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  1. Article ; Online: Predictors of Success for Pulmonary Vein Isolation With Pulsed-Field Ablation Using a Variable-Loop Catheter With 3D Mapping Integration: Complete 12-Month Outcomes From inspIRE.

    De Potter, Tom / Grimaldi, Massimo / Duytschaever, Mattias / Anic, Ante / Vijgen, Johan / Neuzil, Petr / Van Herendael, Hugo / Verma, Atul / Skanes, Allan / Scherr, Daniel / Pürerfellner, Helmut / Rackauskas, Gediminas / Jais, Pierre / Reddy, Vivek Y

    Circulation. Arrhythmia and electrophysiology

    2024  , Page(s) e012667

    Abstract: Background: We previously presented the safety and early efficacy of inspIRE study (Pulsed-Field Ablation (PFA) System for the Treatment of Paroxysmal Atrial Fibrillation by Irreversible Electroporation). With the study's conclusion, we report the ... ...

    Abstract Background: We previously presented the safety and early efficacy of inspIRE study (Pulsed-Field Ablation (PFA) System for the Treatment of Paroxysmal Atrial Fibrillation by Irreversible Electroporation). With the study's conclusion, we report the outcomes of the full pivotal study cohort, with an additional analysis of predictors of success.
    Methods: InspIRE was a prospective, multicenter, single-arm clinical trial of drug-refractory paroxysmal atrial fibrillation. Pulmonary vein isolation was performed with a variable-loop circular catheter integrated with a 3-dimensional mapping system. Follow-up with 24-hour Holter was at 3, 6, and 12 months, as well as remote rhythm monitoring: weekly from 3 to 5 months, monthly from 6 to 12 months, and for symptoms. The primary effectiveness end point (PEE) was acute pulmonary vein isolation plus freedom from any atrial arrhythmia at 12 months. Additional subanalyses report predictors of PEE success.
    Results: The patient cohort included 186 patients: aged 59±10 years, female 30%, and CHA
    Conclusions: The inspIRE study confirms the safety and effectiveness of pulmonary vein isolation using the novel 3-dimensional mapping integrated circular loop catheter. An optimal number of PFA applications (≥48 total or ≥12 per vein) resulted in an improved 1-year success rate of ≈80%.
    Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04524364.
    Language English
    Publishing date 2024-04-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2426129-4
    ISSN 1941-3084 ; 1941-3149
    ISSN (online) 1941-3084
    ISSN 1941-3149
    DOI 10.1161/CIRCEP.123.012667
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  2. Article ; Online: Real-world validation of smartphone-based photoplethysmography for rate and rhythm monitoring in atrial fibrillation.

    Gruwez, Henri / Ezzat, Daniel / Van Puyvelde, Tim / Dhont, Sebastiaan / Meekers, Evelyne / Bruckers, Liesbeth / Wouters, Femke / Kellens, Michiel / Van Herendael, Hugo / Rivero-Ayerza, Maximo / Nuyens, Dieter / Haemers, Peter / Pison, Laurent

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2024  Volume 26, Issue 4

    Abstract: Aims: Photoplethysmography- (PPG) based smartphone applications facilitate heart rate and rhythm monitoring in patients with paroxysmal and persistent atrial fibrillation (AF). Despite an endorsement from the European Heart Rhythm Association, ... ...

