1
|
Maclean E, Mahtani K, Roelas M, Vyas R, Butcher C, Ahluwalia N, Honarbakhsh S, Creta A, Finlay M, Chow A, Earley MJ, Sporton S, Lowe MD, Sawhney V, Ezzat V, Ahsan S, Khan F, Dhinoja M, Lambiase PD, Schilling RJ, Hunter RJ, Segal OR. Transseptal puncture for left atrial ablation: risk factors for cardiac tamponade and a proposed causative classification system. J Cardiovasc Electrophysiol 2022; 33:1747-1755. [PMID: 35671359 PMCID: PMC9543389 DOI: 10.1111/jce.15590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022]
Abstract
Aims Cardiac tamponade is a high morbidity complication of transseptal puncture (TSP). We examined the associations of TSP‐related cardiac tamponade (TRCT) for all patients undergoing left atrial ablation at our center from 2016 to 2020. Methods and Results Patient and procedural variables were extracted retrospectively. Cases of cardiac tamponade were scrutinized to adjudicate TSP culpability. Adjusted multivariate analysis examined predictors of TRCT. A total of 3239 consecutive TSPs were performed; cardiac tamponade occurred in 51 patients (incidence: 1.6%) and was adjudicated as TSP‐related in 35 (incidence: 1.1%; 68.6% of all tamponades). Patients of above‐median age [odds ratio (OR): 2.4 (1.19–4.2), p = .006] and those undergoing re‐do procedures [OR: 1.95 (1.29–3.43, p = .042] were at higher risk of TRCT. Of the operator‐dependent variables, choice of transseptal needle (Endrys vs. Brockenbrough, p > .1) or puncture sheath (Swartz vs. Mullins vs. Agilis vs. Vizigo vs. Cryosheath, all p > .1) did not predict TRCT. Adjusting for operator, equipment and demographics, failure to cross the septum first pass increased TRCT risk [OR: 4.42 (2.45–8.2), p = .001], whilst top quartile operator experience [OR: 0.4 (0.17–0.85), p = .002], transoesophageal echocardiogram [TOE prevalence: 26%, OR: 0.51 (0.11–0.94), p = .023], and use of the SafeSept transseptal guidewire [OR: 0.22 (0.08–0.62), p = .001] reduced TRCT risk. An increase in transseptal guidewire use over time (2016: 15.6%, 2020: 60.2%) correlated with an annual reduction in TRCT (R2 = 0.72, p < .001) and was associated with a relative risk reduction of 70%. Conclusions During left atrial ablation, the risk of TRCT was reduced by operator experience, TOE‐guidance, and use of a transseptal guidewire, and was increased by patient age, re‐do procedures, and failure to cross the septum first pass.
Collapse
Affiliation(s)
- E Maclean
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK.,William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - K Mahtani
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M Roelas
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - R Vyas
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - C Butcher
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - N Ahluwalia
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - S Honarbakhsh
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - A Creta
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M Finlay
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - A Chow
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M J Earley
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - S Sporton
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M D Lowe
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - V Sawhney
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - V Ezzat
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - S Ahsan
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - F Khan
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - M Dhinoja
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - P D Lambiase
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| | - R J Schilling
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK.,William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - R J Hunter
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK.,William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - O R Segal
- Barts Heart Centre, St. Bartholomew's Hospital, W Smithfield, London, EC1A 4AS, UK
| |
Collapse
|
2
|
Ahluwalia N, Graham A, Orini M, Williams S, Ahsan S, Khan F, Ezzat V, Sporton S, Earley M, Chow A, Lambiase P, Dhinoja M. P504VT ablation outcomes and predictors in a UK population- validating existing predictors and novel markers. Europace 2020. [DOI: 10.1093/europace/euaa162.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Radiofrequency catheter ablation (CA) can reduce ventricular tachycardia (VT) burden and registry data suggests an improvement in mortality. However, there is significant heterogeneity in patient morbidity and VT phenotype. A risk prediction model derived from observational data has suggested pre-procedural left ventricular (LV) function, age and underlying ischaemic cardiomyopathy are associated with greater post-procedural mortality. Validation of proposed factors in clinical practice is required to facilitate comprehensive pre-procedural risk stratification and inform decision making.
Purpose
To determine whether proposed pre-procedural predictors of mortality after VTCA are valid in a UK population and explore any association with other predictors.
Method
Patients undergoing VTCA at a tertiary electrophysiology centre between 06/07/16 and 31/07/19 were included. Pre-specified characteristics and mortality follow-up data were analysed from electronic health records. Cox regression analysis was undertaken to determine association with mortality.
Results
161 patients with mean age of 63 ±15.9 years underwent VTCA of whom 133 (83%) were male. During the follow-up period (16 months, 13-24; median, 1st-3rd quartile) 16 patients died. No deaths occured in the 27 (16%) patients with structurally normal hearts. Chronic kidney disease (CKD) stage III-IV (HR 14.73 [4.9-44.4]), LV ejection fraction <35% (HR 7.13 [1.59-31.88]), underlying ischaemic cardiomyopathy (HR 6.17 [1.37-27.85]), LV internal diameter (LVID) (1.08 [1.02-1.15]) and age (HR 1.08 [1.02-1.14]) were associated with significantly greater mortality risk (Table 1) (Figure 1).
Conclusion
Proposed risk stratifying factors are validated in our UK centre’s experience. Additionally, CKD and baseline LVID appear to be associated with mortality in our population and warrant further study.
Risk factor Hazard ratio Lower confidence interval Upper confidence interval P-value Atrial fibrillation (yes/no) 0.14 0.02 1.11 0.06 Age (years) 1.08 1.02 1.14 <0.01 Diabetes (yes/no) 2.43 0.85 6.92 0.10 Chronic kidney disease (yes/no) 14.73 4.88 44.41 <0.01 Ischaemic cardiomyopathy (yes/no) 6.17 1.37 27.85 0.02 LV EF <35% (yes/no) 7.13 1.59 31.88 <0.01 LV internal diameter (mm) 1.08 1.02 1.15 <0.01 Procedural urgency (urgent/elective) 1.12 0.57 2.20 0.75 Table 1: Association between baseline risk factors and mortality risk after VT catheter ablation
Abstract Figure 1: Kaplan-Meier survival curves
Collapse
Affiliation(s)
- N Ahluwalia
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - A Graham
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - M Orini
- University College London, Dept of Mechanical Engineering, London, United Kingdom of Great Britain & Northern Ireland
| | - S Williams
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - S Ahsan
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - F Khan
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - V Ezzat
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - S Sporton
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - M Earley
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - A Chow
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - P Lambiase
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - M Dhinoja
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
3
|
Malcolmson JW, Joshi A, Ginks M, Petersen S, Mohiddin SA, Dhinoja M. P3552Left ventricular pacing for gradient reduction and symptomatic relief in mid-cavity obstructive hypertrophic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J W Malcolmson
- Barts Health NHS Trust, Cardiology, London, United Kingdom
| | - A Joshi
- Barts Health NHS Trust, Cardiology, London, United Kingdom
| | - M Ginks
- Oxford University Hospitals NHS Trust, Cardiology, Oxford, United Kingdom
| | - S Petersen
- Barts Health NHS Trust, Cardiology, London, United Kingdom
| | - S A Mohiddin
- Barts Health NHS Trust, Cardiology, London, United Kingdom
| | - M Dhinoja
- Barts Health NHS Trust, Cardiology, London, United Kingdom
| |
Collapse
|
4
|
Sawhney V, Volkova E, Shaukat M, Khan F, Segal O, Ahsan S, Chow A, Ezzat V, Finlay M, Lambiase P, Lowe M, Dhinoja M, Sporton S, Earley MJ, Hunter RJ, Schilling RJ. Impact of attributed audit on procedural performance in cardiac electrophysiology catheter laboratory. J Interv Card Electrophysiol 2018; 56:199-203. [PMID: 29858762 DOI: 10.1007/s10840-018-0383-6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/15/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE Audit has played a key role in monitoring and improving clinical practice. However, audit often fails to drive change as summative institutional data alone may be insufficient to do so. We hypothesised that the practice of attributed audit, wherein each individual's procedural performance is presented will have a greater impact on clinical practice. This hypothesis was tested in an observational study evaluating improvement in fluoroscopy times for AF ablation. METHODS Retrospective analyses of fluoroscopy times in AF ablations at the Barts Heart Centre (BHC) from 2012-2017. Fluoroscopy times were compared pre- and post- the introduction of attributed audit in 2012 at St Bartholomew's Hospital (SBH). In order to test the hypothesis, this concept was introduced to a second group of experienced operators from the Heart Hospital (HH) as part of a merger of the two institutions in 2015 and change in fluoroscopy times recorded. RESULTS A significant drop in fluoroscopy times (33.3 ± 9.14 to 8.95 ± 2.50, p < 0.0001) from 2012-2014 was noted after the introduction of attributed audit. At the time of merger, a significant difference in fluoroscopy times between operators from the two centres was seen in 2015. Each operator's procedural performance was shared openly at the audit meeting. Subsequent audits showed a steady decrease in fluoroscopy times for each operator with the fluoroscopy time (min, mean±SD) decreasing from 13.29 ± 7.3 in 2015 to 8.84 ± 4.8 (p < 0.0001) in 2017 across the entire group. CONCLUSIONS Systematic improvement in fluoroscopy times for AF ablation procedures was noted byevaluating individual operators' performance. Attributing data to physicians in attributed audit can promptsignificant improvement and hence should be adopted in clinical practice.
