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Article ; Online: Interference from lobe-and-disk left atrial appendage occluder affecting left superior pulmonary vein pulsed field ablation.

Audiat, Charles / Della Rocca, Domenico Giovanni / de Asmundis, Carlo / Chierchia, Gian Battista

2024

Language	English
Publishing date	2024-04-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2229357-7
ISSN	1556-3871 ; 1547-5271
ISSN (online)	1556-3871
ISSN	1547-5271
DOI	10.1016/j.hrthm.2024.03.1808
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Zs.A 6278: Show issues

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Article ; Online: Brockenbrough-Braunwald-Morrow sign and Valsalva manoeuvre: how to unmask dynamic left ventricular outflow tract obstruction.

Mabalukwa, Junior / Nguyen, Damien / Briki, Rachid / Audiat, Charles / Unger, Philippe

European heart journal. Cardiovascular Imaging

2022 Volume 23, Issue 4, Page(s) e169

MeSH term(s)	Cardiomyopathy, Hypertrophic ; Heart Defects, Congenital ; Humans ; Valsalva Maneuver ; Ventricular Dysfunction, Left ; Ventricular Outflow Obstruction/diagnostic imaging ; Ventricular Outflow Obstruction/etiology
Language	English
Publishing date	2022-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2638345-7
ISSN	2047-2412 ; 2047-2404
ISSN (online)	2047-2412
ISSN	2047-2404
DOI	10.1093/ehjci/jeac008
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Zs.A 5614: Show issues

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Article ; Online: Rapidly growing cardiac haemangioma in a patient with Tetralogy of Fallot: case report and brief literature review.

Audiat, Charles / Anghel, Laura / Duttmann, Ruth / Mottart, Kevin / Morissens, Marielle

Acta cardiologica

2022 Volume 78, Issue 4, Page(s) 498–502

MeSH term(s)	Humans ; Tetralogy of Fallot/complications ; Tetralogy of Fallot/diagnosis ; Tetralogy of Fallot/surgery ; Heart Neoplasms/complications ; Heart Neoplasms/diagnosis ; Hemangioma/complications ; Hemangioma/diagnosis
Language	English
Publishing date	2022-06-15
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	390197-x
ISSN	1784-973X ; 0001-5385
ISSN (online)	1784-973X
ISSN	0001-5385
DOI	10.1080/00015385.2022.2088453
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Article ; Online: Pulsed field ablation of the right superior pulmonary vein prevents vagal responses via anterior right ganglionated plexus modulation.

Del Monte, Alvise / Della Rocca, Domenico Giovanni / Pannone, Luigi / Vetta, Giampaolo / Cespón Fernández, María / Marcon, Lorenzo / Doundoulakis, Ioannis / Mouram, Sahar / Audiat, Charles / Zeriouh, Sarah / Monaco, Cinzia / Al Housari, Maysam / Betancur, Andrés / Mené, Roberto / Iacopino, Saverio / Sorgente, Antonio / Bala, Gezim / Ströker, Erwin / Sieira, Juan /

Almorad, Alexandre / Sarkozy, Andrea / Boveda, Serge / de Asmundis, Carlo / Chierchia, Gian-Battista

Heart rhythm

2024

Abstract: Background: Pulsed field ablation (PFA) is selective for the myocardium. However, vagal responses and reversible effects on ganglionated plexi (GP) are observed during pulmonary vein isolation (PVI). Anterior-right GP ablation has been proven to ... ...

Abstract	Background: Pulsed field ablation (PFA) is selective for the myocardium. However, vagal responses and reversible effects on ganglionated plexi (GP) are observed during pulmonary vein isolation (PVI). Anterior-right GP ablation has been proven to effectively prevent vagal responses during radiofrequency-based PVI. Objective: The purpose of this study was to test the hypothesis that PFA-induced transient anterior-right GP modulation when targeting the right superior pulmonary vein (RSPV) before any other pulmonary veins (PVs) may effectively prevent intraprocedural vagal responses. Methods: Eighty consecutive paroxysmal atrial fibrillation patients undergoing PVI with PFA were prospectively included. In the first 40 patients, PVI was performed first targeting the left superior pulmonary vein (LSPV-first group). In the last 40 patients, RSPV was targeted first, followed by left PVs and right inferior PV (RSPV-first group). Heart rate (HR) and extracardiac vagal stimulation (ECVS) were evaluated at baseline, during PVI, and postablation to assess GP modulation. Results: Vagal responses occurred in 31 patients (78%) in the LSPV-first group and 5 (13%) in the RSPV-first group (P <.001). Temporary pacing was needed in 14 patients (35%) in the LSPV-first group and 3 (8%) in the RSPV-first group (P = .003). RSPV isolation was associated with similar acute HR increase in the 2 groups (13 ± 11 bpm vs 15 ± 12 bpm; P = .3). No significant residual changes in HR or ECVS response were documented in both groups at the end of the procedure compared to baseline (all P >.05). Conclusion: PVI with PFA frequently induced vagal responses when initiated from the LSPV. Nevertheless, an RSPV-first approach promoted transient HR increase and reduced vagal response occurrence.
Language	English
Publishing date	2024-01-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2229357-7
ISSN	1556-3871 ; 1547-5271
ISSN (online)	1556-3871
ISSN	1547-5271
DOI	10.1016/j.hrthm.2024.01.040
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Zs.A 6278: Show issues

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Article ; Online: Pericarditis prophylactic therapy after sinus node-sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia.

