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Yamasaki H, Bertagnolli L, Hindricks G, Arya A. “Pseudo” Hisian extrasystole arising from the proximal portion of the left bundle branch. J Electrocardiol 2018; 51:574-576. [DOI: 10.1016/j.jelectrocard.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/13/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
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Nedios S, Koutalas E, Sommer P, Arya A, Rolf S, Husser D, Bollmann A, Hindricks G, Breithardt OA. Asymmetrical left atrial remodelling in atrial fibrillation: relation with diastolic dysfunction and long-term ablation outcomes. Europace 2018; 19:1463-1469. [PMID: 27738076 DOI: 10.1093/europace/euw225] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 06/27/2016] [Indexed: 11/12/2022] Open
Abstract
Aims The association between anatomical left atrial (LA) remodelling and ventricular diastolic dysfunction (DD) in atrial fibrillation (AF) patients is not well studied. We aimed to examine the effect of DD on anatomic LA remodelling and their relation with ablation outcomes. Methods and results In 104 patients (58 ± 10 years, 69% male) referred for AF ablation, LA volume (LAV) was determined by computed tomography. A cutting plane, between the pulmonary vein (PV) ostia and the appendage and parallel to the posterior wall, divided LAV into anterior- (LA-A) and posterior-LA parts. The ratio of LA-A and LAV was defined as the LA asymmetry index (ASI). According to the current guidelines, the presence of DD was evaluated by echocardiography. Regression analysis was used to identify predictors of asymmetry changes and long-term success. Univariate linear regression revealed that ASI is associated with LAV, the presence of DD, and mitral regurgitation. Asymmetry index was higher in patients with DD (n = 35, 62 ± 5 vs. 59 ± 6%, P = 0.013) or mitral regurgitation (n = 67, 61 ± 6 vs. 58 ± 5%, P = 0.025). Multiple linear regression analysis showed that DD (B = 2.6, β = 0.207, 95% confidence interval, CI: 0.167-5.011, P = 0.036) and LAV (B = 0.037, β = 0.211, 95% CI: 0.003-0.071, P = 0.033) were the only factors independently associated with ASI (adjusted r2 = 0.92, F = 6.2, P = 0.003). Regression analysis showed that AF recurrence (33% after 24 months) is associated with asymmetric LA changes, while DD is not. Conclusions Left atrial symmetry changes are associated with DD and dilatation. Since DD could cause LA remodelling, appropriate early treatment should be considered for AF patients with DD, before geometrical changes occur.
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Buettner P, Trieb M, Marsche G, Hindricks G, Arya A, Sommer P, Dinov B, Bollmann A, Husser D, Kornej J. P310HDL-function in atrial fibrillation. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ghosh PS, Ali K, Arya A. A computational study of high pressure polymorphic transformations in monazite-type LaPO 4. Phys Chem Chem Phys 2018; 20:7621-7634. [PMID: 29497716 DOI: 10.1039/c7cp05587k] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Polymorphic transformations in LaPO4 are investigated as a function of pressure using density functional theory (DFT) based calculations under the generalized gradient approximation. The monazite-type (P21/n) → barite-type (Pbnm) structural transformation is identified at 16.2 GPa and experimentally, no transformation is observed near this pressure. A discontinuity in the pressure-volume relation (of 4.16% volume discontinuity compared to the monazite structure at the same pressure) and unit-cell dimensions is observed around 28 GPa, which matches well with the previous experimental results. The pressure of discontinuity matches the DFT calculated monazite-type (P21/n) → post barite-type (P212121) structural transformation pressure. The equation of state, single crystal elastic constants and phonon dispersion curves of the different polymorphs as a function of pressure are determined. Both the barite-type (Pbnm) and post barite-type (P212121) structures are mechanically and dynamically stable at 27 GPa indicating that the monazite-type (P21/n) → barite-type (Pbnm) phase transformation may be hindered by a kinetic barrier. The phase transformation in monazite-type LaPO4 is driven by a softening of the C25 single crystal elastic constant. Moreover, a small displacement and tilting of PO4 tetrahedra as a function of pressure leads to a change in the La chemical environment and creates space for the construction of LaO12 polyhedra from LaO9 due to a phase transformation.
