Wyniki wyszukiwania - Biblioteka Nauki

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His bundle pacing in patients with permanent atrial fibrillation and heart failure with non-reduced ejection fraction – retrospective study

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Skonieczny B. , Sławuta A. , Radziejewska J. , Jagielski D. , Gajek J. , Kozłowski D.

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2023

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tom 6

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nr 2

45-50

EN

Background: Heart failure [HF] constitutes a complex clinical entity and often coexists with atrial fibrillation [AF]. There is scarcity of evidence-based therapies for those with ejection fraction [EF] ≥ 40%. Effect of regularization of ventricular response in patients with HF with EF ≥ 40% and concomitant atrial fibrillation is unknown. Material and methods: This was a retrospective case-series study. 14 patients with symptomatic HF with EF ≥ 40% and permanent atrial fibrillation who had undergone pHBP were identified and enrolled. For 9 patients pHBP was a primary strategy, for the remaining patients it was an upgrade from right ventricular lead. All patients underwent follow-up visit 3 months after the procedure. Results: NYHA class was significantly reduced (mean 2.5 vs. 1.0, p-value < 0.001). Left ventricular ejection fraction significantly increased mean increase 8.5%, 95% CI 7.7–9.2, p < 0.001) Similarly, significant decrease in left ventricular end diastolic diameter was observed (mean decrease 5.4 mm, 95% CI 5.0–5.8 mm, p < 0.001). The degree of mitral regurgitation after three months was lower (mean grade 2.4 vs. 1.2, p < 0.001). At follow-up prescribed doses of beta blocker were higher (mean metoprolol equivalent dose rose by 69.6 mg). Conclusions: Permanent His bundle pacing might be beneficial in the setting of permanent AF and HF with EF ≥ 40%.

2

An echocardiographic tool for the interatrial conduction disorders – old dog, new tricks?

100%

Zawadzki J. M. , Gajek J. J. , Sławuta A. , Kozłowski D. , Zaborniak G. , Kudliński B.

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2023

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tom 6

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nr 2

26-35

EN

Background: Bachmann’s bundle plays a crucial role in the physiology of interatrial signal conduction. In the 1970s, Bayes de Luna introduced the definition of interatrial blocks (IABs), which negatively influence atrioventricular (AV) synchrony and left atrial (LA) activation. We aimed to assess the potential of LA strain technology in evaluating the mechanics of LA in patients with correct conduction and IABs. Additionally, we measured the parameters of regurgitation in pulmonary veins (PV), which depend on the type of interatrial conduction. Material and methods: The study group comprised 51 patients (26M, 25F) with symptomatic COVID-19 and sinus rhythm. Our study analyzed their medical history, electrocardiography (ECG) and echocardiography, including the LA strain parameters. Results: Global peak atrial longitudinal strain (PALS) depended on P wave duration, LA volume, left ventricular ejection fraction (LV EF) and inferior pulmonary veins (PV) regurgitation parameters. Global peak atrial contractile strain (PACS) statistically depends on the LV EF, LA volume and the P wave morphology. Conclusions: The presence of IABs negatively influences PACS and PALS. Examining LA strain is complementary to accurate ECG, which may be helpful in everyday clinical practice, particularly in diagnosing heart failure with preserved ejection fraction (HFpEF) and as a predictor of new episodes of atrial fibrillation (AF).

3

The P wave duration in patients with atrial fibrillation undergoing cryoballoon pulmonary vein isolation. Preliminary results

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Zawadzki J. M. , Adamowicz J. , Sławuta A. , Gajek A. , Zyśko D. , Gajek J.

