Left ventricular diastolic dysfunction in atrial fibrillation: Predictors and relation with symptom severity: Left ventricular diastolic dysfunction in atrialfibrillation:Predictors and relation with symptom severity

Left ventricular diastolic dysfunction (LVDD) is common in the general population, but its prevalence in atrial fibrillation (AF), predictors for LVDD in AF and the association between LVDD and AF-related symptom severity has not been well-studied. In 124 consecutive patients (mean age 61 ± 11years, 60 % male) with paroxysmal (n=70) or persistent AF (n=54) referred for AF catheter ablation, LVDD was evaluated according to current guidelines using transthoracic echocardiography. AF-related symptom severity was quantified using the EHRA score. LVDD was present in 46 patients (37 %). In uni- and multivariable regression analysis, age (OR 1.068 per year, 95 % CI 1.023 – 1.115, p=.003) and persistent AF (OR 2.427 vs paroxysmal AF, 95 % CI 1.112 – 5.3, p=.026) were associated with LVDD. LVDD was found in 11 % with mild AF symptoms (n=27) as opposed to 44 % in patients with moderate- severe AF symptoms (n=97, p=.002). Thus, the OR for moderate-severe AF symptoms was 6.368 (1.797 – 22.568, p=.004) in the presence of LVDD. LVDD (1) occurs frequently in AF, (2) is associated with advancing age and AF progression and (3) is correlated with symptom severity in AF.:1 Introduction ..................................................................................................................................4 1.1 Left ventricular diastolic dysfunction …..........................................................................4 1.1.1 Definition and pathophysiology...........................................................................4 1.1.2 Echocardiographic diagnostic methods ............................................................. 6 1.1.3 Increasing prevalence and importance of left ventricular diastolic dysfunction..9 1.2 Link between left ventricular diastolic dysfunction and atrial fibrillation.....................10 2 Aim of the study .........................................................................................................................12 3 Publication ................................................................................................................................. 12 4 Discussion ..................................................................................................................................18 5 Limitations ................................................................................................................................. 20 6 Conclusion ................................................................................................................................. 20 7 Synopsis ..................................................................................................................................... 21 8 References ..................................................................................................................................22 9 Erklärung ....................................................................................................................................30 10 Curriculum vitae ...................................................................................................................... 31 11 Danksagung ..............................................................................................................................3

First Case of Automatic His Potential Detection With a Novel Ultra High-density Electroanatomical Mapping System for AV Nodal Ablation

AbstractA 74-year old was considered for atrioventricular (AV) nodal ablation in view of atrial fibrillation (AF) with poorly controlled ventricular rate despite being on amiodarone. Targeted AV nodal ablation was successfully performed after identifying the target site for ablation by reviewing an ultra high-density map of the His region produced by automatic electrogram annotation

Results of catheter ablation of atrial fibrillation in hypertrophied hearts – Comparison between primary and secondary hypertrophy

AbstractBackground and purposeApproximately 20–25% of the patients with hypertrophic cardiomyopathy (HCM) develop atrial fibrillation (AF) during the clinical course of the disease, a percentage significantly larger than that of the general population. The purpose of the present study was to report on the procedural results of patients with AF and either primary or secondary left ventricular hypertrophy (LVH).Methods and subjectsTwenty-two consecutive HCM patients (55% male, mean age 57±8 years) with symptomatic AF, having undergone AF ablation procedures between September 2009 and July 2012 were compared with respect to procedural outcome and follow-up characteristics with 22 matched controls with secondary cardiac hypertrophy (64% male, 63±10 years) from our prospective AF catheter ablation registry.Results and conclusionRadiofrequency catheter ablation (RFCA) was successful in restoring long-term sinus rhythm in patients with LVH due to HCM and due to secondary etiology. However, patients with HCM needed more RFCA procedures and frequently additional antiarrhythmic drug therapy in order to maintain sinus rhythm

Occupational radiation exposure in the electrophysiology laboratory with a focus on personnel with reproductive potential and during pregnancy: A European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS)

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EHRA expert consensus document on the management of arrhythmias in frailty syndrome, endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA).

