Article
Medicine, General & Internal
Yun Young Choi, Jaemin Shim, Yun Gi Kim, Kyongjin Min, Seung-Young Roh, Jin Seok Kim, Jong-Il Choi, Young-Hoon Kim
Summary: Adenosine-induced atrial fibrillation (AIAF) does not affect the long-term recurrence rate after pulmonary vein isolation (PVI). Additional ablation for the trigger site of AIAF does not improve clinical outcomes.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Raphael Rosso, Ehud Chorin, Arie Lorin Schwartz, Yuval Levi, Aviram Hochstadt, Sami Viskin
Summary: Pulmonary vein reconnection is the main cause of atrial fibrillation recurrence. Ablation index-guided procedure using a single transseptal approach can achieve adequate PV isolation and highlight the critical role of the carina in the process.
HEART LUNG AND CIRCULATION
(2021)
Article
Medicine, General & Internal
Jianhua Chen, Quanhe Chen, Feilong Zhang, Xuehai Chen, Zhe Xu, Qiong Jiang, Xudong Sun, Jinguo Li, Lianglong Chen, Weiwei Wang
Summary: This study showed that an enhanced endpoint of PVI after the initial PVI can reduce the long-term recurrence rate of AF for patients with paroxysmal or persistent AF.
INTERNATIONAL JOURNAL OF GENERAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Nandor Szegedi, Milan Vecsey-Nagy, Judit Simon, Balint Szilveszter, Szilvia Herczeg, Marton Kolossvary, Hana Idelbi, Istvan Osztheimer, Vivien Klaudia Nagy, Tamas Tahin, Gabor Szeplaki, Victoria Delgado, Jeroen J. Bax, Pal Maurovich-Horvat, Bela Merkely, Laszlo Geller
Summary: This study found that female sex and ventral-caudal orientation of the right superior pulmonary vein are associated with 24-month atrial fibrillation recurrence rates. Pulmonary vein anatomical variations and ostial parameters were not predictive of atrial fibrillation-free survival.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
(2022)
Article
Physiology
Carlos Fambuena-Santos, Ismael Hernandez-Romero, Ruben Molero, Felipe Atienza, Andreu M. Climent, M. S. Guillem
Summary: This study evaluates the use of ECGI to identify reentries and relate rotor density in the pulmonary vein area as an indicator of PVI outcome in AF patients. The results show a direct relationship between the number of rotors in the pulmonary veins and the recurrence of arrhythmia after PVI.
FRONTIERS IN PHYSIOLOGY
(2023)
Article
Biochemistry & Molecular Biology
Javier Garcia-Seara, Laila Gonzalez Melchor, Javier Rodriguez Garcia, Francisco Gude, Jose Luis Martinez Sande, Moises Rodriguez Manero, Xesus Alberte Fernandez Lopez, Carlos Minguito Carazo, Teba Gonzalez Ferrero, Sonia Eiras, Ricardo Lage, Isabel Moscoso, Sandra Feijoo Bandin, Francisca Lago, Ezequiel Alvarez, Clara V. Alvarez, Jose Ramon Gonzalez Juanatey
Summary: This study aims to determine the predictive value of the sST2 biomarker in atrial fibrillation (AF) recurrence. The results showed that sST2 values at 3 months may provide utility in predicting AF recurrence at 6 months in patients who underwent electrical cardioversion (ECV), but not in patients who underwent pulmonary vein isolation (PVI).
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Cardiac & Cardiovascular Systems
Ekrem Uecer, Carsten Jungbauer, Christian Hauck, Manuel Kaufmann, Florian Poschenreider, Lars Maier, Sabine Fredersdorf
Summary: The study investigated the feasibility of using high power radiofrequency energy for a short duration to isolate pulmonary veins, which was found to shorten procedure time and ablation duration. However, the acute effectiveness of this technique appeared to be lower than expected, indicating a need for further studies to improve its efficacy.
CARDIOLOGY JOURNAL
(2021)
Review
Cardiac & Cardiovascular Systems
Mark J. Mulder, Michiel J. B. Kemme, Cornelis P. Allaart
Summary: Pulmonary vein isolation (PVI) by radiofrequency (RF) ablation is an important treatment option for symptomatic atrial fibrillation. However, the lack of consistent and durable isolation of the pulmonary veins affects the long-term efficacy of PVI procedures. Various surrogate markers of ablation lesion formation have been proposed to improve the efficacy of PVI procedures. Real-time assessment of these markers may help create durable and transmural ablation lesions, reducing the risk of reconnection and recurrence.
