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  1. Article ; Online: Impact of weight adjusted high frequency low tidal volume ventilation and atrial pacing in lesion metrics in high-power short-duration ablation: Results of a pilot study.

    Vassallo, Fabricio / Volponi, Carlos / Cunha, Christiano / Corcino, Lucas / Serpa, Eduardo / Simoes, Aloyr / Gasparini, Dalbian / Barbosa, Luiz Fernando / Schmidt, Andre

    Journal of cardiovascular electrophysiology

    2024  Volume 35, Issue 5, Page(s) 975–983

    Abstract: Introduction: Lesion size index (LSI) was introduced with the use of Tacticath™ and as a surrogate of lesion quality. The metric used to achieve the predetermined values involves combined information of contact force (CF), power and radiofrequency time. ...

    Abstract Introduction: Lesion size index (LSI) was introduced with the use of Tacticath™ and as a surrogate of lesion quality. The metric used to achieve the predetermined values involves combined information of contact force (CF), power and radiofrequency time. Rapid atrial pacing (RAP) and high-frequency low-tidal volume ventilation (HFLTV) independently or in combination improve catheter stability and CF and quality of lesions. Data of the impact of body weight adjusted HFLTV ventilation strategy associated with RAP in the lesion metrics still lacking. The study aimed to compare the results of high-power short-duration (HPSD) atrial fibrillation ablation using simultaneous weight adjusted HFLTV and RAP and standard ventilation (SV) protocol.
    Methods: Prospective, nonrandomized study with 136 patients undergoing de novo ablation divided into two groups; 70 in RAP (100 ppm) + HFLTV with 4 mL/kg of tidal volume and 25 breaths/min (group A) and 66 patients with SV in intrinsic sinus rhythm (group B). Ablation using 50 W, CF of 5-10 g/10-20 g and 40 mL/minute flow rate on the posterior and anterior left atrial wall, respectively.
    Results: No procedure-related complications. Group A: Mean LSI points 70 ± 16.5, mean total lower LSI 3.4 ± 0.5, mean total higher LSI 8.2 ± 0.4 and mean total LSI 5.6 ± 0.6. Anterior and posterior wall mean total LSI was 6.0 ± 0.4 and 4.2 ± 0.3, respectively. Mean local impedance drop (LID) points were 118.8 ± 28.4, mean LID index (%) 12.9 ± 1.5, and mean LID < 12% points 55.9 ± 23.8. Anterior and posterior wall mean total LID index were 13.6 ± 2.0 and 11.9 ± 1.7, respectively. Recurrence in 11 (15.7%) patients. Group B: Mean LSI points 56 ± 2.7, mean total lower LSI 2.9 ± 0.7, mean total higher LSI 6.9 ± 0.9, and mean total LSI 4.8 ± 0.8. Anterior and posterior wall mean total LSI was 5.1 ± 0.3 and 3.5 ± 0.5, respectively. Mean LID points were 111.4 ± 21.5, mean LID index (%) 11.4 ± 1.2, and mean LID < 12% points 54.9 ± 25.2. Anterior and posterior wall mean total LID index were 11.8 ± 1.9 and 10.3 ± 1.7, respectively. Recurrence in 14 (21.2%) patients. Mean follow up was 15.2 ± 4.4 months.
    Conclusion: Weight adjusted HFLTV ventilation with RAP HPSD ablation produced lower recurrence rate and better LSI and LID parameters in comparison to SV and intrinsic sinus rhythm.
    MeSH term(s) Humans ; Female ; Pilot Projects ; Male ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/surgery ; Atrial Fibrillation/diagnosis ; Prospective Studies ; Middle Aged ; Aged ; Catheter Ablation/adverse effects ; Treatment Outcome ; Tidal Volume ; Time Factors ; Heart Rate ; Cardiac Pacing, Artificial ; Body Weight
    Language English
    Publishing date 2024-03-14
    Publishing country United States
    Document type Journal Article ; Comparative Study
    ZDB-ID 1025989-2
    ISSN 1540-8167 ; 1045-3873
    ISSN (online) 1540-8167
    ISSN 1045-3873
    DOI 10.1111/jce.16245
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2863: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Comparison of outcomes with low-power long duration versus high-power short duration of ablation: the role of the acute change in sinus rhythm after the ablation as a predictor of long-term success.

