Face and content validity of the virtual reality simulator 'ScanTrainer®'.

Background: Ultrasonography is a first-line imaging in the investigation of women's irregular bleeding and other gynaecological pathologies, e.g. ovarian cysts and early pregnancy problems.

Gynaecological endoscopic surgical education and assessment. A diploma programme in gynaecological endoscopic surgery.

In recent years, training and education in endoscopic surgery has been critically reviewed. Clinicians, both surgeons as gynaecologist who perform endoscopic surgery without proper training of the specific psychomotor skills, are at higher risk to increased patient morbidity and mortality. Although the apprentice-tutor model has long been a successful approach for training of surgeons, recently, clinicians have recognised that endoscopic surgery requires an important training phase outside the operating theatre.

Gynaecological Endoscopic Surgical Education and Assessment. A diploma programme in gynaecological endoscopic surgery.

In recent years, training and education in endoscopic surgery has been critically reviewed. Clinicians, both surgeons as gynaecologist who perform endoscopic surgery without proper training of the specific psychomotor skills are at higher risk to increased patient morbidity and mortality. Although the apprentice-tutor model has long been a successful approach for training of surgeons, recently, clinicians have recognised that endoscopic surgery requires an important training phase outside the operating theatre.

Diagnosis of arrhythmias in athletes using leadless, ambulatory HR monitors.

Exercise-related palpitations, vertigo, and syncope may be caused by benign etiologies but can also herald life-threatening arrhythmias. The precise diagnosis of these findings is therefore essential and potentially life saving but often is a challenge for sports physicians and cardiologists. Leadless, ambulatory HR monitors with chest strap transmitters have been designed to steer exercise intensity in athletes with a baseline sinus rhythm.

Clinical characteristics and acute results of catheter ablation for outflow tract ventricular tachycardia or premature beats.

Purpose: Contemporary outcome data of catheter ablation for outflow tract tachycardia (OTT) and ventricular premature beats (VPBs) are rare. The aim of this study was to describe the clinical characteristics, the acute procedure success rate, and the long-term survival of patients who underwent an ablation procedure for OTT or VPBs.

Methods: The study was a single-center retrospective cohort study.

Left ventricular diastolic dysfunction in atrial fibrillation: predictors and relation with symptom severity.

Background: Left ventricular diastolic dysfunction (LVDD) is common in the general population, but its prevalence in atrial fibrillation (AF), predictors for LVDD in AF and the association between LVDD and AF-related symptom severity has not been well studied.

Methods: In 124 consecutive patients (mean age 61 ± 11years, 60% male) with paroxysmal (n = 70) or persistent AF (n = 54) referred for AF catheter ablation, LVDD was evaluated according to current guidelines using transthoracic echocardiography. AF-related symptom severity was quantified using the European Heart Rhythm Association score.

Catheter ablation of ventricular tachycardias using remote magnetic navigation: a consecutive case-control study.

Unlabelled: Remote Magnetic Navigation for VT Ablation.

Background: This study aimed to compare acute and late outcomes of VT ablation using the magnetic navigation system (MNS) to manual techniques (MAN) in patients with (SHD) and without (NSHD) structural heart disease.

Methods: Ablation data of 113 consecutive patients (43 SHD, 70 NSHD) with ventricular tachycardia treated with catheter ablation at our center were analyzed.

Flutter ablation with remote magnetic navigation: comparison between the 8-mm tip, the irrigated tip and a manual approach.

Introduction: Remote magnetic navigated ablation has proven its feasibility in a large group of arrhythmias. Until now only scarce data are available on the use for atrial flutter. In this study we compared remote magnetic navigation (RMN), using non-irrigated and irrigated tip catheters, to manual radiofrequency ablation for ablating typical atrial flutter.

The magnetic navigation system allows safety and high efficacy for ablation of arrhythmias.

Aims: We aimed to evaluate the safety and long-term efficacy of the magnetic navigation system (MNS) in a large number of patients. The MNS has the potential for improving safety and efficacy based on atraumatic catheter design and superior navigation capabilities.

Methods And Results: In this study, 610 consecutive patients underwent ablation.

Clinical experience with a novel subcutaneous implantable defibrillator system in a single center.

Background: Implantable cardioverter-defibrillators (ICDs) reduce mortality in both primary and secondary prevention, but are associated with substantial short- and long-term morbidity. A totally subcutaneous ICD (S-ICD) system has been developed. We report the initial clinical experience of the first 31 patients implanted at our hospital.

Hemoptysis after pulmonary vein isolation with a cryoballoon: an analysis of the potential etiology.

In a series of 359 cryoballoon ablations with a complete registry of complications, clinically important hemoptysis requiring readmission was observed in 2 patients. One patient had preexisting bronchiectasis; the other had no previous history of pulmonary disease. In the first patient the guiding wire was very distal in one of the veins and exceptional low freezing temperatures were recorded in the left inferior pulmonary vein.

Long-term follow-up after catheter ablation for atrioventricular nodal reentrant tachycardia: a comparison of cryothermal and radiofrequency energy in a large series of patients.

Background: Radiofrequency (RF) catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT) is highly successful but carries a risk for inadvertent atrioventricular block. Cryoablation (cryo) has the potential to assess the safety of a site before the energy is applied.

