Long-term prognosis of drug-induced Brugada syndrome.

Background: Patients with drug-induced Brugada syndrome (BS) are considered at a lower risk than those with a spontaneous type I pattern. Nevertheless, they can present arrhythmic events.

Objective: The purpose of this study was to investigate their clinical characteristics, long-term prognosis and risk factors.

[Practical guidelines to ensure the quality of compounded preparations in community pharmacies].

Compounded preparations are an additional therapeutic option besides registered medicines. Because of their <> they have a great value and thus an undeniable place in the therapeutic arsenal available to the physician. To maintain this position, however, they must be of unquestionable quality.

'The role of novel oral anticoagulants in patients undergoing cryoballoon ablation for atrial fibrillation'.

Aim: Peri-procedural thromboembolic (TE) and hemorrhagic events are complications of major concern for patients undergoing cryoballoon (CB) ablation for atrial fibrillation (AF). While peri-procedural anticoagulation management could decrease the incidence of these complications, data on CB ablation are scarce. The role of novel oral anticoagulants (NOACs) has not been thoroughly tested in this population.

Clinical characterisation and long-term prognosis of women with Brugada syndrome.

Objectives: Brugada syndrome (BS) in women is considered an infrequent condition with a more favourable prognosis than in men. Nevertheless, arrhythmic events and sudden cardiac death (SCD) also occur in this population. Long-term follow-up data of this group are sparse.

Phrenic nerve injury during ablation with the second-generation cryoballoon: analysis of the temperature drop behaviour in a large cohort of patients.

Aims: The present study sought to analyse the relationship between the temperature drop during the cryoenergy application and the occurrence of phrenic nerve injury (PNI) in a large cohort of patients having undergone second-generation cryoballoon ablation (CB-A).

Methods And Results: The first 550 consecutive patients having undergone CB-A for atrial fibrillation were enrolled. Attained temperatures at 20, 30, 40, and 60 s during cryoablation in the right-sided pulmonary veins (PVs) were collected.

On the Quest for the Best Freeze: Predictors of Late Pulmonary Vein Reconnections After Second-Generation Cryoballoon Ablation.

Background: The second-generation cryoballoon is effective in achieving acute pulmonary vein isolation (PVI) and favorable clinical outcome. To date, no data are available on factors affecting late PV reconnection after second-generation cryoballoon ablation.

Methods And Results: A total of 29 consecutive patients (25 male, 86.

Asymptomatic Brugada Syndrome: Clinical Characterization and Long-Term Prognosis.

Background: Among Brugada syndrome patients, asymptomatic individuals are considered to be at the lowest risk. Nevertheless, arrhythmic events and sudden cardiac death are not negligible. Literature focused on this specific group of patients is sparse.

One Year Incidence of Atrial Septal Defect after PV Isolation: A Comparison Between Conventional Radiofrequency and Cryoballoon Ablation.

Background: Transseptal (TS) catheterization is needed to access the left heart during pulmonary vein isolation (PVI) procedures. In the radiofrequency (RF) ablation procedure, left atrial access is commonly achieved with a double TS puncture; cryoballoon (CB) ablation usually requires only a single TS puncture. Our aim was to compare the incidence of iatrogenic septal defect (IASD) between double transseptal conventional RF and CB ablation.

Prognostic value of programmed electrical stimulation in Brugada syndrome: 20 years experience.

Background: The prognostic value of electrophysiological investigations in individuals with Brugada syndrome remains controversial. Different groups have published contradictory data. Long-term follow-up is needed to clarify this issue.

Incidence and characteristics of complications in the setting of second-generation cryoballoon ablation: A large single-center study of 500 consecutive patients.

Background: The second-generation cryoballoon Advance (CB-A) recently launched on the market has technical modifications designed to significantly improve procedural outcome with respect to the first-generation device.

Objective: The purpose of this study was to evaluate the overall incidence of complications in a large sample of patients having undergone pulmonary vein (PV) isolation with CB-A technology.

Methods: All consecutive patients who underwent PV isolation procedures using CB-A technology between June 2012 and February 2015 were considered.

