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Cano Ó, Bazán V, Arana E. Spanish catheter ablation registry. 22nd official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2022). REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2023; 76:910-921. [PMID: 37730116 DOI: 10.1016/j.rec.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 07/18/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article presents results of the Spanish catheter ablation registry for the year 2022. METHODS Data were retrospectively entered into a REDCap platform using a specific form. RESULTS A total of 103 centers participated (75 public, 28 private), which reported 23 360 ablation procedures, with a mean of 227±173 and a median of 202 [interquartile range, 77-312] procedures per center. Activity significantly increased (+5419 procedures,+30.2%) with more centers participating in the registry (10 more than in 2021). The most common procedure continued to be atrial fibrillation ablation (35%, 8185 procedures) followed by cavotricuspid isthmus ablation (20%, 4640 procedures), and intranodal re-entrant tachycardia (17%, 3898 procedures). There was an increase in all reported substrates, especially atrial fibrillation ablation (+40%), with slightly higher global acute success (96%) and lower complication rates (1.8%) and mortality (0.04%, n=10). In total, 525 procedures were performed in pediatric patients (2.2%) CONCLUSIONS: The Spanish catheter ablation registry systematically and continuously collects the national trajectory, which experienced a significant activity increase in 2022 in all of the reported substrates but especially in atrial fibrillation ablation. Acute success increased, while both complications and mortality decreased.
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Affiliation(s)
- Óscar Cano
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
| | - Víctor Bazán
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Eduardo Arana
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Seville, Spain
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Ono K, Iwasaki Y, Akao M, Ikeda T, Ishii K, Inden Y, Kusano K, Kobayashi Y, Koretsune Y, Sasano T, Sumitomo N, Takahashi N, Niwano S, Hagiwara N, Hisatome I, Furukawa T, Honjo H, Maruyama T, Murakawa Y, Yasaka M, Watanabe E, Aiba T, Amino M, Itoh H, Ogawa H, Okumura Y, Aoki‐Kamiya C, Kishihara J, Kodani E, Komatsu T, Sakamoto Y, Satomi K, Shiga T, Shinohara T, Suzuki A, Suzuki S, Sekiguchi Y, Nagase S, Hayami N, Harada M, Fujino T, Makiyama T, Maruyama M, Miake J, Muraji S, Murata H, Morita N, Yokoshiki H, Yoshioka K, Yodogawa K, Inoue H, Okumura K, Kimura T, Tsutsui H, Shimizu W. JCS/JHRS 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias. J Arrhythm 2022; 38:833-973. [PMID: 36524037 PMCID: PMC9745564 DOI: 10.1002/joa3.12714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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3
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Anguera I, Cano Pérez Ó, Bazán V. Spanish catheter ablation registry. 21st official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2021). REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:1029-1039. [PMID: 36244656 PMCID: PMC9558688 DOI: 10.1016/j.rec.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/10/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION AND OBJECTIVES The results of the 2021 Spanish catheter ablation registry are presented. METHODS Data collection was carried out retrospectively by filling in and sending a specific form by the participating centers. RESULTS Data from 93 centers (65 public, 28 private) were analyzed. A total of 17941 ablation procedures were reported with a mean of 193 ± 133 cases per centre. Recovery of activity from SARS-CoV-2 pandemic lockdown has led to a notable increase in the number of procedures (+2772 procedures, +18%) despite a small decrease in participating centers (4 centers less than in 2020). Atrial fibrillation ablation continues to be the leading procedure, with 5848 procedures (32,6%). Together with ablation of the cavotricuspid isthmus (3766; 21%) and atrioventricular nodal reentrant tachycardia (3132; 17,5%) they constitute the 3 most frequently approached substrates. The total success rate reported (94%) is similar to previous years with a similar rate of complications (2%) and mortality (0.07). A total of 401 procedures were performed in pediatric patients (3,8%). CONCLUSIONS The Spanish catheter ablation registry systematically and continuously collects the national activity, which has recovered significantly from the SARS-CoV-2 pandemic impact in 2020. Success rate for 2021 remains high, with a low complication rate.
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Affiliation(s)
- Ignasi Anguera
- Unidad de Arritmias y Electrofisiología, Servicio de Cardiología, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Óscar Cano Pérez
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Víctor Bazán
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
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Anguera I, Cano Pérez Ó, Bazán V. [Spanish catheter ablation registry. 21st official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2021)]. Rev Esp Cardiol 2022; 75:1029-1039. [PMID: 36164639 PMCID: PMC9492424 DOI: 10.1016/j.recesp.2022.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022]
Abstract
Introduction and objectives The results of the 2021 Spanish catheter ablation registry are presented. Methods Data collection was carried out retrospectively by filling in and sending a specific form by the participating centers. Results Data from 93 centers (65 public, 28 private) were analyzed. A total of 17941 ablation procedures were reported with a mean of 193 ± 133 clases per centre. Recovery of activity from SARS-CoV-2 pandemic lockdown has led to a notable increase in the number of procedures (+2772 procedures, +18%) despite a small decrease in participating centers (4 centers less than in 2020). Atrial fibrillation ablation continues to be the leading procedure, with 5848 procedures (32,6%). Together with ablation of the cavotricuspid isthmus (3766; 21%) and atrioventricular nodal reentrant tachycardia (3132; 17,5%) they constitute the 3 most frequently approached substrates. The total success rate reported (94%) is similar to previous years with a similar rate of complications (2%) and mortality (0.07). A total of 401 procedures were performed in pediatric patients (3,8%). Conclusions The Spanish catheter ablation registry systematically and continuously collects the national activity, which has recovered significantly from the SARS-CoV-2 pandemic impact in 2020. Success rate for 2021 remains high, with a low complication rate.
