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Neuzil P, Petrů J, Šedivá L, Chovanec M, Šorf J, Funasako M. Retrieval and replacement feasibility of 7-year-old implanted leadless pacemaker with tines fixation. HeartRhythm Case Rep 2024; 10:2-5. [PMID: 38264113 PMCID: PMC10801068 DOI: 10.1016/j.hrcr.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Affiliation(s)
- Petr Neuzil
- Cardiology Department, Na Homolce Hospital, Prague, Czech Republic
| | - Jan Petrů
- Cardiology Department, Na Homolce Hospital, Prague, Czech Republic
| | - Lucie Šedivá
- Cardiology Department, Na Homolce Hospital, Prague, Czech Republic
| | - Milan Chovanec
- Cardiology Department, Na Homolce Hospital, Prague, Czech Republic
| | - Jan Šorf
- Medtronic Czechia, Prague, Czech Republic
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Funasako M, Petrů J, Hála P, Janotka M, Škoda J, Chovanec M, Šedivá L, Reddy VY, Neužil P. Acute and long-term results with the 3 rd generation visually guided laser balloon ablation system for pv isolation. J Interv Card Electrophysiol 2024; 67:53-60. [PMID: 36805921 PMCID: PMC10770210 DOI: 10.1007/s10840-023-01499-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Visually guided laser balloon ablation is known as an effective pulmonary vein (PV) isolation device. The third-generation laser balloon ablation system (X3) equipped with compliant balloon and an automated motor-driven laser output mechanism, namely RAPID mode, has been clinically proven for PV isolation. METHODS PV isolation with X3 was performed in all the patients with paroxysmal and early-stage persistent atrial fibrillation (AF). Acute data for PV isolation and clinical outcomes including supraventricular tachyarrhythmia (SVT: AF, atrial flutter, or atrial tachycardia)-free survival rate beyond 1 year were analyzed. RESULTS A total of 110 patients (62 ± 13 years old, 80% of paroxysmal AF) were treated with X3. RAPID mode with was utilized to achieve PV isolation in all cases. In combination with RAPID mode and spot mode laser ablation, 91.1% (380/417) of veins were isolated on the first circumferential lesion set and did not require touch-up ablation and during the index procedure 100% of attempted veins were isolated. The mean procedure time was 77.0 ± 22.7 min and LA dwell time was 61.9 ± 22.0 min. Total duration of laser application was 5.1 ± 2.3 min per vein. At 1 year, SVT-free survival rate was 93.7% in paroxysmal AF patients, and 81.1% in persistent AF patients. CONCLUSIONS A novel continuous automatic laser balloon ablation system was proved to be safe and effective for both paroxysmal and persistent AF patients. The clinical result demonstrated that PV isolation with X3 could achieve a high SVT-free survival rate.
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Affiliation(s)
- Moritoshi Funasako
- Cardiology Department, Na Homolce Hospital, Roentgenova 2, Prague, 15030, Czech Republic.
| | - Jan Petrů
- Cardiology Department, Na Homolce Hospital, Roentgenova 2, Prague, 15030, Czech Republic
| | - Pavel Hála
- Cardiology Department, Na Homolce Hospital, Roentgenova 2, Prague, 15030, Czech Republic
| | - Marek Janotka
- Cardiology Department, Na Homolce Hospital, Roentgenova 2, Prague, 15030, Czech Republic
| | - Jan Škoda
- Cardiology Department, Na Homolce Hospital, Roentgenova 2, Prague, 15030, Czech Republic
| | - Milan Chovanec
- Cardiology Department, Na Homolce Hospital, Roentgenova 2, Prague, 15030, Czech Republic
| | - Lucie Šedivá
- Cardiology Department, Na Homolce Hospital, Roentgenova 2, Prague, 15030, Czech Republic
| | - Vivek Y Reddy
- Cardiology Department, Na Homolce Hospital, Roentgenova 2, Prague, 15030, Czech Republic
- The Helmsley Electrophysiology Center, Mount Sinai School of Medicine, New York, NY, USA
| | - Petr Neužil
- Cardiology Department, Na Homolce Hospital, Roentgenova 2, Prague, 15030, Czech Republic
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Minami K, Shtëmbari J, Petrů J, Chovanec M, Funasako M, Hála P, Janotka M, Škoda J, Šedivá L, Reddy VY, Neužil P. Successful Retrieval of a 4-Year-Old Micra Transcatheter Pacemaker System in a Patient With Leadless Biventricular Pacing Therapy. JACC Case Rep 2020; 2:2249-2252. [PMID: 34317150 PMCID: PMC8299839 DOI: 10.1016/j.jaccas.2020.09.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/08/2020] [Accepted: 09/18/2020] [Indexed: 06/13/2023]
Abstract
This is the first report of the management of a patient with cardiac resynchronization therapy using leadless biventricular pacing. Successful retrieval of a 4-year-old Micra transcatheter pacing system (TPS) and reimplantation of a new Micra TPS prevented device-to-device interactions from multiple pacing devices in the right ventricle. (Level of Difficulty: Advanced.).
