Background: Bipolar radiofrequency ablation (B-RFA) is a method used to treat the arrhythmia substrate resistant to unipolar ablation. Few studies have addressed endo-epicardial B-RFA.
Objective: The aim of the study was to evaluate chronic lesions resulting from endo-epicardial B-RFA and to determine optimal settings for such procedures in an animal model.
Background: Cryoballoon ablation (CBA) for atrial fibrillation (AF) is usually preceded by demonstrating pulmonary vein (PV) occlusion using contrast. The aim of the study was to determine efficacy and safety of a simplified protocol for CBA performed without demonstrating PV occlusion and compare achieved results with conventional CBA.
Methods: Paroxysmal AF patients undergoing a first-time CBA were prospectively included.
Despite extensive conventional endoepicardial ablation, significant intramural arrhythmogenic substrate may remain out of reach of unipolar radiofrequency ablation (RFA). The authors present clinical findings and procedural workflow for bipolar radiofrequency ablation (B-RFA) with 1 catheter placed against the endocardium and the other in the pericardial sac to ablate refractory ventricular arrhythmias. No serious adverse events occurred during B-RFA procedures, and the short-term and midterm clinical results were satisfactory.
View Article and Find Full Text PDFJACC Clin Electrophysiol
November 2022
Background: The entrainment response, defined as the difference between the postpacing interval and the tachycardia cycle length (TCL) recorded from a mapping catheter, allows to track down the components of the tachycardia loop.
Objectives: The aim of this study was to evaluate if the postpacing interval measured simultaneously from multiple sites that are remote from the pacing site (PPIR) could be clinically useful in mapping re-entrant circuits.
Methods: Ninety-two episodes of entrainment response in 29 patients with different macro-re-entrant tachycardias were evaluated using a standardized entrainment protocol.
J Cardiovasc Electrophysiol
January 2023
Introduction: Variability of the bipolar atrial electrogram amplitude may affect voltage maps created during ablation procedures, and thus also the extent of ablations. Therefore, the aim of the study was to assess the beat-to-beat electrogram amplitude variability in the left atrium in patients undergoing atrial fibrillation ablation.
Methods: In 11 patients undergoing ablation for atrial fibrillation, 362 mapping points were collected in two series.
Epicardial access is becoming increasingly important for various cardiovascular interventions. Access to dry pericardial space can be challenging and is often associated with significant complications. A novel concealed-needle blunt-tip device is designed to capture the parietal pericardium layer and retract it into the distal end of the device, which houses a fixated concealed needle, in a bid to minimize the likelihood of lacerating the visceral layer of the pericardium.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
December 2019
The aim of the study was to provide quantitative data and to look for new landmarks useful during transseptal puncture (TSP) using a fluoroscopy-guided approach. METHODS AND RESULTS: A total of 104 patients at mean age 57 ± 12 years, of whom 92% underwent pulmonary vein isolation, were analysed. Before TSP catheters were placed in the coronary sinus (CS) and His bundle region.
View Article and Find Full Text PDFBackground: Implantable cardioverter-defibrillator (ICD) therapy has been proven effective in the prevention of sudden cardiac death, but data on outcomes of ICD therapy in the young and otherwise healthy patients with long QT syndrome (LQTS) are limited.
Aim: We sought to collect data on appropriate and inappropriate ICD discharges, risk factors, and ICD-related complications.
Methods: All LQTS patients implanted with an ICD in 14 centres were investigated.
Background: Whether there is any benefit derived from adding oxaliplatin to fluoropyrimidine-based preoperative chemoradiation is currently unknown in cases of advanced cT3 or cT4 tumours. Our aim was to evaluate this issue by analysing a randomized trial, which compared two schedules of preoperative treatment (chemoradiation vs. 5 × 5 Gy with 3 cycles of consolidation chemotherapy) for cT4 or fixed cT3 rectal cancer.
