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  • 1. Aganauskiene, J
    et al.
    Sornmo, L
    Atarius, R
    Blomstrom-Lundqvist, C
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
    Reproducibility of the signal-averaged electrocardiogram using individual lead analysis.1995In: European Heart Journal, Vol. 16, p. 1244-Article in journal (Refereed)
  • 2. Amara, Walid
    et al.
    Larsen, Torben B
    Sciaraffia, Elena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Hernández Madrid, Antonio
    Chen, Jian
    Estner, Heidi
    Todd, Derick
    Bongiorni, Maria G
    Potpara, Tatjana S
    Dagres, Nikolaos
    Sagnol, Pascal
    Blomstrom-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Patients' attitude and knowledge about oral anticoagulation therapy: results of a self-assessment survey in patients with atrial fibrillation conducted by the European Heart Rhythm Association.2016In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 18, no 1, p. 151-155Article in journal (Refereed)
    Abstract [en]

    The purpose of this European Heart Rhythm Association survey was to assess the attitude, level of education, and knowledge concerning oral anticoagulants (OACs) among patients with atrial fibrillation (AF) taking vitamin K antagonists (VKAs), non-VKA oral anticoagulants (NOACs) or antiplatelets. A total of 1147 patients with AF [mean age 66 ± 13 years, 529 (45%) women] from 8 selected European countries responded to this survey. The overall use of OACs and antiplatelets was 77 and 15.3%, respectively. Of the patients taking OACs, 67% were on VKAs, 33% on NOACs, and 17.9% on a combination of OACs and antiplatelets. Among patients on VKAs, 91% correctly stated the target international normalized ratio (INR) level. The proportion of patients on VKA medication who were aware that monthly INR monitoring was required for this treatment and the proportion of patients on NOAC who knew that renal function monitoring at least annually was mandatory for NOACs was 76 and 21%, respectively. An indirect estimation of compliance indicated that 14.5% of patients temporarily discontinued the treatment, and 26.5% of patients reported having missed at least one dose. The survey shows that there is room for improvement regarding education and adherence of patients taking OACs, particularly regarding monitoring requirements for NOACs.

  • 3. Andersson, B
    et al.
    Blomström-Lundqvist, C
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Hedner, T
    Waagstein, F
    Exercise hemodynamics and myocardial metabolism during long-term beta-adrenergic blockade in severe heart failure1991In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 18, no 4, p. 1059-1066Article in journal (Refereed)
    Abstract [en]

    Hemodynamics and myocardial metabolism at rest and during exercise were investigated in 21 patients with heart failure. The patients were evaluated before and after long-term treatment (14 +/- 7 months) with the beta-adrenergic blocking agent metoprolol. Clinical improvement with increased functional capacity occurred during treatment. Maximal work load increased by 25% (104 to 130 W; p less than 0.001). Hemodynamic data showed an increased cardiac index (3.8 to 4.6 liters/min per m2; p less than 0.02) during exercise. Pulmonary capillary wedge pressure decreased at rest (20 to 13 mm Hg; p less than 0.01) and during exercise (32 to 28 mm Hg; p = NS). Stroke volume index (30 to 39 g.m/m2; p less than 0.006) and stroke work index (28 to 46 g.m/m2; p less than 0.006) increased during exercise and long-term metoprolol treatment. The arterial norepinephrine concentration decreased at rest (3.72 to 2.19 nmol/liter; p less than 0.02) but not during exercise (13.2 to 11.1 nmol/liter; p = NS). The arterial-coronary sinus norepinephrine difference suggested a decrease in myocardial spillover during metoprolol treatment (-0.28 to -0.13 nmol/liter; p = NS at rest and -1.13 to -0.27 nmol/liter; p less than 0.05 during exercise). Coronary sinus blood flow was unchanged during treatment. Four patients produced myocardial lactate before the study, but none produced lactate after beta-blockade (p less than 0.05). There was no obvious improvement in a subgroup of patients with ischemic cardiomyopathy. In summary, there were signs of increased myocardial work load without higher metabolic costs after treatment with metoprolol.

  • 4.
    Arbelo, Elena
    et al.
    Univ Barcelona, Hosp Clin Barcelona, Cardiovasc Inst, Dept Cardiol, Barcelona, Spain..
    Brugada, Josep
    Univ Barcelona, Hosp Clin Barcelona, Cardiovasc Inst, Dept Cardiol, Barcelona, Spain..
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Laroche, Cecile
    European Soc Cardiol, EURObservat Res Programme, Sophia Antipolis, France..
    Kautzner, Josef
    Inst Clin & Expt Med, Dept Cardiol, Prague, Czech Republic..
    Pokushalov, Evgeny
    State Res Inst Circulat Pathol, Arrhythmia Dept, Novosibirsk, Russia.;State Res Inst Circulat Pathol, EP Lab, Novosibirsk, Russia..
    Raatikainen, Pekka
    Tampere Univ Hosp, Heart Ctr Co, Tampere, Finland..
    Efremidis, Michael
    Evangelismos Gen Hosp Athens, Lab Cardiac Electrophysiol, Dept Cardiol 2, Athens, Greece..
    Hindricks, Gerhard
    Univ Leipzig, Ctr Heart, Dept Electrophysiol, Leipzig, Germany..
    Barrera, Alberto
    Univ Hosp Virgen de la Victoria, Dept Cardiol, Arrhythmia Unit, Malaga, Spain..
    Maggioni, Aldo
    European Soc Cardiol, EURObservat Res Programme, Sophia Antipolis, France.;Assoc Nazl Med Cardiol Osped Res Ctr AMCO Res Ctr, Florence, Italy..
    Tavazzi, Luigi
    Maria Cecilia Hosp, ES Hlth Sci Fdn, GVM Care & Res, Cotignola, Italy..
    Dagres, Nikolaos
    Univ Leipzig, Ctr Heart, Dept Electrophysiol, Leipzig, Germany..
    Contemporary management of patients undergoing atrial fibrillation ablation: in-hospital and 1-year follow-up findings from the ESC-EHRA atrial fibrillation ablation long-term registry2017In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 38, no 17, p. 1303-1316Article in journal (Refereed)
    Abstract [en]

    Aims The ESC-EHRA Atrial Fibrillation Ablation Long-Term registry is a prospective, multinational study that aims at providing an accurate picture of contemporary real-world ablation for atrial fibrillation (AFib) and its outcome. Methods and results A total of 104 centres in 27 European countries participated and were asked to enrol 20-50 consecutive patients scheduled for first and re-do AFib ablation. Pre-procedural, procedural and 1-year follow-up data were captured on a web-based electronic case record form. Overall, 3630 patients were included, of which 3593 underwent an AFib ablation (98.9%). Median age was 59 years and 32.4% patients had lone atrial fibrillation. Pulmonary vein isolation was attempted in 98.8% of patients and achieved in 95-97%. AFib-related symptoms were present in 97%. Inhospital complications occurred in 7.8% and one patient died due to an atrioesophageal fistula. One-year follow-up was performed in 3180 (88.6%) at a median of 12.4 months (11.9-13.4) after ablation: 52.8% by clinical visit, 44.2% by telephone contact and 3.0% by contact with the general practitioner. At 12-months, the success rate with or without antiarrhythmic drugs (AADs) was 73.6%. A significant portion (46%) was still on AADs. Late complications included 14 additional deaths (4 cardiac, 4 vascular, 6 other causes) and 333 (10.7%) other complications. Conclusion AFib ablation in clinical practice is mostly performed in symptomatic, relatively young and otherwise healthy patients. Overall success rate is satisfactory, but complication rate remains considerable and a significant portion of patients remain on AADs. Monitoring after ablation shows wide variations. Antithrombotic treatment after ablation shows insufficient guideline-adherence.

