• Publikační typ
• dopisy MeSH

• Klíčová slova
• Ablation, Anticoagulation, Arrhythmia, Atrial fibrillation, Atrial flutter, Atrial tachycardia, Catheter ablation, Stroke, Surgical ablation,
• MeSH
• fibrilace síní diagnóza   patofyziologie   chirurgie   MeSH
• katetrizační ablace škodlivé účinky   normy   MeSH
• konsensus MeSH
• kryochirurgie škodlivé účinky   normy   MeSH
• lidé MeSH
• rizikové faktory MeSH
• srdeční katetrizace škodlivé účinky   normy   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• směrnice pro lékařskou praxi MeSH

• Klíčová slova
• Ablation, Anticoagulation, Arrhythmia, Atrial fibrillation, Atrial flutter, Atrial tachycardia, Catheter ablation, Stroke, Surgical ablation,
• MeSH
• fibrilace síní diagnóza   patofyziologie   chirurgie   MeSH
• katetrizační ablace škodlivé účinky   normy   MeSH
• konsensus MeSH
• kryochirurgie škodlivé účinky   normy   MeSH
• lidé MeSH
• rizikové faktory MeSH
• srdeční katetrizace škodlivé účinky   normy   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• směrnice pro lékařskou praxi MeSH

• Klíčová slova
• Ablation, Anticoagulation, Arrhythmia, Atrial fibrillation, Atrial flutter, Atrial tachycardia, Catheter ablation, Stroke, Surgical ablation,
• MeSH
• ablace normy   MeSH
• fibrilace síní chirurgie   MeSH
• kardiologie * MeSH
• katetrizační ablace normy   MeSH
• konsensuální konference jako téma * MeSH
• lidé MeSH
• převodní systém srdeční chirurgie   MeSH
• společnosti lékařské * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• zprávy MeSH

• Klíčová slova
• Ablation, Anticoagulation, Arrhythmia, Atrial fibrillation, Atrial flutter, Atrial tachycardia, Catheter ablation, Stroke, Surgical ablation,
• MeSH
• fibrilace síní diagnóza   patofyziologie   chirurgie   MeSH
• kardiochirurgické výkony normy   MeSH
• katetrizační ablace normy   MeSH
• konsensus MeSH
• lidé MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• AAD, antiarrhythmic drug, AF, atrial fibrillation, AFL, atrial flutter, Ablation, Anticoagulation, Arrhythmia, Atrial fibrillation, Atrial flutter, Atrial tachycardia, CB, cryoballoon, CFAE, complex fractionated atrial electrogram, Catheter ablation, LA, left atrial, LAA, left atrial appendage, LGE, late gadolinium-enhanced, LOE, level of evidence, MRI, magnetic resonance imaging, OAC, oral anticoagulation, RF, radiofrequency, Stroke, Surgical ablation,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinical benefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volume center focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. METHODS: Consecutive patients who underwent catheter ablation for AF between January 2001 and December 2016 were analysed. A total population of 3197 patients was dichotomized by the age of 70 years (394 elderly vs. 2803 younger subjects). Patients were followed in terms of arrhythmia status and survival for a median period of 18 vs. 21 and 35 vs. 57 months, respectively. RESULTS: Elderly patients were more frequently females (49% vs. 29%, P < 0.0001), had a history of hypertension (79% vs. 57%, P < 0.0001), diabetes (16% vs. 11%, P < 0.01), stroke (9% vs. 6%, P < 0.01), coronary/peripheral artery disease (14% vs. 8%, P < 0.0001), and CHA2DS2-VASc score (3.1 ± 1.3 vs. 1.5 ± 1.2 s, P < 0.0001). Major complications were more frequent in elderly (5.3% vs. 3.2%, P = 0.03); however, this difference was driven by vascular complications (3.6% vs. 1.9%, P = 0.04). There were comparable rates of cerebrovascular (0.3 vs. 0.3%) or nonvascular complications (1.8 vs. 1.2%). Good arrhythmia control was inferior in elderly patients as compared with the rest of the cohort, both without and with antiarrhythmic drugs: 44.2% vs. 58.2% (P < 0.0001) and 78.2 vs. 83.2% (P < 0.01), respectively. Poor arrhythmia control was associated with relative risk of all-cause mortality of 2.7 (95% CI: 1.1-6.4) in elderly patients and 1.4 (95% CI: 0.9-2.0) in younger subjects. CONCLUSIONS: Catheter ablation for AF in elderly patients is safe although somewhat less effective. Good arrhythmia control is associated with better survival, especially in elderly patients.