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Affiliation(s)
- Ignasi Anguera
- Unidad de Arritmias y Electrofisiología, Servicio de Cardiología, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - Óscar Cano Pérez
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, España
| | - Víctor Bazán
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
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Luik A, Schmidt K, Haas A, Unger L, Tzamalis P, Brüggenjürgen B. Ablation of Left Atrial Tachycardia following Catheter Ablation of Atrial Fibrillation: 12-Month Success Rates. J Clin Med 2022; 11:jcm11041047. [PMID: 35207318 PMCID: PMC8874450 DOI: 10.3390/jcm11041047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Abstract
The treatment of atrial tachycardia following catheter ablation of atrial fibrillation is often challenging. Electrophysiological studies using high-resolution 3D mapping systems have contributed significantly to their understanding, and new ablation approaches have shown high rates of acute terminations with low recurrences for the clinical AT. However, patient populations are very heterogeneous, and long-term data of the freedom from any atrial tachycardia or any arrhythmia are still sparse. To evaluate long-term success, a unified patient population and predefined ablation strategies are preferred. In this study, we present 12-month success and mean 30 month follow-up data of catheter ablation of left atrial tachycardia. All 35 patients had a history of pulmonary vein isolation (PVI), 71% of which had a previous substrate modification. A total of 54 ATs, with a mean cycle length 297 ± 86 ms, 31 macro-reentries, and 4 localized reentries, were targeted. The ablation strategy to be used was given by the study protocol, depending on the type of reentry and the number of critical isthmuses. All available ablation strategies were included: standard (anatomical) lines, individual lines, critical isthmuses, and focal ablation. All ATs were terminated by ablation. A total of 91% terminated upon the first ablation strategy. Freedom from any AT after 12 months was 82%, and from any arrhythmia, it was 77%. The multi-procedure success after 30 months was 65% for any AT and 55% for any arrhythmia. In conclusion, individual ablation strategies based on the reentry mechanism and the number of critical isthmuses seems promising and demonstrates a high long-term clinical success. Tachycardia comprising a single critical isthmus can be ablated by critical isthmus ablation only. These patients present with the highest 12-month and long-term success rates.
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Affiliation(s)
- Armin Luik
- Karlsruhe Municipal Hospital, Academic Teaching Hospital of the University of Freiburg, 76133 Karlsruhe, Germany; (K.S.); (A.H.); (P.T.)
- Correspondence: ; Tel.: +49-721-9740
| | - Kerstin Schmidt
- Karlsruhe Municipal Hospital, Academic Teaching Hospital of the University of Freiburg, 76133 Karlsruhe, Germany; (K.S.); (A.H.); (P.T.)
| | - Annika Haas
- Karlsruhe Municipal Hospital, Academic Teaching Hospital of the University of Freiburg, 76133 Karlsruhe, Germany; (K.S.); (A.H.); (P.T.)
| | - Laura Unger
- Institute of Biomedical Engineering, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany;
| | - Panagiotis Tzamalis
- Karlsruhe Municipal Hospital, Academic Teaching Hospital of the University of Freiburg, 76133 Karlsruhe, Germany; (K.S.); (A.H.); (P.T.)
| | - Bernd Brüggenjürgen
- Institute for Health Services Research and Technical Orthopaedics, Hanover Medical School, 30625 Hannover, Germany;
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Cózar León R, Anguera Camós I, Cano Pérez Ó. [Spanish Catheter Ablation Registry. 20th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2020)]. Rev Esp Cardiol 2021; 74:1073-1084. [PMID: 34413566 PMCID: PMC8363469 DOI: 10.1016/j.recesp.2021.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/21/2021] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES This article reports the results of the 2020 Spanish Catheter Ablation Registry, a year marked by the SARS-CoV-2 pandemic. METHODS Data were collected retrospectively through completion and return of a specific form by the participating centers. RESULTS Data from 97 centers (67 public, 30 private) were analyzed. A total of 15 169 ablation procedures were reported with a mean of 155 ± 117 and a median [interquartile range] of 115 [62-227]. Because of the SARS-CoV-2 pandemic, both procedures and participating centers markedly decreased (-3380 procedures, -18%) and there were 5 centers less than in 2019. The most common procedure continued to be atrial fibrillation ablation (4513; 30%), well ahead of the remaining substrates, followed by ablation of the cavotricuspid isthmus (3188; 21%), and intranodal re-entry tachycardia (2808; 18%). Ablation of these 3 substrates continued to form the bulk of the procedures. The total success rate was slightly lower than in previous years (88%) with a similar complication rate (n = 309; 2%) and mortality (n = 7; 0.04%). A total of 243 procedures were performed in pediatric patients (1.6%). CONCLUSIONS The Spanish Catheter Ablation Registry systematically and continuously reflects the national trajectory, which, in 2020, was markedly affected by the SARS-CoV-2 pandemic. Although slightly lower than in previous years, the success rate remained high, with a low complication rate.Full English text available from:www.revespcardiol.org/en.
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Affiliation(s)
- Rocío Cózar León
- Unidad de Electrofisiología y Arritmias, Servicio de Cardiología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - Ignasi Anguera Camós
- Unidad de Arritmias y Electrofisiología, Servicio de Cardiología, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - Óscar Cano Pérez
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
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Cózar León R, Anguera Camós I, Cano Pérez Ó. Spanish Catheter Ablation Registry. 20th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2020). REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:1072-1083. [PMID: 34756575 DOI: 10.1016/j.rec.2021.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article reports the results of the 2020 Spanish Catheter Ablation Registry, a year marked by the SARS-CoV-2 pandemic. METHODS Data were collected retrospectively through completion and return of a specific form by the participating centers. RESULTS Data from 97 centers (67 public, 30 private) were analyzed. A total of 15 169 ablation procedures were reported with a mean of 155±117 and a median [interquartile range] of 115 [62-227]. Because of the SARS-CoV-2 pandemic, both procedures and participating centers markedly decreased (-3380 procedures,-18%) and there were 5 centers less than in 2019. The most common procedure continued to be atrial fibrillation ablation (4513; 30%), well ahead of the remaining substrates, followed by ablation of the cavotricuspid isthmus (3188; 21%), and intranodal re-entry tachycardia (2808; 18%). Ablation of these 3 substrates continued to form the bulk of the procedures. The total success rate was slightly lower than in previous years (88%) with a similar complication rate (n=309; 2%) and mortality (n=7; 0.04%). A total of 243 procedures were performed in pediatric patients (1.6%). CONCLUSIONS The Spanish Catheter Ablation Registry systematically and continuously reflects the national trajectory, which, in 2020, was markedly affected by the SARS-CoV-2 pandemic. Although slightly lower than in previous years, the success rate remained high, with a low complication rate.
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Affiliation(s)
- Rocío Cózar León
- Unidad de Electrofisiología y Arritmias, Servicio de Cardiología, Hospital Universitario Virgen Macarena, Seville, Spain.
| | - Ignasi Anguera Camós
- Unidad de Arritmias y Electrofisiología, Servicio de Cardiología, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Óscar Cano Pérez
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
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Quesada A, Cózar R, Anguera I. [Spanish Catheter Ablation Registry. 19th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2019)]. Rev Esp Cardiol 2020; 73:1049-1060. [PMID: 32982011 PMCID: PMC7509535 DOI: 10.1016/j.recesp.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION AND OBJECTIVES This report presents the findings of the 2019 Spanish Catheter Ablation Registry. METHODS Data collection was retrospective. A standardized questionnaire was filled by each of the participant centers. RESULTS Data sent by 102 centers were analyzed, with a total number of ablation procedures performed of 18 549 (the highest historically reported in this registry) for a mean of 181.9 ± 137.0 and a median of 144.5 procedures per center. The ablation targets most frequently treated were atrial fibrillation (n = 5164; 27.8%), cavotricuspid isthmus (n = 3925; 21.1%) and atrioventricular nodal reentrant tachycardia (n = 3768; 20.3%). A new peak is observed in the ablation of atrial fibrillation, increasing the distance from the other substrates. The overall success rate was again 91%. The rate of major complications was 1.9%, and the mortality rate was 0.03%. An electroanatomic mapping system was used in 44.5% of all procedures, with contact force-sensing irrigated catheters become the preferred for complex substrates, as atrial fibrillation (84.8%) or ventricular tachycardia (around 90%). 1.5% of the ablations were performed in pediatric patients. CONCLUSIONS The Spanish Catheter Ablation Registry enrolls systematically and uninterruptedly the ablation procedures performed in Spain, showing a progressive increasing in the number of ablations over the years with a high success rate and low percentages of complications.