Collapse
Affiliation(s)
- V Sawhney
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK.
| | - E Volkova
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - M Shaukat
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - F Khan
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - O Segal
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - S Ahsan
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - A Chow
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - V Ezzat
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - M Finlay
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - P Lambiase
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - M Lowe
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - M Dhinoja
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - S Sporton
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - M J Earley
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - R J Hunter
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| | - R J Schilling
- EP Cardiac Research, Barts Heart Centre, 1 SMLG, London, EC1A 7BE, UK
| |
Collapse
|
5
|
Graham A, Orini M, Martin C, Lowe M, Earley M, Schilling R, Hunter R, Dhinoja M, Lambiase P. 44Early experience of intra-operative use of ECGI during VT ablation. Europace 2017. [DOI: 10.1093/europace/eux283.001] [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: 11/14/2022] Open
|
6
|
Sawhney V, Shaukat M, Volkova E, Khan F, Segal O, Ashan S, Chow A, Ezzat V, Finlay M, Lambiase P, Lowe M, Dhinoja M, Earley MJ, Sporton S, Hunter RJ, Schilling RJ. 55Impact of open audit on procedural performance in electrophysiology catheter laboratory. Europace 2017. [DOI: 10.1093/europace/eux283.012] [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: 11/14/2022] Open
|
7
|
Sawhney V, Shaukat M, Volkova E, Yao Q, Jones N, Honarbakhsh S, Dhillon G, Lowe M, Lambiase P, Dhinoja M, Finlay M, Sportan S, Earley MJ, Schilling RJ, Hunter RJ. 48Catheter ablation for atrial fibrillation on uninterrupted NOACs: a safe approach? Europace 2017. [DOI: 10.1093/europace/eux283.005] [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: 11/13/2022] Open
|
8
|
Sawhney V, Daw H, Whittaker-Axon S, Breitenstein A, Alan C, Lambiase P, Lowe M, Earley MJ, Sportan S, Hunter RJ, Schilling RJ, Dhinoja M. 95Fluoroscopy times in electrophysiology and device procedures: impact of single frame location fluoroscopy. Europace 2017. [DOI: 10.1093/europace/eux283.090] [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: 11/14/2022] Open
|
9
|
Srinivasan NT, Orini M, Providencia R, Martin C, Dhinoja M, Hunter R, Lowe MD, Khan F, Taggart PD, Schilling RJ, Lambiase PD. 105Investigation of the transmural action potential duration and repolarization properties of scar borderzone in patients undergoing ventricular tachycardia ablation. Europace 2017. [DOI: 10.1093/europace/eux283.099] [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: 11/13/2022] Open
|
10
|
Sawhney V, Domenichini G, Baker V, John S, Gamble J, FurnIss G, Panagopoulos D, Campbell N, Rajappan K, Lambiase P, Sporton S, Earley MJ, Dhinoja M, Haywood G, Hunter RJ, Schilling RJ. 21Thromboembolic events in left ventricular endocardial pacing: long-term outcomes from a Multicentre UK registry. Europace 2017. [DOI: 10.1093/europace/eux283.030] [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: 11/12/2022] Open
|
11
|
Sawhney V, Domenichini G, Gamble J, Furniss G, Panagopoulos D, Campbell N, Lowe M, Lambiase P, Haywood G, Sporton S, Earley MJ, Dhinoja M, Hunter R, Betts T, Schilling RJ. 239Long-Term follow-up of thromboembolic complications in left ventricular endocardial pacing: outcomes from a multi centre uk registry. Europace 2017. [DOI: 10.1093/ehjci/eux139.006] [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: 11/13/2022] Open
|
12
|
Martin CA, Chooneea B, Gajendragadkar PR, Begley DA, Dhinoja M, Earley M, Ezzat V, Grace AA, Heck PM, Hunter R, Lambiase PD, Lowe MD, Schilling RJ, Virdee MS, Chow A. P429UK multi-centre registry of transvenous lead extraction: clinical outcome using different techniques. Europace 2017. [DOI: 10.1093/ehjci/eux141.152] [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: 11/14/2022] Open
|
13
|
Sawhney V, Shaukat M, Volkova E, Yao Q, Jones N, Ullah W, Honarbakhsh S, Lowe M, Lambiaise P, Dhinoja M, Finlay M, Sporton S, Earley MJ, Schilling RJ, Hunter RJ. P1726Catheter ablation for atrial fibrillation on uninterrupted NOACs: a safe approach? Europace 2017. [DOI: 10.1093/ehjci/eux161.036] [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: 11/14/2022] Open
|
14
|
Srinivasan NT, Orini M, Providencia R, Martin C, Dhinoja M, Hunter R, Lowe MD, Khan F, Taggart PD, Schilling RJ, Lambiase PD. 117Investigation of the transmural APD properties of scar borderzone in patients undergoing ventricular tachycardia ablation. Europace 2017. [DOI: 10.1093/ehjci/eux135.006] [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: 11/12/2022] Open
|
15
|
Sawhney V, Bacuetes E, Wray M, Dhinoja M, Earley MJ, Schilling RJ, Sporton S. Moderate sedation in cardiac electrophysiology laboratory: a retrospective safety analysis. Heart 2017; 103:1210-1215. [PMID: 28249993 DOI: 10.1136/heartjnl-2016-310676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Received: 09/25/2016] [Revised: 12/30/2016] [Accepted: 01/27/2017] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Cardiac electrophysiology (EP) procedures can be performed under moderate sedation without the direct involvement of an anaesthetist. However, concerns have been raised over the safety of this approach. This study examines the use of a standardised nurse-led physician-directed sedation protocol for EP procedures to determine the safety of moderate sedation administered by non-anaesthesia personnel who have been trained in sedation techniques. METHODS AND RESULTS Consecutive EP procedures done under moderate sedation over 12 years at our institution were evaluated. Serious adverse events were defined as (i) procedural death related to sedation; (ii) intubation and ventilation; and (iii) hypotension requiring inotropic support. Reversal of sedation constituted a minor adverse event. Up to 7117 procedures were included. These comprised ablations (55%), devices (43%) and other procedures (2%). A majority of patients were men with a mean age of 61±10 years. 99.98% of procedures were completed successfully without sedation-related serious adverse events. Two patients (0.02%) required anaesthetic support for intubation. Sedation was reversed in 1.2% of procedures with less than 1% requiring reversal because of persistent drop in oxygen saturation, hypoventilation or markedly reduced level of consciousness. There was no significant difference in the patient characteristics, mean doses of sedative agents and procedure types in the group requiring reversal of sedation when compared with the whole cohort. CONCLUSIONS Our study demonstrates that nurse-led, physician-directed moderate sedation is safe. Anaesthesia services are not required routinely for invasive cardiac EP procedures and should be available on a need basis.