Article
Multidisciplinary Sciences
Jongmin Hwang, Seongwook Han, Chun Hwang, Hyoung-Seob Park, Cheol Hyun Lee, In-Cheol Kim, Yun-Kyeong Cho, Jin Wook Chung, Hyuck-Jun Yoon, Hyungseop Kim, Chang-Wook Nam, Seung-Ho Hur, Jin Young Kim, Yun Seok Kim, Woo Sung Jang
Summary: This study evaluated the efficacy of partial antral ablation for pulmonary vein isolation using high-density mapping. Passively-activated segments may represent muscular discontinuity, and partial antral ablation of directly-activated segments was found to be feasible and effective for PVI.
SCIENTIFIC REPORTS
(2021)
Article
Medicine, General & Internal
Julian Mueller, Karin Nentwich, Artur Berkovitz, Kai Sonne, Olena Kozlova, Sebastian Barth, Alexandru Deacanu, Christian Waechter, Philipp Halbfass, Heiko Lehrmann, Thomas Deneke
Summary: This study investigated the characteristics of patients undergoing redo AF ablation and the impact of different ablation strategies. The results showed that pulmonary vein reconnection was common among all techniques of AF ablation, and different ablation strategies did not improve long-term success.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Shibu Mathew, Islam Saboukh, Parminder Singh, Bastian Fries, Victoria Johnson, Nikita Schneider, Christian Fraebel, Ritvan Chasan, Christian W. W. Hamm, Joern Schmitt
Summary: This study investigated the extension of lesions on the posterior wall and roof of the left atrium after cryoballoon-based pulmonary vein isolation. The results showed that significant portions of the posterior wall and LA roof remained unablated after the procedure, potentially contributing to AF recurrence.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Leon Zwimpfer, Stefanie Aeschbacher, Philipp Krisai, Michael Coslovsky, Anne Springer, Rebecca E. Paladini, Marc Girod, Janik Hufschmid, Sven Knecht, Patrick Badertscher, Jurg H. Beer, Leo H. Bonati, Christine S. Zuern, Laurent Roten, Tobias Reichlin, Christian Sticherling, David Conen, Stefan Osswald, Michael Kuhne
Summary: In the Swiss Atrial Fibrillation Cohort study, there was no consistent evidence of an association between pulmonary vein isolation (PVI) and neurocognitive function in atrial fibrillation patients.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Multidisciplinary Sciences
Ji Hyun Chang, Myung-Jin Cha, Jeong-Wook Seo, Hak Jae Kim, So-Yeon Park, Byoung Hyuck Kim, Euijae Lee, Moo-kang Kim, Hye-sun Yoon, Seil Oh
Summary: The study demonstrated the feasibility of PV and LA posterior wall isolation using non-invasive SABR in a canine model, with observed pathological changes in irradiated lesions. While some dogs did not achieve electrical isolation and experienced adverse events, successfully isolated dogs showed transmural fibrotic scarring.
SCIENTIFIC REPORTS
(2021)
Article
Cardiac & Cardiovascular Systems
Hai-yang Xie, Xiao-gang Guo, Jian-du Yang, Yan-qiao Chen, Zhong-jing Cao, Qi Sun, Jian Ma
Summary: The interval between far-field atrial potential and pulmonary vein potential has been identified as a novel and accurate index for predicting the location of conduction gap in the left superior pulmonary vein. An interval of <5 ms is sensitive and specific for predicting the presence of conduction gap in the upper portion of the ostium in patients undergoing AF ablation.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Alvise Del Monte, Alexandre Almorad, Luigi Pannone, Domenico Giovanni Della Rocca, Antonio Bisignani, Cinzia Monaco, Sahar Mouram, Robbert Ramak, Anais Gauthey, Ingrid Overeinder, Gezim Bala, Antonio Sorgente, Erwin Stroker, Juan Sieira, Pedro Brugada, Mark La Meir, Gian-Battista Chierchia, Carlo de Asmundis
Summary: This study aimed to evaluate the midterm clinical outcome and predictors of single-shot pulmonary vein isolation (PVI) with a novel multielectrode radiofrequency balloon catheter (RFB). The study included 104 consecutive patients with a complication rate of 1%. At a mean follow-up of 10.1 months, the freedom from atrial tachyarrhythmias (ATas) was 82.9%. Specific cut-offs of impedance drop and temperature rise may be useful in predicting persistent single-shot isolation.
