1
|
van der Velden RMJ, Pluymaekers NAHA, Dudink EAMP, Luermans JGLM, Meeder JG, Heesen WF, Lenderink T, Widdershoven JWMG, Bucx JJJ, Rienstra M, Kamp O, van Opstal JM, Kirchhof CJHJ, van Dijk VF, Swart HP, Alings M, Van Gelder IC, Crijns HJGM, Linz D. Cardioversion strategy impacts rate control during recurrences in patients with paroxysmal atrial fibrillation: A subanalysis of the RACE 7 ACWAS trial. Clin Cardiol 2024; 47:e24161. [PMID: 37872853 PMCID: PMC10766137 DOI: 10.1002/clc.24161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND In the Rate Control versus Electrical Cardioversion Trial 7-Acute Cardioversion versus Wait and See, patients with recent-onset atrial fibrillation (AF) were randomized to either early or delayed cardioversion. AIM This prespecified sub-analysis aimed to evaluate heart rate during AF recurrences after an emergency department (ED) visit identified by an electrocardiogram (ECG)-based handheld device. METHODS After the ED visit, included patients (n = 437) were asked to use an ECG-based handheld device to monitor for recurrences during the 4-week follow-up period. 335 patients used the handheld device and were included in this analysis. Recordings from the device were collected and assessed for heart rhythm and rate. Optimal rate control was defined as a target resting heart rate of <110 beats per minute (bpm). RESULTS In 99 patients (29.6%, mean age 67 ± 10 years, 39.4% female, median 6 [3-12] AF recordings) a total of 314 AF recurrences (median 2 [1-3] per patient) were identified during follow-up. The average median resting heart rate at recurrence was 100 ± 21 bpm in the delayed vs 112 ± 25 bpm in the early cardioversion group (p = .011). Optimal rate control was seen in 68.4% [21.3%-100%] and 33.3% [0%-77.5%] of recordings (p = .01), respectively. Randomization group [coefficient -12.09 (-20.55 to -3.63, p = .006) for delayed vs. early cardioversion] and heart rate on index ECG [coefficient 0.46 (0.29-0.63, p < .001) per bpm increase] were identified on multivariable analysis as factors associated with lower median heart rate during AF recurrences. CONCLUSION A delayed cardioversion strategy translated into a favorable heart rate profile during AF recurrences.
Collapse
Affiliation(s)
- Rachel M. J. van der Velden
- Department of CardiologyMaastricht University Medical Centre and Cardiovascular Research Institute MaastrichtMaastrichtThe Netherlands
| | - Nikki A. H. A. Pluymaekers
- Department of CardiologyMaastricht University Medical Centre and Cardiovascular Research Institute MaastrichtMaastrichtThe Netherlands
| | - Elton A. M. P. Dudink
- Department of CardiologyMaastricht University Medical Centre and Cardiovascular Research Institute MaastrichtMaastrichtThe Netherlands
| | - Justin G. L. M. Luermans
- Department of CardiologyMaastricht University Medical Centre and Cardiovascular Research Institute MaastrichtMaastrichtThe Netherlands
- Department of CardiologyRadboudUMCNijmegenThe Netherlands
| | - Joan G. Meeder
- Department of CardiologyVieCuri Medical Center Noord‐LimburgVenloThe Netherlands
| | - Wilfred F. Heesen
- Department of CardiologyVieCuri Medical Center Noord‐LimburgVenloThe Netherlands
| | - Timo Lenderink
- Department of CardiologyZuyderland Medical CenterHeerlenThe Netherlands
| | | | - Jeroen J. J. Bucx
- Department of CardiologyDiakonessenhuis UtrechtUtrechtThe Netherlands
| | - Michiel Rienstra
- Department of Cardiology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Otto Kamp
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMCVrije UniversiteitAmsterdamThe Netherlands
| | | | | | | | - Henk P. Swart
- Department of CardiologyAntonius HospitalSneekThe Netherlands
| | - Marco Alings
- Department of CardiologyAmphia HospitalBredaThe Netherlands
| | - Isabelle C. Van Gelder
- Department of Cardiology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Harry J. G. M. Crijns
- Department of CardiologyMaastricht University Medical Centre and Cardiovascular Research Institute MaastrichtMaastrichtThe Netherlands
| | - Dominik Linz
- Department of CardiologyMaastricht University Medical Centre and Cardiovascular Research Institute MaastrichtMaastrichtThe Netherlands
- Department of CardiologyRadboudUMCNijmegenThe Netherlands
- Department of Cardiology, Center for Heart Rhythm DisordersUniversity of Adelaide and Royal Adelaide HospitalAdelaideAustralia
- Department of Biomedical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| |
Collapse
|
2
|