Collapse
Affiliation(s)
- V Sawhney
- Department of Cardiology, St Bartholomew's Hospital, London, UK
| | - E Bacuetes
- Department of Cardiology, St Bartholomew's Hospital, London, UK
| | - M Wray
- Department of Cardiology, St Bartholomew's Hospital, London, UK
| | - M Dhinoja
- Department of Cardiology, St Bartholomew's Hospital, London, UK
| | - M J Earley
- Department of Cardiology, St Bartholomew's Hospital, London, UK
| | - R J Schilling
- Department of Cardiology, St Bartholomew's Hospital, London, UK
| | - S Sporton
- Department of Cardiology, St Bartholomew's Hospital, London, UK
| |
Collapse
|
16
|
Sawhney V, Breitenstein A, Ullah W, Finlay M, Sporton S, Earley M, Chow A, Dhinoja M, Lambiase P, Schilling R, Hunter R. Epicardial catheter ablation for ventricular tachycardia on uninterrupted warfarin: A safe approach for those with a strong indication for peri-procedural anticoagulation? Int J Cardiol 2016; 222:57-61. [DOI: 10.1016/j.ijcard.2016.07.113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/27/2016] [Accepted: 07/07/2016] [Indexed: 10/21/2022]
|
17
|
Raine D, Begg G, Moore J, Taylor E, Buck R, Honarbakhsh S, Yew Ding W, Redfearn D, Opel A, Opel A, Thomas D, Prakash K, Thomas D, Khokhar A, Honarbakhsh S, Tairova S, Getman N, McAloon C, Honarbakhsh S, Shah M, Al-Lawati K, Al-Lawati K, Ensam B, Collins G, Akbar S, Merghani A, Furniss G, Yones E, Vijayashankar SS, Vijayashankar SS, Shariat H, Moss A, Yeoh A, Sadiq A, Taylor R, Edwards T, Nizam ud Din K, Langley P, Shepherd E, Murray S, Lord S, Bourke J, Plein S, Lip G, Tayebjee MH, Owen N, White S, O'Neill M, Hughes L, Carroll S, Moss-Morris R, Baker V, Kirkby C, Patel K, Robinson G, Antoniou S, Richmond L, Ullah W, Hunter R, Finlay M, Earley M, Whitbread M, Schilling R, Cooper R, Modi S, Somani R, Ng A, Hobson N, Caldwell J, Hadjivassilev S, Ang R, Finlay M, Dhinoja M, Earley M, Sporton S, Schilling R, Hunter R, Hadjivassilev S, Earley M, Lambiase P, Turley A, Child N, Linker N, Owens W, James S, Milner J, Tayebjee M, Sibley J, Griffiths A, Meredith T, Basher Y, Betts T, Rajappan K, Lambiase P, Lowe M, Hunter R, Schilling R, Finlay M, Rakhimbaeva G, Akramova N, Getman T, Hamborg T, O'Hare J, Randeva H, Osman F, Srinivasan N, Kirkby C, Firman E, Tobin L, Murphy C, Lowe M, Hunter R, Finlay M, Schilling R, Lambiase P, Mohan P, Salahia G, Lim H, Lim HS, Batchvarov V, Brennan P, Cox A, Muir A, Behr E, Hamill S, Laventure C, Newell S, Gordon B, Bashir K, Chuen J, Foster W, Yusuf S, Osman F, Hayat S, Panagopoulos D, Davies E, Tomlinson D, Haywood G, Mullan J, Kelland N, Horwood A, Connell N, Odams S, Maloney J, Shetty A, Kyriacou A, Sahu J, Lee J, Uzun O, Wong A, Ashtekar S, Uzun O, Wong A, Ashtekar S, Hashemi J, Gazor S, Redfearn D, Song A, Jenkins J, Glancy J, Wilson D, Sammut E, Diab I, Cripps T, Gill A, Abbas S, Enye J, Wahab A, Elshafie S, Ling K, Carey P, Chatterjee D, Timbrell S, Tufail W, Why H, Martos R, Thornley A, James S, Turley A, Bates M, Linker N, Hassan E, Quick J, Cowell R, Ho E. POSTERS (1)59MULTIPOLAR CONTACT MAPPING GUIDED ABLATION OF TEMPORALLY STABLE HIGH FREQUENCY AND COMPLEX FRACTIONATED ATRIAL ELECTROGRAM SITES IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION60INTRA-CARDIAC AND PERIPHERAL LEVELS OF BIOCHEMICAL MARKERS OF FIBROSES IN PATIENTS UNDERGOING CATHETER ABLATION FOR ATRIAL FIBRILATION61THE DON'T WAIT TO ANTICOAGULATE PROJECT (DWAC) BY THE WEST OF ENGLAND ACADEMIC HEALTH SCIENCE NETWORK (AHSN) OPTIMISES STROKE PREVENTION FOR PATIENTS WITH ATRIAL FIBRILLATION (AF) WITHIN PRIMARY CARE IN LINE WITH NICE CG180 IN THE WEST OF ENGLAND62ILLNESS AND TREATMENT REPRESENTATIONS, COPING AND DISTRESS: VICIOUS CYCLES OF EVERYDAY EXPERIENCES IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION63THE NEEDS OF THE ADOLESCENT LIVING WITH AN INHERITED CARDIAC CONDITION: THE PATIENTS' PERSPECTIVE64SAFETY AND EFFICACY OF PARAMEDIC TREATMENT OF REGULAR SUPRAVENTRICULAR TACHYCARDIA (PARA-SVT)65NATURAL PROGRESSION OF QRS DURATION FOLLOWING IMPLATABLE CARDIOVERTER DEFIBRILLATORS (ICD) - IMPLANTATION66COMPARISON OF EFFICACY OF VOLTAGE DIRECTED CAVOTRICUSPID ISTHMUS ABLATION USING MINI VS CONVENTIONAL ELETRODES67CRYOBALLOON ABLATION (CRYO) FOR ATRIAL FIBRILLATION (AF) CANNOT BE GUIDED BY TEMPERATURE END-POINTS ALONE68MODERATOR BAND ECTOPY UNMASKED BY ADENOSINE AS A CAUSE OF ECTOPIC TRIGGERED IDIOPATHIC VF69EARLY CLINICAL EXPERIENCE WITH TARGETED SITE SELECTION FOR THE WiCS-LV ELECTRODE FOR CRT70DOES VECTOR MAPPING PRIOR TO IMPLANTABLE LOOP RECORDER INSERTION IMPROVE THE DETECTION OF ARRHYTHMIA?71THE ROLE OF SPECKLE TRACKING STRAIN IMAGING IN ASSESSING LEFT VENTRICULAR RESPONSE TO CARDIAC RESYNCHRONISATION THERAPY IN RESPONDERS AND NON-RESPONDERS72EVALUATING PATIENTS' EXPERIENCE AND SATISFACTION OF THE ATRIAL FIBRILLATION ABLATION PROCEDURE: A RETROSPECTIVE ANALYSIS73TROUBLESHOOTING LV LEAD IMPLANTATION - NOVEL “UNIRAIL TECHNIQUE”74SUBCLINICAL ATHEROSCELEROSIS AND COGNITIVE IMPAIRMENT75EFFECT OF LOZARTANE ON DEVELOPMENT OF THE ELECTRICAL INSTABILITY OF THE MYOCARDIUM76THE INTERPLAY BETWEEN BODY COMPOSITION AND LEFT VENTRICULAR REMODELLING IN CARDIAC RESYNCHRONISATION THERAPY77FAMILY SCREENING IN IDIOPATHIC VENTRICULAR FIBRILLATION78MANAGEMENT OF ATRIAL FIBRILLATION IN A LARGE TEACHING HOSPITAL79THE