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Weber A, Bertagnolli L, Dinov B, Sommer P, Bollmann A, Hindricks G, Arya A. P295Safety of epicardial ablation of ventricular tachykardia: A large single center experience. Europace 2018. [DOI: 10.1093/europace/euy015.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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81
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Koenig S, Boudriot E, Thiele H, Arya A, Hindricks G, Dinov B. P790Sustained ventricular tachycardia as early complication after percutaneous coronary intervention for chronic total occlusion. Europace 2018. [DOI: 10.1093/europace/euy015.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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82
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Wijnmaalen AP, Ebert M, De Riva Silva M, Trines SA, Arya A, Hindricks G, Zeppenfeld K. 1024Anteroseptal substrate is associated with poor long-term outcome after catheter ablation in patients with non-ischemic dilated cardiomyopathy. Europace 2018. [DOI: 10.1093/europace/euy015.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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83
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Stegmann C, Jahnke C, Paetsch I, Hilbert S, Arya A, Bollmann A, Hindricks G, Sommer P. Association of left ventricular late gadolinium enhancement with left atrial low voltage areas in patients with atrial fibrillation. Europace 2018; 20:1606-1611. [DOI: 10.1093/europace/euy013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 01/14/2018] [Indexed: 11/14/2022] Open
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Sommer P, Bertagnolli L, Kircher S, Arya A, Bollmann A, Richter S, Rolf S, Hindricks G. Safety profile of near-zero fluoroscopy atrial fibrillation ablation with non-fluoroscopic catheter visualization: experience from 1000 consecutive procedures. Europace 2018; 20:1952-1958. [DOI: 10.1093/europace/eux378] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/16/2017] [Indexed: 01/02/2023] Open
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85
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Husser D, Büttner P, Stübner D, Ueberham L, Platonov PG, Dinov B, Arya A, Hindricks G, Bollmann A. PR Interval Associated Genes, Atrial Remodeling and Rhythm Outcome of Catheter Ablation of Atrial Fibrillation-A Gene-Based Analysis of GWAS Data. Front Genet 2018; 8:224. [PMID: 29312445 PMCID: PMC5742186 DOI: 10.3389/fgene.2017.00224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/11/2017] [Indexed: 01/25/2023] Open
Abstract
Background: PR interval prolongation has recently been shown to associate with advanced left atrial remodeling and atrial fibrillation (AF) recurrence after catheter ablation. While different genome-wide association studies (GWAS) have implicated 13 loci to associate with the PR interval as an AF endophenotype their subsequent associations with AF remodeling and response to catheter ablation are unknown. Here, we perform a gene-based analysis of GWAS data to test the hypothesis that PR interval candidate genes also associate with left atrial remodeling and arrhythmia recurrence following AF catheter ablation. Methods and Results: Samples from 660 patients with paroxysmal (n = 370) or persistent AF (n = 290) undergoing AF catheter ablation were genotyped for ~1,000,000 SNPs. Gene-based association was investigated using VEGAS (versatile gene-based association study). Among the 13 candidate genes, SLC8A1, MEIS1, ITGA9, SCN5A, and SOX5 associated with the PR interval. Of those, ITGA9 and SOX5 were significantly associated with left atrial low voltage areas and left atrial diameter and subsequently with AF recurrence after radiofrequency catheter ablation. Conclusion: This study suggests contributions of ITGA9 and SOX5 to AF remodeling expressed as PR interval prolongation, low voltage areas and left atrial dilatation and subsequently to response to catheter ablation. Future and larger studies are necessary to replicate and apply these findings with the aim of designing AF pathophysiology-based multi-locus risk scores.
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Bajaj N, Bhatt H, Pandey KK, Poswal HK, Arya A, Ghosh PS, Garg N, Deo MN. Phase transition in metal–organic complex trans-PtCl2(PEt3)2 under pressure: insights into the molecular and crystal structure. CrystEngComm 2018. [DOI: 10.1039/c8ce00433a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Molecular reorientations result in structural phase transition in trans-PtCl2(PEt3)2 under pressure, leading to a hydrogen bond assisted supramolecular architecture.