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Affiliation(s)
| | | | - Jan Petrů
- Na Homolce Hospital, Prague, Czech Republic
| | | | | | - Pavel Hála
- Na Homolce Hospital, Prague, Czech Republic
| | | | - Jan Škoda
- Na Homolce Hospital, Prague, Czech Republic
| | | | - Vivek Y. Reddy
- Na Homolce Hospital, Prague, Czech Republic
- Icahn School of Medicine at Mount Sinai, New York, New York
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Y Reddy V, Petrů J, Málek F, Stylos L, Goedeke S, Neužil P. Novel Neuromodulation Approach to Improve Left Ventricular Contractility in Heart Failure: A First-in-Human Proof-of-Concept Study. Circ Arrhythm Electrophysiol 2020; 13:e008407. [PMID: 32991220 DOI: 10.1161/circep.120.008407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Morbidity and mortality outcomes for patients admitted for acute decompensated heart failure are poor and have not significantly changed in decades. Current therapies are focused on symptom relief by addressing signs and symptoms of congestion. The objective of this study was to test a novel neuromodulation therapy of stimulation of epicardial cardiac nerves passing along the posterior surface of the right pulmonary artery. METHODS Fifteen subjects admitted for defibrillator implantation and ejection fraction ≤35% on standard heart failure medications were enrolled. Through femoral arterial access, high fidelity pressure catheters were placed in the left ventricle and aortic root. After electro anatomic rendering of the pulmonary artery and branches, either a circular or basket electrophysiology catheter was placed in the right pulmonary artery to allow electrical intravascular stimulation at 20 Hz, 4 ms pulse width, and ≤20 mA. Changes in maximum positive dP/dt (dP/dtMax) indicated changes in ventricular contractility. RESULTS Of 15 enrolled subjects, 5 were not studied due to equipment failure or abnormal pulmonary arterial anatomy. In the remaining subjects, dP/dtMax increased significantly by 22.6%. There was also a significant increase in maximum negative dP/dt (dP/dtMin), mean arterial pressure, systolic pressure, diastolic pressure, and left ventricular systolic pressure. There was no significant change in heart rate or left ventricular diastolic pressure. CONCLUSIONS In this first-in-human study, we demonstrated that in humans with stable heart failure, left ventricular contractility could be accentuated without an increase in heart rate or left ventricular filling pressures. This benign increase in contractility may benefit patients admitted for acute decompensated heart failure.
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Affiliation(s)
- Vivek Y Reddy
- Na Homolce Hospital, Prague, Czech Republic (V.Y.R., J.P., F.M., P.N.).,Icahn School of Medicine at Mount Sinai, NY (V.Y.R.)
| | - Jan Petrů
- Na Homolce Hospital, Prague, Czech Republic (V.Y.R., J.P., F.M., P.N.)
| | - Filip Málek
- Na Homolce Hospital, Prague, Czech Republic (V.Y.R., J.P., F.M., P.N.)
| | - Lee Stylos
- Cardionomic Inc, New Brighton, MN (L.S., S.G.)
| | | | - Petr Neužil
- Na Homolce Hospital, Prague, Czech Republic (V.Y.R., J.P., F.M., P.N.)
