1
|
Gupta D, Ding WY, Calvert P, Williams E, Das M, Tovmassian L, Tayebjee MH, Haywood G, Martin CA, Rajappan K, Bates MGD, Temple IP, Reichlin T, Chen Z, Balasubramaniam RN, Ronayne C, Clarkson N, Morgan M, Barton J, Kemp I, Mahida S, Sticherling C. Cryoballoon Pulmonary Vein Isolation as First-Line Treatment for Typical Atrial Flutter. Heart 2023; 109:364-371. [PMID: 36396438 DOI: 10.1136/heartjnl-2022-321729] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/17/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE We aimed to compare cryoballoon pulmonary vein isolation (PVI) with standard radiofrequency cavotricuspid isthmus (CTI) ablation as first-line treatment for typical atrial flutter (AFL). METHODS Cryoballoon Pulmonary Vein Isolation as First-Line Treatment for Typical Atrial Flutter was an international, multicentre, open with blinded assessment trial. Patients with CTI-dependent AFL and no documented atrial fibrillation (AF) were randomised to either cryoballoon PVI alone or radiofrequency CTI ablation. Primary efficacy outcome was time to first recurrence of sustained (>30 s) symptomatic atrial arrhythmia (AF/AFL/atrial tachycardia) at 12 months as assessed by continuous monitoring with an implantable loop recorder. Primary safety outcome was a composite of death, stroke, tamponade requiring drainage, atrio-oesophageal fistula, pacemaker implantation, serious vascular complications or persistent phrenic nerve palsy. RESULTS Trial recruitment was halted at 113 of the target 130 patients because of the SARS-CoV-2 pandemic (PVI, n=59; CTI ablation, n=54). Median age was 66 (IQR 61-71) years, with 98 (86.7%) men. At 12 months, the primary outcome occurred in 11 (18.6%) patients in the PVI group and 9 (16.7%) patients in the CTI group. There was no significant difference in the primary efficacy outcome between the groups (HR 1.11, 95% CI 0.46 to 2.67). AFL recurred in six (10.2%) patients in the PVI arm and one (1.9%) patient in the CTI arm (p=0.116). Time to occurrence of AF of ≥2 min was significantly reduced with cryoballoon PVI (HR 0.46, 95% CI 0.25 to 0.85). The composite safety outcome occurred in four patients in the PVI arm and three patients in the CTI arm (p=1.000). CONCLUSION Cryoballoon PVI as first-line treatment for AFL is equally effective compared with standard CTI ablation for preventing recurrence of atrial arrhythmia and better at preventing new-onset AF. TRIAL REGISTRATION NUMBER NCT03401099.
Collapse
Affiliation(s)
- Dhiraj Gupta
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK .,Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Wern Yew Ding
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK.,Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Peter Calvert
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK.,Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Emmanuel Williams
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK.,Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Moloy Das
- Newcastle Upon Tyne Hospital NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - Lilith Tovmassian
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Muzahir H Tayebjee
- Department of Cardiology, Leeds Teaching Hospital NHS Foundation Trust, Leeds, UK
| | - Guy Haywood
- Department of Cardiology, University Hospitals Plymouth NHS Foundation Trust, Plymouth, UK
| | - Claire A Martin
- Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Kim Rajappan
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Matthew G D Bates
- Department of Cardiology, South Tees Hospitals NHS Foundation Trust, James Cook University Hospital, Middlesbrough, UK
| | - Ian Peter Temple
- Department of Cardiology, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Tobias Reichlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Zhong Chen
- Department of Cardiology, Ashford and St Peter's Hospital NHS Foundation Trust, Surrey, UK
| | - Richard N Balasubramaniam
- Department of Cardiology, Royal Bournemouth and Christchurch Hospital NHS Foundation Trust, Bournemouth, UK
| | - Christina Ronayne
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Nichola Clarkson
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Maureen Morgan
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Janet Barton
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Ian Kemp
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Saagar Mahida
- Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | | |
Collapse
|
2
|
Mclaughlin R, O'Reilly D, Ronayne C, Barrett E, Kalachand R, De Frein A, Macanovic B, Connolly R, Power D, Bambury R, Reilly S, Collins D. 152P Analysis of patient access to breast cancer drugs in the USA and Europe with a focus on the UK and Ireland. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
3
|
Hussein A, Das M, Riva S, Morgan M, Ronayne C, Sahni A, Shaw M, Todd D, Hall M, Modi S, Natale A, Dello Russo A, Snowdon R, Gupta D. Use of Ablation Index-Guided Ablation Results in High Rates of Durable Pulmonary Vein Isolation and Freedom From Arrhythmia in Persistent Atrial Fibrillation Patients. Circ Arrhythm Electrophysiol 2018; 11:e006576. [DOI: 10.1161/circep.118.006576] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [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: 11/16/2022]
Affiliation(s)
- Ahmed Hussein
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| | - Moloy Das
- Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (M.D.)
