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Publisher: Oxford University Press   (Total: 396 journals)

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Showing 1 - 200 of 396 Journals sorted alphabetically
ACS Symposium Series     Full-text available via subscription   (SJR: 0.189, CiteScore: 0)
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.79, CiteScore: 2)
Adaptation     Hybrid Journal   (Followers: 9, SJR: 0.143, CiteScore: 0)
Advances in Nutrition     Hybrid Journal   (Followers: 50, SJR: 2.196, CiteScore: 5)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.434, CiteScore: 1)
African Affairs     Hybrid Journal   (Followers: 65, SJR: 1.869, CiteScore: 2)
Age and Ageing     Hybrid Journal   (Followers: 90, SJR: 1.989, CiteScore: 4)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 18, SJR: 1.376, CiteScore: 3)
American Entomologist     Full-text available via subscription   (Followers: 7)
American Historical Review     Hybrid Journal   (Followers: 156, SJR: 0.467, CiteScore: 1)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 42, SJR: 2.113, CiteScore: 3)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 165, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 188, SJR: 2.713, CiteScore: 3)
American J. of Hypertension     Hybrid Journal   (Followers: 25, SJR: 1.322, CiteScore: 3)
American J. of Jurisprudence     Hybrid Journal   (Followers: 19, SJR: 0.281, CiteScore: 1)
American J. of Legal History     Full-text available via subscription   (Followers: 8, SJR: 0.116, CiteScore: 0)
American Law and Economics Review     Hybrid Journal   (Followers: 27, SJR: 1.053, CiteScore: 1)
American Literary History     Hybrid Journal   (Followers: 16, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 22, SJR: 1.038, CiteScore: 1)
Animal Frontiers     Hybrid Journal   (Followers: 1)
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 15, SJR: 1.423, CiteScore: 3)
Annals of Botany     Hybrid Journal   (Followers: 36, SJR: 1.721, CiteScore: 4)
Annals of Oncology     Hybrid Journal   (Followers: 46, SJR: 5.599, CiteScore: 9)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 10, SJR: 0.722, CiteScore: 1)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 32, SJR: 0.728, CiteScore: 2)
AoB Plants     Open Access   (Followers: 4, SJR: 1.28, CiteScore: 3)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 19, SJR: 0.858, CiteScore: 2)
Applied Linguistics     Hybrid Journal   (Followers: 56, SJR: 2.987, CiteScore: 3)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 1.241, CiteScore: 1)
Arbitration Intl.     Full-text available via subscription   (Followers: 20)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 14)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 30, SJR: 0.731, CiteScore: 2)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 3)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 43, SJR: 0.146, CiteScore: 0)
Behavioral Ecology     Hybrid Journal   (Followers: 52, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 315, SJR: 6.14, CiteScore: 8)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 9, SJR: 1.446, CiteScore: 3)
Biometrika     Hybrid Journal   (Followers: 20, SJR: 3.485, CiteScore: 2)
BioScience     Hybrid Journal   (Followers: 29, SJR: 2.754, CiteScore: 4)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.146, CiteScore: 0)
Biostatistics     Hybrid Journal   (Followers: 17, SJR: 1.553, CiteScore: 2)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 175, SJR: 2.115, CiteScore: 3)
BJA Education     Hybrid Journal   (Followers: 65)
Brain     Hybrid Journal   (Followers: 68, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 49, SJR: 2.505, CiteScore: 5)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 3, SJR: 2.15, CiteScore: 3)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 35, SJR: 2.161, CiteScore: 2)
British J. of Aesthetics     Hybrid Journal   (Followers: 25, SJR: 0.508, CiteScore: 1)
British J. of Criminology     Hybrid Journal   (Followers: 590, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 87, SJR: 1.019, CiteScore: 2)
British Medical Bulletin     Hybrid Journal   (Followers: 6, SJR: 1.355, CiteScore: 3)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 32)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 65, SJR: 0.764, CiteScore: 2)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 11, SJR: 2.438, CiteScore: 4)
Cambridge Quarterly     Hybrid Journal   (Followers: 9, SJR: 0.104, CiteScore: 0)
Capital Markets Law J.     Hybrid Journal   (Followers: 2, SJR: 0.222, CiteScore: 0)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.135, CiteScore: 5)
Cardiovascular Research     Hybrid Journal   (Followers: 14, SJR: 3.002, CiteScore: 5)
Cerebral Cortex     Hybrid Journal   (Followers: 46, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 18, SJR: 0.483, CiteScore: 1)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.42, CiteScore: 3)
Children and Schools     Hybrid Journal   (Followers: 5, SJR: 0.246, CiteScore: 0)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 4, SJR: 0.412, CiteScore: 0)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 22, SJR: 0.329, CiteScore: 0)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 10, SJR: 1.392, CiteScore: 2)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 10, SJR: 0.183, CiteScore: 0)
Classical Receptions J.     Hybrid Journal   (Followers: 27, SJR: 0.123, CiteScore: 0)
Clean Energy     Open Access   (Followers: 1)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 67, SJR: 5.051, CiteScore: 5)
Communication Theory     Hybrid Journal   (Followers: 23, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 27, SJR: 0.222, CiteScore: 1)
Community Development J.     Hybrid Journal   (Followers: 27, SJR: 0.268, CiteScore: 1)
Computer J.     Hybrid Journal   (Followers: 9, SJR: 0.319, CiteScore: 1)
Conservation Physiology     Open Access   (Followers: 2, SJR: 1.818, CiteScore: 3)
Contemporary Women's Writing     Hybrid Journal   (Followers: 9, SJR: 0.121, CiteScore: 0)
Contributions to Political Economy     Hybrid Journal   (Followers: 5, SJR: 0.906, CiteScore: 1)
Critical Values     Full-text available via subscription  
Current Developments in Nutrition     Open Access   (Followers: 2)
Current Legal Problems     Hybrid Journal   (Followers: 29)
Current Zoology     Full-text available via subscription   (Followers: 3, SJR: 1.164, CiteScore: 2)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 8, SJR: 1.791, CiteScore: 3)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 14, SJR: 0.259, CiteScore: 1)
Diplomatic History     Hybrid Journal   (Followers: 20, SJR: 0.45, CiteScore: 1)
DNA Research     Open Access   (Followers: 5, SJR: 2.866, CiteScore: 6)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 4)
Early Music     Hybrid Journal   (Followers: 16, SJR: 0.139, CiteScore: 0)
Economic Policy     Hybrid Journal   (Followers: 41, SJR: 3.584, CiteScore: 3)
ELT J.     Hybrid Journal   (Followers: 24, SJR: 0.942, CiteScore: 1)
English Historical Review     Hybrid Journal   (Followers: 54, SJR: 0.612, CiteScore: 1)
English: J. of the English Association     Hybrid Journal   (Followers: 14, SJR: 0.1, CiteScore: 0)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.818, CiteScore: 2)
Environmental Epigenetics     Open Access   (Followers: 3)
Environmental History     Hybrid Journal   (Followers: 27, SJR: 0.408, CiteScore: 1)
EP-Europace     Hybrid Journal   (Followers: 2, SJR: 2.748, CiteScore: 4)
Epidemiologic Reviews     Hybrid Journal   (Followers: 9, SJR: 4.505, CiteScore: 8)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 17, SJR: 0.113, CiteScore: 0)
European Heart J.     Hybrid Journal   (Followers: 59, SJR: 9.315, CiteScore: 9)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 9, SJR: 3.625, CiteScore: 3)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 1)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. : Case Reports     Open Access  
European Heart J. Supplements     Hybrid Journal   (Followers: 8, SJR: 0.223, CiteScore: 0)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9, SJR: 1.681, CiteScore: 2)
European J. of Intl. Law     Hybrid Journal   (Followers: 191, SJR: 0.694, CiteScore: 1)
European J. of Orthodontics     Hybrid Journal   (Followers: 4, SJR: 1.279, CiteScore: 2)
European J. of Public Health     Hybrid Journal   (Followers: 20, SJR: 1.36, CiteScore: 2)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 10, SJR: 1.172, CiteScore: 2)
European Review of Economic History     Hybrid Journal   (Followers: 30, SJR: 0.702, CiteScore: 1)
European Sociological Review     Hybrid Journal   (Followers: 42, SJR: 2.728, CiteScore: 3)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Family Practice     Hybrid Journal   (Followers: 16, SJR: 1.018, CiteScore: 2)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 14, SJR: 1.492, CiteScore: 4)
Fems Microbiology Letters     Hybrid Journal   (Followers: 27, SJR: 0.79, CiteScore: 2)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 31, SJR: 7.063, CiteScore: 13)
Fems Yeast Research     Hybrid Journal   (Followers: 14, SJR: 1.308, CiteScore: 3)
Food Quality and Safety     Open Access   (Followers: 1)
Foreign Policy Analysis     Hybrid Journal   (Followers: 24, SJR: 1.425, CiteScore: 1)
Forest Science     Hybrid Journal   (Followers: 7, SJR: 0.89, CiteScore: 2)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 1.133, CiteScore: 3)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.104, CiteScore: 0)
French History     Hybrid Journal   (Followers: 33, SJR: 0.118, CiteScore: 0)
French Studies     Hybrid Journal   (Followers: 20, SJR: 0.148, CiteScore: 0)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.152, CiteScore: 0)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 13, SJR: 2.578, CiteScore: 4)
Geophysical J. Intl.     Hybrid Journal   (Followers: 35, SJR: 1.506, CiteScore: 3)
German History     Hybrid Journal   (Followers: 23, SJR: 0.161, CiteScore: 0)
GigaScience     Open Access   (Followers: 4, SJR: 5.022, CiteScore: 7)
Global Summitry     Hybrid Journal   (Followers: 1)
Glycobiology     Hybrid Journal   (Followers: 13, SJR: 1.493, CiteScore: 3)
Health and Social Work     Hybrid Journal   (Followers: 56, SJR: 0.388, CiteScore: 1)
Health Education Research     Hybrid Journal   (Followers: 15, SJR: 0.854, CiteScore: 2)
Health Policy and Planning     Hybrid Journal   (Followers: 25, SJR: 1.512, CiteScore: 2)
Health Promotion Intl.     Hybrid Journal   (Followers: 22, SJR: 0.812, CiteScore: 2)
History Workshop J.     Hybrid Journal   (Followers: 31, SJR: 1.278, CiteScore: 1)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 28, SJR: 0.105, CiteScore: 0)
Human Communication Research     Hybrid Journal   (Followers: 15, SJR: 2.146, CiteScore: 3)
Human Molecular Genetics     Hybrid Journal   (Followers: 8, SJR: 3.555, CiteScore: 5)
Human Reproduction     Hybrid Journal   (Followers: 72, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access  
Human Reproduction Update     Hybrid Journal   (Followers: 18, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 59, SJR: 0.756, CiteScore: 1)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 54, SJR: 1.591, CiteScore: 3)
ICSID Review     Hybrid Journal   (Followers: 11)
ILAR J.     Hybrid Journal   (Followers: 2, SJR: 1.732, CiteScore: 4)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.679, CiteScore: 1)
IMA J. of Management Mathematics     Hybrid Journal   (SJR: 0.538, CiteScore: 1)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.496, CiteScore: 1)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 1.987, CiteScore: 2)
Industrial and Corporate Change     Hybrid Journal   (Followers: 10, SJR: 1.792, CiteScore: 2)
Industrial Law J.     Hybrid Journal   (Followers: 37, SJR: 0.249, CiteScore: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 47, SJR: 2.511, CiteScore: 4)
Information and Inference     Free  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 8, SJR: 1.319, CiteScore: 2)
Interacting with Computers     Hybrid Journal   (Followers: 11, SJR: 0.292, CiteScore: 1)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7, SJR: 0.762, CiteScore: 1)
Intl. Affairs     Hybrid Journal   (Followers: 62, SJR: 1.505, CiteScore: 3)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 25)
Intl. Health     Hybrid Journal   (Followers: 6, SJR: 0.851, CiteScore: 2)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 2.167, CiteScore: 4)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 36, SJR: 1.348, CiteScore: 2)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 64, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 242, SJR: 3.969, CiteScore: 5)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 5, SJR: 0.202, CiteScore: 1)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 24, SJR: 0.223, CiteScore: 1)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 10, SJR: 0.285, CiteScore: 1)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.403, CiteScore: 1)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.808, CiteScore: 4)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 11, SJR: 1.545, CiteScore: 1)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 38, SJR: 0.389, CiteScore: 1)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 11, SJR: 0.724, CiteScore: 2)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.168, CiteScore: 1)
Intl. Political Sociology     Hybrid Journal   (Followers: 39, SJR: 1.465, CiteScore: 3)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 23, SJR: 0.401, CiteScore: 1)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 9, SJR: 0.983, CiteScore: 1)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 47, SJR: 2.581, CiteScore: 2)
Intl. Studies Review     Hybrid Journal   (Followers: 25, SJR: 1.201, CiteScore: 1)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 2, SJR: 0.15, CiteScore: 0)
ITNOW     Hybrid Journal   (Followers: 1, SJR: 0.103, CiteScore: 0)
J. of African Economies     Hybrid Journal   (Followers: 17, SJR: 0.533, CiteScore: 1)
J. of American History     Hybrid Journal   (Followers: 46, SJR: 0.297, CiteScore: 1)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 14, SJR: 1.065, CiteScore: 2)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 15, SJR: 2.419, CiteScore: 4)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 5, SJR: 0.585, CiteScore: 1)
J. of Biochemistry     Hybrid Journal   (Followers: 41, SJR: 1.226, CiteScore: 2)
J. of Burn Care & Research     Hybrid Journal   (Followers: 10, SJR: 0.768, CiteScore: 2)
J. of Chromatographic Science     Hybrid Journal   (Followers: 18, SJR: 0.36, CiteScore: 1)
J. of Church and State     Hybrid Journal   (Followers: 11, SJR: 0.139, CiteScore: 0)
J. of Communication     Hybrid Journal   (Followers: 55, SJR: 4.411, CiteScore: 5)
J. of Competition Law and Economics     Hybrid Journal   (Followers: 37, SJR: 0.33, CiteScore: 0)
J. of Complex Networks     Hybrid Journal   (Followers: 2, SJR: 1.05, CiteScore: 4)
J. of Computer-Mediated Communication     Open Access   (Followers: 29, SJR: 2.961, CiteScore: 6)
J. of Conflict and Security Law     Hybrid Journal   (Followers: 12, SJR: 0.402, CiteScore: 0)
J. of Consumer Research     Full-text available via subscription   (Followers: 46, SJR: 5.856, CiteScore: 5)
J. of Crohn's and Colitis     Hybrid Journal   (Followers: 8, SJR: 2.728, CiteScore: 5)

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Journal Cover
EP-Europace
Journal Prestige (SJR): 2.748
Citation Impact (citeScore): 4
Number of Followers: 2  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1099-5129 - ISSN (Online) 1532-2092
Published by Oxford University Press Homepage  [396 journals]
  • 1The future of S-ICD sensing: ‘improve’ significantly increases R:T
           ratio and generates universal device eligibility without impairing vf
           detection
    • Authors: Wiles B; (Presenting Author, Roberts P, Allavatam V, et al.
