Publications by authors named "Roten L"
Background: Either dual antiplatelet therapy or oral anticoagulation in combination with aspirin represent recommended treatment regimens following left atrial appendage closure (LAAC). As the majority of patients receiving LAAC have high bleeding risk, less aggressive antithrombotic treatments are needed, such as single antiplatelet therapy.
Objectives: To compare both ischemic and bleeding outcomes in patients receiving single (SAPT) or dual antiplatelet therapy (DAPT) after successful LAAC.
Background: Early recurrences of atrial tachyarrhythmias (ERATs) after pulmonary vein isolation (PVI) are common. While many correlate to late recurrences (LRs), some do not. The impact of ERATs timing is difficult to assess with noninvasive Holter monitoring because of undersampling.
View Article and Find Full Text PDFPulsed Field Ablation as First-Line Therapy for Atrial Fibrillation: A Substudy of the EU-PORIA Registry.
Circ Arrhythm Electrophysiol
December 2024
Background: Recent studies have demonstrated the benefit of early ablation in preventing the progression of atrial fibrillation (AF). Clinical practice has reflected this shift in AF management and no longer requires patients to fail antiarrhythmic drugs (AADs) before receiving ablation. However, there is limited evidence on outcomes with pulsed field ablation (PFA) as a first-line therapy.
View Article and Find Full Text PDFArticle Synopsis
- Single-shot devices, like the Arctic Front cryoballoon, are becoming popular for pulmonary vein isolation in atrial fibrillation, with a new option, the FARAPULSE pulsed field ablation device, aiming for better safety and effectiveness.
- The SINGLE SHOT CHAMPION trial involves 210 patients with paroxysmal atrial fibrillation randomly assigned to either the FARAPULSE or the cryoballoon treatment, with thorough monitoring for outcomes.
- The study's primary focus is on the first recurrence of atrial tachyarrhythmias within a year after the procedure, alongside safety measures and quality of life assessments.
Article Synopsis
- - The study compared the effects of dexmedetomidine and propofol on heart function in patients undergoing atrial fibrillation ablation, focusing on how each sedative impacts sinus node function and atrioventricular (AV) conduction.
- - A total of 160 patients were enrolled, with findings indicating that patients given dexmedetomidine experienced slower sinus rates and prolonged AV conduction times compared to those given propofol.
- - Despite these differences, both sedatives did not significantly affect certain aspects of heart conduction, such as infrahissian AV conduction and ventricular repolarization, and arrhythmia occurrence was similar across both groups.
Background: Idiopathic ventricular fibrillation (IVF) can be associated with undetected distinct conditions such as microstructural cardiomyopathic alterations (MiCM) or Purkinje (Purk) activities with structurally normal hearts.
Objectives: This study sought to evaluate the characteristics of recurrent VF recorded on implantable defibrillator electrograms, associated with these substrates.
Methods: This was a multicenter collaboration study.
Aims: Atrial fibrillation (AF) ablation and left atrial appendage occlusion (LAAO) are increasingly performed as individual procedures. Pulsed field ablation (PFA) has significantly reduced procedure duration and may be advantageous for the combined approach.
Methods And Results: We have launched a programme for simultaneous AF ablation using PFA and LAAO for patients qualifying for both treatments and excluding those with a complex anatomy.
Background: Atrial fibrillation (AF) and heart failure (HF) coexist, increasing morbidity and mortality. Studies have demonstrated improved outcomes following AF ablation in HF patients with reduced ejection fraction (EF).
Objective: To assess the outcomes of pulsed-field ablation (PFA) in HF.
Background: Atrial fibrillation (AF) and heart failure (HF) coexist, increasing morbidity and mortality. Studies have demonstrated improved outcomes following AF ablation in HF patients with reduced ejection fraction (EF).
Objective: This study sought to assess the outcomes of pulsed field ablation (PFA) in HF.
Background: Pulsed-field ablation (PFA) is a novel nonthermal ablation technology. Its potential value for repeat procedures after unsuccessful thermal ablation for atrial fibrillation has not been assessed.
Objective: The purpose of this study was to summarize our initial experience with patients undergoing repeat procedures using PFA.
Background: Pericardial effusion (PE) is the most common serious left atrial appendage closure (LAAC) complication, but its mechanisms, time course, and prognostic impact are poorly understood.
Objectives: This study sought to assess the frequency, timing, predictors and clinical impact of PE after LAAC.
Methods: Data on consecutive patients undergoing percutaneous LAAC between 2009 and 2022 were prospectively collected including the 1-year follow-up.
Aims: Cardioneuroablation (CNA) is a catheter-based intervention for recurrent vasovagal syncope (VVS) that consists in the modulation of the parasympathetic cardiac autonomic nervous system. This survey aims to provide a comprehensive overview of current CNA utilization in Europe.