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Koščová K, Chovanec M, Petrů J, Šedivá L, Dujka L, Neužil P, Málek F. His bundle pacing after failure of cardiac resynchronization therapy: a case study. J Int Med Res 2020; 48:300060520923495. [PMID: 32420781 PMCID: PMC7235673 DOI: 10.1177/0300060520923495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
His bundle pacing is a relatively new method of cardiac pacing. This method is used in patients with atrioventricular block to prevent heart failure associated with right ventricular pacing, and in patients with bundle branch block and cardiomyopathy. We report a patient with cardiomyopathy and left bundle branch block with failure of cardiac resynchronization therapy. Permanent His bundle pacing was associated with clinical improvement and improvement of parameters of cardiac function.
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Affiliation(s)
- Katarína Koščová
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic
| | - Milan Chovanec
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic
| | - Jan Petrů
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic
| | - Lucie Šedivá
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic
| | - Libor Dujka
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic
| | - Petr Neužil
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic
| | - Filip Málek
- Na Homolce Hospital, Cardiovascular Center, Prague, Czech Republic
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Janotka M, Škoda J, Petrů J, Šedivá L, Chovanec M, Černý Š, Pavel P, Michel M, Skalský I, Benešová M, Neužil P. Arrhythmia recurrence in patients following cardiac surgery with concomitant therapy of atrial fibrillation - experience of our cardiac center. Cor Vasa 2017. [DOI: 10.1016/j.crvasa.2017.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Neužil P, Mráz T, Petrů J, Hála P, Mates M, Kmoníček P, Prokopová M, Reddy VY. Percutaneous closure of left atrial appendage for stroke prevention. Cor Vasa 2016. [DOI: 10.1016/j.crvasa.2016.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
AIMS Durable isolation of the pulmonary veins (PVs) remains the cornerstone of treatment for paroxysmal atrial fibrillation (PAF) and is also used in the treatment of some patients with persistent atrial fibrillation. Visually guided laser ablation (VGLA) has been proven to be safe and effective as a treatment for atrial fibrillation (AF). It has shown high levels of durable PV isolation (PVI), even in the hands of less experienced users. This paper presents the long-term clinical outcomes of all patients treated with VGLA over the course of 4 years in the world's most experienced centre: from early product feasibility work treating only PAF patients to our work using the commercially available product, when we also treated persistent AF patients. METHODS AND RESULTS One hundred and ninety-four patients (63 females, mean age 61 years) with either a history of drug-refractory PAF (time since initial diagnosis: 60.73 months) or persistent AF (time since initial diagnosis: 62.75 months) were treated in our laboratory with VGLA between 7 January 2009 and 17 May 2013. Follow-up of all patients was consistent with our standard clinical practice with a 7-day Holter being performed at the first clinical visit between 4 and 6 months and, for most patients, again at 12 months post-procedure. Twelve lead electrocardiograms were performed at all clinical visits. Recurrence of AF is defined as any documented AF episode >30 s. Acute procedural results show that 692 veins were acutely isolated with a mean procedure and fluoroscopy time of 226 and 20.4 min, respectively. One hundred and seventy (158 PAF and 12 persistent AF) patients reached 1 year of follow-up, 130 (82.3%) patients remained free of AF in the PAF group, and 9 (75%) in the persistent group. Eighty-seven PAF patients have now reached 24 months follow-up and 66 (75.9%) remain free of AF. Fifty-four PAF patients have reached 36 months follow-up with 41 (75.9%) remaining free of AF. Thirty-two PAF patients have reached 48 months follow-up and 24 (75%) remain free of AF. The peri-procedural complications we encountered were phrenic nerve injury in four patients (2.06%), tamponade or pericardial effusion in one patient (0.51%), stroke or transient ischaemic attack in one patient (0.514%), and vascular injury in six patients (3.09%). We experienced no cases of PV stenosis or atrio-oesophageal fistula. CONCLUSION Our single-centre experience using VGLA over 4 years shows that it can be used safely and effectively in normal clinical practice and gives high levels of acute PVI accompanied by good clinical outcomes, even after long-term follow-up.