      Abstract: Background: S-ICD eligibility is determined by an individual’s vector score, with three available sensing vectors; primary (P), secondary (S) and alternate (A). The vector score is a composite measure of signal amplitude and R: T ratio. Eligibility currently requires a single vector to score >100 as lower values confer an unacceptable risk of oversensing. Around 5% of ICD patients have no suitable vector, rising to 13-16% in some patient groups (ACHD, hypertrophic cardiomyopathy). IMPROVE (Integrated Morphology Screening with Personalised Rotation of Vectors) is a novel technique which combines P and A into a personalised vector with optimal R: T ratio. This is achieved through a combination of hierarchical clustering (a morphology-based technique which identifies QRS complexes) and mathematical vector rotation, such that the angle of observation of the vector is varied according to observed morphology. In this study we evaluate IMPROVE programming on both an S-ICD ineligible cohort and assess its effect on VF detection.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy200
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 2QT interval and exercise qt dynamics from 58,852 individuals in UK
           biobank predict ventricular arrhythmias and heart failure
    • Authors: van Duijvenboden S; (Presenting Author, Ramírez J, Orini M, et al.
      Abstract: Introduction: The QT interval from the ECG is widely used to assess ventricular repolarisation, given its prominent role in modulating myocardial vulnerability to malignant arrhythmias and sudden death. Consequently, clinical interest has focused on the prognostic value of resting QT interval and QT adaptation to changing heart rate. However, at present, prognostic data on QT interval and QT dynamics in the general population remain limited. The aim of this work was to investigate the prognostic value of resting QT and QT changes during exercise and recovery from exercise in a large cohort from general population.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy200.001
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 3Mean entropy predicts implantable cardioverter-defibrillator therapy
           using cardiac magnetic resonance texture analysis of scar heterogeneity
    • Authors: Gould J; (Presenting Author, Porter B, Claridge S, et al.
      Abstract: Background: Risk stratification of ventricular arrhythmia remains complex in both ischaemic and non-ischaemic populations.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy200.002
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 21Concurrent increase of sympathetic tone and atrial ectopic activity
           precede the onset of post-operative atrial fibrillation
    • Authors: Ravelli F; (Presenting Author, Masè M, Sinelli S, et al.
      Abstract: Background: Post-operative atrial fibrillation (POAF) is the most common arrhythmic complication of cardiac surgery, occurring in 10-60% of cases with a peak incidence on the second and third postoperative day. Despite the high prevalence, the pathophysiological mechanisms of POAF remain incompletely understood. Several studies have suggested the interplay between autonomic function and ectopic activity as triggering mechanism of POAF, however a thorough, combined analysis of the two factors is lacking. To clarify this aspect, we performed a combined assessment of the time-course of autonomic tone changes and atrial ectopic activity before POAF onset by applying heart rate variability and premature beat analyses to long-term atrial epicardial electrograms.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.002
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 22ECG T-wave predictors of positive ajmaline testing and markers of
           arrhythmic risk in patients with a positive ajmaline test
    • Authors: Srinivasan N; (Presenting Author, Patel K, Dhillon G, et al.
      Abstract: Introduction: The role of ajmaline testing in asymptomatic individuals in order to diagnose Brugada Syndrome (BrS)/Brugada Pattern ECG is much debated. Administration of ajmaline is performed to confirm a diagnosis, stratify risk and provide advice with regard to medication to avoid. However, ajmaline testing has a low pickup rate and within patients who have a positive ajmaline test, only a small number go on to develop ventricular arrhythmia (VA), thus providing challenges in managing the long-term risk of these patients. We aimed to investigate ECG T-wave markers that predict a positive ajmaline test, and also identify markers on the ajmaline positive ECG that predict patients at high risk of future ventricular arrhythmias or events, in order to improve the selection of patients for the test and improve the risk management of ajmaline positive patients.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.003
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 23T-wave morphology restitution predicts arrhythmic risk in the UK biobank
           cohort
    • Authors: Ramírez J; (Presenting Author, van Duijvenboden S, Orini M, et al.
      Abstract: Background: Prospective studies have reported annual sudden cardiac death (SCD) rates of 18-100 per 100, 000 in the general population worldwide. Consequently, enhancement of methods for prediction and prevention are critically important. The TMR index, reflecting the level of variations in the morphology of the T-wave per RR increments, has shown to be a strong arrhythmic risk predictor in chronic heart failure (CHF) patients. However, its predictive value in the general population has never been evaluated. The main objective of this work was to validate the predictive value of TMR in the general population.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.004
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 24Dynamic diastolic activation patterns in haemodynamically unstable VT in
           a chronic porcine infarct model under VA-ECMO support explained by
           detailed analysis of structural infarct anatomy
    • Authors: Whitaker J; (Presenting Author, Kim S, Connolly A, et al.
      Abstract: Background: Post myocardial infarction (MI) ventricular tachycardia (VT) results from altered conduction within viable tissue existing in close proximity to dense scar. Classical descriptions of VT were based on observations of haemodynamically stable VT often made in the context of LV aneurysm. Emergency and secondary prevention therapy for MI has increased the incidence of rapid, haemodynamically unstable VT and reduced the incidence of LV aneurysm, emphasising the need to revisit the mechanistic and structural basis of these haemodynamically unstable VTs.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.005
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 25CMR evaluation of the arrhythmia substrate in patients with atrial
           septal defects
    • Authors: O'Neill L; (Presenting Author, Williams S, Razeghi O, et al.
      Abstract: Introduction: Atrial septal defects (ASDs) are associated with atrial arrhythmias (AAs) however little is known about the arrhythmia substrate in these patients. Left atrial (LA) fibrosis, detected by cardiac MRI (CMR) is well described in patients with atrial fibrillation and structurally normal hearts but fibrosis has not been described in either atria in the ASD cohort. We hypothesised that right atrial (RA) fibrosis is present in patients with ASDs and that the right atrium is important for arrhythmogenesis in this cohort.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.006
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 26A combined MRI and ECG-imaging investigation to determine the
           electrophysiological manifestation of cardiac light-chain and
           transthyretin amyloidosis
    • Authors: Orini M; (Presenting Author, Graham A, Martinez-Naharro A, et al.
      Abstract: Introduction: Cardiac amyloidosis is a disorder characterised by the deposition of abnormal protein fibres (amyloid fibrils) that can lead to heart failure and sudden cardiac death. In recent years, novel cardiac magnetic resonance (CMR) techniques have been developed to quantify the degree of amyloid infiltration and have improved both diagnostic and prognostic accuracy. The electrophysiological (EP) manifestations of cardiac amyloidosis are not well characterised and EP differences between the two most common forms of cardiac amyloidosis, light-chain (AL) and transthyretin (ATTR) amyloidosis, are unknown, which could have implications for sudden cardiac death risk. We conducted a combined CMR and ECG-imaging study in AL and ATTR patients to: (1) Investigate the interaction between structural and EP substrates; (2) Determine whether significant EP differences exist between AL and ATTR; (3) Assess the value of combining ECGi with CMR to correctly classify AL and ATTR.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.007
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 27Outcomes of a nationwide electrocardiographic screening program to
           detect cardiovascular disease in young individuals
    • Authors: Dhutia D; (Presenting Author, Malhotra A, Finnochiaro G, et al.
      Abstract: Background: Evaluation to detect cardiovascular diseases in the young adolescent and adult population is reserved for the minority with symptoms or a family history of cardiovascular disease. There is limited information on the role of cardiovascular screening with electrocardiography (ECG) in a non-select group of young individuals in the general population. We report the diagnostic yield and financial implications of a nationwide screening program including ECG in young individuals in the United Kingdom (UK).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.008
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 28Atrial tachyarrhythmias following percutaneous device closure of
           secundum atrial septal defects: a systematic review and meta-analysis of
           2255 patients
    • Authors: Vyas V; (Presenting Author, Kaura A, Sawhney V, et al.
      Abstract: Introduction: Atrial septal defects (ASDs) are one of the most common forms of congenital heart disease in adults, with secundum ASDs being the most prevalent subtype. Atrial tachyarrhythmias (ATs), particularly atrial fibrillation (AF) are a major source of morbidity in the ASD patient cohort, with the substrate for ATs and their associated complications, persisting despite closure. The optimal timing of anti-arrhythmic intervention is however unclear, with limited evidence currently available to guide decision-making.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.009
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 29A novel protocol of continuous infusion of heparin for maintenance of
           stable act values during EP procedures
    • Authors: Renna M; (Presenting Author, Betts T, Rajappan K, et al.
      Abstract: Background: Current guidelines recommend administration of unfractionated heparin (UFH) during EP procedures to a target activated clotting time (ACT) of 300 to 400 seconds. Standard practice at our Institution has been to administer single intravenous boluses of UFH to achieve and maintain ACT over 300 s, plus intermittent “top-up” boluses if ACT decreases below 300 s. This approach however may result in suboptimal anticoagulation as ACT values often fall below the recommended target. We used a novel regimen of continuous i.v. infusion of UFH aiming at decreasing fluctuations in blood heparin levels. In this protocol, the rate of UFH administration as a continuous infusion is linked to the initial effective heparin bolus (IEB) dose and not, as in other regimens, to patient’s weight. Our objective was to compare the efficacy of an IEB-linked continuous UFH infusion protocol to standard practice of intermittent boluses for maintenance of adequate ACT during EP procedures.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.010
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 30Ischaemic aetiology modifies the association of atrial fibrillation with
           mortality in patients with heart failure with reduced ejection fraction
    • Authors: Mercer B; (Presenting Author, Koshy A, Drozd M, et al.
      Abstract: Aims: Atrial Fibrillation (AF) is common in patients with heart failure and reduced ejection fraction (HFrEF). The recently published CASTLE-AF trial reported that survival in HFrEF can be improved with catheter ablation of AF. A recent post hoc analysis of PARADIGM-HF, has not demonstrated decreased survival in patients with HFrEF and co-existing AF. This is against a backdrop of conflicting historical data. This study aims to characterise the association of AF with mortality in a cohort of contemporarily managed patients with HFrEF and also to assess the impact of HFrEF aetiology on survival.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.011
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 31Successful development of a His bundle pacing service in a district
           hospital
    • Authors: Lewis A; (Presenting Author, Swift M, French A, et al.
      Abstract: Introduction: His bundle pacing (HBP) offers a physiological pattern of ventricular electrical activation, is associated with improved clinical outcomes when compared with conventional right ventricular (RV) pacing, and may be an alternative to cardiac resynchronisation therapy (CRT) in patients in whom conventional CRT is not possible. Although previously restricted to centres with electrophysiological catheter mapping facilities, new delivery systems and pacing leads might enable HBP in conventional cardiac pacing laboratories. We report our experience of introducing a HBP service to the cardiac devices programme at a district general hospital and describe our initial experience of 52 attempted implants.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 32Risk of high grade AV block following cardiac surgery requiring Brady
           device implantation, a 3 year experience at the UK’s largest tertiary
           cardiac centre
    • Authors: Waddingham P; (Presenting Author, Sporton S, Lowe M, et al.
      Abstract: Introduction: Development of brady arrhythmias after cardiac surgery requiring device implantation is a heterogenous condition, with potential morbidity and delays to hospital discharge. The European Society of Cardiology has provided guidance on periods of conservative observation, as there are recognised recovery of AV block (AVB) (up to 7 days) and sinus node function (5 days to weeks) in the early phase after cardiac surgery. We aimed to evaluate risks with different types of cardiac surgical operations that mandate device implant and their outcomes at the Barts Heart Centre over a 3 year period.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.001
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 33Different techniques of cardiac leads extraction: 17-years single centre
           experience
    • Authors: Piro A; (Presenting Author, Lavalle C, Ciccaglioni A, et al.
      Abstract: Background: Cardiovascular implantable electronic devices (CIEDs) have become an important therapeutic modality of cardiovascular care. The increasing rate of CIED implantation determines an increasing rate of CIED related complication, especially including device and leads infections that represents the strongest indication for the complete system removal. Therefore, it is clear the importance of providing safe and efficient transvenous lead extraction (TLE) techniques. TLE techniques used until now, although very effective, are not without risk especially in elderly patients with significant comorbidities.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.002
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 34Transvenous lead extraction on uninterrupted anticoagulation: a
           multicentre registry analyses
    • Authors: Sawhney V; (Presenting Author, Whittaker-Axon S, Breitenstein A, et al.
      Abstract: Introduction: Transvenous lead extraction (TLE) is associated with a risk of potentially life threatening haemmorhagic events. Current consensus guidelines advocate reviewing peri-procedural anticoagulation on an individual case basis. Limited data exist on the safety of patients undergoing TLE on uninterrupted anticoagulation. We investigated the safety of TLE on uninterrupted warfarin with therapeutic INR.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.003
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 35First-in-man implantation of a leadless endocardial left ventricular
           pacing system (WiSE-CRT) utilising a trans-septal approach
    • Authors: James S; (Presenting Author, Rinaldi C, Turley A, et al.
      Abstract: Background: WiSE-CRT is a leadless CRT endocardial pacing system. It uses ultrasound technology to transfer energy from a subcutaneous pulse generator to a receiver electrode implanted on the Left Ventricle (LV) endocardial wall. To date this receiver electrode has always been implanted via a retrograde aortic route. In specific circumstances it is not feasible to access the LV via this route.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.004
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 36First degree atrioventricular block is highly predictive of subsequent
           pacing in elderly patients with syncope: a single centre retrospective
           analysis of implantable loop recorder data
    • Authors: Wijesuriya N; (Presenting Author, Koa-Wing M, Wallis W.
      Abstract: Background: Syncope in the elderly population is frequently the result of intermittent arrhythmia. Implantable Loop Recorders (ILR) are commonly utilised in these patients, attempting to document bradycardias which require pacing. European Society of Cardiology guidelines suggest that certain high risk patients are offered pacemaker implantation as a first-line therapeutic intervention for suspected bradyarrhythmia, such as those with alternating bundle branch block (BBB) or bifascicular block on the resting electrocardiogram (ECG). However, no consensus has yet been reached for syncopal patients with isolated 1st degree atrioventricular block (AVB). Risk stratification based on age is also not part of current practice, despite studies showing that advanced age is a strong predictor of requirement for pacing. The aim of this study was to analyse outcomes of patients who underwent ILR implantation, and assess whether a combination of advanced age and conduction impairment on the resting ECG was a predictor of subsequent pacemaker implantation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.005
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 37Development and application of a novel mapping method to guide atrial
           tachycardia and atrial fibrillation ablation: arrhythmia mapping by
           stochastic trajectory analysis of ranked signals (STAR)
    • Authors: Honarbakhsh S; (Presenting Author, Hunter R, Ullah W, et al.