Implantable cardioverter-defibrillator therapy in Brugada syndrome: a 20-year single-center experience.

Background: Patients with Brugada syndrome and aborted sudden cardiac death or syncope have higher risks for ventricular arrhythmias (VAs) and should undergo implantable cardioverter-defibrillator (ICD) placement. Device-based management of asymptomatic patients is controversial. ICD therapy is associated with high rates of inappropriate shocks and device-related complications.

Regular atrial tachycardias following pulmonary vein isolation for paroxysmal atrial fibrillation: a retrospective comparison between the cryoballoon and conventional focal tip radiofrequency techniques.

Purpose: Occurrence of atrial tachycardias (ATs) following radiofrequency (RF) pulmonary vein (PV) isolation for the treatment of paroxysmal atrial fibrillation (PAF) is a frequent complication. Cryoballoon (CB) ablation might create more homogeneous and demarcated lesions than traditional point by point RF approach, hypothetically leading to a lower incidence of ATs. Our aim is to compare incidence and mechanism of regular ATs occurring after ablation of PAF by means of circumferential point by point RF vs CB ablation.

P-wave indices as predictors of atrial fibrillation recurrence after pulmonary vein isolation in normal left atrial size.

Aims: Prolonged P-wave duration and dispersion are universally accepted noninvasive markers for atrial electrical remodeling. Our aim was to analyze P-wave indices as predictors of atrial fibrillation recurrence after pulmonary vein isolation in patients with normal left atrial size.

Methods: From January 2008 to December 2011, 426 patients with drug-resistant symptomatic paroxysmal atrial fibrillation underwent pulmonary vein isolation as an index procedure by conventional radiofrequency or cryoballoon ablation in our center.

[Improving the quality of compounded medicines through self-assessment: proof of concept].

A systematic quality control of compounded medicines, and an associated guidance of community pharmacists, was identified as a complementary opportunity to improve and guarantee the quality of compounded medicines. Before implementing this on a national scale, a pilot project was organized. Fifty pharmacies prepared the same formula and had it checked regarding labelling, preparation reports and analytical parameters.

Periprocedural outcomes of prophylactic protamine administration for reversal of heparin after cryoballoon ablation of atrial fibrillation.

Purpose: The aim of this study was to investigate the efficacy and the safety of prophylactic use of protamine in a series of heparinized patients having undergone cryoballoon (CB) ablation for atrial fibrillation (AF).

Methods: From October 2013 to January 2014, 54 consecutive patients received protamine after CB ablation to neutralize unfractionated heparin (UFH) effects. They were prospectively included in this study and compared to a control group of 53 patients who underwent CB ablation without receiving protamine.

Spontaneous and adenosine-induced pulmonary vein reconnection after cryoballoon ablation with the second-generation device.

Introduction: Longer observational time and adenosine challenge have proven to be able to detect pulmonary vein (PV) reconnections. The aim of this study was to assess incidence of spontaneous and adenosine-induced PV reconnection after ablation with second-generation cryoballoon (CB-Adv).

Methods And Results: Fifty consecutive patients (76% male, mean age 60.

One-year follow-up after single procedure Cryoballoon ablation: a comparison between the first and second generation balloon.

Background: With respect to the first generation Cryoballoon (CB), the second generation (Cryoballoon Advance [CB-A], Medtronic, Minneapolis, MN, USA) was designed with technical modifications resulting in a larger and more uniform zone of freezing on the balloon's surface aiming at procedural outcome improvement in the setting of atrial fibrillation (AF) ablation. However, a comparison between both technologies on a midterm follow-up is missing in today's literature.

Methods: A total of 100 patients (the last 50 patients with the first generation CB and the first 50 patients with the second generation CB-A upon its inception in our center) having undergone a single CB ablation for paroxysmal AF (PAF) and having completed a 12-month follow-up, were consecutively included in our study.

Comparison of pulmonary vein isolation using cryoballoon versus conventional radiofrequency for paroxysmal atrial fibrillation.

