Tomasz M. Książczyk

Study design and rationale for biomedical shirt-based electrocardiography monitoring in relevant clinical situations: ECG-shirt study

BACKGROUND Today, the main challenge for researchers is to develop new technologies which may help to improve the diagnoses of cardiovascular disease (CVD), thereby reducing healthcare costs and improving the quality of life for patients. This study aims to show the utility of biomedical shirt-based electrocardiography (ECG) monitoring of patients with CVD in different clinical situations using the Nuubo® ECG (nECG) system. METHODS An investigator-initiated, multicenter, prospective observational study was carried out in a cardiology (adult and pediatric) and cardiac rehabilitation wards. ECG monitoring was used with the biomedical shirt in the following four independent groups of patients: 1) 30 patients after pulmonary vein isolation (PVI), 2) 30 cardiac resynchronization therapy (CRT) recipients, 3) 120 patients during cardiac rehabilitation after myocardial infarction, and 4) 40 pediatric patients with supraventricular tachycardia (SVT) before electrophysiology study. Approval for all study groups was obtained from the institutional review board. The biomedical shirt captures the electrocardiographic signal via textile electrodes integrated into a garment. The software allows the visualization and analysis of data such as ECG, heart rate, arrhythmia detecting algorithm and relative position of the body is captured by an electronic device. DISCUSSION The major advantages of the nECG system are continuous ECG monitoring during daily activities, high quality of ECG recordings, as well as assurance of a proper adherence due to adequate comfort while wearing the shirt. There are only a few studies that have examined wearable systems, especially in pediatric populations. TRIAL REGISTRATION This study is registered in ClinicalTrials.gov: Identifier NCT03068169. (Cardiol J 2018; 25, 1: 52-59).

Initial experience of catheter ablation for cardiac arrhythmias in children and adolescents at a newly built ablation centre

BACKGROUND Catheter ablation (CA) therapy is the first-choice treatment in adults with heart rhythm disturbances. Arrhythmias in adults are mainly conditioned by coronary artery disease. Aetiology of arrhythmias in children is mostly associated with inherited heart disorders. According to the current guidelines, CA is widely used in children, indicating the need to make it more achievable in the paediatric population. AIM To assess the efficacy and safety of CA in children with different types of arrhythmias on the initial learning curve at a newly built Ablation Centre in the Independent Paediatric Hospital of the Medical University of Warsaw, Poland. METHODS The study population comprised 32 children with supraventricular tachycardias, asymptomatic pre-excitation syndrome, or ventricular ectopic beats undergoing CA. The mean age of the study population was 14.1 ± 2.4 years. In all patients, electrophysiological study (EPS) and CA were performed. Analysis with respect to procedure duration, fluoroscopy exposure duration, location of accessory pathways (AP), success rate, recurrences, and complications was performed. RESULTS The mean procedure duration was 105.4 ± 41.4 min (range 40-175 min). The mean fluoroscopy duration was 8:34 ± 5:01 min (range 1:28-21:01). The mean exposure to ionising radiation was 4.7 ± 3.2 mcG/kg. EPS revealed signifi¬cantly more frequent presence of AP in the left side (57.1%). The radiofrequency ablation procedure was successful in 26 of 32 (81.3%) children, and cryoablation was successful in two of four patients. In two (6.3%) children minor complications occurred. CONCLUSIONS Catheter ablation may be effectively performed without major complications in the initial phase of the learning curve if a reasonable approach with a gradual increase of the procedural complexity is taken.

Transient complete right bundle branch block following right heart catheterization in children – a report of two cases

Corresponding author: Prof. Bożena Werner MD, PhD, Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 63 A Żwirki i Wigury St, 02-091 Warsaw, Poland, phone: +48 22 317 95 75, e-mail: bozena.werner@wum.edu.pl Accepted: 19.01.2016, accepted: 2.06.2016. Transient complete right bundle branch block following right heart catheterization in children – a report of two cases