Gabriele D'Ambrosio

Very proud to share our manuscript just published in @JCardioEP The #ZAQscore is able to predict the presence and the extent of left atrial low voltage zones before #AFablation. Thanks to the Editorial Board and reviewers. @DrBradleyKnight #EPeeps bit.ly/ZAQscore

Ischaemic VT ablation guided by S3 protocol ILAM mapping: targeting deceleration zone near channel + late potentials -> non inducibility + clean remap. Thank you @ivroca for your tips. @cavaco_diogo @DanielM891 @ADAS3D @LiaMarquesEP @AbbottCardio

The study sought to evaluate the feasibility, safety and clinical efficacy of focal monopolar PFA in patients with non-PV triggered atrial arrhythmia from the SVC @ObaidaAlothman @GeorgiBBorisov @dambrox @christophgelle1 @DrBradleyKnight @hcg_md @GiacomoMugnai @GrahamPeigh

Focal Pulsed Field Ablation for Premature Ventricular Contractions: A Multicenter Experience @AndreaSarkozy @CdeAsmundis @LuigipannoneM @cespon_maria @christophgelle1 @AlviseDelMonte @CirculationEP @Wanginnovate ahajournals.org/doi/10.1161/CI…

Vascular closure devices (VCDs) for femoral venous haemostasis following catheter ablation of atrial fibrillation In >28,000 patients, VCDs associated with ⬇️ vascular complications and bleeding events Our latest in @JCardioEP onlinelibrary.wiley.com/doi/full/10.11… @DhirajGuptaBHRS #EPeeps

🥳We are excited to have the opportunity to dialogue with internationally renowned heart surgeon Prof. Michael A Borger- the Director of the University Clinic of Cardiac Surgery at the Leipzig Heart Center‼️ 📢Do not miss this wonderful video👇 oaepublish.com/vp/academic_ta…

@DGroMein Congratulations!

Very happy and proud to complete my Habilitation-thesis on “Esophageal complications of atrial fibrillation ablation” on April 22nd, 2024 with a scientific lecture at Faculty of Health Sciences Brandenburg. Thanks to my mentors and my family.

We know that patients with AF recurrence after a single shot-PVI were female, older, had a larger left atrium compared to patients without AF recurrence. These parameters are associated with the presence of low voltage areas and non-PV triggers It may be that these patients could benefit from other ablation strategies that you cannot perform with single shot devices. So it may be that one month after the first ablation we will have less recurrence of atrial fibrillation.

#EPeeps - I need your help! If costs would not matter and you had all the options - which energy source would you prefer for a first-do PVI for AF ablation ❓ @YoungDgk @AGEP_DGK @ChristianHeeger @C_Jungen @AriSultanEP @bordistef @jongichun @sebFeickert @rahin_wahedi

@ESCardioNews @escardio @EHRAPresident @HaranBurri @SergeBoveda @EmmaSvennberg @purerfellner @EuropaceEiC @DavidDuncker @GerdHindricks @LuigiDiBiaseMD @natale_md @Phiso_de @drjohnm @jongichun @PrashSanders @Dominik_Linz @drsuneet @DrSalahwany_EP #EPeeps

More info and Interactive Map lnkd.in/djXc3bf5 bit.ly/3VK2LJr

Are you planning to attend #EHRA2024 tomorrow (07.04.2024) in Berlin? As we gear up for a day of enriching discussions and collaborations, I want to bring your attention to an event taking place nearby that might impact your travel plans. Starting from 8:00 AM, a half marathon will take place near the congress venue. To ensure you are aware of any potential disruptions to your journey, I prepared a custom map outlining the marathon route and its proximity to the congress venue. Please take a moment to familiarize yourself with the map. Due to the marathon, several streets will be closed starting from 7:00 AM. Alternative routes and transportation options may be necessary to ensure timely arrival at the congress.

