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Wieczorek J, Cichon M, Wieczorek P, Hoffmann A, Wnuk-Wojnar A, Szydlo K, Lasek-Bal A, Mizia-Stec K. P1816 Cerebral microembolism in low-risk patients with paroxysmal atrial fibrillation before and after pulmonary vein isolationCerebral microembolism in low-risk patients with paroxysmal atrial fibrillation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1164] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Invasive treatment of atrial fibrillation (AF) becomes more suitable and effective therapy. There are no consistent data describing the occurrence of potential neurological complications in low-risk patients with paroxysmal AF.
AIM
to determine the occurrence, consequences and risk factors for brain white matter hiperintensities (WMH) assessed in magnetic resonance imaging (MRI) in low-risk patients before and after pulmonary vein isolation (PVI) treatment.
METHODS
Eighty patients with symptomatic paroxysmal AF (median age: 58 years (IQR 50-63), K/M: 30/50), CHA2DS2-Vasc ≤ 3 (CHA2DS2-Vasc: 2 (IQR 1-2.5)) were included in the study. Before and after a minimum of 6-month period after PVI-RF treatment (med. 9,9 months, IQR 7.6-11.8 months) a clinical evaluation with brain MRI and Mini Mental State Examination (MMSE) test were determined. Severity of brain WMH in MRI was assessed in the Fazekas scale (pic 1). The efficacy of PVI-RF treatment analyzed in a 7-day Holter monitoring was confirmed in 43 (53.8%) patients.
RESULTS
Baseline WMH lesions were found in 55 (68.8%) patients. Patients with baseline WMH lesion obtained similar results in the MMSE test, compared to patients with a normal brain image in the MRI study. There was a statistically significant more frequent occurrence of cerebral WMH lesions among older patients, with a higher CHA2DS2-Vasc score, with left atrial (LA) dilatation and dysfunction. Factors affecting the severity of the WMH were: the co-occurrence of the patent foramen ovale (PFO) and coronary artery disease (CAD).
After PVI-RF treatment there were no significant changes in the presence and severity of WMH lesions. Similarly, there were no significant changes in the cognitive abilities assessed with MMSE test compared to the pre-procedural evaluation. There were also similar factors predisposing to brain WMH changes: older age, higher CHA2DS2-Vasc score and higher BMI. In turn, the degree of the brain WMH severity after observation period was dependent on age, higher CHA2DS2-Vasc score, presence of PFO and CAD and the initial LA function.
CONCLUSIONS Cerebral microembolism assessed in MRI is often found in low-risk patients with paroxysmal AF, and its presence and severity are associated with LA dilatation and dysfunction, age and higher CHA2DS2-Vasc score. Additional factors affecting the severity of WMH lesions are: the co-occurrence of PFO and CAD. PVI-RF procedure and its efficacy does not influence on MRI lesions. In the population of relatively young AF patients with no significant cardiovascular disease burden, cerebral microembolism is not related to cognitive impairment.
Abstract P1816 Figure. pic 1
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Affiliation(s)
- J Wieczorek
- Medical University of Silesia, 1st Department of Cardiology, Katowice, Poland
| | - M Cichon
- Medical University of Silesia, 1st Department of Cardiology, Katowice, Poland
| | - P Wieczorek
- Medical University of Silesia, 1st Department of Cardiology, Katowice, Poland
| | - A Hoffmann
- Medical University of Silesia, 1st Department of Cardiology, Katowice, Poland
| | - A Wnuk-Wojnar
- Medical University of Silesia, 1st Department of Cardiology, Katowice, Poland
| | - K Szydlo
- Medical University of Silesia, 1st Department of Cardiology, Katowice, Poland
| | - A Lasek-Bal
- 7th Public Hospital of the Silesian Medical University, Department of Neurology, Katowice, Poland
| | - K Mizia-Stec
- Medical University of Silesia, 1st Department of Cardiology, Katowice, Poland
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Wybraniec M, Wieczorek J, Wozniak-Skowerska I, Hoffmann A, Nowak S, Wnuk-Wojnar A, Chudek J, Wiecek A, Mizia-Stec K. P2670Plasma renalase concentration in patients with atrial fibrillation undergoing pulmonary vein isolation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2670] [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