Methods And Results: A total of 202 participants from 40 different countries replied to the survey.
Article Synopsis
- Pulmonary vein isolation is an effective treatment for atrial fibrillation, with cryoballoon ablation being superior to medication; the study compares the new PolarX cryoballoon with the existing Arctic Front cryoballoon.
- Patients with symptomatic paroxysmal atrial fibrillation were randomly assigned to receive either cryoballoon treatment and monitored for recurrence of atrial tachyarrhythmias and procedural safety within one year.
- Results showed that the PolarX cryoballoon had a similar effectiveness compared to Arctic Front but caused significantly more cases of phrenic nerve palsies (5% vs. 0%).
Aims: Pacemaker (PM) patients may require a subsequent upgrade to an implantable cardioverter defibrillator (ICD). Limited data exists on this patient population. We sought to characterize this population, to assess predictors for ICD upgrade, and to report the outcome.
View Article and Find Full Text PDFBackground: Recurrence of paroxysmal atrial fibrillation (AF) following pulmonary vein isolation (PVI) is presumably caused by pulmonary vein (PV) reconnections. However, there is little data available on the durability of PVI and incidence of arrhythmia recurrence in patients with persistent AF.
Objectives: The purpose of this study was to evaluate the lesion durability by means of an a priori planned remapping procedure in patients with persistent AF undergoing CLOSE-guided PVI.
Background: Pulsed-field ablation (PFA) has shown promising data in terms of safety and procedural efficiency for pulmonary vein isolation (PVI), with similar long-term outcomes compared to radiofrequency ablation (RFA) and cryoballoon ablation (CBA) in patients with paroxysmal atrial fibrillation (AF).
Objective: The purpose of this study was to compare the procedural and long-term outcomes in patients with persistent AF undergoing PVI using PFA, CBA, or RFA.
Methods: Consecutive patients with persistent AF undergoing first PVI with PFA, CBA, or RFA were included.
Aims: Pulmonary vein isolation (PVI) is increasingly performed in patients with atrial fibrillation (AF). Both AF phenotype and left atrial (LA) volume have been shown to influence ablation outcome. The inter-relationship of the two is incompletely understood.
View Article and Find Full Text PDFArticle Synopsis
- Pulmonary vein isolation (PVI) alone is often inadequate for treating persistent atrial fibrillation, and adding left atrial posterior wall (LAPW) ablation has had mixed results due to concerns about safety and effectiveness.
- This study compares the safety and effectiveness of PVI combined with LAPW ablation versus PVI alone using pulsed-field ablation (PFA) in patients with persistent atrial fibrillation.
- Results show no significant difference in freedom from arrhythmias or major adverse events between the two groups, indicating that adding LAPW ablation may not improve outcomes in this patient population.
Article Synopsis
- Ventricular tachycardia (VT) is a major cause of sudden cardiac death, especially in patients with structural heart conditions, highlighting the need for effective management.
- Catheter ablation has emerged as a safe and effective treatment option for patients experiencing recurrent VT, with existing guidelines outlining when and how to perform the procedure.
- A recent survey by the European Heart Rhythm Association aims to provide insights into various practical aspects of VT management, including procedural techniques and technologies, to establish a clearer understanding of current practices in different medical centers.
Background: Screening for atrial fibrillation (AF) may reveal incidental arrhythmias of relevance. The aim of this study was to describe incidental arrhythmias detected during screening for AF in the STAR-FIB (Predicting SilenT AtRial FIBrillation in Patients at High Thrombembolic Risk) cohort study.
Methods And Results: In the STAR-FIB cohort study, we screened hospitalized patients for AF with 3 repeat 7-day Holter ECGs.
Background: Pulsed-field ablation (PFA) is a novel nonthermal ablation technology with high procedural safety and efficiency for pulmonary vein isolation (PVI). Premarket data showed high PVI durability during mandatory remapping studies. Data on lesion durability in real-world patients with clinically indicated redo procedures are scarce.
View Article and Find Full Text PDFIntroduction: Covert brain infarcts (CBI) are frequent incidental findings on MRI and associated with future stroke risk in patients without a history of clinically evident cerebrovascular events. However, the prognostic value of CBI in first-ever ischemic stroke patients is unclear and previous studies did not report on different etiological stroke subtypes. We aimed to test CBI phenotypes and their association with stroke recurrence in first-ever ischemic stroke patients according to stroke etiology.
View Article and Find Full Text PDFAims: The left atrial posterior wall is a potential ablation target in patients with recurrent atrial fibrillation despite durable pulmonary vein isolation or in patients with roof-dependent atrial tachycardia (AT). Pulsed-field ablation (PFA) offers efficient and safe posterior wall ablation (PWA), but available data are scarce.
Methods And Results: Consecutive patients undergoing PWA using PFA were included.