Predictors of ventricular tachyarrhythmia in patients with implantable cardioverter-defibrillator and non-ischemic systolic heart failure.

Background: The benefit derived from implantable cardioverter-defibrillators (ICD) in subjects with non-ischemic systolic HF (NICM) is less well-established.

Aim: The study aimed to determine the incidence, predictors, and prognostic impact of ventricular arrhythmias in patients with ICD and NICM.

Methods: The study sample included 377 consecutive patients with ICD or cardiac resynchronization cardioverter-defibrillators (CRT-D, 74% of patients) and NICM implanted and monitored remotely in a university hospital.

Does the origin of ablated premature ventricular contractions determine the level of left ventricular function improvement?

Background: Premature ventricular contractions (PVCs) are associated with tachycardiomyopathy and high mortality rate. The treatment depends on the engaged ventricle. For PVCs originating from the right outflow tract (OT), radiofrequency catheter ablation (RFCA) is recommended (class IB‑R recommendation) in preference to pharmacotherapy.

Contrast-induced acute kidney injury in patients undergoing cardiac resynchronization therapy-incidence and prognostic importance. Sub-analysis of data from randomized TRUST CRT trial.

Introduction: Because data on contrast-induced acute kidney injury (CI-AKI) in patients undergoing cardiac resynchronization therapy (CRT-D) are scarce, we aimed to assess the incidence, natural course and prognostic importance of this syndrome in CRT recipients.

Methods: Study population consisted of 100 consecutive patients enrolled into the Triple Site Versus Standard Cardiac Resynchronization (TRUST CRT) trial, who were treated with CRT-D. Two patients were excluded up to 3 months after randomization and not analysed further.

The incidence and risk factors of stroke in patients with acute myocardial infarction treated invasively and concomitant impaired renal function.

Background: Impaired renal function is a marker of poor prognosis in patients with acute myocardial infarction (AMI). The aim of the study was to assess the incidence and independent predictors of stroke in population of patients with AMI treated invasively and concomitant impaired renal function (IRF).

Methods: We analyzed 2,520 consecutive AMI patients admitted to our Center between 2003 and 2007 and treated with percutaneous coronary intervention.

Evaluation of factors affecting persistence of atrial fibrillation in patients with concomitant atrial flutter treated with percutaneous radiofrequency current ablation of the right atrial cavotricuspid isthmus.

Background: Atrial fibrillation (AF) and atrial flutter (AFL) often coexist. In some patients, AF remission is seen after successful percutaneous radiofrequency current ablation of the cavotricuspid isthmus (CTI).

Aim: To evaluate factors affecting AF remission in patients with typical AFL and concomitant AF who underwent CTI ablation.

Many response criteria are poor predictors of outcomes after cardiac resynchronization therapy: validation using data from the randomized trial.

Aims: The aim of the study was to assess the predictive value for outcomes of various response criteria currently used in patients undergoing cardiac resynchronization therapy (CRT).

Methods And Results: Data from TRUST CRT randomized trial in patients with New York Heart Association (NYHA) III-IV class, QRS ≥ 120 ms, ejection fraction ≤ 35%, and mechanical dyssynchrony was analysed. Ninety-seven subjects who survived 6 months after implantation of CRT-defibrillator were classified as responders or non-responders depending on 15 criteria used in most of the previous trials.

The prognostic value of different glucose abnormalities in patients with acute myocardial infarction treated invasively.

Background: Diabetes (DM) deteriorates the prognosis in patients with coronary heart disease. However, the prognostic value of different glucose abnormalities (GA) other than DM in subjects with acute myocardial infarction (AMI) treated invasively remains unclear.

Aims: To assess the incidence and impact of GA on clinical outcomes in AMI patients treated with percutaneous coronary intervention (PCI).

Implantation feasibility, procedure-related adverse events and lead performance during 1-year follow-up in patients undergoing triple-site cardiac resynchronization therapy: a substudy of TRUST CRT randomized trial.

Introduction: This substudy was to assess implantation feasibility and long-term safety of triple-site resynchronization therapy (CRT) in a series of consecutive patients included in a randomized trial.

Methods And Results: One hundred consecutive patients enrolled into Triple-Site Versus Standard Cardiac Resynchronization Therapy Randomized Trial were analyzed. Eligibility criteria included NYHA class III-IV, sinus rhythm, QRS ≥ 120 milliseconds, left ventricular ejection fraction ≤35%, and significant mechanical dyssynchrony.

