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Brussels, Belgium

Background Cryoballoon ablation (CBA) (Arctic Front, Medtronic, USA) has proven very effective in achieving pulmonary vein isolation (PVI). Different transseptal (TS) puncture sites might influence CBA procedure. The aim of the present study was to analyze the influence of different TS puncture sites (anterior, medial and posterior) on the acute and midterm outcomes of CBA in a series of patients undergoing PVI for drug resistant AF. Methods and results A total 103 patients (78 males, mean age: 57 ± 13 years) formed the study group. Transseptal punctures were performed in the anterior, medial and posterior portion of the FO in 41 (39.8%), 35 (34%) and 27 (26.2%) patients respectively. We found no statistical significant difference between the various sites of TS puncture in 1) the grade of PV occlusion (p = ns), the rate of PV isolation (p = ns), freedom from AF at a mean 12 month follow-up (p = ns) and complication rates (p = ns). Mean grade of occlusion was slightly lower in the RIPV when puncturing in the posterior FO but did not reach statistical significance. Mean procedural and fluoroscopy times were significantly lower when using the inner lumen mapping catheter (ILMC) (Achieve, Medtronic, USA) than the circular mapping catheter (CMC) (Lasso, Biosense Webster, California, USA) (107.24 mn vs 97.74 (p ≤ 0.001) and 25.7 mn vs 19.2 mn (p ≤ 0.001)). Conclusion Different sites of TS puncture on the horizontal axis of the FO (anterior, medial and posterior) did not influence grades of PV occlusion, rates of isolation, mid-term outcome and rates of complications during CB ablation. © 2013 Elsevier Ireland Ltd. Source

De Asmundis C.,Heart Rhythm Management Center | Brugada P.,Heart Rhythm Management Center
Revista Espanola de Cardiologia Suplementos | Year: 2013

Despite recent progress in the management of cardiovascular disorders generally, and cardiac arrhythmias in particular, sudden cardiac death remains both a problem for the practising clinician and a major public health issue. An estimate for global annual incidence of sudden cardiac death would be in the range of 4 to 5 million cases per year. Information about the causes and mechanisms of the sudden cardiac death syndrome suggests that a specific reduction will require the development of new and multifaceted approaches, including epidemiologic techniques to address risk characteristics specific to the problem; characterisation of triggering events and identification of specific persons at risk for responding adversely to these events; and methods of evaluating outcomes appropriate to the nature of sudden cardiac death. © 2013 Sociedad Española de Cardiología. Source

Sorgente A.,Heart Rhythm Management Center | Sarkozy A.,Heart Rhythm Management Center | Brugada P.,Heart Rhythm Management Center
Journal of Cardiovascular Electrophysiology | Year: 2010

J-Wave Disaapearance After an Episode of Ventricular Fibrillation. Early repolarization (ER) abnormalities in the inferior-lateral leads are a matter of intense scientific debate because of their demonstrated association with Brugada syndrome (BS) and idiopathic ventricular fibrillation (VF). To add fuel to the fire, we present a case in which ER abnormalities are associated with BS but in which, more importantly, they were shown to be transient and strictly correlated with an episode of VF. © 2010 Wiley Periodicals, Inc. Source

de Asmundis C.,Heart Rhythm Management Center | Sorgente A.,Heart Rhythm Management Center | Brugada P.,Heart Rhythm Management Center
Acta Cardiologica | Year: 2012

Brugada syndrome is one of the important causes of sudden cardiac death in young adults. The condition is associated with typical ECG changes in anteroseptal leads V1 and V2 that can be unmasked by various medications, electrolyte disturbances, and even by fever in susceptible individuals. We here report the case of a 22-year-old female admitted to the emergency room with a typical atrial flutter who developed Brugada-like ECG changes after conversion to sinus rhythm following flecainide infusion with subsequent degeneration in ventricular fibrillation. The patient converted to sinus rhythm after external DC shock intervention. At hospital admission she reported no family history of sudden cardiac death, nor syncope or paroxysmal palpitations. The cardiac echocardiographical exam revealed no structural abnormalities and a normal ejection fraction. This case highlights once more the importance of recognising supraventricular arrhythmias or other rhythm disturbances in young healthy patients as the revealing sign of other underlying pathologies. Source

Capulzini L.,Heart Rhythm Management Center | Brugada P.,Heart Rhythm Management Center | Brugada J.,Instituto Clinico Del Torax | Brugada R.,University of Girona
Revista Espanola de Cardiologia | Year: 2010

Historically, left ventricular cardiomyopathy and coronary heart disease have been regarded as the main causes of ventricular arrhythmia and sudden cardiac death. However, within last two decades, arrhythmias originating from the right ventricle have begun to attract the attention of the scientific world for a number of reasons. Ventricular arrhythmias originating from the right ventricle usually affect younger patients and can lead to sudden cardiac death. The pathophysiologic mechanism of these arrhythmias is not fully understood, which can leave room for a range of different interpretations. Moreover, the intriguing world of genetics is increasingly being drawn into the pathogenesis, diagnosis and prognosis of some of these arrhythmias. This review considers the pathogenesis, diagnosis and treatment of arrhythmogenic right ventricular cardiomyopathy or dysplasia (ARVD), Brugada syndrome, right ventricular outflow tract ventricular tachycardia, and arrhythmias in the right side of the heart due to congenital heart disease. In addition, because ventricular arrhythmias associated with right ventricular heart diseases such as Brugada syndrome and ARVD can explain up to 10-30% of sudden cardiac deaths in young adults in the general population and an even greater percentage in young athletes, this article contains a brief analysis of screening tests used before participation in sports, life-style modification, and treatment options for athletes affected by these conduction disorders. © 2010 Sociedad Española de Cardiología. Source

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