    Abstract Aims: Photoplethysmography- (PPG) based smartphone applications facilitate heart rate and rhythm monitoring in patients with paroxysmal and persistent atrial fibrillation (AF). Despite an endorsement from the European Heart Rhythm Association, validation studies in this setting are lacking. Therefore, we evaluated the accuracy of PPG-derived heart rate and rhythm classification in subjects with an established diagnosis of AF in unsupervised real-world conditions.
    Methods and results: Fifty consecutive patients were enrolled, 4 weeks before undergoing AF ablation. Patients used a handheld single-lead electrocardiography (ECG) device and a fingertip PPG smartphone application to record 3907 heart rhythm measurements twice daily during 8 weeks. The ECG was performed immediately before and after each PPG recording and was given a diagnosis by the majority of three blinded cardiologists. A consistent ECG diagnosis was exhibited along with PPG data of sufficient quality in 3407 measurements. A single measurement exhibited good quality more often with ECG (93.2%) compared to PPG (89.5%; P < 0.001). However, PPG signal quality improved to 96.6% with repeated measurements. Photoplethysmography-based detection of AF demonstrated excellent sensitivity [98.3%; confidence interval (CI): 96.7-99.9%], specificity (99.9%; CI: 99.8-100.0%), positive predictive value (99.6%; CI: 99.1-100.0%), and negative predictive value (99.6%; CI: 99.0-100.0%). Photoplethysmography underestimated the heart rate in AF with 6.6 b.p.m. (95% CI: 5.8 b.p.m. to 7.4 b.p.m.). Bland-Altman analysis revealed increased underestimation in high heart rates. The root mean square error was 11.8 b.p.m.
    Conclusion: Smartphone applications using PPG can be used to monitor patients with AF in unsupervised real-world conditions. The accuracy of AF detection algorithms in this setting is excellent, but PPG-derived heart rate may tend to underestimate higher heart rates.
    MeSH term(s) Humans ; Atrial Fibrillation/diagnosis ; Smartphone ; Photoplethysmography ; Heart Rate ; Predictive Value of Tests ; Electrocardiography/methods ; Algorithms
    Language English
    Publishing date 2024-04-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euae065
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  3. Article ; Online: Paroxysmal Atrial Fibrillation Ablation Using a Novel Variable-Loop Biphasic Pulsed Field Ablation Catheter Integrated With a 3-Dimensional Mapping System: 1-Year Outcomes of the Multicenter inspIRE Study.

    Duytschaever, Mattias / De Potter, Tom / Grimaldi, Massimo / Anic, Ante / Vijgen, Johan / Neuzil, Petr / Van Herendael, Hugo / Verma, Atul / Skanes, Allan / Scherr, Daniel / Pürerfellner, Helmut / Rackauskas, Gediminas / Jaïs, Pierre / Reddy, Vivek Y

    Circulation. Arrhythmia and electrophysiology

    2023  Volume 16, Issue 3, Page(s) e011780

    Abstract: Background: The inspIRE study (Study for Treatment of Paroxysmal Atrial Fibrillation [PAF] by Pulsed Field Ablation [PFA] System With Irreversible Electroporation [IRE]) evaluated safety and effectiveness of a fully integrated biphasic pulsed field ... ...