Abeln BGS, Balt JC, Klaver MN, Maarse M, van Dijk VF, Wijffels MCEF, Boersma LVA. High-density mapping for ablation of atypical atrial flutters - procedural characteristics related to outcome. Pacing Clin Electrophysiol 2023; 46:1403-1411. [PMID: 37724739 DOI: 10.1111/pace.14826] [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: 06/15/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND High-density (HD) mapping is increasingly used to characterize arrhythmic substrate for ablation of atypical atrial flutters (AAFl). However, results on clinical outcomes and factors that are associated with arrhythmia recurrence are scarce. METHODS Single-center, prospective, observational cohort study that enrolled patients with catheter ablation for AAFl using a HD mapping system and a grid-shaped mapping catheter. Procedural characteristics, rates of atrial flutter recurrence, and factors that were associated with atrial flutter recurrence were evaluated. RESULTS Sixty-one patients with a total of 94 AAFl were included in the cohort. HD mapping was used to successfully identify the flutter circuit of 80/94 AAFl. The circuit was not identified for 14/94 AAFl in 11 patients. Critical isthmuses were identified and ablated in 29 patients (48%). Acute procedural success was achieved in 52 patients (85%), and 37 patients (61%) remained free from atrial flutter recurrence during a follow up of 1.3 [1.0-2.1] years. Atrial flutter recurrence was univariably associated with presence of a non-identified flutter circuit (HR:2.6 95% CI [1.1-6.3], p = .04) and critical isthmus-targeted ablation (HR:0.4 [0.15-0.90], p = .03). In multivariable regression analyses, critical isthmus ablation remained significant (HR:0.4 [0.16-0.97], p = .04), whereas presence of a non-identified flutter did not (HR:2.4 [0.96-5.8], p = .06). CONCLUSION HD mapping was successfully used to identify the majority of AAFl circuits. Ablation resulted in freedom from atrial flutter recurrence in 61% of the cohort. Successful identification of all flutter circuits and critical isthmuses appears to be beneficial for long-term outcomes.
Collapse
Affiliation(s)
- Bob G S Abeln
- Cardiology Department, St. Antonius Hospital, Nieuwegein, The Netherlands
- Cardiology Department, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jippe C Balt
- Cardiology Department, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Martijn N Klaver
- Cardiology Department, St. Antonius Hospital, Nieuwegein, The Netherlands
- Cardiology Department, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Moniek Maarse
- Cardiology Department, St. Antonius Hospital, Nieuwegein, The Netherlands
- Cardiology Department, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Vincent F van Dijk
- Cardiology Department, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Lucas V A Boersma
- Cardiology Department, St. Antonius Hospital, Nieuwegein, The Netherlands
- Cardiology Department, Amsterdam University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
3
|
Abeln BGS, van Dijk VF, Balt JC, Wijffels MCEF, Boersma LVA. Dielectric response as a novel marker for ablation lesion quality: Relation to conventional ablation parameters. J Arrhythm 2023; 39:776-783. [PMID: 37799786 PMCID: PMC10549823 DOI: 10.1002/joa3.12907] [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] [Received: 05/16/2023] [Revised: 07/07/2023] [Accepted: 07/23/2023] [Indexed: 10/07/2023] Open
Abstract
Background The tissue response viewer (TRV) is a novel marker for ablation lesion quality that aims to classify lesions into transmural or nontransmural lesions (high or low dielectric response, HDR or LDR) using dielectric-based tissue assessment. The objective of this study was to gain insight in the TRV by relating its outcomes to conventional ablation parameters. Methods Patients that had repeat ablation for atrial fibrillation with a dielectric imaging-based mapping system were enrolled. All ablation data were downloaded from the mapping system and analyzed to explore associations between TRV outcomes and other ablation parameters. Results The cohort included 24 patients, in which 58 pulmonary veins and 8 superior vena cavas were targeted. A total of 388 energy applications were applied, resulting in 639 ablation points. The system classified 36% of ablation points as HDR and 44% as LDR. The system did not provide a dielectric response in 20%. The system's ability to provide a dielectric response was related to longer ablation duration and absence of dragging ablation. HDR (versus LDR) was multivariably associated with longer energy applications, higher mean ablation power, and lower wall thickness. Greater impedance drop was univariably associated with HDR. Conclusion Outcomes of the TRV are associated with conventional ablation parameters (e.g., duration and power) but also local wall thickness. Catheter stability seems important for successful lesion assessment with the TRV. Further reduction of missing outcomes and validation of the tool are warranted before widespread use.