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Setiawan S, Castineira Busto M, Wozniak-Skowerska I, Alskaf E, Boiten HJ, Ahmed A, Karolyi M, Benedek T, Ewe SH, Allen JC, Chao V, Lee CY, Tan F, Lim ST, Ho KW, Soon JL, Tan SY, Martinez Monzonis MA, Pubul Nunez V, Martinez De La Alegria Alonso A, Pena Gil C, Alvarez Barredo M, Bandin Dieguez MA, Gonzalez Juanatey JR, Skowerski M, Hoffmann A, Nowak S, Faryan M, Kolasa J, Skowerski T, Sosnowski M, Wnuk-Wojnar A, Mizia-Stec K, Kardos A, Valkema R, Van Den Berge JC, Van Domburg RT, Zijlstra F, Schinkel AFL, Suleiman A, Almohdar S, Aljizeeri A, Smete O, Abazid R, Alsaileek A, Alharthi M, Al-Mallah M, Bartykowszki A, Kolossvary M, Kocsmar I, Szilveszter B, Jermendy A, Karady J, Sax B, Balogh O, Merkely B, Maurovich-Horvat P, Rat N, Morariu M, Suciu ZS, Stanescu A, Dobra M, Opincariu D, Benedek I. Rapid Fire Abstract: Cardiac imaging with computed tomography and radionuclide techniques: usefulness in miscellaneous patient subsets347A novel CT calcium-based approach for predicting mitral stenosis348Value of 18-fluoro-2-deoxyglucose positron emission tomography-computed tomography in the diagnosis of native, prosthetic and device related infective endocarditis349Pulmonary veins anatomy variants assessment using CT in patients with atrial fibrillation350Aortic valve area using cardiac CT to improve the validity of LVOT measurement (ACTIV-LVOT study)351Impact of early coronary revascularization on long-term outcomes in patients with myocardial ischemia on myocardial perfusion single-photon emission computed tomorgraphy352Is there a correlation between coronary calcium score and high sensitivity c-reactive protein in patients with suspected coronary artery disease?353Coronary CT angiography for the assessment of cardiac allograft vasculopathy after heart transplantation354Correlation between the epicardial fat volume, assessed by coronary computed tomography, and coronary plaque vulnerability in acute coronary syndromes. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew239] [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: 11/12/2022] Open
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Jung H, Kim M, Youn H, Wozniak-Skowerska I, Skowerski M, Skowerski M, Hoffmann A, Hoffmann A, Kolasa J, Kolasa J, Skowerski T, Skowerski T, Sosnowski M, Sosnowski M, Wnuk-Wojnar A, Wnuk-Wojnar A, Gasior Z, Gasior Z, Mizia-Stec K, Mizia-Stec K, Schirmer H, Forsdahl S, Sildnes T, Trovik T, Iqbal A, Astrom Aneq M, Engvall J, Abreu A, Oliveira L, Portugal G, Goncalves M, Mota Carmo M, Santa Clara H, Pereiro T, Oliveira M, Branco L, Ferreira R, Moody W, Sze Lin L, Bloxham N, Fraser H, Taylor R, Holloway B, Edwards N, Ferro C, Townend J, Steeds R, Perea G, Corneli M, Meretta A, Aguirre M, Rosa D, Henquin R, Ronderos R, Perez Balino N, Sunman H, Yorgun H, Sahiner L, Kaya B, Hazirolan T, Ozer N, Aytemir K, Tokgozoglu L, Kabakci G, Oto A, Peovska I, Srbinovska E, Hristova E, Otljanska M, Bosevski M, Arnaudova F, Andova V, Iwaki T. Moderated Posters session * Cardiovascular computed tomography, magnetic resonance and nuclear imaging: 13/12/2013, 08:30-12:30 * Location: Moderated Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet210] [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
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Montoro Lopez M, Pons De Antonio I, Itziar Soto C, Florez Gomez R, Alonso Ladreda A, Rios Blanco J, Refoyo Salicio E, Moreno Yanguela M, Lopez Sendon J, Guzman Martinez G, Van De Heyning CM, Magne J, Pierard L, Bruyere P, Davin L, De Maeyer C, Paelinck B, Vrints C, Lancellotti P, Michalski B, Krzeminska-Pakula M, Lipiec P, Szymczyk E, Chrzanowski L, Kasprzak J, Leao RN, Florencio AF, Oliveira AR, Bento B, Lopes S, Calaca J, Palma Reis R, Krestjyaninov M, Gimaev R, Razin V, Arangalage D, Chiampan A, Cimadevilla C, Touati A, Himbert D, Brochet E, Iung B, Nataf P, Vahanian A, Messika-Zeitoun D, Guvenc T, Karacimen D, Erer H, Ilhan E, Sayar N, Karakus G, Eren M, Iriart X, Tafer N, Roubertie F, Mauriat P, Thambo J, Wang J, Fang F, Yip GW, Sanderson J, Feng W, Yu C, Lam Y, Assabiny A, Apor A, Nagy A, Vago H, Toth A, Merkely B, Kovacs A, Castaldi B, Vida V, Guariento A, Padalino M, Cerutti A, Maschietto N, Biffanti R, Reffo E, Stellin G, Milanesi O, Baronaite-Dudoniene K, Urbaite L, Smalinskas V, Veisaite R, Vasylius T, Vaskelyte J, Puodziukynas A, Wieczorek J, Rybicka-Musialik A, Berger-Kucza A, Hoffmann A, Wnuk-Wojnar A, Mizia-Stec K, Melao F, Ribeiro V, Amorim S, Araujo C, Torres J, Cardoso J, Pinho P, Maciel M, Storsten P, Eriksen M, Boe E, Estensen