Esophageal safety in CLOSE-guided 50 W high-power-short-duration pulmonary vein isolation: The PREHEAT-PVI-registry.

Introduction: Pulmonary vein isolation (PVI) using high-power-short-duration (HPSD) radiofrequency ablation (RF) is emerging as the standard of care for treatment of atrial fibrillation (AF). While procedural short-term to midterm efficacy and efficiency are very promising, this registry aims to investigate esopahgeal safety using an optimized ablation approach.

Methods: In a single-center experience, 388 consecutive standardized first-time AF ablation were performed using a CLOSE-guided-fixed-50 W-circumferential PVI and substrate modification without intraprocedural esophageal temperature measurement.

Short term outcome after left atrial appendage occlusion with the AMPLATZER Amulet and WATCHMAN device: results from the ORIGINAL registry (saxOnian RegIstry analyzinG and followINg left atrial Appendage cLosure).

Background: Various randomized multicenter studies have shown that percutaneous left atrial appendage closure (LAAC) is not inferior in stroke prevention compared to vitamin K antagonists (VKA) and can be performed safely and effectively.

Aims: The prospective multicenter ORIGINAL registry in the Free State of Saxony (saxOnian RegIstry analyzinG and followINg left atrial Appendage cLosure) investigated the efficiency and safety of LAAC with Watchman or Amulet device in a real word setting. A special focus was put on the influence of LAAC frequency on periprocedural efficiency and safety.

Reconnection patterns after CLOSE-guided 50 W high-power-short-duration circumferential pulmonary vein isolation and substrate modification-PV reconnection might no longer be an issue.

Introduction: Ablation of atrial fibrillation (AF) with high-power-short-duration (HPSD) radiofrequency (RF) technology is emerging as a new standard of care in many electrophysiology laboratories. While procedural short-term efficacy and efficiency is very promising, little is known about mid- to long-term effects of HPSD ablation for pulmonary vein isolation (PVI) and left atrial substrate modification.

Methods: In a single-center registry, 412 AF procedures were performed in 400 individual patients using a standardized CLOSE protocol-guided fixed 50 W HPSD ablation, aiming for an ablation index (AI) of 400 on the posterior and 550 on the anterior wall.

Comparison of uninterrupted direct oral anticoagulation with vitamin-K antagonists during AF-ablation in the clinical routine. A single center register.

Background: Uninterrupted direct oral anticoagulation (DOAC) in AF-ablation is recommended, proven by randomized trials. The outcome and the periinterventional differences between DOACs and VKA in the real world clinical practice are discussed controversial.

Hypothesis: To investigate efficiency and safety of uninterrupted DOAC therapy compared to VKA during AF-Ablation in real world setting with a focus on periinterventional heparin dosage.

Procedural efficacy and safety of standardized, ablation index guided fixed 50 W high-power short-duration pulmonary vein isolation and substrate modification using the CLOSE protocol.

Introduction: Ablation index (AI)-guided ablation according to the CLOSE protocol is very effective in terms of chronic pulmonary vein isolation (PVI). However, the optimal radiofrequency (RF) power remains controversial. Here, we thought to investigate the efficiency and safety of an AI-guided fixed circumferential 50 W high-power short-duration (HPSD) PVI using the CLOSE protocol.

Simple periprocedural precautions to reduce Doppler microembolic signals during AF ablation.

Background: Doppler microembolic signals (MES) occur during atrial fibrillation ablation despite of permanent flushed transseptal sheaths, frequent controls of periprocedural coagulation status and the use of irrigated ablation catheters PURPOSE: To investigate the number and type of MES depending on the procedure time, prespecified procedure steps, the activated clotting time (ACT) during the ablation procedure and the catheter contact force.

Methods: In a prospective trial, 53 consecutive atrial fibrillation patients underwent pulmonary vein isolation by super-irrigated "point-by-point" ablation. All patients underwent a periinterventional, continuous transcranial Doppler examination (TCD) of the bilateral middle cerebral arteries during the complete ablation procedure.

The effects of interventional mitral valve repair using the MitraClip System on the results of pulmonary function testing, pulmonary pressure and diffusing capacity of the lung.

Background: The study analyzes changes in lung function, pulmonary pressure and diffusing capacity of the lung in patients with mitral valve regurgitation (MR) treated by MitraClip implantation.

Methods: A total of 43 patients (19 women and 24 men with an average age of 78.0 ± 6.

Soluble ST2 and myocardial fibrosis in 3T cardiac magnetic resonance.

Objective: The soluble form of ST2 (sST2) is a novel laboratory parameter for cardiac risk prediction, and over the past years, several studies have tried to evaluate its utility, especially in the management of heart failure. We investigated whether increased serum levels of sST2 show a characteristic pathomorphologic pattern in 3-Tesla cardiac magnetic resonance imaging (CMRI).

Methods: One hundred and fifty-six patients referred to 3T CMRI due to suspected coronary artery disease (CAD) or myocarditis were prospectively enrolled in the study.

Evaluation of heart involvement in calpainopathy (LGMD2A) using cardiovascular magnetic resonance.

Introduction: Cardiac dysfunction occurs in several forms of limb girdle muscular dystrophy (LGMD). The aim of this study was to investigate cardiac involvement in calpainopathy (LGMD2A).

Methods: Cardiovascular evaluation was performed in 10 patients with genetically verified LGMD2A by echocardiography, 3 Tesla - cardiovascular magnetic resonance, 24-h electrocardiography recordings with heart rate variability (HRV) analysis, and 24-h blood pressure recordings.