The aim of this study was to compare the results of pulmonary vein isolation using conventional irrigated radiofrequency (RF) approach versus the cryoballoon (CB) ablation. From January 2008 to December 2011, a total of 426 patients with drug-resistant symptomatic paroxysmal atrial fibrillation underwent pulmonary vein isolation as the index procedure by conventional manual RF or CB ablation at our center. A final population of 396 patients was considered for analysis and divided into 2 groups: conventional RF ablation (n = 260) and CB ablation (n = 136).

The clinical impact of ajmaline challenge in elderly patients with suspected atrioventricular conduction disease.

Background: The effects and the safety of ajmaline challenge in elderly patients with suspected atrioventricular (AV) conduction disease have not been systematically investigated. The purpose of this study was to assess the response of intravenous administration of ajmaline in patients older than 75 years suspected to be affected by AV conduction disease with respect to unmask high-degree His-Purkinje block or the typical Brugada ECG pattern.

Methods: Consecutive patients older than 75 years having undergone in our centre an electrophysiologic study with intravenous ajmaline administration were eligible for this study.

ICD function and dysfunction in patients with arrhythmogenic cardiac diseases: the role of home monitoring.

Background: Since their implementation in clinical practice, remote home monitoring systems (HM) have undoubtedly become an added value in patients with implantable devices for cardiac rhythm management. The aim of this study was to investigate the impact of HM on clinical management and outcome in patients with channelopathies and other arrhythmogenic diseases who received an implantable cardioverter defibrillator (ICD).

Methods: Fifty-four patients (age 6 months--74 years) were followed by means of HM in our ICD clinic.

Pulmonary vein isolation in patients with Brugada syndrome and atrial fibrillation: a 2-year follow-up.

Aims: Pharmacological treatment of atrial fibrillation (AF) in the setting of Brugada syndrome (BS) might be challenging as many antiarrhythmic drugs (AADs) with sodium channel blocking properties might expose the patients to the development of ventricular arrhythmias. Moreover, patients with BS and implantable cardioverter-defibrillator (ICD) might experience inappropriate shocks because of AF with rapid ventricular response. The role of pulmonary vein isolation (PVI) in patients with BS and recurrent episodes of AF has not been established yet.

Residual conduction after pulmonary vein isolation with a circular multielectrode radiofrequency ablation catheter: the role of adenosine and orciprenalin during a prolonged observation time.

Introduction: Recurrences after pulmonary vein isolation (PVI) in patients (pts) with paroxysmal atrial fibrillation (AF) are mostly due to PV reconnection. The effect of adenosine, orciprenalin and their combination on left atrial PV conduction after PVI with a phased radiofrequency (RF) circular multielectrode ablation catheter (Pulmonary Vein Ablation Catheter, PVAC) was prospectively evaluated during a prolonged waiting time. In addition, it was assessed whether pharmacological reconnection characterizes veins requiring use of an irrigated catheter.

Phrenic nerve paralysis during cryoballoon ablation for atrial fibrillation: a comparison between the first- and second-generation balloon.

Background: Phrenic nerve palsy (PNP) is the most frequently observed complication during cryoballoon ablation (CB; Arctic Front, Medtronic, MN) occurring in roughly 7%-9% of the cases. The new second-generation cryoballoon ablation Arctic Front Advance (CB-A) (Arctic Front) has recently been launched in the market.

Objective: To evaluate the incidence of right PNP with the new CB-A in comparison with the first-generation balloon in a series of consecutive patients that underwent pulmonary vein isolation with this modality.

Repeat procedure using radiofrequency energy for recurrence of atrial fibrillation after initial cryoballoon ablation: a 2-year follow-up.

Aims: The ideal energy source needed to perform 're-isolation' of the pulmonary veins (PVs) during a repeat procedure for recurrence of paroxysmal atrial fibrillation (AF) has not been established yet. In this study we analysed the outcome of repeat procedure using radiofrequency (RF) energy after initial cryoballoon (CB) ablation at 2-year follow-up.

Methods And Results: Consecutive patients having undergone PVs isolation as repeat procedure for recurrent AF after an initial CB ablation were eligible for this study.