Markus Zabel

Correspondence to: Ulrich Krause, MD, Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen, Robert-Koch-Str. 40, 37099 Göttingen, Germany. Email ukrause1@ gwdg. de For Sources of Funding and Disclosures, see page XXX.© 2024 American Heart Association, Inc.

ObjectiveTo test the hypothesis that in recipients of primary prophylactic implantable cardioverter-defibrillators (ICDs), the non-planarity of ECG vector loops predicts (a) deaths despite ICD protection and (b) appropriate ICD shocks.MethodsDigital pre-implant ECGs were collected in 1948 ICD recipients: 21.4% females, median age 65 years, 61.5% ischaemic heart disease (IHD). QRS and T wave three-dimensional loops were constructed using singular value decomposition that allowed to measure the vector loop planarity. The non-planarity, that is, the twist of the three-dimensional loops out of a single plane, was related to all-cause mortality (n=294; 15.3% females; 68.7% IHD) and appropriate ICD shocks (n=162; 10.5% females; 87.7% IHD) during 5-year follow-up after device implantation. Using multivariable Cox regression, the predictive power of QRS and T wave non-planarity was compared with that of age …

BackgroundData comparing remote magnetic catheter navigation (RMN) with manual catheter navigation in combination with contact force sensing (MCN-CF) ablation of atrial fibrillation (AF) is lacking. The primary aim of the present retrospective comparative study was to compare the outcome of RMN versus (vs.) MCN-CF ablation of AF with regards to AF recurrence. Secondary aim was to analyze periprocedural risk, ablation characteristics and repeat procedures.MethodsWe retrospectively analyzed 452 patients undergoing a total of 605 ablations of AF: 180 patients were ablated using RMN, 272 using MCN-CF.ResultsExcept body mass index there was no significant difference between groups at baseline. After a mean 1.6 ± 1.6 years of follow-up and 1.3 ± 0.4 procedures, 81% of the patients in the MCN-CF group remained free of AF recurrence compared to 53% in the RMN group (P < 0.001). After …

Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Community’s 7th Framework Programme (HEALTH-F2-2009-602299) Ministry of Health, Czech Republic Background Three-dimensional (e.g., vectorcardiography) loops of normal physiologic QRS complex and T wave are known to be planar. Non-planarity of these electrocardiogram (ECG) loops was described in cardiac patients, mainly in relation to ischemic heart disease, but predictive values of the extent of non-planarity of the loops have not been systematically researched. Methods Pre-implantation digital ECGs were collected in 1948 cardiac patients (381 females, median age 65, inter-quartile range 56 – 72 years, 62% ischemic heart disease) who obtained an implantable cardioverter-defibrillator (ICD) for primary prophylactic …

BackgroundPrevalence of atrial tachycardias (AT) and atrial fibrillation (AF) is increasing in adult patients with congenital heart disease (CHD) significantly contributing to morbidity. Catheter ablation of AT and AF in the adult CHD population is challenging and recurrence is significant. Pulsed field ablation (PFA) is a new, non-thermal energy source for catheter ablation of AF. Due to its inherent properties of creating effective ablation lesions without permanent affection of non-myocardial tissue, it is attractive for the use in the adult CHD population. To date, its use in the adult CHD population has not been reported.ObjectiveThis study describes initial experience of PFA of AT and AF in adult CHD patients.MethodsProspective enrollment of adult CHD patients with a history of recurrent AT/AF, who had prior radiofrequency (RFA)/cryoenergy (Cryo) ablation of AT/AF. A high-density map using a 3D mapping system …

We report on a 33-year-old patient with Ebstein’s anomaly (EA) of the tricuspid valve who had recurrent episodes of sustained monomorphic ventricular tachycardia (VT). After the first episodes of VT 8 years ago, he had radiofrequency ablation (RFA) of VT within the atrialized right ventricle (aRV) and implantation of an extracardiac implantable cardioverter defibrillator (ICD) system. Implantation of endocardial ICD systems from the superior vena cava was technically not feasible after creation of a bidirectional Glenn shunt at an age of 15 years. The patient now presented with recurrent episodes of monomorphic VT and adequate ICD discharges. He was started on amiodarone and catheter ablation of VT was planned. As the patient had RFA of VT in the past, off-label application of pulsed field ablation (PFA) for ablation of the VT substrate was discussed with the patient. After obtaining written informed consent …

Background and objectivesLong-term oral anticoagulation (OAC) following successful catheter ablation of atrial fibrillation (AF) remains controversial. Prospective data are missing. The ODIn-AF study aimed to evaluate the effect of OAC on the incidence of silent cerebral embolic events and clinically relevant cardioembolic events in patients at intermediate to high risk for embolic events, free from AF after pulmonary vein isolation (PVI).MethodsThis prospective, randomized, multicenter, open-label, blinded endpoint interventional trial enrolled patients who were scheduled for PVI to treat paroxysmal or persistent AF. Six months after PVI, AF-free patients were randomized to receive either continued OAC with dabigatran or no OAC. The primary endpoint was the incidence of new silent micro- and macro-embolic lesions detected on brain MRI at 12 months of follow-up compared to baseline. Safety analysis included …

PurposeFirstly, the aim of our study was to asses the incidence of clinically important non-AF events. Secondly, we wanted to identify possible risk factors leading to incidental non-AF events.MethodsIn this retrospective single center study, all patients implanted with ILR following PVI in our center between 2016 and 2022 were analysed. The indication to ILR implantation and remote monitoring after successful PVI was based on patient preference. Transmissions were carefully reviewed by two independent electrophysiologists. Bradycardic events were defined as documented symptomatic bradycardia, AV-Block II, AV-Block IIIor Sick-Sinus Syndrom. Tachycardic events were defined as documented symptomatic supraventricular tachycardia (non-AF) or ventricular tachycardia> 160/min with at least 30 seconds duration.ResultsA total of 219 patients underwent PVI and consequent ILR implantation. We evaluated a …