26 results found
Salukhe TV, Willems S, Drewitz I, et al., 2012, Propofol sedation administered by cardiologists without assisted ventilation for long cardiac interventions: an assessment of 1000 consecutive patients undergoing atrial fibrillation ablation, EUROPACE, Vol: 14, Pages: 325-330, ISSN: 1099-5129
Lim PB, Wright IJ, Salukhe TV, et al., 2011, Narrow Complex Tachycardia with Alternating Cycle Length: What is the Mechanism?, JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol: 22, Pages: 1399-1401, ISSN: 1045-3873
Willems S, Steven D, Servatius H, et al., 2010, Persistence of pulmonary vein isolation after robotic remote-navigated ablation for atrial fibrillation and its relation to clinical outcome., J Cardiovasc Electrophysiol, Vol: 21, Pages: 1079-1084
AIMS: A robotic navigation system (RNS, Hansen™) has been developed as an alternative method of performing ablation for atrial fibrillation (AF). Despite the growing application of RNS-guided pulmonary vein isolation (PVI), its consequences and mechanisms of subsequent AF recurrences are unknown. We investigated the acute procedural success and persistence of PVI over time after robotic PVI and its relation to clinical outcome. METHODS AND RESULTS: Sixty-four patients (60.7 ± 9.8 years, 53 male) with paroxysmal AF underwent robotic circumferential PVI with 3-dimensional left atrial reconstruction (NavX™). A voluntary repeat invasive electrophysiological study was performed 3 months after ablation irrespective of clinical course. Robotic PVI was successful in all patients without complication (fluoroscopy time: 23.5 [12-34], procedure time: 180 [150-225] minutes). Fluoroscopy time demonstrated a gradual decline but was significantly reduced after the 30th patient following the introduction of additional navigation software (34 [29-45] vs 12 [9-17] minutes; P < 0.001). A repeat study at 3 months was performed in 63% of patients and revealed electrical conduction recovery in 43% of all PVs. Restudied patients without AF recurrence (n = 28) showed a significantly lower number of recovered PVs (1 (0-2) vs 2 (2-3); P = 0.006) and a longer LA-PV conduction delay than patients with AF recurrences (n = 12). Persistent block of all PVs was associated with freedom from AF in all patients. At 3 months, 67% of patients were free of AF, while reablation of recovered PVs led to an overall freedom from AF in 81% of patients after 1 year. CONCLUSION: Robotic PVI for PAF is safe, effective, and requires limited fluoroscopy while yielding comparable success rates to conventional ablation approaches with PV reconduction as a common phenomenon associated with AF recurrences.
Kojodjojo P, O'Neill MD, Lim PB, et al., 2010, Pulmonary venous isolation by antral ablation with a large cryoballoon for treatment of paroxysmal and persistent atrial fibrillation: medium-term outcomes and non-randomised comparison with pulmonary venous isolation by radiofrequency ablation, Heart, Vol: 96, Pages: 1379-1384, ISSN: 1468-201X
Background To prevent atrial fibrillation (AF) recurrenceafter catheter ablation, pulmonary venous isolation (PVI)at an antral level is more effective than segmental ostialablation. Cryoablation around the pulmonary venous (PV)ostia for AF therapy is potentially safer compared toradiofrequency ablation (RFA). The aim of this study wasto investigate the efficacy of a strategy using a largecryoablation balloon to perform antral cryoablation with‘touch-up’ ostial cryoablation for PVI in patients withparoxysmal and persistent AF.Methods Paroxysmal and persistent AF patientsundergoing their first left atrial ablation were recruited.After cryoballoon therapy, each PV was assessed forisolation and if necessary, treated with focal ostialcryoablation until PVI was achieved. Follow-up withHolter monitoring was performed. Clinical outcomes ofthe cryoablation protocol were compared, withconsecutive patients undergoing PVI by RFA.Results 124 consecutive patients underwentcryoablation. 77% of paroxysmal and 48% of persistentAF subjects were free from AF at 12 months aftera single procedure. Over the same time period, 53consecutive paroxysmal AF subjects underwent PVI withRFA and at 12 months, 72% were free from AF at12 months (p¼NS). There were too few persistent AFsubjects (n¼8) undergoing solely PVI by RFA asa comparison group. Procedural and fluoroscopic timesduring cryoablation were significantly shorter than RFA.Conclusions PV isolation can be achieved in less than2 h by a simple cryoablation protocol with excellentresults after a single intervention, particularly forparoxysmal AF.
