Analysis of Electrocardiographic Criteria of Right Ventricular Hypertrophy in Patients with Chronic Thromboembolic Pulmonary Hypertension before and after Balloon Pulmonary Angioplasty.

Background: Chronic thromboembolic pulmonary hypertension (CTEPH) may lead to typical electrocardiographic changes that can be reversed by balloon pulmonary angioplasty (BPA). The aim of this study was to investigate the significance of rarely used electrocardiogram (ECG) parameters, possible electrocardiographic differences between residual and significantly improved CTEPH and the role of electrocardiographic parameters in low mPAP (mean pulmonary arterial pressure) ranges since the mPAP threshold for the definition of pulmonary hypertension has recently been adjusted (≥25 mmHg to >20 mmHg).

Material And Methods: Between March 2014 and October 2020, 140 patients with CTEPH and 10 with CTEPD (chronic thromboembolic pulmonary disease) without pulmonary hypertension (PH) were retrospectively enrolled (12-lead ECG and right heart catheterization before and 6 months after BPA).

Correlation of pulmonary vein reconnection patterns after cryoballoon and duty-cycled ablation of atrial fibrillation with the time of arrhythmia recurrence.

Background: Pulmonary vein isolation (PVI) is safe and effective in the treatment of atrial fibrillation (AF). We compare and correlate pulmonary vein (PV) reconnection patterns at repeat ablation in patients with recurrent AF after PVI using duty-cycled radiofrequency (RF) technology (PVAC) or second-generation cryoballoon (CB) with the time of AF recurrence.

Methods And Results: In total, 85 PVAC and 66 CB patients undergoing a second ablation were enrolled 9.

A modified fluoroscopy protocol to minimize radiation exposure during pulmonary vein isolation with second-generation cryoballoon.

Background: Pulmonary vein isolation (PVI) using second-generation cryoballoon (CB2) is considered to be safe and effective in the treatment of atrial fibrillation (AF). Reported radiation exposure during PVI with CB2 is higher if compared with other technologies. We investigated acute and mid-term effects of a modified fluoroscopy protocol to minimize radiation exposure during CB2 PVI with regard to safety and efficacy.

Uninterrupted use of direct oral anticoagulants versus vitamin K antagonists for catheter ablation of atrial fibrillation with PVAC gold: incidence of silent cerebral microembolic events.

Background: Silent cerebral microembolic events (SCE) after duty-cycled ablation of atrial fibrillation using PVAC have been detected by cerebral magnet resonance imaging (MRI) in a substantial number of patients. The purpose of this study was to investigate if uninterrupted oral anticoagulation with non-vitamin K antagonists (NOACs) compared with vitamin K antagonists (VKA) affects the incidence of SCE after pulmonary vein isolation (PVI) using PVAC Gold.

Methods: Eighty-four consecutive patients (62 ± 15 years, 58% male) undergoing a first PVI were prospectively enrolled.

Is the time of atrial fibrillation recurrence after cryoballoon ablation of paroxysmal atrial fibrillation influenced by the pattern of PV reconnections?

Background: Pulmonary vein isolation (PVI) with 2nd-generation cryoballoon (CB) has been shown to be effective in the treatment of paroxysmal atrial fibrillation (AF). We describe pulmonary vein (PV) reconnection at repeat ablation in patients with AF recurrence after CB PVI and analyze the correlation between the time of AF recurrence and the observed PV reconnection patterns.

Methods: Sixty-six patients undergoing a redo PVI for recurrent AF were enrolled 9.

Is the Time of Atrial Fibrillation Recurrence After Duty-Cycled Radiofrequency Ablation Affected by the Pattern of Pulmonary Vein Reconnections?

Background: Pulmonary vein isolation (PVI) with multielectrode duty-cycled radiofrequency (PVAC) has been shown to be effective in the treatment of atrial fibrillation (AF). We describe pulmonary vein (PV) reconnection at repeat ablation in patients with AF recurrence after PVAC PVI and analyze the correlation between the time of AF recurrence and the observed PV reconnection patterns.

Methods: Eighty-five patients undergoing a redo PVI for recurrent AF 9.

Comparison of pulmonary vein reconnection patterns after multielectrode phased radiofrequency- and cryoballoon ablation of atrial fibrillation.

Background: Pulmonary vein isolation (PVI) using phased radiofrequency (RF) energy has been shown to be effective in the treatment of atrial fibrillation (AF).

Methods: We characterize and compare pulmonary vein (PV) reconnection at repeat ablation in patients with AF after initially successful PVI using phased RF technology (PVAC) or 2nd generation cryoballoon (CB). Eighty five patients undergoing redo PVI using multielectrode PVAC phased RF catheter and 66 patients after CB PVI were enrolled 9.