The risk of stroke in patients with acute myocardial infarction treated invasively.

Background: To assess the incidence, clinical significance, and independent risk factors of stroke in patients with acute myocardial infarction (AMI) treated invasively.

Materials And Methods: We analyzed 2520 consecutive patients with AMI admitted between 2003 and 2007. Data on long-term follow-up were screened to identify patients who had stroke.

Effect of cardiac resynchronization on gradient reduction in patients with obstructive hypertrophic cardiomyopathy: preliminary study.

Background: The purpose of this study was to assess the effectiveness of cardiac resynchronization therapy (CRT) in terms of outflow tract gradient reduction and functional improvement in symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) requiring implantable cardioverter-defibrillator (ICD) implantation.

Methods: Eleven consecutive symptomatic HOCM patients with a significant (≥40 mmHg) gradient and indications for ICD, but without indications for resynchronization, underwent CRT-D implantation. Nine of them (four female, median age of 50 years) in whom the procedure succeeded were screened for New York Heart Association (NYHA) class, outflow gradient, mechanical dyssynchrony, QRS-width change, and 6-minute walking distance (6MWD) and peak oxygen consumption (VO(2)peak) improvement after 6 months and remotely.

The impact of unsuccessful percutaneous coronary intervention on short- and long-term prognosis in STEMI and NSTEMI.

Objectives: To compare the impact of the efficacy of percutaneous coronary intervention (PCI) on prognosis in ST and non-ST elevation myocardial infarction (STEMI and NSTEMI) patients with respect to infarct-related artery (IRA).

Background: The significance of the efficacy of PCI in STEMI and NSTEMI depending on the type of IRA has yet to be clarified.

Methods: Study population consisted of 2,179 STEMI and 554 NSTEMI consecutive patients treated with urgent PCI.

Transseptal versus transaortic approach for radiofrequency ablation in patients with cardioverter-defibrillator and electrical storm.

Purpose: Radiofrequency current ablation (RFCA) of ventricular tachycardia (VT) is usually performed using a retrograde transaortic approach. We compared the mapping accuracy, procedural course, safety, and results of VT ablation using transseptal and transaortic route.

Methods: Twenty-one consecutive patients with ischemic cardiomyopathy and history of electrical storm underwent RFCA with electro-anatomic mapping system.

[Radiofrequency catheter ablation in the treatment of arrhythmias in children--efficacy, safety of the method, predictors of the procedural course and acute success].

Background: Radiofrequency current ablation (RFCA) is a safe and efficient method of treatment in adult patients with symptomatic arrhythmias. Recently RFCA is being also used in the treatment of children with cardiac arrhythmias, however its value in this set of patients is poorly documented. Aims of our study were to assess the feasibility and safety of RFCA procedures in children with symptomatic supraventricular and ventricular arrhythmias, and to identify the parameters which influence the probability of acute success and RFCA course.

Triple-site versus standard cardiac resynchronization therapy study (TRUST CRT): clinical rationale, design, and implementation.

Background: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients with heart failure (HF), lowered LV ejection fraction, and wide QRS. However, many patients (< or =40%) do not respond to this form of pacing. TRUST CRT is a prospective, single-center, randomized, single-blind, parallel, and controlled study that has been designed to treat patients with moderate to severe HF (NYHA III-IV), QRS > or =120 ms, sinus rhythm, LV dysfunction (EF < or = 35%), and signs of mechanical dyssynchrony.

Sleep apnoea as a predictor of mid- and long-term outcome in patients undergoing cardiac resynchronization therapy.

Aims: To assess the impact of baseline apnoea-hypopnoea index (AHI) on mid-term outcome and its change after 6 months of cardiac resynchronization therapy (CRT) on remote outcome.

Methods And Results: In 71 patients with CRT devices, Holter-derived AHI was assessed before and 6 months after the procedure. Baseline AHI >20 was considered abnormal.

A comparison of the clinical course of preexcitation syndrome in children and adolescents and in adults.