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Affiliation(s)
- Aurelio Quesada
- Unidad de Arritmias, Hospital General Universitario de Valencia, Valencia, España
| | - Rocío Cózar
- Unidad de Arritmias, Hospital Virgen Macarena, Sevilla, España
| | - Ignasi Anguera
- Unidad de Arritmias y Electrofisiología, Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
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Quesada A, Cózar R, Anguera I. Spanish Catheter Ablation Registry. 19th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2019). ACTA ACUST UNITED AC 2020; 73:1049-1060. [PMID: 33153956 DOI: 10.1016/j.rec.2020.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/20/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND OBJECTIVES This report presents the findings of the 2019 Spanish Catheter Ablation Registry. METHODS Data collection was retrospective. A standardized questionnaire was filled by each of the participant centers. RESULTS Data sent by 102 centers were analyzed, with a total number of ablation procedures performed of 18549 (the highest historically reported in this registry) for a mean of 181.9±137.0 and a median of 144.5 procedures per center. The ablation targets most frequently treated were atrial fibrillation (n=5164; 27.8%), cavotricuspid isthmus (n=3925; 21.1%) and atrioventricular nodal reentrant tachycardia (n=3768; 20.3%). A new peak is observed in the ablation of atrial fibrillation, increasing the distance from the other substrates. The overall success rate was again 91%. The rate of major complications was 1.9%, and the mortality rate was 0.03%. An electroanatomic mapping system was used in 44.5% of all procedures, with contact force-sensing irrigated catheters become the preferred for complex substrates, as atrial fibrillation (84.8%) or ventricular tachycardia (around 90%). 1.5% of the ablations were performed in pediatric patients. CONCLUSIONS The Spanish Catheter Ablation Registry enrolls systematically and uninterruptedly the ablation procedures performed in Spain, showing a progressive increasing in the number of ablations over the years with a high success rate and low percentages of complications.
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Affiliation(s)
- Aurelio Quesada
- Unidad de Arritmias, Hospital General Universitario de Valencia, Valencia, Spain.
| | - Rocío Cózar
- Unidad de Arritmias, Hospital Virgen Macarena, Sevilla, Spain
| | - Ignasi Anguera
- Unidad de Arritmias y Electrofisiología, Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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Registro Español de Ablación con Catéter. XVIII Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2018). Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2019.07.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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How to make catheter ablation available world-wide? IJC HEART & VASCULATURE 2019; 24:100411. [PMID: 31763437 PMCID: PMC6859742 DOI: 10.1016/j.ijcha.2019.100411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 11/22/2022]
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Ibáñez Criado JL, Quesada A, Cózar R. Spanish Catheter Ablation Registry. 18th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2018). ACTA ACUST UNITED AC 2019; 72:1031-1042. [PMID: 31732435 DOI: 10.1016/j.rec.2019.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/01/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND OBJECTIVES This report presents the findings of the 2018 Spanish Catheter Ablation Registry. METHODS Data collection was retrospective. A standardized questionnaire was completed by each of the participating centers. RESULTS Data sent by 100 centers were analyzed, with a total number of 16566 ablation procedures performed (the highest historically reported in this registry) for a mean of 165.5±127.9 and a median of 119 procedures per center. The ablation targets most frequently treated were atrial fibrillation (n=4234; 25.6%), atrioventricular nodal re-entrant tachycardia (n=3525; 21.3%) and cavotricuspid isthmus (n=3425; 20.7%). A new peak was observed in the ablation of atrial fibrillation, increasing the distance from the other substrates. The overall success rate was 91%. The rate of major complications was 2.2%, and the mortality rate was 0.04%. A total of 2.1% of the ablations were performed in pediatric patients. CONCLUSIONS The Spanish Catheter Ablation Registry enrolls systematically and continuously enrolls the ablation procedures performed in Spain, showing a progressive increasing in the number of ablations over the years, with a high success rate and low percentage of complications.
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Affiliation(s)
- José Luis Ibáñez Criado
- Unidad de Arritmias, Servicio de Cardiología, Hospital General Universitario de Alicante, ISABIAL-FISABIO, Alicante, Spain.
| | - Aurelio Quesada
- Unidad de Arritmias, Hospital General Universitario de Valencia, Valencia, Spain
| | - Rocío Cózar
- Unidad de Arritmias, Hospital Virgen Macarena, Sevilla, Spain
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Maury P, Champ-Rigot L, Rollin A, Mondoly P, Bongard V, Galinier M, Carrié D, Marminia E, Capellino S, Marty L, Milliez P. Comparison between novel and standard high-density 3D electro-anatomical mapping systems for ablation of atrial tachycardia. Heart Vessels 2018; 34:801-808. [PMID: 30456724 DOI: 10.1007/s00380-018-1307-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/09/2018] [Indexed: 10/27/2022]
Abstract
Ultra-high-density mapping allows very accurate characterization of circuits/mechanisms in atrial tachycardia (AT). Whether these advantages will translate into a better procedural or long-term clinical outcome is unknown. Sixty consecutive AT ablation procedures using ultra-high-density mapping (Rhythmia™, group 1) were retrospectively compared to 60 consecutive procedures using standard high-density mapping (Carto/NavX™, group 2) (total 209 AT, 79% left AT). A higher number of maps were performed in group 1 (4.8 ± 2.5 vs 3.2 ± 1.7, p = 0.0001) with similar acquisition duration (12 ± 5 vs 13 ± 6 min per map, p = ns), although with a greater number of activation points (10,543 ± 5854 vs 689 ± 1827 per map, p < 0.0001). AT location remained undetermined in 5 AT in group 1 vs 10 (p = 0.1). Mechanism remained undetermined in 5 AT from group 1 vs 11 (p = 0.06). Acute complete success was achieved in 77%, in both groups. At 1-year follow-up, AT recurred in 37% in group 1 vs 50% in group 2 (p = 0.046). There are less long-term recurrences after AT ablation using ultra-high-density mapping system compared to standard high-density 3D mapping, possibly because of a better comprehensive approach of AT mechanisms.
