Access

Format

Author / Creator

Subject

Recently added

Eresources

Language

Place of Publication

Dates

Location

Sub-series 1: Angus & Robertson book reviews in bound volumes, 1894-1970

Transseptal puncture (TSP) is widely used in catheter-based cardiac interventions to gain left atrial (LA) access, but its workflow has remained largely unchanged and is still a source of serious complications. Pulsed field ablation (PFA) for pulmonary vein isolation (PVI) has been shown to be at least comparable with radiofrequency ablation (RFA) in terms of safety and efficacy. However, PFA catheter delivery to the LA typically requires a standard TSP and an over the wire sheath exchange which can limit workflow and lengthen procedure time—a shorter procedure time being a proposed advantage of PFA over RFA. This study aimed to evaluate a simplified workflow for direct TSP using the PFA sheath (Faradrive, Boston Scientific). We retrospectively analyzed 166 patients undergoing PVI with PFA in our center. TSP was performed by combining a 16.8F PFA sheath (Faradrive, Boston Scientific) and a RF-guidewire (Versacross, Boston Scientific) as a direct approach without the need over an over-the-wire exchange. The patient population had a mean age of 63.8 ± 11.3 years and was 72.3% male (n = 119/166). TSP was achieved in all patients (n = 166, 100%) without complication. The mean time from groin puncture to LA ablation catheter delivery was 16.2 ± 5.5 min with a mean fluoroscopy time of 15.7 ± 12.7 min. Dilator and sheath crossed the septum with no significant resistance in all cases (n = 168, 100%). The RF-guidewire allowed catheters to be tracked back up to the superior vena cava without exchange in cases where another dropdown was desired to locate a preferred puncture site. The stiffness of the wire provided adequate support to advance all sheaths to the left side regardless of outer diameter. This is the first case series on the use of a RF-guidewire combined with the PFA sheath for TSP. This study proved that an over a RF-powered guidewire TSP directly with 16.8F PFA sheath is feasible, reproducible, and safe. This very simplified workflow eliminates the need for both a rigid metal needle and an over the wire sheath exchange reducing procedure time and complexity, fluoroscopy time and potential related risks.

Scientific reports, 2025-03, Vol.15 (1), p.8500-7, Article 8500

The safety of direct transeptal puncture using a radiofrequency guidewire combined with a 17Fr pulsed field ablation sheath

Family-based cardiac screening programmes for persons at risk for genetic cardiac diseases are now recommended. However, the psychological wellbeing and health related quality of life (QoL) of such screened patients is poorly understood, especially in younger patients. We sought to examine wellbeing and QoL in a representative group of adults aged 16 and over in a dedicated family cardiac screening clinic.
Prospective survey of consecutive consenting patients attending a cardiac screening clinic, over a 12 month period. Data were collected using two health measurement tools: the Short Form 12 (version 2) and the Hospital Anxiety and Depression Scale (HADS), along with baseline demographic and screening visit-related data. The HADS and SF-12v.2 outcomes were compared by age group. Associations with a higher HADS score were examined using logistic regression, with multi-level modelling used to account for the family-based structure of the data.
There was a study response rate of 86.6%, with n=334 patients providing valid HADS data (valid response rate 79.5%), and data on n=316 retained for analysis. One-fifth of patients were aged under 25 (n=61). Younger patients were less likely than older to describe significant depression on their HADS scale (p<0.0001), although there were overall no difference between the prevalence of a significant HADS score between the younger and older age groups (18.0% vs 20.0%, p=0.73). Significant positive associates of a higher HADS score were having lower educational attainment, being single or separated, and being closely related to the family proband. Between-family variance in anxiety and depression scores was greater than within-family variance.
High levels of anxiety were seen amongst patients attending a family-based cardiac screening clinic.Younger patients also had high rates of clinically significant anxiety. Higher levels of anxiety and depression tends to run in families, and this has implications for family screening and intervention programmes.

BMC genetics, 2013-01, Vol.14 (1), p.1-1, Article 1

Family-based associations in measures of psychological distress and quality of life in a cardiac screening clinic for inheritable cardiac diseases: a cross-sectional study

Background: Patients receive education before implantable cardioverter defibrillator (ICD) implantation. Patients’ understanding of ICD therapy requires investigation.
Methods: A retrospective cohort study was carried out at two implant centers where patients are educated during a consenting process pre‐ICD implantation. Questionnaires examining understanding of ICD therapy were completed during telephone interviews of patients with ICDs.
Results: Of 75 patients interviewed, 62 (83%) were male. The median age at time of ICD implantation was 64 years (standard deviation [SD] = 9.4; range: 29–82 years). The median interval from implantation to interview was 3 years (SD = 1.9; range: 0.1–9.0 years). Despite 83% (62 of 75) claiming to understand the reason for ICD implantation, no patient suggested arrhythmia termination when describing the indication.
Of shock recipients, 60% (12 of 20) felt poorly prepared for shock therapy. Of patients who experienced a device‐related complication, 83% (10 of 12) reported feeling inadequately forewarned of complications. Excluding patients with cardiac resynchronization therapy defibrillators (n = 6), 65% (45 of 69), 52% (36 of 69), 50% (35 of 69), and 61% (42 of 69) believe their ICD reduces risk of heart attack and improves breathing, exercise capacity, and heart function, respectively. Ninety‐three percent (70 of 75) are satisfied with their decision to accept ICD therapy. Only 12% (9 of 75) believe they will want to inactivate therapies in setting of terminal illness.
Conclusions:
Despite preimplantation education, patient comprehension of the risks and benefits of ICD therapy is poor. Patients’ expectations of ICD therapy may be inappropriate. Education strategies before and after implantation require improvement. (PACE 2012; 35:1097–1102)

Pacing and clinical electrophysiology, 2012-09, Vol.35 (9), p.1097-1102

Deficiencies in Patients' Comprehension of Implantable Cardioverter Defibrillator Therapy

Export record to excel

Export this record

Export record to excel

Sub-series 1: Angus & Robertson book reviews in bound volumes, 1894-1970

Export this record

Export record to excel

The safety of direct transeptal puncture using a radiofrequency guidewire combined with a 17Fr pulsed field ablation sheath

Export this record

Export record to excel

Family-based associations in measures of psychological distress and quality of life in a cardiac screening clinic for inheritable cardiac diseases: a cross-sectional study

Export this record

Export record to excel

Deficiencies in Patients' Comprehension of Implantable Cardioverter Defibrillator Therapy

Refine your search