| 1. |
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| 2. |
- Blain, H., et al.
(author)
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A comprehensive fracture prevention strategy in older adults : the European union geriatric medicine society (EUGMS) statement
- 2016
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In: European Geriatric Medicine. - : Elsevier. - 1878-7649 .- 1878-7657. ; 7:6, s. 519-525
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Journal article (peer-reviewed)abstract
- Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS), in collaboration with the International association of gerontology and geriatrics for the European region (IAGG-ER), the European union of medical specialists (EUMS), the Fragility fracture network (FFN), the International osteoporosis foundation (IOF) - European society for clinical and economic aspects of osteoporosis and osteoarthritis (ECCEO), outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.
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| 3. |
- Luo, Y. -W, et al.
(author)
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Database of diazotrophs in global ocean : abundance, biomass and nitrogen fixation rates
- 2012
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In: Earth System Science Data. - : Copernicus GmbH. - 1866-3508 .- 1866-3516. ; 4:1, s. 47-73
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Journal article (peer-reviewed)abstract
- Marine N-2 fixing microorganisms, termed di-azotrophs, are a key functional group in marine pelagic ecosystems. The biological fixation of dinitrogen ( N-2) to bioavailable nitrogen provides an important new source of nitrogen for pelagic marine ecosystems and influences primary productivity and organic matter export to the deep ocean. As one of a series of efforts to collect biomass and rates specific to different phytoplankton functional groups, we have constructed a database on diazotrophic organisms in the global pelagic upper ocean by compiling about 12 000 direct field measurements of cyanobacterial diazotroph abundances (based on microscopic cell counts or qPCR assays targeting the nifH genes) and N-2 fixation rates. Biomass conversion factors are estimated based on cell sizes to convert abundance data to diazotrophic biomass. The database is limited spatially, lacking large regions of the ocean especially in the Indian Ocean. The data are approximately log-normal distributed, and large variances exist in most sub-databases with non-zero values differing 5 to 8 orders of magnitude. Reporting the geometric mean and the range of one geometric standard error below and above the geometric mean, the pelagic N-2 fixation rate in the global ocean is estimated to be 62 (52-73) Tg Nyr(-1) and the pelagic diazotrophic biomass in the global ocean is estimated to be 2.1 (1.4-3.1) Tg C from cell counts and to 89 (43-150) Tg C from nifH- based abundances. Reporting the arithmetic mean and one standard error instead, these three global estimates are 140 +/- 9.2 Tg Nyr(-1), 18 +/- 1.8 Tg C and 590 +/- 70 Tg C, respectively. Uncertainties related to biomass conversion factors can change the estimate of geometric mean pelagic diazotrophic biomass in the global ocean by about +/- 70 %. It was recently established that the most commonly applied method used to measure N-2 fixation has underestimated the true rates. As a result, one can expect that future rate measurements will shift the mean N-2 fixation rate upward and may result in significantly higher estimates for the global N-2 fixation. The evolving database can nevertheless be used to study spatial and temporal distributions and variations of marine N-2 fixation, to validate geochemical estimates and to parameterize and validate biogeochemical models, keeping in mind that future rate measurements may rise in the future.
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| 4. |
- Rakov, V. A., et al.
