Stefan Bogdan

• Carol Davila University of Medicine and Pharmacy

Introduction: Prognosis after electrical storm (ES) ablation remains severe, especially in patients with recurrent sustained monomorphic ventricular tachycardia (SMVT) or progressive heart failure (HF). However, single-factor-based prediction is suboptimal and may be refined by more complex algorithms. We sought to evaluate if a novel score MSA-VT...

Background: Catheter ablation (CA) for atrial fibrillation (AF) is superior to antiarrhythmic drugs in maintaining sinus rhythm. Novel evidence suggests that increasing the time between the first diagnosis of AF and ablation, or diagnosis-to-ablation time (DAT), is a predictor for AF recurrence post-ablation. Purpose: Our primary objective was to i...

Cardiac resynchronization therapy (CRT) has become part of the standard of care for symptomatic patients with heart failure, reduced ejection fraction (HRrEF), and wide QRS, despite optimal medical therapy. Device technology, operator experience, and post-implant optimization on follow-up have significantly improved CRT response during the last dec...

Heart failure with preserved ejection fraction (HFpEF) has become an emerging concern. The protective effect of bradycardia in patients with reduced ejection fraction using beta-blockers or ivabradine does not improve symptoms in HFpEF. This review aims to assess current data regarding the impact of anti-bradycardia pacing in patients with HFpEF. A...

Introduction: Catheter ablation (CA) for atrial fibrillation (AF) has been proven to have the highest efficacy in maintaining sinus rhythm. Several studies have proposed different scores for predicting post-procedural success, but most have not been validated in prospective cohorts. Further research is required to determine the optimal formulae. Pu...

Background and aims There is limited data concerning the effect of non-revascularized chronic total occlusions (NR-CTOs) after VT ablation. This study sought to evaluate the impact of NR-CTOs after ablation for electrical storm (ES). Methods Post-hoc retrospective analysis of data regarding 64 consecutive post-myocardial infarction patients (out o...

Funding Acknowledgements Type of funding sources: None. Background/Introduction Outcomes in post-myocardial infarction (MI) patients which are referred for catheter ablation (CA) for drug-refractory electrical storm (ES) are influenced both by patient characteristics and procedural results. Previous data has shown higher risk for the first inciden...

Cardiac resynchronization therapy (CRT) restores ventricular dyssynchrony, improving left ventricle (LV) systolic function, symptoms, and outcome in patients with heart failure, systolic dysfunction, and prolonged QRS interval. The left atrium (LA) plays tremendous roles in maintaining cardiac function, being often inflicted in various cardiovascul...

Background Prediction of cardiac resynchronization therapy (CRT) response, particularly a super-response, is of great importance. Study Question The aim of our study was to assess the predictors for super-responders in CRT. Study Design We conducted a retrospective, observational study, which finally included 622 patients with heart failure treat...

Introduction: Cateter ablation (CA) for atrial fibrillation (AF) has been proven to be extremely effective in maintaining sinus rhythm but success rates still vary widely. Procedural costs are not negligible and a low, but nonetheless present, rate of potentially severe complications exists, therefore an accurate estimation of results is necessary...

Background: Electrical storm (ES) is defined by clustering episodes of ventricular tachycardia (VT) and is associated with severe long-term outcomes. We sought to evaluate the prognostic impact of radiofrequency catheter ablation (RFCA) in ES as assessed by aggressive programmed ventricular stimulation (PVS). Methods: Single-center retrospective lo...

Objective. Radiofrequency catheter ablation is an effective treatment option for cardiac arrhythmias including complex and ventricular arrhythmias. Remote magnetic catheter navigation (RMN) has been developed as a novel way of approach aiming to improve outcome and reduce complication rate, and reduce radiation exposure for both operator and patien...

Background Achieving long-term successful outcomes with catheter ablation (CA) of persistent atrial fibrillation (PsAF) remains a challenge. Multiple attempts to determine effective ablation strategies besides the pulmonary veins (PV) were made but, so far, there is no agreed standard approach and no clear consensus as to which is the best one. Amo...

Background: Cardiac resynchronization therapy (CRT) is an established treatment for heart failure with reduced ejection fraction (HfrEF). Etiology may influence the outcome of patients undergoing CRT. Objective: to evaluate whether etiology (ischemic vs non-ischemic) influences the response to CRT and overall outcome. Methods: Our study included HF...

Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). Methods: Patients undergoing CRT were prospectively included. The primary endpoint was adverse cardiovascular events (...

Funding Acknowledgements Type of funding sources: None. Introduction Catheter ablation of accessory pathways (AP) located in the posterior pyramidal space are often challenging due to its anatomical complexity. Scarce of data are available about the ECG features that might indicate when an epicardial approach is required in the ablation of the pos...

Background Right ventricular – arterial (RV-PA) coupling can be estimated by echocardiography using the ratio between (TAPSE) and pulmonary arterial systolic pressure (PASP). TAPSE/PASP ratio proved to be a prognostic parameter in patients with heart failure and reduced ejection fraction (HFrEF). Objective To evaluate the significance of RV-PA cou...

Objectives To provide preliminary data on practice of stress perfusion cardiovascular magnetic resonance (CMR) in a single center in Romania. Methods We retrospectively reviewed the clinical files and CMR reports of patients who underwent stress perfusion CMR in our institution between January 2018 and December 2020. Results A total of 1036 patie...

Aims – Frequent premature ventricular complexes (PVCs) may induce/aggravate LV systolic dysfunction (LVD) by tachy(dyssynchrono)cardiomyopathy (tCMP) in patients with/without previous structural heart disease. High arrhythmic burden (i.e. >26%) is the main predictor of tCMP development in patients with previously normal LV function. However, its pr...

Background: The aim of this study was to explore the rare variants in a cohort of Romanian index cases with hypertrophic cardiomyopathy (HCM). Methods: Forty-five unrelated probands with HCM were screened by targeted next generation sequencing (NGS) of 47 core and emerging genes connected with HCM. Results: We identified 95 variants with allel...

The aim of this European Heart Rhythm Association (EHRA) survey was to assess the utilization of same-day discharge (SDD) in electrophysiology (EP). An online-based questionnaire was shared with the EHRA community between 12 and 30 June 2020 and recorded institutional information, complication assessment, recent experiences, and opinions regarding...

Purpose Response to cardiac resynchronization therapy (CRT) is well-established in patients with typical left bundle branch block (LBBB) but modest or even negative in those with intraventricular conduction delay (IVCD). However, IVCD pattern is heterogeneous, and it is possible that QRS patterns may also respond to CRT. Methods Consecutive baseli...

Background Left ventricular non-compaction (LVNC) is a structural cardiomyopathy (SC) with a high probability of LV systolic dysfunction. Left bundle branch block (LBBB) frequently occurs in SCs. Purpose We sought to analyse the evolution of LVNC-CRT (LC) patients in general and compare it with the non-LVNC-CRT group (nLC). Methods We analysed 40...

Background Right ventricular (RV) stimulation induces supplemental dyssynchrony in case of left bundle branch block (LBBB) patients. Isolated left ventricular (LV) pacing has been proven superior to biventricular pacing (BiV) in terms of acute hemodynamic response. Purpose We sought to determine whether an optimised isolated LV pacing algorithm ca...

Background Electric storm is a life threatening condition, that can complicate multiple cardiac pathologies and is associated with high mortality. Catheter ablation has been shown to reduce ventricular tachycardia (VT) burden in patients with electrical storm but the optimal procedural endpoint and the therapeutic particularities required by differ...

Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF. Background Cardiac resynchronization therapy (CRT) is an effective treatment for patients with heart failure (HF) with reduced ejection fraction. Biventricular pacing is the most common mode of deli...

Aims: The present study sought to determine predictors for success and outcomes of patients who underwent cardiac implantable electronic devices (CIED) extraction indicated for systemic or local CIED related infection in particular where complete lead removal could not be achieved. Methods and results: ESC-EORP ELECTRa (European Lead Extraction...

Interventional electrophysiology (EP) has become the standard of care for arrhythmia management according to current guidelines.1,2 Becoming a heart rhythm specialist can be very challenging in light of a difficult EP curriculum and even more so in the absence of a structured training programme (Table 1).3 The 2017 European Heart Rhythm Association...

Background: The Shockless IMPLant Evaluation (SIMPLE) showed that defibrillation testing (DT) at the time of implantable cardioverter defibrillator (ICD) implant did not improve shock efficacy or reduce mortality. There are no data regarding the risk of complications, including stroke, among patients with atrial fibrillation (AF) who undergo DT....

