Aleksander Bardyszewski - Academia.edu (original) (raw)
Papers by Aleksander Bardyszewski
Pulmonary vein isolation (PVI) using cryoballoon ablation (CBA) is a well-established method for ... more Pulmonary vein isolation (PVI) using cryoballoon ablation (CBA) is a well-established method for the treatment of atrial fibrillation (AF). As a rule, cryoenergy delivery is preceded by demonstrating full pulmonary vein (PV) occlusion by injecting contrast. Research on CBA without the use of contrast is sparse. The aim of the study was to determine efficacy and safety of a simplified protocol for CBA performed without demonstrating PV occlusion by venography and compare achieved results with those observed in patients undergoing conventional CBA. Methods This was a dual-centre, prospective, nonrandomized study (NCT04344743). The study cohort consisted of consecutive patients with paroxysmal AF, with 4 separate pulmonary veins (PVs), undergoing a first-time CBA. All ablations were performed using a 28-mm cryoballoon catheter (Arctic Front Advance, Medtronic). In the non-contrast (NC) group CBA was performed using standardized protocol without demonstrating PV occlusion by venography ...
EP Europace, 2013
Laserballoon-based pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF) h... more Laserballoon-based pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF) has proven safe and effective. Silent brain lesions after AF ablation detected on magnetic resonance imaging (MRI) have been described for several technologies, but its incidence following laserballoon PVI is unknown. The current study sought to assess the incidence of new asymptomatic brain lesions in patients undergoing laserballoon-based PVI. Methods and results Patients referred for PVI underwent pre-and post-procedural MRI of the brain. A total of 86 patients were enroled into the study (laserballoon group: 44 patients, 15 female, age 63 + 9 years, left atrial (LA) diameter 43 + 5 mm; cryoballoon group: 20 patients, 6 female, age 61 + 9 years, LA diameter 41 + 4 mm; and irrigated radiofrequency (RF) group: 22 patients, 11 female, age 64 + 8 years, LA diameter 43 + 6 mm). There was no statistically significant difference between the groups with regard to new asymptomatic brain lesions detected on post-procedural MRI: 5 of 44 (11.4%) patients in the laserballoon group, 1 of 20 (5.0%) patients in the cryoballoon group, and 4 of 22 (18.2%) patients in the irrigated RF group, respectively. In the laserballoon group, one additional patient with a new cerebral lesion experienced transient diplopia. In a multivariate regression model the only risk factor for asymptomatic new lesions was the CHA 2 DS 2 VASc score. Conclusion Following laserballoon-based PVI, new asymptomatic brain lesions were detected in 11.4% of patients. A higher CHA 2-DS 2 VASc score, but not the ablation technology utilized, was the only associated risk factor.
Journal of Cardiovascular Electrophysiology
JACC: Clinical Electrophysiology
A case of a 51 year old patient with a history of myocardial infarction (MI) and recurrent ventri... more A case of a 51 year old patient with a history of myocardial infarction (MI) and recurrent ventricular tachycardia (VT) is presented. Three months after MI the patient underwent coronary angioplasty and one year later received prophylactic implantable cardioverter-defibrillator (ICD) due to complex ventricular arrhythmias, detected on Holter ECG monitoring, and depressed left ventricular ejection fraction. Later on the patient started to experience palpitations and ICD shocks during physical activity (cycling). Interrogation of the ICD memory showed appropriate shocks due to slow (160 betas/min) VT. The device was reprogrammed and new antitachycardia pacing (ATP) algorithms were enabled, however, it occurred proarrhythmic due to the ATP-induced acceleration of VT rate. Finally, in April 2005 he received 37 appropriate ICD shocks during a few hours. The patient was selected for RF ablation and underwent successful procedure with the use of the electro-anatomical CARTO mapping system
A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, w... more A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, was referred to our department for electrophysiological study. Burst pacing from high right atrium using a cycle length of 350 ms induced a slow-fast atrioventricular nodal reentry tachycardia. We excluded the presence of accessory atrioventricular tracts. During tachycardia a constant alternans of QRS morphology and cycle length was observed. The cycle length alternans could be due to the presence of three nodal pathways and activation circulating in a figure-of-eight pattern using alternatively two slow pathways as the antegrade arm of the reentry loop. The alternans could also originate from altering decremental properties of a single slow pathway that changed its conduction properties with relation to the length of the preceding cycle. The QRS alternans occurred both during burst pacing and tachycardia. As it was related to the rate and the changing cycle length, we concluded that it ...
