Publications by authors named "William Ginks"
Background: Many patients with persistent atrial fibrillation (PsAF) have progressed from an initial paroxysmal phenotype; however, there are patients in whom atrial fibrillation (AF) is persistent at diagnosis. Relatively little is known about this subgroup, but prior observational studies have suggested these patients have worse outcomes with ablation.
Objectives: This study sought to: 1) assess demographic and electrophysiologic characteristics of patients with PsAF at first diagnosis compared with those with who have progressed from paroxysmal atrial fibrillation (PAF); and 2) assess the impact of pattern of AF at diagnosis on recurrence post ablation.
Background And Aims: Posterior wall isolation (PWI) is commonly incorporated into catheter ablation (CA) strategies for persistent atrial fibrillation (AF) in an attempt to improve outcomes. In the CAPLA randomized study, adjunctive PWI did not improve freedom from atrial arrhythmia at 12 months compared with pulmonary vein isolation (PVI) alone. Whether additional PWI reduces arrhythmia recurrence over the longer term remains unknown.
View Article and Find Full Text PDFDiagnosis to Ablation in Persistent AF: Any Time Can Be a Good Time to Ablate.
JACC Clin Electrophysiol
July 2024
Article Synopsis
- A study was conducted to evaluate how the time from diagnosis to catheter ablation (DAT) affects the recurrence of atrial fibrillation (AF) in patients.
- The trial involved 334 patients divided into quartiles based on their DAT, with results showing varying AF recurrence rates; longer DAT generally correlated with higher recurrence.
- Despite this trend, overall quality of life improved significantly for all patients, indicating positive outcomes regardless of the length of the DAT, with only the longest DAT group showing a statistically significant risk of recurrence.
Article Synopsis
- This study analyzes patterns of atrial fibrillation (AF) recurrence in patients with persistent AF (PsAF) after catheter ablation, revealing that nearly half of participants experienced recurrence within 12 months.
- Findings show that most recurrences were paroxysmal rather than persistent, and patients with PsAF faced higher healthcare costs and lower quality of life.
- The study highlights the impact of AF recurrence on health outcomes, emphasizing the need for effective strategies to manage recurrent PsAF post-ablation.
Background: Sex-specific outcomes after catheter ablation (CA) for atrial fibrillation (AF) have reported conflicting findings.
Objective: We examined the impact of female sex on outcomes in patients with persistent AF (PsAF) from the Catheter Ablation for Persistent Atrial Fibrillation: A Multicentre Randomized Trial of Pulmonary Vein Isolation vs PVI with Posterior Left Atrial Wall Isolation (CAPLA) randomized trial.
Methods: A total of 338 patients with PsAF were randomized to pulmonary vein isolation (PVI) or PVI with posterior wall isolation (PWI).
Importance: Catheter ablation for patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) is associated with improved left ventricular ejection fraction (LVEF) and survival compared with medical therapy. Nonrandomized studies have reported improved success with posterior wall isolation (PWI).
Objective: To determine the impact of pulmonary vein isolation (PVI) with PWI vs PVI alone on outcomes in patients with HFrEF.
Article Synopsis
- A new study assessed the safety and effectiveness of high power short duration (HPSD) ablation for pulmonary vein isolation (PVI) in patients with atrial fibrillation, using a novel Qdot Micro catheter.
- Results showed that HPSD ablation achieved first pass isolation in 72.3% of patients and had significantly shorter procedure times and lower rates of pulmonary vein reconnection compared to traditional methods.
- The findings suggest HPSD ablation is a promising and safe option for PVI, though further validation through randomized controlled trials is recommended.
Introduction: Hypertrophic cardiomyopathy (HCM) patients with left ventricular (LV) mid-cavity obstruction (LVMCO) often experience severe drug-refractory symptoms thought to be related to intraventricular obstruction. We tested whether ventricular pacing, guided by invasive haemodynamic assessment, reduced LVMCO and improved refractory symptoms.
Methods: Between December 2008 and December 2017, 16 HCM patients with severe refractory symptoms and LVMCO underwent device implantation with haemodynamic pacing study to assess the effect on invasively defined LVMCO gradients.