Risk factors of atrial fibrillation recurrence despite successful radiofrequency ablation of accessory pathway: At 11 years of follow-up

Background: Previous reports on patients with radiofrequency catheter ablation (RFCA) of accessorypathway (AP) and atrial fibrillation (AF) include only short follow-up periods. The aim of this studywas to analyze predictors of recurrence of AF in patients after successful RFCA of APs over long termfollow-up periods.Methods: Of the 1,007 patients who underwent non-pharmacological treatment of APs (between theyears 1993–2008), data of 100 consecutive patients were retrospectively analyzed (75 men, mean age43.6 ± 14.7), with the longest period of follow-up (mean 11.3 ± 3.5 years) after successful RFCA ofAP. In Group 1, there were 72 patients (54 men, mean age 40.66 ± 13.85 years) without documentedepisodes of AF after RFCA of AP. Group 2 consisted of 28 patients (21 men, mean age 50.79 ± 14.49years) with AF episodes despite successful elimination of AP.Results: In univariate analysis, patients from Group 1 were significantly younger at the time of ablationthan patients from Group 2 (40.66 ± 13.85 vs. 50.79 ± 14.49 years; p = 0.002), had shorter historyof AF episodes (4.11 ± 4.07 vs. 8.25 ± 7.50 years; p = 0.024) and had less frequently documentedatrial tachycardia (AT) prior to ablation (3.39 vs. 20.00%; p = 0.022). In multivariate analysis, thehistory of AF in years (p = 0.043), was an independent risk factor for AF recurrences.Conclusions: Older patient age, longer history of AF and AT prior to RFCA of APs identified a subgroupof patients who required additional treatment. In the multivariate analysis, the history of AF inyears (p = 0.043) was a risk factor for AF recurrence

Do we differ in terms of indications and demographics in cardiac resynchronisation recipients in Poland? Insights from the European CRT Survey II Registry

Background: Multiple randomised clinical trials have proven that cardiac resynchronisation therapy (CRT) reduces morbidity and mortality in appropriately selected patients with congestive heart failure and is recommended for such patients as per the European Society of Cardiology guidelines. Aims: In this paper we compare the indications and demographics in cardiac resynchronisation recipients in Poland and other European countries. Methods: In 2015 and 2016, physicians from 42 European countries participated in the second edition of the European Cardiac Resynchronisation Therapy Survey. For 14 months, 288 implanting centres gathered data regarding demography, indications, implanting methods, and guidance compatibility from 11,088 patients receiving CRT. Results: The survey revealed that a vast group of patients were eligible for CRT implantation (although some of them with rela­tively weak guidance recommendations) and showed essential variety in clinical practice when national data were benchmarked. Conclusions: The population of CRT recipients in Poland and other European countries did not differ in terms of demographic and clinical characteristics. In most cases, indications for CRT were in accordance with the guidelines; however some devices were implanted in patients beyond the guideline recommendations. For these procedures, the decision regarding CRT im­plantation relies mainly on the physicians’ experience

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Mechanical thrombectomy in acute stroke : five years of experience in Poland

Objectives: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results: Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250 99 min. 90.3% of the studied patients had MT within 6 h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0–2 - in 31.4% and mRS of 6 in 22% of cases. Conclusion: Our results can help harmonize standards for MT in Poland according to international guideline