    Vassallo, Fabricio / Meigre, Lucas Luis / Cunha, Christiano / Serpa, Eduardo / Simoes, Aloyr / Lovatto, Carlos / Gasparini, Dalbian / Corcino, Lucas / Schmidt, Andre

    Heart and vessels

    2022  Volume 37, Issue 10, Page(s) 1749–1756

    Abstract: Different results are described after atrial fibrillation ablation and multiple predictors of recurrence are well established. Evaluate and analyze if heart rate increase (HRI) during a first atrial fibrillation (AF) ablation with low-power long-duration ...

    Abstract Different results are described after atrial fibrillation ablation and multiple predictors of recurrence are well established. Evaluate and analyze if heart rate increase (HRI) during a first atrial fibrillation (AF) ablation with low-power long-duration (LPLD) and subsequently with high-power short-duration (HPSD) can impact. Retrospectively analyzed 340 consecutive patients (pts) undergoing first AF ablation. There were 158 pts in LPLD group: 113 (71.5%) paroxysmal AF with ablation with a power of 30/20 w, on anterior and posterior left atrial (LA) wall, respectively, and contact force of 10-30g for 30 s. There were 182 pts in HPSD group: 106 (58.2%) paroxysmal AF, who underwent ablation with 45/50 w, contact force of 8-15g/10-20g and 35 mL/min flow rate on anterior and posterior left atrial wall, respectively. Median follow-up was 32 ± 16 months. Success was observed in 94 (59.5%) patients in LPLD and 152 (83.5%) in HPSD, in LPLD group we documented a median HRI of 4.3 bpm (8%), compared to preablation heart rate, while a higher HRI in HPSD group of HRI 13.5 bpm (27.2%) was noted. Heart rate increase was associated with a higher success rate in both ablation techniques and independently showed an important impact on the success rate after AF ablation. HPSD compared to LPLD showed a higher proportion of HRI and also demonstrated a superiority in maintaining sinus rhythm at a long-term follow-up.
    MeSH term(s) Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Humans ; Pulmonary Veins/surgery ; Recurrence ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2022-04-16
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 89678-0
    ISSN 1615-2573 ; 0910-8327 ; 0935-736X
    ISSN (online) 1615-2573
    ISSN 0910-8327 ; 0935-736X
    DOI 10.1007/s00380-022-02066-3
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2049: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Comparison between weight-adjusted, high-frequency, low-tidal-volume ventilation and atrial pacing with normal ventilation in high-power, short-duration atrial fibrillation ablation: Results of a pilot study.

    Vassallo, Fabricio / Cancellieri, Joao Pedro / Cunha, Christiano / Corcino, Lucas / Serpa, Eduardo / Simoes, Aloyr / Hespanhol, Dalton / Volponi, Carlos / Gasparini, Dalbian / Schmidt, Andre

    Heart rhythm O2

    2023  Volume 4, Issue 8, Page(s) 483–490

    Abstract: Background: Better contact force (CF) and catheter stability (CS) during atrial fibrillation (AF) ablation are associated with higher success rate. Changes in CF and CS are observed during respiratory movements and cardiac contraction. Previous studies ... ...