Heart rhythm O2

2024 Volume 5, Issue 2, Page(s) 137–144

Abstract: Background: Pericarditis is the most common complication following hybrid sinus node-sparing ablation for inappropriate sinus tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS).: Objective: The study sought to evaluate the association ...

Abstract	Background: Pericarditis is the most common complication following hybrid sinus node-sparing ablation for inappropriate sinus tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS). Objective: The study sought to evaluate the association of prophylaxis therapy on the risk of symptomatic pericarditis following hybrid IST/POTS ablation. Methods: All consecutive patients undergoing to hybrid ablation of symptomatic IST/POTS refractory or intolerant to drugs were retrospectively analyzed. Pharmacological prophylaxis therapy was based on acetylsalicylic acid and colchicine started on the day of the ablation and continued for at least 3 months. The primary endpoint was occurrence of symptomatic pericarditis. The secondary endpoint was occurrence of pericarditis-related complications, including the following: duration of pericarditis >3 months, hospitalization for pericarditis, postpericardiectomy pleuro-pericarditis, and pericardiectomy. Results: A total of 220 patients undergone to hybrid IST/POTS ablation were included and 44 (20%) underwent prophylaxis therapy. Pericarditis occurred in 101 (45.9%) patients, with 97 (96%) in the first 5 days. At survival analysis, prophylaxis was associated with higher rate of freedom from pericarditis (81.9% vs 47.2%, log-rank Conclusion: In a large cohort of patients undergoing hybrid ablation for IST/POTS, a prophylaxis therapy with acetylsalicylic acid and colchicine was associated with a lower rate of symptomatic pericarditis.
Language	English
Publishing date	2024-01-10
Publishing country	United States
Document type	Journal Article
ISSN	2666-5018
ISSN (online)	2666-5018
DOI	10.1016/j.hroo.2024.01.001
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Article: Safety of the Radiofrequency Balloon for Pulmonary Vein Isolation: A Focus on Lesion Metric Analysis of Posterior Electrodes.

Almorad, Alexandre / Del Monte, Alvise / Teumer, Yannick / El Haddad, Milad / Pannone, Luigi / Della Rocca, Domenico Giovanni / Audiat, Charles / Cespón-Fernández, María / Mouram, Sahar / Ramak, Robbert / Overeinder, Ingrid / Bala, Gezim / Sorgente, Antonio / Ströker, Erwin / Sieira, Juan / Brugada, Pedro / La Meir, Mark / de Asmundis, Carlo / Chierchia, Gian-Battista

Journal of clinical medicine

2023 Volume 12, Issue 19

Abstract: Previous clinical studies on pulmonary vein isolation (PVI) with radiofrequency balloons (RFB) reported safe and effective procedures for a 20 s RF delivery via posterior electrodes. Recent recommendations from the manufacturer suggest reducing the ... ...

Abstract	Previous clinical studies on pulmonary vein isolation (PVI) with radiofrequency balloons (RFB) reported safe and effective procedures for a 20 s RF delivery via posterior electrodes. Recent recommendations from the manufacturer suggest reducing the application time to 15 s on the posterior wall (PW) when facing the esophagus region. Here, we retrospectively assess whether 15 s of RF delivery time on posterior electrodes is safe while still ensuring lesion metrics of sufficient quality. This retrospective study included 133 patients with paroxysmal and persistent atrial fibrillation who underwent PVI using an RFB (Heliostar, Biosense Webster, Inc., Irvine, CA, USA) at two European centers. The ablation protocol was set for an RF duration of 20 s/60 s for the posterior/anterior electrodes. A multielectrode temperature probe was systematically used. In the case of an esophageal temperature rise (ETR) above 42 °C (ETR+), an endoscopic evaluation was performed. All posterior electrode lesion metric dynamics (temperature (T) and impedance (Z)) were collected from the RFB generator and analyzed offline. In total, 2435 posterior electrode applications were analyzed. With an RF delivery of 19.8 (19.7-19.8) s, the median impedance drop was 18.4 (12.2-25.2) Ω, while the temperature rise was 11.1 (7.1-14.9) °C. Accordingly, impedance (84.6 (79.3-90.2) Ω) and temperature plateaus (38 (35.3-41.1) °C) were reached at 13.9 (10.6-16) s and 16.4 (12.6-18.5) s, respectively. Overall, 99.6% and 95.8% of electrodes reached 90% (16.6 Ω) and 95% (17.5 Ω) of their impedance drops within 15 s of RF delivery, while 97.2% and 92.8% achieved 90% (34.2 °C) and 95% (36.1 °C) of their temperature rise to reach the plateaus within 15 s of RF delivery. An ETR >42 °C occurred in 37 (30.1%) patients after 17.7 ± 2.3 s of RF delivery. In the ETR+ group, the impedance drop and temperature rise on the posterior electrodes were higher compared to patients where ETR was <42 °C. Two asymptomatic thermal esophageal injuries were observed. In conclusion, 15 s of RF delivery on the posterior electrodes provides a good balance between safety, with no esophageal temperature rise, and efficacy with high-profile lesion metrics.
Language	English
Publishing date	2023-09-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12196256
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Article ; Online: Posterior wall isolation via a multi-electrode radiofrequency balloon catheter: feasibility, technical considerations, endoscopic findings and comparison with cryoballoon technologies.