There is an increasing proportion of the general population surviving to old age with significant chronic disease, multi-morbidity, and disability. The prevalence of pre-frail state and frailty syndrome increases exponentially with advancing age and is associated with greater morbidity, disability, hospitalization, institutionalization, mortality, and health care resource use. Frailty represents a global problem, making early identification, evaluation, and treatment to prevent the cascade of events leading from functional decline to disability and death, one of the challenges of geriatric and general medicine. Cardiac arrhythmias are common in advancing age, chronic illness, and frailty and include a broad spectrum of rhythm and conduction abnormalities. However, no systematic studies or recommendations on the management of arrhythmias are available specifically for the elderly and frail population, and the uptake of many effective antiarrhythmic therapies in these patients remains the slowest. This European Heart Rhythm Association (EHRA) consensus document focuses on the biology of frailty, common comorbidities, and methods of assessing frailty, in respect to a specific issue of arrhythmias and conduction disease, provide evidence base advice on the management of arrhythmias in patients with frailty syndrome, and identifies knowledge gaps and directions for future research

Left ventricular diastolic dysfunction in atrial fibrillation: Predictors and relation with symptom severity: Left ventricular diastolic dysfunction in atrialfibrillation:Predictors and relation with symptom severity

Left ventricular diastolic dysfunction (LVDD) is common in the general population, but its prevalence in atrial fibrillation (AF), predictors for LVDD in AF and the association between LVDD and AF-related symptom severity has not been well-studied. In 124 consecutive patients (mean age 61 ± 11years, 60 % male) with paroxysmal (n=70) or persistent AF (n=54) referred for AF catheter ablation, LVDD was evaluated according to current guidelines using transthoracic echocardiography. AF-related symptom severity was quantified using the EHRA score. LVDD was present in 46 patients (37 %). In uni- and multivariable regression analysis, age (OR 1.068 per year, 95 % CI 1.023 – 1.115, p=.003) and persistent AF (OR 2.427 vs paroxysmal AF, 95 % CI 1.112 – 5.3, p=.026) were associated with LVDD. LVDD was found in 11 % with mild AF symptoms (n=27) as opposed to 44 % in patients with moderate- severe AF symptoms (n=97, p=.002). Thus, the OR for moderate-severe AF symptoms was 6.368 (1.797 – 22.568, p=.004) in the presence of LVDD. LVDD (1) occurs frequently in AF, (2) is associated with advancing age and AF progression and (3) is correlated with symptom severity in AF.:1 Introduction ..................................................................................................................................4 1.1 Left ventricular diastolic dysfunction …..........................................................................4 1.1.1 Definition and pathophysiology...........................................................................4 1.1.2 Echocardiographic diagnostic methods ............................................................. 6 1.1.3 Increasing prevalence and importance of left ventricular diastolic dysfunction..9 1.2 Link between left ventricular diastolic dysfunction and atrial fibrillation.....................10 2 Aim of the study .........................................................................................................................12 3 Publication ................................................................................................................................. 12 4 Discussion ..................................................................................................................................18 5 Limitations ................................................................................................................................. 20 6 Conclusion ................................................................................................................................. 20 7 Synopsis ..................................................................................................................................... 21 8 References ..................................................................................................................................22 9 Erklärung ....................................................................................................................................30 10 Curriculum vitae ...................................................................................................................... 31 11 Danksagung ..............................................................................................................................3

First Case of Automatic His Potential Detection With a Novel Ultra High-density Electroanatomical Mapping System for AV Nodal Ablation

A 74-year old was considered for atrioventricular (AV) nodal ablation in view of atrial fibrillation (AF) with poorly controlled ventricular rate despite being on amiodarone. Targeted AV nodal ablation was successfully performed after identifying the target site for ablation by reviewing an ultra high-density map of the His region produced by automatic electrogram annotation

Survey on the research activities within the EHRA Young EP community

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Current status of interventional cardiac electrophysiology training in ESC member countries: an EHRA Young EP Report

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