M, Erikssen G, Smiseth O, Skulstad H, Miglioranza M, Gargani L, Sant`Anna R, Rover M, Martins V, Mantovanni A, Kalil R, Leiria T, Luo X, Fang F, Lee P, Zhang Z, Lam Y, Sanderson J, Kwong JS, Yu C, Borowiec A, Dabrowski R, Wozniak J, Jasek S, Chwyczko T, Kowalik I, Janas J, Musiej-Nowakowska E, Szwed H, Palinsky M, Petrovicova J, Pirscova M, Baricevic Z, Lovric D, Cikes M, Skoric B, Ljubas Macek J, Reskovic Luksic V, Separovic Hanzevacki J, Milicic D, Elmissiri A, El Shahid G, Abdal-Wahhab S, Vural MG, Yilmaz M, Cetin S, Akdemir R, Yoldas TK, Yeter E, Karamanou A, Hamodraka E, Lekakis I, Paraskevaidis I, Kremastinos D, Appiah-Dwomoh EK, Wang V, Otto C, Mayar F, Bonaventura K, Sunman H, Canpolat U, Kuyumcu M, Yorgun H, Sahiner L, Ozer N. Club 35 Poster Session Wednesday 11 December: 11/12/2013, 09:30-16:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet213] [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
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Szydlo K, Wnuk-Wojnar A, Trusz-Gluza M, Wozniak-Skowerska I, Czerwinski C, Hoffmann A, Nowak S. 786 Assessment of long-term follow-up results of circumferential pulmonary veins RF catheter ablation in patients with paroxysmal atrial fibrillation- usefulness of 7-days Holter recording. Europace 2005. [DOI: 10.1016/eupace/7.supplement_1.179-b] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - A. Wnuk-Wojnar
- I Dept. of Cardiology, Silesian Medical Academy, Katowice, Poland
| | - M. Trusz-Gluza
- I Dept. of Cardiology, Silesian Medical Academy, Katowice, Poland
| | | | - C. Czerwinski
- I Dept. of Cardiology, Silesian Medical Academy, Katowice, Poland
| | - A. Hoffmann
- I Dept. of Cardiology, Silesian Medical Academy, Katowice, Poland
| | - S. Nowak
- I Dept. of Cardiology, Silesian Medical Academy, Katowice, Poland
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Drzewiecki J, Trusz-Gluza M, Wnuk-Wojnar A, Jaklik A, Czerwiński C, Filipecki A, Szydło K, Ciemniewski Z, Giec L. [Intravenous ablation of the atrio-ventricular junction in patients with supraventricular tachyarrhythmias]. Kardiol Pol 1993; 38:5-11; discussion 12-3. [PMID: 8230978] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Since the first successful therapeutic DC ablation of the AV junction in 1986, we have treated 20 symptomatic patients with drug-refractory supraventricular tachyarrhythmias (average of 6 antiarrhythmic drugs prior to the ablation attempt). The primary rhythm disturbances necessitating ablation were: AV nodal reentrant tachycardia (50% of pts), atrial flutter or fibrillation, with an uncontrolled rapid ventricular response (40%), atrioventricular reentrant tachycardia using an accessory pathway (20%), atrial tachycardia (10%), and junctional reciprocating tachycardia (5%). Percutaneous catheter ablation of the AV junction was made by Gallagher's method. The USCI 4-polar catheter (7F) was used in 40% of pts, and bipolar Cordis catheter (5F) in the remaining 60%. 70% of pts received either one or two shocks, usually of 200 or 300 J during one session. Another 25% received stored cumulative energy from 800 to 1200 J (in two sessions), and one patient--1800 J (during three sessions). In 85% of pts, the immediate post-ablation conduction was third-degree AV block with the escape pacemaker, ranging from 20 to 50 beats/min., which was infra-His in 57%, and supra-His in 43% of pts. In 15% of pts were either first-degree AV block (10%) or normal AV conduction (5%). A His bundle deflection more than 0.2 mV was predictive of successful production of third-degree AV block. Except a mild and transient increase of indicating enzymes (CPK and CPK-MB) we did not observe any other serious complications directly related to the ablalation procedure. Follow-up study included 19 pts (time range from 2 to 56 months, mean 28).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J Drzewiecki
- I Kliniki Kardiologii, Instytutu Kardiologii Sl. A.M., Katowicach
