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  1. Article ; Online: Durable pulmonary vein isolation with optimized high-power and very high-power short-duration temperature-controlled ablation: A step-by-step guide.

    De Potter, Tom J R / De Becker, Benjamin / Duytschaever, Mattias

    Journal of cardiovascular electrophysiology

    2024  Volume 35, Issue 5, Page(s) 886–894

    Abstract: Introduction: Through systematic scientific rigor, the CLOSE guided workflow was developed and has been shown to improve pulmonary vein isolation durability. However, this technique was developed at a time when using power-controlled ablation catheters ... ...

    Abstract Introduction: Through systematic scientific rigor, the CLOSE guided workflow was developed and has been shown to improve pulmonary vein isolation durability. However, this technique was developed at a time when using power-controlled ablation catheters with conventional power ranges was the norm. There has been increased adoption of a high-power and very high-power short-duration ablation practice propelled by the availability of the temperature-controlled radiofrequency QDOT MICRO catheter.
    Methods: There are fundamental differences in biophysics between very high-powered temperature guided ablation and conventional ablation strategy that may impact patient outcomes. The catheter's design and ablation modes offer flexibility in technique while accommodating the individual operator's clinical discretion and preference to deliver a durable, transmural, and contiguous lesion set.
    Results: Here, we provide recommendations for 3 different workflows using the QDOT MICRO catheter in a step-by-step manner for pulmonary vein isolation based on our cumulative experience as early adopters of the technology and the data available in the scientific literature.
    Conclusions: With standardization, temperature-controlled ablation with the QDOT MICRO catheter provides operators the flexibility of implementing different ablation strategies to ensure durable contiguous pulmonary vein isolation depending on patient characteristics.
    MeSH term(s) Humans ; Action Potentials ; Atrial Fibrillation/surgery ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/diagnosis ; Cardiac Catheters ; Catheter Ablation/instrumentation ; Equipment Design ; Heart Rate ; Pulmonary Veins/surgery ; Pulmonary Veins/physiopathology ; Temperature ; Time Factors ; Treatment Outcome ; Workflow
    Language English
    Publishing date 2024-03-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1025989-2
    ISSN 1540-8167 ; 1045-3873
    ISSN (online) 1540-8167
    ISSN 1045-3873
    DOI 10.1111/jce.16217
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    Zs.A 2863: Show issues Location:
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  2. Article ; Online: Cost-utility of VISITAG SURPOINT in catheter ablation of atrial fibrillation.

    De Potter, Tom / Tong, Cindy / Maccioni, Sonia / Velleca, Maria / Galvain, Thibaut

    Pacing and clinical electrophysiology : PACE

    2024  Volume 47, Issue 4, Page(s) 568–576

    Abstract: Background: Clinical studies have demonstrated the safety, efficacy, and efficiency of VISITAG SURPOINT® (VS), which provides important lesion markers during catheter ablation (CA) of atrial fibrillation (AF). The present study evaluated the cost- ... ...