Drewitz I, Willems S, Salukhe TV, et al., 2010, Atrial fibrillation cycle length is a sole independent predictor of a substrate for consecutive arrhythmias in patients with persistent atrial fibrillation., Circ Arrhythm Electrophysiol, Vol: 3, Pages: 351-360
BACKGROUND: Termination of persistent atrial fibrillation (AF) can be achieved through ablation, with the majority of patients terminating to an atrial tachycardia (AT) and fewer directly to sinus rhythm (SR). We aimed to identify potential predictors for the existence of a substrate for AT on termination to SR. METHODS AND RESULTS: We assessed 95 persistent AF patients (age, 60+/-10 years) who underwent catheter ablation to the end point of AF termination. Forty patients terminated directly to SR (SRterm) and 55 to ATs (ATterm). Compared with the ATterm group, the SRterm group were younger (56+/-10 versus 63+/-9 years, P=0.001), had shorter durations of AF before ablation (9+/-26 versus 14+/-20 months, P<0.001), smaller left atrial diameters (41+/-5 versus 45+/-5 mm, P=0.015), and longer baseline AF cycle lengths (178+/-23 versus 159+/-31 ms, P=0.005). However, AF cycle length was the sole independent predictor of direct termination to SR. The most frequent AF termination site in SRterm patients was the pulmonary veins (53%), whereas in ATterm patients this was within the left atrium (58%). After follow-up of 12+/-6 months, there was a trend toward a greater proportion of patients in SR among those who terminated directly to SR after a single procedure. The most frequent type of recurrence was paroxysmal AF in SRterm patients and AT in ATterm patients. CONCLUSIONS: Patients who terminate to SR through ablation without an intermediate AT are characterized by a less altered arrhythmogenic substrate. Baseline AF cycle lengths emerged as a sole independent predictor of a substrate for consecutive arrhythmias.
Rostock T, Drewitz I, Steven D, et al., 2010, Characterization, Mapping, and Catheter Ablation of Recurrent Atrial Tachycardias After Stepwise Ablation of Long-Lasting Persistent Atrial Fibrillation, CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, Vol: 3, Pages: 160-169, ISSN: 1941-3149
Salukhe TV, Briceno NI, Ferenczi EA, et al., 2010, Is there benefit in implanting defibrillators in patients with severe heart failure?, HEART, Vol: 96, Pages: 599-603, ISSN: 1355-6037
Linton NWF, Koa-Wing M, Francis DP, et al., 2009, Cardiac ripple mapping: A novel three-dimensional visualization method for use with electroanatomic mapping of cardiac arrhythmias, HEART RHYTHM, Vol: 6, Pages: 1754-1762, ISSN: 1547-5271
Koa-Wing M, Kojodjojo P, Malcolme-Lawes LC, et al., 2009, Robotically Assisted Ablation Produces More Rapid and Greater Signal Attenuation Than Manual Ablation, JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol: 20, Pages: 1398-1404, ISSN: 1045-3873
Kojodjojo P, Gohil N, Barker D, et al., 2008, Outcomes of elderly patients aged 80 and over with symptomatic, severe aortic stenosis: impact of patients choice of refusing aortic valve replacement on survival, QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, Vol: 101, Pages: 567-573, ISSN: 1460-2725
Dimopoulos K, Diller G-P, Koltsida E, et al., 2008, Prevalence, predictors, and prognostic value of renal dysfunction in adults with congenital heart disease, CIRCULATION, Vol: 117, Pages: 2320-2328, ISSN: 0009-7322
Salukhe TV, Dimopoulos K, Sutton R, et al., 2008, Instantaneous effects of resynchronisation therapy on exercise performance in heart failure patients: the mechanistic role and predictive power of total isovolumic time, HEART, Vol: 94, Pages: 59-64, ISSN: 1355-6037
Salukhe TV, Wright I, Wright M, et al., 2008, A fortuitous syncope. The pitfalls of integrated bipolar defibrillator leads., Indian Pacing Electrophysiol J, Vol: 8, Pages: 312-316
Myopotential oversensing in implantable defibrillators causing inhibition of pacing and inappropriate therapies is well described. Current literature is dominated by reports of diaphragmatic muscle as the source of such far-field oversensing. Those reporting pectoral muscle sources were invariably due to unipolar sensing circuits, incorrect DF-1 connections or inappropriate programming. We report an interesting case of pectoral muscle myopotential oversensing causing inhibition of bradycardia pacing leading to presyncope and syncope.