Right heart disease can be associated with increased risk for arrhythmias, both ventricular and supraventricular. Right sided arrhythmias may occur in the setting of structural disease predominantly affecting the right heart—such as cardiomyopathies (arrhythmogenic right ventricular dysplasia, cardiac sarcoidosis) and congenital heart disease (corr...

Cardiac resynchronization therapy (CRT) targets dyssynchrony correction in heart failure patients with reduced left ventricular systolic function and electrical disease. In the following chapter we will analyze the pathophysiology of dyssynchrony and dyssynchrony assessment, the extent of clinical evidence in cardiac resynchronization therapy and c...

Aims: Albumin is a marker of frailty. Scarce data are available on correlations between frailty-related parameters and outcomes in patients undergoing TAVI. This study sought to evaluate the relation between albumin and mortality in TAVI candidates. Methods and results: A total of 150 patients (mean age 81±6 years) undergoing TAVI were included...

With the ageing of the general population, clinicians are facing with increased frequency the challenge of administering parenteral anti-coagulation therapy in the elderly, the main indications being venous thromboembolism (VTE), acute coronary syndromes (ACS), atrial fibrillation and bridging therapy. Assessing the risk/benefit ratio is always dif...

Full title: Clinical Outcomes in Patients with Severe Renal Dysfunction Including Dialysis Following Defibrillator Implantation Published in Am J Nephrol 2015;42:295–304 Submission for the "Best Research by Young Electrophysiologists" session BACKGROUND: Renal dysfunction is associated with increased mortality in heart failure (HF) patients. Howeve...

Lead extraction (LE) is necessary for patients who are suffering from a related infection, or in opening venous occlusions that prevent the insertion of additional lead. In severe cases of fibrous encapsulation of the lead within a vein, laser-based cardiac LE has become one of the foremost methods of removal. In cases where the laser radiation (ty...

Background: Current lead extraction (LE) devices can harm the blood vessel endothelium, increasing the risk of perforation. Objective: Proof of concept for using a solid-state pulsed laser at 355 nm with a hybrid catheter in LE. Methods: A hybrid catheter was used comprising optical fibers for the delivery of 355 nm laser pulses at 30 Hz and 6...

Background: Renal dysfunction is associated with increased mortality in heart failure (HF) patients. However, there are limited data regarding clinical and arrhythmic outcomes associated with implantable cardioverter defibrillator (ICD) therapy in this population. Methods: We evaluated outcomes associated with the severity of renal dysfunction w...

The use of cardiovascular implantable electronic devices (CIED) has made remarkable progress during the past 20 years. Overall, devices, leads, and delivery systems have evolved resulting in easier implantation, improved long-term reliability and better battery life span. Article see p 1048 Implantable cardioverter defibrillators (ICD), initially...

This editorial refers to ‘Long-term clinical effects of ventricular pacing reduction with a changeover mode to minimize ventricular pacing in a general pacemaker population’, by M. Stockburger et al. , on page doi:10.1093/eurheartj/ehu336 During the 1990s and the early years of the 2000s, there was considerable debate on the advantages of ‘physiol...

CRT Response in Patients with Renal Dysfunction IntroductionRenal dysfunction is associated with increased morbi-mortality in heart failure patients. Data regarding functional and clinical efficacy of cardiac resynchronization therapy (CRT) in this population are limited. Methods and ResultsWe aimed to evaluate the rate of functional response to CR...

Objectives: Pulmonary arterial hypertension (PAH) is a rare and severe disease with incompletely under stood pathogenesis. PAH is associated with pulmonary arterial remodeling and inflammation. We evaluated the effects of Sildenafil on the Monocrotaline (MCT) -induced disease in Wistar rats, for potential benefit in the early phases of inflammatio...

We present a case of atrial fibrilatlon in a pregnant woman (known with Wolff-Parkinson-White syndrome) treated with direct courent cardioversion. The risk of arrhythmia in pregnancy is related to fetal hypoperfusion, with possible teratogenic effect. Termination of atrial fibrillation episodes must always be attempted in pregnancy. Also, for acute...

Atrial flutter is a frequent arrhythmia. In the critical care setting, the arrhythmia may present in any patient, but it is most commonly seen in patients with impaired ventricular function, valvular disease, atrial dilatation or after cardiac surgery. Atrial flutter is most often arising from a macroreentry circuit in the right atrium or around sc...