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Affiliation(s)
- Philippe Maury
- Cardiology, University Hospital Rangueil, 31059, Toulouse Cedex 09, France. .,Unité Inserm U 1048, Toulouse, France.
| | | | - Anne Rollin
- Cardiology, University Hospital Rangueil, 31059, Toulouse Cedex 09, France
| | - Pierre Mondoly
- Cardiology, University Hospital Rangueil, 31059, Toulouse Cedex 09, France
| | - Vanina Bongard
- Cardiology, University Hospital Rangueil, 31059, Toulouse Cedex 09, France
| | - Michel Galinier
- Cardiology, University Hospital Rangueil, 31059, Toulouse Cedex 09, France
| | - Didier Carrié
- Cardiology, University Hospital Rangueil, 31059, Toulouse Cedex 09, France
| | | | | | - Lilian Marty
- Cardiology, University Hospital Rangueil, 31059, Toulouse Cedex 09, France
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Registro Español de Ablación con Catéter. XVII Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2017). Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2018.07.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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García-Fernández FJ, Ibáñez Criado JL, Quesada Dorador A. Spanish Catheter Ablation Registry. 17th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2017). ACTA ACUST UNITED AC 2018; 71:941-951. [PMID: 30268656 DOI: 10.1016/j.rec.2018.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 07/10/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES This report describes the findings of the 2017 Spanish Catheter Ablation Registry. METHODS Data collection was retrospective. A standardized questionnaire was completed by each of the participating centers. RESULTS A total of 15 284 ablation procedures were performed by 98 institutions (the highest number of ablations and institutions historically reported in this registry), with a mean of 156±126 and a median of 136 procedures per center. For the first time, the most frequently treated ablation target was atrial fibrillation (n=3457; 22.6%), followed by cavotricuspid isthmus (n=3449; 22.5%) and atrioventricular nodal re-entrant tachycardia (n=3429; 22.4%). The overall success rate was 87%. The rate of major complications was 2.6%, and the mortality rate was 0.09%. The percentage of procedures performed without fluoroscopic support increased to 6% of all ablations, and 2.3% of all ablations were performed in pediatric patients. CONCLUSIONS The Spanish Ablation Catheter Registry systematically and uninterruptedly collects data on the ablation procedures performed in Spain, revealing that both the number of ablations and the number of centers performing them has progressively increased, while maintaining a high success rate and a low percentage of complications.
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16
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Busch S, Forkmann M, Kuck KH, Lewalter T, Ince H, Straube F, Wieneke H, Julian Chun KR, Eckardt L, Schmitt C, Hochadel M, Senges J, Brachmann J. Acute and long-term outcome of focal atrial tachycardia ablation in the real world: results of the german ablation registry. Clin Res Cardiol 2018; 107:430-436. [PMID: 29344680 DOI: 10.1007/s00392-018-1204-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/15/2018] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Catheter ablation of focal atrial tachycardia (FAT) can be a challenging procedure and results have been rarely described. The purpose of this study was to determine the characteristics and results of FAT ablation in the large cohort of the German Ablation Registry. METHODS The German Ablation Registry is a nationwide prospective multicenter database including 12566 patients who underwent an ablation procedure between 2007 and 2010. Among them 431 (3.4%) underwent an FAT ablation and 413 patients with documented locations were analyzed. Patients were divided into three groups according to the FAT location: biatrial (BiA, n = 31, 7.5%), left atrial (LA, n = 110, 26.5%), and right atrial (RA, n = 272, 66%). RESULTS Acute success rate was 84% (68 vs. 85 vs. 85% in biA, LA, and RA, respectively, p = 0.038). 4.8% of patients had an early recurrence during hospitalization, most in biatrial location (p < 0.001). No major acute complication occurred. At 12 months, 81% were asymptomatic or improved. The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) was 3.7%. Arrhythmia freedom without antiarrhythmic drugs was 58% and was lower in biA (34 vs. 56% in LA vs. 62% in RA, p = 0.019). Early recurrence during hospitalization was an outstanding predictive factor for recurrence during follow-up. CONCLUSION In this large patient population, FAT ablation had a relatively high acute success rate with a low complication rate. During follow-up, the recurrence rate was high, particularly in biatrial location. This was frequently predicted by an early recurrence during hospitalization.
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Affiliation(s)
- Sonia Busch
- Klinik für Kardiologie, Angiologie und Pneumologie, II. Medizinische Klinik, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Germany.
| | - Mathias Forkmann
- Klinik für Kardiologie, Angiologie und Pneumologie, II. Medizinische Klinik, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Germany
| | - Karl-Heinz Kuck
- Klinik für Kardiologie und internistische Intensivmedizin, Klinik für Kardiologie, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Thorsten Lewalter
- Peter Osypka Herzzentrum München, Abteilung fuer Kardiologie und Innere Medizin, Graz, Germany
| | - Hüseyin Ince
- Vivantes Klinikum Am Urban, Berlin, Klinik fuer Kardiologie und Internistische Intensivmedizin, Berlin, Germany
| | | | - Heinrich Wieneke
- Klinik fuer Kardiologie und Angiologie, Contilia Herz- und Gefäßzentrum Essen, Essen, Germany
| | - K R Julian Chun
- CCB Cardioangiologisches Centrum Bethanien Frankfurt am Main, Frankfurt am Main, Germany
| | - Lars Eckardt
- Abteilung für Rhythmologie (Elektrophysiologie und kardiologische Elektrochirurgie), Universitätsklinikum Muenster, Muenster, Germany
| | - Claus Schmitt
- Staedtisches Klinikum Karlsruhe, Medizinische Klinik IV, Karlsruhe, Germany
| | - Matthias Hochadel
- Stiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
| | - Jochen Senges
- Stiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
| | - Johannes Brachmann
- Klinik für Kardiologie, Angiologie und Pneumologie, II. Medizinische Klinik, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Germany
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Fontenla A, García-Fernández J, Ibáñez JL. Registro Español de Ablación con Catéter. XVI Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2016). Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2017.07.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Spanish Catheter Ablation Registry. 16th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2016). ACTA ACUST UNITED AC 2017; 70:971-982. [PMID: 28939092 DOI: 10.1016/j.rec.2017.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 07/31/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES This report describes the findings of the 2016 Spanish Catheter Ablation Registry. METHODS Data were retrospectively collected by means of a standardized questionnaire completed by each of the participating centers. RESULTS Data were collected from 83 centers. A total of 13 482 ablation procedures were performed (the highest historically reported in this registry), with a mean of 162.4 ± 116 and a median of 136 procedures per center. The most frequently treated ablation targets were atrioventricular nodal re-entrant tachycardia (n = 3058; 22.7%), atrial fibrillation (n = 2953; 21.9%), and cavotricuspid isthmus (n = 2892; 21.4%). There was a peak in ablation procedures for atrial fibrillation, which, for the first time in this registry, became the second most treated substrate. After exclusion of atrial fibrillation and ventricular tachycardia with underlying heart disease, the overall success rate was 86%. The rate of major complications was 2.3%, and the mortality rate was 0.05%. In all, 2.7% of the ablations were performed in pediatric patients. CONCLUSIONS The Spanish Catheter Ablation Registry systematically and uninterruptedly records the ablation procedures performed in Spain, showing a progressive rise in the number of ablations performed, with a high success rate and a low percentage of complications.