  • 5. Asplund, A
    et al.
    Beerman, B
    Bergfeldt, L
    Blomström, Per
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Medicinska vetenskaper.
    Blomström-Lundqvist, Carina
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Medicinska vetenskaper.
    Treatment of atrial fibrillation. Recommendations from a workshop arranged by the Medical Products Agency (Uppsala, Sweden) and the Swedish Society of Cardiology1993In: European Heart Journal, no 14, p. 1427-33Article in journal (Refereed)
  • 6.
    Baensch, Dietmar
    et al.
    Univ Hosp Rostock, Dept Internal Med 1, Div Cardiol, Heart Ctr Rostock, D-18057 Rostock, Germany..
    Bonnemeier, Hendrik
    Univ Hosp Schleswig Holstein, Dept Internal Med Cardiol & Angiol 3, Kiel, Germany..
    Brandt, Johan
    Skane Univ Hosp, Arrhythmia Dept, Lund, Sweden..
    Bode, Frank
    Univ Hosp Schleswig Holstein, Med Clin Cardiol Angiol & Intens Care Med 2, Lubeck, Germany..
    Svendsen, Jesper Hastrup
    Copenhagen Univ Hosp, Rigshosp, Dept Cardiol, Ctr Heart, Copenhagen, Denmark.;Univ Copenhagen, Danish Arrhythmia Res Ctr, Copenhagen, Denmark..
    Taborsky, Milos
    Fac Hosp Olomouc, Dept Internal Med Cardiol 1, Olomouc, Czech Republic..
    Kuster, Stefan
    DRK Hosp Molln Ratzeburg, Dept Internal Med, Cardiol, Ratzeburg, Germany..
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Felk, Angelika
    Biotronik, Berlin, Germany..
    Hauser, Tino
    Biotronik, Berlin, Germany..
    Suling, Anna
    Univ Med Ctr Hamburg Eppendorf, Dept Med Biometry & Epidemiol, Hamburg, Germany..
    Wegscheider, Karl
    Univ Med Ctr Hamburg Eppendorf, Dept Med Biometry & Epidemiol, Hamburg, Germany..
    Intra-operative defibrillation testing and clinical shock efficacy in patients with implantable cardioverter-defibrillators: the NORDIC ICD randomized clinical trial2015In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 36, no 37, p. 2500-2507Article in journal (Refereed)
    Abstract [en]

    Aims This trial was designed to test the hypothesis that shock efficacy during follow-up is not impaired in patients implanted without defibrillation (DF) testing during first implantable cardioverter-defibrillator (ICD) implantation. Methods and results Between February 2011 and July 2013, 1077 patients were randomly assigned (1 : 1) to first time ICD implantation with (n = 540) or without (n = 537) DF testing. The intra-operative DF testing was standardized across all participating centres, and all ICD shocks were programmed to 40 J irrespective of DF test results. The primary end point was the average first shock efficacy (FSE) for all true ventricular tachycardia and fibrillation (VT/VF) episodes during follow-up. The secondary end points included procedural data, serious adverse events, and mortality. During a median follow-up of 22.8 months, the model-based FSE was found to be non-inferior in patients with an ICD implanted without a DF test, with a difference in FSE of 3.0% in favour of the no DF test [confidence interval (CI) -3.0 to 9.0%, Pnon-inferiority <0.001 for the pre-defined non-inferiority margin of 210%). A total of 112 procedure-related serious adverse events occurred within 30 days in 94 patients (17.6%) tested compared with 89 events in 74 patients (13.9%) not tested (P = 0.095). Conclusion Defibrillation efficacy during follow-up is not inferior in patients with a 40 J ICD implanted without DF testing. Defibrillation testing during first time ICD implantation should no longer be recommended for routine left-sided ICD implantation.

  • 7.
    Bagge, Louise
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Blomström, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Jidéus, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery.
    Lönnerholm, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Left atrial function after epicardial pulmonary vein isolation in patients with atrial fibrillation2017In: Journal of interventional cardiac electrophysiology (Print), ISSN 1383-875X, E-ISSN 1572-8595, Vol. 50, no 2, p. 195-201Article in journal (Refereed)
  • 8. Bagge, Louise
    et al.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Surgical ablation for atrial fibrillation in mitral valve disease: impact of the maze procedure-authors' response.2017In: Europace, ISSN 1099-5129, E-ISSN 1532-2092Article in journal (Refereed)
  • 9.
    Bagge, Louise
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Probst, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Blomström, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Thelin, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Quality of Life Is Not Significantly Improved by Adding Epicardial Left Atrial Cryoablation to Mitral Valve Surgery Than if Performed Alone2017In: Cardiovascular Electrophysiology, ISSN 1045-3873, E-ISSN 1540-8167, Vol. 28, no 5, p. 589-590, article id MA19Article in journal (Other academic)
  • 10.
    Bagge, Louise
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Probst, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Jensen, Steen M
    Faculty of Medicine, Department of Public Health and Clinical Medicine (Heart centre) Umeå University, SE-901 87 Umeå, Sweden.
    Blomström, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Thelin, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery.
    Holmgren, Anders
    Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology, Umeå University, SE-901 87 Umeå, Sweden.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Quality of life is not improved after mitral valve surgery combined with epicardial left atrial cryoablation as compared with mitral valve surgery alone: a substudy of the double blind randomized SWEDish Multicentre Atrial Fibrillation study (SWEDMAF)2017In: Europace, ISSN 1099-5129, E-ISSN 1532-2092Article in journal (Refereed)
  • 11. Bianchi, Stefano
    et al.
    Rossi, Pietro
    Schauerte, Patrick
    Elvan, Arif
    Blomström Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Kornet, Lilian
    Gal, Pim
    Mörtsell, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Wouters, Griet
    Gemein, Christopher
    Increase of Ventricular Interval During Atrial Fibrillation by Atrioventricular Node Vagal Stimulation: Chronic Clinical Atrioventricular-Nodal Stimulation Download Study2015In: Circulation: Arrhythmia and Electrophysiology, ISSN 1941-3149, E-ISSN 1941-3084, Vol. 8, no 3, p. 562-568Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: -Patients with a high ventricular rate during atrial fibrillation (AF) are at increased risk of receiving inappropriate implantable cardioverter defibrillator (ICD) shocks. The objective was to demonstrate the feasibility of high frequency atrioventricular-nodal stimulation (AVNS) to reduce the ventricular rate during AF to prevent inappropriate ICD shocks.

    METHODS AND RESULTS: -Patients with a new atrial lead placement as part of a CRT-D implant and a history of paroxysmal or persistent AF were eligible. If proper atrial lead position was confirmed, AVNS software was uploaded to the CRT device, tested and optimized. AVNS was delivered via a right atrial pacing lead positioned in the posterior right atrium. Software allowed initiation of high frequency bursts triggered on rapidly conducted AF. Importantly, the efficacy was evaluated during spontaneous AF episodes between 1 and 6 months after implant. Forty-four patients were enrolled in 4 centers. Successful atrial lead placement occurred in 74%. Median implant time of the AVNS lead was 37 minutes. In 26 (81%) patients, manual AVNS tests increased the ventricular interval by > 25%. Between 1 and 6 months, automatic AVNS activations occurred in 4 patients with rapidly conducted AF, and in 3 patients, AVNS slowed the ventricular rate out of the ICD shock zone. No adverse events were associated with the AVNS software.

    CONCLUSIONS: -The present study demonstrated the feasibility of implementation of AVNS in a CRT-D system. AVNS increased ventricular interval > 25% in 81% of patients. AVNS did not influence the safety profile of the CRT-D system.