(author)
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New insights into lightning processes gained from triggered-lightning experiments in Florida and Alabama
- 1998
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In: Journal of Geophysical Research - Atmospheres. - 2169-897X .- 2169-8996. ; 103:D12, s. 14117-14130
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Journal article (peer-reviewed)abstract
- Analyses of electric and magnetic fields measured at distances from tens to hundreds of meters from the ground strike point of triggered lightning at Camp Blanding, Florida, and at 10 and 20 m at Fort McClellan, Alabama, in conjunction with currents measured at the lightning channel base and with optical observations, allow us to make new inferences on several aspects of the lightning discharge and additionally to verify the recently published “two-wave†mechanism of the lightning M component. At very close ranges (a few tens of meters or less) the time rate of change of the final portion of the dart leader electric field can be comparable to that of the return stroke. The variation of the close dart leader electric field change with distance is somewhat slower than the inverse proportionality predicted by the uniformly charged leader model, perhaps because of a decrease of leader charge density with decreasing height associated with an incomplete development of the corona sheath at the bottom of the channel. There is a positive linear correlation between the leader electric field change at close range and the succeeding return stroke current peak at the channel base. The formation of each step of a dart-stepped leader is associated with a charge of a few millicoulombs and a current of a few kiloamperes. In an altitude-triggered lightning the downward negative leader of the bidirectional leader system and the resulting return stroke serve to provide a relatively low-impedance connection between the upward moving positive leader tip and the ground, the processes that follow likely being similar to those in classical triggered lightning. Lightning appears to be able to reduce, via breakdown processes in the soil and on the ground surface, the grounding impedance which it initially encounters at the strike point, so at the time of channel-base current peak the reduced grounding impedance is always much lower than the equivalent impedance of the channel. At close ranges the measured M-component magnetic fields have waveshapes that are similar to those of the channel-base currents, whereas the measured M-component electric fields have waveforms that appear to be the time derivatives of the channel-base current waveforms, in further confirmation of the “two-wave†M-component mechanism.
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| 5. |
- Abbassi, Fariba, et al.
(author)
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Novel Benchmark Values for Redo Liver Transplantation Does the Outcome Justify the Effort?
- 2022
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In: Annals of Surgery. - : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 276:5, s. 860-867
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Journal article (peer-reviewed)abstract
- Objective: To define benchmark cutoffs for redo liver transplantation (redo-LT). Background: In the era of organ shortage, redo-LT is frequently discussed in terms of expected poor outcome and wasteful resources. However, there is a lack of benchmark data to reliably evaluate outcomes after redo-LT. Methods: We collected data on redo-LT between January 2010 and December 2018 from 22 high-volume transplant centers. Benchmark cases were defined as recipients with model of end stage liver disease (MELD) score <= 25, absence of portal vein thrombosis, no mechanical ventilation at the time of surgery, receiving a graft from a donor after brain death. Also, high-urgent priority and early redo-LT including those for primary nonfunction (PNF) or hepatic artery thrombosis were excluded. Benchmark cutoffs were derived from the 75th percentile of the medians of all benchmark centers. Results: Of 1110 redo-LT, 373 (34%) cases qualified as benchmark cases. Among these cases, the rate of postoperative complications until discharge was 76%, and increased up to 87% at 1-year, respectively. One-year overall survival rate was excellent with 90%. Benchmark cutoffs included Comprehensive Complication Index CCI (R) at 1-year of <= 72, and in-hospital and 1-year mortality rates of <= 13% and <= 15%, respectively. In contrast, patients who received a redo-LT for PNF showed worse outcomes with some values dramatically outside the redoLT benchmarks. Conclusion: This study shows that redo-LT achieves good outcome when looking at benchmark scenarios. However, this figure changes in high-risk redo-LT, as for example in PNF. This analysis objectifies for the first-time results and efforts for redo-LT and can serve as a basis for discussion about the use of scarce resources.
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| 6. |
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| 7. |
- Evrard, E., et al.
(author)
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Responses of juvenile European flounder (Platichthys flesus) to multistress in the Vilaine estuary, during a 6-month survey
- 2013
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In: Environmental science and pollution research international. - : Springer Science and Business Media LLC. - 0944-1344 .- 1614-7499. ; 20:2, s. 676-689
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Journal article (peer-reviewed)abstract
- Physiological and genetic responses of age 0+ Platichthys flesus were investigated in the eutrophicated and moderately contaminated Vilaine estuary, during a 6-month survey. The main objective of this study was to explore the biological responses of fishes during their juvenile period in an estuarine system in order to detect a possible selective pressure induced by the environmental stress. Our results showed a general convergence in physiological responses along the survey: an increase in genotoxicity was associated with an increase in mRNA expression of ATPase and betaine homocysteine methyltransferase. These results could suggest an increase of cellular damage, energetic request, and detoxification rate related to the growing exposure time to stress. Considering the aging of the cohort, the genetic characteristics of the Vilaine flounder cohort came closer to the one observed in a highly stressed system, the Seine estuary, suggesting a potential selective pressure mainly induced by the chemical stress. © 2012 Springer-Verlag.