      Abstract: Background: Atrial fibrillation (AF) may be driven by stable or intermittent localised sources, whether focal or rotational. We hypothesised that driver sites critical for AF maintenance could be identified through probabilistic analysis looking at predominant activation patterns.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.006
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 38Location of ablation lesions guided by the acqmap system in atrial
           fibrillation ablation
    • Authors: Twomey D; (Presenting Author, Thornley A, James S, et al.
      Abstract: Introduction: The AcQMap Imaging and Mapping System allows the generation of atrial maps using a spherical catheter composed of 48 ultrasound transducers to collect anatomical data and 48 biopotential electrodes to measure intracardiac potential fields, allowing the demonstration of high density activation wavefronts. This single centre study documents our initial experience with the system in patients undergoing AF ablation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.007
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 39Utility of ultra-high density activation mapping for ablation in
           congenital heart disease compared to structurally normal hearts
    • Authors: Sawhney V; (Presenting Author, Whittaker-Axon S, Daw H, et al.
      Abstract: Introduction: Catheter ablation for atrial arrhythmias is an effective treatment modality. Current electroanatomical mapping (EAM) systems are limited by their ability to accurately define the tachycardia circuit. This can pose a challenge in patients with complex congenital heart disease (CHD) and affect procedure times. A new EAM (Rhythmia, Boston Scientific, MA) is capable of automatic annotation with high resolution using a mini-basket 64-electrode mapping catheter. We hypothesized that Rhythmia would significantly reduce procedure times in CHD patients.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.008
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 40Targeted left ventricular endocardial leads for cardiac
           resynchronisation therapy guided by detailed ultra high precision
           haemodynamic assessment and high resolution electroanatomical mapping
    • Authors: Butcher C; (Presenting Author, Sohaib S, Shun-Shin M, et al.
      Abstract: Background: Endocardial left ventricular (LV) pacing allows stimulation at almost any LV site in contrast to coronary venous pacing.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.009
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 41First clinical use of novel ablation catheter incorporating local
           impedance data
    • Authors: Martin C; (Presenting Author, Martin R, Gajendragadkar P, et al.
      Abstract: Introduction: Successful catheter ablation is limited by both poor spatial resolution of abnormal local signals and inability to deliver an effective lesion due to poor tissue contact. We report first worldwide use of the Intellanav MiFi OI catheter (Boston Scientific), providing ultra-high density mapping and incorporating a ‘DirectSense’ algorithm to measure local tissue impedance (LI).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.010
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 4A multi-centred evaluation of high powered ablation guided by ablation
           index: establishing ablation targets for pulmonary vein isolation
    • Authors: Dhillon G; (Presenting Author, Ahsan S, Honarbakhsh S, et al.
      Abstract: Background: A strategy of pulmonary vein isolation (PVI) using high power delivered by surround flow (STSF) catheters guided by ablation index (AI) was evaluated in a multicentre registry.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy200.003
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 5Cryoablation for persistent and long standing persistent atrial
           fibrillation: results from a multicentre European Registry
    • Authors: Sawhney V; (Presenting Author, Schilling R, Providencia R, et al.
      Abstract: Background: Although pulmonary vein isolation using the cryoballoon is a well established treatment for paroxysmal AF, it’s role in persistent AF ablation remains less clear. We examined the procedural success and long-term outcomes of cryoablation in persistent AF and long standing persistent AF.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy200.004
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 42First simultaneous invasive validation of electrocardiographic imaging
           (ECGi) in intact human heart with epicardial mapping
    • Authors: Graham A; (Presenting Author, Orini M, Zacur E, et al.
      Abstract: Introduction: Non-invasive electrocardiography (ECGi) combines body surface electrical data and anatomical information from medical imaging to calculate epicardial unipolar electrograms which are displayed on the epicardial surface of the heart. This gives insight into the electrophysiological substrate customarily available only with invasive contact electro anatomical mapping (EAM). The potential to rapidly localise exit sites of unstable ventricular arrhythmias and to define potentially arrhythmogenic substrate, without the need for invasive testing, has resulted in widespread interest in this technology. Invasive validation of the system has taken place using animal models and in humans sequentially after bypass surgery. These studies have shown good correlation between unipolar electrogram morphology, activation times, repolarisation times and pacing sites. However, validation of the system in the intact human heart during physiological conditions is lacking. We present the first real world invasive validation of the most recent iteration of the system in the intact human heart.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy203.011
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 43Transvenous lead extraction in patients with systemic infective
           indication predicts 30-day all-cause mortality
    • Authors: Gould J; (Presenting Author, Klis M, Sieniewicz B, et al.
      Abstract: Background: Transvenous lead extraction (TLE) may be necessary due to system infection/erosion or lead malfunction. Patients with infective indication for TLE are considered to have a higher risk of major complication and mortality than those with non-infective indications. We hypothesised that patients with a systemic infective indication for TLE would have a higher procedure related major complication and mortality rate compared to patients with localised pocket infection/erosion.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy202
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 44The impact of pulmonary vein isolation on drivers in atrial
           fibrillation: does baseline driver burden and distribution predict the
           acute response'
    • Authors: Dhillon G; (Presenting Author, Schilling R, Honarbakhsh S, et al.
      Abstract: Background: The impact of pulmonary vein isolation (PVI) on the mechanisms sustaining persistent AF remains unclear. Better understanding of the impact of PVI may help select patients likely to respond. Rotational activation patterns may act as drivers in persistent AF. We hypothesized that the burden and distribution of rotational activation patterns in persistent AF predict the acute response to PVI.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy202.001
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 45Cardiac resynchronization therapy in congenital heart disease patients,
           the largest worldwide single center experience
    • Authors: Ibrahim M; (Presenting Author, Ksiazczyk T, Hammad S, et al.
      Abstract: Objectives: We report the largest worldwide single centre experience of cardiac resynchronization therapy (CRT) in patients with congenital heart disease (CHD).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy202.002
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 46Stroke and bleed events in patients with non-valvular atrial
           fibrillation on direct oral anticoagulants: a retrospective study across
           200 clinical commissioning groups in NHS England from 2013 to 2016
    • Authors: Sheth H; (Presenting Author, McNally D, Santibanez-Koref M, et al.
      Abstract: Background: Effectiveness and safety of the direct oral anticoagulants (DOACs) compared to warfarin have been a subject of debate following the publication of randomised controlled trials. Widespread adoption of DOACs have not been followed-up with a systemic analysis of stroke and bleed event rates in UK clinical practice.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy202.003
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 47Use of novel electrogram ‘Lumipoint’ algorithms to detect critical
           isthmus and abnormal potentials for ablation in ventricular tachycardia
    • Authors: Martin C; (Presenting Author, Takigawa M, Martin R, et al.
      Abstract: Introduction: Automatic mapping systems aid rapid acquisition of activation maps. However, they may annotate farfield rather than nearfield signal in low voltage areas, making maps difficult to interpret. A novel ‘Lumipoint’ algorithm (Boston Scientific) analyses the complete electrogram tracing, and therefore includes all nearfield as well as farfield signals in its analysis. A window of interest highlights regions that activate at certain time, which may be used to aid comprehension of the map. We report use of this feature in VT ablation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy202.004
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 48Improving implantable cardioverter defibrillator (ICD) arrhythmia
           discrimination: an innovative approach combining Laser Doppler Perfusion
           Monitoring with a novel algorithm for its interpretation (The
           “SafeShock” Approach)
    • Authors: Keene D; (Presenting Author, Shun-Shin M, Arnold A, et al.
      Abstract: Background: Inappropriate and unnecessary therapies delivered by Implantable Cardioverter Defibrillators (ICDs) are unpleasant for patients, increase healthcare costs and may reduce survival. Current discrimination of events relies on the automated interpretation of sensed electrograms. This approach does not consider the contemporaneous haemodynamic state of the patient which could be key to determining the need for ICD therapy or whether it could be safely withheld. In this study, we investigate the combination of using microvascular laser Doppler tissue perfusion with a new algorithm to detect the hemodynamic changes of VF that could assist ICD arrhythmia discrimination.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy202.005
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 49Atrial fibrilation detection with deep learning: a survey
    • Authors: Honchar O; (Presenting Author, Sahan V, Fridman R, et al.
      Abstract: Introduction: Atrial fibrillation (AF) is the most common cardiac disease. Both heart failure and myocardial infarction increase risk of AF and vice versa creating a feed-forward loop that increases mortality. Other cardiovascular outcomes attributed to AF are stroke and thromboembolism (1). Despite growing understanding of AF burden, research is needed into validation of it’s definitions and measures. Technologies will change the landscape of long-term AF monitoring (2). AF has well known patterns and is easily detected, developing an efficient and accurate automated system for diagnosing AF is still challenging problem. We propose deep learning (DL) approach to diagnosis of AF from raw ECG signal. DL algorithms already have shown their power in computer vision (CV) and natural language processing tasks and we prove, that their ability to find spatial patterns in data is applicable to cardiological data as well. We compare convolutional neural networks (CNN) and their state of the art architectures trained on the raw data and combinations of convolutional, recurrent neural networks trained on MFCC transform features and show that all of them show excellent reliability and accuracy on 2 datasets: MIT-BIH Atrial Fibrillation Database (3) and PhysioNet/Computing in Cardiology Challenge 2017 (4).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy202.006
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 50Stereotactic ablative radiotherapy (SABR) treatment of ventricular
           arrhythmia: a planning study for a novel progressive fractionation
           schedule
    • Authors: Lee J; (Presenting Author, Riley S, Tahir B, et al.
      Abstract: Introduction: Catheter ablation of scar related ventricular arrhythmia (VA) represents a challenging procedure in often very sick patients with moderate overall success. SABR (25 Gy single fraction) has been described in a recent case series as an alternative treatment for ventricular arrhythmia that recurs following conventional ablation [1]. However, evidence from contemporary studies of lung cancer radiotherapy suggest that an increase in ‘off target’ cardiac radiation dose adversely affects survival [2]. An optimum radiotherapy dose and regime for cardiac ventricular arrhythmias needs to be established and use of a fractionated treatment schedule could reduce cardiac dose and risks of toxicity.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy202.007
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 51Retrograde coronary venous and intracoronary ethanol injection: a novel
           technique for ventricular ectopic ablation
    • Authors: Sawhney V; (Presenting Author, Whittaker-Axon S, McLellan A, et al.
      Abstract: Introduction: Ventricular ectopics (VE) refractory to antiarrhythmic medication and standard percutaneous catheter ablation techniques are likely to have a poor prognosis. Alternative approaches may be required in patients where endocardial and epicardial approaches have failed to terminate VEs originating from an intramural focus. We report our experience with intracoronary and retrograde coronary venous ethanol ablation for VE.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy201
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 52His resynchronization therapy vs. biventricular pacing for heart failure
           with LBBB: a within-patient comparison of effects on acute haemodynamic
           function and ventricular activation
    • Authors: Arnold A; (Presenting Author, Shun-Shin M, Keene D, et al.
      Abstract: Background: Biventricular pacing improves outcomes in heart failure with left bundle branch block but many patients do not respond and even in responders morbidity and mortality remain high. His bundle pacing is a new method for delivering cardiac resynchronization. We performed a head-to-head acute crossover comparison between His bundle pacing and biventricular pacing, measuring effects on ventricular activation and acute haemodynamic function.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy201.001
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 53Optimum lesion set and predictors of outcome in persistent atrial
           fibrillation ablation: a meta-regression analysis
    • Authors: Sau A; (Presenting Author, Al-Aidarous S, Howard J, et al.
      Abstract: Aims: Ablation of persistent atrial fibrillation (PsAF) has been performed by a wide range of techniques with varying success rates. The range of success rates may be due to technical differences in the ablation process, however numerous additional factors including patient demographics, co-morbidities and trial design may have a significant impact. We conducted a meta-regression of existing studies of PsAF ablation in order to elucidate the factors affecting AF recurrence.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy201.002
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 54Utilisation of ECG-imaging for pre-procedural prediction of earliest
           activation sites of ventricular tachycardia
    • Authors: Graham A; (Presenting Author, Orini M, Martin C, et al.
      Abstract: Introduction: Ventricular tachycardia (VT) in patients with structural heart disease is associated with increased mortality and morbidity. Antiarrhythmic drugs can reduce the number of ICD therapies, but their long-term use is hindered by side effects. Treatment usually involves implantation of ICDs that offer abortive therapy without altering the substrate responsible for arrhythmia. Catheter ablation of VT offers a potential cure; however, efficacy remains sub-optimal. These procedures are hindered by hemodynamically non-tolerated VT and gaps in our knowledge regarding optimal sites for ablation during normal sinus rhythm. Electrocardiographic imaging (ECGi) allows non-invasive study of the interaction between arrhythmogenic substrate and earliest sites of activation during VT providing insight into potential targets for ablation without the need to induce VT.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy201.003
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 55Validation and utility of a novel mapping system in ablation of complex
           arrhythmias in adult congenital heart disease
    • Authors: Sawhney V; (Presenting Author, Garcia J, Daw H, et al.
      Abstract: Background: Multiple tachycardia circuits in patients with congenital heart disease (CHD) pose a challenge in identification of the critical isthmus. We sought to validate a novel wavefront mapping system using the High-density (HD) Grid catheter (Abbott Medical). The system was validated for (1) mapping complex wavefront patterns in atria tachycardia (AT) (2) defining critical isthmus in areas of scar.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy201.004
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 56Repolarization terminal portion dispersion predicts ventricular
           arrhythmias in patients with structural heart disease and mildly reduced
           left ventricular ejection fraction
    • Authors: Nguyen B; (Presenting Author, Scacciavillani R, Iuliano S, et al.
      Abstract: Introduction: Depressed left ventricular ejection fraction (LVEF) is the major indication for primary prevention implantable cardioverter-defibrillator (ICD) implantation. However, sudden cardiac death (SCD) also occurs without a reduced LVEF, and additional predictors are needed. Ventricular arrhythmias (VAs) are associated with increased cardiac repolarization variability. We assessed the intra-QT phase in patients with structural heart disease (with a relatively preserved LVEF and with a depressed LVEF) with and without sustained VAs.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy201.005
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 57Persistent atrial fibrillation mapping using 5D-RETRO-Mapping reveal the
           AF substrate has stable components
    • Authors: Mann I; (Presenting Author, Linton N, Qureshi N, et al.
      Abstract: Background: Activation mapping of atrial fibrillation (AF) wavefronts is challenging due to cycle length and electrogram morphology variation making window-of-interest setting burdensome. As a result AF mapping is labour intensive leading to studies being limited to short segments of AF within limited myocardial areas. We have developed a method to track uniform wavefronts continuously using a spiral mapping catheter (AFocusII). All wavefront vectors are displayed on orbital plots to show every activation direction over the mapping period. The orbital plots are then projected onto the 3 D geometry. Sequential mapping of different areas of atria using the catheter enables a RETRO-Map to be created, displaying every wavefront over the mapped time period on a single left atrial geometry. This 5 D representation of AF can be used to study the substrate of AF.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy201.006
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 58Does absolute refractory period pacing stabilise T-wave alternans to
           prevent VT/VF' An in vivo human and in silico study
    • Authors: Santos D; (Presenting Author, Orini M, Zhou X, et al.