• Klíčová slova
• Atrial fibrillation, Catheter ablation, Complications, The elderly,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Prevalence of atrial fibrillation (AF) increases with age. Radiofrequency catheter ablation (RFCA) is an established treatment option superior to antiarrhythmics (AAs). In this study, we investigated safety and efficacy of RFCA of AF in octogenarians. METHODS: From our database, we extracted procedural and follow-up data for patients ≥ 80 years with symptomatic AF undergoing RFCA and compared this population to RFCA patients ≤ 50 years. All patients underwent pulmonary vein isolation (PVI) supplemented by linear lesions in PVI-nonresponders. Arrhythmia-free survival was assessed using seven day Holter every three months post procedure. All patients completed their 12 months follow-up. RESULTS: Fifty patients aged ≥ 80 years (80.5 ± 1.6 years) were compared to 259 patients aged ≤ 50 years (43.5 ± 5.5 years). The RFCA complication rate did not vary between groups. No differences in procedural characteristics were seen after being analyzed by type of AF. Among patients with paroxysmal AF, 71.4% octogenarian vs. 84.7% young patients was free of any arrhythmia, without AAs, after single procedure. For non-paroxysmal AF, arrhythmia-free survival without AAs, was considerably lower (58.6% octogenarians vs. 81.2% younger patients, P = 0.023). If AAs were used, arrhythmia-free survival for paroxysmal AF increased to 90.5% and 92.1% in octogenarians and younger patients, respectively; and in non-paroxysmal AF it increased to 79.3% vs. 88.4%. CONCLUSIONS: RFCA is a safe and effective strategy to achieve normal sinus rhythm in a highly selected group of octogenarians. Paroxysmal AF ablation in octogenarians has similar clinical effectiveness as that seen in much younger patients. Non-paroxysmal AF ablation has lower, but still reasonable clinical effectiveness.

• Klíčová slova
• Atrial fibrillation, Catheter ablation, Effectiveness, Octogenarians, Safety, The elderly,
• Publikační typ
• časopisecké články MeSH

Radiofrequency catheter ablation has become the treatment of choice for atrial fibrillation (AF) that does not respond to antiarrhythmic drug therapy. During the procedure, fluoroscopy imaging is still considered essential to visualise catheters in real-time. However, radiation is often ignored by physicians since it is invisible and the long-term risks are underestimated. In this respect, it must be emphasised that radiation exposure has various potentially harmful effects, such as acute skin injury, malignancies and genetic disease, both to patients and physicians. For this reason, every electrophysiologist should be aware of the problem and should learn how to decrease radiation exposure by both changing the setting of the system and using complementary imaging technologies. In this review, we aim to discuss the basics of X-ray exposure and suggest practical instructions for how to reduce radiation dosage during AF ablation procedures.

• Klíčová slova
• Atrial fibrillation, fluoroscopy, imaging technology, radiation exposure, radiofrequency ablation,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Catheter ablation of persistent atrial fibrillation yields an unsatisfactorily high number of failures. The hybrid approach has recently emerged as a technique that overcomes the limitations of both surgical and catheter procedures alone. METHODS AND RESULTS: We investigated the sequential (staged) hybrid method, which consists of a surgical thoracoscopic radiofrequency ablation procedure followed by radiofrequency catheter ablation 6 to 8 weeks later using the CARTO 3 mapping system. Fifty consecutive patients (mean age 62±7 years, 32 males) with long-standing persistent atrial fibrillation (41±34 months) and a dilated left atrium (>45 mm) were included and prospectively followed in an unblinded registry. During the electrophysiological part of the study, all 4 pulmonary veins were found to be isolated in 36 (72%) patients and a complete box-lesion was confirmed in 14 (28%) patients. All gaps were successfully re-ablated. Twelve months after the completed hybrid ablation, 47 patients (94%) were in normal sinus rhythm (4 patients with paroxysmal atrial fibrillation required propafenone and 1 patient underwent a redo catheter procedure). The majority of arrhythmias recurred during the first 3 months. Beyond 12 months, there were no arrhythmia recurrences detected. The surgical part of the procedure was complicated by 7 (13.7%) major complications, while no serious adverse events were recorded during the radiofrequency catheter part of the procedure. CONCLUSIONS: The staged hybrid epicardial-endocardial treatment of long-standing persistent atrial fibrillation seems to be extremely effective in maintenance of normal sinus rhythm compared to radiofrequency catheter or surgical ablation alone. Epicardial ablation alone cannot guarantee durable transmural lesions. CLINICAL TRIAL REGISTRATION: URL: www.ablace.cz Unique identifier: cz-060520121617.

• Klíčová slova
• hybrid approach, persistent atrial fibrillation, radiofrequency ablation, sequential, surgical treatment,
• MeSH
• antiarytmika terapeutické užití   MeSH
• časové faktory MeSH
• elektrofyziologické techniky kardiologické MeSH
• endokard patofyziologie   chirurgie   MeSH
• fibrilace síní diagnóza   patofyziologie   chirurgie   MeSH
• Kaplanův-Meierův odhad MeSH
• katetrizační ablace škodlivé účinky   metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• perikard patofyziologie   chirurgie   MeSH
• přežití bez známek nemoci MeSH
• prospektivní studie MeSH
• recidiva MeSH
• registrace MeSH
• reoperace MeSH
• senioři MeSH
• venae pulmonales patofyziologie   chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antiarytmika MeSH