3-T magnetic resonance for determination of aortic valve area: a comparison to echocardiography.

Objectives: For evaluation of aortic valve area (AVA), transthoracic echocardiography (TTE) is the method of choice. Cardiac magnetic resonance (CMR) at 1.5-Tesla is an alternative.

Right ventricular reduction for repair of functional tricuspid valve regurgitation: one-year follow up.

Background And Aim Of The Study: The study aim was to assess the impact of reducing the right ventricular (RV) cavity in order to optimize the outcome of tricuspid valve (TV) repair in cases of functional tricuspid regurgitation (FTR) with dilated right ventricle.

Methods: Between May 2007 and February 2010, a total of 17 patients (six males, 11 females; mean age 69.5 +/- 10.

Time-resolved magnetic resonance imaging of contrast kinetics to identify severe tricuspid valve regurgitation.

Introduction: The gold standard for identifying and grading tricuspid valve regurgitation is transthoracic echocardiography. However, the acoustic window using transthoracic echocardiography is not always sufficient to quantify the amount of regurgitation. Time-resolved imaging of contrast kinetics (TRICKS) is a 4-dimensional magnetic resonance angiography option with high spatial and temporal resolution.

Influence of adenosine on ventricular function measurements as part of a comprehensive stress perfusion magnetic resonance imaging study.

Background: Stress-rest perfusion magnetic resonance imaging (MRI) has become one of the major indications for cardiovascular MRI. Standard multibreath hold short-axis image acquisition is the gold standard for LV function assessment and part of a comprehensive stress-rest perfusion MRI study, but takes up to 10 min. The total scan time could significantly be shortened when cine imaging would be performed between stress and rest perfusion.

Influence of the trigger technique on ventricular function measurements using 3-Tesla magnetic resonance imaging: comparison of ECG versus pulse wave triggering.

Background: Three Tesla cardiovascular magnetic resonance imaging (3T-CMR) is increasingly used in clinical practice. Despite many advantages one drawback is that ECG signal disturbances and artifacts increase with higher magnetic field strength resulting in trigger problems and false gating. This particularly affects cardiac imaging because most pulse sequences require ECG triggering.

Correlation of heart-type fatty acid-binding protein with mortality and echocardiographic data in patients with pulmonary embolism at intermediate risk.

Background: The management strategy in patients presenting with pulmonary embolism at intermediate risk still remains controversial. Our aim was to determine the role of heart-type fatty acid-binding protein (H-FABP) in this patient population.

Methods: One hundred one consecutive patients with confirmed pulmonary embolism and echocardiographic signs of right ventricular overload but without evidence for hypotension or shock, referred to as pulmonary embolism at intermediate risk, were included in the study.

Interatrial septal closure devices and aortic perforation: a note of caution.

Percutaneous defect closure is well established in patients with a symptomatic patent foramen ovale (PFO). Despite a safe interventional procedure, severe complications have been described during device implantation or follow up. Two patients are described whose cases may serve to warn of an unusual complication associated with a closure device.

Nomograms for severity of aortic valve stenosis using peak aortic valve pressure gradient and left ventricular ejection fraction.

Aims: Continuity equation to evaluate aortic valve area (AVA(CE)) is critically dependent on accurate measurement of left ventricular outflow tract diameter and velocity. To circumvent these limitations, the present study aimed to generate nomograms for a facilitated estimation of aortic valve area using peak aortic valve pressure gradient (DeltapAv) and left ventricular ejection fraction (LVEF).

Methods And Results: Two hundred and fifty-five subjects with non-invasively and invasively defined aortic valve stenosis (AS) formed the basis of this study.

Nitric oxide synthases are crucially involved in the development of the severe cardiomyopathy of caveolin-1 knockout mice.

Targeted ablation of caveolin-1 (cav-1) results in a severe cardiomyopathy. How the loss of cav-1 mediates these abnormalities is currently under investigation. Mounting evidence indicates that cav-1 acts as a negative regulator of endothelial nitric oxide synthase resulting in a constitutive hyperactivation of the nitric oxide (NO)-pathway in cav-1 knockout mice (cav-1 ko).

Levosimendan is superior to enoximone in refractory cardiogenic shock complicating acute myocardial infarction.

Objective: Cardiogenic shock is the leading cause of death in patients hospitalized for acute myocardial infarction. The objectives were to investigate the effects of levosimendan, a novel inodilator, compared with the phosphodiesterase-III inhibitor enoximone in refractory cardiogenic shock complicating acute myocardial infarction, on top of current therapy.

Design: Prospective, randomized, controlled single-center clinical trial.

Right ventricular reduction as an adjunct procedure in tricuspid valve repair.

Functional tricuspid regurgitation secondary to mitral valve disease can not be attributed to the dilatation of the tricuspid annulus alone. Furthermore, geometrical changes of the right ventricle lead to tethering of the tricuspid valve leaflets and thereby to an incomplete leaflet coaptation. With this pathologic entity, conventional isolated tricuspid valve annuloplasty will presumably result in significant residual tricuspid regurgitation.

Protein kinase C in the human heart: differential regulation of the isoforms in aortic stenosis or dilated cardiomyopathy.

Objectives: Protein kinase C (PKC) is a central enzyme in the regulation of growth and hypertrophy. Little was known on PKC isoform regulation in human heart. Goal of this study was to characterize the isoforms of protein kinase C in human heart, their changes during ontogenesis, and their regulation in myocardial hypertrophy and heart failure.