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Ghosh PS, Kuganathan N, Arya A, Grimes RW. Phase stability, electronic structures and elastic properties of (U,Np)O2 and (Th,Np)O2 mixed oxides. Phys Chem Chem Phys 2018; 20:18707-18717. [DOI: 10.1039/c8cp02414f] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Mixing enthalpies (ΔHmix) of U1−xNpxO2 and Th1−xNpxO2 solid solutions are derived from atomic scale simulations based on density functional theory (DFT) employing the generalised gradient approximation corrected with an effective Hubbard parameter (Ueff).
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Efimova E, Fischer J, Bertagnolli L, Dinov B, Kircher S, Rolf S, Sommer P, Bollmann A, Richter S, Meyer A, Garbade J, Hindricks G, Arya A. Predictors of ventricular arrhythmia after left ventricular assist device implantation: A large single-center observational study. Heart Rhythm 2017; 14:1812-1819. [DOI: 10.1016/j.hrthm.2017.07.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Indexed: 11/28/2022]
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89
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Bertagnolli L, Torri F, Paetsch I, Jahnke C, Hindricks G, Arya A, Dinov B. Cardiac magnetic resonance imaging for coregistration during ablation of ischemic ventricular tachycardia for identification of the critical isthmus. HeartRhythm Case Rep 2017; 4:70-72. [PMID: 29876292 PMCID: PMC5988470 DOI: 10.1016/j.hrcr.2017.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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90
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Kircher S, Arya A, Altmann D, Rolf S, Bollmann A, Sommer P, Dagres N, Richter S, Breithardt OA, Dinov B, Husser D, Eitel C, Gaspar T, Piorkowski C, Hindricks G. Individually tailored vs. standardized substrate modification during radiofrequency catheter ablation for atrial fibrillation: a randomized study. Europace 2017; 20:1766-1775. [DOI: 10.1093/europace/eux310] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/08/2017] [Indexed: 11/13/2022] Open
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91
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Ebert M, Stegmann C, Kosiuk J, Dinov B, Richter S, Arya A, Müssigbrodt A, Sommer P, Hindricks G, Bollmann A. Predictors, management, and outcome of cardioversion failure early after atrial fibrillation ablation. Europace 2017; 20:1428-1434. [DOI: 10.1093/europace/eux327] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/18/2017] [Indexed: 11/13/2022] Open
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92
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Piorkowski C, Breithardt OA, Razavi H, Nabutovsky Y, Rosenberg SP, Markovitz CD, Arya A, Rolf S, John S, Kosiuk J, Olson E, Eitel C, Huo Y, Döring M, Richter S, Ryu K, Gaspar T, Prinzen FW, Hindricks G, Sommer P. Mapping-guided characterization of mechanical and electrical activation patterns in patients with normal systolic function using a sensor-based tracking technology. Europace 2017; 19:1700-1709. [PMID: 27738070 DOI: 10.1093/europace/euw261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 07/29/2016] [Indexed: 11/14/2022] Open
Abstract
Aims In times of evolving cardiac resynchronization therapy, intra-procedural characterization of left ventricular (LV) mechanical activation patterns is desired but technically challenging with currently available technologies. In patients with normal systolic function, we evaluated the feasibility of characterizing LV wall motion using a novel sensor-based, real-time tracking technology. Methods and results Ten patients underwent simultaneous motion and electrical mapping of the LV endocardium during sinus rhythm using electroanatomical mapping and navigational systems (EnSite™ NavX™ and MediGuide™, SJM). Epicardial motion data were also collected simultaneously at corresponding locations from accessible coronary sinus branches. Displacements at each mapping point and times of electrical and mechanical activation were combined over each of the six standard LV wall segments. Mechanical activation timing was compared with that from electrical activation and preoperative 2D speckle tracking echocardiography (echo). MediGuide-based displacement data were further analysed to estimate LV chamber volumes that were compared with echo and magnetic resonance imaging (MRI). The lateral and septal walls exhibited the largest (12.5 [11.6-15.0] mm) and smallest (10.2 [9.0-11.3] mm) displacement, respectively. Radial displacement was significantly larger endocardially than epicardially (endo: 6.7 [5.0-9.1] mm; epi: 3.8 [2.4-5.6] mm), while longitudinal displacement was significantly larger epicardially (endo: 8.0 [5.0-10.6] mm; epi: 10.3 [7.4-13.8] mm). Most often, the anteroseptal/anterior and lateral walls showed the earliest and latest mechanical activations, respectively. 9/10 patients had concordant or adjacent wall segments of latest mechanical and electrical activation, and 6/10 patients had concordant or adjacent wall segments of latest mechanical activation as measured by MediGuide and echo. MediGuide's LV chamber volumes were significantly correlated with MRI (R2= 0.73, P < 0.01) and echo (R2= 0.75, P < 0.001). Conclusion The feasibility of mapping-guided intra-procedural characterization of LV wall motion was established. Clinical trial registration http://www.clinicaltrials.gov; Unique identifier: CT01629160.
