| 1. |
- Bongiorni, Maria Grazia, et al.
(författare)
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How European centres diagnose, treat, and prevent CIED infections : Results of an European Heart Rhythm Association survey
- 2012
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 14:11, s. 1666-1669
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of our survey is to analyse the clinical approach used to prevent and treat cardiovascular implantable electronic device (CIED) infections in Europe. The survey involves high-volume implanting centres. According to the survey the incidence of CIED infections shows a slight decrease in most centres and is substantially under 2% in the majority of centres interviewed. However, there are still differences in terms of prophylactic antibiotic therapy: 8.9% of the centres administer oxacillin as preoperative treatment, 4.4% of them do not give any antibiotic therapy, all centres use some kind of skin antisepsis, but only 42.2% use chlorhexidine. In case of local infection, 43.5% of centres perform lead extraction as first approach. In the case of systemic infection or evidence of lead or valvular endocarditis, 95% of centres treat these conditions by extracting the leads, which indicates that the adherence to the lead extraction guidelines is quite good.
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| 2. |
- Bongiorni, Maria Grazia, et al.
(författare)
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Preferred tools and techniques for implantation of cardiac electronic devices in Europe : results of the European Heart Rhythm Association survey
- 2013
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 15:11, s. 1664-1668
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this European Heart Rhythm Association (EHRA) survey was to assess clinical practice in relation to the tools and techniques used for cardiac implantable electronic devices procedures in the European countries. Responses to the questionnaire were received from 62 members of the EHRA research network. The survey involved high-, medium-, and low-volume implanting centres, performing, respectively, more than 200, 100199 and under 100 implants per year. The following topics were explored: the side approach for implantation, surgical techniques for pocket incision, first venous access for lead implantation, preference of lead fixation, preferred coil number for implantable cardioverter-defibrillator (ICD) leads, right ventricular pacing site, generator placement site, subcutaneous ICD implantation, specific tools and techniques for cardiac resynchronization therapy (CRT), lead implantation sequence in CRT, coronary sinus cannulation technique, target site for left ventricular lead placement, strategy in left ventricular lead implant failure, mean CRT implantation time, optimization of the atrioventricular (AV) and ventriculo-ventricular intervals, CRT implants in patients with permanent atrial fibrillation, AV node ablation in patients with permanent AF. This panoramic view allows us to find out the operator preferences regarding the techniques and tools for device implantation in Europe. The results showed different practices in all the fields we investigated, nevertheless the survey also outlines a good adherence to the common standards and recommendations.
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| 3. |
- Dobreanu, Dan, et al.
(författare)
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Approach to cardiac resyncronization therapy
- 2012
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 14:9, s. 1359-1362
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Tidskriftsartikel (refereegranskat)abstract
- AIMS:The purpose of this EP Wire is to compare indications, techniques, implant strategy, and follow-up regarding cardiac resynchronization therapy (CRT) in several countries across Europe.METHODS AND RESULTS:Forty-one centres, members of the EHRA-EP Research Network, responded to this survey and completed the questions. Thirty-two per cent of the responding centres always use CRT in heart failure (HF) patients with New York Heart Association functional class II and QRS width >120 ms, and 55% of the responding centres demand additional criteria when indicating CRT, most often QRS width >150 ms (49%) and echocardiographic criteria of asynchrony (34%). Only 10% of centres indicate CRT in all HF patients with QRS >120 ms and right bundle branch block, and 51% demand additional criteria, most frequently echocardiographic asynchrony parameters. The vast majority of centres also indicate CRT in patients with atrial fibrillation and standard criteria for CRT. In 24% of the centres, biventricular pacemaker (CRT-P) is implanted in all situations, unless there is an indication for secondary prevention of sudden cardiac death, while 10% always choose to implant a biventricular defibrillator (CRT-D). There are no clear evidence-based recommendations concerning the implant procedure and follow-up in patients treated with CRT; therefore, the chosen strategies vary widely from one centre to another.CONCLUSION:This EP Wire survey shows a wide variation not only as far as CRT indications are concerned, but especially in techniques, implant strategy, and follow-up across the European countries.
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| 4. |
- Lewalter, Thorsten, et al.
(författare)
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Atrial fibrillation ablation techniques
- 2012
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 14:10, s. 1515-1517
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Tidskriftsartikel (refereegranskat)abstract
- We performed a survey on current atrial fibrillation (AF) ablation techniques used for catheter ablation of AF among the European Heart Rhythm Association Research Network. The focus of this questionnaire is on the ablation strategy, such as the use of different lesion sets or sites of ablation in the various forms of AF, and on the technical aspects of catheter ablation with respect to energy sources and imaging modalities.
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| 5. |
- Marinskis, Germanas, et al.
(författare)
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Performing magnetic resonance imaging in patients with implantable pacemakers and defibrillators : results of a European Heart Rhythm Association survey
- 2012
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 14:12, s. 1807-1809
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of our survey was to evaluate the experience, current practice and attitudes of performing magnetic resonance imaging (MRI) studies in patients with cardiac implantable electronic devices. Fifty-one centre-members of European Heart Rhythm Association Research network have responded to the survey. According to the obtained data, 55.2 of responding centres do not perform MRI scans in patients with non-MRI-certified pacemakers and 65.8 in patients with such implantable cardioverter defibrillators (ICDs). Reported complication rate in patients with non-MRI-certified devices is low and conforms to the literature data. Experience with newer MRI-compatible pacemakers and ICDs is limited to single cases in most centres. This survey shows limited experience with performing MRI studies in patients with implanted pacemakers and ICDs. In concordance with available guidelines, most centres limit MRI scans in patients with non-MRI-certified devices. The implant numbers for MRI-certified devices and experience with performing MRI scans in these patients are still low.
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| 6. |
- Marinskis, Germanas, et al.