      Abstract: Introduction: T-wave alternans (TWA), a change in ventricular repolarization occurring on an every other beat basis, is a predictor of ventricular-tachycardia/fibrillation and sudden cardiac death (SCD). Absolute refractory period (ARP) pacing has been shown to reduce TWA magnitude in an animal model and has been proposed as anti-arrhythmic therapy. The aim of this study was to investigate ARP pacing mechanisms in the intact human heart.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy201.007
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 59Poster presentation: neonatal hypothyroidism secondary to amiodarone
           given for intractable supraventricular hypothyroidism. Sakethram
           Vijayashankar, Orhan Uzun
    • Authors: Vijayashankar S; (Presenting Author, Uzun O.
      Abstract: We report a neonate born via emergency caeserean sectionfor Foetal SVT with oligohydramnios and stunted growth. His mother was given flecanide and digoxin to control SVT as a fetus. Despite treatment the arrhythmia was difficult to control. A few hours after birth he had repeated episodes of SVT requiring multiple doses of adenosine. He was then placed on flecanide, propranolol and digoxin to control the SVT. However owing to persistant tachycardia amiodarone was added to control recurrent episodes of SVT. Thyroid function tests before commencing amiodarone were normal. At 4 weeks of life the patient presented to A&E on two occassions with hypothermia. Extensive investigations including for sepsis were all negative. His thyroid function at the time was indicative of subclinical hypothyroidism, hence the hypothermia was considered to be secondary to hypothyroidism. Amiodarone was promptly stopped and flecanide dose was increased to keep the SVT under control. Hypothyroidism episodes continued for about a week after stopping the amiodarone but the child has had no further episdoes of hypothermia. His thyroid functions remained abnormal for 2 months post but later on these have normalised completely. The SVT is well controlled on flecanide and propranolol with a plan to reduce their doses in a staged manner in the near future.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 60Contact force sensing and automated radiofrequency annotation:
           re-defining the approach to slow pathway modification'
    • Authors: Newcomb D; (Presenting Author, Wood C, Tomlinson D.
      Abstract: Background: When used appropriately, contact force (CF)-sensing and the VISITAG™ Module (Biosense Webster Inc.) have provided a suitable learning platform towards superior ablation outcome (https://doi.org/10.1101/232694) and a greater understanding of in vivotissue effects of radiofrequency (RF) during pulmonary vein isolation (PVI) (https://doi.org/10.1101/284539). This same methodological approach may be applied to other arrhythmias to potentially re-define suitable acute intra-procedural RF delivery end-points. Slow pathway modification for AV node re-entrant tachycardia (AVNRT) is commonly performed, discrete and outcomes readily assessed, yet there remains a ∼0.5-1% risk of iatrogenic complete AV block; historically-derived ablation strategies for slow pathway modification typically involve ∼60 s focal RF at 30-60 W. Therefore, the aims of this service evaluation are to report the minimum permissible annotated RF delivery to achieve curative slow pathway modification, using the VISITAG™ Module.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.001
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 61Modern implantable cardioverter defibrillator programming minimises all
           therapy including inappropriate shocks
    • Authors: Dsouza E; (Presenting Author, Swift M, Brader S, et al.
      Abstract: Introduction: Implantable cardio-verter defibrillators (ICD) treat life threating arrhythmias, but may also treat rhythms inappropriately or unnecessarily. Delaying ICD therapy and setting a high ventricular rate for treatment has been shown to reduce therapies. We audited the outcome of patients programmed according to standardised protocols using delayed detection.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.002
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 62Utilising advanced roles to support efficiencies within a cardioversion
           service to improve the patient pathway and experience
    • Authors: Stevenson D; (Presenting Author, Sandilands A, Woo D, et al.
      Abstract: Introduction: Patients referred for an elective Day Case Cardioversion (DCCV) are managed by the Cardiac Rhythm Management (CRM) team based at Glenfield Hospital. Over recent years DCCV activity reduced significantly (approximately 50%) due to increasing bed pressures. Patients underwent DCCV in a side room of the cardiology day case ward with a subsequent minimum recovery period of 2 hours in a ward bed supported by CRM specialist nurses. If a side room or ward beds were unavailable these were sought elsewhere within the hospital delaying start times and creating anxiety for some patients. In order to maintain patient safety, additional CRM nurses were pulled from other responsibilities in order to support the needs of sedated patients, negatively impacting on team efficiency. Patients waiting for DCCV under general anaesthesia experienced longer waiting times due to limited availability of anaesthetic support. Physician Assistants in Anaesthesia (PAA’s) are fully trained healthcare professionals working under the supervision of a Consultant Anaesthetist and whose skills had been identified as being underutilised within their department. A pilot was implemented whereby patients underwent DCCV under Propofol with PAA support in a Catheter Lab anaesthetic room. The required recovery time was shorter enabling patients to be transferred back to the day case cardiology ward radial lounge (seated area) within 30 minutes for a further 2 hours rest period. This bypassed the requirement for a ward bed at any point during admission (unless the patient became clinically unwell and required further care).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.003
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 63Cardiac physiologist led implantable loop recorder service is feasible,
           safe and improves waiting times
    • Authors: Davies G; (Presenting Author, Sammut E, Parker J.
      Abstract: Implantable loop recorders (ILRs) are increasingly used in cardiology to investigate cardiac syncope or arrhythmia. The original generation of ILRs were implanted in an electrophysiology (EP) laboratory by physicians with experience of surgical implantation of other cardiac electronic devices. The latest generation of ILRs have seen significant technological advances which include a reduction in device size and the development of a pre-packaged implant kit. These developments have allowed both ILR insertion to be undertaken outside the EP lab in an outpatient setting, and the potential for non-physician staff to perform the procedure. We aimed to prove that a recently developed cardiac physiologist led ILR service is safe, and to assess the impact on outpatient waiting times with this model.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.004
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 64The value of a nurse led helpline in preventing hospital attendance
           following ablation for atrial fibrillation
    • Authors: Champney F; (Presenting Author, Julia-Calvo J, Patel M, et al.
      Abstract: Introduction: Reducing hospital readmission rates has been identified both as a national and international priority, with some healthcare funding arrangements reducing or denying payments for patients who re-admit as an emergency. Strategies to reduce hospital attendance vary between centers and there is a lack of evidence regarding their efficacy.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.005
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 65Consecutive subcutaneous ICD implantation is safe and feasible without
           general anaesthesia: the first report of an UK Centre experience
    • Authors: Liu A; (Presenting Author, Soar R, Wrigley C, et al.
      Abstract: Introduction: In patients at risk from sudden cardiac death, implantable cardiac defibrillators (ICD) confer significant long-term prognostic benefits. In patients without pacing indications, subcutaneous ICD (S-ICD) have emerged as a safer alternative to transvenous systems. However, most S-ICDs are still implanted under general anaesthesia (GA), exposing patients to GA complications and necessitating anaesthetic team presence. From a safety viewpoint, S-ICD implantation under local anaesthesia and sedation is highly attractive, but rarely reported. We present the first such report, of our single-centre experience of consecutive S-ICD implantations, without the need for general anaesthesia.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.006
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 6Safety and efficacy of wireless LV endocardial pacing; a multicentre
           international study examining real world use of the WiSE CRT pacing system
           
    • Authors: Sieniewicz B; (Presenting Author, Betts T, James S, et al.
      Abstract: Introduction: Biventricular endocardial pacing (BiV ENDO) is a potential therapy for patients who cannot receive transvenous, epicardial CRT or who have failed to adequately respond. BiV ENDO CRT is traditionally delivered via trans-septal pacing leads, mandating lifelong anti-coagulation due to the risk of thromboembolic complications. The introduction of a new wireless LV endocardial pacing system (WiSE-CRT System, EBR Systems, Sunnyvale, California) avoids the need for long-term anticoagulation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy200.005
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 66Novel quadripolar active fixation left ventricular pacing lead for
           cardiac resynchronisation therapy: initial UK experience
    • Authors: Chapman M; (Presenting Author, Linker N, Bates M, et al.
      Abstract: Background: Cardiac resynchronisation therapy (CRT) is an established treatment for patients with systolic heart failure. Implantation of passive fixation left ventricular (LV) leads can be limited by unsuitable coronary sinus anatomy or early lead displacement. Use of quadripolar leads reduces complications and mortality rate when compared to bipolar leads. Furthermore, active fixation leads have been shown to facilitate targeted pacing which improves CRT response. Therefore, the use of quadripolar active fixation LV leads may improve implantation success rates, reduce early displacement and enable targeted lead placement to improve patient outcome.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.007
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 67Terminating persistent atrial fibrillation using a novel dipole density
           mapping system
    • Authors: Shi R; (Presenting Author, Chen Z, Hussain W, et al.
      Abstract: Background: The non-contact dipole density (DD) mapping system is designed to provide global, live mapping of atrial fibrillation (AF). Ablation results of persistent AF guided by this system are unknown.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.008
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 68Appropriate and inappropriate ICD therapy with evidence-based
           programming: a real-world comparison with trial data
    • Authors: Chapman M; (Presenting Author, Patterson Z, Beaney E, et al.
      Abstract: Introduction: Both appropriate and inappropriate ICD therapies are associated with increased mortality. MADIT-RIT and PainFree SST showed that with novel programming strategies, inappropriate therapy can be as low as 2.3%/yr. Both trials featured exclusion criteria that may limit application of research findings to a real-word population. We retrospectively compared both appropriate and inappropriate therapy rates to the published data.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.009
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 69Automated detection of repetitive focal activations in persistent atrial
           fibrillation: validation of a novel detection algorithm and application
           through panoramic and sequential mapping
    • Authors: Honarbakhsh S; (Presenting Author, Schilling R, Dhillon G, et al.
      Abstract: Background: Identifying drivers in persistent atrial fibrillation (AF) remains difficult. The aim of the study was to validate an automated system for focal activation detection using basket (simultaneous mapping) and PentaRay (sequential mapping) catheters in AF.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.010
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 70Multicentre randomised trial comparing contact force with electrical
           coupling index in atrial flutter ablation (VERISMART TRIAL)
    • Authors: O'Neill J; (Presenting Author, Begg G, Sohaib A, et al.
      Abstract: Introduction: Electrical coupling index (ECI) and contact force (CF) have been developed to aid lesion formation during catheter ablation. ECI measures tissue impedance and capacitance whilst CF measures tissue catheter contact. The aim of this study was to determine whether the presence of catheter/tissue interaction information, such as ECI and CF, reduce time to achieve bidirectional block during atrial flutter (AFL) ablation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.011
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 712.5 year micra tps implant experience; a comparison with the post
           approval registry
    • Authors: Robinson T; (Presenting Author, Chuen J.
      Abstract: Introduction: The Micra TPS leadless pacemaker has fewer complications than conventional transvenous systems. The Micra Post Approval Registry assessed its safety and clinical performance in clinical practice. We compare our data with the post approval registry.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.012
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 72Left ventricular endocardial pacing with second generation of a novel
           wireless CRT system (WiSE-CRT system): comparison of threshold trends with
           those for the original system
    • Authors: James S; (Presenting Author, Chapman M, Turley A.
      Abstract: Introduction: The WiSE-CRT system (EBR Systems, Inc.) is a leadless endocardial pacing system for cardiac resynchronization therapy. It uses ultrasound-based technology to transfer energy acoustically from a subcutaneously implanted pulse generator (transmitter) to a receiver-electrode implanted on the Left Ventricle (LV) endocardial wall which converts acoustic energy to an electrical pulse. The original hardware has been revised and Generation 2 system (Gen2) now contains the new Model 4100 transmitter.We describe the threshold performance for patients implanted with Gen 2 v original systems
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.013
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 73“From core to line block” targeting atrial activation pattern of
           interest: a new ablation strategy for persistent atrial fibrillation
    • Authors: Shi R; (Presenting Author, Chen Z, Hussain W, et al.
      Abstract: Background: Ablation strategy targeting the core of atrial fibrillation (AF) rotors alone can lead to both stabilization and destabilization of re-entrant activity. Non-contact dipole density (DD) mapping system is designed to provide rapid global, live mapping of AF.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.014
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 74Early experience using the adivsor HD grid to map atrial fibrilation
    • Authors: Karim N; (Presenting Author, Srinivasan N, Garcia J, et al.
      Abstract: Introduction: The high density (HD) grid catheter with 16 x 1 mm electrodes with 3 mm electrode spacings, is designed for use with the Precision platform to map complex cardiac arrhythmia. The rapid high density points acquisition with the automated HD wave data algorithm, is uniquely designed to automatically assess orthogonal electrogram size and provide more accurate wavefront propagation. The catheter has only been used in animal models previously and we describe the early human experience in mapping complex atrial arrhythmias.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.015
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 75Do radiofrequency ablation lesions titrated to impedance drop correlate
           with recommended empirical target parameters for catheter ablation of
           atrial fibrillation'
    • Authors: Taylor M; Thornley A, Bates M, et al.
      Abstract: Background: Pulmonary vein isolation remains the cornerstone of catheter ablation for atrial fibrillation (AF). Achieving durable trans-mural ablation lesions remains challenging. Various ablation parameters have been used to infer transmural lesion formation. These include Force-Time Integral, Ablation Index and Lesion Stability Index (LSI). However these approaches all rely on the basic assumption that all patients’ atria will require the same amount of energy to achieve transmural lesions at a given site. Patient specific factors such as atrial wall thickness, composition of tissue and degree of fibrosis may influence the energy requirements to achieve transmural lesions. An impedance drop of 10 Ohms has been described as a safe and reliable method to infer transmural lesion formation in human and animal models. Titrating ablation duration to this target impedance drop is a recognised strategy for lesion validation during catheter ablation but it has not been described how impedance drop correlates with other target ablation parameters. We describe the relationship between impedance drop directed ablation and current recommended LSI target values for AF ablation of 6 for anterior and 4 for posterior sites.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.016
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 76A study on the effectiveness of cavotricuspid isthmus ablation in
           preventing post ablation atrial fibrillation
    • Authors: Thomas M; (Presenting Author, Hogan P, Crewe I, et al.
      Abstract: Objective: To determine whether an atrial flutter ablation alone is sufficient to prevent post ablation atrial fibrillation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.017
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 77Implantable loop recorders: nurse led implantation is safe and
           economical
    • Authors: Shailendra P; (Presenting Author, Adlan A, Deegan L, et al.
      Abstract: Introduction: Implantable loop recorders (ILR) are a useful but often underused resource for the investigation of unexplained syncope; with prior studies suggesting a diagnostic yield of around 35%. We sought to evaluate our local experience in the use of ILR including the safety, feasibility and economic impact of a new nurse-led implant service.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.018
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 78An allied health professional-led implantable loop recorder (ILR)
           service without prophylactic antiobiotics delivered outside the catheter
           laboratory environment reduces infection: a single centre experience
    • Authors: Dirksen A; (Presenting Author, Lim C, Barnard A, et al.