Collapse
Affiliation(s)
- Bob G. S. Abeln
- Cardiology DepartmentSt. Antonius HospitalNieuwegeinthe Netherlands
- Cardiology DepartmentAmsterdam University Medical CenterAmsterdamthe Netherlands
| | | | - Jippe C. Balt
- Cardiology DepartmentSt. Antonius HospitalNieuwegeinthe Netherlands
| | | | - Lucas V. A. Boersma
- Cardiology DepartmentSt. Antonius HospitalNieuwegeinthe Netherlands
- Cardiology DepartmentAmsterdam University Medical CenterAmsterdamthe Netherlands
| |
Collapse
|
4
|
Breeman KTN, Oosterwerff EFJ, de Graaf MA, Juffer A, Saleem-Talib S, Maass AH, Wilde AAM, Boersma LVA, Ramanna H, van Dijk VF, van Erven L, Delnoy PPHM, Tjong FVY, Knops RE. Five-year safety and efficacy of leadless pacemakers in a Dutch cohort. Heart Rhythm 2023:S1547-5271(23)02322-6. [PMID: 37271354 DOI: 10.1016/j.hrthm.2023.05.031] [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: 04/07/2023] [Revised: 05/16/2023] [Accepted: 05/26/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Adequate real-world safety and efficacy of leadless pacemakers (LPs) has been demonstrated up to three years after implantation. Longer-term data is warranted to assess the net clinical benefit of leadless pacing. OBJECTIVE To evaluate the long-term safety and efficacy of LP therapy in a real-world cohort. METHODS In this retrospective cohort study, all consecutive patients were included with a first LP implantation from December 21, 2012 to December 13, 2016 in six Dutch high-volume centers. The primary safety endpoint was the rate of major procedure- or device-related complications (i.e., requiring surgery) at five-year follow-up. Analyses were performed with and without Nanostim battery advisory-related complications. The primary efficacy endpoint was the percentage of patients with a pacing capture threshold of ≤2.0V at implantation and without ≥1.5V increase at the last follow-up visit. RESULTS 179 patients were included (mean age 79±9 years), 93 (52%) with a Nanostim and 86 (48%) with a Micra VR LP. Mean follow-up duration was 44±26 months. Forty-one major complications occurred, of which seven not advisory-related. The five-year major complication rate was 4% without advisory-related complications and 27% including advisory-related complications. Not advisory-related major complications occurred median 10 days (range 0-88 days) post-implantation. The pacing capture threshold was low in 163/167 (98%) and stable in 157/160 (98%). CONCLUSION The long-term major complication rate without advisory-related complications was low with LPs. No complications occurred after the acute phase and no infections occurred, which may be a specific benefit of LPs. The performance was adequate with a stable pacing capture threshold.
Collapse
Affiliation(s)
- Karel T N Breeman
- Amsterdam UMC location AMC, Department of Cardiology, Amsterdam, The Netherlands, Amsterdam Cardiovascular Sciences, Heart failure & arrhythmias, Amsterdam, The Netherlands.
| | - Erik F J Oosterwerff
- Isala Clinics, Department of Cardiology, Zwolle, The Netherlands; Flevo Hospital, Department of Cardiology, Almere, The Netherlands
| | - Michiel A de Graaf
- Leiden University Medical Center, Department of Cardiology, Leiden, The Netherlands
| | - Albert Juffer
- St. Antonius Hospital, Department of Cardiology, Nieuwegein, the Netherlands
| | | | - Alexander H Maass
- University Medical Center Groningen, Department of Cardiology, Groningen, Netherlands
| | - Arthur A M Wilde
- Amsterdam UMC location AMC, Department of Cardiology, Amsterdam, The Netherlands, Amsterdam Cardiovascular Sciences, Heart failure & arrhythmias, Amsterdam, The Netherlands
| | - Lucas V A Boersma
- Amsterdam UMC location AMC, Department of Cardiology, Amsterdam, The Netherlands, Amsterdam Cardiovascular Sciences, Heart failure & arrhythmias, Amsterdam, The Netherlands; St. Antonius Hospital, Department of Cardiology, Nieuwegein, the Netherlands
| | - Hemanth Ramanna
- Haga Teaching Hospital, Department of Cardiology, the Hague, The Netherlands
| | - Vincent F van Dijk
- St. Antonius Hospital, Department of Cardiology, Nieuwegein, the Netherlands
| | - Lieselot van Erven
- Leiden University Medical Center, Department of Cardiology, Leiden, The Netherlands
| | | | - Fleur V Y Tjong
- Amsterdam UMC location AMC, Department of Cardiology, Amsterdam, The Netherlands, Amsterdam Cardiovascular Sciences, Heart failure & arrhythmias, Amsterdam, The Netherlands
| | - Reinoud E Knops
- Amsterdam UMC location AMC, Department of Cardiology, Amsterdam, The Netherlands, Amsterdam Cardiovascular Sciences, Heart failure & arrhythmias, Amsterdam, The Netherlands
| |
Collapse
|
5
|
Balt JC, Abeln BGS, Mahmoodi BK, van Dijk VF, Wijffels MCEF, Boersma LVA. Long-term success of a multi-electrode substrate mapping and ablation strategy versus a classic single tip mapping and ablation strategy for ventricular tachycardia ablation in patients with ischemic cardiomyopathy. Pacing Clin Electrophysiol 2023. [PMID: 37254956 DOI: 10.1111/pace.14717] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/31/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Over the past years, mapping and ablation techniques for the treatment of ventricular tachycardia (VT) have evolved rapidly. High Density (HD) substrate mapping is now routine and pre-procedural imaging is increasingly used. The additional value of these techniques for long-term VT-free survival is not clear. METHODS We compared baseline and procedural characteristics, procedural success, safety and outcome of mapping and ablation of ventricular tachycardia in patients with ischemic heart disease between two groups. (1) Low Density (LD) group: VT mapping and ablation with a 4 mm single tip catheter (2) HD group: HD substrate mapping with the Pentaray (Biosense Webster, USA) or HD Grid (Abbott, USA) catheter and ablation with a 4 mm single tip catheter. RESULTS VT ablation was performed in 133 patients (71 patients in LD group and 62 patients in HD group). The median follow-up was 5.0 years in LD group and 2.0 years in HD group. One-, two-, and five-year VT recurrence rates were 47%, 56%, and 65% in the LD group versus 39%, 50%, and 55% in the HD group (log-rank test for VT recurrence p = .70). One-, two-, and five-year ICD shock recurrence rates were 14%, 18%, and 24% in the LD group versus 8%, 15%, and 19% in the HD group (log-rank test for ICD-shock p = .79). All-cause mortality, cardiac (non-arrhythmic), and arrhythmic death, were similar in both groups. Severe procedural complications (tamponade, stroke, or procedural death) occurred in four patients (5%, 1 vascular, 3 tamponade) in the LD group versus two patients (3%, both tamponade) in the HD group (NS). In univariate and multivariable analysis, only a higher LVEF was significantly associated with VT-free survival. HD mapping was not significantly associated with VT-free survival. Anterior infarct location and age were significantly associated with ICD recurrent shock in both univariate and multivariable analyses. CONCLUSIONS In patients with ischemic cardiomyopathy, a HD substrate mapping, and ablation strategy did not lead to higher VT-free survival and shock-free survival compared to a single tip mapping and ablation strategy. In this study, only LVF is an independent predictor for VT recurrence. Anterior infarct location and age predict recurrent ICD shocks.