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Oebel S, Dinov B, Arya A, Hilbert S, Sommer P, Bollmann A, Hindricks G, Paetsch I, Jahnke C. ECG morphology of premature ventricular contractions predicts the presence of myocardial fibrotic substrate on cardiac magnetic resonance imaging in patients undergoing ablation. J Cardiovasc Electrophysiol 2017; 28:1316-1323. [PMID: 28791747 DOI: 10.1111/jce.13309] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 07/26/2017] [Accepted: 08/01/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND The most likely origin of premature ventricular contractions (PVCs) may be deduced from surface electrocardiogram (ECG) analysis while planning an electrophysiological study (EPS). Apart from purely benign forms of increased ventricular ectopy, myocardial substrate (e.g., regional fibrosis) may be present in certain cases, which will significantly impact the ablation approach. Cardiac magnetic resonance (CMR) imaging can reliably identify fibrotic target lesions and, hence, may assist in adequate patient selection and procedural planning. METHODS AND RESULTS We analyzed 101 patients (59% males, mean age 57.15 ± 15.5 years, mean PVC count 19,801 ± 14,021 per 24 hours) referred for ablation of PVCs. The CMR (1.5T, Philips Ingenia, Best, The Netherlands) protocol included cine and three-dimensional-delayed enhancement imaging using standard cardiac geometries. On surface, ECG right bundle branch block (RBBB) morphology was present in 43% of patients. Twenty-one patients showed the fibrotic substrate on CMR. On univariate analysis, both RBBB morphology (P < 0.001) and presence of multiple PVC morphologies (≥2) significantly predicted the presence of fibrotic substrate (P = 0.01), which various baseline characteristics including left ventricular ejection fraction (45.7 ± 12.6% vs. 50.6 ± 11.0%, P = 0.08) failed to do. CMR-identified fibrosis was associated with the site of origin of the clinical PVCs during EPS and was successfully treated by radiofrequency ablation in 93% (PVC reduction >95%). CONCLUSION In patients with RBBB morphology and/or multiple PVC patterns, CMR imaging before ablation may be helpful due to the increased prevalence of fibrotic lesions with regard to patient stratification and periprocedural management.
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Rani P, Kumar A, Vishwanadh B, Ali K, Arya A, Tewari R, Subramaniam A. Liquid like nucleation in free-standing nanoscale films. NANOSCALE 2017; 9:12283-12287. [PMID: 28703820 DOI: 10.1039/c7nr03225k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The concept of a critical nucleus size (r*) is of pivotal importance in phase transformations involving nucleation and growth. The current investigation pertains to crystallization in nanoscale thin films and study of the same using high resolution lattice fringe imaging (HRLFI) and finite element simulations. Using the CuZrAl bulk metallic glass system as a model system for this study, we demonstrate a liquid like nucleation behaviour in nanoscale free-standing films upon heating. The r* for the formation of the Cu10Zr7 phase in thin films (of decreasing thickness) approaches that of the r* for the formation of the crystal from a liquid (i.e.). Working in the nucleation dominant regime, we introduce the concept of 'depth sensitive lattice fringe imaging'. The thickness of the film is determined by electron energy loss spectroscopy and the strain energy of the system is computed using finite element computations.