View Article and Find Full Text PDFBackground: Improvements in local control are required when using preoperative chemoradiation for cT4 or advanced cT3 rectal cancer. There is therefore a need to explore more effective schedules.
Patients And Methods: Patients with fixed cT3 or cT4 cancer were randomized either to 5 × 5 Gy and three cycles of FOLFOX4 (group A) or to 50.
Purpose: To assess local control after preoperative radiation and local excision and to determine an optimal radiotherapy regimen.
Methods: Eighty-nine patients with G1-2 rectal adenocarcinoma <3-4 cm; unfavourable cT1N0 (23.6%), cT2N0 (62.
A 18-year-old patient with abnormal origin of right coronary artery and ventricular tachycardia during exercises is presented. Myocardial biopsy revealed arrhythmogenic right ventricular cardiomyopathy.
View Article and Find Full Text PDFWe present a case of 44 year-old female who was admitted to the hospital due to performed radio frequency ablation because of VF during WPW syndrome, which was complicated by dissection of left main. The dissection was treated with success by primary percutaneous coronary intervention with two metal stents.
View Article and Find Full Text PDFAim: We aimed to characterize electrophysiological properties of pulmonary veins (PVs) in patients with Wolff-Parkinson-White (WPW) syndrome and atrial fibrillation (AF), and to compare them to those in patients with WPW without AF.
Methods And Results: A total of 31 patients (mean age 40 ± 15 years, 23 males) with WPW were recruited: 16 patients with (AF group) and 15 without (controls) a history of AF. The basic electrophysiological (EPS) and echocardiographic data were not different between the 2 groups.
A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated with RF ablation delivered through coronary sinus is presented. Based on multiple electrophysiological parameters (surface ECG, electroanatomical map collected from the endocardium, bipolar and unipolar endocardial recordings, and unsuccesful ablation attempts from the endocardial side) the tachycardia loop was found to be located epicardially. This allowed for successful ablation approach.
View Article and Find Full Text PDFBackground: Distal intramural spread is present within 1 cm from visible tumor in a substantial proportion of patients. Therefore, ≥ 1 cm of distal bowel clearance is recommended as minimally acceptable. However, clinical results are contradictory in answering the question of whether this rule is valid.
View Article and Find Full Text PDFWe describe a case of a 77-year-old patient with recurrent, symptomatic ventricular tachycardia with a bizarre QRS complex originating from the right ventricle lateral wall. The small region of slow conduction was the critical substrate for initiation and maintenance of ventricular tachycardia, confirmed by a successful one RF application.
View Article and Find Full Text PDFWe present two new cases of the short QT syndrome--a 23-year-old male and his 42-year-old mother. Invasive electrophysiological study was negative in both patients. Due to polymorphic ventricular tachycardia recorded during Holter ECG monitoring, an ICD was implanted in the male patient for primary prevention.
View Article and Find Full Text PDFA 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, was referred to our department for electrophysiological study. Burst pacing from high right atrium using a cycle length of 350 ms induced a slowfast atrioventricular nodal reentry tachycardia. We excluded the presence of accessory atrioventricular tracts.
View Article and Find Full Text PDFA case of a 51 year old patient with a history of myocardial infarction (MI) and recurrent ventricular tachycardia (VT) is presented. Three months after MI the patient underwent coronary angioplasty and one year later received prophylactic implantable cardioverter-defibrillator (ICD) due to complex ventricular arrhythmias, detected on Holter ECG monitoring, and depressed left ventricular ejection fraction. Later on the patient started to experience palpitations and ICD shocks during physical activity (cycling).
View Article and Find Full Text PDFThe advent of laparoscopic colorectal surgery evoked discussion on its advantages and limitations. Although application of laparoscopy in the management of benign colorectal diseases has been widely accepted, its use for treatment of malignancies is still controversial. Many reports suggest that laparoscopic operations provide similar oncological radicality as open procedures, with less operative trauma, shorter hospital stay and low complication rate.
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