  • 12.
    Blomstrom-Lundqvist, Carina
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
    Non-pharmacological rate or rhythm control--it is time for randomized studies.2005In: J Cardiovasc Electrophysiol, ISSN 1045-3873, Vol. 16, no 5, p. 462-4Article in journal (Refereed)
  • 13.
    Blomström Lundqvist, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Auricchio, Angelo
    Brugada, Josep
    Boriani, Giuseppe
    Bremerich, Jens
    Cabrera, Jose Angel
    Frank, Herbert
    Gutberlet, Matthias
    Heidbuchel, Hein
    Kuck, Karl-Heinz
    Lancellotti, Patrizio
    Rademakers, Frank
    Winkels, Gerard
    Wolpert, Christian
    Vardas, Panos E
    The use of imaging for electrophysiological and devices procedures: a report from the first European Heart Rhythm Association Policy Conference, jointly organized with the European Association of Cardiovascular Imaging (EACVI), the Council of Cardiovascular Imaging and the European Society of Cardiac Radiology2013In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 15, no 7, p. 927-936Article in journal (Refereed)
    Abstract [en]

    Implantations of cardiac devices therapies and ablation procedures frequently depend on accurate and reliable imaging modalities for pre-procedural assessments, intra-procedural guidance, detection of complications, and the follow-up of patients. An understanding of echocardiography, cardiovascular magnetic resonance imaging, nuclear cardiology, X-ray computed tomography, positron emission tomography, and vascular ultrasound is indispensable for cardiologists, electrophysiologists as well as radiologists, and it is currently recommended that physicians should be trained in several imaging modalities. There are, however, no current guidelines or recommendations by electrophysiologists, cardiac imaging specialists, and radiologists, on the appropriate use of cardiovascular imaging for selected patient indications, which needs to be addressed. A Policy Conference on the use of imaging in electrophysiology and device management, with representatives from different expert areas of radiology and electrophysiology and commercial developers of imaging and device technologies, was therefore jointly organized by European Heart Rhythm Association (EHRA), the Council of Cardiovascular Imaging and the European Society of Cardiac Radiology (ESCR). The objectives were to assess the state of the level of evidence and a first step towards a consensus document for currently employed imaging techniques to guide future clinical use, to elucidate the issue of reimbursement structures and health economy, and finally to define the need for appropriate educational programmes to ensure clinical competence for electrophysiologists, imaging specialists, and radiologists.

  • 14.
    Blomström, P
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Blomström-Lundqvist, C
    Olsson, S B
    Fåhraeus, T
    Lährs, C
    Indikation för utredning och behandling av patient med Wolff-Parkinson-Whites syndrom1990In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 87, no 1-2, p. 31-34Article in journal (Refereed)
  • 15.
    Blomström, P
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Edvardsson, N
    Blomström-Lundqvist, C
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Olsson, S B
    Precision of preoperative electrophysiological study in predicting the intraoperatively defined location of single left-sided accessory pathways1987In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 8, no 5, p. 510-520Article in journal (Refereed)
    Abstract [en]

    In 34 patients with a left-side anomalous pathway (AP) considered for arrhythmia surgery, the atrial insertion of the anomalous pathway in the preoperative investigation was determined by using three different techniques. The atrial activation sequence during orthodromic tachycardia or ventricular stimulation was recorded in the coronary sinus by using either (a) unipolar leads from an eight-polar electrode catheter with an interelectrode distance of 1 cm, (b) bipolar leads from consecutively positioned pairs of electrodes on the same electrode catheter or (c) bipolar leads recorded at one centimeter intervals by withdrawal of the electrode catheter. The corresponding location at surgery was obtained by atrial epicardial mapping during ventricular stimulation. Each way of recording the atrial activation sequence in the coronary sinus during orthodromic tachycardia or ventricular stimulation was compared with regard to their predictive value in assessing the corresponding location by intraoperative mapping. At surgery, a visual grid system was used to define the anatomical landmarks which were located 20 mm apart.

    When the unipolar technique was used to assess the anomalous pathway location, there was a difference corresponding to a distance of 2–2.5 anatomical landmarks (48 mm) between the preoperative and intraoperative assessments. With the bipolar technique the difference was up to 3 anatomical landmarks (60 mm) while it was up to 4.5 anatomical landmarks (90 mm) when the withdrawal technique was employed. The unipolar technique was superior in differentiating a left lateral from a left posterior or a septal location.

  • 16.
    Blomström, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Berglin-William-Olsson, E
    Olsson, S B
    Pre- and intraoperative identification of multiple accessory pathways. Experience of 19 pathways in 9 patients1989In: Cardiology, ISSN 0008-6312, E-ISSN 1421-9751, Vol. 76, no 1, p. 42-52Article in journal (Refereed)
    Abstract [en]

    The pre- and intraoperative electrophysiological studies in 9 patients with two or more accessory pathways are described. The presence of multiple accessory pathways was clinically suspected in only 2 patients. During the preoperative electrophysiological study two accessory pathways were identified in 7 patients and a single pathway in 2 patients. At operation, additionally three accessory pathways were identified in 3 patients. One out of two pathways, found preoperatively, could not be confirmed in 1 patient. It is concluded that the clinical or preoperative electrophysiological evidence of only one accessory pathway should not distract one's attention from considering multiple accessory pathways in patients presenting only one type of tachycardia.

  • 17.
    Blomström-Lundqvist, C
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Late potentials--a clinical update1992In: Clinical Physiology, ISSN 0144-5979, E-ISSN 1365-2281, Vol. 12, no 3, p. 319-323Article in journal (Refereed)
  • 18.
    Blomström-Lundqvist, C
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Beckman-Suurkäla, M
    Wallentin, I
    Jonsson, R
    Olsson, S B
    Ventricular dimensions and wall motion assessed by echocardiography in patients with arrhythmogenic right ventricular dysplasia1988In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 9, no 12, p. 1291-1302Article in journal (Refereed)
    Abstract [en]

    Twenty patients with arrhythmogenic right ventricular dysplasia (ARVD) and 20 healthy volunteers underwent cross-sectional echocardiographic examination for the assessment of ventricular dimensions and wall motion. Right ventricular cavity diameters and wall segments were selected from the inflow and outflow tracts and the right ventricular body. The measurement error for measuring cavity dimensions was low throughout and the reproducibility of wall motion scoring was high in both the normal subjects and the patients. All except one patient had increased dimensions and/or abnormal wall motion in the right ventricle. The right ventricular inflow tract was dilated in nine patients, the outflow tract in 11 patients and the short- or long-axis diameters of the right ventricular body were increased in seven patients. Right ventricular wall motion abnormalities, being the most frequent finding, ranged from mild hypokinesia only to dyskinesia or sacculations, and were fairly evenly distributed among the segments studied. Left ventricular abnormalities, found in eight patients, were generally mild. Cross-sectional echocardiography thus provides highly reproducible measurements of right ventricular size and contraction patterns even in patients with wall shape deformities, and is therefore a feasible non-invasive method for the evaluation of right-sided myocardial abnormalities in patients with ARVD. The diagnostic accuracy of this technique warrants further clarification.

  • 19.
    Blomström-Lundqvist, C
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Blomström, P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Beckman-Suurkäa, M
    Incessant ventricular tachycardia with a right bundle-branch block pattern and left axis deviation abolished by catheter manipulation1990In: Pacing and Clinical Electrophysiology, ISSN 0147-8389, E-ISSN 1540-8159, Vol. 13, no 1, p. 11-16Article in journal (Refereed)
    Abstract [en]

    A 22-year-old man underwent electrophysiological evaluation for incessant wide QRS complex tachycardia with a pattern of right bundle-branch block and left axis deviation. The right and left ventricles were enlarged and hypokinetic consistent with dilated cardiomyopathy. Ventricular tachycardia was diagnosed by demonstrating capture and fusion beats, atrioventricular dissociation, and His potential activation that began after the onset of each QRS complex. Atrial extrastimuli and rapid atrial pacing failed to terminate the tachycardia and, although ventricular stimulation was successful, the tachycardia spontaneously restarted after one or two sinus beats. The tachycardia was unexpectedly abolished during catheter manipulation in the left ventricle and has not recurred during three-years of follow-up. The picture of a cardiomyopathy resolved. The ease with which the tachycardia was abolished by catheter manipulation implicate a therapeutic potential for catheter ablation of this type of tachycardia.

