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Öğe Acute effect of outflow tract premature ventricular complex ablation on QT dispersion, Tp-e interval and Tp-e/QT ratio(Taylor & Francis Ltd, 2021) Uslu, Abdulkadir; Kup, Ayhan; Gulsen, Kamil; Demir, Serdar; Kanar, Batur Gonenc; Taylan, Gokay; Sari, MunevverBackground: There is limited data regarding the effect of idiopathic premature ventricular complexes (PVC) on myocardial repolarisation. Most of PVC's originate from right and left ventricular outflow tracts (RVOT and LVOT). Aim: The aim of this study is to evaluate the acute effect of outflow tract PVC ablation on electrocardiographic repolarisation markers. Methods: A total of 180 patients (49.2 +/- 13.6 years, 74 male) without any exclusion criteria who had undergone outflow tract PVC ablation between 1 January 2015 and 1 November 2018 constituted our study population. Electrocardiographic recordings that had been obtained before and after ablation procedure on the same day were retrospectively evaluated for the QTc dispersion, Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio. Significance of difference between pre- and postablation values was tested. Results: There was no significant difference regarding QTc dispersion between pre- and post-ablation state (36.5 +/- 20.9 vs. 35.3 +/- 16.4 ms, p: NS). However, Tp-e and Tp-e/QT values in all lateral precordial derivations were observed to decrease significantly after PVC ablation (in the respective order on derivation V5: 104.0 +/- 21.6 ms vs. 91.1 +/- 14.8 ms, pvs. 0.23 +/- 0.04, p<.001). Conclusions: Based on these observations, it may be suggested that frequent outflow tract PVC's increase transmural dispersion of repolarisation and this effect is attenuated by catheter ablation in the acute phase. Results of further prospective studies are required for evaluation of the long term effects of PVC ablation on myocardial repolarisation.Öğe Evaluation of acute alterations in electrocardiographic parameters after cryoballoon ablation of atrial fibrillation and possible association with recurrence(Turkish Soc Cardiology, 2021) Uslu, Abdulkadir; Kup, Ayhan; Demir, Serdar; Gulsen, Kamil; Kanar, Batur Gonenc; Celik, Mehmet; Taylan, GokayObjective: This study aimed to evaluate the acute effect of cryoballoon ablation (CB-A) on electrocardiographic parameters that have been suggested to reflect heterogeneity in atrial conduction and ventricular repolarization. Methods: A total of 67 patients (52.6 +/- 13.2 years, 43 men) without any exclusion criteria who had undergone CB-A for atrial fibrillation (AF) between January 01, 2015, and December 31, 2018, constituted our study population. Electrographic recordings obtained before and after the ablation procedure on the same day were retrospectively evaluated for the P-wave dispersion, QTc dispersion, Tp-Te interval, and Tp-Te/QT ratio. The pre- and post-ablation values were tested for significant differences. The association of the possible CB-A-related changes in these parameters with AF recurrence during follow-up was evaluated. Results: P dispersion (30.1 +/- 6.8 vs. 35.9 +/- 9.4 ms, p<0.001), QT dispersion (20.7 +/- 7.5 vs. 24.0 +/- 8.8 ms, p<0.001), Tp-Te duration (on V5 83.6 +/- 8.1 vs. 110.2 +/- 9.5 ms, p<0.001), and Tp-Te/QT ratio (on V5 0.22 +/- 0.03 vs. 0.28 +/- 0.02, p<0.001) were observed to increase significantly after CB-A. There was no association between the magnitudes of change in any parameter and AF recurrence. Conclusion: CB-A had significant effects on electrocardiographic parameters related to atrial conduction and ventricular repolarization in the acute phase after CB-A. Further prospective studies are required to examine the time-related course of these alterations and their impact on clinical outcomes.Öğe Fluoroscopy time and scattered radiation during electrophysiology procedures: analysis of one-year data of a laboratory providing electrophysiology training(Taylor & Francis Ltd, 2021) Gulsen, Kamil; Akgun, Taylan; Kup, Ayhan; Uslu, Abdulkadir; Kanar, Batur Gonenc; Taylan, Gokay; Kayan, FethullahObjectives Patients and medical staff expose to significant radiation during electro-physiological (EP) procedures. There are few data regarding the leading factors of longer fluoroscopy time and higher scattered radiation in a laboratory giving EP training during those interventions. Material and methods The patients' recordings that underwent EP procedure in a single centre arrhythmia unit from February 2019 to January 2020 were examined. Prospectively collected data regarding procedure duration, fluoroscopy time and total air kerma, demographic characteristics of the patients, type of procedure, success of ablation and the use of electro anatomic mapping were retrospectively evaluated. Predictors of total air kerma were analysed with linear regression analysis. Results Study population consisted of 437 patients with a median age of 47 (39-56); 184 (42.1%) were male. Median fluoroscopy time was 768 (420-1320) seconds and median cumulative air kerma was 369 (191-750) mGy. Fluoroscopy time and cumulative air kerma were significantly lower in diagnostic EP studies compared to other procedures. There was no difference in terms of total air kerma between the procedures other than the diagnostic EP study. In multivariable linear regression analysis; body surface area, fluoroscopy time, not using the electro-anatomical mapping, unsuccessful ablation and atrial flutter ablation were predictors of total air kerma in EP studies performed by trainees. Conclusion Scattered radiation during EP procedures performed by in-training operators is related with some factors. Awareness about those may help to effort reducing the harmful effect of ionising radiation.Öğe Integrating the Left Atrium Diameter to Improve the Predictive Ability of the Age, Creatinine, and Ejection Fraction Score for Atrial Fibrillation Recurrence After Cryoballoon Ablation(Kare Publ, 2023) Taylan, Gokay; Gok, Murat; Kurtul, Alparslan; Uslu, Abdulkadir; Kup, Ayhan; Demir, Serdar; Gulsen, KamilBackground: Several clinical trials have assessed predictors for atrial fibrillation recur rence following cryoballoon catheter ablation. With these predictors, a practical and new scoring system can be developed to evaluate atrial fibrillation recurrence. The present study aimed to analyze the predictive value of the age, creatinine, and ejection fraction -left atrium score for potential recurrence of atrial fibrillation following cryoballoon cath- eter ablation in patients with symptomatic paroxysmal or persistent atrial fibrillation. Methods: We retrospectively analyzed records of patients undergoing cryoballoon cath- eter ablation. atrial fibrillation recurrence was defined as an emerging atrial fibrillation episode around 12-month follow-up (with the exclusion of a 3-month blanking period). Univariate and multivariate analyses were performed to assess predictors of atrial fibrilation recurrence. In addition, receiver operating characteristic analysis was harnessed to evaluate the performance of the age, creatinine, and ejection fraction, left atrium score in determining the risk of atrial fibrillation recurrence. