Publications by authors named "Tamas SziliTorok"

Background: Electrographic flow (EGF) mapping allows for the visualization of global atrial wavefront propagations. One mechanism of initiation and maintenance of atrial fibrillation (AF) is stimulation from EGF-identified focal sources that serve as driver sites of fibrillatory conduction. Electrographic flow consistency (EGFC) further quantifies the concordance of observed wavefront patterns, indicating that a healthier substrate shows more organized wavefront propagation and higher EGFC.

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Background: Dextro-transposition of the great arteries (dTGA) stands out as a prevalent cyanotic congenital heart defect (CHD), characterized by an intricate reversal in the arrangement of the major arteries. In the past, several surgical procedures have been used to treat dTGA, including the atrial switch. Although the method is no longer used, survivors of the procedure still living among us.

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Background: An atrioventricular defibrillator system with a floating atrial dipole (VDD ICD) can provide atrial sensing by a single lead. Our aim was to compare the arrhythmia detection efficacy of VDD ICDs with conventional single- (VVI) and dual-chamber (DDD) defibrillators.

Methods: Data from consecutive patients undergoing ICD implantation were retrospectively analyzed.

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Article Synopsis
  • Atrial tachycardia (AT) often occurs after heart surgeries, and the study explores a new charge density-based mapping system (CDM) for catheter ablation (CA) of post-surgical AT compared to the traditional CARTO method.
  • In a study involving 35 patients, procedural safety and efficiency were similar for both CDM (20 patients) and CARTO (15 patients), with acute success rates of 95% for CDM and 73.3% for CARTO.
  • The findings suggest that using the CDM system results in significantly fewer AT recurrences after treatment (10% for CDM vs. 46.7% for CARTO), indicating its
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Background: Since the Substrate and Trigger Ablation for Reduction of Atrial Fibrillation Trial Part II (STAR-AF II), there has been a trend toward pulmonary vein isolation (PVI)-only ablation strategies for persistent atrial fibrillation (PeAF). Electrographic flow (EGF) mapping can identify active sources of atrial fibrillation (AF) and estimate the electrographic flow consistency (EGFC) of wavefront propagation through substrate, revealing functional AF mechanisms.

Objective: We sought to examine the success of a PVI-only ablation strategy for a redo PeAF/longstanding PeAF population.

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Introduction: Transplant vasculopathy resembles atherosclerotic plaque formation and is a major contributor to late graft failure in kidney transplant recipients (KTR). Remnant lipoproteins and associated triglycerides are causal risk factors for atherosclerotic plaques and have been implicated in late kidney graft failure. However, whether remnants derived from liver (containing apolipoprotein [apo] B100) or intestine (containing apoB48) are clinically more important is unclear.

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Article Synopsis
  • Robotic magnetic navigation (RMN)-guided catheter ablation (CA) technology has been effectively used for nearly 20 years in treating heart rhythm disorders, showing benefits like greater catheter stability and safety.
  • This consensus paper aims to compile current knowledge and offer guidelines on utilizing RMN-guided CA for conditions like atrial fibrillation (AF) and ventricular arrhythmias (VA).
  • The expert group reviewed literature and shared experiences to create a structured set of recommendations, addressing practical aspects of RMN use in clinical settings for optimal patient care.
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Chronic kidney disease (CKD) represents a significant global health challenge, characterized by kidney damage and decreased function. Its prevalence has steadily increased, necessitating a comprehensive understanding of its epidemiology, risk factors, and management strategies. While traditional prognostic markers such as estimated glomerular filtration rate (eGFR) and albuminuria provide valuable insights, they may not fully capture the complexity of CKD progression and associated cardiovascular (CV) risks.

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Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) has emerged as an alternative to transvenous systems for prevention of sudden cardiac death. However, concerns have been raised regarding its efficacy and safety in obese individuals.

Objective: The purpose of this study was to perform a meta-analysis to evaluate the efficacy and safety of the S-ICD in patients with obesity by assessing the relationship between body mass index (BMI) and clinical outcomes.

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Background: To preserve the benefit of atrial sensing without the implantation of an additional lead, a single-lead ICD system with a floating atrial dipole (DX ICD) has been developed. The purpose of this nationwide survey was to provide an overview of the current key influences of device selection focusing on DX ICD and to test the applicability of a previously published decision-making flowchart of ICD-type selection.

Methods: An online questionnaire was sent to all implanting centers in Hungary.

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Background: Electrographic flow (EGF) mapping enables full spatiotemporal reconstruction of organized wavefront propagation to identify extrapulmonary vein sources of atrial fibrillation (AF).

Objectives: FLOW-AF (A Randomized Controlled Study to Evaluate the Reliability of the Ablacon Electrographic FLOW [EGF] Algorithm Technology [Ablamap Software] to Identify AF Sources and Guide Ablation Therapy in Patients With Persistent Atrial Fibrillation) was multicenter, randomized controlled study of EGF mapping to: 1) stratify a nonparoxysmal AF population undergoing redo ablation; 2) guide ablation of these extrapulmonary vein AF sources; and 3) improve AF recurrence outcomes.

Methods: FLOW-AF enrolled persistent atrial fibrillation (PerAF)/long-standing PerAF patients undergoing redo ablation at 4 centers.

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(1) Background: Early reintervention increases the risk of infection of cardiac implantable electronic devices (CIEDs). Some operators therefore delay lead repositioning in the case of dislocation by weeks; however, there is no evidence to support this practice. The aim of our study was to evaluate the impact of the timing of reoperation on infection risk.

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Background: The use of an antibacterial envelope is cost-effective for patients at high risk of developing cardiac implantable electronic device (CIED) infection. The identification of these high-risk patients may be facilitated using a clinical risk score. The aim of the current study is to evaluate the PADIT score for identifying high-risk patients in patients undergoing a CIED procedure in a tertiary academic center.

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Background: Insulin resistance plays an important role in the development of post-transplantation diabetes mellitus (PTDM) in kidney transplant recipients (KTRs). Current methods for the direct determination of insulin resistance are complicated and invasive. Therefore, this study aimed to investigate the relevance of indirect insulin resistance indices in relation to the development of PTDM in KTRs.

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Background: Chronic limb-threatening ischemia (CLTI) is associated with high rates of long-term cardiovascular mortality. Exercise stress testing to detect obstructive coronary artery disease (CAD) can be difficult in this subset of patients due to inability to undergo exercise testing, presence of balanced ischemia and severe coronary artery calcification (CAC).

Aim: To test the feasibility of regadenoson stress dynamic perfusion computed tomography (DPCT) in CLTI patients.

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Introduction: Pulmonary vein isolation (PVI) is a pivotal part of ablative therapy for atrial fibrillation (AF). Currently, there are multiple techniques available to realize PVI, including: manual-guided cryoballoon (MAN-CB), manual-guided radiofrequency (MAN-RF), and robotic magnetic navigation-guided radiofrequency ablation (RMN-RF). There is a lack of large prospective trials comparing contemporary RMN-RF with the more conventional ablation techniques.

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Article Synopsis
  • A novel dipole charge density mapping (DCDM) system was used to visualize a single accessory pathway (AP) with dual atrial insertion sites during catheter ablation in a 43-year-old man with recurrent tachycardia.
  • The DCDM identified two early atrial activation points, confirming the presence of the complex AP structure, leading to successful treatment.
  • This case suggests that accessory pathways may have more complex anatomical variations than previously thought, highlighting the potential for improved mapping techniques in arrhythmia management.
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Background: The presence of an untreated chronic total coronary occlusion (CTO) is associated with a higher risk of ventricular arrhythmias (VAs). This increased risk may be modulated by the presence of an existing scar.

Objectives: To evaluate whether scar size is associated with VA in patients with an implantable cardioverter-defibrillator (ICD) and a CTO.

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Article Synopsis
  • Electrographic flow (EGF) mapping detects active sources of atrial fibrillation (AF) outside the pulmonary veins, aiming to improve classification and treatment of persistent AF based on its underlying causes.
  • The FLOW-AF trial will assess the accuracy of EGF mapping using Ablamap software to identify AF sources in patients with persistent AF who have not had success with previous pulmonary vein isolation.
  • The study involves 85 participants who will be randomly assigned to receive either just pulmonary vein isolation or both pulmonary vein isolation and targeted ablation of identified extravascular AF sources, focusing on safety and effectiveness outcomes.
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Unlabelled: With rising incidence and prevalence of type 2 diabetes, prevention including identification of prospective biomarkers becomes increasingly relevant. Although ketone bodies recently received a renewed interest as potential biomarkers, data linking these metabolites to diabetes risk are scarce. Therefore, the present prospective study investigated a potential association between fasting ketone bodies and incident type 2 diabetes in the general population.

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Background: Catheter ablation (CA) remains challenging due to suboptimal success rates in persistent atrial fibrillation (AF). Existing mapping technologies cannot reliably distinguish sources in this patient population. Recently, the novel electrographic flow (EGF) mapping system was developed using a modified Horn-Schunk optical flow algorithm to detect and quantify patterns of electrical wavefront propagation in the atria.

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Background: Implantable cardioverter-defibrillators (ICDs) are frequently used for primary and secondary prevention in patients with cardiomyopathies due to different etiologies. However, long-term outcome studies in patients with noncompaction cardiomyopathy (NCCM) are scarce.

Objectives: This study summarizes the long-term outcome of ICD therapy in patients with NCCM compared with those with dilated cardiomyopathy (DCM) or hypertrophic cardiomyopathy (HCM).

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Background: Catheter ablation (CA) has become a well-established first-line therapy for a broad spectrum of arrhythmias, including atrial tachycardias (ATs). In this study we aimed to assess the performance of the integrated novel high-resolution new generation noncontact mapping system (AcQMap) with robotic magnetic navigation (RMN) system in CA procedures for patients with ATs including comparing patient subgroups based on the utilized mapping modality, arrhythmia mechanism, localization and type of procedure.

Methods: All patients undergoing CA for AT using the AcQMap-RMN system were included.

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