Publications by authors named "Mats Jensen-Urstad"

Background: Atrioventricular nodal re-entrant tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia. We sought to investigate the incidence of atrial fibrillation in patients with electrophysiologically confirmed/ablated AVNRT and its association with transient ischemic attack (TIA)/stroke as well as mortality during long-term follow-up.

Methods: From the Karolinska Ablation Registry, 2855 consecutive patients with a first-time ablation for AVNRT between 2005 and 2018 were analyzed.

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Ventricular tachycardia (VT) in patients with structural heart disease is potentially life threatening, and most patients have an indication for an implantable cardioverter-defibrillator (ICD). Catheter ablation is an effective therapeutic strategy to reduce the risk of VT recurrence and subsequent ICD therapies. However, VT ablation is a technically complex procedure with significant risks and should be performed in experienced centers with appropriate resources.

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Background: Atrial fibrillation (AF) is associated with the development of dementia, and observational studies have shown that oral anticoagulation and catheter ablation reduce dementia risk. However, such studies did not consistently report on periprocedural anticoagulation and long-term oral anticoagulation coverage, for which reason the separate effect of AF ablation on dementia risk could not be established.

Objective: We evaluated the protective effect of AF ablation in a large cohort of patients who received optimized anticoagulation and compared them with patients who were managed medically.

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Article Synopsis
  • The study investigates low-voltage zones (LVZs) in the left atrium as potential predictors for the recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) in patients with persistent AF.
  • A cohort of 439 patients was analyzed, finding that about 25% had significant LVZs, primarily located in the anterior wall of the left atrium. Key predictors identified include advanced age, female sex, coronary artery disease, and enlarged left atrial diameter.
  • The results, showing a strong model for predicting LVZs, suggest that these factors could help personalize ablation procedures for better patient outcomes in treating persistent AF.
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Aims: Controversy remains as to whether the exercise stress test (EST) is sufficient for risk evaluation in patients with pre-excitation. This study aims to clarify the usefulness of EST in risk stratification in both asymptomatic and symptomatic patients presenting with pre-excitation.

Methods And Results: This prospective study includes consecutive asymptomatic and symptomatic patients with pre-excitation referred for risk assessment.

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Objective: Catheter ablation of atrial fibrillation effectively reduces symptomatic burden. However, its long-term effect on mortality and stroke is unclear. We investigated if patients with atrial fibrillation who undergo catheter ablation have lower risk for all-cause mortality or stroke than patients who are managed medically.

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Objective: Previous studies have found that endurance sport activity is associated with an increased risk of atrial fibrillation (AF) in men. However, it remains unclear whether endurance sports also influence the risk of AF in women. We aimed to examine whether participation in endurance sports may affect the risk of AF in female athletes.

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Aim: Evaluation of the diagnostic accuracy of a rhythm recording device, for detection of atrial tachyarrhythmia (ATA) and atrial fibrillation (AF) compared to 12-lead-electrocardiogram (12-L-ECG).

Research Design And Methods: Two hundred 12-L-ECGs (reference standard) and Coala Heart Monitor (CHM) recordings (index test) were collected from 189 patients. Two electrophysiologists independently performed manual analysis of all 12-L-ECGs and CHM recordings in random order.

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Background: Intracardiac echocardiography (ICE) is frequently used to guide electrophysiology procedures. The novel automated algorithm Cartosoundfam is a model-based algorithm which reconstructs a 3D anatomy of the left atrium (LA) based on a set of 2D intracardiac echocardiography (ICE) frames, without the need to manually annotate ultrasound (US) contours.

Objective: The aim of this study was to determine the feasibility of the Cartosoundfam module in routine clinical setting.