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Bochenek A, Religa Z, Tomaszewski J, Wnuk-Wojnar A, Drzewiecki J, Reek C, Pietrzycki A, Spyt J. [Angioplasty of the ostium of the left coronary artery using a venous patch]. Kardiol Pol 1992; 37:142-5. [PMID: 1479770] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Isolated critical ostial stenosis of the left main coronary artery (LMCA) without narrowing in the distal parts of coronary vessels is rather rare cause of angina. It was observed in 7 our patients: 5F and 2M aged 42-55 yrs (mean 47.5). Five of them were in unstable condition. In all of them a direct surgical angioplasty of the LMCA was performed. Cardiopulmonary bypass with moderate hypothermia were used in all patients. The LMCA was approached from behind. A curved incision was made into the right lateral aortic wall toward the LMCA. Care was taken to stay away from the commissure between the noncoronary and the left coronary cusp. The posterior aspect of the LMCA was incised across the stenosis and prolonged through bifurcation. A venous onlay patch was used to enlarge not only the LMCA but also the adjacent 2 cm of aortic incision, so as to give the LMCA ostium a funnel shape, which favors a homogeneous blood flow. The mean aortic cross clamping time was 46 min. The patients were easily weaned from cardiopulmonary bypass. The early and late results are good--all patients were discharged from the hospital free of symptoms. In 6 patients a perfect patency of the left main stem was documented during control coronarography. In our opinion direct surgical angioplasty of LMCA is better then the conventional surgical treatment because normal geometry of LMCA ostium and normal blood flow can be restored using this method.
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Affiliation(s)
- A Bochenek
- Katedry i I Kliniki Kardiochirurgii Sl.A.M., Katowicach
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Dabrowski A, Kołodziej P, Krupienicz A, Drzewiecki J, Giec L, Trusz-Gluza M, Wnuk-Wojnar A, Kopeć P, Sredniawa B. [Comparative evaluation of the results of Holter monitoring and programmed ventricular stimulation in patients with ischemic heart disease]. Kardiol Pol 1990; 33:34-9. [PMID: 2277476] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
24-hour ECG Holter monitoring and programmed ventricular stimulation were performed in 81 patients (64 males and 17 females aged 35-65). No ++anti-arrhythythmic agents nor beta-blockers were administrated. 58 patients suffered from myocardial infarction in the past, and 38 had a history of ventricular tachycardia. Right atrial and ventricular stimulation (in 7 patients also left ventricular stimulation) was performed using stimuli of a 2 ms pulse width. 24-hour ECG Holter monitoring was recorded on a magnetic tape from two bipolar precordial leads. Both examinations results were compared to assess correlation between ECG Holter monitoring parameters and inducibility of VT or VF by programmed stimulation. Significant correlation was stated among occurrence of: 1) spontaneous sustained ventricular tachycardia and induced by stimulation monomorphic sustained VT (p less than 0.005) as well as estimated both sustained and nonsustained VT (p less than 0.010) 2) spontaneous nonsustained VT and induced by stimulation sustained or nonsustained monomorphic VT (p less than 0.025). There was no correlation between spontaneous ventricular arrhythmias estimated by Lown and Wolf's classification and possibility to induce monomorphic VT as well as between any of ECG Holter monitoring parameters and polymorphic VT or ventricular fibrillation induced by stimulation. Aggressiveness extent of stimulation protocol necessary to induce monomorphic VT was similar in patients with or without VT recorded by Holter method.
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Affiliation(s)
- A Dabrowski
- I Klinika Kardiologii IK SL. AM w Katowicach, Warszawie
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Fojt E, Dosiak J, Reichert A, Wnuk-Wojnar A. [Disorders of myocardial blood supply in sportsmen]. Pol Tyg Lek 1986; 41:1309-13. [PMID: 3822901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Adamczyk R, Cierpka L, Kalandyk Z, Wnuk-Wojnar A, Majewski W, Rudzki P, Korzekwa P. [Profundoplasty in patients with high surgical risk]. Pol Tyg Lek 1981; 36:1577-80. [PMID: 7335538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Drzewiecki J, Giec L, Zmudziński J, Wnuk-Wojnar A, Kozak T, Odój P, Potyka K, Dukalska D, Ochała T, Młynarska Z, Kocot A. [Register of myocardial infarct mortality in Bytom]. Pol Tyg Lek 1980; 35:937-40. [PMID: 7422581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Giec L, Drzewiecki J, Zmudziński J, Kozak T, Wnuk-Wojnar A, Odój P, Rowiński A, Dukalska D, Ochała T, Młynarska Z. [Incidence of myocardial infarct in Bytom]. Pol Tyg Lek 1980; 35:871-3. [PMID: 7413508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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