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nr 1

44-47

EN

The pulmonary vein isolation remains the major target of atrial fibrillation ablation. The cryoablation lesions in the left atrium are supposed to disconnect the pulmonary vein from the atrium on the atrial side of the orifices. We hypothesized that the cryoballoon pulmonary vein isolation could result in the prolongation of the P wave duration. The aim of the study was to assess the duration of the P wave in 12-lead electrocardiogram and the influence of pulmonary vein isolation on this parameter. The study group included 21 patients (11 women and 10 men) 66.2+/-7.4 years of age undergoing cryoballoon ablation. In order to measure the P wave duration, we used the constant acquisition of electrogram and the electrocardiographic channels provided by LABSYSTEM™ Pro EP Recording System (Boston Scientific), magnifying the leads 64x. We calculated the duration in the simultaneously recorded 12-lead ECG, from the beginning of the earliest recorded P wave deflection, until the end of the latest P-wave deflection recorded in any lead. The P wave duration in the entire study group was 141.7+/-12.5 ms before the ablation and increased significantly to 151.1+/-11.5 ms (p<0.05) after the procedure. The respective values in women were 144.1+/-4.3 vs. 156.0+/-4.7 ms (p<0.01) and 139.1+/-4.6 vs. 145.6+/-4.5 ms in men (p<0.05). The mean standard deviation of every single measurement considered separately was 4.4+/-2.1 ms before the cryoablation and 4.6+/-1.8 ms after the procedure (p= not significant (n.s).), indicating very good reproducibility of the measurements. We concluded, that cryoballoon pulmonary vein isolation leads to the prolongation of the measured P wave duration. It seemed to result from conduction disturbances created by cryoablation. The clinical significance of the observed changes remains unknown.

4

100%

Sokołowska J. , Sokołowska M. , Adamowicz J. , Zyśko D. , Radziejewska J. , Sławuta A.

European Journal of Translational and Clinical Medicine

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2019

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tom 2

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nr 2

19-22

EN

Background Atrioventricular nodal reentry tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia. The relatively ineffective antiarrhythmic drugs and the predominant young age makes the catheter ablation the therapy of choice in many patients. This results in predominance of this arrhythmia in electrophysiological labs. The aim of the study was to analyze the gender-related differences among patients undergoing the radiofrequency catheter ablation of slow pathway entrance to the atrioventricular node. Material and methods The study group comprised of 147 consecutive patients with diagnosed atrioventricular nodal reentry tachycardia, who underwent the radiofrequency catheter ablation (RFCA) of slow pathway. Patients have been divided into 2 groups, based on sex. Results The overall 97.3% of effectiveness of RFCA was observed. Women were significantly younger than men (53.7+/-17.2 vs 57.7+/-9.8 years) with lower radiation dose (2383.5+/-1993.2 vs 2891.6+/-2377.1 cGyxcm2). Conclusions Younger age of women in comparison to men during RFCA of AVNRT reflects earlier onset of symptoms in women. Gender does not affect the time of fluoroscopy, but the higher rate of inducible tachycardia after RFCA in women may suggest the existence of anatomical difficulties or the operator’s apprehensions. Sex-related difference in radiation dose that we have observed may result from the greater volume of the men’s chest

5

100%

Sokołowska J. , Sokołowska M. , Adamowicz J. , Zyśko D. , Radziejewska J. , Sławuta A.

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nr 2

19-22

EN

Background: Atrioventricular nodal reentry tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia. The relatively ineffective antiarrhythmic drugs and the predominant young age makes the catheter ablation the therapy of choice in many patients. This results in predominance of this arrhythmia in electrophysiological labs. The aim of the study was to analyze the gender-related differences among patients undergoing the radiofrequency catheter ablation of slow pathway entrance to the atrioventricular node. Material and methods: The study group comprised of 147 consecutive patients with diagnosed atrioventricular nodal reentry tachycardia, who underwent the radiofrequency catheter ablation (RFCA) of slow pathway. Patients have been divided into 2 groups, based on sex. Results: The overall 97.3% of effectiveness of RFCA was observed. Women were significantly younger than men (53.7+/-17.2 vs 57.7+/-9.8 years) with lower radiation dose (2383.5+/-1993.2 vs 2891.6+/-2377.1 cGyxcm2). Conclusions: Younger age of women in comparison to men during RFCA of AVNRT reflects earlier onset of symptoms in women. Gender does not affect the time of fluoroscopy, but the higher rate of inducible tachycardia after RFCA in women may suggest the existence of anatomical difficulties or the operator’s apprehensions. Sex-related difference in radiation dose that we have observed may result from the greater volume of the men’s chest.