Collapse
Affiliation(s)
- Jippe C Balt
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Bob G S Abeln
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
- Department of Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Vincent F van Dijk
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Lucas V A Boersma
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
- Department of Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| |
Collapse
|
6
|
van der Velden RMJ, Pluymaekers NAHA, Dudink EAMP, Luermans JGLM, Meeder JG, Heesen WF, Lenderink T, Widdershoven JWMG, Bucx JJJ, Rienstra M, Kamp O, van Opstal JM, Kirchhof CJHJ, van Dijk VF, Swart HP, Alings M, Van Gelder IC, Crijns HJGM, Linz D. Mobile health adherence for the detection of recurrent recent-onset atrial fibrillation. Heart 2022; 109:26-33. [PMID: 36322782 DOI: 10.1136/heartjnl-2022-321346] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/05/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The Rate Control versus Electrical Cardioversion Trial 7-Acute Cardioversion versus Wait and See trial compared early to delayed cardioversion for patients with recent-onset symptomatic atrial fibrillation (AF). This study aims to evaluate the adherence to a 4-week mobile health (mHealth) prescription to detect AF recurrences after an emergency department visit. METHODS After the emergency department visit, the 437 included patients, irrespective of randomisation arm (early or delayed cardioversion), were asked to record heart rate and rhythm for 1 min three times daily and in case of symptoms by an electrocardiography-based handheld device for 4 weeks (if available). Adherence was appraised as number of performed measurements per number of recordings asked from the patient and was evaluated for longitudinal adherence consistency. All patients who used the handheld device were included in this subanalysis. RESULTS 335 patients (58% males; median age 67 (IQR 11) years) were included. The median overall adherence of all patients was 83.3% (IQR 29.9%). The median number of monitoring days was 27 out of 27 (IQR 5), whereas the median number of full monitoring days was 16 out of 27 (IQR 14). Higher age and a previous paroxysm of AF were identified as multivariable adjusted factors associated with adherence. CONCLUSIONS In this randomised trial, a 4-week mHealth prescription to monitor for AF recurrences after an emergency department visit for recent-onset AF was feasible with 85.7% of patients consistently using the device with at least one measurement per day. Older patients were more adherent. TRIAL REGISTRATION NUMBER NCT02248753.
Collapse
Affiliation(s)
| | | | - Elton A M P Dudink
- Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Justin G L M Luermans
- Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Cardiology, RadboudUMC, Nijmegen, The Netherlands
| | - Joan G Meeder
- Cardiology, VieCuri Medisch Centrum, Venlo, The Netherlands
| | | | - Timo Lenderink
- Cardiology, Zuyderland Medisch Centrum Heerlen, Heerlen, The Netherlands
| | | | - Jeroen J J Bucx
- Cardiology, Diakonessenhuis Utrecht Zeist Doorn, Utrecht, The Netherlands
| | | | - Otto Kamp
- Cardiology, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | | | | | | | - Henk P Swart
- Cardiology, Antonius Hospital, Sneek, The Netherlands
| | - Marco Alings
- Cardiology, Amphia Hospital, Breda, The Netherlands
| | | | - Harry J G M Crijns
- Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Dominik Linz
- Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Biomedical Sciences, University of Copenhagen, Kobenhavn, Denmark.,Center for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| |
Collapse
|
7
|
Liebregts M, van Dijk VF, Boersma LV, Balt JC. Ablation of ventricular tachycardia using state-of-the art pre-procedural imaging, magnetic-based three-dimensional mapping and ultra-low temperature cryoablation technology. HeartRhythm Case Rep 2022; 8:390-392. [PMID: 35607343 PMCID: PMC9123308 DOI: 10.1016/j.hrcr.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
8
|