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| 8. |
- Kapelios, Chris J, et al.
(author)
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Association between loop diuretic dose changes and outcomes in chronic heart failure : observations from the ESC-EORP Heart Failure Long-Term Registry.
- 2020
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In: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 22:8, s. 1424-1437
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Journal article (peer-reviewed)abstract
- AIMS: Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and outcomes.METHODS AND RESULTS: We included 8130 HF patients from the ESC-EORP Heart Failure Long-Term Registry. Among patients who had dose decreased, successful decrease was defined as the decrease not followed by death, HF hospitalization, New York Heart Association class deterioration, or subsequent increase in LD dose. Mean age was 66 ± 13 years, 71% men, 62% HF with reduced ejection fraction, 19% HF with mid-range ejection fraction, 19% HF with preserved ejection fraction. Median [interquartile range (IQR)] LD dose was 40 (25-80) mg. LD dose was increased in 16%, decreased in 8.3% and unchanged in 76%. Median (IQR) follow-up was 372 (363-419) days. Diuretic dose increase (vs. no change) was associated with HF death [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.12-2.08; P = 0.008] and nominally with cardiovascular death (HR 1.25, 95% CI 0.96-1.63; P = 0.103). Decrease of diuretic dose (vs. no change) was associated with nominally lower HF (HR 0.59, 95% CI 0.33-1.07; P = 0.083) and cardiovascular mortality (HR 0.62, 95% CI 0.38-1.00; P = 0.052). Among patients who had LD dose decreased, systolic blood pressure [odds ratio (OR) 1.11 per 10 mmHg increase, 95% CI 1.01-1.22; P = 0.032], and absence of (i) sleep apnoea (OR 0.24, 95% CI 0.09-0.69; P = 0.008), (ii) peripheral congestion (OR 0.48, 95% CI 0.29-0.80; P = 0.005), and (iii) moderate/severe mitral regurgitation (OR 0.57, 95% CI 0.37-0.87; P = 0.008) were independently associated with successful decrease.CONCLUSION: Diuretic dose was unchanged in 76% and decreased in 8.3% of outpatients with chronic HF. LD dose increase was associated with worse outcomes, while the LD dose decrease group showed a trend for better outcomes compared with the no-change group. Higher systolic blood pressure, and absence of (i) sleep apnoea, (ii) peripheral congestion, and (iii) moderate/severe mitral regurgitation were independently associated with successful dose decrease.
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| 9. |
- Knobler, R., et al.
(author)
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Guidelines on the use of extracorporeal photopheresis
- 2014
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In: Journal of the European Academy of Dermatology and Venereology. - : Wiley-Blackwell. - 0926-9959 .- 1468-3083. ; 28:s1, s. 1-37
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Journal article (peer-reviewed)abstract
- BackgroundAfter the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma was published in 1983 with its subsequent recognition by the FDA for its refractory forms, the technology has shown significant promise in the treatment of other severe and refractory conditions in a multi-disciplinary setting. Among the major studied conditions are graft versus host disease after allogeneic bone marrow transplantation, systemic sclerosis, solid organ transplant rejection and inflammatory bowel disease. Materials and methodsIn order to provide recognized expert practical guidelines for the use of this technology for all indications the European Dermatology Forum (EDF) proceeded to address these questions in the hands of the recognized experts within and outside the field of dermatology. This was done using the recognized and approved guidelines of EDF for this task. Results and conclusionThese guidelines provide at present the most comprehensive available expert recommendations for the use of extracorporeal photopheresis based on the available published literature and expert consensus opinion.