  • 20.
    Blomström-Lundqvist, C
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Caidahl, K
    Olsson, S B
    Rudin, A
    Electrocardiographic findings and frequency of arrhythmias in Bartter's syndrome1989In: British Heart Journal, ISSN 0007-0769, Vol. 61, no 3, p. 274-279Article in journal (Refereed)
    Abstract [en]

    Twenty four hour electrocardiograms in 20 patients with Bartter's syndrome, a disorder associated with chronic potassium deficiency, were analysed for atrial and ventricular extrasystoles, pauses (RR interval greater than 2 s), and heart rate. The 12 lead resting electrocardiogram was also evaluated. There were slight electrocardiographic changes with ST segment depression (greater than or equal to - 0.5 mm) in seven patients, flat or low amplitude T waves in seven, and U waves (greater than or equal to + 1.0 mm) in three patients. The QT interval was prolonged in 18 patients. Nine patients had one or more ventricular extrasystoles in 24 hours. Only two patients had more than 200 ventricular extrasystoles in 24 hours. No patient had ventricular tachycardia. A total of nine patients had one or more atrial extrasystoles in 24 hours, but only one patient had more than 200 in 24 hours. One patient had an attack of non-sustained supraventricular tachycardia. No patient had pauses. Dangerous tachycardia was rare in these patients with chronic potassium deficiency caused by Bartter's syndrome. The general pattern of slight electrocardiographic changes may reflect an adaptation of the myocardium to hypokalaemia. Further studies are, however, needed to determine whether these findings are relevant to long term prognosis.

  • 21.
    Blomström-Lundqvist, C
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Edvardsson, N
    Transesophageal versus intracardiac atrial stimulation in assessing electrophysiologic parameters of the sinus and AV nodes and of the atrial myocardium1987In: Pacing and Clinical Electrophysiology, ISSN 0147-8389, E-ISSN 1540-8159, Vol. 10, no 5, p. 1081-1095Article in journal (Refereed)
    Abstract [en]

    Electrophysiological porameters of the sinus and AV nodes and of the atrial myocardium were assessed with both transesophageal atrial stimulation (TAS) and intracardiac atrial stimulation (ICS) in the same patient during the same study. The study group was comprised of nine men and seven women, aged 45 to 79 years, referred for the evaluation of syncope of possible arrhythmogenic origin. Twelve patients were included for analysis. Autonomic inhibition (AI) was obtained in five patients. The most striking result was the significantly longer AERP with TAS (mean 286 ± 9 ms) than with ICS (mean 244 ± 12 ms; p < 0.02). After AI, the AERP was even more prolonged with TAS (mean 332 ± 20 ms) than with ICS (mean 237 ± 8 ms; p < 0.01). Intraatrial and AV nodal conduction times assessed at multiple paced cycle lengths were significantly shorter with TAS than with ICS. There was no difference between TAS and ICS with regard to AVERP, Wenckebach periodicity and H-V intervals. Although a tendency towards shorter sinus node recovery time (SNRT) and sinoatrial conduction time (SACT) was observed with TAS, the difference was not statistically significant. Possible mechanisms of the differences are discussed. It seemed clear that the site of origin of an atrial impulse can have definite effects upon excitability and conduction properties of atrial and AV nodal fibers. Enhanced sympathetic activity during TAS was also suggested. The electrophysiological properties inherent in the TAS technique warrant further elucidation.

  • 22.
    Blomström-Lundqvist, C
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Hirsch, I
    Olsson, S B
    Edvardsson, N
    Quantitative analysis of the signal-averaged QRS in patients with arrhythmogenic right ventricular dysplasia1988In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 9, no 3, p. 301-312Article in journal (Refereed)
    Abstract [en]

    Temporal signal averaging of the surface QRS (VI + V3 + V5) was performed in 16 patients with arrhythmogenic right ventricular dysplasia and in 16 normal subjects. The differences between ARVD patients and normals were large for the filtered QRS duration (FQRSd) (146.2±18.9 vs. 91.8±4.1ms, P<000001), the late potential duration (LPd) (83.5±23.3 ms vs. 23.6±4.6ms, P< 0.00001), the LPd/ FQRSd ratio (53.9± 10.1% vs. 25.8±5.1%, P <0.00001), the filtered QRS amplitude (234.0±61.1μV vs. 429±942 fiV, P <0001), and the root mean square voltage of the signals in the terminal 40 and 50 ms of the FQRS (RMS40 and RMS50) (18.4± 10.0μV vs. 118.4±49.8p.V, P<0.0005 and 27.9± 19.2μV vs. 217.0±66.3fiV, P<0000002). RMS50 <40μV discriminated best between ARVD and normals (81% sensitivity and 100% specificity). The right-sided predominance of the abnormalities in ARVD was demonstrated by the significantly longer FQRSd and LPd, and the higher ratio LPd/FQRSd in right than in left precordial leads. The arrhythmia susceptibility did not seem to influence the presence of or properties ofLP in the ARVD group. Patients with multiple QRS morphologies during ventricular tachycardia (VT) had, compared with patients with only one type of VT, longer LPd (108.3 ±46.4 ms vs. 64.2 ±31.7 ms, P<0.02) and lower RMS40 voltage (9.4±9.9 μV vs. 25.4±21.6 μV, P<0.05). The relative heart volume was positively correlated with delayed activity, but an enlarged heart was not apre-requisitefor the presence ofLP. The method thus identifies changes which are specific to ARVD. The findings indicate that certain electrical or morphological conditions are required for the occurrence of arrhythmias.

  • 23.
    Blomström-Lundqvist, C
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
    Noor, A M
    Eskilsson, J
    Persson, S
    Safety of transvenous right ventricular endomyocardial biopsy guided by two-dimensional echocardiography.1993In: Clin Cardiol, ISSN 0160-9289, Vol. 16, no 6, p. 487-92Article in journal (Refereed)
  • 24.
    Blomström-Lundqvist, C
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Olsson, S B
    Eneström, S
    Arytmogen högerkammardysplasi - ofta förbisedd genes till ventrikulära arytmier1986In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 83, no 41, p. 3427-3430Article in journal (Other academic)
  • 25.
    Blomström-Lundqvist, C
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Sabel, K G
    Olsson, S B
    A long term follow up of 15 patients with arrhythmogenic right ventricular dysplasia1987In: British Heart Journal, ISSN 0007-0769, Vol. 58, no 5, p. 477-488Article in journal (Refereed)
    Abstract [en]

    The clinical course in 15 patients with features consistent with arrhythmogenic right ventricular dysplasia is described. At referral seven patients had abnormal physical findings, nine had abnormal electrocardiograms with non-specific right-sided abnormalities, and seven patients had increased heart size or prominent right ventricles on chest x ray. During long term follow up (mean 8.8 years, range 1.5 to 28 years) 11 patients had abnormal physical findings, 11 had electrocardiographic changes, and nine had increased heart size. Recurrent sustained right ventricular tachycardia was the most common arrhythmia (10 patients). Two patients experienced ventricular fibrillation. Seven patients suffered from over 10 episodes of ventricular tachycardia, nine required cardioversions, and 10 patients had associated serious symptoms such as syncope, severe hypotension, or cardiac arrest. Four patients required operation to correct the arrhythmia and three patients developed right heart failure. Two out of three deaths were sudden. These data suggest that in arrhythmogenic right ventricular dysplasia right ventricular abnormalities may be progressive and that the condition may affect the left ventricle. The course of the ventricular arrhythmias was highly variable and could not be predicted in individual patients. The potential for lethal ventricular arrhythmias is evident and warrants intensive diagnostic efforts to identify patients with adverse prognostic features.

  • 26.
    Blomström-Lundqvist, C
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Selin, K
    Jonsson, R
    Johansson, S R
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Schlossman, D
    Olsson, S B
    Cardioangiographic findings in patients with arrhythmogenic right ventricular dysplasia1988In: British Heart Journal, ISSN 0007-0769, Vol. 59, no 5, p. 556-563Article in journal (Refereed)
    Abstract [en]

    The dimension, contractility, and regional wall motion of the right and left ventricles were scored on the angiograms of 13 patients with arrhythmogenic right ventricular dysplasia. In 10 patients the right ventricle was enlarged, in eight the contractility of the right ventricle was reduced, and in all but one patient there were regional wall motion abnormalities of the right ventricle. The most common abnormality of regional wall motion was mild hypokinesia. There were bulging or dyskinetic areas in seven patients. Regional wall motion abnormalities of the left ventricle were found in five patients, two of whom also had bulging or dyskinetic areas. The reproducibility of right ventricular dimension, contractility, and regional wall motion scores was generally fair but varied unexpectedly both within and between two observers (Kendall's Tau 0.38-0.92). The score values of regional wall motion for some of the segments differed considerably within and between observers. One of the observers consistently gave higher scores than the other. These data suggest that a more objective approach is needed for evaluating angiographic changes in arrhythmogenic right ventricular dysplasia.

