Bogdan Muntean

Adaptive servoventilation improves cardiac function in patients with chronic heart failure and Cheyne-Stokes respiration.

Sleep disordered breathing (SDB), especially Cheyne–Stokes respiration (CSR) is common in patients with chronic heart failure (CHF). Adaptive servoventilation (ASV) was recently introduced to treat CSR in CHF. The aim of this study was to investigate the effects of ASV on CSR and CHF parameters.

Cryoballoon Pulmonary Vein Isolation Supported by Intracardiac Echocardiography: Integration of a Nonfluoroscopic Imaging Technique in Atrial Fibrillation Ablation

Intracardiac Echo Supported Cryoballoon Ablation. Introduction: Cryoballoon ablation has been adopted for pulmonary vein (PV) isolation (PVI) in many centers. Complete occlusion of PV by an adequately sized balloon is crucial for effectiveness of cryoenergy delivery. The aim of this study was to evaluate intracardiac echocardiography (ICE) as an alternative imaging technique compared to angiographic imaging in cryoballoon PVI.

Coronary sinus signal amplitude predicts left atrial scarring

Abstract Background: Left atrial scarring is recognised as a critical component in the maintenance of atrial fibrillation and is associated with the failure of interventional treatment. Diminished bipolar voltage (LV) has been proposed as a useful tool for left atrial scar quantification. We hypothesised that, due to its anatomic location, signals on the coronary sinus catheter might be used to predict the amount of left atrial low voltage. Methods and results: A total of 124 patients (42% women, average age 66 ± 9 years) were included. Forty-one with paroxysmal and 83 with persistent atrial fibrillation. Left atrial low-voltage (<0.5 mV, measured during sinus rhythm) area size and distribution varied considerably among the included patients (mean: 34.9%; maximum: 94.6%; minimum: 0.4%). Spearman correlation revealed a strong negative correlation between bipolar voltage of the signals on the coronary sinus catheter and the amount of left atrial scarring (R = −0.778, p < .0001). The optimal CS voltage cut off for prediction of left atrial low-voltage size of ≥50% was 1.9 mV with an area-under-the receiver-operating-characteristic (ROC) curve of 0.982, a sensitivity of 97% and a specificity of 98%. Conclusions: There is a strong negative correlation between the size of left atrial low-voltage areas (LVA) and coronary sinus signal amplitude. With increasing left atrial LVA size, CS signal amplitudes decrease, and vice versa. On the basis of these findings, average CS signal amplitudes of ≤1.9 mV can be used as a predictor for a left atrial low-voltage size of ≥50%.

MAGNETICALLY GUIDED IRRIGATED GOLD-TIP CATHETER ABLATION OF PERSISTENT ATRIAL FIBRILLATION -SAFETY, FEASIBILITY AND OUTCOME IN MID-TERM FOLLOW-UP

Background: Magnetically guided irrigated ablation has been introduced for atrial fibrillation (AF) ablation. However, data on ablation of persistent AF is scarce and first generation platinum-iridium catheters were burdened by char formation at the catheter tip. Furthermore, energy transmission of these catheters may be suboptimal. Irrigated gold-tip catheters have been introduced to overcome these problems

CRYOBALLOON ABLATION OF PAROXYSMAL ATRIAL FIBRILLATION GUIDED BY INTRACARDIAC ECHOCARDIOGRAPHY: PREDICTION OF ACUTE SUCCESS BY A NON-FLUOROSCOPIC IMAGING TECHNIQUE

Background: Cryoballoon ablation has been adopted for pulmonary vein (PV) isolation in many centers. Complete occlusion of PV and adequate balloon size are essential for effectiveness of cryoenergy delivery. Traditionally decision for balloon sizes and confirmation of PV occlusion is based on PV angiography. The aim of this study was to replace repetitive angiographic imaging by intracardiac echocardiography (ICE) and to demonstrate its usefulness for balloon guiding and monitoring of PV peak flow velocity.