Dimopoulos K, Okonko DO, Diller G-P, et al., 2006, Abnormal ventilatory response to exercise in adults with congenital heart disease relates to cyanosis and predicts survival, CIRCULATION, Vol: 113, Pages: 2796-2802, ISSN: 0009-7322
Salukhe TV, Francis DP, Morgan M, et al., 2006, Mechanism of cardiac output gain from cardiac resynchronization therapy in patients with coronary artery disease or idiopathic dilated cardiomyopathy, AMERICAN JOURNAL OF CARDIOLOGY, Vol: 97, Pages: 1358-1364, ISSN: 0002-9149
Salukhe TV, Francis DP, Morgan M, et al., 2005, Reduction in total isovolumic time under pharmacological stress: a final common pathway for cardiac output gain from cardiac resynchronisation therapy, 27th Congress of the European-Society-of-Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 54-54, ISSN: 0195-668X
Salukhe TV, Francis DP, Clague JR, et al., 2005, Chronic heart failure patients with restrictive LV filling pattern have significantly less benefit from cardiac resynchronization therapy than patients with late LV filling pattern, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 100, Pages: 5-12, ISSN: 0167-5273
Salukhe TV, Henein MY, Sutton R, 2005, Ischemic mitral regurgitation and its related risk after myocardial infarction, CIRCULATION, Vol: 111, Pages: 254-256, ISSN: 0009-7322
Salukhe TV, Dob D, Sutton R, 2004, Pacemakers and defibrillators: anaesthetic implications, BRITISH JOURNAL OF ANAESTHESIA, Vol: 93, Pages: 95-104, ISSN: 0007-0912
Salukhe TV, Dimopoulos K, Sutton R, et al., 2004, Life-years gained from defibrillator implantation - Markedly nonlinear increase during 3 years of follow-up and its implications, CIRCULATION, Vol: 109, Pages: 1848-1853, ISSN: 0009-7322
Salukhe TV, Dimopoulos K, Francis D, 2004, Cardiac resynchronisation may reduce all-cause mortality: meta-analysis of preliminary COMPANION data with CONTAK-CD, InSync ICD, MIRACLE and MUSTIC, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 93, Pages: 101-103, ISSN: 0167-5273
Dimopoulos K, Salukhe TV, Coats AJS, et al., 2004, Meta-analyses of mortality and morbidity effects of an angiotensin receptor blocker in patients with chronic heart failure already receiving an ACE inhibitor (alone or with a beta-blocker), INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 93, Pages: 105-111, ISSN: 0167-5273
Francis DP, Salukhe TV, 2003, Who needs a defibrillator after myocardial infarction?, LANCET, Vol: 362, Pages: 91-92, ISSN: 0140-6736
Salukhe TV, Henein MY, Sutton R, 2003, Pacing in heart failure: patient and pacing mode selection, EUROPEAN HEART JOURNAL, Vol: 24, Pages: 977-986, ISSN: 0195-668X
Salukhe TV, Francis DP, Sutton R, 2003, Comparison of medical therapy, pacing and defibrillation in heart failure (COMPANION) trial terminated early; combined biventricular pacemaker-defibrillators reduce all-cause mortality and hospitalization, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 87, Pages: 119-120, ISSN: 0167-5273
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