EFFECT OF LEFT VENTRICULAR LEAD POSITION ON SURVIVAL IN PATIENTS WITH BINVENTRICULAR PACEMAKRS/DEFIBRILLATORS80ACUTE DEVICE IMPLANT-RELATED COMPLICATIONS DO NOT INCREASE LATE MORTALITY81ABORTED CARIDAC ARREST AS THE SENTINEL PRESENTATION IN A COHORT OF PATIENTS WITH THE CONCEALED BRUGADA PHENOTYPE82POST-CARDIAC DEVICE IMPLANTATION MOBILISATION ADVICE: A NATIONAL SURVEY83DO RISK SCORES DEVELOPED TO PROTECT ONE-YEAR MORTALITY ACTUALLY HELP IN ACCURATELY SELECTING PATIENTS RECEIVING PRIMARY PREVENTION ICD?84ATRIAL TACHYCARDIA ARISING FROM THE NON-CORONARY AORTIC CUSP85THE EFFECT OF DIFFERENT ATRIAL FIBRILLATION ABLATION STRATEGIES ON SURFACE ECG P WAVE DURATION86PRESCRIBING DRONEDARONE: HOW IS IT DONE ACROSS THE UK AND IS IT SAFE?87A CASE OF WIDE COMPLEX TACHYCARDIA88TRANSITION TO DEDICATED DAY CASE DEVICES - SAFETY AND EFFICACY IN A LARGE VOLUME CENTRE89SEQUENTIAL REGIONAL DOMINANT FREQUENCY MAPPING DURING ATRIAL FIBRILLATION: A NOVEL TEQUNIQUE90ELECTIVE CARDIOVERSION ENERGY PROTOCOLS: A RETROSPECTIVE COMPARISON OF ESCALATION STRATEGIES91THE INCIDENCE OF CLINCALLY RELEVANT HAEMATOMAS WITH PERIOPERATIVE USE OF NEWER P2Y12 INHIBITORS AND INTERRUPTED NOAC THERAPY IN CARDIAC IMPLANTABLE ELECTRONIC DEVICE INSERTION92AN AUDIT OF THE OUTCOMES FOR CHEMICAL AND DIRECT CURRENT CARDIOVERSION FOR ATRIAL FIBRILLATION AT OUR DGH OVER A 3 YEAR DURATION93REAL LIFE ACUTE MANAGEMET OF HAEMODYNAMICALLY TOLERATED MONOMORPHIC VENTRICULAR TACHYCARDIA. ARE WE MAKING EVIDENCE BASED ON DECISIONS?94A SERVICE EVALUATION TO ASSESS THE EFFICACY AND SAFETY OF NOVEL ORAL ANTICOAGULANTS VERSUS WARFARIN FOR ELECTIVE CARDIVERSION IN PATIENTS WITH NON VALVULAR AF IN A NURSE LED CARDIOVERSION SERVICE95PICK UP RATE OF IMPLANTED LOOP RECORDER AT A DISTRICT HOSPITAL. Europace 2016. [DOI: 10.1093/europace/euw273] [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: 11/13/2022] Open
|
18
|
Philippsen T, Orini M, Martin C, Volkova E, Ormerod J, Sohaib S, Elamin N, Blake S, Sawhney V, Ahmad S, Waring O, Bowers R, Raiman L, Hazelwood T, Mills R, Corrado C, Honarbakhsh S, Von Maydell A, Norrish G, Chubb H, Chubb H, Chubb H, Toledano M, Ruiz A, van Zalen J, Foley P, Pearman C, Rehal O, Foley P, Wong L, Foley P, Pearman C, Brahmbhatt D, Khan H, Wardley J, Akbar S, Christensen L, Hansen M, Brandes A, Tinker A, Munroe P, Lambiase P, Honarbakhsh S, McLean A, Lambiase P, Schilling R, Lane J, Chow A, Earley M, Hunter R, Khan F, Lambiase P, Schilling R, Sporton S, Dhinoja M, Camm C, Xavier R, de Sousa M, Betts T, Shun-Shin M, Wright I, Lim E, Lim P, Koawing M, Lefroy D, Linton N, Davies D, Peters N, Kanagaratnam P, Francis D, Whinnett Z, Khan M, Bowes R, Sahu J, Sheridan P, Rogers D, Kyriacou A, Kelland N, Lewis N, Lee J, Segall E, Diab I, Breitenstein A, Ullah W, Sporton S, Earley M, Finlay M, Dhinoja M, Schilling R, Hunter R, Ahmed M, Petkar S, Davidson N, Stout M, Pearce KP, Leo M, Ginks M, Rajappan K, Bashir Y, Balasubramaniam R, Sopher S, Betts T, Paisey J, Cheong J, Roy D, Adhya S, Williams S, O'Neill M, Niederer S, Providencia R, Srinivasan N, Ahsan S, Lowe M, Segal O, Hunter R, Finlay M, Earley M, Schilling R, Lambiase P, Stella S, Cantwell C, Chowdhury R, Kim S, Linton N, Whinnett Z, Koa-Wing M, Lefroy D, Davies DW, Kanagaratnam P, Lim PB, Qureshi N, Peters N, Cantarutti N, Limongelli G, Elliott P, Kaski J, Williams S, Lal K, Harrison J, Whitaker J, Kiedrowicz R, Wright M, O'Neill M, Harrison J, Whitaker J, Williams S, Wright M, Schaeffter T, Razavi R, O'Neill M, Karim R, Williams S, Harrison J, Whitaker J, Wright M, Schaeffter T, Razavi R, O'Neill M, Montanes M, Ella Field E, Walsh H, Callaghan N, Till J, Mangat J, Lowe M, Kaski J, Ruiz Duthil A, Li A, Saba M, Patel N, Beale L, Brickley G, Lloyd G, French A, Khavandi A, McCrea W, Barnes E, Chandrasekaran B, Parry J, Garth L, Chapman J, Todd D, Hobbs J, Modi S, Waktare J, Hall M, Gupta D, Snowdon R, Papageorgiou N, Providência R, Falconer D, Sewart E, Ahsan S, Segal O, Ezzat V, Rowland E, Lowe M, Lambiase P, Chow A, Swift M, Charlton P, James J, Colling A, Barnes E, Starling L, Kontogeorgis A, Roses-Noguer F, Wong T, Jarman J, Clague J, Till J, Colling A, James J, Hawkins M, Burnell S, Chandrasekaran B, Coulson J, Smith L, Choudhury M, Oguguo E, Boyett M, Morris G, Flinn W, Chari A, Belham M, Pugh P, Somarakis K, Parasa R, Allata A, Hashim H, Mathew T, Kayasundar S, Venables P, Quinn J, Ivanova J, Brown S, Oliver R, Lyons M, Chuen M, Walsh J, Robinson T, Staniforth A, Ahsan A, Jamil-Copley S. POSTERS (2)96CONTINUOUS VERSUS INTERMITTENT MONITORING FOR DETECTION OF SUBCLINICAL ATRIAL FIBRILLATION IN HIGH-RISK PATIENTS97HIGH DAY-TO-DAY INTRA-INDIVIDUAL REPRODUCIBILITY OF THE HEART RATE RESPONSE TO EXERCISE IN THE UK BIOBANK DATA98USE OF NOVEL GLOBAL ULTRASOUND IMAGING AND CONTINUEOUS DIPOLE DENSITY MAPPING TO GUIDE ABLATION IN MACRO-REENTRANT TACHYCARDIAS99ANTICOAGULATION AND THE RISK OF COMPLICATIONS IN PATIENTS UNDERGOING VT AND PVC ABLATION100NON-SUSTAINED VENTRICULAR TACHYCARDIA FREQUENTLY PRECEDES CARDIAC ARREST IN PATIENTS WITH BRUGADA SYNDROME101USING HIGH PRECISION HAEMODYNAMIC MEASUREMENTS TO ASSESS DIFFERENCES IN AV OPTIMUM BETWEEN DIFFERENT LEFT VENTRICULAR LEAD POSITIONS IN BIVENTRICULAR PACING102CAN WE PREDICT MEDIUM TERM MORTALITY FROM TRANSVENOUS LEAD