E. Kozluk

Association between Variants on Chromosome 4q25, 16q22 and 1q21 and Atrial Fibrillation in the Polish Population

Background Genome-wide studies have shown that polymorphisms on chromosome 4q25, 16q22 and 1q21 correlate with atrial fibrillation (AF). However, the distribution of these polymorphisms differs significantly among populations. Objective To test the polymorphisms on chromosome 4q25, 16q22 and 1q21 in a group of patients (pts) that underwent catheter ablation of AF. Methods Four hundred and ten patients with AF that underwent pulmonary vein isolation were included in the study. Control group (n = 550) was taken from healthy population, matched for age, sex and presence of hypertension. All participants were genotyped for the presence of the rs2200733, rs10033464, rs17570669, rs3853445, rs6838973 (4q25), rs7193343 (16q22) and rs13376333 (1q21) polymorphisms. Results All the polymorphisms tested (except rs17570669) correlated significantly with AF in univariate analysis (p values between 0.039 for rs7193343 and 2.7e-27 for rs2200733), with the odds ratio (OR) 0.572 and 0.617 for rs3853445 and rs6838973, respectively (protective role) and OR 1.268 to 3.52 for the other polymorphisms. All 4q25 SNPs tested but rs3853445 were independently linked with AF in multivariate logistic regression analysis. In haplotype analysis six out of nine 4q25 haplotypes were significantly linked with AF. The T allele of rs2200733 favoured increased number of episodes of AF per month (p = 0.045) and larger pulmonary vein diameter (recessive model, p = 0.032). Conclusions Patients qualified for catheter ablation of AF have a significantly higher frequency of 4q25, 16q22 and 1q21 variants than the control group. The T allele of rs2200733 favours larger pulmonary veins and increased number of episodes of AF.

The 4q25, 1q21, and 16q22 polymorphisms and recurrence of atrial fibrillation after pulmonary vein isolation.

Introduction The efficacy of pulmonary vein isolation (PVI) in atrial fibrillation (AF) is well documented. Several single nucleotide polymorphisms (SNPs) are associated with AF, mainly in the 4q25 locus, but also in 16q22 and 1q21. The aim of our study was to test the association between those SNPs and short- and long-term results of PVI. Material and methods Patients with AF who underwent PVI between 2006 and 2009 were included in the study. Pulmonary vein isolation was performed using a 4-mm non-irrigated ablation catheter, circular mapping catheter, and the LocaLisa system. All patients were genotyped for the 4q25, 16q22, and 1q21 SNPs. Results Two-hundred and thirty-eight patients were included. The median follow-up was 45 months. Six-month efficacy was 59.7%. None of the polymorphisms was linked with the risk of AF recurrence after 6 months in univariate analysis. In multivariate analysis rs2200733 in the recessive model was linked significantly with AF recurrence (odds ratio 1.87, p = 0.008). None of the polymorphisms predicted AF recurrence in long-term follow-up. Conclusions There is a trend in the relationship between TT genotype of the rs2200733 polymorphism and increased rate of AF recurrence after PVI in short-term (6 months) follow-up. None of the tested SNPs 4q25, 16q22, and 1q21 correlated with the results of a single AF ablation in long-term follow-up.

Safety and efficacy of cryoablation without the use of fluoroscopy

BACKGROUND Development of electroanatomical systems make it possible to perform ablations without the use of fluoroscopy. The aim of this study was to evaluate the efficacy and safety of cryoablation pro-cedures without the use of fluoroscopy. METHODS The study group consisted of 45 patients (14 female; age 36 ± 15 years) treated with cry-oablation using the EnSite electroanatomical system: 10 with ventricular extrasystoly from the right ventricle, 6 with the arrhythmogenic site near the left coronary artery, 17 patients with Wolff-Parkinson- -White syndrome (WPW), 2 patients with atrioventricular nodal reentrant tachycardia (AVNRT) type 2, 7 patients with AVNRT type 1, 3 patients with atrial tachycardia. RESULTS In 38 of the 45 patients (84%) cryoablation procedure was performed without the use of fluoroscopy. Cryoablation efficacy was 78.9%. In 5 patients unsuccessful cryoablation was fallowed by radiofrequency applications. Finally, efficacy reached 92.1%. There were no deaths. In 1 patient a small adverse event - right bundle branch block was observed after ablation of para-Hisian accessory path-way. No other adverse events were observed. In the long term follow-up efficacy was 89.5%. CONCLUSIONS Cryoablation using electroanatomical system without the use of fluoroscopy is a safe and efficient procedure and it is a possible alternative in most patients qualified for cryoablation.

Short-term hemodynamic variability in supine and tilted position in young women

The aim of the study was to evaluate short-term changes in hemodynamic parameters observed in supine and tilted positions. Six young women (age: 21–25) participated in the study. The cardiac inter-beat interval (RR), stroke volume (SV), ejection time (ET) and pre-ejection period (PEP) parameters were followed over two six-minute periods, in supine position and 10 minutes after a 60-degree head-up tilting manoeuvre, using continuously recorded impedance cardiography (ICG) and electrocardiography (ECG) signals. Hemodynamic variability was evaluated using standard deviation (SD), coefficient of variation (CV) and quartile deviation (QD). For the supine position, the mean (M), SD, CV and QD of the observed parameters were as follows. SV: 66 ml, 11 ml, 17.5 %, 16 ml. RR: 878 ms, 100 ms, 11.2 %, 111 ms. ET: 292 ms, 32 ms, 11.4 %, 47 ms. PEP: 115 ms, 15 ms, 13.4 %, 19 ms. In the tilted position, the following were observed. SV: 53 ml, 10 ml, 19.8 %, 12.5 ml. RR: 736 ms, 88 ms, 11.8 %, 74 ms. ET: 252 ms, 30 ms, 11.7 %, 23 ms. PEP: 134 ms, 12 ms, 9 %, 13 ms. The changes in hemodynamic variability caused by tilting are not unidirectional.

Entropy in description of vasovagal syndrome

In this paper we present an example of application of Approximate Entropy and Sample Entropy in analysis of vasovagal syndrome. In our research we conducted an analysis based on three types of data: RRI (RR intervals), SBP (systolic blood pressure) and TPR (total peripheral resistance), which were measured simultaneously with the head up tilt table test (HUTT). The HUTT tests were preformed with Task Force Monitor device. In the tilt test we examined 30 patients recommended to diagnosis of vasovagal syncope (V V S) because of their faint episodes.