      Abstract: Introduction: The implantable loop recorder (ILR, LINQ™ Medtronic) is an injectable device which can be administered rapidly and safely with appropriate training. Given its perceived ease-of-use by cardiologists, from consultants to junior registrars, there is often a less-than-robust training program. As this is a relatively new technology, there are no specific guidance for antibiotic prophylaxis for ILR implantations, resulting in variable antibiotic practice across trusts, and within-trusts. Therefore when there is a complication, it is uncertain if this is due to operator technique or lack of antibiotic therapy, or a combination of both. We hypothesised that the main determinant of ILR complication was due to operator technique rather than antibiotic prophylaxis.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.019
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 79Catheter ablation for persistent and long standing persistent atrial
           fibrillation using the box-set lesion pattern. Procedural success and
           symptom based recurrence rates over 2 year follow-up
    • Authors: Varini R; (Presenting Author, Haywood G.
      Abstract: Background: The optimal approach to catheter ablation in cases of persistent atrial fibrillation (PersAF) remains unclear. We have been using the “box” lesion set to achieve wide area left atrial posterior wall isolation (LAPWI) in addition to pulmonary vein isolation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.020
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 80A novel model of clinical exercise delivery reduces key modifible risk
           factors in patients with atrial fibrillation
    • Authors: Rumble Y; (Presenting Author, Thompson M, Price J, et al.
      Abstract: Introduction: Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia. The prevalence of AF roughly doubles with each advancing decade of age and in an aging population strategies to reduce the incidence and burden of AF is of paramount importance. Current strategies to manage AF include medical therapy and invasive procedures such as cardioversion and ablation. With increasing strain on the healthcare system, lifestyle interventions offer a potent and cost-effective way to address key modifiable risk factors. This can reduce the incidence and burden of AF and reduce this risk of AF-related stroke. Despite the paucity of information about exercise and nutrition with AF, there are no standard pathways of care, such as cardiac rehabilitation in which to aid this population. Therefore, the current study investigates the effectiveness of an exercise and nutrition programme on key modifiable AF risk factors of hypertension, excess body mass and poor cardiovascular capacity as well as individual’s confidence towards exercise.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.021
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 81Long-term outcomes of ICD implants in adult congenital heart disease
           patients: a single centre experience
    • Authors: Sawhney V; (Presenting Author, Whittaker-Axon S, Daw H, et al.
      Abstract: Background: Sudden Cardiac Death (SCD) due to ventricular arrhythmias (VA) accounts for nearly a third of all deaths in the adult congenital heart disease (ACHD) population. Implantable cardioverter defibrillators (ICD) are effective in preventing SCD. However, there is little evidence to establish the safety and efficacy of ICDs in the ACHD population. We reviewed the indications and long-term outcomes of ICD implants in our ACHD patients.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.022
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 82Electrophysiological properties of the South Asian heart
    • Authors: O'Neill J; (Presenting Author, Tayebjee M.
      Abstract: Background: South Asians have a lower burden of cardiac arrhythmia in comparison with Caucasians despite a higher prevalence of traditional cardiovascular risk factors. The reason for this disparity is uncertain but it may be related to differences in the electrophysiological properties of the South Asian heart.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.023
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 83Atrial size and function in a South Asian population and their
           relationship with the prevalence of atrial fibrillation
    • Authors: O'Neill J; (Presenting Author, Swoboda P, Plein S, et al.
      Abstract: Introduction: South Asians have a low prevalence of atrial fibrillation compared with Caucasians despite having a higher prevalence of conventional risk factors for the condition. The reason for this disparity is uncertain but may be due to ethnic variations in atrial morphology and function. We aimed to investigate this using the reference technique of cardiovascular magnetic resonance imaging (MRI).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.024
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 84Incidence of subclinical atrial fibrillation in a South Asian population
    • Authors: O'Neill J; (Presenting Author, Jegodzinski L, Tayebjee M.
      Abstract: Background: South Asians have a lower prevalence of clinical atrial fibrillation (AF) compared with Caucasians despite higher rates of conventional risk factors and a higher incidence of stroke. It is not clear whether South Asians truly experience less AF or whether this is due to under-detection of the arrhythmia. Therefore, we aimed to determine whether South Asian pacemaker patients have a lower incidence of device-detected subclinical episodes of AF compared with Caucasian controls.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.025
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 85Prevalence of arrhythmia’s and conduction abnormalities (ACAs) in
           cardiac-variant Fabry disease
    • Authors: Varian F; (Presenting Author, Walker R, Watson O, et al.
      Abstract: Introduction: Fabry disease in an X-linked lysosomal storage disorder caused by deficiency of the α-galactosidase A enzyme. Up to 75% of mortality has been reported due to cardiovascular problems; the majority (62%) attributed to Sudden Cardiac Death (SCD) (Baig et al 2017). Average prevalence of VT has been reported as 15.3% with frequency of malignant ventricular arrhythmias reported to range from 5-30% (ibid). Prevalence of VT and pAF has been detected to range from 8.3% and 13.3% respectively on ECG and Holter monitoring (Shah et al 2005) and up to 33% identified on loop recorders, suggesting under-reporting of clinically relevant arrhythmias on ECG/Holter (Weidemann et al 2016). Prevalence of asystole and bradycardia requiring PPM ranges from 10.6% to 31%. Implantation of ICD-DR ranges from 1.28% to 25% (Shah et al 2005, Weidemann et al 2016). Implantation of PPM for bradyarrhythmia ranges from 5.13% from Holter/ECG to 60% following loop implantation (ibid). This is the first single centre evaluation of cardiac-variant Fabry disease.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.026
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 86Cross over between direct oral anticoagulants
    • Authors: Marchetti G; (Presenting Author, Roncuzzi R, Urbinati S.
      Abstract: Introduction: Non vitamin K antagonist oral anticoagulants (NOACs) have many favorable characteristics compared with warfarin and adherence to anticoagulation is higher with NOACs, but little known is about crossover between NOACs.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.027
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 87Spatiotemporal stability of non-pulmonary vein propagation patterns in
           persistent atrial fibrillation identified through novel dipole-density
           non-contact mapping before and after pulmonary vein isolation
    • Authors: Pope M; (Presenting Author, Bates M, Gouda S, et al.
      Abstract: Introduction: Pulmonary vein isolation (PVI) is the basis for catheter ablation of atrial fibrillation (AF), but efficacy in persistent AF is limited and possible non-pulmonary vein drivers are increasingly thought to be important for arrhythmia maintenance and propagation. Non-contact dipole density mapping enables real time visualization of whole chamber activation revealing regions of rotational activation and focal firing that may be important in AF maintenance.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.028
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 88Quality of and predictors of anticoagulation control among multi ethnic
           cohorts receiving vka therapy for stroke prevention in atrial fibrillation
           
    • Authors: Zulkifly H; (Presenting Author, Cheli P, Lutchman I, et al.
      Abstract: Introduction: To ensure the effectiveness and safety of vitamin K anatomist (VKA) therapy among atrial fibrillation (AF) patients, the International Normalised Ratio (INR) should be 2.0-3.0. Although epidemiological studies suggest poorer INR control in non-white cohorts, anticoagulation control comparing different ethnic groups has not been well-investigated.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.029
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 89Ablation of the ganglionated plexus terminates sustained atrial
           fibrillation
    • Authors: Kim M; (Presenting Author, Sandler B, Sikkel M, et al.
      Abstract: Background: Classical electrophysiological studies involve inducing a tachycardia to prove mechanism, ablating the target and then confirming non-inducibility. This has not been the case in atrial fibrillation (AF) as the mechanisms are not known. We postulated that ablation of ectopy-triggering ganglionated plexus (ET-GP) sites that trigger AF would also terminate AF, thus proving their role in the pathophysiology of AF.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.030
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 91Acute efficacy of contiguous versus discontiguous point-by-point
           radiofrequency energy isolation of pulmonary veins in patients with
           paroxysmal atrial fibrillation: a randomized study
    • Authors: Aldhoon B; (Presenting Author, Peichl P, Osmancik P, et al.
      Abstract: Background: Durable pulmonary vein (PV) isolation (PVI) determines the clinical success of catheter ablation for atrial fibrillation (AF). Secondary analysis of EFFICAS-II study suggested that contiguity of radiofrequency (RF) lesions resulted in more durable PVI. In the randomized study, we investigated whether completely discontiguous deployment of ablation lesions adversely affected the acute efficacy of PVI.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.032
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 90Mapping the processes involved in remote monitoring of heart failure
           patients at a specialist NHS cardiology clinic
    • Authors: Brahmbhatt D; (Presenting Author, Evans L, Riley J, et al.
      Abstract: Introduction: Effective remote monitoring (RM) for patients with heart failure (HF) could improve care by replacing time-consuming routine clinic appointments with a model of care allowing rapid review only when needed. Symptoms of worsening HF may present only a few days before a patient needs hospitalisation, but the underlying process of fluid build-up usually occurs over several weeks. Detecting this sub-clinical deterioration through cardiovascular implantable electronic devices (CIEDs), such as pacemakers and defibrillators, enables prompt intervention to correct the fluid build-up, preventing some hospital admissions. Currently, there is no agreed protocol for how CIED RM should occur; consequently practice varies across different centres. Research trials have shown conflicting results on the benefit of RM, which is likely linked to the context within which the technology is used: centres with RM experience and necessary infrastructure to rapidly make decisions on data received being more successful than clinics lacking this. The aim of this study is to map a current RM care pathway at a specialist NHS cardiology clinic to gain a detailed understanding of the complexities of the RM process, identify opportunities for improvement and to use the results as a blueprint for other centres initiating RM of HF through CIEDs.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.031
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 7Nurse led pacing is here: innovation and transformation
    • Authors: Whittock K; (Presenting Author, Panting J, Ahamad M, et al.
      Abstract: Introduction: Workforce capacity and capability are perhaps the most significant factors driving the need for transformation and innovation in the National Health Service. Highly skilled consultant staff are busy, sought after and expensive. Therefore it makes sense to make best use of that senior consultant expertise with role substitution where safe and effective. Compared to a decade ago, consultants no longer undertake less complex tasks such as loop recorder implants. Indeed, physiologists and nurses across the country tend to undertake such implants both safely and effectively, with consequent enhancement of their roles. In some organisations advanced nurse practitioners also undertake coronary angiography and deliver direct patient care in subspecialty clinics such as heart failure or rapid access chest pain. We sought to develop the advanced nursing role of ‘pacing practitioner’, to incorporate independent pacemaker generator change procedures and bradycardia pacemaker implants.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 8The clinical and financial impact of a new nurse-led service for
           insertion of implantable loop recorders at UHL
    • Authors: Armstrong S; (Presenting Author, Bracaloni L, Turner D, et al.
      Abstract: Introduction: The implantable loop recorder (ILR) plays a crucial role to facilitate diagnosis in patients with unexplained syncope or palpitations. Historically, ILRs have been implanted by cardiologists. However, since the introduction of the small injectable loop recorders, there has been a national move towards training Allied Healthcare Professionals (AHCPs). We developed a dedicated Nurse-led ILR implantation service at UHL. The aims were to improve time to diagnosis, meet the 6 weeks waiting time target, improve patient satisfaction and reduce bed days whilst maintaining low complication rates. An Arrhythmia Advanced Nurse Practitioner and a senior Catheter Lab Nurse were trained in clinical consent, aseptic technique, ILR implantation and suturing by a team of Consultants. Full competency was achieved within two months. A dedicated weekly nurse-led ILR implantation list of 5-6 patients was set up from May 2017. Patients were admitted as a day case with their procedures carried out in a decommissioned catheterisation laboratory. Patients were discharged home 30 minutes post-procedure with facilities for home monitoring set-up. We carried out a review of the service to assess its efficiency and determine whether its objectives were met.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.001
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 92Left atrial appendage occlusion for stroke prevention in atrial
           fibrillation: experience from a single tertiary centre in the UK
    • Authors: Hussain S; (Presenting Author, Kovac J, Somani R.
      Abstract: Introduction: NHS England’s Commissioning through Evaluation (CtE) programme allows a limited number of patients to access treatments which are currently not funded via the NHS, but nonetheless show significant promise for the future, while new clinical and patient experience data are collected within a formal evaluation framework. We present our experience as one of the ten UK sites which undertook left atrial appendage occlusion (LAAO) for stroke prevention in patients with atrial fibrillation (AF) as part of the CtE process.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.033
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 93Dual energy cardiac computed tomography is feasible in guiding optimal
           left ventricular lead placement in CRT upgrades using coronary venous
           anatomy, scar and dyssynchrony data
    • Authors: Gould J; (Presenting Author, Behar J, Rajani R, et al.
      Abstract: Background: Pacing the heart remote from myocardial scar and in the latest mechanically activated regions may improve Cardiac Resynchronization Therapy (CRT) response. In this study, we evaluate the feasibility of pre-procedural dual energy cardiac computed tomography (DECCT) to guide left ventricular (LV) lead implantation in patients undergoing CRT upgrade. Avoiding scar and targeting the most dyssynchronous areas may improve procedural success and CRT response.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.034
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 94Characterisation of arrhythmia triggers in atrial septal defects:
           Patterns of atrial ectopy on continuous holter monitoring
    • Authors: O'Neill L; (Presenting Author, Williams S, Whitaker J, et al.
      Abstract: Background: Atrial fibrillation (AF) is common in atrial septal defect patients (ASD) but little is known about the triggers for these arrhythmias.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.035
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 95Left atrial scarring and conduction velocity dynamics: rate-dependent
           conduction slowing predicts sites of micro-reentrant atrial tachycardias
    • Authors: Honarbakhsh S; (Presenting Author, Schilling R, Orini M, et al.
      Abstract: Introduction: Low voltage zones (LVZs) are associated with conduction velocity (CV) slowing. Rate-dependent CV slowing may play a role in reentry mechanisms.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.036
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 96Single centre experience of genotype-positive catecholaminergic
           polymorphic ventricular tachycardia and defibrillator therapy
    • Authors: Hanington O; (Presenting Author, Barman P, Stuart G.
      Abstract: Introduction: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare, inherited cardiac channelopathy. Affected patients have an increased risk of ventricular arrhythmias, often presenting with syncope or sudden cardiac death. CPVT is predominantly caused by mutations in the Ryanodine receptor (RyR2), expressing autosomal dominance. Typically CPVT is a disease of childhood, with the majority of patients presenting under 20 years. Implantable cardiac defibrillators (ICD) are indicated in selected CPVT patients. Due to the rarity of the condition however, little has been published regarding ICD therapy in these patients, in particular genotype-positive CPVT patients.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.037
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 97Contact force guided ablation of typical atrial flutter reduces
           fluoroscopy time with similar procedure time
    • Authors: Srinivasan N; (Presenting Author, Simon R, Baca M, et al.