    Abstract Background: The inspIRE study (Study for Treatment of Paroxysmal Atrial Fibrillation [PAF] by Pulsed Field Ablation [PFA] System With Irreversible Electroporation [IRE]) evaluated safety and effectiveness of a fully integrated biphasic pulsed field ablation (PFA) system with a variable-loop circular catheter for the treatment of drug-refractory paroxysmal atrial fibrillation.
    Methods: Subjects underwent pulmonary vein (PV) isolation with the PFA system, using at least 12 applications per vein; adenosine/isoproterenol was administered to confirm entrance block. Wave I assessed initial safety, including for esophageal lesions, silent cerebral lesions, and PV stenosis. Wave II (pivotal phase) tested (1) primary safety, incidence of early-onset primary adverse events, and (2) primary effectiveness, confirmed PV isolation with freedom from documented atrial arrhythmia at 12 months. The study design specified an interim analysis to determine early success once 30 subjects reached the 12-month follow-up and all subjects reached 3-month follow-up.
    Results: Across 13 centers in Europe/Canada, 226 subjects were enrolled, met criteria for safety and effectiveness evaluations, and received PFA (Wave I, 40; Wave II, 186). Wave I demonstrated no esophageal thermal lesions or PV stenosis. Among 39 subjects with cerebral magnetic resonance imaging, silent cerebral lesions were detected in 4 of the first 6 subjects, after which workflow enhancements, including a 10-second pause between PFA applications, were implemented; subsequently, only 4 of 33 subjects had silent cerebral lesions. In the Wave II phase, no primary adverse events were reported. Upon declaring early success, 83 subjects reached 12-month follow-up. With 100% entrance block, PV isolation without acute reconnection was achieved in 97.1% of targeted veins. For Wave II, the primary effectiveness end point per Kaplan-Meier at the time of interim analysis was 70.9%; 12-month freedom from symptomatic atrial fibrillation/atrial flutter/atrial tachycardia recurrence and repeat ablation was 78.9% and 92.3%, respectively. Total procedure and transpired PFA times were 70.1±27.7 and 26.7±14.0 minutes, respectively.
    Conclusions: The inspIRE trial confirmed the safety and effectiveness of the novel mapping-integrated PFA system.
    Registration: URL: https://www.
    Clinicaltrials: gov; unique identifier: NCT04524364.
    MeSH term(s) Humans ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Atrial Fibrillation/etiology ; Constriction, Pathologic/etiology ; Constriction, Pathologic/surgery ; Treatment Outcome ; Catheters ; Europe ; Pulmonary Veins/surgery ; Stenosis, Pulmonary Vein/etiology ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Recurrence
    Language English
    Publishing date 2023-02-03
    Publishing country United States
    Document type Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2426129-4
    ISSN 1941-3084 ; 1941-3149
    ISSN (online) 1941-3084
    ISSN 1941-3149
    DOI 10.1161/CIRCEP.122.011780
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The MADIT-ICD benefit score helps to select implantable cardioverter-defibrillator candidates in cardiac resynchronization therapy.

    Dauw, Jeroen / Martens, Pieter / Nijst, Petra / Meekers, Evelyne / Deferm, Sébastien / Gruwez, Henri / Rivero-Ayerza, Maximo / Van Herendael, Hugo / Pison, Laurent / Nuyens, Dieter / Dupont, Matthias / Mullens, Wilfried

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2022  Volume 24, Issue 8, Page(s) 1276–1283

    Abstract: Aims: The aim of this study is to evaluate whether the MADIT-ICD benefit score can predict who benefits most from the addition of implantable cardioverter-defibrillator (ICD) to cardiac resynchronization therapy (CRT) in real-world patients with heart ... ...

    Abstract Aims: The aim of this study is to evaluate whether the MADIT-ICD benefit score can predict who benefits most from the addition of implantable cardioverter-defibrillator (ICD) to cardiac resynchronization therapy (CRT) in real-world patients with heart failure with reduced ejection fraction (HFrEF) and to compare this with selection according to a multidisciplinary expert centre approach.
    Methods and results: Consecutive HFrEF patients who received a CRT for a guideline indication at a tertiary care hospital (Ziekenhuis Oost-Limburg, Genk, Belgium) between October 2008 and September 2016, were retrospectively evaluated. The MADIT-ICD benefit groups (low, intermediate, and high) were compared with the current multidisciplinary expert centre approach. Endpoints were (i) sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) and (ii) non-arrhythmic mortality. Of the 475 included patients, 165 (34.7%) were in the lowest, 220 (46.3%) in the intermediate, and 90 (19.0%) in the highest benefit group. After a median follow-up of 34 months, VT/VF occurred in 3 (1.8%) patients in the lowest, 9 (4.1%) in the intermediate, and 13 (14.4%) in the highest benefit group (P < 0.001). Vice versa, non-arrhythmic death occurred in 32 (19.4%) in the lowest, 32 (14.6%) in the intermediate, and 3 (3.3%) in the highest benefit group (P = 0.002). The predictive power for ICD benefit was comparable between expert multidisciplinary judgement and the MADIT-ICD benefit score: Uno's C-statistic 0.69 vs. 0.69 (P = 0.936) for VT/VF and 0.62 vs. 0.60 (P = 0.790) for non-arrhythmic mortality.
    Conclusion: The MADIT-ICD benefit score can identify who benefits most from CRT-D and is comparable with multidisciplinary judgement in a CRT expert centre.
    MeSH term(s) Arrhythmias, Cardiac/therapy ; Cardiac Resynchronization Therapy/adverse effects ; Defibrillators, Implantable ; Heart Failure/diagnosis ; Heart Failure/therapy ; Humans ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Tachycardia, Ventricular/diagnosis ; Tachycardia, Ventricular/therapy ; Treatment Outcome ; Ventricular Fibrillation/therapy
    Language English
    Publishing date 2022-03-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euac039
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  5. Article: Anatomical variation requiring simultaneous isolation of all pulmonary veins using a box lesion set.