Article
Cardiac & Cardiovascular Systems
Raja Jayaram, Michael Jones, Svetlana Reilly, Mark J. Crabtree, Nikhil Pal, Nicola Goodfellow, Keshav Nahar, Jillian Simon, Ricardo Carnicer, Ravi DeSilva, Chandana Ratnatunga, Mario Petrou, Rana Sayeed, Andrea Roalfe, Keith M. Channon, Yaver Bashir, Timothy Betts, Michael Hill, Barbara Casadei
Summary: Cardiac surgery and cardiopulmonary bypass have negative effects on atrial nitroso-redox balance, which can be prevented by perioperative atorvastatin treatment. However, it does not significantly impact certain postoperative indicators.
CARDIOVASCULAR RESEARCH
(2022)
Article
Critical Care Medicine
Jonathan P. Bedford, Tessa Garside, Julie L. Darbyshire, Timothy R. Betts, J. Duncan Young, Peter J. Watkinson
Summary: This study used an international expert panel to identify important predictors of new-onset atrial fibrillation (NOAF) risk during critical illness. The results support further research into modifiable risk factors including plasma electrolyte concentrations, rates of change of these electrolytes, fluid balance, choice of vasoactive medications, and the use of preventative medications in high-risk patients.
JOURNAL OF THE INTENSIVE CARE SOCIETY
(2022)
Article
Cardiac & Cardiovascular Systems
Reinoud E. Knops, Willeke van der Stuijt, Peter Paul H. M. Delnoy, Lucas V. A. Boersma, Juergen Kuschyk, Mikhael F. El-Chami, Hendrik Bonnemeier, Elijah R. Behr, Tom F. Brouwer, Stefan Kaab, Suneet Mittal, Anne-Floor B. E. Quast, Lonneke Smeding, Jan G. P. Tijssen, Nick R. Bijsterveld, Sergio Richter, Marc A. Brouwer, Joris R. de Groot, Kirsten M. Kooiman, Pier D. Lambiase, Petr Neuzil, Kevin Vernooy, Marco Alings, Timothy R. Betts, Frank A. L. E. Bracke, Martin C. Burke, Jonas S. S. G. de Jong, David J. Wright, Ward P. J. Jansen, Zachary I. Whinnet, Peter Nordbeck, Michael Knaut, Berit T. Philbert, Jurren M. van Opstal, Alexandru B. Chicos, Cornelis P. Allaart, Alida E. Borger van der Burg, Jude F. Clancy, Jose M. Dizon, Marc A. Miller, Dmitry Nemirovsky, Ralf Surber, Gaurav A. Upadhyay, Raul Weiss, Anouk de Weger, Arthur A. M. Wilde, Louise R. A. Olde Nordkamp
Summary: In this trial, there was no difference in shock efficacy between S-ICD and TV-ICD. Although patients in the S-ICD group were more likely to receive shocks, the total number of appropriate shocks did not differ between the two groups.
Article
Cardiac & Cardiovascular Systems
Michael T. B. Pope, Milena Leo, Andre e Gala, Timothy R. Betts
Summary: SuperMap is a novel non-contact algorithm for mapping organized atrial arrhythmias. It is faster than conventional high-density contact mapping and provides accurate results with a higher number of electrogram points.
Review
Cardiac & Cardiovascular Systems
Roy S. Gardner, Fabio Quartieri, Tim R. Betts, Muhammad R. Afzal, Harish Manyam, Nima Badie, Fady Dawoud, Leyla Sabet, Kevin Davis, Fujian Qu, Kyungmoo Ryu, John Ip
Summary: The study evaluated the clinical impact of selecting only key EGMs for review, finding that it significantly reduced the burden of EGM review and TP days without delaying diagnosis for true arrhythmia patients.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Martin R. Cowie, Andrew Flett, Peter Cowburn, Paul Foley, Badrinathan Chandrasekaran, Ian Loke, Chris Critoph, Roy S. Gardner, Kaushik Guha, Tim R. Betts, Gerry Carr-White, Amir Zaidi, Hoong Sern Lim, Carl Hayward, Ashish Patwala, Dominic Rogers, Stephen Pettit, Carlo Gazzola, John Henderson, Philip B. Adamson
Summary: The COAST study aimed to evaluate the safety, effectiveness, and feasibility of haemodynamic-guided heart failure management using a sensor implanted in the pulmonary artery in NYHA Class III patients. Results showed successful implementation at 14 specialist centres in the UK, significantly reducing hospitalization rates for high-risk patients.
Review
Cardiac & Cardiovascular Systems
Pok-Tin Tang, Mark Davies, Yaver Bashir, Timothy R. Betts, Michala Pedersen, Kim Rajappan, Matthew R. Ginks, Rohan S. Wijesurendra
Summary: This study found that same-day discharge after atrial fibrillation ablation may be an effective and safe strategy, although the available evidence is of low quality and more prospective studies are needed to confirm the findings.