      Abstract: Introduction: Catheter ablation of the cavotricuspid isthmus (CTI) is widely accepted as the treatment of choice for typical atrial flutter (AFL). Ablation success is influenced by the efficacy of radiofrequency (RF) lesions and outcomes are influenced by the type of catheter used due to the nature and thickness of the tissue. Recently the advent of contact force (CF) technology has been shown to improve the safety and efficacy of RF ablation in atrial fibrillation. We aimed to investigate whether CF guided ablation influenced the efficacy of CTI ablation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.038
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 98Screening for atrial fibrillation in primary care using the alivecor
           device: AF incidence, feasibility and patient acceptability
    • Authors: Murphy B; (Presenting Author, Singh D, Lip G, et al.
      Abstract: Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia and an important stroke risk factor. Lifetime risk of developing AF is 1 in 4 and the prevalence increases with age, from 1% in adults to 7% in those aged ≥65 years. As AF is often asymptomatic and undiagnosed in older populations, early identification is necessary to impact stroke prevention though oral anticoagulation (OAC). A systematic review found that screening those aged ≥65 years detected undiagnosed AF in 1.4%, and among these 67% were at high stroke risk. The AliveCor device, paired with a smartphone, produces a high quality, 1-lead ECG with an in-built algorithm to detect AF. The aims of this study were to determine the incidence of unknown atrial fibrillation in primary care in those aged ≥65 years screened using the AliveCor device and to test the feasibility of, and patient-rated acceptability of using the AliveCor device in this setting.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.039
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 100A retrospective study of the effect of cardioversion upon ejection
           fraction in people with atrial fibrillation and heart failure with
           systolic dysfunction
    • Authors: Wall C; (Presenting Author, Jankowski T, Flynn R, et al.
      Abstract: Aims To determine the effect of successful cardioversion upon ejection fraction in patients with left ventricular systolic dysfunction.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.041
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 101Previous valve surgery predicts mortality in patients undergoing
           transvenous lead extraction for infective indications
    • Authors: Gould J; (Presenting Author, Klis M, Porter B, et al.
      Abstract: Background: Transvenous lead extraction (TLE) may be necessary due to system infection/erosion or lead malfunction. Patients with infective indication for TLE are considered to have a higher risk of major complication and mortality than those with non-infective indications. We hypothesise that patients with previous valve surgery would have a higher procedure related major complication and mortality rate compared to non-infective patients.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.042
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 99Validation of the modified microlife blood pressure monitor in patients
           with paroxysmal atrial fibrillation
    • Authors: Huppertz N; (Presenting Author, Lip G, Lane D.
      Abstract: Background: Atrial fibrillation (AF) is an important risk factor for stroke. Undiagnosed AF accounts for up to 6% of all strokes, therefore early detection and treatment of AF are paramount to reduce stroke occurrence. Previous research has shown that the Microlife WatchBP03 AFIB, an automated oscillometric blood pressure (BP) monitor with an inbuilt AF algorithm, can accurately detect permanent AF. Little data currently exists on whether the monitor is able to detect paroxysmal AF to the same diagnostic accuracy.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.040
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 102Leadless pacemaker implantation: experience from a single tertiary
           centre in the UK
    • Authors: Ihekwaba U; (Presenting Author, Chelliah R, Loke I, et al.
      Abstract: Introduction: Leadless pacemakers are increasingly being used as an alternative to conventional pacemakers when single chamber pacing is required for the treatment of bradyarrhythmias. Initial studies have demonstrated favourable efficacy and safety results compared to conventional transvenous pacemakers. As a tertiary centre in the UK, the purpose of this retrospective study was to evaluate our ‘real world’ experience over two years with the Micra™ Transcatheter Pacing System (Medtronic, Minneapolis, MN, USA).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.043
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 103Myocardial fibrosis in non-ischaemic dilated cardiomyopathy is
           associated with increased activation recovery interval variability
    • Authors: Porter B; (Presenting Author, Van Duijvenboden S, Sieniewicz B, et al.
      Abstract: Introduction: The presence of myocardial fibrosis on cardiovascular magnetic resonance (CMR) imaging in patients with non-ischaemic dilated cardiomyopathy (NIDCM) is an independent predictor for sudden cardiac death. Enhanced beat-to-beat variability of repolarisation (BVR) and its role in arrhythmogenesis has been suggested as a potential explanation for this association; however, a direct relationship between fibrosis and BVR of ventricular action potential duration (APD) has yet to be demonstrated. We hypothesised that the presence of late gadolinium enhancement (LGE) in patients with NIDCM would be associated with increased repolarisation instability at the level of APD.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.044
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 104Improving validity of cardiac magnetic resonance imaging in patients
           with atrial fibrillation
    • Authors: Stoll V; (Presenting Author, Bunting K, Liu B, et al.
      Abstract: Introduction: Cardiac magnetic resonance (CMR) imaging is underused in patients with atrial fibrillation (AF) due to concerns over the validity of averaging measurements in patients with an irregular ventricular rhythm and difficulty with the breath-holding technique.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.045
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 105Global AF voltage is reduced with pulmonary vein isolation in
           persistent AF
    • Authors: Nagy S; (Presenting Author, Kim S, Mann I, et al.
      Abstract: Background: Low voltage areas (LVA) in the left atrium (LA) may represent fibrosis and are thought to play a role in the maintenance of persistent AF (psAF). Most LVA strategies include voltage mapping following PVI. Catheter ablation of LVAs identified in AF or sinus rhythm (SR) by electroanatomical mapping (EAM) has been used to treat psAF.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.046
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 106Mean atrial fibrillation voltage and cycle length assessed by a novel
           algorithm do not correlate in persistent AF
    • Authors: Nagy S; (Presenting Author, Kim S, Mann I, et al.
      Abstract: Background: During paced rhythm, left atrial voltage has been shown to reduce with shorter cycle lengths and sinus rhythm voltage is known to be significantly larger than atrial fibrillation (AF) voltage when measured by contact endocardial mapping. It is thought that rapid AF drivers may co-localise with low voltage areas. Whether the association between left atrial cycle length and voltage is present in native abnormal rhythms has not previously been described. We evaluated the relationship between atrial fibrillation cycle length (AFCL) as assessed by a novel algorithm (ACL) and mean atrial fibrillation voltage (AFV) in persistent AF (psAF).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy205.047
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 110Utility of implantable loop recorders in the management of paediatric
           inherited cardiovascular disease
    • Authors: Mullin J; (Presenting Author, Norrish G, Field E, et al.
      Abstract: Background: Syncope, pre-syncope and palpitations are worrying symptoms in children with known or suspected inherited cardiac disease (ICC), but it can be difficult to distinguish a benign from malignant cause. This study evaluates the use of implantable loop recorders (ILR) in the management of these patients.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 111Opportunisitc testing for atrial fibrillation
    • Authors: Lee G; (Presenting Author, Sisman T, Zeynep Z.
      Abstract: Introduction: It is well known that early identification of Atrial fibrillation (AF) has the ability to reduce AF-related strokes that are associated with significant mortality and morbidity as well as ensuring AF is diagnosed early and optimally managed. With the advent of smartphones and other mobile devices, we can now undertake opportunistic testing in a variety of clinical settings.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.001
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 112Development of an allied health professional led implantable loop
           recorder service: outcomes and financial implications of the first 6
           months
    • Authors: Terrington R; (Presenting Author, Moncada, A, Robinson T.
      Abstract: Introduction: Implantable loop recorders (ILRs) have traditionally been inserted in the cardiac catheter lab on a Consultant-led list. The most modern generation of device (e.g. Medtronic LINQ) is designed to be injected subcutaneously. The relative simplicity of the procedure brings it within the skill set of Allied Health Professionals (AHP), freeing up medical staff and catheter lab time which increases revenue. We describe the development and outcomes of an AHP led loop recorder implant service.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.002
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 113Improving the quality of care for patients with new onset atrial
           fibrillation
    • Authors: Tyndall K; (Presenting Author, Begg G, Russell C, et al.
      Abstract: Introduction: NICE guidelines clearly outline the treatment strategy for AF. It is recommended that most decisions regarding anticoagulation and rate control should be undertaken in primary care. In Leeds, over 90% of patients with new onset AF were previously referred to a secondary care rapid access AF clinic. A new service was therefore designed to facilitate management of patients with new onset AF in primary care.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.003
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 106 months prospective audit of implantable loop recorders - what does
           this tell us about diagnostic yield'
    • Authors: Armstrong S; (Presenting Author, Somani R, Ng A, et al.
      Abstract: Introduction: The documentation of cardiac arrhythmias through monitoring is challenging due to their intermittent nature and variable frequency. Choice of the relevant recording system relies on the duration, frequency and symptoms to obtain symptom–rhythm correlation, which is key to aiding diagnosis of arrhythmias that may cause syncope. The incidence of Cardiac syncope has been reported to be 9.4% compared with 21.2% for vasovagal syncope and 36.6% for unknown causes with mortality risk associated with this of 50.5% at 5 years. The implantable loop recorder (ILR) plays a crucial role to facilitate diagnosis in patients with unexplained syncope or palpitations. Recent changes to the ESC guidelines for syncope (2018) have suggested that ILR implants are a first line option of cardiac monitoring and have been proven to be a cost effective strategy compared to traditional investigations. To increase compliance of the ESC recommendations we introduced a Nurse-led ILR implant service to facilitate throughput and be cost effective. The aim of the study was to look at the diagnostic yield from ILRs following the introduction of the nurse led ILR implant service.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.003
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 9Optimising the management of post-surgical temporary pacing care. A
           review of a novel cardiac physiologist lead pacing service
    • Authors: Meese D; (Presenting Author, Stachurska K, Haldar S, et al.
      Abstract: Introduction: In the UK, 42 cardiothoracic surgical centres currently perform approximately 35, 000 procedures per annum. Arrhythmia post-surgery is common and temporary epicardial pacing is routinely used post operatively. In the UK, post-surgical temporary pacing care is traditionally managed by: surgeons; anaesthetists; intensivists and nurses who may not have pacemaker-programming expertise. At our tertiary referral centre, we have introduced dedicated cardiac physiologists to review temporary pacemaker settings early in the post-operative period. The aim of this study was to evaluate the time from admission to Intensive care unit (ITU) post-surgery to first contact with a cardiac physiologist, and to assess whether this interaction conferred a change in pacemaker programming and potential patient benefit.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.002
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 11Development, implementation and audit of locally agreed standards for
           permanent pacemaker follow-up
    • Authors: Beaney E; (Presenting Author, Patterson Z, Chapman M, et al.
      Abstract: Background: Quality Assurance (QA) is an integral process in ensuring the highest standards of healthcare are consistently delivered. There is a great emphasis on continuous service improvement within cardiac physiology, as highlighted by the recommendations contained in Improving Quality in Physiological Services (IQIPS) departmental accreditation. Robust QA processes are currently implemented in echocardiography but there are no widely accepted standards for pacemaker follow-up. Current BHRS national standards define the qualifications required by those undertaking pacemaker follow-up and suggest a minimum data-set but do not define an audit process to ensure compliance with these requirements. Comprehensive guidance on the QA of pacemaker Follow-up is lacking. Pacemaker follow-up is predominantly performed by cardiac physiologists or specialist nurses and routinely involves autonomous decision-making and application of clinical judgement. Without robust QA processes, variation in clinical service quality may remain undetected and unaddressed. Development of a standardised QA process for pacemaker Follow-up will help identify variation in clinical practice and may highlight areas to improve patient safety, device optimisation and clinical outcomes.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.004
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 114High voltage impedance rise: mechanism and management. A case series
    • Authors: Monkhouse C; (Presenting Author, Cambridge A, Chow A, et al.
      Abstract: Introduction: Monitoring the high voltage (HV) impedance of an implantable cardioverter defibrillator (ICD) circuit is an essential part in monitoring the function of an ICD. The normal range for HV impedance is approximately 30-110 ohms from a single coil circuit and from 20-70 ohms for a dual coil circuit. Gradual rises in shock impedance have been historically attributed to metal ion oxidisation (MIO) and environmental stress cracking (ESC). We present a case series of ICD patients with a significant rise in shock impedance above the upper limit of normality which all triggered an alert. We discuss the potential underlying mechanisms at play and the management plan of such challenging cases.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.004
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 115Ritual ECG defacement: irritating and potentially dangerous!
    • Authors: Leader J; (Presenting Author.
      Abstract: Background: It is a common occurrence in our hospital to find handwritten scribblings on patients’ electrocardiograms [ECG]. These scribblings, often circles, around perceived abnormalities, are drawn by usually inexperienced healthcare practitioners for two reasons. The medical professional feels unconfident about his ECG diagnosis and therefore wants in some way to highlight the perceived ECG abnormality to fellow healthcare professionals as a means of justifying his subsequent management plan.The medical professional is sure of his ECG diagnosis but does not feel confident that his fellow healthcare professionals would be astute enough to detect the abnormalities and therefore feels the need to help them by drawing a circle round what he has identified to be the abnormality.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.005
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 116Inter and intra-observer reproducibility of atrial fibrosis assessment
           using late gadolinium enhanced cardiac magnetic resonance imaging
    • Authors: Sim I; (Presenting Author, Razeghi O, O'Neill L, et al.
      Abstract: Background: Atrial fibrosis represents a key component of structural remodelling in atrial fibrillation (AF). Late gadolinium enhancement (LGE) cardiac magnetic resonance imaging (CMR) is the only available tool for non-invasive assessment of atrial fibrosis. However, clinical implementation of LGE CMR has not become widespread in part due to concerns over the reproducibility of image processing techniques. The aim of this project was to assess inter-observer and intra-observer reproducibility in fibrosis quantification using a custom-built software platform.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.006
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 117Assessing and improving quality of life data aggregation before and
           after AF ablation
    • Authors: Chu G; (Presenting Author, Antoun I, Armstrong S, et al.
      Abstract: Background: With no definitive evidence of prognostic benefit, AF ablation is predicated on quality of life (QoL) enhancement. Robust systematic QoL data collection is needed, but can be challenging in the modern clinical environment.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.007
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 118Procedure learning curve in ablation of persistent atrial fibrillation
           utilising a non-contact dipole density mapping system
    • Authors: Shi R; (Presenting Author, Chen Z, Chambers R, et al.
      Abstract: Background: The non-contact dipole density (DD) mapping system uses ultrasound to reconstruct the cardiac anatomy, and dipole density to track local activation wave fronts of atrial fibrillation (AF). The learning curve in adopting this system to guide AF ablation is not clear.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.008
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 120How long should we wait before device implantation following cardiac
           surgery' A 3 year single centre experience
    • Authors: Waddingham P; (Presenting Author, Sporton S, Schilling R, et al.
