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| 2. |
- Björkenheim, Anna, 1980-, et al.
(författare)
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Rhythm Control and its Relation to Symptoms During the First Two Years After Radiofrequency Ablation for Atrial Fibrillation
- 2016
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Ingår i: Pacing and Clinical Electrophysiology. - Hoboken, USA : Wiley-Blackwell Publishing Inc.. - 0147-8389 .- 1540-8159. ; 39:9, s. 914-925
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate rhythm control up to two years after AF ablation and its relation to reported symptoms.Background: The implantable loop recorder (ILR) continuously records the ECG, has an automatic AF detection algorithm and a possibility for patients to activate an ECG recording during symptoms.Methods: Fifty-seven patients (mean age 57±9 years, 60% male, 88% paroxysmal AF) underwent AF ablation following ILR implantation. Device data were downloaded at the ablation and three, six, 12, 18 and 24 months after ablation.Results: Fifty-four patients completed the two-year follow-up. Thirteen (24%) patients had no AF episodes detected by ILR during follow-up. Ten of 41 patients (24%) with AF recurrence were only detected by ILR and AF recurrences were detected earlier by ILR (P<0.001). The median AF burden in patients with AF recurrence was 5.7% (IQR 0.4-14.4) and was even lower in patients with AF only detected by ILR (P = 0.001). Forty-eight % of the patients indicated symptoms via the patient activator but 33% of those recordings were not due to AF. Early AF recurrence (within 3 months) was highly associated with later AF recurrence (P<0.001). AF burden >0.5% and longest >6h before the ablation were independent predictors of AF recurrence during intermittent but not continuous monitoring.Conclusions: After AF ablation, the AF burden was low throughout the 24 months follow-up. Nevertheless, symptoms were commonly indicated but one third of patient activated recordings did not show AF. Continuous monitoring was superior to intermittent follow-up in detecting AF episodes and assessing the AF burden.Clinical trial registration: URL: http://clinicaltrials.gov. Unique Identifier: NCT00697359.
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- Kesek, Milos, et al.
(författare)
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Two Cases of LQT Syndrome with Malignant Syncope after Switch from Propranolol to Bisoprolol
- 2016
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Ingår i: Pacing and Clinical Electrophysiology. - : Wiley. - 0147-8389 .- 1540-8159. ; 39:3, s. 305-306
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Tidskriftsartikel (refereegranskat)abstract
- Propranolol in slow-release form has been the first-line treatment in long QT (LQT) until it was withdrawn from the market. We describe two cases where a switch to bisoprolol resulted in worsening of arrhythmia control: A man with LQT2, asymptomatic on propranolol, experienced syncope after switching to bisoprolol 5 mg daily. He switched back to propranolol and has remained asymptomatic during subsequent 12 months. A man with classical Jervell Lange-Nielsen syndrome, previous gangliectomy, and ICD implantation, switched to bisoprolol 5 mg daily. Four months later he experienced a tachycardia storm. He switched back to propranolol and has remained free from arrhythmias during subsequent 12 months.
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- Magnusson, Peter, et al.
(författare)
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Risk Markers and Appropriate Implantable Defibrillator Therapy in Hypertrophic Cardiomyopathy
- 2016
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Ingår i: Pacing and Clinical Electrophysiology. - : Wiley. - 0147-8389 .- 1540-8159. ; 39:3, s. 291-301
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Tidskriftsartikel (refereegranskat)abstract
- Background: Risk stratification of sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) is mainly based on evaluations from patients at highly specialized centers.Aim: To evaluate risk markers for appropriate implantable cardioverter defibrillator (ICD) therapy in an unselected, nationwide cohort of HCM.Methods: Patients with an ICD due to HCM were identified from the Swedish ICD Registry since its start in 1995, merged with Patient Register data, and medical records were retrieved. Risk markers for ventricular arrhythmias leading to appropriate ICD therapy were analyzed using Cox proportional hazard ratio (HR).Results: Of 321 patients (70.1% males), at least one appropriate therapy occurred in 77 (24.0%) during a mean follow-up of 5.4 years (5.3% per year; primary prevention 4.5%, secondary prevention 7.0%). Cumulative incidences at 1 year, 3 years, and 5 years were 8.1%, 15.3%, and 21.3%, respectively. Cardioversion effectively restored rhythm in 52% of the first episode and antitachycardia pacing was sufficient in the remaining. For the whole cohort, ejection fraction (EF) <50% (HR 2.63; P < 0.001) was associated with appropriate ICD therapy. In primary prevention, patients with established risk markers experienced appropriate therapy; atrial fibrillation (AF; HR 2.54; P = 0.010), EF < 50% (HR 2.78; P = 0.004), and nonsustained ventricular tachycardia (HR 1.80; P = 0.109) had the highest HR, and wall thickness 30 mm, syncope, exercise blood pressure response, or family history of SCD had weaker associations.Conclusion: ICD therapy successfully terminates ventricular arrhythmias in HCM. In addition to conventional risk markers, a history of AF or EF < 50% may be considered in risk stratification.