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Husser D, Ueberham L, Hindricks G, Büttner P, Ingram C, Weeke P, Shoemaker MB, Adams V, Arya A, Sommer P, Darbar D, Roden DM, Bollmann A. Rare variants in genes encoding the cardiac sodium channel and associated compounds and their impact on outcome of catheter ablation of atrial fibrillation. PLoS One 2017; 12:e0183690. [PMID: 28837624 PMCID: PMC5570360 DOI: 10.1371/journal.pone.0183690] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/09/2017] [Indexed: 12/19/2022] Open
Abstract
Aim Rare variants of genes encoding the cardiac sodium channel and associated compounds have been linked with atrial fibrillation (AF). Nevertheless, current expert consensus does not support genetic testing in AF, which is in part based on the fact that “there is no therapeutic impact derived from AF genetic test results”. However, there are no studies available supporting this recommendation. Consequently, this study analyzed the impact of rare variants affecting the cardiac sodium channel on rhythm outcome of AF catheter ablation. Methods and results In 137 consecutive patients with lone AF enrolled in the Leipzig Heart Center AF ablation registry, screening for mutations in SCN5A, SCN1B – 4B, CAV3, GPD1L, SNTA1 and MOG1 was performed. We identified 3 rare non-synonymous variants in SCN5A, 5 in SCN1B, 1 in SCN4B, 1 in CAV3, 6 in GPD1L, 3 in SNTA1 and 3 in MOG1 (16%). Variant carriers were otherwise comparable with non-variant carriers. Analysis of AF recurrence rates after radiofrequency AF catheter ablation by serial 7-day Holter ECG monitoring between 3 and 12 months revealed no difference between groups, i.e. 45% in variant carriers vs. 49% in non-variant carriers. Conclusions Rare variants in genes encoding the cardiac sodium channel and associated compounds are frequently found in lone AF but were not found to impact the outcome of AF catheter ablation. This finding supports current recommendations not to screen for rare variants for the ablation outcome in AF. Nevertheless, it may at least be helpful for understanding AF mechanisms and larger studies are needed to further explore the possible association between genotype and response to AF therapies.
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96
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Nedios S, Darma A, Richter S, Doering M, Muessigbrodt A, Arya A, Sommer P, Hindricks G, Bollmann A. P5463Cardiac resynchronization therapy in patients with Atrial Fibrillation. Predictors of sinUs rhythm REstoration (CRT-AF PURE). Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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97
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Dörschner M, Bollmann A, Dinov B, Richter S, Döring M, Arya A, Müssigbrodt A, Kircher S, Dagres N, Sommer P, Hindricks G, Bode K. Structured pain management reduces patient discomfort after catheter ablation and rhythm device surgery. Eur J Pain 2017; 21:1723-1731. [DOI: 10.1002/ejp.1084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2017] [Indexed: 01/23/2023]
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98
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Wojdyła-Hordyńska A, Kowalski O, Hordyński GJ, Dinov B, Sommer P, Hindricks G, Feusette P, Arya A. The effect of radiofrequency catheter ablation of frequent premature ventricular complexes and arrhythmia burden on left ventricular function. Kardiol Pol 2017; 75:698-704. [PMID: 28708198 DOI: 10.5603/kp.a2017.0058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Frequent premature ventricular complexes (PVC) are related to reversible tachycardia-induced cardiomyopathy. However, the role of arrhythmia burden on the outcome of the catheter ablation has not been fully recognised. AIM The aim of this study was to assess the effect of catheter ablation and PVC burden in patients with and without structural heart disease (SHD) on left ventricular ejection fraction (LVEF). METHODS Transthoracic echocardiography was done before and six months after radiofrequency catheter ablation in 109 consecutive patients (61 men, age 55 ± 17 years) with frequent PVCs. Sixty-five (59.6%) patients had underlying SHD. RESULTS The catheter ablation procedure was successful in 93 (85.3%) patients. Baseline PVC burden was higher in patients with SHD (22,267 ± 12,934) compared to those without concomitant SHD (15,546 ± 7888), p = 0.005. Nevertheless, patients with LVEF ≤ 50% at baseline presented greater LVEF recovery (from 44% to 56%) than those with LVEF > 50% at baseline after catheter ablation. In both groups, the LVEF improved (p < 0.001); however, no difference was observed be-tween patients with SHD (5.7% ± 1.37%) and without (4.6% ± 0.96%) SHD; p = 0.89. PVC burden was higher in patients with (24,350 ± 2776 PVC/day) compared to those without (17,588 ± 1970 PVC/day) improvement of LVEF. In multivariate regression analysis PVC burden > 20,000/day (but not age, p = 0.95; gender, p = 0.89; presence of SHD, p = 0.53; QRS complex width of the treated PVC, p = 0.21, LVEF before ablation, p = 0.19; and site of origin, p = 47) predicted improvement in LVEF after successful catheter ablation (odds ratio: 3.53; 95% confidence interval: 1.15-10.75; p = 0.023). CONCLUSIONS Catheter ablation of frequent PVCs improves left ventricular function in multivariate analysis predicted improvement of LVEF within six months after the successful catheter ablation procedure in patients with PVC burden exceeding 20,000/24 h.