EXTRACTION PRE-OPERATIVELY?103PREVENTION OF UNECESSARY ADMISSIONS IN ATRIAL FIBRILLATION104EPICARDIAL CATHETER ABLATION FOR VENTRICULAR TACHYCARDIA ON UNINTERRUPTED WARFARIN: A SAFE APPROACH?105HOW WELL DOES THE NATIONAL INSTITUTE OF CLINICAL EXCELLENCE (NICE) GUIDENCE ON TRANSIENT LOSS OF CONSCIOUSNESS (T-LoC) WORK IN A REAL WORLD? AN AUDIT OF THE SECOND STAGE SPECIALIST CARDIOVASCULAT ASSESSMENT AND DIAGNOSIS106DETECTION OF ATRIAL FIBRILLATION IN COMMUNITY LOCATIONS USING NOVEL TECHNOLOGY'S AS A METHOD OF STROKE PREVENTION IN THE OVER 65'S ASYMPTOMATIC POPULATION - SHOULD IT BECOME STANDARD PRACTISE?107HIGH-DOSE ISOPRENALINE INFUSION AS A METHOD OF INDUCTION OF ATRIAL FIBRILLATION: A MULTI-CENTRE, PLACEBO CONTROLLED CLINICAL TRIAL IN PATIENTS WITH VARYING ARRHYTHMIC RISK108PACEMAKER COMPLICATIONS IN A DISTRICT GENERAL HOSPITAL109CARDIAC RESYNCHRONISATION THERAPY: A TRADE-OFF BETWEEN LEFT VENTRICULAR VOLTAGE OUTPUT AND EJECTION FRACTION?110RAPID DETERIORATION IN LEFT VENTRICULAR FUNCTION AND ACUTE HEART FAILURE AFTER DUAL CHAMBER PACEMAKER INSERTION WITH RESOLUTION FOLLOWING BIVENTRICULAR PACING111LOCALLY PERSONALISED ATRIAL ELECTROPHYSIOLOGY MODELS FROM PENTARAY CATHETER MEASUREMENTS112EVALUATION OF SUBCUTANEOUS ICD VERSUS TRANSVENOUS ICD- A PROPENSITY MATCHED COST-EFFICACY ANALYSIS OF COMPLICATIONS & OUTCOMES113LOCALISING DRIVERS USING ORGANISATIONAL INDEX IN CONTACT MAPPING OF HUMAN PERSISTENT ATRIAL FIBRILLATION114RISK FACTORS FOR SUDDEN CARDIAC DEATH IN PAEDIATRIC HYPERTROPHIC CARDIOMYOPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS115EFFECT OF CATHETER STABILITY AND CONTACT FORCE ON VISITAG DENSITY DURING PULMONARY VEIN ISOLATION116HEPATIC CAPSULE ENHANCEMENT IS COMMONLY SEEN DURING MR-GUIDED ABLATION OF ATRIAL FLUTTER: A MECHANISTIC INSIGHT INTO PROCEDURAL PAIN117DOES HIGHER CONTACT FORCE IMPAIR LESION FORMATION AT THE CAVOTRICUSPID ISTHMUS? INSIGHTS FROM MR-GUIDED ABLATION OF ATRIAL FLUTTER118CLINICAL CHARACTERISATION OF A MALIGNANT SCN5A MUTATION IN CHILDHOOD119RADIOFREQUENCY ASSOCIATED VENTRICULAR FIBRILLATION120CONTRACTILE RESERVE EXPRESSED AS SYSTOLIC VELOCITY DOES NOT PREDICT RESPONSE TO CRT121DAY-CASE DEVICES - A RETROSPECTIVE STUDY USING PATIENT CODING DATA122PATIENTS UNDERGOING SVT ABLATION HAVE A HIGH INCIDENCE OF SECONDARY ARRHYTHMIA ON FOLLOW UP: IMPLICATIONS FOR PRE-PROCEDURE COUNSELLING123PROGNOSTIC ROLE OF HAEMOGLOBINN AND RED BLOOD CELL DITRIBUTION WIDTH IN PATIENTS WITH HEART FAILURE UNDERGOING CARDIAC RESYNCHRONIZATION THERAPY124REMOTE MONITORING AND FOLLOW UP DEVICES125A 20-YEAR, SINGLE-CENTRE EXPERIENCE OF IMPLANTABLE CARDIOVERTER DEFIBRILLATORS (ICD) IN CHILDREN: TIME TO CONSIDER THE SUBCUTANEOUS ICD?126EXPERIENCE OF MAGNETIC REASONANCE IMAGING (MEI) IN PATIENTS WITH MRI CONDITIONAL DEVICES127THE SINUS BRADYCARDIA SEEN IN ATHLETES IS NOT CAUSED BY ENHANCED VAGAL TONE BUT INSTEAD REFLECTS INTRINSIC CHANGES IN THE SINUS NODE REVEALED BY
I
(F) BLOCKADE128SUCCESSFUL DAY-CASE PACEMAKER IMPLANTATION - AN EIGHT YEAR SINGLE-CENTRE EXPERIENCE129LEFT VENTRICULAR INDEX MASS ASSOCIATED WITH ESC HYPERTROPHIC CARDIOMYOPATHY RISK SCORE IN PATIENTS WITH ICDs: A TERTIARY CENTRE HCM REGISTRY130A DGH EXPERIENCE OF DAY-CASE CARDIAC PACEMAKER IMPLANTATION131IS PRE-PROCEDURAL FASTING A NECESSITY FOR SAFE PACEMAKER IMPLANTATION? Europace 2016. [DOI: 10.1093/europace/euw274] [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: 11/14/2022] Open
|
19
|
Evans J, Silberbauer J, Glover B, Kontogeorgis A, McLellan A, Panikker S, Sieniewicz B, Martin C, Burg M, Providencia R, Behar J, Burke M, Withers K, White J, Lencioni M, Carolan-Rees G, Wood K, Patrick H, Griffith M, Gomes J, Kirubakaran S, O'Nunain S, Bencat M, McCready J, Michael K, Hashemi J, Gupta D, Akl S, Redfearn D, Lim E, Panikker S, Butcher C, Khan H, Mantziari L, Jarman J, Hussain W, Jones D, Clague J, Ernst S, Markides V, Wong T, Ezzat V, Schilling R, Lowe M, Whitaker J, Virmani R, Kutys R, Jarman J, Fastl T, Haldar S, Butcher C, Khan H, Mantziari L, O'Neill M, Corado C, Nicol E, Foran J, Markides V, Niederer S, Wong T, Behar J, Sohal M, Jais P, Derval N, Spragg D, Van Gelder B, Bracke F, Steendijk P, Rinaldi C, Chooneea B, Gajendragadkar P, Ahsan S, Begley D, Dhinoja M, Earley M, Ezzat V, Finlay M, Grace A, Heck P, Hunter R, Lambiase P, Lowe M, Rowland E, Schilling R, Segal O, Sporton S, Virdee M, Chow A, Apap Bologna R, Camilleri W, Sammut M, Aquilina O, Barra S, Papageorgiou N, Falconer D, Duehmke R, Rehal O, Ahsan S, Ezzat V, Dhinoja M, Ioannou A, Segal O, Sporton S, Rowland E, Lowe M, Lambiase P, Agarwal S, Chow A, Toth D, Mountney P, Reiml S, Panayioutu M, Brost A, Fahn B, Sohal M, Patel N, Claridge S, Jackson T, Adhya S, Sieniwicz B, O'Neill M, Razavi R, Rhode K, Rinaldi C, Tjong F, Brouwer T, Koop B, Soltis B, Shuros A, Knops R. ORAL ABSTRACTS (2)EP & Ablation19CARDIAC ABLATION PATIENT REPORTED OUTCOMES MEASURES (PROMS): ANALYSIS OF POST-ABLATION AND 1 YEAR FOLLOW-UP DATA20INTENTIONAL CORONARY VEIN EXIT AND CARBON DIOXIDE INSUFFLATION TO ALLOW SAFE SUBXIPHOID EPICARDIAL ACCESS FOR VENTRICULAR MAPPING AND ABLATION - FIRST EXPERIENCE21PACED FRACTIONATION DETECTION AS A TOOL FOR MAPPING SCARS IN VT22DOES USE OF CONTACT-FORCE SENSING CATHETERS IMPROVE THE OUTCOME OF ABLATION OF VENTRICULAR