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| 6. |
- Miller, Jennifer L, et al.
(författare)
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Gender Disparities in Symptoms of Anxiety, Depression, and Quality of Life in Defibrillator Recipients.
- 2016
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Ingår i: Pacing and Clinical Electrophysiology. - : Wiley-Blackwell. - 0147-8389 .- 1540-8159. ; 39:2, s. 149-159
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Most patients cope well with an implantable cardioverter defibrillator (ICD), but psychological distress and ICD-related concerns have been reported in about 20% of ICD recipients. Many previous studies have not distinguished between genders.METHODS: In this nationwide study we compared quality of life, anxiety, and depression symptoms between the genders in ICD recipients, and determined predictors of each of these variables in men and women. All adult Swedish ICD recipients were invited by mail to participate and 2,771 patients (66 ± 12 years) completed standardized measures of quality of life, symptoms of anxiety, and depression. Time since implantation ranged from 1 year to 23 years with a mean of 4.7 ± 3.9.RESULTS: Women reported worse quality of life (mean index 0.790 vs 0.825) and higher prevalence of anxiety (20.5% vs 14.7%) than did men (P < 0.001 for both comparisons), while there were no differences in symptoms of depression (8.8% vs 8.2%).CONCLUSIONS: Most ICD recipients report a good quality of life, without emotional distress, but among the minority with distress, women fare worse than men.
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| 8. |
- Reitan, Christian, et al.
(författare)
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Long-term Results of Cardiac Resynchronization Therapy; A Comparison Between CRT-Pacemakers Versus Primary Prophylactic CRT-Defibrillators.
- 2015
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Ingår i: PACE. - : Wiley. - 1540-8159. ; 38:6, s. 758-767
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Tidskriftsartikel (refereegranskat)abstract
- Cardiac resynchronization Therapy (CRT) with or without a defibrillator has a positive effect on mortality and morbidity for patients with heart failure. However, comparisons between CRT-Defibrillators (CRT-D) and CRT-Pacemakers (CRT-P) are relatively scarce outside the clinical trial setting. This study aimed to assess baseline characteristics in relation to long-term prognosis in patients treated with CRT, and to investigate the potential benefit CRT-D vs. CRT-P.
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| 10. |
- Stabile, Giuseppe, et al.
(författare)
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Atrial fibrillation history impact on catheter ablation outcome : Findings from the ESC-EHRA atrial fibrillation ablation long-term registry
- 2019
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Ingår i: Pacing and Clinical Electrophysiology. - : Wiley. - 0147-8389 .- 1540-8159. ; 42:3, s. 313-320
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Atrial fibrillation (AF) promotes atrial remodeling that in turn promote AF perpetuation. The aim of our study was to investigate the impact of AF history length on one-year outcome of AF catheter ablation in a cohort of patients enrolled in the Atrial Fibrillation Ablation Registry.METHODS: We described the real-life clinical epidemiology, therapeutic strategies and the short- and mid-term outcomes of 1948 patients (71.9% with paroxysmal AF) undergoing AF ablation procedures, stratified according to AF history duration (< 2 years or ≥ 2 years).RESULTS: The mean AF history duration was 46,2±57,4 months, 592 patients had an AF history duration < 2 years (mean 10,2±5,9 months), and 1356 patients ≥ 2 years (mean 75,5±63,5 months) (P < 0.001). Patients with AF history duration < 2 years were younger, had a lower incidence of hypertension, coronary artery disease, hypertrophic cardiomyopathy and had a lower CHA2 DS2 -VaSc Score. At one year, the logrank test showed a lower incidence of AF recurrence in patients with AF history duration < 2 years (28.9%) than in patients with AF history duration ≥ 2 years (34.0%) (P = 0.037). AF history duration ≥ 2 years, overall ablation procedure duration, hypertension and chronic kidney disease were all predictors of recurrences after the blanking period.CONCLUSIONS: In this multicenter registry, performing catheter ablation in patients with an AF history ≥ 2 years was associated with higher rates of AF recurrences at one year. Since cumulative time in AF in not necessarily equivalent to AF history, its role remains to be clarified.
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