    Ströker, Erwin / Van Herendael, Hugo / Rondelez, Koen / Rivero-Ayerza, Maximo

    Acta cardiologica

    2014  Volume 69, Issue 6, Page(s) 702–703

    MeSH term(s) Aged ; Atrial Fibrillation/surgery ; Catheter Ablation/methods ; Electrocardiography ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Male ; Pulmonary Veins/abnormalities ; Pulmonary Veins/surgery
    Language English
    Publishing date 2014-12-30
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 390197-x
    ISSN 0001-5385
    ISSN 0001-5385
    DOI 10.1080/ac.69.6.1000018
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  6. Article ; Online: Quality of life and healthcare utilisation improvements after atrial fibrillation ablation.

    Gupta, Dhiraj / Vijgen, Johan / Potter, Tom De / Scherr, Daniel / Van Herendael, Hugo / Knecht, Sebastien / Kobza, Richard / Berte, Benjamin / Sandgaard, Niels / Albenque, Jean-Paul / Széplaki, Gábor / Stevenhagen, Yorick / Taghji, Philippe / Wright, Matt / Duytschaever, Mattias

    Heart (British Cardiac Society)

    2021  Volume 107, Issue 16, Page(s) 1296–1302

    Abstract: Objective: Pulmonary vein isolation (PVI) guided by a standardised CLOSE (contiguous optimised lesions) protocol has been shown to increase clinical success after catheter ablation for paroxysmal atrial fibrillation (PAF). This study analysed healthcare ...

    Abstract Objective: Pulmonary vein isolation (PVI) guided by a standardised CLOSE (contiguous optimised lesions) protocol has been shown to increase clinical success after catheter ablation for paroxysmal atrial fibrillation (PAF). This study analysed healthcare utilisation and quality of life (QOL) outcomes from a large multicentre prospective study, measured association between QOL and atrial fibrillation (AF) burden and identified factors associated with lack of QOL improvement.
    Methods: CLOSE-guided ablation was performed in 329 consecutive patients (age 61.4 years, 60.8% male) with drug-refractory PAF in 17 European centres. QOL was measured at baseline and 12 months post-ablation via Atrial Fibrillation Effect on QualiTy of Life Survey (AFEQT) and EuroQoL EQ-5D-5L questionnaires. All-cause and cardiovascular hospitalisations and cardioversions over 12 months pre-ablation and post-ablation were recorded. Rhythm monitoring included weekly and symptom-driven trans-telephonic monitoring, plus ECG and Holter monitoring at 3, 6 and 12 months. AF burden was defined as the percentage of postblanking tracings with an atrial tachyarrhythmia ≥30 s. Continuous measures across multiple time points were analysed using paired t-tests, and associations between various continuous measures were analysed using independent sample t-tests. Each statistical test used two-sided p values with a significance level of 0.05.
    Results: Both QOL instruments showed significant 12-month improvements across all domains: AFEQT score increased 25.1-37.5 points and 33.3%-50.8% fewer patients reporting any problem across EuroQoL EQ-5D-5L domains. Overall, AFEQT improvement was highly associated with AF burden (p=0.009 for <10% vs ≥10% burden, p<0.001 for <20% vs ≥20% burden). Cardiovascular hospitalisations were significantly decreased after ablation (42%, p=0.001). Patients without substantial improvement in AFEQT (55/301, 18.2%) had higher AFEQT and CHA
    Conclusions: QOL improved and healthcare utilisation decreased significantly after ablation with a standardised CLOSE protocol. QOL improvement was significantly associated with impairment at baseline and AF burden after ablation.
    Trial registration number: NCT03062046.
    MeSH term(s) Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/psychology ; Atrial Fibrillation/surgery ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Cost of Illness ; Electric Countershock/statistics & numerical data ; Electrocardiography, Ambulatory/methods ; Electrocardiography, Ambulatory/statistics & numerical data ; Europe/epidemiology ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Outcome Assessment, Health Care ; Patient Acceptance of Health Care/statistics & numerical data ; Perioperative Period/psychology ; Perioperative Period/statistics & numerical data ; Pulmonary Veins/surgery ; Quality of Life ; Surveys and Questionnaires
    Language English
    Publishing date 2021-05-05
    Publishing country England
    Document type Clinical Trial ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 1303417-0
    ISSN 1468-201X ; 1355-6037
    ISSN (online) 1468-201X
    ISSN 1355-6037
    DOI 10.1136/heartjnl-2020-318676
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  7. Article ; Online: Atrial fibrillation screening with photo-plethysmography through a smartphone camera.

