Publications by authors named "Matthew M Zipse"
Background: Identification of patients at risk for atrial fibrillation (AF) after typical atrial flutter (tAFL) ablation is important to guide monitoring and treatment.
Objective: The purpose of this study was to create and validate a risk score to predict AF after tAFL ablation METHODS: We identified patients who underwent tAFL ablation with no AF history between 2017 and 2022 and randomly allocated to derivation and validation cohorts. We collected clinical variables and measured conduction parameters in sinus rhythm on an electrophysiology recording system (CardioLab, GE Healthcare).
The 1 implantation of an atrial only leadless pacemaker in right atrial appendage.
J Interv Card Electrophysiol
December 2023
Risk of Adverse Outcomes Associated With Cardiac Sarcoidosis Diagnostic Schemes.
JACC Clin Electrophysiol
August 2023
Article Synopsis
- A study evaluated the association of various cardiac sarcoidosis (CS) diagnostic criteria from different years (1993, 2006, 2014, and 2017) with negative health outcomes in patients.
- Research involved analyzing data from a global cardiac sarcoidosis registry and identified adverse events like mortality and surgeries in 587 patients.
- Results showed patients meeting the 1993 and 2006 criteria had significantly higher chances of experiencing adverse outcomes compared to those who didn't, while the 2014 and 2017 criteria did not show a significant correlation with these events.
Article Synopsis
- Esophageal injury is a recognized risk during catheter ablation procedures, and new methods to reduce this risk are being evaluated through temperature gradient studies.
- Researchers conducted experiments using a porcine heart model to analyze how different ablation techniques affected temperature changes in the left atrium and surrounding tissues, specifically focusing on the esophagus.
- Results showed that standard ablation techniques resulted in a significantly higher temperature increase at the anterior wall of the esophagus compared to high-power short duration approaches, indicating potential risks with different methods.
Article Synopsis
- Unipolar electrograms (UniEGMs) are often used for localizing focal arrhythmias, but their effectiveness in ablation of deeper premature ventricular contractions (PVCs) is questionable.
- This study compared bipolar electrograms (BiEGMs) to UniEGMs in guiding the successful ablation of PVCs originating from both the right ventricular outflow tract (RVOT) and intramural outflow tracts.
- Results showed that BiEGMs provided a better identification of activation times, particularly for intramural PVCs, highlighting their superior role in successful ablation compared to UniEGMs.
Article Synopsis
- Ventricular tachycardia (VT) in cardiac sarcoidosis (CS) is linked to high mortality rates, and catheter ablation could offer better outcomes compared to traditional medical management.
- A study analyzed data from 158 patients with CS and VT at 16 medical centers over 16 years, focusing on the effectiveness of catheter ablation and accompanying medical treatments.
- Results showed that 54% of patients had complete success with ablation, with a significant reduction in VT storms and defibrillator shocks, although 46% experienced VT recurrence over a follow-up period of about 2.5 years.
Increased incidence of cavotricuspid isthmus atrial flutter following slow pathway ablation.
J Interv Card Electrophysiol
April 2022
Article Synopsis
- * A retrospective analysis of 544 patients’ ablation procedures over a decade revealed that patients undergoing atrioventricular nodal reentry tachycardia ablation had a significantly higher incidence of CTI-dependent flutter (4.97%) than those receiving other ablation types (0%).
- * The findings suggest a strong association between atrioventricular nodal reentry tachycardia ablation and the development of atrial
Background: Ventricular tachycardia (VT) catheter ablation success may be limited when transcutaneous epicardial access is contraindicated. Surgical ablation (SurgAbl) is an option, but ablation guidance is limited without simultaneously acquired electrophysiological data.
Objective: We describe our SurgAbl experience utilizing contemporary electroanatomic mapping (EAM) among patients with refractory VT storm.
Article Synopsis
- Long-term right ventricular (RV) pacing can worsen heart failure, but the effectiveness of cardiac resynchronization therapy (CRT) versus dual chamber (DC) devices for patients needing frequent RV pacing is not well understood in practice.
- This retrospective study analyzed data from 3100 Medicare patients undergoing ICD implantation from 2010 to 2016, focusing on those needing pacing but lacking a strong indication for CRT.
- Researchers evaluated the impact of device type on outcomes like mortality, heart failure hospitalizations, and complications using statistical modeling to understand variability in device usage across different hospitals.
Uncovering a unique path: Antidromic AVRT utilizing a left anteroseptal Mahaim-like accessory pathway.
Pacing Clin Electrophysiol
January 2021
A 40-year-old man presented to our emergency department 2 hours after onset of shortness of breath, palpitations, and presyncope secondary to an adenosine-responsive wide complex tachycardia. Electrophysiology study was diagnostic for antidromic atrioventricular (AV) reentrant tachycardia utilizing a muscular connection from the anterior interventricular vein to the left ventricle with Mahaim-like properties, successfully treated with ablation in the distal coronary sinus (CS) system. This case highlights accessory pathways (a) with unique features (i.
