1,721,014 research outputs found
Comparison of effectiveness the radiofrequency modified maze procedure and mitral valve surgery using transseptal or septal-superior approaches the for the treatment of atrial fibrillation.
No full textThe purpose of this scientific work was to evaluate safety and efficacy of treatment of atrial fibrillation using monopolar radiofrequency ablation electrodes in patients who undergo mitral valve surgical correction using incisions of atrial septum (trans-septal and superior septal approaches). More than 80% of the patients are free of atrial fibrillation one year after the operation and 76% of these patients do not use anti-arrhythmic drugs. During the final visit of follow-up it was recorded that 71.5% of the patients remained free of atrial fibrillation and flutter. The maze procedure increases duration of cardiopulmonary by-pas for 16 ± 3 min, only. The baseline and surgical correction data in groups of patients of trans-septal and superior septal approaches did not differ. The method of mitral valve correction (implantation of mitral valve prosthesis or plasty of the valve) had no statistically significant influence on the results of atrial fibrillation treatment. The factors influencing the efficacy of the treatment include higher class of heart failure and larger longitudinal measurement of the left atrium found on echoscopy using M-mode. Combined therapy of secondary atrial tachycardia and atypical atrial flutter (by means of anti-arrhythmic drugs, trans-oesophageal stimulation and per-catheter ablation) enables to improve the results of maze procedure. The superior septal approach should be used in complicated operations as using this incision it is more convenient to inspect the mitral valve and correct mitral valve malformation
Modifikuotos radiodažninės labirinto procedūros ir mitralinio vožtuvo ydos korekcijos, atliekamos per tarpprieširdinės pertvaros ir viršutinį pertvaros pjūvius efektyvumo palyginimas gydant prieširdžių virpėjimą.
No full textThe purpose of this scientific work was to evaluate safety and efficacy of treatment of atrial fibrillation using monopolar radiofrequency ablation electrodes in patients who undergo mitral valve surgical correction using incisions of atrial septum (trans-septal and superior septal approaches). More than 80% of the patients are free of atrial fibrillation one year after the operation and 76% of these patients do not use anti-arrhythmic drugs. During the final visit of follow-up it was recorded that 71.5% of the patients remained free of atrial fibrillation and flutter. The maze procedure increases duration of cardiopulmonary by-pas for 16 ± 3 min, only. The baseline and surgical correction data in groups of patients of trans-septal and superior septal approaches did not differ. The method of mitral valve correction (implantation of mitral valve prosthesis or plasty of the valve) had no statistically significant influence on the results of atrial fibrillation treatment. The factors influencing the efficacy of the treatment include higher class of heart failure and larger longitudinal measurement of the left atrium found on echoscopy using M-mode. Combined therapy of secondary atrial tachycardia and atypical atrial flutter (by means of anti-arrhythmic drugs, trans-oesophageal stimulation and per-catheter ablation) enables to improve the results of maze procedure. The superior septal approach should be used in complicated operations as using this incision it is more convenient to inspect the mitral valve and correct mitral valve malformation
Relative blood pressure increase is associated with subsequent atrial episodes in long-term out-patient monitoring: TriggersAF /
No full textBackground: The role of chronic blood pressure (BP) increase in atrial brillation (AF) pathogenesis is usually limited to risk factor assessment. Dynamic real-time BP uctuations before arrhythmia initiation remain poorly understood. This study aims to investigate the chronological changes of BP before AF. Methods: In this single-center prospective cohort study subjects with diagnosed paroxysmal or persistent AF underwent a 7-day outpatient telemonitoring. All patients were in sinus rhythm at the moment of inclusion. During the monitoring period, a continuous single-lead electrocardiogram (ECG) was registered. The recorded data was manually classi ed into four cardiac rhythm categories: atrial brillation, atrial tachycardia or utter, frequent premature atrial contractions, and no arrhythmia. In addition, arterial blood pressure (BP) measurements were obtained periodically for the rst 2 days at intervals of 15 minutes during the day, every 30 minutes during the night, followed by conventional BP measurements for the remaining observation period. BP data was synchronised with the ECG recordings. Systolic (SBP) and diastolic (DBP) values