TACHYCARDIA?23RETROGRADE AORTIC ACCESS OF THE PULMONARY VENOUS ATRIUM PROVIDES EQUIVALENT OUTCOMES TO RIGHT ATRIAL OR TRANSEPTAL ACCESS OF THE LEFT ATRIUM IN PATIENTS WITH CONGENITAL HEART DISEASE24COMPUTATIONAL THREE-DIMENSION LEFT ATRIAL APPENDAGE WALL THICKNESS MAPS AND HISTOLOGICAL ANALYSIS TO GUIDE LEFT ATRIAL APPENDAGE ELECTRICAL ISOLATIONPacing & Devices25IDENTIFYING THE OPTIMAL LOCATION FOR LV ENDOCARIDAL PACING:RESULTS FROM A MULTICENTRE INTERNATIONAL REGISTRY OF LV ENDOCARDIAL PACING26UK MULTI-CENTRE REGISTRY OF TRANSVENOUS LEAD EXTRACTION: CLINICAL OUTCOME USING TRACTION, CUTTING SHEATHS AND LASER TECHNIQUES27SKIN FISTULA FORMATION - A NEW EXPERIENCE WITH THE NEW TYRX ABSORBABLE ANTIMICROVIAL ENVELOPE28BIFOCAL RIGHT VENTRICULAR PACING IN PATIENTS WITH FAILED CORONARY-SINUS LEAD IMPLANTS: LONG-TERM RESULTS FROM MULTICENTRE REGISTRY29REAL TIME X-MRI GUIDED LEFT VENTRICULAR LEAD IMPLANTATION FOR TARGETED DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY30ACUTE AND CHRONIC PERFORMANCE OF COMMUNICATING LEADLESS ANTI-TACHYCARDIA PACEMAKER AND SUBCUTANEOUS IMPLANTABLE DEFIBRILLATOR. Europace 2016. [DOI: 10.1093/europace/euw271] [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: 11/12/2022] Open
|
20
|
Martin C, Papageorgiou N, Srinivasan N, Luther V, Ang R, Saberwal B, Sawhney V, Martin C, Orini M, Srinivasan N, Bhar-Amato J, Chow A, Lowe M, Simon R, Lambiase P, Providência R, Srinivasan N, Bronis K, Moscoso Costa F, Cavaco D, Adragao P, Tousoulis D, Hunter R, Schilling R, Segal O, Chow A, Rowland E, Lowe M, Lambiase P, Orini M, Providencia R, Simon R, Khan F, Segal O, Ahsan S, Chow A, Lowe M, Schilling R, Taggart P, Lambiase P, Linton N, Jamil-Copley S, Koa-Wing M, Lim P, Qureshi N, Whinnett Z, Davies D, Peters N, Kanagaratnam P, Opel A, Ullah W, Baker V, Finlay M, Dhinoja M, Earley M, Sporton S, Hunter R, Schilling R, Roy A, Perera D, Sporton S, Dhinoja M, Segal O, Lambiase P, Lowe M, Chow A, Hunter R, Rowland E, Khan F, Ezzat V, Providencia R, Earley M, Finlay M, Schilling R, Ahsan S, Bacuetes EB, Wray MW, Dhinoja MD, Earley ME, Schilling RJS, Sporton SS, Curtain J, Gajendragadkar P, Begley D, Fynn S, Grace A, Heck P, Virdee M, Salaunkey K, Agarwal S. MODERATED POSTERS (2)51GLOBAL HIGH DENSITY MAPPING OF RE-ENTRY VULNERABILITY INDEX INDENTIFIES SITES OF RIGHT VENTRICULAR ARRHYTHMIA INITIATION IN BRUGADA SYNDROME AND ARVC52THE ROLE OF ADENOSINE-GUIDED PULMONARY VEIN ISOLATION IN PATIENTS UNDERGOING ATRIAL FIBRILLATION ABLATION:AN UPDATED META-ANALYSIS53FIRST EVIDENT THAT T-PEAK AND TPEAK-TEND CORRELATE WITH RIGHT TO LEFT AND TRANSMURAL DYNAMIC DISPERSION OF REPOLARIZATION IN THE INTACT HUMAN HEART54RIPPLE MAPPING VENTRICULAR SCAR TO CHARACTERIZE CHANNELS SUPPORTING RE-ENTRANT TACHYCARDIA AS A GUIDE TO ABLATION55LONG TERM DURABILITY OF PULMONARY VEIN ISOLATION: INSIGHTS FROM A RANDOMISED TRIAL OF CRYOBALLOON VERSUS RADIOFREQUENCY ABLATION FOR A COMBINED APPROACH56A SINGLE-CENTRE EXPERIENCE OF THE CONVERGENT PROCEDURE FOR THE TREATMENT OF LONG-STANDING PERSISTENT ATRIAL FIBRILLATION57MODERATE SEDATION IN THE CARDIAC ELECTROPHYSIOLOGY LABORATORY: A RETROSPECTIVE ANALYSIS TO ASSESS SAFETY58USE OF GENERAL ANAESTHESIA IN CATHETER ABLATION OF PERSISTENT AF: IMPROVED OUTCOME AND COST EFFECTIVENESS:. Europace 2016. [DOI: 10.1093/europace/euw269] [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: 11/13/2022] Open
|
21
|
Sawhney V, Breitenstein A, Sporton S, Dhinoja M. Percutaneous lead extraction and venous recanalisation using spectranetics tight rail: A single centre experience. Indian Pacing Electrophysiol J 2016. [PMCID: PMC5197445 DOI: 10.1016/j.ipej.2016.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Aims Despite advances in lead extraction tools, percutaneous lead extraction remains a complex procedure associated with significant morbidity and mortality. Moreover, no standards or directives exist to guide physicians in the choice of their extraction tool or approach and all operators tend to have their own preferred method. The reporting of outcomes with existing and newly emerging extraction technology is therefore encouraged. Methods and results Four lead extraction procedures using the new spectranetics tight rail rotating dilator sheath are described here. All patients (n = 3) had chronically implanted leads (mean duration = 11.7 years) and the pre-procedure venogram showed occluded left subclavian and brachiocephalic veins with extensive collateralisation. All leads were extracted successfully using this newly designed rotating dilator sheath and vascular access was also retained by venous recanalisation using this kit. One patient required a second extraction procedure at four weeks due to diaphragmatic twitch without macroscopic coronary sinus (CS) lead displacement. This was replaced with a transseptal LV lead. There were no other procedure related complications and all patients remained well with good lead parameters at three months follow-up. Conclusion The use of this new tight rail extraction tool appears safe and effective in chronically implanted leads. Moreover, it helps to preserve the vascular access by recanalisation of long tortuous occlusions. Its use across various centres and larger number of patients will be required to confirm our results.