    Abstract Background: Better contact force (CF) and catheter stability (CS) during atrial fibrillation (AF) ablation are associated with higher success rate. Changes in CF and CS are observed during respiratory movements and cardiac contraction. Previous studies have suggested that rapid atrial pacing (RAP) and high-frequency, low-tidal-volume ventilation (HFLTV) independently or in combination improve CS and CF and quality of lesions. Data from a body weight-adjusted HFLTV strategy associated with RAP in AF high-power, short-duration (HPSD) ablation are still lacking.
    Objective: This study aimed to compare the results of HPSD AF ablation using simultaneous weight-adjusted HFLTV and RAP and standard ventilation (SV) protocol.
    Methods: This was a prospective, nonrandomized study with 136 patients undergoing de novo ablation were divided into 2 groups: 70 in RAP (100 ppm) + HFLTV with 4 mL/kg of tidal volume and 25 breaths/min (group A) and 66 patients with SV in intrinsic sinus rhythm (group B). The ablation used 50 W, CF of 5 to 10 g and 10 to 20 g, and 40 mL/min flow rate on the posterior and anterior left atrial walls, respectively.
    Results: There were no procedure-related complications. In group A, left atrial and total ablation times were 53.5 ± 8.3 minutes and 67.4 ± 10.1 minutes, respectively. Radiofrequency time was 19.7 ± 5.7 minutes, radioscopy time was 3.4 ± 1.8 minutes, 62 (88.6%) patients had first-pass isolation, 23 (33.3%) patients had elevation of luminal esophageal temperature, and 7 (10%) patients had recurrence. In group B, left atrial time was 56.7 ± 10.8 minutes, total ablation time was 72.4 ± 11.5 minutes, radiofrequency time was 22.4 ± 6.2 minutes, radioscopy time was 3.6 ± 3 minutes, 58 (87.9%) patients had first-pass isolation, and 20 (30.3%) patients had luminal esophageal temperature elevation.
    Conclusion: Weight-adjusted HFLTV with RAP in comparison with SV and intrinsic sinus rhythm in HPSD ablation is safe with no CO
    Language English
    Publishing date 2023-07-08
    Publishing country United States
    Document type Journal Article
    ISSN 2666-5018
    ISSN (online) 2666-5018
    DOI 10.1016/j.hroo.2023.07.001
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  4. Article ; Online: Incidental parasympathetic cardiac denervation during atrial fibrillation ablation using high power short duration: a marker of long-term success.

    Vassallo, Fabricio / Corcino, Lucas / Cunha, Christiano / Serpa, Eduardo / Lovatto, Carlos / Simoes, Aloyr / Carloni, Hermes / Hespanhol, Dalton / Gasparini, Dalbian / Barbosa, Luiz Fernando / Schmidt, Andre

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

    2023  

    Abstract: Background: There are multiple factors in both technique and substrate that lead to recurrence of atrial fibrillation after ablation. We sought to examine whether the degree of heart rate increase (HRI) caused by concurrent high-power-short-duration ( ... ...

    Abstract Background: There are multiple factors in both technique and substrate that lead to recurrence of atrial fibrillation after ablation. We sought to examine whether the degree of heart rate increase (HRI) caused by concurrent high-power-short-duration (HPSD) incidental parasympathetic denervation during AF ablation predicts long term success. Between December 2018 and December 2021, prospectively enrolled 214 patients who presented in sinus rhythm at AF ablation. Used 50 W of power and contact force (CF) of 5-15 g and 10-20 g at a flow rate of 40 mL/min on the anterior and posterior left atrial walls, respectively.
    Results: Males were 143 (66.8%) and paroxysmal was 124 (57.9%) patients. Mean age 61.1 ± 12.3 years and follow-up time was 32.8 ± 13.2 months. Arrhythmia occurred after 90 days in 39 (18.2%) patients, 19 (48.7%) from the paroxysmal and 20 (51.3%) from the persistent AF patients. Recurrence group showed a lower HRI from a mean of 57 ± 7.7 to 64.4 ± 10.4 bpm (12.3%) while in success group HRI was from 53.8 ± 9.7 to 66.8 ± 11.6 bpm [(24.2%) p = 0.04]. We divided HRI in 3 percentiles of ≤ 8%, > 8 ≤ 37% and > 37%. A predictor of recurrence was identified in those in the first (< 8%, p = 0.006) and a predictor of success in the later (> 37%, p = 0.01) HRI percentile.
    Conclusion: Atrial fibrillation ablation with HPSD incidental cardiac parasympathetic denervation identified that patients with lower heart rate increase are prone to recurrence while those with higher heart rate increase had higher maintenance of sinus rhythm at a long-term follow-up.
    Language English
    Publishing date 2023-09-29
    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/s10840-023-01653-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5214: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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