Thanks, but that doesn't answer my question. I'll try to rephrase it: The beauty of @drsuneet study is that it identifies also the predictors of long-term recurrent AF, regardless of whether the AF pattern is paroxysmal or persistent after a single shot-PVI. Patients with AF recurrence were older, had a larger left atrial diameter and a higher CHA2DS2-VASc score (female population 33%) compared to patients without AF recurrence. These parameters are associated with the presence of low voltage areas and non-PV triggers! It may be that these patients could benefit from other ablation strategies that you cannot perform with single shot devices. So it may be that one month after the ablation we will have less recurrence of atrial fibrillation. What do you Think? @natale_md @purerfellner @christophgelle1 @LuigiDiBiaseMD @dogi84md

While 1 month is the “ideal” blanking period duration true based on “optimal cutoff”…The specificity is only 78% It’s more *meaningful* to the patient in your office to forego “optimal” durations and instead focus on specificity Meaning a recurrence after point X is actionable

Thank you, the CIRCA-DOSE was focused on paroxysmal AF, in this study they analyzed both paroxysmal and persistent AF patients and identified predictors of long-term recurrent AF regardless of whether the AF pattern is paroxysmal or persistent. In our previous study, we proposed an AF ablation workflow independent of AF pattern based on the same parameters. bit.ly/ZAQscore

@dambrox We did this a few years back in the CIRCA-DOSE data of cryoballoon vs RF PVI. In our series there was a substantial overlap, but focusing only on specificity showed the BP could shorten to 50-60d Will take a closer look at your paper (thanks for sharing) sciencedirect.com/science/articl…

The blanking period (#BP) post Cryoballoon (#CB) Pulmonary Vein Isolation (#PVI) might be shorter than we think! Continuous monitoring via #ILRs revealed that patients with AF recurrence and AF burden >0% after just 30 days Following #CB #PVI have a significantly higher risk of long-term recurrent AF regardless of whether the #AF pattern is #paroxysmal or #persistent. by @drsuneet

@heartablator Nice! And of course today we can offer more to our patients, low voltage zone-guided ablation, non-PVI triggers, LAA isolation, etc. ... I think it doesn't make sense to just do PVI if you already know you're going to have a recurrence after 1 month.

At that time, we were not doing any voltage mapping as a routine. At this time we would typically just isolate the veins in patients with paroxysmal atrial fibrillation and in some of the persistent patients who have a healthy voltage map. We tend to isolate the posterior wall if it has zones of low voltage. We frequently find areas of low voltage and fractionation on the anterior wall and mitral annulus. We typically isolate these, frequently using the anterior mitral line approach and then incorporating areas of fragmentation and low voltage into the line.

@heartablator Interesting! Have you done a voltage map? Have you noticed any low voltage zones?

@dambrox No. The lesion set included the posterior wall as part of the PV Antrum Isolation

@heartablator Did you perform RF PVI only?

@dambrox A number of studies showed that the same is true of RF ablation as well including our experience pubmed.ncbi.nlm.nih.gov/29759429/

@Dr_JozaEP Agreed, and the second question would be: How many single shot re-PVI's should be done?

@dambrox Very interesting- personally I would not consider cryo/single shot in a patient with probable HFpEF or enlarged LA.. And a follow up question being: what is the earliest time you would take a patient back to the EP lab after recurrence? 1 month? 6 weeks? 3 months?

Should we limit the #BP to one month post #CB #PVI? Should we avoid single-shot PVI devices in favor of 3D mapping guided ablation in this patient population? Share your thoughts! 💬 @hrs_journal @natale_md @christophgelle1 @EHRAPresident @LuigiDiBiaseMD @aalahmadmd @DrJasonAndrade @aportasanchez @Dr_Santangeli @themistoclakis @FredSacher_EP @drraviele @KTamirisaMD @purerfellner @Phiso_de @NTrayanova @ManlioMarquez @HanCardiomd @GerdHindricks #Epeeps #AblateAF #FOAMed #CardioTwitter #MedEd

Patients with an AF recurrence were older, had larger left atrial diameter, and had a higher CHA2DS2-VASc score (Female population 33%) in comparison to patients without AF recurrence. 👉bit.ly/CB_BlankingP