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

2023 Volume 67, Issue 2, Page(s) 273–283

Abstract: Background: Posterior wall (PW) isolation is an important adjunctive ablation target in patients with non-paroxysmal atrial fibrillation (AF). Traditionally performed with point-by-point radiofrequency (RF) ablation, PW isolation has also been performed ...

Abstract	Background: Posterior wall (PW) isolation is an important adjunctive ablation target in patients with non-paroxysmal atrial fibrillation (AF). Traditionally performed with point-by-point radiofrequency (RF) ablation, PW isolation has also been performed with different cryoballoon technologies. We aimed at assessing the feasibility of PW isolation with the novel RF balloon catheter Heliostar™ (Biosense Webster, CA, USA). Methods: We prospectively enrolled 32 consecutive patients with persistent AF scheduled for first-time ablation with the Heliostar™ device. Procedural data were compared with those from 96 consecutive persistent AF patients undergoing pulmonary vein (PV) plus PW isolation with a cryoballoon device. The ratio RF balloon/cryoballoon was 1:3 for each operator involved in the study, aiming at avoiding any imbalance related to different experience. Results: Single-shot PV isolation was documented in a significantly higher number of cases with the RF balloon technology compared to cryoballoon ablation (89.8% vs. 81.0%; p = 0.02, respectively). PW isolation was achieved with a similar number of balloon applications between the two groups (11 ± 4 with the RF balloon versus 11 ± 2 with the cryoballoon; p = 0.16), but in a significantly shorter time among RF balloon patients (228 ± 72 s versus 1274 ± 277 s with cryoballoon; p < 0.001). Primary safety endpoint occurred in none of the RF balloon patients versus 5 (5.2%) patients in the cryoballoon group (p = 0.33). Primary efficacy endpoint was achieved in all (100%) RF balloon patients versus 93 (96.9%) cryoballoon ones (p = 0.57). Oesophageal endoscopy did not show any signs of thermal lesions in RF balloon patients with luminal temperature rise. Conclusions: RF balloon-based PW isolation was safe and promoted shorter procedure times compared to similar cryoballoon-based ablation procedures.
MeSH term(s)	Humans ; Cryosurgery/methods ; Feasibility Studies ; Treatment Outcome ; Catheter Ablation/methods ; Recurrence ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/surgery ; Pulmonary Veins/surgery ; Catheters
Language	English
Publishing date	2023-04-27
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1329179-8
ISSN	1572-8595 ; 1383-875X
ISSN (online)	1572-8595
ISSN	1383-875X
DOI	10.1007/s10840-023-01549-1
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Article ; Online: Redo procedures after sinus node sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia.

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

2023 Volume 26, Issue 1

Abstract: Aims: A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug- ... ...

Abstract	Aims: A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug-resistant IST/POTS. The aim of this study was to evaluate the long-term rate of redo procedures after hybrid IST ablation and procedural strategy, outcomes and safety of redo procedures. Methods and results: All consecutive patients from 2015 to 2023 were prospectively enrolled in the UZ Brussel monocentric IST/POTS registry. They were analysed if the following inclusion criteria were fulfilled: 1) diagnosis of IST or POTS, 2) symptomatic IST/POTS refractory or intolerant to drugs, and 3) hybrid SN sparing ablation performed. The primary endpoint was redo procedure. The primary safety endpoint was pacemaker (PM) implantation. A total of 220 patients undergone to hybrid IST ablation were included, 185 patients (84.1%) were treated for IST and 61 patients (27.7%) for POTS.After a follow-up of 73.3 ± 16.2 months, 34 patients (15.4%) underwent a redo. A total of 23 patients (67.6%) had a redo for IST recurrence and 11 patients (32.4%) for other arrhythmias. Pacemaker implantation was performed in 21 patients (9.5%). Nine patients (4.1%) had no redo procedure and experienced sick sinus syndrome requiring a PM. Twelve patients (5.4%) received a PM as a shared therapeutic choice combined with SN ablation procedure. Conclusion: In a large cohort of patients the long-term free survival from redo procedure after hybrid IST ablation was 84.6% with a low PM implantation rate.
MeSH term(s)	Humans ; Tachycardia, Sinus/diagnosis ; Tachycardia, Sinus/surgery ; Tachycardia, Sinus/drug therapy ; Sinoatrial Node ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Heart Rate
Language	English
Publishing date	2023-12-28
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/euad373
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