Bakker A, Mathijssen H, Dorland G, Balt JC, van Dijk VF, Veltkamp M, Akdim F, Grutters JC, Post MC. Long-term monitoring of arrhythmias with cardiovascular implantable electronic devices in patients with cardiac sarcoidosis. Heart Rhythm 2021; 19:352-360. [PMID: 34843965 DOI: 10.1016/j.hrthm.2021.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/26/2021] [Revised: 11/06/2021] [Accepted: 11/18/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Risk stratification for sudden cardiac death (SCD) in cardiac sarcoidosis (CS) is challenging in patients without overt cardiac symptoms. OBJECTIVE The purpose of this study was to determine the incidence of ventricular arrhythmias (VAs) and mortality after long-term monitoring with a cardiovascular implantable electronic device (CIED) in CS patients identified after systematic screening of patients with extracardiac sarcoidosis (ECS). METHODS A retrospective study was performed in 547 predominantly Caucasian patients with ECS screened for cardiac involvement. If CS was diagnosed, risk stratification (high vs low risk) for SCD was performed by a multidisciplinary team. The primary endpoint was defined as sustained VA, appropriate implantable cardioverter-defibrillator (ICD) therapy, or cardiac death. RESULTS In total, 105 patients were included (mean follow-up 33 ± 16 months). An ICD was implanted in 17 high-risk patients (16.2%), whereas 80 low-risk patients (76.1%) received an implantable loop recorder (ILR). Eight low-risk patients (7.6%) did not receive a device. The primary endpoint occurred in 4.8% (n = 5), with an overall annualized event rate of 1.7%. The annualized event rate was 9.8% in high-risk patients and 0.4% in low-risk patients. Nine low-risk patients received an ICD during follow-up, in 7 patients as a result of the ILR recordings. None of these patients required ICD therapy. CONCLUSION In CS patients without overt cardiac symptoms at initial presentation the annualized overall event rate was 1.7%; 10% in high-risk patients, but only 0.4% in low-risk patients. In low-risk patients long-term arrhythmia monitoring with an ILR enabled early detection of clinically important arrhythmias without showing impact on prognosis.
Collapse
Affiliation(s)
- Annelies Bakker
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Nieuwegein, The Netherlands; Department of Cardiology, Amphia Hospital Breda, Breda, The Netherlands.
| | - Harold Mathijssen
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Nieuwegein, The Netherlands
| | - Galina Dorland
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Nieuwegein, The Netherlands
| | - Jippe C Balt
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Nieuwegein, The Netherlands
| | - Vincent F van Dijk
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Nieuwegein, The Netherlands
| | - Marcel Veltkamp
- Department of Pulmonology, St. Antonius Hospital Nieuwegein/Utrecht, Nieuwegein, The Netherlands; Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Fatima Akdim
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Nieuwegein, The Netherlands
| | - Jan C Grutters
- Department of Pulmonology, St. Antonius Hospital Nieuwegein/Utrecht, Nieuwegein, The Netherlands; Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn C Post
- Department of Cardiology, St. Antonius Hospital Nieuwegein/Utrecht, Nieuwegein, The Netherlands; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
9
|
van Dijk VF, Boersma LVA. Non-transvenous ICD therapy: current status and beyond. Herz 2021; 46:520-525. [PMID: 34751802 DOI: 10.1007/s00059-021-05077-4] [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] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 11/28/2022]
Abstract
Subcutaneous implantable cardioverter/defibrillators (S-ICDs) have been developed to offer ICD treatment to patients without venous access to the heart and to overcome complications associated with transvenous leads, particularly lead fracture/insulation defects and endocarditis. Several studies and registries have demonstrated the feasibility and safety of S‑ICD in different groups of patients. Further developments in S‑ICD technology involve the combination with devices that can provide anti-bradycardia and anti-tachycardia pacing if needed. The extravascular ICD (EV-ICD) is a new system that similarly offers ICD therapy without a transvenous lead but uses a substernal instead of a subcutaneous lead to facilitate detection of ventricular fibrillation and to provide anti-tachycardia and also temporary anti-bradycardia pacing. The first animal but also clinical data on EV-ICDs have been published. This review discusses the current state, potential advantages and limitations, and future research of both S‑ICD and EV-ICD.