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Article Synopsis
  • The study investigated how the timing of electrical cardioversion (ECV) affects the long-term success in treating early recurrences of atrial fibrillation after a pulmonary vein isolation procedure.
  • Out of 133 patients analyzed, 85.7% had successful ECV, while factors like higher body mass index and ECV occurring more than 7 days after recurrence were linked to ECV failure.
  • Patients who had a failed ECV or had the procedure performed more than 7 days after the initial recurrence were at a significantly higher risk for late recurrences of atrial fibrillation after one year.
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Article Synopsis
  • * The study evaluated 242 AF patients (121 men) before and six months after PVI using various assessments for symptoms, HRQOL, and functional impairment.
  • * Results indicated that while women reported higher symptom severity at the start, they experienced larger gains in HRQOL and decreased symptoms after the procedure compared to men, with no significant differences in the type of AF or outcomes from the ablation.
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A pulmonary vein isolation procedure in a patient with an atrial septal defect (ASD) closure device was complicated by entrapment of a mapping catheter in the device. The procedure was converted to open heart surgery, the device with the trapped catheter was explanted, the ASD was covered with a bovine patch, and a cryomaze procedure was performed. ().

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Purpose: Patients with WPW syndrome have an increased mortality rate compared to the general population. Although asymptomatic preexcitation has previously been considered benign, recent studies have found that also asymptomatic patients have clinical and electrophysiological factors associated with increased risk of sudden cardiac death. This study compares the baseline electrophysiological characteristics of accessory pathways in symptomatic and asymptomatic patients with preexcitation.

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Background: Atrial fibrillation (AF) and heart failure (HF) frequently coexist and can be challenging to treat. Pharmacologically based rhythm control of AF has not proven to be superior to rate control. Ablation-based rhythm control was compared with rate control to evaluate if clinical outcomes in patients with HF and AF could be improved.

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The authors stopped a case of left atrial appendage occlusion because of miscolored brownish devices. The investigation demonstrated that devices may show a range of colors from a typical blue to a brownish hue, depending on oxide layer thickness, and this does not appear to have any impact on the performance of the device. ().

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Article Synopsis
  • This study evaluates complications from catheter ablation for atrial fibrillation (AF) to explore the safety of same-day patient discharge.
  • Out of 5414 AF ablations, only 2.0% experienced major complications, predominantly occurring within the first 6 hours post-procedure.
  • Findings suggest that since few complications arise after 6 hours, many patients can safely be discharged on the same day.
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Aims: Palpitations, particularly common in women, are generally considered benign symptoms rarely caused by clinically important arrhythmias. Nevertheless, palpitations may cause anxiety, depression, and decreased health-related quality of life (HRQOL). This study investigates to what degree palpitations cause symptoms such as anxiety and depression and affect HRQOL in women and whether direct feedback of underlying heart rhythm during palpitations decrease anxiety and depression and increase HRQOL in women.

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Article Synopsis
  • - The study aimed to speed up the recruitment process for clinical trials by using digital methods, like eAuthentication and handheld ECG monitoring, so participants could consent and get health feedback from home.
  • - Over about two months, 2,424 women expressed interest, and 1,082 were included in the study, achieving a high participation rate with a low dropout rate of 9%.
  • - Participants completed a total of 101,804 ECG recordings, demonstrating that a fully digital approach can improve adherence and broaden geographic participant diversity.
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Objective: The preferential sites for focal atrial tachycardia (FAT) are mainly in the right atrium in both sexes. However, a limited number of studies have indicated that sex differences in the localization of FAT. This study investigated possible sex differences in the distribution of FAT in a large cohort of patients referred for ablation.

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Purpose: Cather ablation is known to influence the autonomic nervous system. This study sought to investigate the association of sinus heart rate pre-/post-ablation and recurrences in patients with atrial fibrillation undergoing pulmonary vein isolation (PVI).

Methods: Between January 2012 and December 2017, data of 482 patients undergoing their first PVI were included.

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Aims: Iatrogenic cardiac tamponades are a rare but dreaded complication of invasive electrophysiology procedures (EPs). Their long-term impact on clinical outcomes is unknown. This study analysed the risk of death or serious cardiovascular events in patients suffering from EP-related cardiac tamponade requiring pericardiocentesis during long-term follow-up.

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: Several handheld thumb ECG devices for on-demand recording of heart rhythm have become available lately. These can be used both by health-care providers and purchased by laypersons for private use.: This profile describes the Coala Heart Monitor.

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