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Catheter ablation of atrial fibrillation in patients with left ventricular systolic dysfunction: a systematic review and meta-analysis

M. Anselmino, M. Matta, F. D'Ascenzo, TJ. Bunch, RJ. Schilling, RJ. Hunter, C. Pappone, T. Neumann, G. Noelker, M. Fiala, E. Bertaglia, A. Frontera, E. Duncan, C. Nalliah, P. Jais, R. Weerasooriya, JM. Kalman, F. Gaita,

. 2014 ; 7 (6) : 1011-8. (Arrhythmia and electrophysiology)

Language English Country United States

Document type Journal Article, Meta-Analysis, Review

Persistent link   https://www.medvik.cz/link/bmc15014044

BACKGROUND: Catheter ablation of atrial fibrillation (AFCA) is an established therapeutic option for rhythm control in symptomatic patients. Its efficacy and safety among patients with left ventricular systolic dysfunction is based on small populations, and data concerning long-term outcome are limited. We performed this meta-analysis to assess safety and long-term outcome of AFCA in patients with left ventricular systolic dysfunction, to evaluate predictors of recurrence and impact on left ventricular function. METHODS AND RESULTS: A systematic review was conducted in MEDLINE/PubMed and Cochrane Library. Randomized controlled trials, clinical trials, and observational studies including patients with left ventricular systolic dysfunction undergoing AFCA were included. Twenty-six studies were selected, including 1838 patients. Mean follow-up was 23 (95% confidence interval, 18-40) months. Overall complication rate was 4.2% (3.6%-4.8%). Efficacy in maintaining sinus rhythm at follow-up end was 60% (54%-67%). Meta-regression analysis revealed that time since first atrial fibrillation (P=0.030) and heart failure (P=0.045) diagnosis related to higher, whereas absence of known structural heart disease (P=0.003) to lower incidence of atrial fibrillation recurrences. Left ventricular ejection fraction improved significantly during follow-up by 13% (P<0.001), with a significant reduction of patients presenting an ejection fraction <35% (P<0.001). N-terminal pro-brain natriuretic peptide blood levels decreased by 620 pg/mL (P<0.001). CONCLUSIONS: AFCA efficacy in patients with impaired left ventricular systolic function improves when performed early in the natural history of atrial fibrillation and heart failure. AFCA provides long-term benefits on left ventricular function, significantly reducing the number of patients with severely impaired systolic function.

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$a Anselmino, Matteo $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.). $7 gn_A_00007212
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$a Catheter ablation of atrial fibrillation in patients with left ventricular systolic dysfunction: a systematic review and meta-analysis / $c M. Anselmino, M. Matta, F. D'Ascenzo, TJ. Bunch, RJ. Schilling, RJ. Hunter, C. Pappone, T. Neumann, G. Noelker, M. Fiala, E. Bertaglia, A. Frontera, E. Duncan, C. Nalliah, P. Jais, R. Weerasooriya, JM. Kalman, F. Gaita,
520    9_
$a BACKGROUND: Catheter ablation of atrial fibrillation (AFCA) is an established therapeutic option for rhythm control in symptomatic patients. Its efficacy and safety among patients with left ventricular systolic dysfunction is based on small populations, and data concerning long-term outcome are limited. We performed this meta-analysis to assess safety and long-term outcome of AFCA in patients with left ventricular systolic dysfunction, to evaluate predictors of recurrence and impact on left ventricular function. METHODS AND RESULTS: A systematic review was conducted in MEDLINE/PubMed and Cochrane Library. Randomized controlled trials, clinical trials, and observational studies including patients with left ventricular systolic dysfunction undergoing AFCA were included. Twenty-six studies were selected, including 1838 patients. Mean follow-up was 23 (95% confidence interval, 18-40) months. Overall complication rate was 4.2% (3.6%-4.8%). Efficacy in maintaining sinus rhythm at follow-up end was 60% (54%-67%). Meta-regression analysis revealed that time since first atrial fibrillation (P=0.030) and heart failure (P=0.045) diagnosis related to higher, whereas absence of known structural heart disease (P=0.003) to lower incidence of atrial fibrillation recurrences. Left ventricular ejection fraction improved significantly during follow-up by 13% (P<0.001), with a significant reduction of patients presenting an ejection fraction <35% (P<0.001). N-terminal pro-brain natriuretic peptide blood levels decreased by 620 pg/mL (P<0.001). CONCLUSIONS: AFCA efficacy in patients with impaired left ventricular systolic function improves when performed early in the natural history of atrial fibrillation and heart failure. AFCA provides long-term benefits on left ventricular function, significantly reducing the number of patients with severely impaired systolic function.
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$a Matta, Mario $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a D'Ascenzo, Fabrizio $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Bunch, T Jared $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Schilling, Richard J $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Hunter, Ross J $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Pappone, Carlo $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Neumann, Thomas $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Noelker, Georg $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Fiala, Martin $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Bertaglia, Emanuele $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Frontera, Antonio $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Duncan, Edward $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Nalliah, Chrishan $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Jais, Pierre $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Weerasooriya, Rukshen $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Kalman, Jon M $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.).
700    1_
$a Gaita, Fiorenzo $u From the Cardiology Division, Department of Medical Sciences, University of Turin, Turin, Italy (M.A., M.M., F.D.A., F.G.); Department of Cardiology, Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B.); Cardiovascular Biomedical Research Unit, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (R.J.S., R.J.H.); Department of Arrhythmology, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (C.P.); Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim (T.N.); Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (G.N.); Department of Cardiology, Heart Centre, Hospital Podlesi as, Třinec, Czech Republic (M.F.); Department of Cardiological, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy (E.B.); Department of Cardiology, Bristol Heart Institute, University Hospital Bristol NHS Trust, Bristol, United Kingdom (A.F., E.D.); Department of Cardiology, Westmead Hospital, Sydney, Australia (C.N.); Department of Cardiology, University of Sydney, Sydney, Australia (C.N.); Department of Cardiac Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France (P.J., R.W.); Department of Cardiology, University of Western Australia, Crawley, Western Australia (R.W.); and Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia (J.M.K.). fiorenzo.gaita@unito.it.
773    0_
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