Collapse
Affiliation(s)
- Vincent F van Dijk
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435, CM Nieuwegein, The Netherlands
| | - Lucas V A Boersma
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435, CM Nieuwegein, The Netherlands. .,Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
| |
Collapse
|
10
|
Wouters PC, van Lieshout C, van Dijk VF, Delnoy PPH, Doevendans PA, Cramer MJ, Frederix GW, van Slochteren FJ, Meine M. Advanced image-supported lead placement in cardiac resynchronisation therapy: protocol for the multicentre, randomised controlled ADVISE trial and early economic evaluation. BMJ Open 2021; 11:e054115. [PMID: 34697125 PMCID: PMC8547507 DOI: 10.1136/bmjopen-2021-054115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Achieving optimal placement of the left ventricular (LV) lead in cardiac resynchronisation therapy (CRT) is a prerequisite in order to achieve maximum clinical benefit, and is likely to help avoid non-response. Pacing outside scar tissue and targeting late activated segments may improve outcome. The present study will be the first randomised controlled trial to compare the efficacy of real-time image-guided LV lead delivery to conventional CRT implantation. In addition, to estimate the cost-effectiveness of targeted lead implantation, an early decision analytic model was developed, and described here. METHODS AND ANALYSIS A multicentre, interventional, randomised, controlled trial will be conducted in a total of 130 patients with a class I or IIa indication for CRT implantation. Patients will be stratified to ischaemic heart failure aetiology and 1:1 randomised to either empirical lead placement or live image-guided lead placement. Ultimate lead location and echocardiographic assessment will be performed by core laboratories, blinded to treatment allocation and patient information. Late gadolinium enhancement cardiac magnetic resonance imaging (CMR) and CINE-CMR with feature-tracking postprocessing software will be used to semi-automatically determine myocardial scar and late mechanical activation. The subsequent treatment file with optimal LV-lead positions will be fused with the fluoroscopy, resulting in live target-visualisation during the procedure. The primary endpoint is the difference in percentage of successfully targeted LV-lead location. Secondary endpoints are relative percentage reduction in indexed LV end-systolic volume, a hierarchical clinical endpoint, and quality of life. The early analytic model was developed using a Markov-model, consisting of seven mutually exclusive health states. ETHICS AND DISSEMINATION The protocol was approved by the Medical Research Ethics Committee Utrecht (NL73416.041.20). All participants are required to provide written informed consent. Results will be submitted to peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05053568; Trial NL8666.
Collapse
Affiliation(s)
- Philippe C Wouters
- Department of Cardiology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Chris van Lieshout
- Department of Public Health, Healthcare Innovation & Evaluation and Medical Humanities (PHM), Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Vincent F van Dijk
- Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | | | - Pieter Afm Doevendans
- Department of Cardiology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Maarten J Cramer
- Department of Cardiology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - Geert Wj Frederix
- Department of Public Health, Healthcare Innovation & Evaluation and Medical Humanities (PHM), Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | | | - Mathias Meine
- Department of Cardiology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| |
Collapse
|
11
|
Abeln BGS, van den Broek JLPM, van Dijk VF, Balt JC, Wijffels MCEF, Dekker LRC, Boersma LVA. Dielectric imaging for electrophysiology procedures: The technology, current state, and future potential. J Cardiovasc Electrophysiol 2021; 32:1140-1146. [PMID: 33629788 DOI: 10.1111/jce.14971] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/22/2020] [Revised: 02/08/2021] [Accepted: 02/13/2021] [Indexed: 11/30/2022]
Abstract
Electroanatomic mapping systems have become an essential tool to guide the identification and ablation of arrhythmic substrate. Recently, a novel guiding system for electrophysiology procedures was introduced that uses dielectric sensing to perform high resolution anatomical imaging. Dielectric imaging systems use electrical fields to differentiate anatomic structures based on their conductivity and permittivity. This technique enables non-fluoroscopic, noncontact mapping of anatomic structures, assessment of pulmonary vein occlusion state during cryoballoon ablation, and has the potential to assess for additional tissue characterization including tissue thickness and tissue type. This article elaborates on the functioning and potential of dielectric imaging systems and provides two cases to illustrate the clinical impact for electrophysiology procedures.
Collapse
Affiliation(s)
- Bob G S Abeln
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Vincent F van Dijk
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Jippe C Balt
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Lukas R C Dekker
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Lucas V A Boersma
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| |
Collapse
|
12
|
Kingma JS, Frenay IM, Meinders AJ, van Dijk VF, Harmsze AM. [A poisonous spring smoothie with wild herbs: accidental intoxication with foxglove (Digitalis purpurea)]. Ned Tijdschr Geneeskd 2020; 164:D5306. [PMID: 33331728] [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: 06/12/2023]
Abstract
BACKGROUND At a time when self-sufficiency and health are becoming increasingly important in society, the chances of intoxications with wild plants are increasing. Foxglove contains poisonous cardiac glycosides such as digoxin, digitoxin and gitoxin. The levels vary greatly and depend on the season and the location of the plants. The "non-digoxin" cardiac glycosides show a limited cross-reaction with the digoxin assay. This means that a low or therapeutic digoxin level does not rule out a severe foxglove intoxication. Due to the long half-life of the different cardiac glycosides, toxic symptoms can be persistent. CASE DESCRIPTION A 43-year-old woman arrived at the Emergency Department with persistent vomiting and specific ECG-abnormalities. The day before, she drunk a smoothie made from wild plants picked in the woods. Patient appeared to have mistaken foxglove for common sorrel. CONCLUSION In case of persistent gastrointestinal complaints with specific ECG abnormalities after ingestion of plant material, clinicians should be aware of a foxglove intoxication.