JACC: Clinical Electrophysiology
In a good rythm, May 24, 2017
<jats:p> Electrical storm is a life-threatening condition and requires immediate treatment.... more <jats:p> Electrical storm is a life-threatening condition and requires immediate treatment. In most cases ventricular arrhythmia originates from previously formed lesions in the cardiac muscle. Such patients, following the necessary initial treatment, should be forwarded to catheter ablation, which is proven to reduce arrhythmia recurrence and to improve overall morbidity. Along with the technological progress related to electroanatomical mapping the growing role of meticulous substrate mapping and modification for successful ablation is being recognized. </jats:p>
Atypical left atrial flutter may occur as a complication after atrial fibrillation ablation, espe... more Atypical left atrial flutter may occur as a complication after atrial fibrillation ablation, especially when linear and substrate ablation were initially deployed. In such cases, the most effective therapy is radiofrequency ablation, but the procedure can be long lasting and challenging. Use of multielectrode catheters and high-density mapping algorithms together with a conventional electrophysiological approach may shorten and simplify treatment. Case report A 43-year-old woman, after previous ablations for atrial fibrillation and typical atrial flutter, was scheduled for another ablation, due to symptomatic atypical atrial flutter. Echocardiography showed left atrial (LA) diameter within the normal range (40 mm) and normal ejection fraction (65%). Previously the patient underwent circumferential pulmonary vein isolation and linear ablation with lines in the cavo-tricuspid isthmus (CTI), left atrial roof and mitral isthmus groove. During the last ablation, bi-directional block was ...
A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated w... more A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated with RF ablation delivered through coronary sinus is presented. Based on multiple electrophysiological parameters (surface ECG, electroanatomical map collected from the endocardium, bipolar and unipolar endocardial recordings, and unsuccesful ablation attempts from the endocardial side) the tachycardia loop was found to be located epicardially. This allowed for successful ablation approach.
JACC: Clinical Electrophysiology, 2021
OBJECTIVES This multicenter registry aimed to assess the reproducibility and safety of intentiona... more OBJECTIVES This multicenter registry aimed to assess the reproducibility and safety of intentional coronary vein exit and carbon dioxide insufflation to facilitate subxiphoid epicardial access in the setting of ventricular tachycardia ablation. BACKGROUND Epicardial ablation for ventricular tachycardia is not a widespread technique due to the significant potential complications associated with subxiphoid puncture. The first experience in 12 patients showed that intentional coronary vein exit and carbon dioxide insufflation was technically feasible. METHODS A branch of the coronary sinus was cannulated by means of a diagnostic JR4 coronary catheter. Intentional perforation at the distal portion of that branch was performed with a high tip load 0.014-inch angioplasty wire. A microcatheter was advanced over the wire into the pericardial space. Carbon dioxide was then insufflated into the pericardial space, allowing direct visualization of the anterior pericardial space to facilitate subxiphoid puncture. RESULTS Intentional coronary vein exit was attempted in 102 consecutive patients in 16 different centers and successfully completed in 101 patients. Significant pericardial adhesions were confirmed in 3 patients, preventing carbon dioxide insufflation and epicardial ablation. None of the punctures were complicated with inadvertent right ventricular puncture or damage to a coronary artery. Significant bleeding (>80 ml) due to coronary vein exit occurred in 5 patients, without hemodynamic compromise. None of the patients required surgery. CONCLUSIONS Coronary vein exit and carbon dioxide insufflation can be safely and reproducibly achieved to facilitate subxiphoid pericardial access in the setting of ventricular tachycardia ablation.