    Abstract Background: Clinical studies have demonstrated the safety, efficacy, and efficiency of VISITAG SURPOINT® (VS), which provides important lesion markers during catheter ablation (CA) of atrial fibrillation (AF). The present study evaluated the cost-effectiveness of CA with VS compared to CA without VS in AF from the publicly-funded German and Belgium healthcare perspectives.
    Methods: We constructed a two-stage cost utility model that included a decision tree to simulate clinical events, costs, and utilities during the first year after the index procedure and a Markov model to simulate transitions between health states throughout a patient's lifetime. Model inputs included published literature, a meta-analysis of randomized controlled trials AF outcomes, and publicly available administrative data on costs. Deterministic and probabilistic sensitivity analyses were conducted to determine the robustness of the model.
    Results: CA with VS was associated with lower per patient costs vs CA without VS (Germany: €3295 vs. €3936, Belgium: €3194 vs. €3814) and similar quality-adjusted life-years (QALYs) per patient (Germany: 5.35 vs. 5.34, Belgium: 5.68 vs. 5.67). CA with VS was the dominant ablation strategy (incremental cost-effectiveness ratios: Germany: €-52,455/QALY, Belgium: €-50,676/QALY). The model results were robust and not highly sensitive to variation to individual parameters with regard to QALYs or costs. Freedom from AF and procedure time had the greatest impact on model results, highlighting the importance of these outcomes in ablation.
    Conclusions: CA with VS resulted in cost savings and QALY gains compared to CA without VS, supporting the increased adoption of VS in CA in Germany and Belgium.
    MeSH term(s) Humans ; Atrial Fibrillation/surgery ; Cost-Benefit Analysis ; Catheter Ablation/methods ; Quality-Adjusted Life Years ; Belgium
    Language English
    Publishing date 2024-02-26
    Publishing country United States
    Document type Meta-Analysis ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 424437-0
    ISSN 1540-8159 ; 0147-8389
    ISSN (online) 1540-8159
    ISSN 0147-8389
    DOI 10.1111/pace.14931
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  3. Article ; Online: Evaluating Autonomic Outcomes After Pulmonary Vein Isolation: The Differential Effects of Pulsed-Field and Radiofrequency Energy.

    Valeriano, Chiara / Buytaert, Dimitri / Addeo, Lucio / De Schouwer, Koen / Geelen, Peter / De Potter, Tom

    Heart rhythm

    2024  

    Language English
    Publishing date 2024-04-23
    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.2024.04.075
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    Zs.A 6278: Show issues Location:
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  4. Article ; Online: Pre-cath Laboratory Planning for Left Atrial Appendage Occlusion - Optional or Essential?

    Devgun, Jasneet / De Potter, Tom / Fabbricatore, Davide / Wang, Dee Dee

    Cardiac electrophysiology clinics

    2023  Volume 15, Issue 2, Page(s) 141–150

    Abstract: In the wake of rapid advancement in cardiovascular procedural technologies, physician-led preprocedural planning utilizing multi-modality imaging training is increasingly recognized as invaluable for procedural accuracy. Left atrial appendage occlusion ( ... ...

    Abstract In the wake of rapid advancement in cardiovascular procedural technologies, physician-led preprocedural planning utilizing multi-modality imaging training is increasingly recognized as invaluable for procedural accuracy. Left atrial appendage occlusion (LAAO) is one such procedure in which complications such as device leak, cardiac injury, and device embolization can be decreased substantially with incorporation of physician driven imaging and digital tools. We discuss the benefits of cardiac CT and 3D printing in preprocedural planning for the Heart Team, as well as novel applications by physicians of intraprocedural 3D angiography and dynamic fusion imaging. Furthermore, incorporation of computational modeling and artificial intelligence (AI) may yield promise. For optimal patient-centric procedural success, we advocate for standardized preprocedural imaging planning by physicians within the Heart Team as an essential part of LAAO.
    MeSH term(s) Humans ; Atrial Appendage/diagnostic imaging ; Atrial Appendage/surgery ; Treatment Outcome ; Artificial Intelligence ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/surgery ; Echocardiography, Transesophageal/methods ; Cardiac Catheterization/methods
    Language English
    Publishing date 2023-04-19
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1877-9190
    ISSN (online) 1877-9190
    DOI 10.1016/j.ccep.2023.01.009
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  5. Article ; Online: Safety and efficacy of catheter ablation on patients with persistent atrial fibrillation by targeting repetitive activation patterns and focal impulses.

    de Potter, Tom / Sarkozy, Andrea / Duytschaever, Mattias / Bulava, Alan

    Pacing and clinical electrophysiology : PACE

    2023  Volume 46, Issue 7, Page(s) 729–737

    Abstract: Background: The study is intended to evaluate the acute and long-term effectiveness and peri-procedural safety in ablation of persistent atrial fibrillation (PsAF) using the CartoFinder algorithm guided ablation (CFGA) targeting on repetitive activation ...