  • 27.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Atrial fibrillation: from atrial extrasystoles to atrial cardiomyopathy - what have we learned from basic science and interventional procedures?2016In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 279, no 5, p. 406-411Article in journal (Other academic)
  • 28.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    CABANA Trial, another favourable view.2018In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, no 30, p. 2771-2772Article in journal (Refereed)
  • 29.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    CABANATrial, another favourable view2018In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, no 30, p. 2771-2772Article in journal (Other academic)
  • 30.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    The safety of reusing ablation catheters with temperature control and the need for a validation protocol and guidelines for reprocessing1998In: Pacing and Clinical Electrophysiology, ISSN 0147-8389, E-ISSN 1540-8159, Vol. 21, no 12, p. 2563-2570Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to evaluate the safety of reusing ablation catheters with temperature control, which has not previously been reported. A review of previously conducted studies on the feasibility of reusing electrode catheters is also presented. From September 1994 to December 1997, 74 deflectable ablation catheters with temperature control (Cordis-Websters and Osypkas) were used during mean 7.6 +/- 8.0 ablation sessions. The catheter tests included visual inspection for surface defects using a magnification glass, impedance measurements, evaluation of the catheter deflection capability, and the integrity of the thermistor and thermocouple. The catheters were sterilized by Sterrad after each use. A total of 41 catheters were rejected after an average 9.1 +/- 8.8 uses (range 1-31). The main reasons for rejection were inaccurate temperature measurements by the thermistor or thermocouple (19%), breakage of or defect in the internal pulling wire (12%), loss or disturbance of electrogram (9%), and loss of deflection capability (8%). The reuse of the catheters has not resulted in any major catheter failures or any major adverse clinical complications. There were no local or systemic infections. It can be concluded that these types of ablation catheters will sustain repeated uses and resterilizations without untoward harm to the patient provided that a thorough validation protocol and guidelines for quality control and rejection of catheters are used. There seems to be no rational for setting a limit for the number of reuses, since most failures occurred at any time of reuse.

  • 31.
    Blomström-Lundqvist, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Blomström, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Safety and efficacy of pharmacological cardioversion of atrial fibrillation using intravenous vernakalant, a new antiarrhythmic drug with atrial selectivity2012In: Expert Opinion on Drug Safety, ISSN 1474-0338, E-ISSN 1744-764X, Vol. 11, no 4, p. 671-679Article in journal (Refereed)
    Abstract [en]

    Introduction:

    Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia that due to its frequent hospitalizations and increased complication rates imposes a significant health economic burden. Many patients with recurrent AF are admitted to the hospital for cardioversion to restore sinus rhythm. Given this knowledge, it is clearly important to identify a feasible and effective approach for cardioversion of these patients. Cardioversion always requires careful assessment of potential complications, which apart from thromboembolic risks, include proarrhythmias and those related to the deep sedation required for electrical cardioversion. Even though electrical cardioversion is proven to be safe and effective, the need for anesthesia makes alternative strategies more attractive.

    Areas covered:

    The research discussed is the alternative strategies for cardioversion, including electrical cardioversion and the new relatively atrial-selective antiarrhythmic drug, vernakalant. The literature search methodology undertaken included search in PubMed (cardioversion, vernakalant, conversion as key words).

    Expert opinion:

    Vernakalant is shown to have good conversion rates, an apparently safe antiarrhythmic profile and is well tolerated in patients with a history of ischemic heart disease. In most cases of recent-onset AF, pharmacological cardioversion can provide a probably more cost-effective and safer alternative to electrical cardioversion, which can then be used as a second option for those who failed the first attempt of cardioversion.

  • 32.
    Blomström-Lundqvist, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Blomström, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Rosenqvist, M
    Implanterbar defibrillator ett framsteg i behandlingen av kammararytmier1990In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 87, no 34, p. 2573-2578Article in journal (Refereed)
  • 33.
    Blomström-Lundqvist, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Dohnal, M
    Hirsch, I
    Lindblad, A
    Hjalmarson, A
    Olsson, S B
    Edvardsson, N
    Effect of long term treatment with metoprolol and sotalol on ventricular repolarisation measured by use of transoesophageal atrial pacing1986In: British Heart Journal, ISSN 0007-0769, Vol. 55, no 2, p. 181-186Article in journal (Refereed)
    Abstract [en]

    The effects of long term (4 weeks) treatment with oral metoprolol (100 mg twice daily) and sotalol (160 mg twice daily) on ventricular repolarisation time were compared in a double blind crossover study in 20 patients post-infarction. For QT interval studies transoesophageal atrial pacing was performed at a cycle length of 800 ms. Sotalol prolonged the QT interval by 5-7% compared with metoprolol. The prolongation reflects a change in the repolarisation time because there was no change in the QS interval. Measurements of heart rate at rest and during bicycle exercise indicated that metoprolol and sotalol in the doses selected were equipotent as beta blockers. Transoesophageal atrial pacing is a simple non-invasive method with few and mild side effects that is well suited to drug studies.

  • 34.
    Blomström-Lundqvist, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Gizurarson, Sigfus
    Schwieler, Jonas
    Jensen, Steen M
    Bergfeldt, Lennart
    Kennebäck, Göran
    Rubulis, Aigars
    Malmborg, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Raatikainen, Pekka
    Lönnerholm, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Höglund, Niklas
    Mörtsell, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Effect of catheter ablation vs antiarrhythmic medication on quality of life in patients with atrial fibrillation - a randomized clinical trial with general health as primary outcome and atrial fibrillation burden assessed by an implantable cardiac monitorArticle in journal (Refereed)
    Abstract [en]

    Importance: Quality of life is currently not standard primary outcome in ablation trials even though indication is driven by symptoms. Effects on true atrial fibrillation burden are unknown because continuous rhythm monitoring is lacking.

    Objective: To demonstrate superior General Health and secondly greater reduction in true atrial fibrillation burden on continuous monitoring, by catheter ablation compared with antiarrhythmic medication in symptomatic atrial fibrillation patients at 12 months.

    Design: CAPTAF, a randomized clinical trial based on intention-to-treat, included patients from July 2008 to May 2013 with four years follow-up. Patients and physicians blinded to readings from rhythm recorders. Core laboratories evaluated rhythm recordings blinded to allocated treatments.

    Setting: Multicenter study conducted at five referral centers.

    Participants: Patients aged 30-70 years referred from community hospitals for ablation of atrial fibrillation with at least 6 months history, were eligible if maximum one antiarrhythmic drug or a beta-blocker had failed. Major exclusion criteria; ejection fraction <35%, left atrial diameter >60 mm, and prior atrial fibrillation ablation. Of 167 eligible patients, 10 failed inclusion or exclusion criteria and two withdrew consents. Twelve months follow-up completed by 97%.

    Intervention(s): Pulmonary vein isolation performed with preferred technique. Medication group tested previously not used antiarrhythmic drugs. The blanking period was 3 months.

    Main Outcome(s) and Measure(s): Change in General Health by the Short Form-36 questionnaire from baseline to 12 months.

    Results: Of 155 included patients, aged mean 56,1 years, 77.4% males, 55.5% had only tested beta-blockers. Seventy-five of 79 (94.9%) patients received allocated ablation with two (2.7%) cross-overs, while 74 of 76 (97.4%) received allocated medication with eight (10.8%) cross-overs. General Health improved more by ablation than by medication; mean change 11.9, 95% CI 7.7 to 16.2 versus 3.1, 95% CI -0.9 to 7.1, p=0.003. Atrial fibrillation burden (% of time) decreased more by ablation, least square mean -6.8 %, CI -12.9 to -0.7, p=0.03.

    Conclusions and Relevance: General health improved more and atrial fibrillation burden decreased more by ablation than by medication, emphasizing ablation as superior strategy and general health as a feasible new primary endpoint.