| | - Stefania Riva
- Centro Cardiologico Monzino, Milan, Italy (S.R., A.D.R.)
| | - Maureen Morgan
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| | - Christina Ronayne
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| | - Ankita Sahni
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| | - Matthew Shaw
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| | - Derick Todd
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| | - Mark Hall
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| | - Simon Modi
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| | | | | | - Richard Snowdon
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| | - Dhiraj Gupta
- Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, England, United Kingdom (A.H., M.M., C.R., A.S., M.S., D.T., M.H., S.M., R.S., D.G.)
| |
Collapse
|
4
|
Kirkwood G, Snowdon R, Das M, Morgan M, Ronayne C, Shaw M, Maille B, Gupta A, Gupta D. P5766Low baseline impedance and impedance response predict late pulmonary vein reconnection after ablation index guided ablation in persistent AF. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5766] [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: 11/12/2022] Open
Affiliation(s)
- G Kirkwood
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - R Snowdon
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - M Das
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - M Morgan
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - C Ronayne
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - M Shaw
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - B Maille
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - A Gupta
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - D Gupta
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| |
Collapse
|
5
|
Maille B, Das M, Hussein A, Shaw M, Chaturvedi V, Morgan M, Ronayne C, Snowdon RL, Gupta D. Accuracy of left atrial bipolar voltages obtained by ConfiDENSE multielectrode mapping in patients with persistent atrial fibrillation. J Cardiovasc Electrophysiol 2018; 29:881-888. [DOI: 10.1111/jce.13472] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 11/06/2017] [Revised: 01/25/2018] [Accepted: 02/20/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Baptiste Maille
- Institute of Cardiovascular Medicine and Science, Department of Cardiology; Liverpool Heart and Chest Hospital; Thomas Drive Liverpool L14 3PE UK
| | - Moloy Das
- Department of Cardiology; Freeman Hospital; Freeman Road Newcastle upon Tyne NE7 7DN UK
| | - Ahmed Hussein
- Institute of Cardiovascular Medicine and Science, Department of Cardiology; Liverpool Heart and Chest Hospital; Thomas Drive Liverpool L14 3PE UK
| | - Matthew Shaw
- Institute of Cardiovascular Medicine and Science, Department of Cardiology; Liverpool Heart and Chest Hospital; Thomas Drive Liverpool L14 3PE UK
| | - Vivek Chaturvedi
- Institute of Cardiovascular Medicine and Science, Department of Cardiology; Liverpool Heart and Chest Hospital; Thomas Drive Liverpool L14 3PE UK
| | - Maureen Morgan
- Institute of Cardiovascular Medicine and Science, Department of Cardiology; Liverpool Heart and Chest Hospital; Thomas Drive Liverpool L14 3PE UK
| | - Christina Ronayne
- Institute of Cardiovascular Medicine and Science, Department of Cardiology; Liverpool Heart and Chest Hospital; Thomas Drive Liverpool L14 3PE UK
| | - Richard L. Snowdon
- Institute of Cardiovascular Medicine and Science, Department of Cardiology; Liverpool Heart and Chest Hospital; Thomas Drive Liverpool L14 3PE UK
| | - Dhiraj Gupta
- Institute of Cardiovascular Medicine and Science, Department of Cardiology; Liverpool Heart and Chest Hospital; Thomas Drive Liverpool L14 3PE UK
| |
Collapse
|
6
|
Maille B, Das M, Hussein A, Shaw M, Chaturvedi V, Morgan M, Ronayne C, Snowdon R. 33Accuracy of left atrial bipolar voltages obtained by ConfiDENSE multielectrode mapping in patients with persistent atrial fibrillation. Europace 2017. [DOI: 10.1093/europace/eux283.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