Purpose: The aim of this study was to evaluate the long-term efficacy and safety of cryothermal ablation in a large series of patients and compare it to RF.

Cryoablation: how to improve results in atrioventricular nodal reentrant tachycardia ablation?

Ablation for atrioventricular nodal reentry tachycardia is very effective, with a potential for damage to the normal conduction system. Cryoablation is an alternative, as it allows cryomapping, which permits assessment of slow pathway elimination at innocent freezing temperatures, avoiding permanent damage to the normal conduction system. It is associated with shorter radiation times and the absence of heart block in all published data.

A randomized comparison of transseptal and transaortic approaches for magnetically guided ablation of left-sided accessory pathways.

Objectives: Radiofrequency catheter ablation of left-sided accessory pathways (APs) can be performed either by a transseptal (TS) or transaortic (TA) approach. When performed manually, these techniques are equally effective. The aim of this prospective randomized study was to compare these approaches using a magnetic navigation system (MNS) (Niobe, Stereotaxis, St.

Transcranial measurement of cerebral microembolic signals during endocardial pulmonary vein isolation: comparison of three different ablation techniques.

Introduction: Isolation of the pulmonary veins (PVI) using high ablation energy is an effective treatment for atrial fibrillation (AF) with a success rate of 50-95%; however, postoperative neurological complications still occur in 0.5-10%. In this study the incidence of cerebral microembolic signals (MES) as a risk factor for neurological complications is examined during 3 percutaneous endocardial ablation procedure strategies: segmental PVI using a conventional radiofrequency (RF) ablation catheter, segmental PVI using an irrigated RF tip catheter, and circumferential PVI with a cryoballoon catheter (CB).

Initial experience with catheter ablation using remote magnetic navigation in adults with complex congenital heart disease and in small children.

Background: The improved outcomes and increased availability of surgery for congenital heart disease (CHD) over the last three decades have created a small but steadily increasing subset of patients with unique needs: children and adults with complex arrhythmias in the setting of structural cardiac abnormalities. Radiofrequency catheter ablation (RFCA) in these patients, and in small children with normal cardiac anatomy, is effective but challenging. An understanding of specific anatomical and electrophysiological characteristics of these patients and the technical challenges in addressing them are critical to the success of this therapy.

Electro-anatomical mapping of the left atrium before and after cryothermal balloon isolation of the pulmonary veins.

Introduction: The 28 mm cryoballoon catheter is a device used for pulmonary vein isolation (PVI). The aim of this study was to evaluate the extent of the ablation in the antral regions of the left atrium.

Methods And Results: Eighteen patients with drug refractory, symptomatic, paroxysmal AF were enrolled.

One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation.

Aims: Pulmonary vein isolation (PVI) with cryoenergy delivered through a balloon is a new approach in the treatment of atrial fibrillation (AF), but long-term follow-up is lacking. The aim of this study was to provide insight in the success rate and the incidence of recurrences.

Methods And Results: Patients with symptomatic AF despite anti-arrhythmic drugs (AADs) were treated with cryoballoon PVI.

Focal AF-ablation after pulmonary vein isolation in a patient with hypertrophic cardiomyopathy using cryothermal energy.

A 42-year-old man, with a history of hypertrophic cardiomyopathy (HCM), an electrocardiogram pattern of ventricular preexcitation typical for mutations in the PRKAG2 gene, and highly symptomatic paroxysmal drug-resistant atrial fibrillation (AF), underwent successful circumferential isolation of his pulmonary veins using a 28-mm double lumen cryoballoon. Because AF was still inducible with programmed stimulation, fractionated signals were targeted in the left atrium with a conventional cryocatheter. Ablation of an endocardial focus with fractionated potentials at the base of the left appendage terminated the episode and rendered AF noninducible.

Magnetically guided left ventricular lead implantation based on a virtual three-dimensional reconstructed image of the coronary sinus.

Aims: Left ventricular (LV) lead implantation is feasible using remote magnetic navigation of a guidewire (Stereotaxis, St Louis, MO, USA). A novel software that performs a three-dimensional (3D) reconstruction of vessels based on two or more angiographic views has been developed recently (CardiOp-B system, Paeion Inc., Haifa, Israel).

Symptoms versus objective rhythm monitoring in patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation.

Background: Pulmonary vein (PV) ablation is a treatment option for patients with atrial fibrillation (AF). The efficacy of treatment is often assessed by the evaluation of symptoms. However, a high proportion of AF episodes occur in the absence of symptoms as observed in pharmacological treated patients.

Pulmonary vein isolation using an occluding cryoballoon for circumferential ablation: feasibility, complications, and short-term outcome.

Aims: To assess safety, feasibility and short term outcome of pulmonary vein (PV) isolation in paroxysmal atrial fibrillation (AF) with a cryoballoon.

Methods: We consecutively treated 57 patients with a double lumen 23 or 28 mm cryoballoon. The acute results, complications and follow-up over the first three months were analysed, using a comprehensive and intensive follow-up period.

Left ventricular lead implantation assisted by magnetic navigation in a patient with a persistent left superior vena cava.

In a woman with a persistent left superior vena cava and a dilated coronary sinus, a right-sided biventricular ICD implantation was performed assisted by remote magnetic navigation. Intra-cardiac echocardiography was helpful in locating the coronary sinus os.