  • 35.
    Blomström-Lundqvist, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Johansson, Birgitta
    Berglin, Eva
    Nilsson, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery.
    Jensen, Steen M
    Thelin, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery.
    Holmgren, Anders
    Edvardsson, Nils
    Källner, Göran
    Blomström, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    A randomized double-blind study of epicardial left atrial cryoablation for permanent atrial fibrillation in patients undergoing mitral valve surgery: the SWEDish Multicentre Atrial Fibrillation study (SWEDMAF)2007In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 28, no 23, p. 2902-2908Article in journal (Refereed)
    Abstract [en]

    AIMS: The efficacy of epicardial left atrial (LA) cryoablation in eliminating atrial fibrillation (AF) in patients undergoing mitral valve surgery (MVS) is unknown. We hypothesized that MVS combined with LA cryoablation is superior to MVS alone. METHODS AND RESULTS: Sixty-nine patients with permanent AF, included at four centres, underwent MVS with or without epicardial LA cryoablation. The primary endpoint was regained sinus rhythm. Risk factors for failed AF cryoablation were elucidated. Sixty-five out of 69 patients reached the primary endpoint. At 6 and 12 months follow-up, 73.3% of patients who underwent cryoablation had regained sinus rhythm at both follow-ups, compared with 45.7 and 42.9% of patients, respectively, who underwent MVS alone (group differences, at 6 months P = 0.024, after 12 months P = 0.013). The in-hospital complication rate was 11.4% in the MVS group and 26.5% in the cryoablation group (P = 0.110). Risk factors for failed elimination of AF by cryoablation were duration of permanent AF (P = 0.012) and presence of coronary artery disease (P = 0.047), according to multiple logistic regression analysis. CONCLUSION: This first prospective randomized study showed that combining MVS with epicardial LA cryoablation is significantly better in eliminating pre-operative permanent AF than MVS alone.

  • 36.
    Blomström-Lundqvist, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Olsson, S B
    Edvardsson, N
    Follow-up by repeated signal-averaged surface QRS in patients with the syndrome of arrhythmogenic right ventricular dysplasia1989In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 10, no suppl D, p. 54-60Article in journal (Refereed)
    Abstract [en]

    Repeated signal-averaged surface electrocardiograms were recorded with a mean interval of 32·5 months (range 14 to 55 months) in 12 patients with the syndrome of arrhythmogenic right ventricular dysplasia (ARVD). The mean differences in the amplitude and duration of the filtered QRS complex (FQRS), the root mean square voltage of the last 40 ms of the FQRS and the duration of the terminal potentials of less than 25 µV were not statistically significant between the recordings. A wide spectrum of changes in the voltage and duration of the terminal potentials was observed, irrespective of the clinical susceptibility to ventricular tachycardia. Three patients developed changes suggesting a progression, with a decreased voltage and prolonged duration of the terminal potentials, and four patients showed the opposite pattern. In five patients the signals were stationary.

    It is concluded that the properties of late potentials may change with time in patients with ARVD. Follow-up by repeated signal-averaged QRS does not appear to be useful in predicting the susceptibility to ventricular tachycardia in ARVD. Its application in predicting and following progressive right ventricular morphological changes remains to be determined.

  • 37.
    Blomström-Lundqvist, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Potpara, Tatjana S
    Univ Belgrade, Sch Med, Belgrade, Serbia.
    Malmborg, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Supraventricular Arrhythmias in Patients with Adult Congenital Heart Disease.2017In: Arrhythmia & electrophysiology review, ISSN 2050-3369, Vol. 6, no 2, p. 42-49Article in journal (Refereed)
    Abstract [en]

    An increasing number of patients with congenital heart disease survive to adulthood; such prolonged survival is related to a rapid evolution of successful surgical repairs and modern diagnostic techniques. Despite these improvements, corrective atrial incisions performed at surgery still lead to subsequent myocardial scarring harbouring a potential substrate for macro-reentrant atrial tachycardia. Macroreentrant atrial tachycardias are the most common (75 %) type of supraventricular tachycardia (SVT) in patients with adult congenital heart disease (ACHD). Patients with ACHD, atrial tachycardias and impaired ventricular function - important risk factors for sudden cardiac death (SCD) - have a 2-9 % SCD risk per decade. Moreover, ACHD imposes certain considerations when choosing antiarrhythmic drugs from a safety aspect and also when considering catheter ablation procedures related to the inherent cardiac anatomical barriers and required expertise. Expert recommendations for physicians managing these patients are therefore mandatory. This review summarises current evidence-based developments in the field, focusing on advances in and general recommendations for the management of ACHD, including the recently published recommendations on management of SVT by the European Heart Rhythm Association.

  • 38.
    Blomström-Lundqvist, Carina
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
    Scheinman, Melvin M
    Aliot, Etienne M
    Alpert, Joseph S
    Calkins, Hugh
    Camm, A John
    Campbell, W Barton
    Haines, David E
    Kuck, Karl H
    Lerman, Bruce B
    Miller, D Douglas
    Shaeffer, Charlie Willard
    Stevenson, William G
    Tomaselli, Gordon F
    Antman, Elliott M
    Smith, Sidney C
    Alpert, Joseph S
    Faxon, David P
    Fuster, Valentin
    Gibbons, Raymond J
    Gregoratos, Gabriel
    Hiratzka, Loren F
    Hunt, Sharon Ann
    Jacobs, Alice K
    Russell, Richard O
    Priori, Silvia G
    Blanc, Jean Jacques
    Budaj, Andzrej
    Burgos, Enrique Fernandez
    Cowie, Martin
    Deckers, Jaap Willem
    Garcia, Maria Angeles Alonso
    Klein, Werner W
    Lekakis, John
    Lindahl, Bertil
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
    Mazzotta, Gianfranco
    Morais, Joáo Carlos Araujo
    Oto, Ali
    Smiseth, Otto
    Trappe, Hans Joachim
    ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias--executive summary. a report of the American college of cardiology/American heart association task force on practice guidelines and the European society of cardiology committee for practice guidelines (writing committee to develop guidelines for the management of patients with supraventricular arrhythmias) developed in collaboration with NASPE-Heart Rhythm Society.2003In: J Am Coll Cardiol, ISSN 0735-1097, Vol. 42, no 8, p. 1493-531Article in journal (Refereed)
  • 39.
    Blomström-Lundqvist, Carina
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. kardiologi, arytmi.
    Scheinman, Melvin M
    Aliot, Etienne M
    Alpert, Joseph S
    Calkins, Hugh
    Camm, A John
    Campbell, W Barton
    Haines, David E
    Kuck, Karl H
    Lerman, Bruce B
    Miller, D Douglas
    Shaeffer, Charlie Willard
    Stevenson, William G
    Tomaselli, Gordon F
    Antman, Elliott M
    Smith, Sidney C
    Alpert, Joseph S
    Faxon, David P
    Fuster, Valentin
    Gibbons, Raymond J
    Gregoratos, Gabriel
    Hiratzka, Loren F
    Hunt, Sharon Ann
    Jacobs, Alice K
    Russell, Richard O
    Priori, Silvia G
    Blanc, Jean-Jacques
    Budaj, Andzrej
    Burgos, Enrique Fernandez
    Cowie, Martin
    Deckers, Jaap Willem
    Garcia, Maria Angeles Alonso
    Klein, Werner W
    Lekakis, John
    Lindahl, Bertil
    Mazzotta, Gianfranco
    Morais, João Carlos Araujo
    Oto, Ali
    Smiseth, Otto
    Trappe, Hans-Joachim
    ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias).2003In: Circulation, ISSN 1524-4539, Vol. 108, no 15, p. 1871-909Article in journal (Refereed)
  • 40. Bongiorni, Maria G
    et al.
    Burri, Haran
    Deharo, Jean C
    Starck, Christoph
    Kennergren, Charles
    Saghy, Laszlo
    Rao, Archana
    Tascini, Carlo
    Lever, Nigel
    Kutarski, Andrzej
    Fernandez Lozano, Ignacio
    Strathmore, Neil
    Costa, Roberto
    Epstein, Laurence
    Love, Charles
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    2018 EHRA expert consensus statement on lead extraction: recommendations on definitions, endpoints, research trial design, and data collection requirements for clinical scientific studies and registries2018In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 20, no 7, article id 1217Article in journal (Refereed)
  • 41. Bongiorni, Maria Grazia
    et al.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Kennergren, Charles
    Dagres, Nikolaos
    Pison, Laurent
    Svendsen, Jesper Hastrup
    Auricchio, Angelo
    Current practice in transvenous lead extraction: a European Heart Rhythm Association EP Network Survey2012In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 14, no 6, p. 783-786Article in journal (Refereed)
    Abstract [en]

    AIM:

    Current practice with regard to transvenous lead extraction among European implanting centres was analysed by this survey.