within 60 minutes before AF (investigational group) were compared to the control BP of the same patients measured in at least 2 consecutive hours with no AF detected. The analysis segregates day and night. Since AF tended to group into a series of episodes, a lter of a minimal duration without AF before the start of the episode was applied (5, 10, 20 or 30 minutes), aiming to select the initializing episode of the AF and avoid duplicate BP measurements. Results: The enrolment lasted from 2020 to 2023, resulting in 165 subjects, aged 59.0±11.8 years, 61.8% male. Physicians manually annotated a total duration of 26961 hours in a single-lead ECG analysis. Among detected atrial arrhythmia episodes 1520 were AF in 54 patients (Figure 1). The individual relative change of BP yielded an increase of SBP before daytime and nighttime AF and an increase of DBP before nighttime AF irrespective of the lter used (Figure 2). When no lter was applied the BP before AF vs. control was as follows, respectively: 1) Daytime SBP change +2% (±9) vs. 0% (±11), p<0.001 and nighttime +11% (±10) vs. 0% (±12), p<0.001; 2) Daytime DBP change 0% (±10) vs. 0% (±12), p=0.5 and nighttime +14% (±20) vs. 0% (±16), p<0.001. The absolute BP values did not differ between AF vs. control groups irrespective of the lter used. With 5-min lter: 1) Daytime SBP 125 (±13) vs. 127 (±17), p=0.5 and nighttime 118 (±15) vs. 117 (±18), p=0.5; 2) Daytime DBP 80 (±12) vs. 81 (±13), p=0.5 and at nighttime 68 (±15) vs. 68 (±15), p=0.8. Conclusions: This is the rst study to assess the chronological changes of BP before AF. Within 60 minutes before AF episodes the relative individual daytime and nighttime systolic BP and the relative individual nighttime diastolic BP increase. This, however, does not transfer to a difference in absolute BP values
Kardiovaskulinės sistemos rodiklių sąsajos su prieširdžių virpėjimu tyrimas - santrauka anglų kalba.
No full textBackground. The majority of paroxysmal atrial fibrillation (AF) cases are caused by primary arterial hypertension (PAH). Identifying the patients with an increased risk of the arrhythmia in this population would allow us to prevent AF and its complications. Aim. To define the cardiovascular factors that would allow to identify patients with paroxysmal AF or an increased risk of the arrhythmia in the population of patients with PAH. Methods. In a PAH population two groups were compared: patients with paroxysmal AF (n=68) and patients without episodes of the arrhythmia (n=65). Blood tests, ultrasound of the heart determining left atrial (LA) function parameters, 24-hour ambulatory ECG and arterial blood pressure monitoring were performed for all the patients. Results. Binary logistic regression analysis revealed that lower LA ejection fraction (p=0.025), LA reservoir strain (p=0.001), LA reservoir strain rate (p<0.001) and higher number of short-run atrial tachyarrhythmia episodes during 24-hour ambulatory ECG monitoring (p=0.013) were linked to paroxysmal AF. Conclusions. In the population of patients with PAH, heart ultrasound parameters of the LA (reservoir strain, reservoir strain rate, and ejection fraction) and the number of short-run atrial tachyarrhythmia episodes during 24-hour ambulatory ECG monitoring can predict paroxysmal atrial fibrillation
Analysis of the link between various cardiovascular factors and atrial fibrillation.
No full textBackground. The majority of paroxysmal atrial fibrillation (AF) cases are caused by primary arterial hypertension (PAH). Identifying the patients with an increased risk of the arrhythmia in this population would allow us to prevent AF and its complications. Aim. To define the cardiovascular factors that would allow to identify patients with paroxysmal AF or an increased risk of the arrhythmia in the population of patients with PAH. Methods. In a PAH population two groups were compared: patients with paroxysmal AF (n=68) and patients without episodes of the arrhythmia (n=65). Blood tests, ultrasound of the heart determining left atrial (LA) function parameters, 24-hour ambulatory ECG and arterial blood pressure monitoring were performed for all the patients. Results. Binary logistic regression analysis revealed that lower LA ejection fraction (p=0.025), LA reservoir strain (p=0.001), LA reservoir strain rate (p<0.001) and higher number of short-run atrial tachyarrhythmia episodes during 24-hour ambulatory ECG monitoring (p=0.013) were linked to paroxysmal AF. Conclusions. In the population of patients with PAH, heart ultrasound parameters of the LA (reservoir strain, reservoir strain rate, and ejection fraction) and the number of short-run atrial tachyarrhythmia episodes during 24-hour ambulatory ECG monitoring can predict paroxysmal atrial fibrillation
Mitralinio vožtuvo paravalvulinių fistulių susidarymo priežasčių nustatymas, jų gydymo metodų paliginimas.