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Banik S, Das PK, Bendounan A, Vobornik I, Arya A, Beaulieu N, Fujii J, Thamizhavel A, Sastry PU, Sinha AK, Phase DM, Deb SK. Giant Rashba effect at the topological surface of PrGe revealing antiferromagnetic spintronics. Sci Rep 2017; 7:4120. [PMID: 28646153 PMCID: PMC5482886 DOI: 10.1038/s41598-017-02401-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 04/11/2017] [Indexed: 11/17/2022] Open
Abstract
Rashba spin-orbit splitting in the magnetic materials opens up a new perspective in the field of spintronics. Here, we report a giant Rashba spin-orbit splitting on the PrGe [010] surface in the paramagnetic phase with Rashba coefficient α R = 5 eVÅ. We find that α R can be tuned in this system as a function of temperature at different magnetic phases. Rashba type spin polarized surface states originates due to the strong hybridization between Pr 4f states with the conduction electrons. Significant changes observed in the spin polarized surface states across the magnetic transitions are due to the competition between Dzyaloshinsky-Moriya interaction and exchange interaction present in this system. Presence of Dzyaloshinsky-Moriya interaction on the topological surface give rise to Saddle point singularity which leads to electron-like and hole-like Rashba spin split bands in the [Formula: see text] and [Formula: see text] directions, respectively. Supporting evidences of Dzyaloshinsky-Moriya interaction have been obtained as anisotropic magnetoresistance with respect to field direction and first-order type hysteresis in the X-ray diffraction measurements. A giant negative magnetoresistance of 43% in the antiferromagnetic phase and tunable Rashba parameter with temperature makes this material a suitable candidate for application in the antiferromagnetic spintronic devices.
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Dinov B, Bode K, Koenig S, Oebel S, Sommer P, Bollmann A, Hindricks G, Arya A. Signal-Averaged Electrocardiography as a Noninvasive Tool for Evaluating the Outcomes After Radiofrequency Catheter Ablation of Ventricular Tachycardia in Patients With Ischemic Heart Disease: Reassessment of an Old Tool. Circ Arrhythm Electrophysiol 2017; 9:CIRCEP.115.003673. [PMID: 27635068 DOI: 10.1161/circep.115.003673] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 08/15/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Inducibility of ventricular tachycardia (VT) has limited ability to predict recurrent VT after catheter ablation (CA). We sought to correlate the signal-averaged ECG (SAECG) with the endocardial scar characteristics in patients with ischemic VTs. We suggest that successful CA can result in normalization of the SAECG. METHODS AND RESULTS Fifty patients (42 male; aged 67±10 years, ejection fraction 34±12%) with ischemic VTs were prospectively enrolled. SAECG was performed before and after CA. Patients with at least 2 abnormal criteria (filtered QRS ≥114 ms; root mean square 40 <20 μV, and low-amplitude potentials 40 >38 ms) were defined as having positive SAECG. There was a linear correlation between endocardial scar area (<1.5 mV) and filtered QRS (r=0.414; P=0.003). CA resulted in normalization of the SAECG in 6 patients. In patients with filtered QRS ≤120 ms, 13 (40.6%) patients had normal SAECG after CA compared with 7 (21.9%) before ablation (P=0.034). Patients with normal or normalized SAECG after CA had better VT-free survival compared with those whose SAECG remained abnormal. Abnormal SAECG after CA was a predictor for VT recurrence: hazard ratio=3.64; P=0.039 for the overall population, and hazard ratio=5.80; P=0.022 for patients having QRS ≤120 ms. CONCLUSIONS There is a significant correlation between the surface SAECG and endocardial scar size in patients with ischemic VTs. A successful CA can result in normalization of SAECG that is associated with more favorable long-term outcomes. SAECG can be useful to assess the procedural success of VT ablation.
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