    METHODS AND RESULTS:

    Among all contacted centres, 164, from 30 countries, declared that they perform transvenous lead extraction and answered 58 questions with a compliance rate of 99.9%. Data from the survey show that there seems to be an overall increasing experience of managing various techniques of lead extraction and a widespread involvement of cardiac centres in this treatment. Results and complication rates seem comparable with those of main international registries.

    CONCLUSION:

    This survey gives an interesting snapshot of lead extraction in Europe today and gives some clues for future research and prospective European registries.

  • 42. Bongiorni, Maria Grazia
    et al.
    Chen, Jian
    Dagres, Nikolaos
    Estner, Heidi
    Hernandez-Madrid, Antonio
    Hocini, Meleze
    Larsen, Torben Bjerregaard
    Pison, Laurent
    Potpara, Tatjana
    Proclemer, Alessandro
    Sciaraffia, Elena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Todd, Derick
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    EHRA research network surveys: 6 years of EP wires activity2015In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 17, no 11Article in journal (Refereed)
    Abstract [en]

    Clinical practice should follow guidelines and recommendations mainly based on the results of controlled trials, which are often conducted in selected populations and special conditions, whereas clinical practice may be influenced by factors different from controlled scientific studies. Hence, the real-world setting is better assessed by the observational registries enrolling patients for longer periods of time. However, this may be difficult, expensive, and time-consuming. In 2009, the Scientific Initiatives Committee of the European Heart Rhythm Association (EHRA) has instigated a series of surveys covering the controversial issues in clinical electrophysiology (EP). With this in mind, an EHRA EP research network has been created, which included EP centres in Europe among which the surveys on 'hot topic' were circulated. This review summarizes the overall experience conducting EP wires over the past 6 years, categorizing and assessing the topics regarding clinical EP, and evaluating the acceptance and feedback from the responding centres, in order to improve participation in the surveys and better address the research needs and aspirations of the European EP community.

  • 43.
    Bongiorni, Maria Grazia
    et al.
    Univ Hosp Pisa, Dept Cardiol, Via Paradisa 2, I-56124 Pisa, Italy..
    Kennergren, Charles
    Sahlgrens Univ Hosp, Dept Cardiothorac Surg, S-41345 Gothenburg, Sweden..
    Butter, Christian
    Heart Ctr Brandenburg Bernau, Dept Cardiol, Ladeburger Str 17m, D-16321 Bernau, Germany.;Med Sch Brandenburg, Ladeburger Str 17m, D-16321 Bernau, Germany..
    Deharo, Jean Claude
    CHU La Timone, La Timone Univ Hosp, Arrhythmias Unit, Dept Cardiol, 265 Rue St Pierre, F-13005 Marseille, France..
    Kutarski, Andrzej
    Med Univ Lublin, Dept Cardiol, Ul Jaczewskiego 8, PL-20954 Lublin, Poland..
    Rinaldi, Christopher A.
    Guys & St Thomas Hosp, Cardiol Dept, 6th Floor East Wing,Westminster Bridge Rd, London SE1 7EH, England..
    Romano, Simone L.
    Univ Hosp Pisa, Dept Cardiol, Via Paradisa 2, I-56124 Pisa, Italy..
    Maggioni, Aldo P.
    European Soc Cardiol, European Heart House,2035 Route Colles, F-06903 Sophia Antipolis, France.;ANMCO Res Ctr, Via La Marmora 34, I-50121 Florence, Italy..
    Andarala, Maryna
    European Soc Cardiol, European Heart House,2035 Route Colles, F-06903 Sophia Antipolis, France..
    Auricchio, Angelo
    Fdn Cardioctr Ticino, Div Cardiol, Via Tesserete 48, CH-6900 Lugano, Switzerland..
    Kuck, Karl-Heinz
    Asklepios Klin St Georg, Dept Cardiol, Lohmuhlenstr 5, D-20099 Hamburg, Germany..
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia. Uppsala Univ, Inst Med Sci, Dept Cardiol, S-75185 Uppsala, Sweden..
    The European Lead Extraction ConTRolled (ELECTRa) study: a European Heart Rhythm Association (EHRA) Registry of Transvenous Lead Extraction Outcomes2017In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 38, no 40, p. 2995-3005Article in journal (Refereed)
    Abstract [en]

    Aims The European Lead Extraction ConTRolled Registry (ELECTRa), is a prospective registry of consecutive transvenous lead extraction (TLE) procedures conducted by the European Heart Rhythm Association (EHRA) in order to identify the safety and efficacy of the current practice of TLE Methods and results European centres performing TLE, invited by the organizing committee on behalf of EHRA, prospectively recruited all consecutive patients undergoing TLE at their institution. The primary endpoint was TLE safety defined by pre-discharge major procedure-related complications including death. Secondary endpoints included clinical and radiological success and overall complication rates. Outcomes were compared between Low Volume (LoV) vs. High Volume (HiV) centers (LoV < 30 and HiV >= 30 procedures/year). A total of 3555 consecutive patients (pts) of whom 3510 underwent TLE at 73 centres in 19 European countries were enrolled between November 2012 and May 2014. The primary endpoint of in-hospital procedure-related major complication rate was 1.7% [95% CI 1.3-2.1%] (58/3510 pts) including a mortality of 0.5% [95% CI 0.3-0.8%] (17/3510 pts). Approximately two-thirds (37/58) of these complications occurred during the procedure and one-third (21/58) in the post-operative period. The most common procedure related complications were those requiring pericardiocentesis or chest tube and/or surgical repair (1.4% [95% CI 1.0-1.8%]). Complete clinical and radiological success rates were 96.7% [95% CI 96.1-97.3%] and 95.7% [95% CI 95.2-96.2%], respectively. The all cause in-hospital major complications and deaths were significantly lower in HiV centres vs. LoV centres (2.4% [95% CI 1.9-3.0%] vs. 4.1% [95% CI 2.7-6.0%], P = 0.0146; and 1.2% [95% CI 0.8-1.6%] vs. 2.5% [95% CI 1.5-4.1%] P = 0.0088), although those related to the procedure did not reach statistical significance. Radiological and clinical successes were more frequent in HiV vs. LoV centres. Conclusion The ELECTRa study is the largest prospective registry on TLE and confirmed the safety and efficacy of the current practice of TLE. Lead extraction was associated with a higher success rate with lower all cause complication and mortality rates in high volume compared with low volume centres.

  • 44. Bongiorni, Maria Grazia
    et al.
    Marinskis, Germanas
    Lip, Gregory Y H
    Svendsen, Jesper Hastrup
    Dobreanu, Dan
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    How European centres diagnose, treat, and prevent CIED infections: Results of an European Heart Rhythm Association survey2012In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 14, no 11, p. 1666-1669Article in journal (Refereed)
    Abstract [en]

    The purpose of our survey is to analyse the clinical approach used to prevent and treat cardiovascular implantable electronic device (CIED) infections in Europe. The survey involves high-volume implanting centres. According to the survey the incidence of CIED infections shows a slight decrease in most centres and is substantially under 2% in the majority of centres interviewed. However, there are still differences in terms of prophylactic antibiotic therapy: 8.9% of the centres administer oxacillin as preoperative treatment, 4.4% of them do not give any antibiotic therapy, all centres use some kind of skin antisepsis, but only 42.2% use chlorhexidine. In case of local infection, 43.5% of centres perform lead extraction as first approach. In the case of systemic infection or evidence of lead or valvular endocarditis, 95% of centres treat these conditions by extracting the leads, which indicates that the adherence to the lead extraction guidelines is quite good.