Collapse
Affiliation(s)
- Jurjen S Kingma
- St. Antonius ziekenhuis, afd. Klinische Farmacie,Nieuwegein
- Contact: Jurjen S. Kingma
| | | | | | | | | |
Collapse
|
13
|
Wintgens LIS, Klaver MN, Swaans MJ, Alipour A, Balt JC, van Dijk VF, Rensing BJWM, Wijffels MCEF, Boersma LVA. Left atrial catheter ablation in patients with previously implanted left atrial appendage closure devices. Europace 2020; 21:428-433. [PMID: 30380015 DOI: 10.1093/europace/euy237] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/20/2018] [Indexed: 01/19/2023] Open
Abstract
AIMS Left atrial appendage closure (LAAC) is increasingly used as an alternative to oral anticoagulation (OAC) for stroke prevention in atrial fibrillation (AF) patients. Feasibility and safety of left atrial (LA) catheter ablation (CA) in patients with previously implanted LAAC devices have not been well studied. We report on the feasibility, safety, and efficacy of LA CA in the presence of a previously implanted LAAC device. METHODS AND RESULTS In this prospective cohort study consecutive patients that underwent LA CA with a previously implanted Watchman device were included. Periprocedural characteristics and long-term clinical follow-up were evaluated. Twenty-three LA CA procedures were performed in 19/162 AF patients with previously implanted Watchman devices [47% male, age 63.9 ± 6.2 years, CHA2DS2-VASc 4.0 (3.0-5.0); HASBLED 3.0 (2.0-4.0); 63% paroxysmal]. Left atrial CA was performed with irrigated radiofrequency (RF; n = 20, 87%) or phased RF (n = 3, 13%) in a mean of 18 months after LAAC implantation (range 4-80 months). Targets of CA consisted of pulmonary vein isolation (n = 19, 83%), superior vena cava isolation (n = 13, 57%), and additional linear lesions (n = 8, 35%). Procedures were carried out under vitamin K antagonist (VKA; n = 6, 26%), non-VKA OAC (NOAC; n = 8, 35%), or single antiplatelet therapy alone (n = 9, 39%). Left atrial CA was successful without any signs of interference from the device. Procedure-related complications were not observed. During a mean follow-up of 28 months, 11 patients (58%) had AF recurrence. CONCLUSION Left atrial CA after LAAC appears to be feasible, effective, and safe in this single centre cohort. Previously implanted Watchman device should not be a reason to relinquish CA in symptomatic AF patients, even in patients on single antiplatelet therapy alone.
Collapse
Affiliation(s)
- Lisette I S Wintgens
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, the Netherlands
| | - Martijn N Klaver
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, the Netherlands
| | - Martin J Swaans
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, the Netherlands
| | - Arash Alipour
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, the Netherlands.,Department of Cardiology, Rivierenland Hospital, President Kennedylaan 1, WP Tiel, the Netherlands
| | - Jippe C Balt
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, the Netherlands
| | - Vincent F van Dijk
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, the Netherlands
| | - Benno J W M Rensing
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, the Netherlands
| | - Maurits C E F Wijffels
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, the Netherlands
| | - Lucas V A Boersma
- Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, the Netherlands.,Department of Cardiology, Amsterdam UMC, Location AMC, Meibergdreef 9, AZ Amsterdam, the Netherlands
| |
Collapse
|
14
|
van Dijk VF, Boersma LVA. The subcutaneous implantable cardioverter defibrillator in 2019 and beyond. Trends Cardiovasc Med 2020; 30:378-384. [DOI: 10.1016/j.tcm.2019.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 11/16/2022]
|
15
|
van Dijk VF, Quast AFBE, Schaap J, Balt JC, Kelder JC, Wijffels MCEF, de Groot JR, Boersma LVA. ICD implantation for secondary prevention in patients with ventricular arrhythmia in the setting of acute cardiac ischemia and a history of myocardial infarction. J Cardiovasc Electrophysiol 2020; 31:536-543. [PMID: 31944462 DOI: 10.1111/jce.14357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Received: 11/19/2019] [Revised: 12/13/2019] [Accepted: 12/17/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In patients with a prior myocardial infarction (MI) but preserved left ventricular (LV) function, sustained ventricular arrhythmias (VAs) may arise in the setting of an acute coronary syndrome (ACS). It is unknown whether an implantable cardioverter-defibrillator (ICD) is mandatory in these patients as VA might be triggered by a reversible cause. The purpose of this study is to analyze the benefit of ICD therapy in this patient population. METHODS We conducted a retrospective observational study in ICD recipients implanted from 2008 to 2011. The study group consisted of patients with sustained VA in the setting of an ACS, with a history of MI, but with left ventricular ejection fraction (LVEF) greater than 35 (group A). The two control groups consisted of patients admitted with VA with a history of MI, but without ACS at presentation, either with LVEF greater than 35% (group B) or ≤35% (group C). The primary endpoint was the number of patients with appropriate ICD therapy (antitachycardia pacing or shock). RESULTS A total of 291 patients were included with a mean follow-up of 5.3 years. Appropriate ICD therapy occurred in 45.6% of the patients in group A vs 51.6% and 60.4% in groups B and C (P = .11). In group A, 31.1% received an appropriate ICD shock vs 34.7% and 44.3% in control groups B and C (P = .12). CONCLUSION On the basis of these data, ICD implantation seems warranted in patients with history of MI presenting with VA in the setting of an ACS, despite preserved LV function and adequate revascularization. Further trials, preferably randomizes, should be performed to address these findings.