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| 10. |
- Sliwa, Karen, et al.
(author)
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Clinical presentation, management, and 6-month outcomes in women with peripartum cardiomyopathy: an ESC EORP registry.
- 2020
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In: European heart journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 41:39, s. 3787-3797
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Journal article (peer-reviewed)abstract
- We sought to describe the clinical presentation, management, and 6-month outcomes in women with peripartum cardiomyopathy (PPCM) globally.In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global registry on PPCM, under the auspices of the ESC EURObservational Research Programme. These societies were tasked with identifying centres who could participate in this registry. In low-income countries, e.g. Mozambique or Burkina Faso, where there are no national societies due to a shortage of cardiologists, we identified potential participants through abstracts and publications and encouraged participation into the study. Seven hundred and thirty-nine women were enrolled in 49 countries in Europe (33%), Africa (29%), Asia-Pacific (15%), and the Middle East (22%). Mean age was 31±6years, mean left ventricular ejection fraction (LVEF) was 31±10%, and 10% had a previous pregnancy complicated by PPCM. Symptom-onset occurred most often within 1month of delivery (44%). At diagnosis, 67% of patients had severe (NYHA III/IV) symptoms and 67% had a LVEF ≤35%. Fifteen percent received bromocriptine with significant regional variation (Europe 15%, Africa 26%, Asia-Pacific 8%, the Middle East 4%, P<0.001). Follow-up was available for 598 (81%) women. Six-month mortality was 6% overall, lowest in Europe (4%), and highest in the Middle East (10%). Most deaths were due to heart failure (42%) or sudden (30%). Re-admission for any reason occurred in 10% (with just over half of these for heart failure) and thromboembolic events in 7%. Myocardial recovery (LVEF > 50%) occurred only in 46%, most commonly in Asia-Pacific (62%), and least commonly in the Middle East (25%). Neonatal death occurred in 5% with marked regional variation (Europe 2%, the Middle East 9%).Peripartum cardiomyopathy is a global disease, but clinical presentation and outcomes vary by region. Just under half of women experience myocardial recovery. Peripartum cardiomyopathy is a disease with substantial maternal and neonatal morbidity and mortality.
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| 11. |
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| 12. |
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| 13. |
- Bonapace, Stefano, et al.
(author)
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Brachial pulse pressure in acute heart failure. Results of the Heart Failure Registry
- 2019
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In: ESC Heart Failure. - : WILEY PERIODICALS, INC. - 2055-5822. ; 6:6, s. 1167-1177
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Journal article (peer-reviewed)abstract
- Aims To investigate the still uncertain independent prognostic impact of pulse pressure (PP) in acute heart failure (HF), in particular across the left ventricular ejection fraction (EF) phenotypes, and the potential contribution of PP in outlining the individual phenotypes. Methods and results We prospectively evaluated 1-year death and rehospitalization in 4314 patients admitted for acute HF grouped by EF and stratified by their PP level on admission. In HF with reduced (amp;lt; 40%) EF (HFrEF), the highest quartiles of PP had the lowest unadjusted [hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.61-0.98] and adjusted (HR 0.64 0.50-0.82) risk of 1 year all cause death compared to the lowest quartile. Its prognostic impact was partially mediated by systolic blood pressure (SBP). In HF with preserved (amp;gt;= 50%) EF (HFpEF), the intermediate quartile of PP showed the lowest 1 year all cause mortality in unadjusted (HR 0.598, CI 0.416-0.858) and adjusted (HR 0.55, 95% CI 0.388-0.801) models with no relationship with SBP. In a receiver operating characteristic analysis, a combination of PP amp;gt; 60 mmHg and SBP amp;gt; 140 mmHg was associated to a preserved EF with a high performance value. No prognostic significance of PP was found in the HF with mid-range EF subgroup. Conclusions In acute HFrEF, there is an almost linear inverse relation between mortality and PP, partly mediated by SBP. In HFpEF, a J-shaped relationship between mortality and PP was present with a better prognosis at the nadir. A combination of PP amp;gt; 60 mmHg with SBP amp;gt; 140 mmHg may be clinically helpful as marker of a preserved left ventricular EF.