    Verbrugge, Frederik H / Proesmans, Tine / Vijgen, Johan / Mullens, Wilfried / Rivero-Ayerza, Maximo / Van Herendael, Hugo / Vandervoort, Pieter / Nuyens, Dieter

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2019  Volume 21, Issue 8, Page(s) 1167–1175

    Abstract: Aims: This cross-sectional study was set up to assess the feasibility of mass screening for atrial fibrillation (AF) with only the use of a smartphone.: Methods and results: A local newspaper published an article, allowing to subscribe for a 7-day ... ...

    Abstract Aims: This cross-sectional study was set up to assess the feasibility of mass screening for atrial fibrillation (AF) with only the use of a smartphone.
    Methods and results: A local newspaper published an article, allowing to subscribe for a 7-day screening period to detect AF. Screening was performed through an application that uses photo-plethysmography (PPG) technology by exploiting a smartphone camera. Participants received instructions on how to perform correct measurements twice daily, with notifications pushed through the application's software. In case of heart rhythm irregularities, raw PPG signals underwent secondary offline analysis to confirm a final diagnosis. From 12 328 readers who voluntarily signed up for screening (49 ± 14 years; 58% men), 120 446 unique PPG traces were obtained. Photo-plethysmography signal quality was adequate for analysis in 92% of cases. Possible AF was detected in 136 individuals (1.1%). They were older (P < 0.001), more frequently men (P < 0.001), and had higher body mass index (P = 0.004). In addition, participants who strictly adhered to the recommended screening frequency (i.e. twice daily) were more often diagnosed with possible AF (1.9% vs. 1.0% in individuals who did not adhere; P = 0.008). Symptoms of palpitations, confusion, and shortness of breath were more frequent in case of AF (P < 0.001). The cumulative diagnostic yield for possible AF increased from 0.4% with a single heart rhythm assessment to 1.4% with screening during the entire 7-day screening period.
    Conclusion: Mass screening for AF using only a smartphone with dedicated application based on PPG technology is feasible and attractive because of its low cost and logistic requirements.
    MeSH term(s) Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Belgium/epidemiology ; Cross-Sectional Studies ; Feasibility Studies ; Female ; Humans ; Male ; Mass Screening/instrumentation ; Mass Screening/methods ; Middle Aged ; Mobile Applications ; Photoplethysmography/instrumentation ; Photoplethysmography/methods ; Smartphone
    Language English
    Publishing date 2019-05-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euz119
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  8. Article ; Online: Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia.

    Van Herendael, Hugo / Dorian, Paul

    Vascular health and risk management

    2010  Volume 6, Page(s) 465–472

    Abstract: Amiodarone has emerged as the leading antiarrhythmic therapy for termination and prevention of ventricular arrhythmia in different clinical settings because of its proven efficacy and safety. In patients with shock refractory out-of-hospital cardiac ... ...