Collapse
|
22
|
Sawhney V, Campbell N, Brouilette S, Coppen S, Harbo M, Baker V, Ikebe C, Shintani Y, Hunter R, Dhinoja M, Johnston A, Earley M, Sporton S, Bendix L, Suzuki K, Schilling R. Telomere shortening and telomerase activity in ischaemic cardiomyopathy patients – Potential markers of ventricular arrhythmia. Int J Cardiol 2016; 207:157-63. [DOI: 10.1016/j.ijcard.2016.01.066] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 12/09/2015] [Accepted: 01/01/2016] [Indexed: 11/25/2022]
|
23
|
Ng F, Lane J, Nisbet A, Betts TR, Arathoon N, Hayward C, Opel A, Abozguia K, Behradfar E, Debney M, Nygren A, Hartley A, Lyon A, Efimov I, Vigmond E, Peters N, Montaigne D, Tinker A, Walters T, Wong M, Morton J, Sparks P, Kistler P, Kalman J, Leo M, Panikker S, Kanagaratnam P, Koa-Wing M, Davies D, Hildick-Smith D, Wynne DG, Ormerod O, Segal OR, Chow AW, Todd D, Cabrera Gomes S, Kirkwood GJ, Fox D, Pepper C, Foran J, Wong T, Patel H, Morley-Smith A, Patel K, Lyon A, Ahsan S, Akhtar M, Hadjivassilev S, Ang R, Finlay M, Dhinoja M, Earley M, Schilling R, Hunter R, Sporton S, Cutler M, Johnson J, Rowan S, Lewis W, Costantini O, Natale A, Ziv O. Moderated Posters 251Gap junction uncoupling during ischaemia activates normally quiescent purkinje-myocardial junctions resulting in accelerated and more complex activation patterns52The role of gαi2 signalling in cardiac electrophysiology53Midline atrial tachycardia: mapping and differentiation54A multicentre experience of percutaneous left atrial appendage occlusion using different technologies in the united kingdom55Opportunistic screening for atrial fibrillation during flu clinics56Primary care achievement of anticoagulation in atrial fibrillation: as assessed by the quality and outcomes framework57Is combined ablation for paroxysmal atrial fibrillation using balloon cryoablation and radiofrequency ablation superior to either technique alone? long-term follow up and cost analysis58Impact of voltage mapping to guide whether or not to perform ablation of the posterior wall in patient with persistent atrial fibrillation:. Europace 2016. [DOI: 10.1093/europace/euv328] [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: 11/14/2022] Open
|
24
|
Honarbakhsh S, Wakefield LA, Sekhri N, Archbold A, Dhinoja M, Weerackody R, Ranjadayalan K. 43 * Anticoagulation strategies in patients with atrial fibrillation does our current practise result in unnecessary delays? Europace 2014. [DOI: 10.1093/europace/euu240.1] [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: 11/14/2022] Open
|
25
|
Hunter RJ, Lee G, Ullah W, Finlay M, Lovell M, Baker V, McLean A, Dhinoja M, Earley MJ, Sporton S, Schilling RJ. 30 * Use of a contact force sensing catheter with advanced catheter location significantly reduces fluoroscopy time and radiation dose in catheter ablation of atrial fibrillation. Europace 2014. [DOI: 10.1093/europace/euu238.12] [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: 11/14/2022] Open
|
26
|
Phan TT, Khan S, Dewhurst M, Lee D, James S, de Belder M, Linker NJ, Thornley A, Turley AJ, Ahmed FZ, Arumugam P, Allen S, Daniels K, Clarke B, Mamas M, James J, Zaidi AM, Ullah W, Hunter R, Lovell M, Dhinoja M, Earley M, Sporton S, Schilling R, Raju H, Hedley P, Arno G, Ware J, Jeffery S, Cook S, Christiansen M, Behr ER, Sohal M, Chen Z, Sammut E, Jackson T, Child N, Wright M, O'Neill M, Cooklin M, Gill J, Carr-White G, Razavi R, Rinaldi CA, Nunn LM, Lopes L, Syrris P, Plagnol V, Firman E, Dalageorgou C, Domingo D, Zorio E, Murday V, Findlay I, Duncan A, Fynn S, White A, Goddard M, Carr-White G, Robert L, Bueser T, Langman C, Bundgaard H, Ferrero-Miliani L, Wheeldon N, O'Beirne A, Suvarna SK, Lowe MD, McKenna WJ, Elliott PM, Lambiase PD. YOUNG INVESTIGATORS COMPETITION, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut313] [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: 11/12/2022] Open
|
27
|
Riley G, Hopkins S, Piccini I, Brown N, Fabritz L, Kirchhof P, Raju H, Bevan S, Sheppard MN, Behr ER, Ng FS, Sulkin MS, Peters NS, Efimov IR, Vanheusden FJ, Li X, Chu GS, Almeida TP, Schlindwein FS, Ng GA, Crockford CJ, Ahmed O, Kaba R, Berry R, Dhillon OS, Ullah W, Hunter R, Lovell M, Dhinoja M, Sporton S, Earley MJ, Diab IG, Schilling RJ, Goonewardene M, Heck PM, Begley DA, Fynn S, Virdee M, Grace A, Agarwal SC, Wilson DG, Ahmed N, Nolan R, French A, Frontera A, Duncan ER, Thomas G. MODERATED POSTERS, SESSION 1, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut317] [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: 11/14/2022] Open
|
28
|
Lee G, Hunter R, Lovell M, Finlay M, Sawhney V, Ullah W, Diab I, Dhinoja M, Earley M, Sporton S, Schilling RJ, Williams SE, Linton NWF, Harrison J, Wright M, O'Neill M, Jamil-Copley S, Linton N, Koa-Wing M, Lim PB, Hayat S, Qureshi N, Whinnett Z, Davies W, Peters N, Francis D, Kanagaratnam P, Jamil-Copley S, Ryan B, Kojodjojo P, Qureshi N, Koa-Wing M, Hayat S, Kyriacou A, Sandler B, Sohaib A, Wright I, Davies W, Peters N, Whinnett Z, Kanagaratnam P, Lim PB, Qureshi NA, Bai W, Ariff B, Williams A, Monro C, Kim S, Jamil-Copley S, Hayat S, Kao-Wing M, Kyriacou A, Sandler B, Fu NS, Kanagaratnam P, Whinnett Z, Davies DW, Lefroy D, Peters NS, Lim PB, Ryan MJ, Ezzat VA, O'Leary J, Bull C, Chow A, Lambiase P, Lowe MD, Anwar AS, Collitt S, Iddon P, Rice N, Dodd M, Dunsdale A, Petkar S, Mudd J, Linker N, Fitzpatrick AP, Fraser S, Choo WK, Padfield G, Rushworth G, Bloe C, Forsyth P, Cross SJ, Leslie SJ, Phan TT, Dewhurst M, Lee D, Williams D, James S, Thornley A, de Belder M, Linker N, Turley A, Campbell NG, Cantor E, Sawhney V, Duncan ER, Demartini C, Baker V, Diab IG, Dhinoja M, Earley MJ, Sporton S, Davies LC, Schilling RJ, Pettit SJ, Randles DA, Shaw M, Hawkins NM, Wright DJ, Lambiase PD, Barr C, Knops R, Neuzil P, Theuns D, Johansen JB, Hood M, Pederson S, Reeve HL, Boersma L. ABSTRACTS FOR ORAL PRESENTATION, SESSION 3, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut316] [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: 11/14/2022] Open