    Abstract Background: The study is intended to evaluate the acute and long-term effectiveness and peri-procedural safety in ablation of persistent atrial fibrillation (PsAF) using the CartoFinder algorithm guided ablation (CFGA) targeting on repetitive activation patterns (RAPs) and focal impulses (FIs) identified in dynamic maps.
    Methods: This is a prospective, single-arm, multicenter study. A 64-pole multielectrode basket catheter was used for intracardiac global electrogram (EGM) mapping. The RAPs or FIs were repeatedly mapped and ablated for up to five iterations by the CartoFinder algorithm to achieve sinus rhythm (SR) or organized atrial tachycardia (AT), which were followed by PVI. All patients were followed up for 12 months after procedure.
    Results: Sixty-four PsAF patients (age, 60.7 ± 9.1 years; male, 76.6%; median PsAF duration, 6.0 months) underwent CFGA on RAPs/FIs. Six patients (9.4%) reported primary adverse event (PAE) including groin hematoma (2), complete heart block (1), tamponade (1), pericarditis (1), and pseudoaneurysm (1). Repeated mapping and ablation on RAPs/FIs resulted in the cycle length (CL) increase from 191.0 ± 167.6 ms at baseline to 365.7 ± 296.7 ms in the LA and from 167.8 ± 41.6 ms to 379.4 ± 293.5 ms in the RA and 30.2% (19/63) AF termination to SR or organized AT. The 12-month arrhythmia-free and symptomatic AF-free rates were 60.9% and 75.0%, respectively. Patients with acute AF termination showed a higher 12-month arrhythmia-free rate (76.9%) than those without (50.0%, p = .04).
    Conclusions: The study demonstrated that the CartoFinder algorithm can be used for global activation mapping during PsAF ablation. Patients with acute AF termination had a lower 12-month AF recurrence rate compared to patients without.
    MeSH term(s) Humans ; Male ; Middle Aged ; Aged ; Atrial Fibrillation ; Prospective Studies ; Treatment Outcome ; Recurrence ; Tachycardia, Supraventricular ; Catheter Ablation/methods ; Pulmonary Veins/surgery
    Language English
    Publishing date 2023-05-20
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ZDB-ID 424437-0
    ISSN 1540-8159 ; 0147-8389
    ISSN (online) 1540-8159
    ISSN 0147-8389
    DOI 10.1111/pace.14708
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    Zs.A 1466: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 399: Show issues

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  6. Article ; Online: Teaching by illustrating - A classical case of AVNRT.

    De Potter, Tom J R

    European heart journal. Case reports

    2020  Volume 4, Issue 5, Page(s) 1

    Language English
    Publishing date 2020-10-17
    Publishing country England
    Document type Editorial ; Comment
    ISSN 2514-2119
    ISSN (online) 2514-2119
    DOI 10.1093/ehjcr/ytaa197
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  7. Article ; Online: Pre-cath Laboratory Planning for Left Atrial Appendage Occlusion - Optional or Essential?

    Devgun, Jasneet / De Potter, Tom / Fabbricatore, Davide / Wang, Dee Dee

    Interventional cardiology clinics

    2022  Volume 11, Issue 2, Page(s) 143–152

    Abstract: In the wake of rapid advancement in cardiovascular procedural technologies, physician-led preprocedural planning utilizing multi-modality imaging training is increasingly recognized as invaluable for procedural accuracy. Left atrial appendage occlusion ( ... ...