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| 14. |
- Breitbarth, Eike, et al.
(author)
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Physiological constraints on the global distribution of Trichodesmium – effect of temperature on diazotrophy
- 2007
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In: Biogeosciences. ; 4, s. 53-61
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Journal article (peer-reviewed)abstract
- The cyanobacterium Trichodesmium is an important link in the global nitrogen cycle due to its significant input of atmospheric nitrogen to the ocean. Attempts to incorporate Trichodesmium in ocean biogeochemical circulation models have, so far, relied on the observed correlation between temperature and Trichodesmium abundance. This correlation may result in part from a direct effect of temperature on Trichodesmium growth rates through the control of cellular biochemical processes, or indirectly through temperature influence on mixed layer depth, light and nutrient regimes. Here we present results indicating that the observed correlation of Trichodesmium with temperature in the field reflects primarily the direct physiological effects of temperature on diazotrophic growth of Trichodesmium. Trichodesmium IMS-101 (an isolate of Trichodesmium) could acclimate and grow at temperatures ranging from 20 to 34°C. Maximum growth rates (μmax=0.25 day–1) and maximum nitrogen fixation rates (0.13 mmol N mol POC−1 h–1) were measured within 24 to 30°C. Combining this empirical relationship with global warming scenarios derived from state-of-the-art climate models sets a physiological constraint on the future distribution of Trichodesmium that could significantly affect the future nitrogen input into oligotrophic waters by this diazotroph.
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| 15. |
- Breitbarth, Eike, et al.
(author)
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Physiological constraints on the global distribution of Trichodesmium – effect of temperature on diazotrophy
- 2007
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In: Biogeosciences. - : Copernicus GmbH. - 1726-4170 .- 1726-4189. ; 4:1, s. 53-61
-
Journal article (peer-reviewed)abstract
- The cyanobacterium Trichodesmium is an important link in the global nitrogen cycle due to its significant input of atmospheric nitrogen to the ocean. Attempts to incorporate Trichodesmium in ocean biogeochemical circulation models have, so far, relied on the observed correlation between temperature and Trichodesmium abundance. This correlation may result in part from a direct effect of temperature on Trichodesmium growth rates through the control of cellular biochemical processes, or indirectly through temperature influence on mixed layer depth, light and nutrient regimes. Here we present results indicating that the observed correlation of Trichodesmium with temperature in the field reflects primarily the direct physiological effects of temperature on diazotrophic growth of Trichodesmium. Trichodesmium IMS-101 (an isolate of T. erythraeum) could acclimate and grow at temperatures ranging from 20 to 34C.Maximum growth rates (μmax=0.25 day-1) and maximum nitrogen fixation rates (0.13 mmol N mol POC-1 h-1) were measured within 24 to 30C. Combining this empirical relationship with global warming scenarios derived from state-of-the-art climate models sets a physiological constraint on the future distribution of Trichodesmium that could significantly affect the future nitrogen input into oligotrophic waters by this diazotroph.
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| 16. |
- Charrier, Grégory, 1978, et al.
(author)
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Development of new microsatellite markers derived from expressed sequence tags for the great scallop (Pecten maximus)
- 2012
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In: Conservation Genetics Resources. - : Springer Science and Business Media LLC. - 1877-7252 .- 1877-7260. ; 4:4, s. 931-934
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Journal article (peer-reviewed)abstract
- Nine microsatellites were developed from expressed sequence tags sequences for the great scallop (Pecten maximus), and were tested in three natural populations. These markers displayed low to moderate levels of variability. On average across all populations, the number of alleles per locus ranged from 1.333 to 8.667, and the observed and expected heterozygosities ranged from 0.029 to 0.703 and 0.028 to 0.711, respectively. All loci conformed to Hardy-Weinberg equilibrium, except PmGC20 in one single population. These new loci might be very useful for the genetic monitoring of the possible impact of aquaculture on the genetic diversity of native scallop populations.