      Abstract: Introduction: Appropriate timing of device implantation after cardiac surgery is a clinical challenge, balanced between patient safety and potential for conduction system recovery. The European Society of Cardiology guidelines on permanent pacing (PPM) post cardiac surgery suggest observation for up to 7 days in high degree AV block (AVB) or up to week in sinus node dysfunction. We aimed to evaluate trends over 3 years in implant timings and outcomes at 1 month Follow-up at the the Barts Heart Centre.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.010
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 121Star analysis of value for money for use of oral anticoagulants by
           quality-adjusted life gain
    • Authors: Orlowski A; (Presenting Author, Wilkins J, Ashton R, et al.
      Abstract: Background: The value for money of warfarin and direct-acting oral anticoagulants (DOACs) for prevention of stroke in atrial fibrillation was analysed. Both treatment options are effective, cost-effective, and recommended in treatment guidelines, but current product pricing differs considerably.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.011
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 122Business case modelling to estimate net budget impact associated with
           improved diagnosis and treatment of atrial fibrillation
    • Authors: Orlowski A; (Presenting Author, Wilkins J, Ashton R, et al.
      Abstract: Background: Of patients with known atrial fibrillation (AF), 78% are offered and maintained on appropriate anticoagulant therapy. The Academic Health Science Network’s AF Budget Impact Model uses public data on expected population prevalence, identification, and management of AF to show the net budget impact of addressing identified gaps in care.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.012
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 123Targeted left ventricular endocardial leads for cardiac
           resynchronisation therapy guided by detailed haemodynamic assessment and
           high resolution electroanatomical mapping
    • Authors: Butcher C; (Presenting Author, Sohaib S, Shun-Shin M, et al.
      Abstract: Introduction: Endocardial left ventricular (LV) pacing allows stimulation at almost any LV site in contrast to coronary venous pacing.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.013
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 124High incidence of monomorphic non-sustained ventricular tachycardia in
           hypertrophic cardiomyopathy patients without apical aneurysms
    • Authors: Kelham M; (Presenting Author, Lane J, Whittaker-Axon S, et al.
      Abstract: Introduction: Ventricular arrhythmias are the principle cause of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). The presence of non-sustained ventricular tachycardia (NSVT) on Holter monitoring is one of seven variables in the HCM Risk-SCD calculator that estimates five year SCD risk to guide implantable cardiac-defibrillator (ICD) implantation. Recurrent monomorphic ventricular tachycardia (VT) has been noted to occur almost exclusively in HCM patients with left ventricular apical aneurysms. In a population of HCM patients with primary prevention ICDs, we sought to ascertain: the incidence of NSVT, whether monomorphic VT is restricted to those with apical aneurysms, and if calculated risk scores correlated with observed events of ventricular arrhythmia ICD detections and therapies.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.014
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 125An integrated multi-professional approach to AF management: initial
           experience and short-term outcomes of a new rapid access clinic in
           secondary care
    • Authors: Viswanathan K; (Presenting Author, Beith C, Pittaway L, et al.
      Abstract: Introduction: An integrated, structured approach to management of atrial fibrillation (AF) is now recommended by the European Society of Cardiology. Published data on outcomes of such models within secondary care in the UK is limited. We report on a new integrated care pathway for newly diagnosed arrhythmias - atrial fibrillation (AF) and supraventricular tachycardia (SVT) across Calderdale and Greater Huddersfield CCGs (population 450, 000) developed collaboratively between primary and secondary care.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.015
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 126Outcomes after ICD implantation in octogenarians
    • Authors: Saheecha S; (Presenting Author, Tyebally S, Lim W, et al.
      Abstract: Introduction: Implantable cardioverter-defibrillator (ICD) therapy improves survival in patients with severe left ventricular systolic dysfunction. The mean age of patients recruited in the pivotal primary prevention trials was <65 years and hence high quality data supporting the benefit of ICD implantation in octogenarians is limited. Our aim was to retrospectively examine outcomes in octogenarians undergoing ICD implantation compared to younger patients.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.016
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 127Can corrected sinus node recovery time be used to predict the need for
           atrial pacing in an ICD population'
    • Authors: Wiles B; (Presenting Author, Roberts P, Morgan J.
      Abstract: Introduction: Improvements in single chamber ICD rhythm discrimination and the emergence of a subcutaneous defibrillator have led to a decrease in the number of ICD patients who routinely receive an atrial lead. Whilst this paradigm shift is expected to reduce long-term device related complication rates, it might create a cohort of ICD patients with symptomatic sino-atrial node (SAN) disease and a device which cannot deliver atrial pacing. This could be prevented by the identification of a measurable parameter, which could accurately predict atrial pacing need in the ICD population. In this study we assess the discriminatory value of corrected sinus node recovery time (CSNRT), a largely historical measure of SAN automaticity, to device parameters which are currently utilised in the identification of atrial pacing need. We also sought to assess the influence of beta blocker therapy on CSNRT values and to assess the distribution of CSNRT in the ICD population.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.017
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 128Permanent His bundle pacing- device programming
    • Authors: Swift M; (Presenting Author, James J, Brader S, et al.
      Abstract: Methods: 57 PHBP devices have been implanted using the Medtronic C315 His catheter and a select secure lead. Implantation has been guided with a Medtronic PAS system, running at 100 mm/s, attached to the atrial channel at a sensitivity of 0.05 mV. Patients were followed up in a specific physiologist led PHBP clinic.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.018
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 129Left ventricular endocardial pacing with a novel wireless CRT system
           (WiSE-CRT) pacing threshold trends: medium term two year data
    • Authors: Twomey D; (Presenting Author, Butter C, Riahi S, et al.
      Abstract: Introduction: The WiSE-CRT leadless endocardial LV pacing system is a novel solution for patients unable to undergo standard CRT. It uses ultrasound energy from a subcutaneous pulse generator and a receiver-electrode implanted on the endocardial wall of the left ventricle. This study reports the threshold trend of the leadless LV electrode.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.019
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 130Incidence of atrial arrhythmia and uptake of anticoagulation in stroke
           and non-stroke populations according to arrhythmia burden; a 7-year
           experience
    • Authors: Chousou P; (Presenting Author, Bellanti R, Sanders K, et al.
      Abstract: Background/Introduction: Among patients with unexplained ischaemic stroke, prolonged cardiac rhythm monitoring with an Implantable Loop Recorder (ILR) has been found to uncover a high incidence of Atrial Fibrillation (AF). However, the incidence of AF detected by ILR in the general population is not known. It is also unclear what burden of AF is required to increase stroke risk and whether short bursts of AF are truly pathologic requiring life-long anticoagulation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.020
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 131Atrial fibrillation upskilling program improves anticoagulation rates
           in primary care
    • Authors: Saeed Z; Porter B, (Presenting Author, Adeleke Y, et al.
      Abstract: Introduction: Atrial fibrillation (AF) remains a leading cause of ischaemic stroke despite the availability of effective medications. The area served by Hounslow CCG has had high rates of strokes secondary to AF and rates below the pan London standard for anticoagulation. Improved diagnosis and management has potential significant benefits for individual patients and economically for our health service due to the expensive nature of stroke care. An integrated approach was taken as outlined below to try meet quality standards such as the Pan London AF standards.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.021
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 132Cardiac implantable electronic devices extraction: a UK single centre
           experience and review
    • Authors: Monga S; (Presenting Author, Brown S, Mehisen M, et al.
      Abstract: Background: A large number of Cardiac Implantable Electronic Devices (CIED) are implanted for management of arrhythmias and heart failure leading to an increase in the number of device extraction procedures. Despite the evolution of technology directed at this approach, extraction procedures carry considerable risk of morbidity and mortality even in experienced hands.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.022
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 133Endocardial left ventricular pacing and AV node ablation in a patient
           with Ebstein’s anomaly and mechanical tricuspid valve replacement with
           an inaccessible coronary sinus
    • Authors: Chapman M; (Presenting Author, McMinn J, James S, et al.
      Abstract: Introduction: Ebstein’s anomaly is characterised by apical displacement of the tricuspid valve (TV), an “atrialised” portion of the right ventricle (RV) and dilatation of the true tricuspid annulus. Permanent pacing is infrequently required but due to RV anatomical abnormalities and high rates of TV intervention, endocardial RV pacing is rarely performed and surgically implanted epicardial leads are often used. Other options include implantation of pace-sense leads via the coronary sinus (CS).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.023
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 134Extracting infected cardiac implantable electronic devices, a
           significant healthcare cost
    • Authors: Brough C; (Presenting Author, Wright D.
      Abstract: Background: A rise in cardiac implantable electronic device (CIED) infection has previously been reported in America, with a 57% increase between 2004 and 2006. Extraction is the definitive method to eradicate infection, although reburial and chronic antibiotic use may be considered when procedural risks are outweighed by patient co-morbidities. The cost of managing patients with device infections is unknown and therefore we aim to quantify the expense incurred at a single UK tertiary cardio-thoracic centre performing transvenous extraction and re-implantation as clinically indicated.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.024
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 135Pulmonary vein isolation using a point by point workflow - CMR analysis
           and procedural success rates
    • Authors: O'Neill L; (Presenting Author, Williams S, Karim R, et al.
      Abstract: Background: The Close Protocol point-by-point workflow for pulmonary vein isolation (PVI) targeting pre-defined Ablation Index (AI, a composite of contact force, time and power) values and minimising inter-lesion distance may optimise the creation of durable radiofrequency ablation lesions. Cardiac MRI (CMR) is the only non-invasive tool to assess the appearances of post ablation scar.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.025
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 136Structured antibiotic regimen results in greater than fifty percent
           reduction in device infections
    • Authors: Srinivasan N; (Presenting Author, Behar J, Monkhouse C, et al.
      Abstract: Introduction: Between April 2015 to April 2016, 1734 cardiac devices were implanted at our centre, with an infection rate of 1.2%. In order to further reduce infection rates, a standardized antibiotic regimen was implemented. We aimed to see if this would reduce infection rated.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.026
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 137A novel technique for performing transseptal puncture guided by
           non-fluoroscopic 3D mapping
    • Authors: Sawhney V; (Presenting Author, Breitenstein A, Garcia J, et al.
      Abstract: Background: Transseptal puncture (TSP) is commonly performed under fluoroscopic guidance in left atrial ablation procedures. This exposes patients and healthcare professionals to deleterious ionizing radiation. We describe a novel technique for performing TSP non-fluoroscopically using a 3 D mapping system.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.027
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 138Predictors of atrial fibrillation recurrence following cryoablation for
           paroxysmal atrial fibrillation
    • Authors: Patel M; (Presenting Author, Champney F, Silberbauer J, et al.
      Abstract: Introduction: Cryoablation is an effective technique for pulmonary vein isolation (PVI) in treatment for paroxysmal AF (PAF). The Artic Front Advance™ Cryoballoon (Medtronic) is the second-generation device with rates of acute PVI over 98%. AF recurrence following cryoablation is 20-30%. Factors including gender, left atrial measurements on echo and hypertension have been associated with AF recurrence following ablation. There is limited data on the predictors of success following cryoablation for PAF especially in relation to specific atrial echo parameters including dimensions, area and volume.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.028
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 139Direct oral anticoagulants reduce time to direct current cardioversion
           over a 5 year period
    • Authors: Terri T; Price D, Foley P, (Presenting Author.
      Abstract: Introduction: Prevention of cardio-embolism during elective direct current cardioversion (DCCV) requires anti-coagulation traditionally with warfarin, more recently direct oral anti-coagulants (DOACs) have been approved for use in non-valvular atrial fibrillation. Effective anti-coagulation with warfarin requires monitoring of the effect using the international normalised ratio (INR), waiting at least three weeks whilst the INR is consistently above 2.0. DOACs require no monitoring and may remove delay. We sought to determine whether the introduction of DOACs changed practice
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.029
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 140Can deviation from NICE guideline TA314 ever be justified'
    • Authors: Brady P; (Presenting Author, Chandrasekaran B, Foley P.
      Abstract: Introduction: Ventricular tachycardia (VT) is a significant cause of morbidity and mortality in patients with structural heart disease.Implantable Cardioverter Defibrillators (ICDs) carry a class I indication for implantation to prevent sudden cardiac death (SCD) in patients with symptomatic Heart Failure who have a Left Ventricular Ejection Fraction (LVEF) less than 35% despite optimal medical therapy. Cardiac Resynchronisation Therapy (CRT) has an established role in the treatment of patients with severe left ventricular systolic dysfunction (LVED) and symptomatic heart failure despite optimal medical therapy (OMT).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.030
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 12Appropriate ILR programming improves detection of events and reduces
           inappropriate alerts. Reduction in home monitoring workload for
           physiologists made possible
    • Authors: Little C; (Presenting Author, Foley P, Haynes D.
      Abstract: Introduction: Implantable loop recorders (ILR’s) have become increasingly popular to Follow-up using home monitoring (HM). Since its introduction in 2000, HM data is accessed via websites, which means for the Physiologist, the workload has increased exponentially (Armstrong 2016).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.005
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 141Ventricular tachycardia ablation: single centre experience
    • Authors: Adlan A; (Presenting Author, Arujuna A, Dowd R, et al.
      Abstract: Background: Ventricular tachycardia (VT) is associated with increased morbidity and in patients with previous myocardial infarction there is an increased risk of sudden death. There is growing evidence for the effectiveness of catheter ablation over medications in improving morbidity in patients with recurrent VT and ischaemic cardiomyopathy (ICM). As a result the threshold for referring for VT ablation has fallen over recent years and this has led to increasing numbers of cases being performed. Given the paucity of real world data since the emergence of distinct patient selection criteria we sought to present our single centre experience.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.031
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 142A real world assessment of the clinical utility of TYRX antimicrobial
           envelope to prevent cardiac implantable electronic device infection in a
           high-risk patient cohort
    • Authors: Devereux F; (Presenting Author, Zaidi A, Cunnington C, et al.
      Abstract: Background: Infection is the commonest reason for cardiovascular implantable electronic device (CIED) extraction. Certain patient characteristics, medications and procedures are recognised to be associated with increased risk of CIED infection. In view of this there has been growing interest in exploring the utility of the absorbable TYRX antimicrobial envelope to reduce the risk of ensuing infection CIED infection in patients undergoing primary and secondary CIED procedures. We report observed CIED infection rates following the use of TYRX antimicrobial envelope in a “high-risk” patient cohort.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.032
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 143Test-Retest repeatability of speed of heart rate recovery in response
           to orthostatic challenge
    • Authors: Perez-Denia L; (Presenting Author, Rice C, Foran T, et al.
      Abstract: Introduction: An impaired transient heart rate (HR) response to standing is a well-known marker of autonomic dysfunction. A new parameter, speed of HR recovery (HRR10s 20s), has recently been proposed to characterize this response and has been noted as a novel mortality risk factor in those aged over 50. The short-term repeatability of this parameter has yet to be assessed.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.033
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 144Entrainment of induced ventricular fibrillation: a human feasibility
           and proof of concept study
    • Authors: Begg G; (Presenting Author, Holden A, Bounford K, et al.