(författare)
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Practices of cardiac implantable electronic device follow-up : results of the European Heart Rhythm Association survey
- 2012
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 14:3, s. 423-425
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Tidskriftsartikel (refereegranskat)abstract
- This survey analyses some details of follow-up of patients with cardiac implantable electronic devices (CIEDs) in 40 centresthe members of the European Heart Rhythm Association (EHRA) research network. Results of this survey show that practices of CIED follow-up are not homogeneous between EHRA research network centres, and recommended clinical evaluation of the patients regarding possible device up-grade is not always performed. Remote device monitoring appears to be an evolving practice, mostly used in implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillator recipients.
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| 7. |
- Marinskis, Germanas, et al.
(författare)
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X-ray exposure hazards for physicians performing ablation procedures and device implantation : results of the European Heart Rhythm Association survey
- 2013
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 15:3, s. 444-446
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the survey was to evaluate physician's and authorities policies and clinical practices when using occupational X-ray during ablation procedures and device implantation. This survey shows infrequent use of lead gloves, radiation absorbing pads, and lead glass cabins, but increasing use of three-dimensional mapping systems to decrease X-ray radiation hazards. Digital fluoroscopy with decreased frame rate is not used by approximately one-third of responding centres.
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| 8. |
- Normand, Camilla, et al.
(författare)
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Cardiac resynchronization therapy pacemaker or cardiac resynchronization therapy defibrillator : what determines the choice?-findings from the ESC CRT Survey II
- 2019
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 21:6, s. 918-927
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The decision to implant a cardiac resynchronization therapy pacemaker (CRT-P) or a cardiac resynchronization therapy defibrillator (CRT-D) may be challenging. There are no clear guideline recommendations as no randomized study of cardiac resynchronization therapy (CRT) has been designed to compare the effects of CRT-P with those of CRT-D on patients' outcomes. In the CRT Survey II, we studied patient and implantation centre characteristics associated with the choice of CRT-P vs. CRT-D.METHODS AND RESULTS: Clinical practice data from 10 692 patients undergoing CRT implantation of whom 7467 (70%) patients received a CRT-D and 3225 (30%) received a CRT-P across 42 ESC countries were collected and analysed between October 2015 and January 2017. Factors favouring the selection of CRT-P implantation included age >75 years, female gender, non-ischaemic heart failure (HF) aetiology, New York Heart Association functional Class III/IV symptoms, left ventricular ejection fraction >25%, atrial fibrillation, atrioventricular (AV) block II/III, and implantation in a university hospital.CONCLUSION: In a large cohort from the CRT Survey II, we found that patients allocated to receive CRT-P exhibited particular phenotypes with more symptomatic HF, more frequent comorbidities, advanced age, female gender, non-ischaemic HF aetiology, atrial fibrillation, and evidence of AV block. There were substantial differences in the proportion of patients allocated to receive CRT-P vs. CRT-D between countries.
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| 9. |
- Pison, Laurent, et al.
(författare)
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Imaging techniques in electrophysiology and implantable device procedures : results of the European Heart Rhythm Association survey
- 2013
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 15:9, s. 1333-1336
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this European Heart Rhythm Association (EHRA) survey is to assess the implementation and use of imaging techniques in cardiac electrophysiology (EP) and device procedures across European cardiovascular centres. Forty European centres, all members of the EHRA EP research network, responded to this survey. Thirty-one centres (88) use transthoracic echocardiography (TTE) to evaluate left atrial size and/or volume before atrial fibrillation (AF) ablation. Sixteen centres (46) perform delayed-enhancement cardiac magnetic resonance imaging (MRI) to guide ventricular tachycardia ablation. Electroanatomical mapping (EAM) systems are available in 65 of responding centres and the use of robotic catheter and remote magnetic navigation systems is limited to 10. Fusion of EAM data with cardiac computed tomography (CT) and/or MRI is performed in up to 43 of AF ablation procedures. Seventeen out of 35 (49) responding centres also perform TTE to predict a favourable response to cardiac resynchronization therapy (CRT). Imaging of the cardiac venous system with CT and identification of myocardial scar using CT or MRI, is not routinely performed in the majority of centres [32 (91) and 26 (75) centres, respectively) prior to CRT. This EHRA survey shows that several imaging techniques are used to guide catheter ablation and CRT procedures in European centres. Echocardiographic imaging, EAM techniques, and cardiac CT/MRI are commonly used.
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| 10. |
- Pison, Laurent, et al.
(författare)
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Surgical and hybrid atrial fibrillation ablation procedures
- 2012
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 14:7, s. 939-941
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this EP Wire is to survey clinical practice in this rapidly evolving field as the variety of surgical techniques and the heterogeneity of treated patients make the comparison of results and outcomes challenging. Twenty-four European centres, all members of the EHRA EP research network, responded to this survey and completed the questions. Of the participating centres, 11 (46) performed (irrespective of the technique) stand-alone surgical atrial fibrillation (AF) ablation in 2011. Seven hospitals (64) performed totally thoracoscopic AF ablation procedures off-pump (in 20100 of their cases). The most commonly used lesion set was only pulmonary vein isolation in five hospitals (46). Eight centres (73) performed validation of the surgical lesion set at the time of intervention. The most important indication for performing stand-alone, totally thoracoscopic surgical AF ablation in seven participating hospitals was failed catheter ablation. According to their definition of success, participating centres reported their success rate to be 10100 for paroxysmal AF and 095 for (longstanding) persistent AF. The most frequently encountered complications during stand-alone, surgical AF ablation were pneumothorax and haemothorax in up to 10 of the cases. This EP Wire survey shows a wide variation not only in indications for stand-alone, surgical AF ablation, but also in surgical techniques, lesion sets, follow-up, and outcome.
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