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Registro Español de Ablación con Catéter. XV Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2015). Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.06.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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20
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Pedrote A, Fontenla A, García-Fernández J. Spanish Catheter Ablation Registry. 15th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2015). ACTA ACUST UNITED AC 2016; 69:1061-1070. [PMID: 27692603 DOI: 10.1016/j.rec.2016.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 06/30/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES This report presents the findings of the 2015 Spanish Catheter Ablation Registry. METHODS For data collection, each center was allowed to choose freely between 2 systems: retrospective, requiring the completion of a standardized questionnaire, and prospective, involving reporting to a central database. RESULTS Data were collected from 82 centers. A total of 12 863 ablation procedures were performed, for a mean of 157±119 and a median of 138 procedures per center. The ablation target most frequently treated was cavotricuspid isthmus (n=2992 [23.2%]), followed by atrioventricular nodal reentrant tachycardia (n=2966 [23%]) and atrial fibrillation (n=2640 [20.5%]). There were fewer ablation procedures for atrial tachycardia, idiopathic ventricular tachycardia and accessory pathways, while those for ventricular tachycardia in ischemic cardiomyopathy remained steady. The overall success rate, excluding atrial fibrillation and ventricular tachycardia in cardiomyopathy, was 87.5%, the rate of major complications was 2%, and the mortality rate was 0.08%. CONCLUSIONS The 2015 registry is the first to show a slight reduction in the number of centers sending in their results and in the total number of ablation procedures performed. The most frequently treated substrate was the cavotricuspid isthmus. There was also a slight decrease in the success rate. The complications and mortality rates remained low.
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Affiliation(s)
- Alonso Pedrote
- Unidad de Arritmias, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - Adolfo Fontenla
- Unidad de Arritmias, Hospital Universitario 12 de Octubre, Madrid, Spain
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Ferreira-González I, Abu-Assi E, Arias MA, Gallego P, Sánchez-Recalde Á, Avanzas P, Bayes-Genis A, de Isla LP, Sanchis J. REVISTA ESPAÑOLA DE CARDIOLOGÍA. Estado actual y perspectiva futura. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ferreira-González I, Abu-Assi E, Arias MA, Gallego P, Sánchez-Recalde Á, Avanzas P, Bayes-Genis A, de Isla LP, Sanchis J. Revista Española de Cardiología: Current Position and Future Directions. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2016; 69:327-336. [PMID: 26927537 DOI: 10.1016/j.rec.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 06/05/2023]
Affiliation(s)
| | | | | | | | | | - Pablo Avanzas
- Former Associate Editor, Revista Española de Cardiología
| | | | | | - Juan Sanchis
- Former Editor-in-Chief, Revista Española de Cardiología
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López-Sendón JL, González-Juanatey JR, Pinto F, Castillo JC, Badimón L, Dalmau R, Torrecilla EG, Mínguez JRL, Maceira AM, Pascual-Figal D, Moya-Prats JLP, Sionis A, Zamorano JL. Quality markers in cardiology: measures of outcomes and clinical practice--a perspective of the Spanish Society of Cardiology and of Thoracic and Cardiovascular Surgery. Eur Heart J 2016; 37:12-23. [PMID: 26491106 PMCID: PMC4692288 DOI: 10.1093/eurheartj/ehv527] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/04/2015] [Accepted: 09/18/2015] [Indexed: 02/06/2023] Open
Affiliation(s)
- José-Luis López-Sendón
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | | | - Fausto Pinto
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - José Cuenca Castillo
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - Lina Badimón
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - Regina Dalmau
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | | | | | - Alicia M Maceira
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - Domingo Pascual-Figal
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | | | - Alessandro Sionis
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
| | - José Luis Zamorano
- Cardiology/Planta 1, Hospital Universitario La Paz, Paseo de la Casellana 261, Madrid, Spain
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Registro Español de Ablación con Catéter. XIV Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2014). Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2015.08.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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25
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López-Sendón J, González-Juanatey JR, Pinto F, Cuenca Castillo J, Badimón L, Dalmau R, González Torrecilla E, López-Mínguez JR, Maceira AM, Pascual-Figal D, Pomar Moya-Prats JL, Sionis A, Zamorano JL. Indicadores de calidad en cardiología. Principales indicadores para medir la calidad de los resultados (indicadores de resultados) y parámetros de calidad relacionados con mejores resultados en la práctica clínica (indicadores de práctica asistencial). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): Declaración de posicionamiento de consenso de SEC/SECTCV. CIRUGIA CARDIOVASCULAR 2015. [DOI: 10.1016/j.circv.2015.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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26
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López-Sendón JL, González-Juanatey JR, Pinto F, Castillo JC, Badimón L, Dalmau R, Torrecilla EG, Mínguez JRL, Maceira AM, Pascual-Figal D, Moya-Prats JLP, Sionis A, Zamorano JL. Quality markers in cardiology: measures of outcomes and clinical practice —a perspective of the Spanish Society of Cardiology and of Thoracic and Cardiovascular Surgery1. CIRUGIA CARDIOVASCULAR 2015. [DOI: 10.1016/j.circv.2015.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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27
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López-Sendón J, González-Juanatey JR, Pinto F, Cuenca Castillo J, Badimón L, Dalmau R, González Torrecilla E, López-Mínguez JR, Maceira AM, Pascual-Figal D, Pomar Moya-Prats JL, Sionis A, Zamorano JL. Indicadores de calidad en cardiología. Principales indicadores para medir la calidad de los resultados (indicadores de resultados) y parámetros de calidad relacionados con mejores resultados en la práctica clínica (indicadores de práctica asistencial). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): Declaración de posicionamiento de consenso de SEC/SECTCV. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2015.07.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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28
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Gil-Ortega I, Pedrote-Martínez A, Fontenla-Cerezuela A. Spanish Catheter Ablation Registry. 14th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2014). ACTA ACUST UNITED AC 2015; 68:1127-37. [PMID: 26507960 DOI: 10.1016/j.rec.2015.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 08/10/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES This report presents the findings of the 2014 Spanish Catheter Ablation Registry. METHODS For data collection, each center was allowed to choose freely between 2 systems: retrospective, requiring the completion of a standardized questionnaire, and prospective, involving reporting to a central database. RESULTS Data were collected from 85 centers. A total of 12 871 ablation procedures were performed, for a mean of 149.5±103 procedures per center. The ablation targets most frequently treated were atrioventricular nodal reentrant tachycardia (n=3026; 23.5%), cavotricuspid isthmus (n=2833; 22.0%), and atrial fibrillation (n=2498; 19.4%). The number of ablation procedures for ventricular arrhythmias was similar to that of 2013, but there was a slight increase in the treatment of all the ventricular substrates, especially those associated with idiopathic ventricular tachycardia and scarring following myocardial infarction. The overall success rate was 95%, the rate of major complications was 1.3%, and the mortality rate was 0.02%. CONCLUSIONS The 2014 registry shows that the number of ablation procedures performed continued its upward trend and that, overall, the success rate was high and the number of complications low. Ablation of complex conditions continued to increase.