    Abstract Amiodarone has emerged as the leading antiarrhythmic therapy for termination and prevention of ventricular arrhythmia in different clinical settings because of its proven efficacy and safety. In patients with shock refractory out-of-hospital cardiac arrest and hemodynamically destabilizing ventricular arrhythmia, amiodarone is the most effective drug available to assist in resuscitation. Although the superiority of the transvenous implantable cardioverter defibrillator (ICD) over amiodarone has been well established in the preventive treatment of patients at high risk of life-threatening ventricular arrhythmias, amiodarone (if used with a beta-blocker) is the most effective antiarrhythmic drug to prevent ICD shocks and treat electrical storm. Both the pharmacokinetics and the electrophysiologic profile of amiodarone are complex, and its optimal and safe use requires careful patient surveillance with respect to potential adverse effects.
    MeSH term(s) Administration, Oral ; Amiodarone/administration & dosage ; Amiodarone/adverse effects ; Amiodarone/therapeutic use ; Anti-Arrhythmia Agents/administration & dosage ; Anti-Arrhythmia Agents/adverse effects ; Anti-Arrhythmia Agents/therapeutic use ; Humans ; Infusions, Intravenous ; Tachycardia, Ventricular/drug therapy ; Tachycardia, Ventricular/prevention & control ; Ventricular Fibrillation/drug therapy ; Ventricular Fibrillation/prevention & control
    Chemical Substances Anti-Arrhythmia Agents ; Amiodarone (N3RQ532IUT)
    Language English
    Publishing date 2010-08-09
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2186568-1
    ISSN 1178-2048 ; 1176-6344
    ISSN (online) 1178-2048
    ISSN 1176-6344
    DOI 10.2147/vhrm.s6611
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  9. Article ; Online: Sacubitril/valsartan reduces ventricular arrhythmias in parallel with left ventricular reverse remodeling in heart failure with reduced ejection fraction.

    Martens, Pieter / Nuyens, Dieter / Rivero-Ayerza, Maximo / Van Herendael, Hugo / Vercammen, Jan / Ceyssens, Wendy / Luwel, Evert / Dupont, Matthias / Mullens, Wilfried

    Clinical research in cardiology : official journal of the German Cardiac Society

    2019  Volume 108, Issue 10, Page(s) 1074–1082

    Abstract: Background: Sacubitril/valsartan reduced the occurrence of sudden cardiac death in the PARADIGM-HF trial. However, limited information is available about the mechanism.: Methods: Heart failure (HF)-patients receiving sacubitril/valsartan for a class- ... ...