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| 17. |
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| 18. |
- Crespo-Leiro, Maria G., et al.
(author)
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European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1-year follow-up outcomes and differences across regions
- 2016
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In: European Journal of Heart Failure. - : WILEY-BLACKWELL. - 1388-9842 .- 1879-0844. ; 18:6, s. 613-625
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Journal article (peer-reviewed)abstract
- AimsThe European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT-R) was set up with the aim of describing the clinical epidemiology and the 1-year outcomes of patients with heart failure (HF) with the added intention of comparing differences between participating countries. Methods and resultsThe ESC-HF-LT-R is a prospective, observational registry contributed to by 211 cardiology centres in 21 European and/or Mediterranean countries, all being member countries of the ESC. Between May 2011 and April 2013 it collected data on 12440 patients, 40.5% of them hospitalized with acute HF (AHF) and 59.5% outpatients with chronic HF (CHF). The all-cause 1-year mortality rate was 23.6% for AHF and 6.4% for CHF. The combined endpoint of mortality or HF hospitalization within 1year had a rate of 36% for AHF and 14.5% for CHF. All-cause mortality rates in the different regions ranged from 21.6% to 36.5% in patients with AHF, and from 6.9% to 15.6% in those with CHF. These differences in mortality between regions are thought reflect differences in the characteristics and/or management of these patients. ConclusionThe ESC-HF-LT-R shows that 1-year all-cause mortality of patients with AHF is still high while the mortality of CHF is lower. This registry provides the opportunity to evaluate the management and outcomes of patients with HF and identify areas for improvement.
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| 19. |
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| 20. |
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| 21. |
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| 22. |
- Morvezen, R., et al.
(author)
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Multiplex PCR sets of novel microsatellite loci for the great scallop Pecten maximus and their application in parentage assignment
- 2013
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In: Aquatic Living Resources. - : EDP Sciences. - 0990-7440 .- 1765-2952. ; 26:3, s. 207-213
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Journal article (peer-reviewed)abstract
- We report the isolation, development and multiplex optimisation of 12 new microsatellite loci for the great scallop, Pecten maximus. Diversity was moderate to high, with number of alleles ranging from 4 to 20 and observed heterozygosity between 0.28 and 0.88. Progeny produced in a commercial hatchery was used to test locus power for parentage assignment. The percentage of offspring that was unambiguously assigned to a unique pair of parents was 97% (software package CERVUS-COLONY). Parentage assignment revealed that 22% of the studied progeny resulted from unplanned crosses. Effective population size of the study progeny was also estimated. Our study illustrates the power of microsatellites for the genetic monitoring of hatchery-produced great scallops.
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| 23. |
- Semenov, V. E., et al.
(author)
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Preliminary results on the Multipactor effect prediction in RF components with ferrites
- 2013
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In: 14th IEEE International Vacuum Electronics Conference, IVEC 2013 - Proceedings. - 9781467359757 ; , s. Art. no. 6571019-
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Conference paper (peer-reviewed)abstract
- This paper deals with the analysis of the Multipactor effect in RF components with ferrites performed through the preliminary measurements of ferrites secondary emission coefficient and the simulations of the effect of a continuous magnetic field on the electron bunch spread. The impact of this effect on the Multipactor threshold was quantified. © 2013 IEEE.
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| 24. |
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| 25. |
- Tilz, Roland Richard, et al.
