Adam Gorlo

Scanmed (Poland)

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Paweł Derejko

Medical University of Warsaw

Michał Orczykowski

Institute of Cardiology

ŁS

Łukasz Szumowski

Institute of Cardiology

Robert Bodalski

Institute of Cardiology

Róbert Hatala

National Institute of Cardiovascular Diseases

Paulus Kirchhof

University of Birmingham

Rodrigue Garcia

Centre Hospitalier Universitaire de Poitiers

Vincenzo Russo

University of Campania "Luigi Vanvitelli"

Emilce Trucco

Hospital Universitari de Girona Doctor Josep Trueta

Isabelle C. Van Gelder

University Medical Center Groningen

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Inserm

Institute of Cardiology

Medical University of Warsaw

Universitat de Barcelona

University of Birmingham

Consorci Institut D'Investigacions Biomediques August Pi I Sunyer

Hospital Clínic de Barcelona

Centro de Investigación en Red en Enfermedades Cardiovasculares

Cardinal Stefan Wyszyński University in Warsaw

Assistance Publique – Hôpitaux de Paris

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B-PO05-100 SAFETY AND EFFICACY OF CRYOBALLOON ABLATION OF ATRIAL FIBRILLATION IN PATIENTS WITH MECHANICAL MITRAL VALVE

Heart Rhythm (2021)

Michał Orczykowski Krzysztof Kaczmarek Andrzej Główniak Paweł Derejko Piotr Urbanek

Mitral valve replacement

Mechanical valve

10.1016/j.hrthm.2021.06.1019

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Design and deployment of the STEEER-AF trial to evaluate and improve guideline adherence: a cluster-randomized trial by the European Society of Cardiology and European Heart Rhythm Association

EP Europace (2024)

Maciej Sterliński Karina V Bunting Giuseppe Boriani Serge Bovéda Eduard Guasch

Abstract Aims The aim is to describe the rationale, design, delivery, and baseline characteristics of the Stroke prevention and rhythm control Treatment: Evaluation of an Educational programme of the European society of cardiology in a cluster-Randomized trial in patients with Atrial Fibrillation (STEEER-AF) trial. Methods and results STEEER-AF is a pragmatic trial designed to objectively and robustly determine whether guidelines are adhered to in routine practice and evaluate a targeted educational programme for healthcare professionals. Seventy centres were randomized in six countries (France, Germany, Italy, Poland, Spain, and UK; 2022–23). The STEEER-AF centres recruited 1732 patients with a diagnosis of atrial fibrillation (AF), with a mean age of 68.9 years (SD 11.7), CHA2DS2-VASc score of 3.2 (SD 1.8), and 647 (37%) women. Eight hundred and forty-three patients (49%) were in AF at enrolment and 760 (44%) in sinus rhythm. Oral anticoagulant therapy was prescribed in 1543 patients (89%), with the majority receiving direct oral anticoagulants (1378; 89%). Previous cardioversion, antiarrhythmic drug therapy, or ablation was recorded in 836 patients (48.3%). Five hundred fifty-one patients (31.8%) were currently receiving an antiarrhythmic drug, and 446 (25.8%) were scheduled to receive a future cardioversion or ablation. The educational programme engaged 195 healthcare professionals across centres randomized to the intervention group, consisting of bespoke interactive online learning and reinforcement activities, supported by national expert trainers. Conclusion The STEEER-AF trial was successfully deployed across six European countries to investigate guideline adherence in real-world practice and evaluate if a structured educational programme for healthcare professionals can improve patient-level care. Clinical Trial Registration Clinicaltrials.gov, NCT04396418.

Guideline

Heart Rhythm

10.1093/europace/euae178

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Distances between transseptal puncture site and anatomical landmarks

Journal of Cardiovascular Electrophysiology (2019)

Paweł Derejko Andrzej Hasiec Aleksander Bardyszewski Jacek Kuśnierz Dobromiła Dzwonkowska

Abstract The aim of the study was to provide quantitative data and to look for new landmarks useful during transseptal puncture (TSP) using a fluoroscopy‐guided approach. Methods and results A total of 104 patients at mean age 57 ± 12 years, of whom 92% underwent pulmonary vein isolation, were analysed. Before TSP catheters were placed in the coronary sinus (CS) and His bundle region. A guidewire running from femoral vein through great veins was left loose in superior vena cava. Before TSP X‐ray images were taken in right anterior oblique (RAO) 45° and RAO 53° projections. Locations posterior to TSP site in RAO were described with negative values and those anterior with positive values. The measured distances in millimeters were as follows: (a) between TSP site and posterior atrial wall (RAO 45 = –21 ± 7 mm; RAO 53 = –19 ± 6 mm (b) between TSP site and free guidewire (RAO 45 = –5 ± 4 mm, RAO 53 = –3 ± 4 mm (c) between TSP site and CS ostium (RAO 45 = 9 ± 6 mm; RAO 53 = 8 ± 5 mm (d) between TSP site and His region (RAO 45 = 29 ± 8 mm; RAO 53 = 30 ± 8 mm). We observed correlations between measured distances and age, body mass index and sizes of cardiac chambers. The distance between TSP site and the line projected by the guidewire running between great veins, measured in mid‐RAO projections, was very small. Conclusion The distances between TSP site and standard anatomical landmarks used during TSP vary with regard to age, physique and cardiac chamber dimensions. TSP site, as assessed in mid RAO, is in direct vicinity to the line projected by a guidewire running between the great veins.

Anatomical landmark

Ostium

Great cardiac vein

10.1111/jce.14224

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[Is Q-wave on admission associated with microvascular injury in patients with acute myocardial infarction treated with primary angioplasty?].

PubMed (2004)

Sławomir Dobrzycki Janusz Korecki Marcin Kożuch Karol Kamiński Grażyna Latocha-Korecka

Impaired microvascular flow, despite patent epicardial artery (no-reflow phenomenon), leads to greater left ventricular dysfunction after myocardial infarction (MI). Predictive factors associated with no-reflow remain largely unexplored. Q-wave on admission (Q(A)) is a sign of extensive ischemia probably predisposing to no-reflow. The aim of the study was to explore possible relation between Q(A) and electrocardiographic signs of no-reflow in patients with first MI.The study group was composed of 108 patients (81 men; mean age 60+/-11 years), with first ST-segment elevation MI, treated successfully with primary angioplasty (p-PTCA). ECG tracings were obtained before and 30 minutes after p-PTCA. The sum of ST-segment elevations (sum(ST(el))) in 3 contiguous leads with the highest ST(el) was calculated. Lack of 50% reduction of the sum(ST(el)) 30 minutes after angioplasty was defined as ECG sign of no-reflow. Presence of Q(A) was estimated in leads with ST(el).Q(A) was found in 42 (39%) patients. Q(A) was more often observed in patients with ECG signs of no-reflow (38% vs. 18%; p<0.05). Group with Q(A) showed larger damage of left ventricle estimated with ECG QRS score (7.7+/-4.4 vs. 6.1+/-3.4; p<0.05) as well as worse ejection fraction (42% vs. 46%; p=0.05).Patients with Q(A) have more often ECG signs of no-reflow than other patients with MI. Previously described worse function of left ventricle in this group, may be partially caused by more frequent no-reflow occurring in those patients. This fact suggests that adjunctive therapy preventing no-reflow could be beneficial in this group of patients.

ST elevation

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