Background: Atrioventricular reentrant tachycardia (AVRT) in patients with preexcitation syndrome (PS) is the main cause of paroxysmal regular arrhythmias in children and adolescents. While the previously published data most commonly concern clinical consequences of PS in adults, few researchers have evaluated the problem in children and adolescents. The aim of the study was to compare the clinical course of PS between the population of children and adolescents below 19 years of age and the population of adult patients.

Mid-term outcomes of triple-site vs. conventional cardiac resynchronization therapy: a preliminary study.

Background: The primary objectives of this study were to compare the implantation course of triple-site (double left-single right) and conventional cardiac resynchronization devices. The secondary target was to assess mid-term outcomes of both types of cardiac resynchronization therapy (CRT).

Methods: Fifty-four patients with NYHA classes III-IV, left ventricular EFor=120 ms were included; 27 received triple-site pacemakers (TRIV group), 27 conventional CRT devices (BIV group).

Sequence of electrical activation, atrial remodelling and atrial fibrillation in patients with nodal re-entrant tachycardia.

Objective: The objective of the study was to verify, if the particular sequence of electrical atrioventricular activation during tachycardia is associated with the development of atrial remodelling and predisposition to atrial fibrillation (AF) in patients with nodal reentry tachycardia (AVNRT).

Methods And Results: We assessed 117 consecutive patients with AVNRT identified during electrophysiological study. Two groups were identified: the AF group, n = 21 (17.

Triple-site biventricular pacing in patients undergoing cardiac resynchronization therapy: a feasibility study.

Aims: To evaluate implantation safety and efficiency of triple-site (double left-single right) cardiac resynchronization therapy (CRT) and to assess the outcome of this procedure.

Methods And Results: Twenty-six patients with New York Heart Association (NYHA) class III-IV, left ventricular ejection fraction (EF) < or = 35%, and QRS > or = 120 ms underwent triple-site CRT. Procedural course and complications were analysed.

Radiofrequency catheter ablation in children and adolescents with preexcitation syndrome.

Background: Atrioventricular reentrant tachycardia (AVRT) is the most common tachycardia, accounting for 70% of regular narrow-QRS arrhythmias in children. Because of the potential disadvantages of a life-long drug therapy and relatively favourable results from radiofrequency catheter ablation (RFCA) therapy in adults, the indications for ablation therapy in children with preexcitation syndrome (PS) need to be considered.

Aim: To assess efficacy and safety of RFCA in children and adolescents with PS.

Triple site biventricular pacing in a patient with congestive heart failure and severe mechanical dyssynchrony.

We report on a case of a 62-year-old patient with symptomatic heart failure and severe ventricular electrical and mechanical dyssynchrony, who was implanted percutaneously with a triple site (dual-left single-right) resynchronization device. At 3-months follow-up, the patient's functional status improved significantly as shown by subjective and objective tests. Furthermore, this mode of pacing has allowed nearly complete inter- and intraventricular mechanical resynchronization.

Influence of reciprocating tachycardia on the development of atrial fibrillation in patients with preexcitation syndrome.

Background: We sought to evaluate the influence of atrio-ventricular reentrant tachycardia (AVRT) on atrial pressures during tachycardia and the presence of atrial fibrillation (AF) in patients with preexcitation syndrome.

Methods: The study population consisted of 88 patients (37 females, mean age 37.3 years) with left-sided accessory pathway and AVRT induced during electrophysiologic study.

Radio-frequency ablation of arrhythmias following congenital heart surgery.

Background: Cardiac arrhythmias as a late complication following congenital heart surgery are encountered more and more frequently in clinical practice. The use of new electrophysiological methods of visualisation and mapping improves the efficacy of radio-frequency (RF) ablation of these arrhythmias.

Aim: To assess patterns of atrial arrhythmias following congenital heart surgery and to examine the efficacy of RF ablation using the electro-anatomical CARTO system.

Effect of percutaneous interventions within the coronary sinus on the success rate of the implantations of resynchronization pacemakers.

Background: Cardiac resynchronization therapy (CRT) becomes a "gold standard" in therapy of selected patients with advanced heart failure. We set out to evaluate the feasibility and safety of percutaneous interventions within coronary sinus (CS) and their effect on the success rate of left ventricular (LV) lead implantation during CRT.

Methods: The study analyzed eight consecutive patients with the indications for CRT, who needed additional procedures within CS to overcome technical problems during left ventricular (LV) electrode implantation.