      Abstract: Background: Defibrillation testing of de novo implants, box changes, and revisions for ICDs or cardiac resynchronisation defibrillators (CRT-D) provides an opportunity for testing the effects of applied electrical perturbations on human ventricular fibrillation. Repetitive small amplitude pacing is used in anti-tachycardia, and has been proposed as an alternative to large amplitude defibrillation shocks.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.034
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 145Identification of focal sources in human atrial fibrillation by a
           divergence-based approach
    • Authors: Masè M; (Presenting Author, Cristoforetti A, Disertori M, et al.
      Abstract: Introduction: The expanding role of catheter ablation of atrial fibrillation (AF) and the still unsatisfying outcomes of the procedure in more persistent forms have stimulated the development of novel mapping strategies to identify patient-specific drivers. AF drivers may include focal discharges or rotors. Visual evidence of these mechanisms has been provided by mapping studies, however few methods, mostly addressed to rotor characterization, have attempted to quantify conduction dynamics. Given the renewed interest for focal drivers in AF, in this work we propose a novel analysis framework based on the divergence of velocity vector fields, which aims toquantitatively characterize propagation patterns and to identify region with focal activation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.035
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 146Impact of non dipping status on ventricular electrical mechanical
           dysfunction in patients with prehypertension
    • Authors: Im S; (Presenting Author.
      Abstract: Background: Left ventricle (LV) remodelling in patients with hypertension (HTN) changes the structure of myocardium, and influences on electrical conduction system. However, there was limited data about the association between the non-dipping status and ventricular electromechanical intervals in pre-hypertensive patients.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.036
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 147An unusual source of ventricular tachycardia stimulation in a diseased
           heart
    • Authors: Chaturvedi V; (Presenting Author, Kumar S, Agarw A, et al.
      Abstract: Introduction: A 45 year old man presented with recurrent wide QRS tachycardia(WCT), LVEF 15%, and cardiogenic shock requiring multiple electrical cardioversion (DCCV) despite being on several drugs including amiodarone. It was noticed he had two WCT, and one of them, WCT 1, terminated with carotid massage. His coronary angiogram showed nonobstructive disease.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.037
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 148Real life experience of cryoballoon ablation compared to radiofrequency
           ablation for paroxysmal atrial fibrillation
    • Authors: Lazdam M; (Presenting Author, Sandilands A, Somani R, et al.
      Abstract: Background: Atrial fibrillation is a common tachyarrhythmia with significant morbidity and mortality. Pulmonary vein isolation has been shown to significantly improve symptoms. Radiofrequency ablation has been used widely and became the mainstay ablative therapy. Pulmonary vein isolation using Cryoballoon therapy has recently been shown to be non-inferior to radiofrequency ablation.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.038
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 149The role of cardiac rhythm management specialists with an interest in
           cardio-oncology
    • Authors: Brough C; (Presenting Author.
      Abstract: Background: Cardio-oncology is a rapidly evolving discipline, due to the increasing knowledge of the cardiovascular toxicity in management strategies but also increased survivorship. Cardiac rhythm management specialists have a unique role in the decisions of device implantation, deactivation and extraction, however the evidence base is frequently absent. We present a 10 year epidemiological study on the transvenous extraction of cardiac implantable electronic devices (CIED) among patients with malignancy.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.039
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 150Contemporary intracardiac defibrillator complications and the cost of
           correction
    • Authors: Brough C; (Presenting Author, Wright D.
      Abstract: Background: The rate of implantation of intracardiac defibrillators in the United Kingdom continues to increase, 661 pacemakers per million, 121 defibrillators per million and 77 cardiac resynchronisation systems per million in 2008 in the United Kingdom, rising to 717, 112 and 177 per million respectively in 2016. Non primary procedures (ie generator change, lead replacement) are considered higher risk than the initial implant but comparison of complications reported is challenging due to the variation in complication definition and reported numerator, denominator and follow-up duration. Although the cost of revising complications is included in QALY assessments, national tariff values are relied upon which often do not accurately represent the true clinical cost. We report the complications/reoperations of standard defibrillator procedures and the total patient morbidity to 1 year, with complication revision micro-costed.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.040
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 151Systematic pace-mapping to delineate ventricular tachycardia circuit in
           a patient with limited substrate based ablation targets
    • Authors: Taylor M; (Presenting Author, Twomey D, James , , et al.
      Abstract: Introduction: Catheter ablation is an established treatment for patients with ventricular tachycardia (VT). In patients with haemodynamically-tolerated VT, activation mapping and entrainment can be used to identify VT ablation targets. For patients with non-sustained or un-mappable VTs, substrate-based ablation is utilised. Pace mapping in sinus rhythm (SR) is an effective strategy to determine the critical isthmus of the re-entry VT circuit. We present a case where pace mapping allowed accurate delineation of the critical isthmus of the VT re-entry circuit allowing focused ablation and resulting in a successful outcome.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.041
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 152Empowering patients through educating and counselling for lifestyle
           changes using the web-based intervention “care information exchange”:
           a mixed method service evaluation
    • Authors: Dirksen A; (Presenting Author, Taraborrelli P, Lim C, et al.
      Abstract: The Imperial Syncope Diagnostic Unit in London diagnoses and supports patients with orthostatic intolerance (OI). In the context of often debilitating symptoms, patients are individually supported with education and advice on managing lifestyle and up-titrating medications. Information technology is increasingly applied within the UK healthcare system in various specialities. We tested the feasibility of using a web-based intervention tool in supporting patients with OI to adjust lifestyle and medication to improve symptoms. We Focused on the usability and satisfaction with the web-based intervention, and gauged the perceived patient benefit from using this tool.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.042
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 153Sacubitril/valsartan is safe in patients with implanted devices
    • Authors: Ferguson N; (Presenting Author, Dixon G, Chandrasekaran B, et al.
      Abstract: Introduction: Sacubitril/Valsartan is a first in class angiotensin receptor neprilysin inhibitor (ARNI) which is superior to Angiotensin converting enzyme inhibitors (ACEI) in patients with moderate to severe symptomatic severe left ventricular dysfunction. These patients are often also eligible for device therapy, although in the global PARADIGM-HF trial, very few (15%) patients had implantable cardioverter defibrillators (ICD). The effect of sacubitril/valsartan on pacing and defibrillator parameters is unknown and we sought to examine these.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.043
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 154Successful slow pathway modification via the jugular route in a patient
           with azygous continuation of the inferior vena cava
    • Authors: Taylor M; (Presenting Author, Thornley A.
      Abstract: Introduction: Azygous continuation of the inferior vena cava (IVC) is a vascular abnormality affecting 0.1% of the general population. Although normally asymptomatic it can complicate electrophysiology (EP) procedures. It is more prevalent in patients with congenital heart disease and therefore more frequently encountered during EP procedures. We present the case of a 53-year-old male with typical AV nodal reentrant tachycardia (AVNRT) who was found to have azygous continuation of the IVC and subsequently underwent successful ablation via subclavian and jugular access.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.044
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 155Atrial fibrillation detection algorithms in implantable loop recorders
           used to investigate patients with unexplained ischaemic stroke; a 6-year
           experience
    • Authors: Chousou P; (Presenting Author, Bellanti R, Sanders K, et al.
      Abstract: Background/Introduction: Among patients with unexplained ischaemic stroke, prolonged cardiac rhythm monitoring with an Implantable Loop Recorder (ILR) has been found to uncover a high incidence of Atrial Fibrillation (AF). Recent studies have shown that prolonged monitoring with an ILR is superior to conventional short-term monitoring for atrial arrhythmia detection. The Medtronic Reveal XT ILR has a dedicated algorithm for detection of atrial arrhythmia. However, since the introduction of the Medtronic Reveal LINQ ILR, which has enhanced AF detection algorithms, our unit has been routinely using LINQ ILRs for the investigation of unexplained ischaemic stroke. We report our 6-year experience of atrial arrhythmia detection methods.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy204.045
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 161Permanent pacemaker implantation after paediatric heart
           transplantation: risk factors, indications, and outcomes
    • Authors: Mahmood A; (Presenting Author, Fenton M, Morrison A, et al.
      Abstract: Introduction: Permanent pacemaker (PPM) placement in adults following orthotopic heart transplantation (OHT) has been well documented, however there have been few reports addressing the need for PPM implantation in paediatric heart transplant recipients. We describe the incidence, risk factors, clinical indications, and long-term outcomes of PPM implantation in children who underwent cardiac transplantation using the bicaval technique.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy206
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 162Aetiology and outcomes of paediatric out-of-hospital cardiac arrest
           survivors
    • Authors: Siddiqui A; (Presenting Author, Ja J, Norrish G, et al.
      Abstract: Background: Sudden cardiac death (SCD) accounts for over 400 deaths per year among young people in the United Kingdom and is most commonly caused by undiagnosed inherited cardiac conditions (ICC). The aetiology of paediatric resuscitated cardiac arrest (RCA) is thought to be similar, but this has not been systematically evaluated. This study describes the aetiology and outcomes of paediatric RCA in a retrospective single centre cohort.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy206.001
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 163Prevalence of left axis deviation in children with long QT syndrome
    • Authors: Rainton S; (Presenting Author, Field E, Walsh H, et al.
      Abstract: Background: Long QT syndrome (LQTS) is an inherited primary arrhythmia syndrome associated with sudden cardiac death in the young. Recent studies have suggested that there may be subtle structural cardiac abnormalities in LQTS patients. Our aim was to study the prevalence of left axis deviation (LAD), as a potential marker of a structural phenotype, amongst paediatric patients with Long QT Syndrome (LQTS).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy206.002
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 13Atrial fibrillation opportunity gap analysis tool to aid allocation of
           resources to detect cases and protect against complications
    • Authors: Orlowski A; (Presenting Author, Wilkins J, Ashton R, et al.
      Abstract: Background: In the UK, public health care aims to achieve equity of access to care, which requires appropriate targeting of resources. In England, around 2.5% of the population has atrial fibrillation (AF). As part of a nationwide programme between Public Health England and the Academic Health Science Networks, the Atrial Fibrillation Opportunity Analysis tool was developed to inform where opportunities to address gaps in AF detection and management exist at national, regional, and local levels.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.006
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 14Refining stroke risk stratification in low risk patients with atrial
           fibrillation: derivation of the ABCD score from a nationwide multi-center
           registry
    • Authors: Shin S; (Presenting Author, Kim D, Kim J, et al.
      Abstract: Background: Stroke and thromboembolic events may still occur in ‘low risk’ atrial fibrillation (AF) patients as categorized by CHA2DS2-VASc score. Our aim was to assess the prevalence of embolic stroke in clinically ‘low-risk’ AF patients using a non-gender CHA2DS2-VASc score (i.e. CHA2DS2-VA) of 0–1 and identify risk factors associated with stroke. Second, we used these data to derive and validate a novel risk stratification schema, for refining stroke risk stratification amongst this ‘low risk’ cohort.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.007
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 15Is sleep apnoea unrecognised in patients with atrial fibrillation'
    • Authors: Broughton C; Piracha S, McGibbon K, et al.
      Abstract: Introduction: There is a recognised association between atrial fibrillation and obstructive sleep apnoea, and consequent worse outcomes and poor rate control with antiarrhythmic drugs, cardio-version and ablation. (1,2) There have been several studies looking at the prevalence of this association (3) and we have reviewed the incidence of this at our institution and the relation to self-reported sleepiness.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.008
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 16Long-term outcomes following catheter ablation in patients with atrial
           fibrillation and heart failure: 7-year follow-up of the ARC-HF trial
    • Authors: Wong C; (Presenting Author, Zakeri R, Khan H, et al.
      Abstract: Background: Catheter ablation has been shown to improve symptoms, exercise performance and neurohormonal status, as compared to medical (rate control) therapy in patients with co-existing atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF). Recent trials have suggested a reduction in early mortality associated with ablation in this group, however long-term outcomes remain unclear.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.009
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 17Incidence of left atrial appendage thrombus in patients undergoing AF
           ablation in the NOAC era: is toe needed in low risk patients'
    • Authors: Taylor M; (Presenting Author, Gilbert G, Thornley A, et al.
      Abstract: Introduction: During the last two decades catheter ablation has become a successful treatment for patients with symptomatic atrial fibrillation (AF). Stroke is a rare but potentially catastrophic complication of left atrial catheter ablation. Despite the use of anti-coagulation pre-procedural transoesophageal echocardiogram (TOE) is often performed to exclude left atrial appendage (LAA) thrombus. Guidelines do not stipulate which patients require TOE prior to AF ablation. McCready et al (2010) found no LAA thrombus in 248 patients with a CHA2DS2-VASc of 0. At James Cook University Hospital patients with a CHA2DS2-VASc score of 0 do not routinely undergo TOE prior to AF ablation although there is variation in operator threshold. This single centre retrospective study aimed to assess the usefulness of CHA2DS2-VASc in predicting the risk of LAA thrombus and identifying whether low risk patients routinely require TOE.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.010
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 18Non-pulmonary vein triggers of atrial fibrillation in patients with
           complete pulmonary vein isolation
    • Authors: Kim M; (Presenting Author, Sandler B, Sikkel M, et al.
      Abstract: Background: Patients with recurrences of atrial fibrillation (AF) after pulmonary vein isolation (PVI) present a clinical dilemma when veins remain isolated. High-Frequency Stimulation (HFS) delivered within the local myocardial refractory period enables neural stimulation, without myocardial capture, of presumed ganglionated plexus sites (GP) that reproducibly trigger atrial ectopy and AF.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy198.011
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 19Neuro-specific stimulation of the left atrial ganglionated-plexi sites
           reveals triggered atrial activity
    • Authors: Sandler B; Sikkel M, Cantwell C, et al.
      Abstract: Background: Holter recordings in patients with paroxysmal atrial fibrillation (AF) will often show a range of atrial activity including single ectopic, repetitive ectopy, self-terminating AF and sustained AF. It is not known why this variation occurs, though autonomic causes are often suggested. Short pulse of high output HFS delivered within the local myocardial refractory period can be used to study the specific effects of neural stimulation without myocardial capture.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199
      Issue No: Vol. 20, No. suppl_4 (2018)
       
  • 20The ET-GP study: ablation of ectopy-triggering ganglionated-plexus
           without pulmonary vein isolation for paroxysmal atrial fibrillation
    • Authors: Sandler B; (Presenting Author, Sikkel M, Kim M, et al.
      Abstract: Background: High-Frequency Stimulation (HFS) delivered within the myocardial refractory period enables isolated neural stimulation without direct myocardial capture. There are presumed ganglionated plexus sites (GP) in the left atrium that reproducibly trigger atrial ectopy and fibrillation. It is not known if these ectopy-triggering GP sites (ET-GP) have a role in the pathogenesis of atrial fibrillation (AF). In order to address this, we conducted a prospective, randomised, blinded, feasibility study of ET-GP ablation (without pulmonary vein isolation) vs. pulmonary vein isolation (PVI).
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/europace/euy199.001
      Issue No: Vol. 20, No. suppl_4 (2018)
       
 
 
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