Collapse
Affiliation(s)
- Vincent F van Dijk
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Anne-Floor B E Quast
- Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jeroen Schaap
- Department of Cardiology, Amphia Hospital, Breda, The Netherlands
| | - Jippe C Balt
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - J C Kelder
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Joris R de Groot
- Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Lucas V A Boersma
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.,Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
16
|
van den Brink FS, van Dijk VF, Boersma LV, Wijffels MC, Gelissen J, Daeter E, Sonker U, Balt J. A combined epicardial implantation and subsequent extraction strategy in pacemaker device infection in pacemaker-dependent patients. Pacing Clin Electrophysiol 2018; 41:906-911. [PMID: 29790185 DOI: 10.1111/pace.13382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/25/2017] [Revised: 03/13/2018] [Accepted: 04/24/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Treatment infections is challenging in pacemaker (PM) dependent patients. We proposed a novel implantation strategy for this group of patients. METHODS Patients who were PM dependent and were admitted with a PM infection received a combined procedure of left ventricular (LV) epicardial implantation of a PM lead and subsequent extraction of the infected system. No temporary pacing wire was used and the PM generator was placed in the left flank. RESULTS Between 2012 and 2015 we treated 16 patients who were PM dependent and with a PM infection. The majority of patients were male (81% [13/16]) and the median age was 71 years (50-91). The cause of infection was valvular endocarditis in 38% (6/16), lead infection in 25% (4/16), and isolated pocket infection in 38% (6/16). All patients underwent epicardial implantation of a LV lead (1084T bipolar lead; St. Jude Medical Myodex, St. Paul, MN, USA) and extraction of the infected device. There was no occurrence of periprocedural mortality and no postprocedural tamponades. There was one complication in the form of a hemorrhage at the infected device extraction site. In the median follow-up period of 17 months there were four of 16 deaths, none of which were attributable to epicardial LV implantation. LV-lead threshold was 1.1V (±0.7V) upon implantation that increased to 1.2V (±0.6V) at 0.4-ms pulse duration. There were no reinfections of the epicardial lead or device. CONCLUSION Epicardial left ventricle PM implantation and subsequent extraction of an infected PM in PM-dependent patients is feasible and safe with good long-term outcome.
Collapse
Affiliation(s)
| | - Vincent F van Dijk
- Department of Cardiology, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Lucas Va Boersma
- Department of Cardiology, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands
- Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
| | | | - John Gelissen
- Department of Cardiology, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Edgar Daeter
- Deparment of Cardiothoracic Surgery, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Uday Sonker
- Deparment of Cardiothoracic Surgery, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Jippe Balt
- Department of Cardiology, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands
| |
Collapse
|
17
|
Quast AFBE, van Dijk VF, Yap SC, Maass AH, Boersma LVA, Theuns DA, Knops RE. Six-year follow-up of the initial Dutch subcutaneous implantable cardioverter-defibrillator cohort: Long-term complications, replacements, and battery longevity. J Cardiovasc Electrophysiol 2018; 29:1010-1016. [DOI: 10.1111/jce.13498] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/26/2018] [Accepted: 03/30/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Anne-Floor B. E. Quast
- Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center; University of Amsterdam; Amsterdam the Netherlands
| | | | - Sing-Chien Yap
- Department of Cardiology; Erasmus Medical Center; Rotterdam the Netherlands
| | - Alexander H. Maass
- Department of Cardiology, University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | | | - Dominic A. Theuns
- Department of Cardiology; Erasmus Medical Center; Rotterdam the Netherlands
| | - Reinoud E. Knops
- Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center; University of Amsterdam; Amsterdam the Netherlands
| |
Collapse
|
18
|
van Dijk VF, Fanggiday J, Balt JC, Wijffels MC, Daeter EJ, Kelder JC, Boersma LV. Effects of epicardial versus transvenous left ventricular lead placement on left ventricular function and cardiac perfusion in cardiac resynchronization therapy: A randomized clinical trial. J Cardiovasc Electrophysiol 2017; 28:917-923. [DOI: 10.1111/jce.13242] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/13/2017] [Accepted: 04/20/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | - Jim Fanggiday
- Department of Nuclear medicine; St Antonius Hospital
| | | | | | - Edgar J. Daeter
- Department of Cardiothoracic surgery; St Antonius Hospital; Koekoekslaan 1 3435 CM Nieuwegein The Netherlands
| | | | | |
Collapse
|
19
|
van Dijk VF, Delnoy PPH, Smit JJJ, Ramdat Misier RA, Elvan A, van Es HW, Rensing BJ, Raciti G, Boersma LV. Preliminary findings on the safety of 1.5 and 3 Tesla magnetic resonance imaging in cardiac pacemaker patients. J Cardiovasc Electrophysiol 2017; 28:806-810. [DOI: 10.1111/jce.13231] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/05/2017] [Accepted: 04/07/2017] [Indexed: 11/28/2022]
|
20
|
Alipour A, Swaans MJ, van Dijk VF, Balt JC, Post MC, Bosschaert MA, Rensing BJ, Reddy VY, Boersma LV. Ablation for Atrial Fibrillation Combined With Left Atrial Appendage Closure. JACC Clin Electrophysiol 2015; 1:486-495. [DOI: 10.1016/j.jacep.2015.07.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 07/08/2015] [Accepted: 07/16/2015] [Indexed: 10/22/2022]
|