    Abstract In the wake of rapid advancement in cardiovascular procedural technologies, physician-led preprocedural planning utilizing multi-modality imaging training is increasingly recognized as invaluable for procedural accuracy. Left atrial appendage occlusion (LAAO) is one such procedure in which complications such as device leak, cardiac injury, and device embolization can be decreased substantially with incorporation of physician driven imaging and digital tools. We discuss the benefits of cardiac CT and 3D printing in preprocedural planning for the Heart Team, as well as novel applications by physicians of intraprocedural 3D angiography and dynamic fusion imaging. Furthermore, incorporation of computational modeling and artificial intelligence (AI) may yield promise. For optimal patient-centric procedural success, we advocate for standardized preprocedural imaging planning by physicians within the Heart Team as an essential part of LAAO.
    MeSH term(s) Artificial Intelligence ; Atrial Appendage/diagnostic imaging ; Atrial Appendage/surgery ; Atrial Fibrillation/surgery ; Echocardiography, Transesophageal/methods ; Humans ; Treatment Outcome
    Language English
    Publishing date 2022-03-10
    Publishing country Netherlands
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ISSN 2211-7466
    ISSN (online) 2211-7466
    DOI 10.1016/j.iccl.2021.11.003
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  8. Article: Noninvasive neurological monitoring to enhance pLVAD-assisted ventricular tachycardia ablation - a Mini review.

    De Potter, Tom / Valeriano, Chiara / Buytaert, Dimitri / Bouchez, Stefaan / Ector, Joris

    Frontiers in cardiovascular medicine

    2023  Volume 10, Page(s) 1140153

    Abstract: For critically ill patients, hemodynamic fluctuations can be life-threatening; this is particularly true for patients experiencing cardiac comorbidities. Patients may suffer from problems with heart contractility and rate, vascular tone, and ... ...

    Abstract For critically ill patients, hemodynamic fluctuations can be life-threatening; this is particularly true for patients experiencing cardiac comorbidities. Patients may suffer from problems with heart contractility and rate, vascular tone, and intravascular volume, resulting in hemodynamic instability. Unsurprisingly, hemodynamic support provides a crucial and specific benefit during percutaneous ablation of ventricular tachycardia (VT). Mapping, understanding, and treating the arrhythmia during sustained VT without hemodynamic support is often infeasible due to patient hemodynamic collapse. Substrate mapping in sinus rhythm can be successful for VT ablation, but there are limitations to this approach. Patients with nonischemic cardiomyopathy may present for ablation without exhibiting useful endocardial and/or epicardial substrate-based ablation targets, either due to diffuse extent or a lack of identifiable substrate. This leaves activation mapping during ongoing VT as the only viable diagnostic strategy. By enhancing cardiac output, percutaneous left ventricular assist devices (pLVAD) may facilitate conditions for mapping that would otherwise be incompatible with survival. However, the optimal mean arterial pressure to maintain end-organ perfusion in presence of nonpulsatile flow remains unknown. Near infrared oxygenation monitoring during pLVAD support provides assessment of critical end-organ perfusion during VT, enabling successful mapping and ablation with the continual assurance of adequate brain oxygenation. This focused review provides practical use case scenarios for such an approach, which aims to allow mapping and ablation of ongoing VT while drastically reducing the risk of ischemic brain injury.
    Language English
    Publishing date 2023-03-08
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2023.1140153
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  9. Article ; Online: Ultra-low temperature cryoablation: The coolest innovation EP has been waiting for?

    De Potter, Tom J R / Boersma, Lucas V A

    Journal of cardiovascular electrophysiology

    2021  Volume 32, Issue 3, Page(s) 578–579

    MeSH term(s) Catheter Ablation ; Cryosurgery/adverse effects ; Humans ; Pulmonary Veins/surgery ; Temperature
    Language English
    Publishing date 2021-02-01
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1025989-2
    ISSN 1540-8167 ; 1045-3873
    ISSN (online) 1540-8167
    ISSN 1045-3873
    DOI 10.1111/jce.14900
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  10. Article ; Online: Are CHADS

    Smet, Lily M / De Potter, Tom / Heggermont, Ward A

    Intensive & critical care nursing

    2020  Volume 61, Page(s) 102945

    MeSH term(s) Atrial Fibrillation/diagnosis ; Coronary Artery Bypass ; Humans ; Incidence ; Risk Assessment ; Risk Factors
    Language English
    Publishing date 2020-10-29
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 1105892-4
    ISSN 1532-4036 ; 0964-3397
    ISSN (online) 1532-4036
    ISSN 0964-3397
    DOI 10.1016/j.iccn.2020.102945
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