Journal of Cardiovascular Electrophysiology, 2019
The aim of the study was to provide quantitative data and to look for new landmarks useful during... more 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°p rojections. 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.
In a good rythm, 2016
Zaburzenia rytmu i funkcji układu autonomicznego w przebiegu ostrych i przewlekłych chorób z zaję... more Zaburzenia rytmu i funkcji układu autonomicznego w przebiegu ostrych i przewlekłych chorób z zajęciem prawej komory serca Arrhythmias and autonomic nervous system dysfunction in acute and chronic diseases with right ventricle involvement
Kardiologia Polska, 2006
A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, w... more A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, was referred to our department for electrophysiological study. Burst pacing from high right atrium using a cycle length of 350 ms induced a slow-fast atrioventricular nodal reentry tachycardia. We excluded the presence of accessory atrioventricular tracts. During tachycardia a constant alternans of QRS morphology and cycle length was observed. The cycle length alternans could be due to the presence of three nodal pathways and activation circulating in a figure-of-eight pattern using alternatively two slow pathways as the antegrade arm of the reentry loop. The alternans could also originate from altering decremental properties of a single slow pathway that changed its conduction properties with relation to the length of the preceding cycle. The QRS alternans occurred both during burst pacing and tachycardia. As it was related to the rate and the changing cycle length, we concluded that it could reflect aberration in intraventricular conduction.
In a good rythm, 2015
Streszczenie Nieinfekcyjne, odległe powikłania elektroterapii stanowią istotny problem kliniczny.... more Streszczenie Nieinfekcyjne, odległe powikłania elektroterapii stanowią istotny problem kliniczny. Po powikłaniach infekcyjnych są najpoważniejszymi i najczęściej spotykanymi komplikacjami elektroterapii. Występują z częstością od 5% do 12,4%, powikłania poważne stanowią 75% wszystkich powikłań. Do najczęściej spotykanych należą powikłania związane z budową elektrod i ich obecnością w układzie sercowo-naczyniowym, stanowią one przyczynę ponad 47% wszystkich przezskórnych usunięć elektrod. Pozostałe powikłania występują sporadycznie. Rozwój bezelektrodowych stymulatorów i podskórnych kardiowerterów-defibrylatorów daje nadzieję na wyeliminowanie większości powikłań współczesnej elektroterapii.
Kardiologia polska, 2011
A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated w... more A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated with RF ablation delivered through coronary sinus is presented. Based on multiple electrophysiological parameters (surface ECG, electroanatomical map collected from the endocardium, bipolar and unipolar endocardial recordings, and unsuccesful ablation attempts from the endocardial side) the tachycardia loop was found to be located epicardially. This allowed for successful ablation approach.
Kardiologia polska, 2008
We describe a case of a 77-year-old patient with recurrent, symptomatic ventricular tachycardia w... more We describe a case of a 77-year-old patient with recurrent, symptomatic ventricular tachycardia with a bizarre QRS complex originating from the right ventricle lateral wall. The small region of slow conduction was the critical substrate for initiation and maintenance of ventricular tachycardia, confirmed by a successful one RF application.
Kardiologia polska, 2006
A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, w... more A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, was referred to our department for electrophysiological study. Burst pacing from high right atrium using a cycle length of 350 ms induced a slowfast atrioventricular nodal reentry tachycardia. We excluded the presence of accessory atrioventricular tracts. During tachycardia a constant alternans of QRS morphology and cycle length was observed. The cycle length alternans could be due to the presence of three nodal pathways and activation circulating in a figure-of-eight pattern using alternatively two slow pathways as the antegrade arm of the reentry loop. The alternans could also originate from altering decremental properties of a single slow pathway that changed its conduction properties with relation to the length of the preceding cycle. The QRS alternans occurred both during burst pacing and tachycardia. As it was related to the rate and the changing cycle length, we concluded that it c...
