Laurent Macle

Dormant pulmonary vein conduction revealed by adenosine after ostial radiofrequency catheter ablation.

Introduction: The endogenous nucleoside adenosine is an important intermediate in cellular metabolism, a regulator of function in many organ systems, and a pharmacologic agent with potent electrophysiologic effects. We studied the effects of adenosine on the activation of the pulmonary veins (PVs) after successful ostial isolation in patients with atrial fibrillation (AF).

Laser lead extraction: predictors of success and complications.

Background: Paralleling the rise in pacemaker and defibrillator implantations, lead extraction procedures are increasingly required. Concerns regarding failure and complications remain.

Early Recurrence of Atrial Tachyarrhythmias Following Radiofrequency Catheter Ablation of Atrial Fibrillation

The use of blanking periods, the immediate period postablation during which transient tachyarrhythmia episodes are not considered recurrences, has been predicated on the assumption that not all early recurrences of atrial tachyarrhythmias (ERAT) will lead to later recurrences and, as such, does not necessarily represent treatment failure. While ERAT can be expected to occur in approximately 38% of patients within the first 3 months of atrial fibrillation (AF) ablation, only half of these patients will manifest later recurrences. Clinical features related to the patients history of AF, the index ablation procedure, and particularities of the ERAT can help identify patients at higher risk of later recurrence in whom aggressive attempts to control rhythm, including early cardioversion and reintervention, may be justified. (PACE 2012; 35:106–116)

Morphometric Ablation Lesion Characteristics Comparing 4, 6, and 8 mm Electrode‐Tip Cryocatheters

Introduction: Despite widespread clinical use, ablation lesions produced by cryocatheters with 6 and 8 mm electrode‐tips have not been fully characterized. We, therefore, sought to quantify and compare lesion dimensions and thrombus formation with 4, 6, and 8 mm electrode‐tip cryocatheters.

Laser lead extraction in adult congenital heart disease.

Background: In adults with congenital heart disease (ACHD), lead extraction procedures are expected to parallel increasing transvenous pacemaker and defibrillator implantations. We sought to assess the safety and feasibility of laser lead extraction in ACHD.

Incidence and significance of early recurrences associated with different ablation strategies for AF: a STAR-AF substudy.

Early Recurrence in STAR‐AF.

Adenosine Testing in Atrial Flutter Ablation: Unmasking of Dormant Conduction Across the Cavotricuspid Isthmus and Risk of Recurrence

Adenosine‐induced hyperpolarization may identify pulmonary veins at risk of reconnection following electrical isolation for atrial fibrillation. The potential role of adenosine testing in other arrhythmic substrates, such as cavotricuspid isthmus (CTI)‐dependent atrial flutter, remains unclear. We assessed whether dormant conduction across the CTI may be revealed by adenosine after ablation‐induced bidirectional block, and its association with recurrent flutter.

Blood Pressure and Atrial Fibrillation: A Combined AF-CHF and AFFIRM Analysis.

Hypertension is an established risk factor for new‐onset atrial fibrillation (AF). However, the relationship between blood pressure and recurrent AF is less well understood.

Efficacy of Amiodarone in Patients with Atrial Fibrillation with and without Left Ventricular Dysfunction: A Pooled Analysis of AFFIRM and AF-CHF Trials

Despite amiodarones established safety profile in the setting of heart failure, it is unknown whether its impact on cardiovascular outcomes in patients with atrial fibrillation is modulated by left ventricular function.

Reducing Radiation Exposure During CRT Implant Procedures: Single‐Center Experience With Low‐Dose Fluoroscopy Settings and a Sensor‐Based Navigation System (MediGuide)

Cardiac resynchronization therapy (CRT) implant procedures are often complex and prolonged, resulting in substantial ionizing radiation (IR) exposure to the patient and operator. We assessed the impact of lower‐dose fluoroscopy settings and a sensor‐based electromagnetic tracking system (MediGuide™, MDG) on reducing IR exposure during CRT implantation.