No full textIntroduction: Mitral paravalvular leak (PVL) is well-known complication. Repeat surgery was the only effective therapy. Recently, catheter-based PVL closure has gained global spread. The outcomes for treatment of this complication are unknown. Aim: To compare redo surgery versus surgical transapical catheter-based closure with “purpose specific” device in mitral PVL. Tasks: To determine the incidence of mitral PVL. To establish risk factors for mitral PVL. To establish early and late mortality following mitral valve replacement (MVR). To compare the early effectiveness and safety between conventional redo surgery and surgical transapical catheter-based closure for mitral PVL. Methods and patients: To determine the incidence, risk factors for mitral PVL occurrence, early and late mortality following MVR a cohort of 551 patients underwent comprehensive analysis. To compare the effectiveness and safety between two treatment modalities for mitral PVL a cohort of 73 patients was investigated. These underwent either conventional redo surgery or surgical transapical catheter-based closure procedure. Results: The incidence of mitral PVL at median follow-up of 5.5 years was 6.8 %. The relevant risk factors for the mitral PVL were the surgeon and ischemic etiology of the mitral valve lesion. In hospital (30 days) mortality after MVR was 10.7%. Five-year survival was 75% and 10-year survival was 62%. Patients with transapical catheter-based closure of mitral PVL had similar PVL closure results compared to conventional redo surgery. Also, patients after surgical transapical catheter-based closure experienced less complications compared to conventional redo surgery. Conclusions Surgical transapical catheter-based closure of mitral PVL is not inferior compared to conventional redo surgery in the effectiveness of mitral PVL reduction. Surgical transapical catheter-based closure of mitral PVL is safer in the early postoperative period compared to conventional redo surgery
Incidence and risk factors for mitral paravalvular leak and comparison of the treatment modalities.
No full textIntroduction: Mitral paravalvular leak (PVL) is well-known complication. Repeat surgery was the only effective therapy. Recently, catheter-based PVL closure has gained global spread. The outcomes for treatment of this complication are unknown. Aim: To compare redo surgery versus surgical transapical catheter-based closure with “purpose specific” device in mitral PVL. Tasks: To determine the incidence of mitral PVL. To establish risk factors for mitral PVL. To establish early and late mortality following mitral valve replacement (MVR). To compare the early effectiveness and safety between conventional redo surgery and surgical transapical catheter-based closure for mitral PVL. Methods and patients: To determine the incidence, risk factors for mitral PVL occurrence, early and late mortality following MVR a cohort of 551 patients underwent comprehensive analysis. To compare the effectiveness and safety between two treatment modalities for mitral PVL a cohort of 73 patients was investigated. These underwent either conventional redo surgery or surgical transapical catheter-based closure procedure. Results: The incidence of mitral PVL at median follow-up of 5.5 years was 6.8 %. The relevant risk factors for the mitral PVL were the surgeon and ischemic etiology of the mitral valve lesion. In hospital (30 days) mortality after MVR was 10.7%. Five-year survival was 75% and 10-year survival was 62%. Patients with transapical catheter-based closure of mitral PVL had similar PVL closure results compared to conventional redo surgery. Also, patients after surgical transapical catheter-based closure experienced less complications compared to conventional redo surgery. Conclusions Surgical transapical catheter-based closure of mitral PVL is not inferior compared to conventional redo surgery in the effectiveness of mitral PVL reduction. Surgical transapical catheter-based closure of mitral PVL is safer in the early postoperative period compared to conventional redo surgery
Iki slenkstinio didelio dažnio elektrinio lauko stimuliacijos efektas angiogenezei ir kraujagyslių endotelio augimo veiksnio sintezei kardiomiocituose. Širdies remodeliacija: mechaninio tempimo, slenkstinės ir iki slenkstinės elektrinės stimuliacijos įtaka kardiomiocitams ir simpatinės sistemos neuronams.