Pulmonary vein isolation (PVI) using cryoballoon ablation (CBA) is a well-established method for ... more Pulmonary vein isolation (PVI) using cryoballoon ablation (CBA) is a well-established method for the treatment of atrial fibrillation (AF). As a rule, cryoenergy delivery is preceded by demonstrating full pulmonary vein (PV) occlusion by injecting contrast. Research on CBA without the use of contrast is sparse. The aim of the study was to determine efficacy and safety of a simplified protocol for CBA performed without demonstrating PV occlusion by venography and compare achieved results with those observed in patients undergoing conventional CBA. Methods This was a dual-centre, prospective, nonrandomized study (NCT04344743). The study cohort consisted of consecutive patients with paroxysmal AF, with 4 separate pulmonary veins (PVs), undergoing a first-time CBA. All ablations were performed using a 28-mm cryoballoon catheter (Arctic Front Advance, Medtronic). In the non-contrast (NC) group CBA was performed using standardized protocol without demonstrating PV occlusion by venography ...
EP Europace, 2013
Laserballoon-based pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF) h... more Laserballoon-based pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF) has proven safe and effective. Silent brain lesions after AF ablation detected on magnetic resonance imaging (MRI) have been described for several technologies, but its incidence following laserballoon PVI is unknown. The current study sought to assess the incidence of new asymptomatic brain lesions in patients undergoing laserballoon-based PVI. Methods and results Patients referred for PVI underwent pre-and post-procedural MRI of the brain. A total of 86 patients were enroled into the study (laserballoon group: 44 patients, 15 female, age 63 + 9 years, left atrial (LA) diameter 43 + 5 mm; cryoballoon group: 20 patients, 6 female, age 61 + 9 years, LA diameter 41 + 4 mm; and irrigated radiofrequency (RF) group: 22 patients, 11 female, age 64 + 8 years, LA diameter 43 + 6 mm). There was no statistically significant difference between the groups with regard to new asymptomatic brain lesions detected on post-procedural MRI: 5 of 44 (11.4%) patients in the laserballoon group, 1 of 20 (5.0%) patients in the cryoballoon group, and 4 of 22 (18.2%) patients in the irrigated RF group, respectively. In the laserballoon group, one additional patient with a new cerebral lesion experienced transient diplopia. In a multivariate regression model the only risk factor for asymptomatic new lesions was the CHA 2 DS 2 VASc score. Conclusion Following laserballoon-based PVI, new asymptomatic brain lesions were detected in 11.4% of patients. A higher CHA 2-DS 2 VASc score, but not the ablation technology utilized, was the only associated risk factor.
Journal of Cardiovascular Electrophysiology
JACC: Clinical Electrophysiology
A case of a 51 year old patient with a history of myocardial infarction (MI) and recurrent ventri... more A case of a 51 year old patient with a history of myocardial infarction (MI) and recurrent ventricular tachycardia (VT) is presented. Three months after MI the patient underwent coronary angioplasty and one year later received prophylactic implantable cardioverter-defibrillator (ICD) due to complex ventricular arrhythmias, detected on Holter ECG monitoring, and depressed left ventricular ejection fraction. Later on the patient started to experience palpitations and ICD shocks during physical activity (cycling). Interrogation of the ICD memory showed appropriate shocks due to slow (160 betas/min) VT. The device was reprogrammed and new antitachycardia pacing (ATP) algorithms were enabled, however, it occurred proarrhythmic due to the ATP-induced acceleration of VT rate. Finally, in April 2005 he received 37 appropriate ICD shocks during a few hours. The patient was selected for RF ablation and underwent successful procedure with the use of the electro-anatomical CARTO mapping system
A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, w... more A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, was referred to our department for electrophysiological study. Burst pacing from high right atrium using a cycle length of 350 ms induced a slow-fast atrioventricular nodal reentry tachycardia. We excluded the presence of accessory atrioventricular tracts. During tachycardia a constant alternans of QRS morphology and cycle length was observed. The cycle length alternans could be due to the presence of three nodal pathways and activation circulating in a figure-of-eight pattern using alternatively two slow pathways as the antegrade arm of the reentry loop. The alternans could also originate from altering decremental properties of a single slow pathway that changed its conduction properties with relation to the length of the preceding cycle. The QRS alternans occurred both during burst pacing and tachycardia. As it was related to the rate and the changing cycle length, we concluded that it ...