    Abstract Background: Sacubitril/valsartan reduced the occurrence of sudden cardiac death in the PARADIGM-HF trial. However, limited information is available about the mechanism.
    Methods: Heart failure (HF)-patients receiving sacubitril/valsartan for a class-I indication equipped with an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT) with remote tele-monitoring were retrospectively analyzed. Device-registered arrhythmic-events were determined [ventricular tachycardia/fibrillation (VT/VF), appropriate therapy, non-sustained VT (NsVT; > 4beats and < 30 s), hourly premature ventricular contraction (PVC)-burden], following sacubitril/valsartan initiation (incident-analysis) and over an equal time period before initiation (antecedent-analysis). Reverse remodeling to sacubitril/valsartan was defined as an improvement of left ventricular ejection fraction of ≥ 5% between baseline and follow-up.
    Results: A-total of 151 HF-patients with reduced LVEF (29 ± 9%) were included. Patients were switched from ACE-I or ARB to equal doses of sacubitril/valsartan (expressed as %-target-dose; before = 58 ± 30% vs. after = 56 ± 27%). The mean follow-up of both the incident and antecedent analysis was 364 days. Following the initiation, VT/VF-burden dropped (individual patients with VT/VF pre_n = 19 vs. post_n = 10, total-episodes of VT/VF pre_n = 51 vs. post_n = 14, both p < 0.001), resulting in reduced occurrence of appropriate therapy (pre_n = 16 vs. post_n = 6; p < 0.001). NsVT-burden per patient also dropped (mean episodes pre_n = 7.7 ± 11.8 vs. post_n = 3.7 ± 5.4; p < 0.001). There was no impact on atrial-fibrillation burden. PVC-burden dropped significantly which was associated with an improvement in BiV-pacing in patients with < 90% BiV-pacing at baseline. A higher degree of reverse remodeling was associated with a lower burden of NsVT and PVCs (both p < 0.05).
    Conclusion: Initiation of sacubitril/valsartan is associated with a lower degree of VT/VF, resulting in less ICD-interventions. This beneficial effect on ventricular arrhythmias might be related to cardiac reverse remodeling.
    MeSH term(s) Aged ; Aminobutyrates/therapeutic use ; Angiotensin Receptor Antagonists/therapeutic use ; Arrhythmias, Cardiac/drug therapy ; Arrhythmias, Cardiac/etiology ; Arrhythmias, Cardiac/physiopathology ; Belgium/epidemiology ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/prevention & control ; Drug Combinations ; Female ; Follow-Up Studies ; Heart Failure/complications ; Heart Failure/drug therapy ; Heart Failure/physiopathology ; Humans ; Incidence ; Male ; Neprilysin ; Retrospective Studies ; Stroke Volume/physiology ; Survival Rate/trends ; Tetrazoles/therapeutic use ; Treatment Outcome ; Ventricular Function, Left/physiology ; Ventricular Remodeling/drug effects
    Chemical Substances Aminobutyrates ; Angiotensin Receptor Antagonists ; Drug Combinations ; Tetrazoles ; Neprilysin (EC 3.4.24.11) ; sacubitril and valsartan sodium hydrate drug combination (WB8FT61183)
    Language English
    Publishing date 2019-02-20
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2213295-8
    ISSN 1861-0692 ; 1861-0684
    ISSN (online) 1861-0692
    ISSN 1861-0684
    DOI 10.1007/s00392-019-01440-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Contralateral pneumothorax after endocardial dual-chamber pacemaker implantation resulting from atrial lead perforation.

    Van Herendael, Hugo / Willems, Rik

    Acta cardiologica

    2009  Volume 64, Issue 2, Page(s) 271–273

    Abstract: We describe the occurrence of a right-sided pneumothorax following a left-sided dual chamber pacemaker implantation, due to a perforation of the screw of the J-shaped active-fixation lead through the right atrial wall. A review of the literature ... ...

    Abstract We describe the occurrence of a right-sided pneumothorax following a left-sided dual chamber pacemaker implantation, due to a perforation of the screw of the J-shaped active-fixation lead through the right atrial wall. A review of the literature regarding complications of different atrial lead types (passive vs. active and J-shape vs. straight) is provided. Current data suggest that passive-fixation leads could have an advantage, provided they can be positioned satisfactorily because of the lower risk of pericardial complications. If active-fixation leads are used, straight leads might be preferable above J-shaped leads because of the lower rate of perforation.
    MeSH term(s) Aged ; Atrioventricular Block/therapy ; Device Removal/methods ; Diagnosis, Differential ; Electrodes, Implanted/adverse effects ; Follow-Up Studies ; Heart Atria/injuries ; Heart Injuries/diagnostic imaging ; Heart Injuries/surgery ; Humans ; Male ; Pacemaker, Artificial/adverse effects ; Pneumothorax/diagnostic imaging ; Pneumothorax/etiology ; Pneumothorax/surgery ; Prosthesis Implantation/adverse effects ; Tomography, X-Ray Computed
    Language English
    Publishing date 2009-04
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 390197-x
    ISSN 0001-5385
    ISSN 0001-5385
    DOI 10.2143/AC.64.2.2036150
    Database MEDical Literature Analysis and Retrieval System OnLINE

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