A subvalvular catheter approach for radiofrequency ablation of right-sided accessory pathways.

Background: Conventional catheter ablation of right-sided accessory pathways (RAPs) can be challenging.

Objective: To determine if a subvalvular catheter approach for RAPs targeting the ventricular insertion site, as on the left side, can improve catheter stability and tissue contact and thus increase acute and chronic ablation success rates.

Methods And Results: We retrospectively compared 22 patients (pts) with conventional catheter ablation of RAPs (group 1) with 9 consecutive pts (group 2) undergoing catheter ablation of a RAP using a subvalvular catheter approach targeting the ventricular site of AP.

Incidence of early pulmonary vein reconnections using different energy sources for pulmonary vein isolation: Multielectrode phased radiofrequency vs second-generation cryoballoon.

Objective: To determine and compare the incidence of early recurrence of conduction after pulmonary vein isolation (PVI) using two different ablation technologies: phased radiofrequency by a multipolar ablation catheter (PVAC) and cryo-ablation by a second-generation cryoballoon (CB).

Methods And Results: Two hundred patients (pts) with atrial fibrillation underwent PVI with PVAC (Group 1) or CB (Group 2), with 100 pts in each group. The incidence of PV reconnection (PVR) for each vein was examined in both groups at least 30 minutes after successful PVI.

Follow-Up (Measurement) of Corrected QT Interval in Adult Patients before and after Lung Transplantation.

Background: Prolongation of the corrected QT (QTc) interval is well known for many drugs, some of which are an integral part of the therapeutic regimen after lung transplantation (LTX). Therefore, we investigated the QTc interval after LTX in the present study.

Patients And Methods: The medical records of patients after LTX were studied for demographic data, indication of LTX, medication, and baseline and follow-up ECGs.

Is there a prognostic relevance of electrophysiological studies in bundle branch block patients?

Background: The present European guidelines suggest a diagnostic electrophysiological (EP) study to determine indication for cardiac pacing in patients with bundle branch block and unexplained syncope. We evaluated the prognostic relevance of an EP study for mortality and the development of permanent complete atrioventricular (AV) block in patients with symptomatic bifascicular block and first-degree AV block.

Hypothesis: The HV interval is a poor prognostic marker to predict the development of permanent AV block in patients with symptomatic bifascicular block (BFB) and AV block I°.

Prognostic Relevance of Nonsustained Ventricular Tachycardia in Patients with Pulmonary Hypertension.

Increased pulmonary vascular resistance in patients with pulmonary hypertension (PH) leads to an increased afterload of right heart and cardiac remodeling which could provide the substrate or trigger for arrhythmias. Supraventricular arrhythmias were associated with clinical deterioration but were not associated with sudden cardiac death (SCD). SCD has been reported to account for approximately 30% of deaths in patients with pulmonary arterial hypertension (PAH).

Contraindications for video capsule endoscopy.

Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality.

Evaluation of the prognostic value of electrocardiography parameters and heart rhythm in patients with pulmonary hypertension.

Background: Several studies have analyzed arrhythmias in patients with pulmonary hypertension (PH) and increased P-wave duration was identified as a risk factor for development of atrial fibrillation (AF).

Methods: We retrospectively analyzed the incidence of arrhythmias in patients with an initial diagnosis of PH during long-term follow-up and assessed the prognostic value of electrocardiography (ECG) data. Data from 167 patients were analyzed (Dana Point Classification: Group 1: 59 patients, Group 2: 28 patients, Group 3: 39 patients, Group 4: 41 patients).

Transient Elimination of Posterior Right Ventricular Outflow Tract Ectopy by Sternal Pressure.

Background: Ventricular ectopy (VE) originating in the right ventricular outflow tract (RVOT) is a common arrhythmia. Mechanisms triggering or eliminating VE from RVOT are not entirely understood.

Methods And Results: A patient with frequent, symptomatic VE underwent an electrophysiologic study: VE origin was mapped by NavX 3D navigation (St.

Usefulness of N-acetylcysteine or ascorbic acid versus placebo to prevent contrast-induced acute kidney injury in patients undergoing elective cardiac catheterization: a single-center, prospective, randomized, double-blind, placebo-controlled trial.

Background: Contrast-induced acute kidney injury (CI-AKI) is a serious complication of procedures requiring contrast media associated with rising costs, prolonged hospitalization, and increased mortality. The aim of this study was to assess whether prophylactic administration of standard dosages of intravenous N-acetylcysteine or ascorbic acid reduce the incidence of CI-AKI in patients with chronic renal insufficiency undergoing elective cardiac catheterization.