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Affiliation(s)
- Ignacio Gil-Ortega
- Unidad de Arritmias, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain.
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29
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López-Sendón J, González-Juanatey JR, Pinto F, Cuenca Castillo J, Badimón L, Dalmau R, González Torrecilla E, López-Mínguez JR, Maceira AM, Pascual-Figal D, Pomar Moya-Prats JL, Sionis A, Zamorano JL. Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper. ACTA ACUST UNITED AC 2015; 68:976-995.e10. [PMID: 26315766 DOI: 10.1016/j.rec.2015.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 07/21/2015] [Indexed: 02/06/2023]
Abstract
Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries.
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Affiliation(s)
- José López-Sendón
- Servicio de Cardiología, Hospital Universitario La Paz, IdiPaz, Madrid, Spain.
| | - José Ramón González-Juanatey
- Sociedad Española de Cardiología, Madrid, Spain; Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Fausto Pinto
- European Society of Cardiology; Department of Cardiology, University Hospital Santa Maria, Lisbon, Portugal
| | - José Cuenca Castillo
- Sociedad Española de Cirugía Torácica-Cardiovascular; Servicio de Cirugía Cardiaca, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Lina Badimón
- Centro de Investigación Cardiovascular (CSIC-ICCC), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Regina Dalmau
- Unidad de Rehabilitación Cardiaca, Servicio de Cardiología, Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - Esteban González Torrecilla
- Unidad de Electrofisiología y Arritmias, Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - José Ramón López-Mínguez
- Unidad de Cardiología intervencionista, Servicio de Cardiología, Hospital Infanta Crsitina, Badajoz, Spain
| | - Alicia M Maceira
- Unidad de Imagen Cardiaca, Servicio de Cardiología, ERESA Medical Center, Valencia, Spain
| | - Domingo Pascual-Figal
- Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | | | - Alessandro Sionis
- Unidad de Cuidados Intensivos Cardiológicos, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - José Luis Zamorano
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Withers KL, Wood KA, Carolan-Rees G, Patrick H, Lencioni M, Griffith M. Living on a knife edge-the daily struggle of coping with symptomatic cardiac arrhythmias. Health Qual Life Outcomes 2015; 13:86. [PMID: 26104746 PMCID: PMC4477616 DOI: 10.1186/s12955-015-0282-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 06/10/2015] [Indexed: 11/17/2022] Open
Abstract
Background In 2010 a retrospective audit was undertaken to assess the viability of using PROMs in patients with symptomatic cardiac arrhythmias having undergone percutaneous arrhythmia ablation. A response rate of 74 % was achieved, with finding suggesting that arrhythmia patients reported a significant impact on their work, social and family life. Aims To conduct a qualitative cross sectional survey to understand patients’ perspectives of how cardiac arrhythmias affect their daily lives, as part of a program to develop a Patient Reported Outcome Measure (PROM). Method Twenty five patients aged 18 or over, diagnosed with a variety of symptomatic cardiac arrhythmias referred for a cardiac ablation procedure took part in cognitive interviews. These aimed to inform the development of a patient reported outcome measure and to determine factors important to this patient group. Common themes were identified using content analysis. Results Participants reported that symptoms of their arrhythmia caused them considerable problems and impacted adversely on their quality of life in many ways. This extended through daily routine, work and social activities and also to friends and family, with fear and anxiety being significant factors for most responders. Patients felt their illness was poorly understood, even by health professionals, and often reported that they felt isolated, lacking support and information. Conclusion Symptomatic cardiac arrhythmias are a source of debilitating and life limiting symptoms, having a negative impact on quality of life. Symptoms and related complications are relevant across different arrhythmia substrates and patient groups. Trial registration The study is registered on the Clinical Trials website, Identifier NCT01672528
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Affiliation(s)
- Kathleen L Withers
- Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK.
| | - Kathryn A Wood
- Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC, 27710, USA.
| | - Grace Carolan-Rees
- Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK.
| | - Hannah Patrick
- National Institute for Health and Care Excellence, 10 Spring Gardens, London, SW1A 2BU, UK.
| | - Mauro Lencioni
- Cardiology Department, University Hospitals Birmingham NHS Foundation Trust, Edgebaston, Birmingham, B15 2GW, UK.
| | - Michael Griffith
- Cardiology Department, University Hospitals Birmingham NHS Foundation Trust, Edgebaston, Birmingham, B15 2GW, UK.
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Katz DF, Turakhia MP, Sauer WH, Tzou WS, Heath RR, Zipse MM, Aleong RG, Varosy PD, Kao DP. Safety of ventricular tachycardia ablation in clinical practice: findings from 9699 hospital discharge records. Circ Arrhythm Electrophysiol 2015; 8:362-70. [PMID: 25688143 PMCID: PMC9893573 DOI: 10.1161/circep.114.002336] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 02/03/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Outcomes of ventricular tachycardia (VT) ablation have been described in clinical trials and single-center studies. We assessed the safety of VT ablation in clinical practice. METHODS AND RESULTS Using administrative hospitalization data between 1994 and 2011, we identified hospitalizations with primary diagnosis of VT (International Classification of Diseases-9 Clinical Modification code: 427.1) and cardiac ablation (International Classification of Diseases-9 Clinical Modification code: 37.34). We quantified in-hospital adverse events (AEs), including death, stroke, intracerebral hemorrhage, pericardial complications, hematoma or hemorrhage, blood transfusion, or cardiogenic shock. Secondary outcomes included major AEs (stroke, tamponade, or death) and death. Multivariable mixed effects models identified patient and hospital characteristics associated with AEs. Of 9699 hospitalizations with VT ablations (age, 56.5 ± 17.6; 60.1% men), AEs were reported in 825 (8.5%), major AEs in 295 (3.0%), and death in 110 (1.1%). Heart failure had the strongest association with death (odds ratio, 5.52; 95% confidence interval, 2.97-10.3) and major AE (odds ratio, 2.99; 95% confidence interval, 2.15-4.16). Anemia (odds ratio, 4.84; 95% confidence interval, 3.79-6.19) and unscheduled admission (odds ratio, 1.64; 95% confidence interval, 1.37-1.97) were associated with AEs. During the study period, incidence of AEs increased from 9.2% to 12.8% as did the burden of AE risk factors (0.034 patient/y; P < 0.001). Hospital volume > 25 cases/y was associated with fewer AEs compared with lower volume centers (6.4% versus 8.8%; P = 0.008). CONCLUSIONS VT ablation-associated AE rates in clinical practice are similar to those reported in the literature. Over time rates have increased as have the number of AE risk factors per patient. Ablations done electively and at hospitals with higher procedural volume are associated with lower incidence of AEs.