Article
Cardiac & Cardiovascular Systems
Michael T. B. Pope, Pawel Kuklik, Andre Briosa e Gala, Milena Leo, Michael Mahmoudi, John Paisey, Timothy R. Betts
Summary: Adenosine accelerates atrial fibrillation and promotes rotational activation patterns with no impact on focal activation. There is little evidence that rotational activation seen with adenosine represents promising targets for ablation aimed at sites of stable arrhythmogenic sources in the left atrium.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Cardiac & Cardiovascular Systems
Tim R. Betts, Marek Grygier, Jens Erik Nielsen Kudsk, Thomas Schmitz, Marcus Sandri, Gavino Casu, Martin Bergmann, David Hildick-Smith, Thomas Christen, Dominic J. Allocco
Summary: The FLXibility Post-Approval Study collected data on unselected patients implanted with a WATCHMAN FLX in a commercial clinical setting. The study found that the device had excellent procedural success rates, high LAA seal rates, and low rates of thromboembolic events in everyday clinical practice.
Article
Cardiac & Cardiovascular Systems
Timothy R. Betts, Wilson W. Good, Lea Melki, Andreas Metzner, Andrew Grace, Atul Verma, Stephen Murray, Simon James, Tom Wong, Lucas V. A. Boersma, Daniel Steven, Arian Sultan, Sonia Busch, Petr Neuzil, Carlo de Asmundis, Justin Lee, Tamas Szili-Torok
Summary: The RECOVER AF study evaluated the performance of non-contact charge-density mapping to guide the ablation of non-PV targets in persistent AF patients. The study showed that 76% of patients were AF-free at 12 months. For patients who had only received PVI, the AF-free rate was 91%.
Article
Cardiac & Cardiovascular Systems
Jens Erik Nielsen-Kudsk, Sergio Berti, Francesco Caprioglio, Federico Ronco, Dabit Arzamendi, Timothy Betts, Claudio Tondo, Thomas Christen, Dominic J. Allocco
Summary: This study aimed to investigate the efficacy and safety of ICE-guided LAAC with the Watchman FLX device. The results showed that ICE can be successfully used to guide LAAC with the Watchman FLX, with high procedural success, effective LAAC, and minimal complications.
JACC-CARDIOVASCULAR INTERVENTIONS
(2023)
Review
Cardiac & Cardiovascular Systems
Andre Briosa e Gala, Michael Timothy Brian Pope, Milena Leo, Alexander James Sharp, Victor Tsoi, John Paisey, Nick Curzen, Timothy Rider Betts
Summary: This study aims to systematically summarize the feasibility, safety, and efficacy of 'pill-in-the-pocket' oral anticoagulation in AF patients. The results show that pill-in-the-pocket OAC can reduce bleeding complications and provide the same thromboembolic protection as continuous OAC. However, current evidence is insufficient to guide practice, and further studies are needed to improve our understanding of the relationship between AF burden and thromboembolic risk.
ARRHYTHMIA & ELECTROPHYSIOLOGY REVIEW
(2023)
Review
Cardiac & Cardiovascular Systems
Lucas Boersma, Jason G. Andrade, Tim Betts, Mattias Duytschaever, Helmut Purerfellner, Francesco Santoro, Stylianos Tzeis, Atul Verma
Summary: Over the past 25 years, there has been a significant interest in developing new catheters and energy sources to optimize the durability and safety of ablation, as well as studying the mechanisms for atrial fibrillation and devising ablation strategies. Although pulmonary vein ablation has been the basis for every AF ablation, it has been recognized that this is not enough to cure all patients, especially those with non-paroxysmal AF.
Article
Cardiac & Cardiovascular Systems
Zdenek Starek, Andrea Di Cori, Timothy R. Betts, Gael Clerici, Daniel Gras, Evgeny Lyan, Paolo Della Bella, Jingyun Li, Benjamin Hack, Laura Zitella Verbick, Philipp Sommer
Summary: This study aimed to determine correlations between pre-ablation mapping characteristics and 12-month outcomes after a single PVI-only catheter ablation of AF. The results showed that a larger extension of low-voltage area was associated with an increased risk of arrhythmia recurrence. These patients may benefit from substrate modification beyond PVI.
Article
Cardiac & Cardiovascular Systems
Peregrine G. Green, Cristiana Monteiro, David A. Holdsworth, Timothy R. Betts, Neil Herring
Summary: Fusion pacing is maintained during exercise without impairing exercise capacity compared with fixed AV delays. However, using whichever algorithm gives the narrowest QRS duration at rest is associated with a narrower QRS duration during exercise, higher peak stroke volume, and improved cardiac efficiency.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