Methods: In a single-center, prospective, randomized, double-blind, placebo-controlled trial, the preventive effects of N-acetylcysteine and ascorbic acid were evaluated in 520 patients with chronically impaired renal function (serum creatinine ≥1.

Does the number of simultaneously activated electrodes during phased RF multielectrode ablation of atrial fibrillation influence the incidence of silent cerebral microembolism?

Background: Asymptomatic cerebral embolus (ACE) detected by diffusion-weighted magnetic resonance imaging (DW-MRI) following atrial fibrillation (AF) ablation has been reported at varying rates with different ablation techniques.

Objective: To evaluate the incidence of ACE after phased radiofrequency ablation for AF with procedural modifications that potentially reduce the embolic load.

Methods: One hundred twenty consecutive patients with AF underwent MRI before ablation, 24 hours after ablation, and at 4-6 weeks.

Right atrial tachycardias related to regions of low-voltage myocardium in patients without prior cardiac surgery: catheter ablation and follow-up results.

Aims: There are only few descriptions of patients without prior cardiac surgery in whom a large low-voltage zone (LVZ) or scar is the electrophysiological substrate for various atrial tachycardias. We describe the electrophysiological and electroanatomic characteristics of unusual macroreentrant atrial tachycardias (MRATs) in seven patients with spontaneous right atrial (RA) scarring and present long-term follow-up results.

Methods And Results: In 7 of 326 patients with MRAT treated with radiofrequency ablation we detected regions of RA spontaneous LVZ or scarring during conventional mapping of the arrhythmia.

Investigation into causes of abnormal cerebral MRI findings following PVAC duty-cycled, phased RF ablation of atrial fibrillation.

Introduction: Left atrial catheter ablation of the pulmonary veins (PVs) is an established option for patients with atrial fibrillation (AF). Asymptomatic cerebral emboli (ACE) detected by diffusion weighted MRI (DW-MRI) following AF ablation has been reported at varying rates. This variability may be linked to procedural variables and demographic risk factors.

Pulmonary vein re-isolation for atrial fibrillation using duty-cycled phased radiofrequency ablation: safety and efficacy of a primary 2:1 bipolar/unipolar ablation mode.

Purpose: Pulmonary vein isolation (PVI) using phased radiofrequency (RF) energy has been shown to be effective in the treatment of paroxysmal atrial fibrillation (AF). We characterize pulmonary vein (PV) conduction at repeat ablation in patients with AF after an initial successful PVI using phased RF technology and analyze the effects of a primary 2:1 ablation mode.

Methods And Results: A primary 4:1 bipolar/unipolar mode in group A patients (n = 22) was compared with a primary 2:1 mode in group B (n = 22) acutely and during follow-up.

Capsule Endoscopy in Patients with Cardiac Pacemakers and Implantable Cardioverter Defibrillators: (Re)evaluation of the Current State in Germany, Austria, and Switzerland 2010.

Background and Aims. The study was a repeated evaluation of the experience of capsule endoscopy (CE) in patients with cardiac pacemaker or implantable cardioverter defibrillator (ICD). Patients and Methods.

Capsule endoscopy in patients with cardiac pacemakers, implantable cardioverter defibrillators, and left heart devices: a review of the current literature.

Background and Study Aims. Capsule endoscopy is an established tool for investigation of the small intestine. Because of limited clinical experience in patients with cardiac devices, the Food and Drug Administration and the manufacturer recommended not to use capsule endoscopy in these patients.

Capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter-defibrillators - a retrospective multicenter investigation.

Background & Aims: Capsule endoscopy (CE) is an established tool for the investigation of the small intestine. The Food and Drug Administration, Given Imaging and Olympus have not recommended the use of capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators (ICDs). The aim of this retrospective study was to investigate the safety of capsule endoscopy systems (Given Imaging and Olympus) when applied in patients with different types of pacemakers/ICDs in vivo.

Catheter ablation of non-sustained focal right atrial tachycardia guided by virtual non-contact electrograms.

Aims: Conventional mapping and catheter ablation of non-sustained focal atrial tachycardia (AT) can be challenging and time consuming. We examined the characteristics and clinical outcomes after catheter ablation of recurrent, sustained AT presenting as non-sustained tachycardia during electrophysiological studies (EPSs), using a non-contact mapping system.

Methods And Results: In 9 of 88 consecutive patients undergoing ablation of sustained right AT, the tachycardia was non-sustained during EPSs, precluding conventional mapping.