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Affiliation(s)
| | | | | | | | | | | | | | - Paul D. Varosy
- University of Colorado, Aurora, CO,Eastem Colorado VA Medical Center, Denver, CO
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García-Bolao I, Ruiz-Mateas F, Bazan V, Berruezo A, Alcalde O, Leal del Ojo J, Acosta J, Martínez Sellés M, Mosquera I. Update in cardiac arrhythmias and pacing. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2015; 68:226-233. [PMID: 25677720 DOI: 10.1016/j.rec.2014.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/11/2014] [Indexed: 06/04/2023]
Abstract
This article discusses the main advances in cardiac arrhythmias and pacing published between 2013 and 2014. Special attention is given to the interventional treatment of atrial fibrillation and ventricular arrhythmias, and on advances in cardiac pacing and implantable cardioverter defibrillators, with particular reference to the elderly patient.
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Affiliation(s)
- Ignacio García-Bolao
- Unidad de Arritmias, Departamento de Cardiología y Cirugía Cardiaca, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain.
| | - Francisco Ruiz-Mateas
- Unidad de Estimulación Cardiaca, Área de Cardiología, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - Victor Bazan
- Unidad de Arritmias, Servicio de Cardiología, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Antonio Berruezo
- Unidad de Arritmias, Servicio de Cardiología, Instituto del Tórax, Hospital Clinic e IDIBAPS, Barcelona, Spain
| | - Oscar Alcalde
- Unidad de Arritmias, Departamento de Cardiología y Cirugía Cardiaca, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain
| | - Juan Leal del Ojo
- Unidad de Electrofisiología y Arritmias, Servicio de Cardiología, Hospital Nuestra Señora de Valme, Sevilla, Spain
| | - Juan Acosta
- Unidad de Arritmias, Servicio de Cardiología, Instituto del Tórax, Hospital Clinic e IDIBAPS, Barcelona, Spain
| | - Manuel Martínez Sellés
- Departamento de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ignacio Mosquera
- Unidad de Arritmias, Hospital Universitario A Coruña, A Coruña, Spain
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Sánchez Muñoz JJ, Peñafiel Verdú P, Martínez Sánchez J, Salar Alcaraz M, Valdés Chavarri M, García Alberola A. Utilidad de un catéter de ablación con sensor de fuerza en la evaluación de las áreas de cicatriz miocárdicas de pacientes con taquicardia ventricular. Rev Esp Cardiol (Engl Ed) 2015. [DOI: 10.1016/j.recesp.2014.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Keegan R, Aguinaga L, Fenelon G, Uribe W, Rodriguez Diez G, Scanavacca M, Patete M, Carhuaz RZ, Labadet C, De Zuloaga C, Pozzer D, Scazzuso F. The first Latin American Catheter Ablation Registry. Europace 2015; 17:794-800. [PMID: 25616407 DOI: 10.1093/europace/euu322] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/09/2014] [Indexed: 11/14/2022] Open
Abstract
AIMS To assess the results of transcatheter ablation of cardiac arrhythmias in Latin America and establish the first Latin American transcatheter ablation registry. METHODS AND RESULTS All ablation procedures performed between 1 January and 31 December 2012 were analysed retrospectively. Data were obtained on the characteristics and resources of participating centres (public or private institution, number of beds, cardiac surgery availability, type of room for the procedures, days per week assigned to electrophysiology procedures, type of fluoroscopy equipment, availability and type of electroanatomical mapping system, intracardiac echo, cryoablation, and number of electrophysiologists) and the results of 17 different ablation substrates: atrio-ventricular node reentrant tachycardia, typical atrial flutter, atypical atrial flutter, left free wall accessory pathway, right free wall accessory pathway, septal accessory pathway, right-sided focal atrial tachycardia, left-sided focal atrial tachycardia, paroxysmal atrial fibrillation, non-paroxysmal atrial fibrillation, atrio-ventricular node, premature ventricular complex, idiopathic ventricular tachycardia, post-myocardial infarction ventricular tachycardia, ventricular tachycardia in chronic chagasic cardiomyopathy, ventricular tachycardia in congenital heart disease, and ventricular tachycardias in other structural heart diseases. Data of 15 099 procedures were received from 120 centres in 13 participating countries (Argentina, Bolivia, Brazil, Chile, Colombia, Cuba, El Salvador, Guatemala, Mexico, Peru, Dominican Republic, Uruguay, and Venezuela). Accessory pathway was the group of arrhythmias most frequently ablated (31%), followed by atrio-ventricular node reentrant tachycardia (29%), typical atrial flutter (14%), and atrial fibrillation (11%). Overall success was 92% with the rate of global complications at 4% and mortality 0.05%. CONCLUSION Catheter ablation in Latin America can be considered effective and safe.