No full textTo evaluate growth factors response to various stimulation techniques in the field of neurocardiology. This research asses the influence of electric field and stretching effect on biologically active proteins. In this work the following research tasks are answered: To investigate the effect of sub threshold electrical stimulation on vascular endothelial growth factor regulation in cultured neonatal rat ventricular myocytes. To evaluate the role of autoantibodies in cases of dilated cardiomyopathy, inducing the expression of vascular endothelial growth factor in cardiomyocytes; to evaluate the effect of contraction and the secretion of vascular endothelial growth factor as a cell response to stretching. Investigate the effect of high frequencies, irregular stimulation on vascular myocytes and their nerve growth factor. To evaluate the response of the sympathetic system neurons to mechanical stretching in the evaluation of biologically active substances such as vascular endothelial growth and neuronal growth factors. Up to now, studies have shown that high-frequency threshold or sub-threshold electrical stimulation can lead to the production of biologically active molecules in non-cardiac tissues. Meanwhile, based on this study, we show that viable myocytes can produce bioactive proteins that have a positive effect on cell proliferation and vitality of endothelium cells in vitro
Comparison of minimally invasive epicardial ablation methods of atrial fibrillation treatment.
No full textThis is an observational, retrospective study of 127 patients (79 % males; mean age 52 ± 10 years [range, 23–75 years]) who underwent minimally invasive standalone surgical ablation of paroxysmal, persistent and longstanding persistent AF from 2008 to 2015. Mean follow-up was 60±21 months. Three different devices have been used for the ablation: Cardioblate® Gemini® surgical ablation system; Medtronic, Inc., Minneapolis, MN, USA; COBRA Adhere XL™ ablation system, Estech, Inc, California, CA, USA; AFx FLEX 10 microwave ablation system, Guidant, AFx, Fremont, CA, USA. The absence of arrhythmia was confirmed at 3, 6, and 12 months, and annually thereafter, with 24-hour Holter monitoring. The mean duration of preoperative AF was 6.5 ± 5.4 years. Six (5%) patients had a paroxysmal AF, and 19 patients (15%) had a long-standing persistent AF. Mean left atrial diameter was 4.3±0.8 cm. There were two postoperative strokes (2 %) and three conversions to median sternotomy (2.4%). Permanent pacemakers were implanted in 10 (8%) patients. There were no intra- or postoperative deaths. At 1, 2, 3, 4, and 5 years postoperatively, freedom from AF was 70%, 48%, 41%, 38%, 34%, 32% of patients, respectively. The best results were achieved then bipolar ablation device (Cardioblate® Gemini® surgical ablation system;) was used (χ2 = 12,521, p = 0.0004). At 1, 2, 3, 4, and 5 years postoperatively, freedom from AF was 73%, 58%, 48%, 44%, 42%, 42% of patients, respectively if bipolar ablation device was used.The failure to achieve pulmonary vein isolation (“exit” block) was the only independent predictor of long-term recurrence of AF (HR −3 [95 % CI 1,858 to 8,586], p = 0,001). Conclusions: In the present series, the efficacy of epicardial surgical ablation was similar to that reported previously. The rate of arrhythmia recurrence increased over time. Achieving pulmonary vein isolation is essential to AF elimination
Results and their comparison of invasive atrial fibrillation treatment methods: surgical Mini Maze and percatheter cryoablation.
No full textThis study evaluated and compared the results of two invasive atrial fibrillation treatments - the Mini Maze and percatheter cryoablation. The study evaluated the efficacy of both treatments in maintaining sinus rhythm at 1, 2 and 4 years after the intervention, and at 10 years after Mini Maze surgery. It also compared the safety of Mini Maze surgery and percatheter cryoablation in terms of complication rates. Anatomical parameters of the left atrium and their changes after both interventional procedures were assessed and their relationship with the outcome was investigated. In this study, we investigated the changes in patients' symptoms after invasive treatment, comparing pre- and post-procedure outcomes. The results are unique as there is no literature comparing the outcomes of percatheter and surgical treatments with each other, and there are no long-term results at ten years to assess the effectiveness of the treatment
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