(author)
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Which patients with atrial fibrillation undergo an ablation procedure today in Europe? : A report from the ESC-EHRA-EORP Atrial Fibrillation Ablation Long-Term and Atrial Fibrillation General Pilot Registries
- 2020
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In: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 22:2, s. 250-258
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Journal article (peer-reviewed)abstract
- AimsRhythm control management in patients with atrial fibrillation (AF) may be unequal across Europe. The aim of this study was to investigate how selective the patient cohort referred for AF ablation is, as compared to the general AF population in Europe, and to describe the governing mechanisms for such selection.Methods and resultsDescriptive comparative statistical analyses of the baseline characteristics were performed between the cohorts of Atrial Fibrillation Ablation Long-Term (ESC EORP AFA-LT) registry, designed to provide a picture of contemporary real-world AF ablation, and the AF population from the AF-General (ESC EORP AF-Gen) pilot registry. Data collection was performed using a web-based system. In the AFA and in the Atrial Fibrillation General (AFG) pilot registries, 3593 and 3049 patients were enrolled, respectively. Patients who underwent AF ablation were younger, more commonly male, and had significantly less comorbidities. Atrial Fibrillation Ablation patients often presented without comorbidities, resulting in a lower risk of stroke (CHA2DS2-VASc ≥5: 2.9% vs. 24.5%, all P < 0.001) and bleeding (HAS-BLED ≥2: 8.5% vs. 40.5%, P < 0.001) but with European Heart Rhythm Association (EHRA) scores >1 and more prevalent AF-related symptoms such as palpitations, fatigue, and weakness (all P < 0.001) as compared to the general AF patients. Atrial Fibrillation Ablation patients were significantly more often male, had higher left ventricular ejection fraction (59.5% vs. 52.4%) and smaller left atrial size on echocardiogram (P < 0.001 each).ConclusionThe comparison of the patient cohorts in the AFA and AFG registries showed that AF ablation in European clinical practice is mostly performed in relatively young, symptomatic and relatively healthy patients.
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| 26. |
- van Rosmalen, Frank, et al.
(author)
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Adenosine usage during AF ablation in Europe and selected long-term findings from the ESC-EHRA EORP Atrial Fibrillation Ablation Long-Term registry.
- 2021
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In: Journal of Interventional Cardiac Electrophysiology. - : Springer Science and Business Media LLC. - 1383-875X .- 1572-8595. ; 60, s. 395-406
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Journal article (peer-reviewed)abstract
- BACKGROUND: Adenosine can be used to reveal dormant pulmonary vein (PV) conduction after PV isolation (PVI). This study presents a subanalysis of real-world 1-year follow-up data from the ESC-EHRA EORP Atrial Fibrillation (AF) Ablation Long-Term registry to analyze the usage of adenosine during PVI treatment in terms of rhythm outcome and safety.METHODS: The registry consists of 104 participating centers in 27 countries within the European Society of Cardiology. The registry data was split into an adenosine group (AG) and no-adenosine group (NAG). Procedure characteristics and patient outcome were compared.RESULTS: Adenosine was administered in 10.8% of the 3591 PVI patients included in the registry. Spain, the Netherlands, and Italy included the majority of adenosine cases (48.8%). Adenosine was applied more often in combination with open irrigation radiofrequency (RF) energy (74.7%) and less often in combination with nonirrigated RF energy (1.6%). After 1 year, a higher percentage of the AG was free from AF compared with the NAG (68.9% vs 59.1%, p < 0.001). Adenosine was associated with better rhythm outcome in RF ablation procedures, but not in cryo-ablation procedures (freedom from AF: RF: AG: 70.9%, NAG: 58.1%, p < 0.001, cryo: AG: 63.9%, NAG: 63.8%, p = 0.991).CONCLUSIONS: The use of adenosine was associated with a better rhythm outcome after 1 year follow-up and seems more useful in patients treated with RF energy compared with patients treated with cryo energy. Given the improved rhythm outcome at 1-year follow-up, it seems reasonable to encourage the use of adenosine during RF AF ablation.
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