7
|
Hussein A, Das M, Chaturvedi V, Asfour IK, Daryanani N, Morgan M, Ronayne C, Shaw M, Snowdon R, Gupta D. Prospective use of Ablation Index targets improves clinical outcomes following ablation for atrial fibrillation. J Cardiovasc Electrophysiol 2017. [PMID: 28639728 DOI: 10.1111/jce.13281] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [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] [Indexed: 12/11/2022]
Abstract
AIMS Late recovery of ablated tissue leading to reconnection of pulmonary veins remains common following radiofrequency catheter ablation for AF. Ablation Index (AI), a novel ablation quality marker, incorporates contact force (CF), time, and power in a weighted formula. We hypothesized that prospective use of our previously published derived AI targets would result in better outcomes when compared to CF-guided ablation. METHODS Eighty-nine consecutive drug-refractory AF patients (49% paroxysmal) underwent AI-guided ablation (AI-group). AI targets were 550 for anterior/roof and 400 for posterior/inferior left atrial segments. Procedural and clinical outcomes of these patients were compared to 89 propensity-matched controls who underwent CF-guided ablation (CF-group). All 178 procedures were otherwise similar, and both groups were followed-up for 12 months. The last 25 patients from each group underwent analysis of all VisiTags™ for ablation duration, CF, Force-Time Integral, and impedance drop. RESULTS First-pass pulmonary vein isolation (PVI) was more frequent in AI-group than in CF-group (173 [97%] vs. 149 [84%] circles, P < 0.001), and acute PV reconnection was lower (11 [6%] vs. 24 [13%] circles, P = 0.02). Mean PVI ablation time was similar (AI-group: 42 ± 9 vs. CF-group: 45 ± 14 minutes, P = 0.14). Median impedance drop for AI-group was significantly higher than in CF-group (13.7 [9-19] Ω vs. 8.8 [5.2-13] Ω, P < 0.001). Two major complications occurred in CF-group and none in AI-group. Atrial tachyarrhythmia recurrence was significantly lower in AI-group (15 of 89 [17%]) than in CF-group (33 of 89 [37%], P = 0.002). CONCLUSION AI-guided ablation is associated with significant improvements in the incidence of acute PV reconnection and atrial tachyarrhythmia recurrence rate compared to CF-guided ablation, potentially due to creation of better quality lesions as suggested by greater impedance drop.
Collapse
Affiliation(s)
- Ahmed Hussein
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Moloy Das
- Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, UK
| | - Vivek Chaturvedi
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Issa Khalil Asfour
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Niji Daryanani
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Maureen Morgan
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Christina Ronayne
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Matthew Shaw
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Richard Snowdon
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Dhiraj Gupta
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| |
Collapse
|
8
|
Hussein A, Das M, Chaturvedi V, Asfour I, Morgan M, Ronayne C, Shaw M, Snowdon R, Gupta D. 1362Prospective use of ablation index targets improves clinical outcomes following ablation for atrial fibrillation. Europace 2017. [DOI: 10.1093/ehjci/eux157.002] [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
|
9
|
Maille B, Hussein A, Chaturvedi V, Morgan M, Ronayne C, Snowdon R, Gupta D. P330Reverse remodelling of the left atrium occurs early after catheter ablation for persistent atrial fibrillation. Europace 2017. [DOI: 10.1093/ehjci/eux141.057] [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
|