JACC: Clinical Electrophysiology
In a good rythm, May 24, 2017
<jats:p> Electrical storm is a life-threatening condition and requires immediate treatment.... more <jats:p> Electrical storm is a life-threatening condition and requires immediate treatment. In most cases ventricular arrhythmia originates from previously formed lesions in the cardiac muscle. Such patients, following the necessary initial treatment, should be forwarded to catheter ablation, which is proven to reduce arrhythmia recurrence and to improve overall morbidity. Along with the technological progress related to electroanatomical mapping the growing role of meticulous substrate mapping and modification for successful ablation is being recognized. </jats:p>
Atypical left atrial flutter may occur as a complication after atrial fibrillation ablation, espe... more Atypical left atrial flutter may occur as a complication after atrial fibrillation ablation, especially when linear and substrate ablation were initially deployed. In such cases, the most effective therapy is radiofrequency ablation, but the procedure can be long lasting and challenging. Use of multielectrode catheters and high-density mapping algorithms together with a conventional electrophysiological approach may shorten and simplify treatment. Case report A 43-year-old woman, after previous ablations for atrial fibrillation and typical atrial flutter, was scheduled for another ablation, due to symptomatic atypical atrial flutter. Echocardiography showed left atrial (LA) diameter within the normal range (40 mm) and normal ejection fraction (65%). Previously the patient underwent circumferential pulmonary vein isolation and linear ablation with lines in the cavo-tricuspid isthmus (CTI), left atrial roof and mitral isthmus groove. During the last ablation, bi-directional block was ...
A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated w... more A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated with RF ablation delivered through coronary sinus is presented. Based on multiple electrophysiological parameters (surface ECG, electroanatomical map collected from the endocardium, bipolar and unipolar endocardial recordings, and unsuccesful ablation attempts from the endocardial side) the tachycardia loop was found to be located epicardially. This allowed for successful ablation approach.
JACC: Clinical Electrophysiology, 2021
OBJECTIVES This multicenter registry aimed to assess the reproducibility and safety of intentiona... more OBJECTIVES This multicenter registry aimed to assess the reproducibility and safety of intentional coronary vein exit and carbon dioxide insufflation to facilitate subxiphoid epicardial access in the setting of ventricular tachycardia ablation. BACKGROUND Epicardial ablation for ventricular tachycardia is not a widespread technique due to the significant potential complications associated with subxiphoid puncture. The first experience in 12 patients showed that intentional coronary vein exit and carbon dioxide insufflation was technically feasible. METHODS A branch of the coronary sinus was cannulated by means of a diagnostic JR4 coronary catheter. Intentional perforation at the distal portion of that branch was performed with a high tip load 0.014-inch angioplasty wire. A microcatheter was advanced over the wire into the pericardial space. Carbon dioxide was then insufflated into the pericardial space, allowing direct visualization of the anterior pericardial space to facilitate subxiphoid puncture. RESULTS Intentional coronary vein exit was attempted in 102 consecutive patients in 16 different centers and successfully completed in 101 patients. Significant pericardial adhesions were confirmed in 3 patients, preventing carbon dioxide insufflation and epicardial ablation. None of the punctures were complicated with inadvertent right ventricular puncture or damage to a coronary artery. Significant bleeding (>80 ml) due to coronary vein exit occurred in 5 patients, without hemodynamic compromise. None of the patients required surgery. CONCLUSIONS Coronary vein exit and carbon dioxide insufflation can be safely and reproducibly achieved to facilitate subxiphoid pericardial access in the setting of ventricular tachycardia ablation.