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Affiliation(s)
- Roberto Keegan
- Servicio de Electrofisiología, Hospital Privado del Sur, 164th Las Heras St, 8000, Bahía Blanca, Argentina
| | | | | | - William Uribe
- Servicio de Electrofisiología, CES Cardiología y Clínica Las Américas, Medellín, Colombia
| | | | | | - Manuel Patete
- Unidad Especializada de Arritmias, Caracas, Venezuela
| | | | | | | | - Domingo Pozzer
- Instituto de Cardiología de Corrientes, Corrientes, Argentina
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Sánchez Muñoz JJ, Peñafiel Verdú P, Martínez Sánchez J, Salar Alcaraz M, Valdés Chavarri M, García Alberola A. Usefulness of the contact force sensing catheter to assess the areas of myocardial scar in patients with ventricular tachycardia. ACTA ACUST UNITED AC 2014; 68:159-60. [PMID: 25499952 DOI: 10.1016/j.rec.2014.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/17/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Juan José Sánchez Muñoz
- Unidad de Arritmias, Servicio Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain.
| | - Pablo Peñafiel Verdú
- Unidad de Arritmias, Servicio Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | - Juan Martínez Sánchez
- Unidad de Arritmias, Servicio Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | - Mariela Salar Alcaraz
- Unidad de Arritmias, Servicio Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | - Mariano Valdés Chavarri
- Unidad de Arritmias, Servicio Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | - Arcadio García Alberola
- Unidad de Arritmias, Servicio Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
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Ferrero de Loma-Osorio Á, Gil-Ortega I, Pedrote-Martínez A. Registro Español de Ablación con Catéter. XIII Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2013). Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2014.07.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Spanish Catheter Ablation Registry. 13th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2013). ACTA ACUST UNITED AC 2014; 67:925-35. [PMID: 25278211 DOI: 10.1016/j.rec.2014.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 07/15/2014] [Indexed: 11/21/2022]
Abstract
INTRODUCTION AND OBJECTIVES This report presents the results of the 2013 Spanish Catheter Ablation Registry. METHODS Data were collected using 2 systems: retrospectively by completing a dedicated form and prospectively by reporting to a central database. Each participating center chose 1 of the 2 data collection methods. RESULTS Eighty centers voluntarily contributed data to the registry. A total of 11 987 ablation procedures were performed, with a mean (standard deviation) of 149 (105) procedures per center. The 3 main arrhythmic substrates treated were atrioventricular nodal reentrant tachycardia (n=2959; 24.6%), cavotricuspid isthmus ablation (n=2700; 22.5%), and atrial fibrillation (n=2201; 18.4%). The number of ventricular ablation procedures was similar to the 2012 activity, but there was a slight increase in procedures for scar-related postmyocardial infarction ventricular tachycardia. The success rate was 94.4%, major complications occurred in 1.8%, and the mortality rate was 0.03%. CONCLUSIONS In line with previous reports, the data from the 2013 registry show a continuing increase in the number of ablations performed. Overall, there was a high success rate and few complications. Ablation of complex substrates has continued to increase.
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Neven K, van Driel V, van Wessel H, van Es R, du Pré B, Doevendans PA, Wittkampf F. Safety and Feasibility of Closed Chest Epicardial Catheter Ablation Using Electroporation. Circ Arrhythm Electrophysiol 2014; 7:913-9. [DOI: 10.1161/circep.114.001607] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kars Neven
- From the Departments of Cardiology (K.N., V.v.D., H.v.W., R.v.E., B.d.P., P.A.D., F.W.) and Medical Physiology (B.d.P.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rhythmology, Alfried Krupp Krankenhaus, Essen, Germany (K.N.); St Jude Medical, Veenendaal, The Netherlands (H.v.W.); and ICIN-Netherlands Heart Institute, Utrecht, The Netherlands (P.A.D.)
| | - Vincent van Driel
- From the Departments of Cardiology (K.N., V.v.D., H.v.W., R.v.E., B.d.P., P.A.D., F.W.) and Medical Physiology (B.d.P.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rhythmology, Alfried Krupp Krankenhaus, Essen, Germany (K.N.); St Jude Medical, Veenendaal, The Netherlands (H.v.W.); and ICIN-Netherlands Heart Institute, Utrecht, The Netherlands (P.A.D.)
| | - Harry van Wessel
- From the Departments of Cardiology (K.N., V.v.D., H.v.W., R.v.E., B.d.P., P.A.D., F.W.) and Medical Physiology (B.d.P.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rhythmology, Alfried Krupp Krankenhaus, Essen, Germany (K.N.); St Jude Medical, Veenendaal, The Netherlands (H.v.W.); and ICIN-Netherlands Heart Institute, Utrecht, The Netherlands (P.A.D.)
| | - René van Es
- From the Departments of Cardiology (K.N., V.v.D., H.v.W., R.v.E., B.d.P., P.A.D., F.W.) and Medical Physiology (B.d.P.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rhythmology, Alfried Krupp Krankenhaus, Essen, Germany (K.N.); St Jude Medical, Veenendaal, The Netherlands (H.v.W.); and ICIN-Netherlands Heart Institute, Utrecht, The Netherlands (P.A.D.)
| | - Bastiaan du Pré
- From the Departments of Cardiology (K.N., V.v.D., H.v.W., R.v.E., B.d.P., P.A.D., F.W.) and Medical Physiology (B.d.P.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rhythmology, Alfried Krupp Krankenhaus, Essen, Germany (K.N.); St Jude Medical, Veenendaal, The Netherlands (H.v.W.); and ICIN-Netherlands Heart Institute, Utrecht, The Netherlands (P.A.D.)
| | - Pieter A. Doevendans
- From the Departments of Cardiology (K.N., V.v.D., H.v.W., R.v.E., B.d.P., P.A.D., F.W.) and Medical Physiology (B.d.P.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rhythmology, Alfried Krupp Krankenhaus, Essen, Germany (K.N.); St Jude Medical, Veenendaal, The Netherlands (H.v.W.); and ICIN-Netherlands Heart Institute, Utrecht, The Netherlands (P.A.D.)
| | - Fred Wittkampf
- From the Departments of Cardiology (K.N., V.v.D., H.v.W., R.v.E., B.d.P., P.A.D., F.W.) and Medical Physiology (B.d.P.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rhythmology, Alfried Krupp Krankenhaus, Essen, Germany (K.N.); St Jude Medical, Veenendaal, The Netherlands (H.v.W.); and ICIN-Netherlands Heart Institute, Utrecht, The Netherlands (P.A.D.)
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Martí-Almor J, Bazan V, Vallès E, Benito B, Jauregui-Abularach ME, Bruguera-Cortada J. Resultados a largo plazo de la crioablación con balón para el tratamiento de la fibrilación auricular en un centro de bajo volumen. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2014.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Martí-Almor J, Bazan V, Vallès E, Benito B, Jauregui-Abularach ME, Bruguera-Cortada J. Long-term outcome of cryoballoon ablation of atrial fibrillation in a low-volume center. ACTA ACUST UNITED AC 2014; 67:577-8. [PMID: 24952401 DOI: 10.1016/j.rec.2014.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 02/18/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Julio Martí-Almor
- Unidad de Arritmias, Servicio de Cardiología, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Victor Bazan
- Unidad de Arritmias, Servicio de Cardiología, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, Spain.
| | - Ermengol Vallès
- Unidad de Arritmias, Servicio de Cardiología, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Begoña Benito
- Unidad de Arritmias, Servicio de Cardiología, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | - Jordi Bruguera-Cortada
- Unidad de Arritmias, Servicio de Cardiología, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, Spain
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