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Affiliation(s)
- Lucie Šedivá
- Department of Cardiology, Na Homolce Hospital, Roentgenova 2, Prague 5 150 30, Czech Republic
| | - Jan Petrů
- Department of Cardiology, Na Homolce Hospital, Roentgenova 2, Prague 5 150 30, Czech Republic
| | - Jan Škoda
- Department of Cardiology, Na Homolce Hospital, Roentgenova 2, Prague 5 150 30, Czech Republic
| | - Marek Janotka
- Department of Cardiology, Na Homolce Hospital, Roentgenova 2, Prague 5 150 30, Czech Republic
| | - Milan Chovanec
- Department of Cardiology, Na Homolce Hospital, Roentgenova 2, Prague 5 150 30, Czech Republic
| | - Vivek Reddy
- Department of Cardiology, Mount Sinai Hospital, New York 150 00, USA
| | - Petr Neužil
- Department of Cardiology, Na Homolce Hospital, Roentgenova 2, Prague 5 150 30, Czech Republic
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Vondráková D, Málek F, Ošťádal P, Vránová J, Sedláčková L, Šedivá L, Petrů J, Škoda J, Neužil P. Short term effect of CRT on biomarkers of cardiac remodelling and fibrosis: NT-proBNP, sST2, galectin-3, and a marker of oxidative stress--ceruloplasmin--a pilot study. Int J Cardiol 2012; 159:159-60. [PMID: 22658572 DOI: 10.1016/j.ijcard.2012.05.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 05/11/2012] [Indexed: 11/17/2022]
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Vondráková D, Málek F, Dvorák J, Sedivá L, Kupec J, Petrů J, Táborský M, Neuzil P. Critical evaluation of the optimal medical therapy in the cardiac resynchronization therapy candidates--single centre experience. Vnitr Lek 2011; 57:799-802. [PMID: 22097686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED The aim of the present study was to evaluate the optimal medical therapy in the chronic heart failure (CHF) patients referred from the comunity centres and the outpatients cardiology clinics for the cardiac resynchronization therapy with defibrilator (CRTD) to the Department of Cardiology, Na Homolce Hospital with the device implantation between 1st January 2008 and 30st September 2009. METHODS The optimal medical therapy was analysed retrospectively from the medical records of 179 consecutive CHF patients NYHA class III-IV. Beta-blockers (BB) were used only in 81% subjects referred for CRTD, ACE inhibitors (ACEI) were used only in 68% patients Angiotensin receptor blockers (ARB) were used in 18% subjects. ACEI or ARB were used in 81%, spironolacton was use in 59%. Recommended target DD for BB (carvedilol 25 mg bid) was used only in 13% subjects, recommended target DD for ACEI (enalapril 10 mg bid) was used only in 9.4% patients. RESULTS In the Department of Cardiology, the optimal medical therapy was changed after CRTD, BB were used in 95% subjects at discharge (p < 0.01) and the number of patients reaching at least of 50% of recommended daily dose (DD) of BB increased (p < 0.05). ACEI were recommended after CRTD in 80% subjects after implantation (p < 0.05), the number of patients reaching at least of 50% of recommended DD for ACEIs increased too (p < 0.05). There was no significant difference in ARB use recomended in the hospital (19% after CRTD - NS). ACEI or ARB were used in 98% patients after the device implanted (p < 0.05) and spironolacton in 77% after CRTD (p < 0.05). CONCLUSIONS Despite optimal composition of the optimal medical heart failure therapy only small number of CRTD candidates are reaching recommended drug dose. The optimization of the medical therapy in the specialized center lead to significantly higher proportion of CHF using the optimal therapy with the increased dose of BB and ACEI.
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Affiliation(s)
- D Vondráková
- Department of Cardiology, Cardiovascular Centre, Na Homolce Hospital, Prague
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Tersíp T, Petrů J. [Personal experience with palliative endoscopic treatment of stenoses in the upper gastrointestinal tract]. Rozhl Chir 1996; 75:243-4. [PMID: 8769005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The authors discuss the endoscopic approach to stenoses in the area of the oesophagus and cardia in patients with contraindication of radical surgery. They describe the method of treatment with regard to the type and character of the stenosis. The work is based on 10 years experience with palliative endoscopic treatment of benign and malignant stenoses of the upper GIT. During this period more than 800 dilatations were made, 150 oesophageal prostheses were introduced and during the past two years 25 metallic stents.
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Affiliation(s)
- T Tersíp
- III. chirurgická klinika 1. LF UK, Praha
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Stuj J, Petrů J. [Periappendicular abscesses in children]. Rozhl Chir 1979; 58:667-9. [PMID: 542860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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