Journal of Cardiovascular Electrophysiology, 2019
The aim of the study was to provide quantitative data and to look for new landmarks useful during... more 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°p rojections. 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.
In a good rythm, 2016
Zaburzenia rytmu i funkcji układu autonomicznego w przebiegu ostrych i przewlekłych chorób z zaję... more Zaburzenia rytmu i funkcji układu autonomicznego w przebiegu ostrych i przewlekłych chorób z zajęciem prawej komory serca Arrhythmias and autonomic nervous system dysfunction in acute and chronic diseases with right ventricle involvement
Kardiologia Polska, 2006
A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, w... more A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, was referred to our department for electrophysiological study. Burst pacing from high right atrium using a cycle length of 350 ms induced a slow-fast atrioventricular nodal reentry tachycardia. We excluded the presence of accessory atrioventricular tracts. During tachycardia a constant alternans of QRS morphology and cycle length was observed. The cycle length alternans could be due to the presence of three nodal pathways and activation circulating in a figure-of-eight pattern using alternatively two slow pathways as the antegrade arm of the reentry loop. The alternans could also originate from altering decremental properties of a single slow pathway that changed its conduction properties with relation to the length of the preceding cycle. The QRS alternans occurred both during burst pacing and tachycardia. As it was related to the rate and the changing cycle length, we concluded that it could reflect aberration in intraventricular conduction.
In a good rythm, 2015
Streszczenie Nieinfekcyjne, odległe powikłania elektroterapii stanowią istotny problem kliniczny.... more Streszczenie Nieinfekcyjne, odległe powikłania elektroterapii stanowią istotny problem kliniczny. Po powikłaniach infekcyjnych są najpoważniejszymi i najczęściej spotykanymi komplikacjami elektroterapii. Występują z częstością od 5% do 12,4%, powikłania poważne stanowią 75% wszystkich powikłań. Do najczęściej spotykanych należą powikłania związane z budową elektrod i ich obecnością w układzie sercowo-naczyniowym, stanowią one przyczynę ponad 47% wszystkich przezskórnych usunięć elektrod. Pozostałe powikłania występują sporadycznie. Rozwój bezelektrodowych stymulatorów i podskórnych kardiowerterów-defibrylatorów daje nadzieję na wyeliminowanie większości powikłań współczesnej elektroterapii.
Kardiologia polska, 2011
A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated w... more A case of a 58 year-old man with epicardially located reentrant ventricular tachycardia treated with RF ablation delivered through coronary sinus is presented. Based on multiple electrophysiological parameters (surface ECG, electroanatomical map collected from the endocardium, bipolar and unipolar endocardial recordings, and unsuccesful ablation attempts from the endocardial side) the tachycardia loop was found to be located epicardially. This allowed for successful ablation approach.
Kardiologia polska, 2008
We describe a case of a 77-year-old patient with recurrent, symptomatic ventricular tachycardia w... more We describe a case of a 77-year-old patient with recurrent, symptomatic ventricular tachycardia with a bizarre QRS complex originating from the right ventricle lateral wall. The small region of slow conduction was the critical substrate for initiation and maintenance of ventricular tachycardia, confirmed by a successful one RF application.
Kardiologia polska, 2006
A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, w... more A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, was referred to our department for electrophysiological study. Burst pacing from high right atrium using a cycle length of 350 ms induced a slowfast atrioventricular nodal reentry tachycardia. We excluded the presence of accessory atrioventricular tracts. During tachycardia a constant alternans of QRS morphology and cycle length was observed. The cycle length alternans could be due to the presence of three nodal pathways and activation circulating in a figure-of-eight pattern using alternatively two slow pathways as the antegrade arm of the reentry loop. The alternans could also originate from altering decremental properties of a single slow pathway that changed its conduction properties with relation to the length of the preceding cycle. The QRS alternans occurred both during burst pacing and tachycardia. As it was related to the rate and the changing cycle length, we concluded that it c...