  • 45. Bongiorni, Maria Grazia
    et al.
    Proclemer, Alessandro
    Dobreanu, Dan
    Marinskis, Germanas
    Pison, Laurent
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Preferred tools and techniques for implantation of cardiac electronic devices in Europe: results of the European Heart Rhythm Association survey2013In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 15, no 11, p. 1664-1668Article in journal (Refereed)
    Abstract [en]

    The aim of this European Heart Rhythm Association (EHRA) survey was to assess clinical practice in relation to the tools and techniques used for cardiac implantable electronic devices procedures in the European countries. Responses to the questionnaire were received from 62 members of the EHRA research network. The survey involved high-, medium-, and low-volume implanting centres, performing, respectively, more than 200, 100199 and under 100 implants per year. The following topics were explored: the side approach for implantation, surgical techniques for pocket incision, first venous access for lead implantation, preference of lead fixation, preferred coil number for implantable cardioverter-defibrillator (ICD) leads, right ventricular pacing site, generator placement site, subcutaneous ICD implantation, specific tools and techniques for cardiac resynchronization therapy (CRT), lead implantation sequence in CRT, coronary sinus cannulation technique, target site for left ventricular lead placement, strategy in left ventricular lead implant failure, mean CRT implantation time, optimization of the atrioventricular (AV) and ventriculo-ventricular intervals, CRT implants in patients with permanent atrial fibrillation, AV node ablation in patients with permanent AF. This panoramic view allows us to find out the operator preferences regarding the techniques and tools for device implantation in Europe. The results showed different practices in all the fields we investigated, nevertheless the survey also outlines a good adherence to the common standards and recommendations.

  • 46. Bongiorni, Maria Grazia
    et al.
    Romano, Simone L
    Kennergren, Charles
    Butter, Christian
    Deharo, Jean Claude
    Kutarsky, Andrzej
    Rinaldi, Christopher Aldo
    Maggioni, Aldo P
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Auricchio, Angelo
    ELECTRa (European Lead Extraction ConTRolled) Registry-Shedding light on transvenous lead extraction real-world practice in Europe2013In: Herzschrittmachertherapie & Elektrophysiologie, ISSN 0938-7412, E-ISSN 1435-1544, Vol. 24, no 3, p. 171-175Article in journal (Refereed)
    Abstract [en]

    With the growing recognition of the clinical need and wider indications for cardiovascular implantable electronic devices (CIED), the number of implant procedures has increased considerably. Consequently, the rate of complications related to these devices has also increased. Transvenous lead extraction (TLE) is the gold standard in the treatment of CIED-related infective complications and is often required in the management of lead malfunction. An increasing number of centers currently perform TLE procedures. The ELECTRa (European Lead Extraction ConTRolled) Registry is the first large prospective multicenter registry of consecutive patients undergoing TLE in Europe, conducted by the European Heart Rhythm Association (EHRA) and managed by the European Society of Cardiology (ESC) EURObservational Research Department. The primary objective of the registry is to evaluate the acute and long-term safety of TLE; the secondary objective is to describe the characteristics of the patients, the leads, the indications for TLE, and the tools and techniques currently used for TLE. About 100 centers will be enrolled on a voluntary basis from European countries; they are anonymous and stratified on the basis of their volume of activity into high-volume centers (> 30 patients/year) and low-volume centers: (≤ 30 patients/year). Each participating center will have to enroll and follow up for 1 year consecutively assessed patients undergoing TLE from November 2012 to January 2014. The target is to achieve a sample size of at least 3,500 patients for statistical analysis. Data will be collected using a Web-based system and will be audited at randomly selected centers. The official start was on 6 November. Eighty-nine centers have joined so far, 65 centers are currently active, those who have already obtained the approval of their own ethics committee, and 1,099 patients were enrolled at the end of June 2013. The independence of the registry, the consecutiveness of the patient enrolment, and the monitoring of the study are characteristics of this registry that will contribute to the scientific validity of the objectives to be achieved.

  • 47. Boriani, Giuseppe
    et al.
    Fauchier, Laurent
    Aguinaga, Luis
    Beattie, James M
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Cohen, Ariel
    Dan, Gheorghe-Andrei
    Genovesi, Simonetta
    Israel, Carsten
    Joung, Boyoung
    Kalarus, Zbigniew
    Lampert, Rachel
    Malavasi, Vincenzo L
    Mansourati, Jacques
    Mont, Lluis
    Potpara, Tatjana
    Thornton, Andrew
    Lip, Gregory Y H
    European Heart Rhythm Association (EHRA) consensus document on management of arrhythmias and cardiac electronic devices in the critically ill and post-surgery patient, endorsed by endorsed by Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Cardiac Arrhythmia Society of Southern Africa (CASSA), and Latin American Heart Rhythm Society (LAHRS).2018In: Europace, ISSN 1099-5129, E-ISSN 1532-2092Article in journal (Refereed)
  • 48. Brignole, Michele
    et al.
    Auricchio, Angelo
    Baron-Esquivias, Gonzalo
    Bordachar, Pierre
    Boriani, Giuseppe
    Breithardt, Ole-A
    Cleland, John
    Deharo, Jean-Claude
    Delgado, Victoria
    Elliott, Perry M
    Gorenek, Bulent
    Israel, Carsten W
    Leclercq, Christophe
    Linde, Cecilia
    Mont, Lluís
    Padeletti, Luigi
    Sutton, Richard
    Vardas, Panos E
    2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)2013In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 34, no 29, p. 2281-2329Article in journal (Refereed)
  • 49. Brignole, Michele
    et al.
    Auricchio, Angelo
    Baron-Esquivias, Gonzalo
    Bordachar, Pierre
    Boriani, Giuseppe
    Breithardt, Ole-A
    Cleland, John
    Deharo, Jean-Claude
    Delgado, Victoria
    Elliott, Perry M
    Gorenek, Bulent
    Israel, Carsten W
    Leclercq, Christophe
    Linde, Cecilia
    Mont, Lluís
    Padeletti, Luigi
    Sutton, Richard
    Vardas, Panos E
    2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)2013In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 15, no 8, p. 1070-1118Article in journal (Refereed)
  • 50. Brugada, Josep
    et al.
    Blom, Nico
    Sarquella-Brugada, Georgia
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Deanfield, John
    Janousek, Jan
    Abrams, Dominic
    Bauersfeld, Urs
    Brugada, Ramon
    Drago, Fabrizio
    de Groot, Natasja
    Happonen, Juha-Matti
    Hebe, Joachim
    Yen Ho, Siew
    Marijon, Eloi
    Paul, Thomas
    Pfammatter, Jean-Pierre
    Rosenthal, Eric
    Pharmacological and non-pharmacological therapy for arrhythmias in the pediatric population: EHRA and AEPC-Arrhythmia Working Group joint consensus statement2013In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 15, no 9, p. 1337-1382Article in journal (Refereed)
    Abstract [en]

    In children with structurally normal hearts, the mechanisms of arrhythmias are usually the same as in the adult patient. Some arrhythmias are particularly associated with young age and very rarely seen in adult patients. Arrhythmias in structural heart disease may be associated either with the underlying abnormality or result from surgical intervention. Chronic haemodynamic stress of congenital heart disease (CHD) might create an electrophysiological and anatomic substrate highly favourable for re-entrant arrhythmias.As a general rule, prescription of antiarrhythmic drugs requires a clear diagnosis with electrocardiographic documentation of a given arrhythmia. Risk-benefit analysis of drug therapy should be considered when facing an arrhythmia in a child. Prophylactic antiarrhythmic drug therapy is given only to protect the child from recurrent supraventricular tachycardia during this time span until the disease will eventually cease spontaneously. In the last decades, radiofrequency catheter ablation is progressively used as curative therapy for tachyarrhythmias in children and patients with or without CHD. Even in young children, procedures can be performed with high success rates and low complication rates as shown by several retrospective and prospective paediatric multi-centre studies. Three-dimensional mapping and non-fluoroscopic navigation techniques and enhanced catheter technology have further improved safety and efficacy even in CHD patients with complex arrhythmias.During last decades, cardiac devices (pacemakers and implantable cardiac defibrillator) have developed rapidly. The pacing generator size has diminished and the pacing leads have become progressively thinner. These developments have made application of cardiac pacing in children easier although no dedicated paediatric pacing systems exist.

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