Das M, Wynn GJ, Saeed Y, Gomes S, Morgan M, Ronayne C, Bonnett LJ, Waktare JEP, Todd DM, Hall MCS, Snowdon RL, Modi S, Gupta D. Pulmonary Vein Re-Isolation as a Routine Strategy Regardless of Symptoms: The PRESSURE Randomized Controlled Trial. JACC Clin Electrophysiol 2017; 3:602-611. [PMID: 29759434 DOI: 10.1016/j.jacep.2017.01.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 10/31/2016] [Revised: 01/17/2017] [Accepted: 01/19/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The goal of this study was to determine whether a strategy of early re-isolation of pulmonary vein (PV) reconnection in all patients, regardless of symptoms, would reduce the recurrence of atrial fibrillation (AF) and improve quality of life. BACKGROUND Lasting pulmonary vein isolation (PVI) remains elusive. PV reconnection is strongly linked to the recurrence of arrhythmia. METHODS A total of 80 patients with paroxysmal AF were randomized 1:1 after contact force-guided PVI to receive either standard care or undergo a repeat electrophysiology study after 2 months regardless of symptoms (repeat study). At the initial procedure, PVI was demonstrated by entrance/exit block and adenosine administration after a minimum 20-min wait. At the repeat study, all sites of PV reconnection were re-ablated. Patients recorded electrocardiograms daily and whenever symptomatic for 12 months using a handheld monitor. Recurrence was defined as ≥30 s of atrial tachyarrhythmia (AT) after a 3-month blanking period. The Atrial Fibrillation Effect on Quality-of-Life Questionnaire was completed at baseline and at 6 and 12 months. RESULTS All 40 patients randomized to repeat study attended for this after 62 ± 6 days, of whom 25 (62.5%) had reconnection of 41 (26%) PVs. There were no complications related to these procedures. Subjects recorded a total of 32,203 electrocardiograms (380 [335 to 447] per patient) during 12.6 (12.2 to 13.2) months of follow-up. AT recurrence was significantly lower for the repeat study group (17.5% vs. 42.5%; p = 0.03), as was AT burden (p = 0.03). Scores on the Atrial Fibrillation Effect on Quality-of-Life Questionnaire were higher in the repeat study group at 6 months (p < 0.001) and 12 months (p = 0.02). CONCLUSIONS A strategy of routine repeat assessment with re-isolation of PV reconnection improved freedom from AT recurrence, AT burden, and quality of life compared with current standard care. (The Effect of Early Repeat Atrial Fibrillation [AF] on AF Recurrence [PRESSURE]; NCT01942408).
Collapse
Affiliation(s)
- Moloy Das
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Gareth J Wynn
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; The Royal Melbourne Hospital, Melbourne, Australia
| | - Yawer Saeed
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Sean Gomes
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; The Prince of Wales Hospital, Sydney, Australia
| | - Maureen Morgan
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Christina Ronayne
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Laura J Bonnett
- Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom
| | - Johan E P Waktare
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Derick M Todd
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Mark C S Hall
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Richard L Snowdon
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Simon Modi
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Dhiraj Gupta
- Institute of Cardiovascular Medicine and Science, Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.
| |
Collapse
|
11
|