View Article and Find Full Text PDFBackground Patients undergoing lead extraction for infected devices have worse outcomes compared with those with noninfected devices. We assessed predictors of in-hospital mortality and procedure-related major adverse events (MAEs) in a large cohort undergoing lead extraction. Methods and Results Deidentified hospital records procedure from 7 states between 1994 and 2013 were aggregated and procedure codes were used to identify hospital records reporting lead extraction.
View Article and Find Full Text PDFBackground: Epicardial adipose (EA) tissue may limit effective radiofrequency ablation (RFA).
Objectives: We sought to evaluate the lesion formation of different ablation strategies on ventricular myocardium with overlying EA.
Methods: Bovine myocardium with EA was placed in a circulating saline bath in an ex vivo model.
Follow-Up After Catheter Ablation of Papillary Muscles and Valve Cusps.
JACC Clin Electrophysiol
October 2019
Objectives: The goal of this study was to determine the impact of catheter ablation in the region of papillary muscles (PMs) and valvular cusps (VC) on mitral, tricuspid, or aortic valve function.
Background: Ventricular arrhythmias arising from PMs and VCs often require extensive catheter ablation. Little is known regarding the risk of valve dysfunction after radiofrequency catheter ablation of such arrhythmias.
Article Synopsis
- Defibrillation testing (DFT) is used during ICD implantation to check if the device can handle dangerous heart rhythms, but it can lead to complications, and many studies suggest skipping it is safe.
- A study analyzed data from over 499,000 patients across nearly 1,800 hospitals between 2010 and 2015 to track how DFT usage changed over time.
- The findings show that the use of DFT significantly decreased from 71.6% to 36.4% during the study period, with certain patient characteristics influencing the decision to perform testing.
Bipolar radiofrequency ablation creates different lesion characteristics compared to simultaneous unipolar ablation.
J Cardiovasc Electrophysiol
December 2019
Introduction: Both bipolar and simultaneous radiofrequency ablation (bRFA, simRFA) have been used to treat thick midmyocardial substrate as well as during circular, multipolar ablation between shorter distances.
Objectives: We sought to evaluate the biophysical parameters of simRFA, sequential unipolar RFA (seqRFA), and bRFA.
Methods: Bovine myocardium was placed in a circulating saline bath.
Article Synopsis
- Cardiac sarcoidosis (CS) can lead to serious heart issues like arrhythmias and sudden death, especially in patients with preserved heart function, making it hard to assess risk effectively.* -
- In a study of 120 patients with biopsy-confirmed CS, electrophysiologic testing (EPS) was performed to identify those at higher risk, and 7 patients (6%) showed inducible ventricular tachycardia, leading to the placement of implantable defibrillators.* -
- The results indicated that a positive EPS was linked to higher risks of arrhythmias, highlighting its value for those with probable CS; however, negative EPS does not completely rule out the risk of sudden cardiac death due to disease
Article Synopsis
- Delayed high-grade atrioventricular block (DH-AVB) is a potential complication after transcatheter aortic valve replacement (TAVR) that hasn't been thoroughly explored in outpatients, particularly with recent TAVR technologies.
- A study at the University of Colorado investigated the use of ambulatory event monitoring (AEM) to detect DH-AVB, finding that 10% of monitored patients developed this condition within 30 days of discharge and identified hypertension and right bundle branch block (RBBB) as associated risk factors.
- The research highlights the importance of AEM for early identification of DH-AVB post-TAVR, suggesting that while RBBB is a risk factor, it may not be
Article Synopsis
- - The study explored the relationship between esophageal position during atrial fibrillation ablation and the risk of esophageal injury, particularly focusing on how esophageal course could impact heating during the procedure.
- - Out of 68 patients assessed, almost half had a midline esophagus, while a significant portion had leftward positioning, which correlated with higher luminal temperatures during ablation and an increased risk of atrioesophageal fistula (AEF).
- - The findings suggest that a leftward or confined esophageal position may elevate the chances of injury during AF ablation, indicating the need for careful evaluation of esophageal alignment before procedures.
Article Synopsis
- The study examines the effectiveness and safety of repeat ablation procedures for treating ventricular arrhythmias in patients with nonischemic cardiomyopathy (NICM).* -
- Among the 88 NICM patients analyzed, those requiring multiple ablations had similar survival rates from arrhythmias as those who had only one, but experienced higher complication rates and used more nonstandard ablation methods.* -
- Midmyocardial substrate (MMS) presence was linked to a higher need for repeat procedures; however, with multiple ablations, the outcomes in terms of arrhythmia-free survival were comparable to those without MMS.*
Objectives: The goal of this study was to characterize differences in ablation lesions with varying radiofrequency ablation (RFA) power and time.
Background: Increasing power delivery or prolonging duration can improve the efficacy of RFA. However, the extent to which ablation lesion characteristics change, based on varying degrees of power and duration, is unknown.
Near-Field Ultrasound Imaging of Ablation Lesion Formation: More Than Meets the Eye?
Circ Arrhythm Electrophysiol
December 2017