|
29
|
Fabritz L, Fortmuller L, Vloumidi E, Yue TY, Syeda F, Kirchhof P, Leube R, Krusche C, Chin SH, Winter J, Brack KE, Ng GA, Ng FS, Holzem KM, Koppel AC, Janks D, Wit AL, Peters NS, Efimov IR, Chowdhury RA, El-Harasis MA, Dupont E, Terracciano CMN, Peters NS, Mellor GJ, Raju H, de Noronha SV, Papadakis M, Sharma S, Behr ER, Sheppard MN, Jamil-Copley S, Bai W, Ariff B, Lim PB, Koa-Wing M, Kyriacou A, Hayat S, Sohaib A, Qureshi N, Sandler B, O'Regan D, Whinnett Z, Davies W, Rueckert D, Kanagaratnam P, Peters N, Lambiase PD, Chow AW, Lowe MD, Segal OR, Ahsan S, de Bono J, Dhaliwal M, Mfuko C, Ng A, Sandilands A, Paisey J, Roberts P, Morgan JM, McCready J, Yue A, Ullah W, Hunter R, Lovell M, Dhinoja M, Sporton S, Earley M, Schilling R, Ghosh J, Martin A, Keech A, Chan KH, Gomes S, Singarayar S, McGuire M, Lee G, Hunter R, Berriman T, Diab I, Kamdar R, Richmond L, Baker V, Goromonzi F, Sawhney V, Duncan E, Unsworth B, Mayet J, Abrams D, Dhinoja M, Sporton S, Earley M, Schilling RJ, Bowers RW, Mulholland V, Balasubramaniam RN, Paisey JR, Sopher SM, Chu GS, Chin SH, Winter J, Armstrong S, Masca N, Almeida TP, Brown PD, Sandilands AJ, Schlindwein FS, Ng GA. ABSTRACTS FOR ORAL PRESENTATION, SESSION 2, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut315] [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: 11/13/2022] Open
|
30
|
Ullah W, Hunter R, Lovell M, Dhillon O, Diab I, Dhinoja M, Earley M, Sporton S, Schilling R. Contact force during ablation of persistent atrial fibrillation and electrogram attenuation. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2336] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
31
|
Hunter RJ, Berriman TJ, Diab I, Kamdar R, Richmond L, Baker V, Goromonzi F, Duncan E, Sawhney V, Unsworth B, Mayet J, Dhinoja M, Earley MJ, Sporton S, Schilling RJ. 057 A randomised controlled trial of catheter ablation vs medical treatment of atrial fibrillation in heart failure (the CAMTAF trial). Heart 2012. [DOI: 10.1136/heartjnl-2012-301877b.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
32
|
Hunter RJ, Berriman TJ, Diab I, Baker V, Finlay M, Richmond L, Duncan E, Kamdar R, Thomas G, Abrams D, Dhinoja M, Earley MJ, Sporton S, Schilling RJ. 136 Long term efficacy of catheter ablation for AF: impact of additional targeting of fractionated electrograms. Heart 2010. [DOI: 10.1136/hrt.2010.196113.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
Duncan E, Liew R, Goromonzi F, Richmond L, Baker V, Thomas G, Tayebjee M, Finlay M, Abrams D, Dhinoja M, Earley M, Sporton S, Schilling RJ. 133 A randomised controlled trial of catheter ablation of atrial fibrillation comparing manual and robotic navigation: experience with the hansen robotic system. Heart 2010. [DOI: 10.1136/hrt.2010.196113.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
34
|
Tayebjee MH, Duncan E, Baker V, Dhinoja M, Earley MJ, Sporton S, Schilling RJ. 135 Combined radiofrequency and cryoablation for paroxysmal atrial fibrillation. A novel technique to reduce recurrences: Abstract 135 Table 1. Heart 2010. [DOI: 10.1136/hrt.2010.196113.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
35
|
Hunter RJ, Berriman TJ, Diab I, Baker V, Finlay M, Richmond L, Duncan E, Kamdar R, Thomas G, Abrams D, Dhinoja M, Sporton S, Earley MJ, Schilling RJ. Long-term efficacy of catheter ablation for atrial fibrillation: impact of additional targeting of fractionated electrograms. Heart 2010; 96:1372-8. [PMID: 20483892 DOI: 10.1136/hrt.2009.188128] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To investigate long-term efficacy of catheter ablation for atrial fibrillation (AF) and the impact of ablating complex or fractionated electrograms (CFEs) in addition to pulmonary vein isolation and linear lesions in persistent AF (PeAF). METHODS Consecutive cases from 2002-2007 were analysed. All the patients underwent a wide-area circumferential ablation with confirmation of electrical isolation. For PeAF, linear lesions were added, with additional targeting of CFE from 2005. Data were collected in a prospective database. Attempts were made to contact all patients for follow-up. RESULTS 285 patients underwent 530 procedures. The mean (SD) age was 57 (11) years, 75% were male, 20% had structural heart disease and 53% had paroxysmal AF (PAF). The mean number of procedures was 1.9 per patient (1.7 for PAF and 2.0 for PeAF). Procedural complications included stroke or transient ischemic attack in 0.6% and pericardial effusion requiring drainage in 1.7%. During 2.7 years (0.2 to 7.4 years) of follow-up from the last procedure, there were seven deaths (unrelated to their ablation or AF) and three strokes or transient ischemic attack (0.3% per year). Freedom from AF/atrial tachyarrhythmia was 86% for PAF and 68% for PeAF. Late recurrence was 3 per 100 years of follow-up after >3 years. The Kaplan-Meier analysis showed that CFE ablation improved the outcome for PeAF after the first cluster of procedures (p=0.049), with a trend towards improved final outcome (p=0.130). CONCLUSIONS Long-term freedom from AF is achievable in most patients with PAF and PeAF with low rates of late recurrence. Additional targeting of CFE improves outcome for PeAF. Late adverse events including stroke are few.
Collapse
Affiliation(s)
- R J Hunter
- Cardiology Research Department, Barts and The London NHS Trust, St Bartholomew's Hospital, Queen Mary, University of London, West Smithfield, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|