Furniss G, Opel A, Hussein A, Pearman C, Grace A, Connelly D, Orlowski A, Banerjee A, McNicholas T, Providencia R, Montañes M, Providencia R, Panagopoulos D, Tomlinson D, Dalrymple-Hay M, Haywood G, Butler A, Ang R, Ullah W, Schwartz R, Fannon M, Finlay M, Hunter R, Schilling R, Das M, Asfour I, Morgan M, Ronayne C, Shaw M, Snowdon R, Gupta D, Todd D, King R, Hall M, Modi S, Mediratta N, Gupta D, Reddy V, Neuzil P, Willems S, Verma A, Heck P, Schilling R, Lambiase P, Hall M, Nicholl B, McQueenie R, Jani BD, McKeag N, Gallacher K, Mair F, Heaton D, Macdonald J, Burnell J, Ryan R, Marshall T, Sutton C, O'Callaghan S, Kenny R, Karim N, Srinivasan N, Ferreira M, Goncalves L, Lambiase P, Toledano M, Field E, Walsh H, Maguire K, Cervi E, Kaski J, Perez Tome M, Pantazis A, Elliott P, Lambiase P, Segal O. ORAL ABSTRACTS (3)EP & Ablation31LEFT ATRIAL POSTERIOR WALL ISOLATION (THE “BOX LESION PATTERN”) IN THE TREATMENT OF ATRIAL FIBRILLATION: A SINGLE CENTRE EXPERIENCE32DAY CASE CRYOBLATION (CRYO) FOR PAROXYSMAL ATRIAL FIBRILLATION (pAF) IN THE DISTRICT GENERAL HOSPITAL IS SAFE AND EFFECTIVE IF DONE IN HIGH VOLUME WITH EXPERIENCED OPERATORS33ABLATION INDEX-GUIDED PULMONARY VEIN ISOLATION FOR ATRIAL FIBRILLATION MAY IMPROVE CLINICAL OUTCOMES IN COMPARISON TO CONTACT FORCE-GUIDED ABLATION34THE PROCEDURAL COMPLICATION RATES AND SHORT-TERM SUCCESS RATES OF THORACOSCOPIC AF ABLATION DURING THE INSTITUTIONAL LEARNING CURVE35INITIAL PROCEDURAL RESULTS FROM DDRAMATIC-SVT STUDY: DD MECHANISM IDENTIFICATION AND LOCALISATION USING DIPOLE DENSITY MAPPING TO GUIDE ABLATION STRATEGY36MORBIDITY AND MORTALITY IN MIDDLE-AGED INDIVIDUALS WITH ATRIAL FIBRILLATION: UK BIOBANK DATAClinical EP37THE GM AHSN AF LANDSCAPE TOOL: A SHARED PUBLIC DATA PLATFORM TO PROMOTE QUALITY IMPROVEMENTS AND IDENTIFY OPPORTUNITIES TO PREVENT AF-RELATED STROKE IN THE DEVOLVED GREATER MANCHESTER HEALTH SYSTEM38REAL WORLD PERSISTENCE, ADHERENCE AND SWITCH-OVER ACROSS ANTICOAGULANTS IN ATRIAL FIBRILLATION-A NATIONAL POPULATION-BASED STUDY39ORTHOSTATIC HYPOTENSION AND ATRIAL FIBRILLATION40PREVALENCE OF SHORT QT AND CRITERIA OF SEVERITY IN A YOUNG ASYMPTOMATIC COHORT41SURFACE ELECTROCARDIOGRAPHIC FEATURES AND PREVALENCE OF ARRHYTHMIAS IN PAEDIATRIC FRIEDREICH'S ATAXIA42RISK STRATIFICATION OF TYPE 1 MYOTONIC DYSTROPHY: IS THE ECG ACCURATE ENOUGH TO SELECT PATIENTS AT RISK OF BRADYARRHYTHMIC EVENTS? Europace 2016. [DOI: 10.1093/europace/euw272] [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
|
12
|
Das M, Wynn G, Saeed Y, Gomes S, Morgan M, Ronayne C, Waktare J, Todd D, Hall M, Snowdon R, Modi S, Gupta D. 22-02: Results of the Pulmonary vein RE-isolation as a routine Strategy: a SUccess Rate Evaluation (PRESSURE) randomised controlled trial. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i25c] [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
|
13
|
Hill K, Ronayne C. Use of dressings to secure intravenous devices. Br J Nurs 2015; 24:S5-S8. [PMID: 26697627] [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: 06/05/2023]
|
14
|
Ronayne C. A phenomenological study to understand the experiences of nurses with regard to brainstem death. Intensive Crit Care Nurs 2008; 25:90-8. [PMID: 18657425 DOI: 10.1016/j.iccn.2008.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Revised: 06/05/2008] [Accepted: 06/15/2008] [Indexed: 11/16/2022]
Abstract
METHOD In this study six nurses from general intensive care units were interviewed. The resulting transcripts were analysed using hermeneutic phenomenology. FINDINGS The findings fall into five categories, feelings, communication, protection, education, and technology. Nurses appear to suffer a degree of cognitive dissonance that both adds to their stress and leads to difficulties in explaining brainstem death to relatives. CONCLUSION Nurses need more education and support to enable them to overcome cognitive dissonance and so give relatives honest information. Verbal information should be supplemented with a written information leaflet given to all relatives.
Collapse
Affiliation(s)
- Christina Ronayne
- Gartnavel General Hospital, Great Western Road, Glasgow G12, United Kingdom.
| |
Collapse
|
15
|
Abstract
Pruritus in patients with liver disease is often uncontrollable; however, washing daily with aqueous cream instead of soap has been found to significantly reduce the degree of itching. It also causes no side effects.
Collapse
|