical use there is still limited knowledge of the acute and long-term response of normal and diseased myocardium to STAR.

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Background: The highest mortality and morbidity worldwide is associated with atherosclerotic cardiovascular disease (ASCVD), which has in background both environmental and genetic risk factors. Apolipoprotein L1 (APOL1) variability influences the risk of ASCVD in Africans, but little is known about the APOL1 and ASCVD in other ethnic groups.

Methods: To investigate the role of APOL1 and ASCVD, we have genotyped four (rs13056427, rs136147, rs10854688 and rs9610473) APOL1 polymorphisms in a group of 1541 male patients with acute coronary syndrome (ACS) and 1338 male controls.

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Background: Management of hypertrophic obstructive cardiomyopathy (HOCM) is often challenging, depending on clinical manifestation. This case report illustrates the complex treatment of HOCM with associated recurrent ventricular arrhythmias.

Case Summary: A 54-year-old female with HOCM diagnosed in 2012 underwent a failed attempt for alcohol septal ablation, implantation of an implantable cardioverter-defibrillator, and repeated radiofrequency ablations (including ablation of the septal bulge to reduce LV obstruction).

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Background: Part of the current stereotactic arrythmia radioablation (STAR) workflow is transfer of findings from the electroanatomic mapping (EAM) to computed tomography (CT). Here, we analyzed inter- and intraobserver variation in a modified EAM-CT registration using automatic registration algorithms designed to yield higher robustness.

Materials And Methods: This work is based on data of 10 patients who had previously undergone STAR.

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Aims: Recent-onset dilated cardiomyopathy (RODCM) is characterized by heterogeneous aetiology and diverse clinical outcomes, with scarce data on genotype-phenotype correlates. Our aim was to correlate individual RODCM genotypes with left ventricular reverse remodelling (LVRR) and clinical outcomes.

Methods And Results: In this prospective study, a total of 386 Czech RODCM patients with symptom duration ≤6 months underwent genetic counselling and whole-exome sequencing (WES).

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Catheter ablation (CA) has become an established treatment strategy for managing recurrent ventricular tachycardias (VTs) in patients with structural heart disease. In recent years, percutaneous mechanical circulatory support (PMCS) devices have been increasingly used intra-operatively to improve the ablation outcome. One indication would be rescue therapy for patients who develop haemodynamic deterioration during the ablation.

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Background And Objectives: The relevance of the use of intra-aortic balloon pump (IABP) in cardiogenic shock (CS) has been discussed over the past years. The aim of this study is to describe a single-centre 10-year experience with IABP and analyse the risk factors for 30-day mortality.

Methods: The data for this single-centre, observational, retrospective study were drawn from records dated from January 2012 to May 2022 pertaining to patients presenting with CS, treated with IABP and hospitalised at the Department of Acute Cardiology, Institute for Clinical and Experimental Medicine, Prague.

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Article Synopsis
  • A prospective observational study evaluated the use of pulsed electric field (PF) ablation for treating ventricular arrhythmias, focusing on its efficacy and safety in a small patient population of 44 individuals.
  • The study showed an 84% acute success rate in eliminating frequent ventricular premature complexes (VPCs) and non-inducibility of ventricular tachycardia (VT), indicating that PF ablation can effectively treat these conditions.
  • At a 3-month follow-up, 81% of patients with VPCs experienced sustained suppression, but only 52% of patients with scar-related VT remained free of any arrhythmias, suggesting that while PF ablation is promising, its long-term effectiveness for VT may need further
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Background: Atrial fibrillation (AF) and heart failure (HF) coexist, increasing morbidity and mortality. Studies have demonstrated improved outcomes following AF ablation in HF patients with reduced ejection fraction (EF).

Objective: To assess the outcomes of pulsed-field ablation (PFA) in HF.

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Background: Atrial fibrillation (AF) and heart failure (HF) coexist, increasing morbidity and mortality. Studies have demonstrated improved outcomes following AF ablation in HF patients with reduced ejection fraction (EF).

Objective: This study sought to assess the outcomes of pulsed field ablation (PFA) in HF.

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Aims: Patients with structural heart disease (SHD) undergoing catheter ablation (CA) for ventricular tachycardia (VT) are at considerable risk of periprocedural complications, including acute haemodynamic decompensation (AHD). The PAINESD score was proposed to predict the risk of AHD. The goal of this study was to validate the PAINESD score using the retrospective analysis of data from a large-volume heart centre.

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  • There is limited understanding of how idiopathic ventricular fibrillation (IVF) starts, but previous research suggests that it usually doesn't depend on pauses in heart rhythm.
  • The study aimed to investigate the initiation patterns of polymorphic ventricular tachycardia (PVT) in IVF patients, analyzing a total of 410 arrhythmia episodes among 180 patients.
  • Results showed that about 27.2% of PVT episodes were pause-dependent, with the majority occurring during normal heart rhythms and initiating PVCs mostly having short coupling intervals (under 350 ms).
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  • The study investigates how left ventricular septal myocardial pacing (LVSP) and left bundle branch pacing (LBBP) compare to biventricular pacing (BVP) on heart function and electrical synchrony in patients needing cardiac resynchronization therapy.
  • Findings show that while QRS duration was similar across all pacing methods, LBBP led to improved electrical synchrony and higher systolic blood pressure compared to BVP.
  • Results indicate that LVSP and BVP offered similar outcomes, but LBBP was superior, particularly in patients without ischemic heart disease.
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Clinical outcomes of catheter ablation for atrial fibrillation (AF) are suboptimal due, in part, to challenges in achieving durable lesions. Although focal point-by-point ablation allows for the creation of any required lesion set, this strategy necessitates the generation of contiguous lesions without gaps. A large-tip catheter, capable of creating wide-footprint ablation lesions, may increase ablation effectiveness and efficiency.

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We present a case of a 32-year-old male with a history of palpitations and preexcitation on ECG who underwent altogether four failed catheter ablations using different approaches in the two other electrophysiology centers within two years. ECG showed overt preexcitation with a positive delta wave in lead I and negative in leads V1-V3, suggesting a right free wall accessory pathway. During the electrophysiological study, the accessory pathway was localized on the free lateral wall.

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Background: Data on the clinical significance of iron deficiency (ID) in patients with myocardial infarction (MI) are conflicting. This may be related to the use of various ID criteria. We aimed to compare the association of different ID criteria with all-cause mortality after MI.

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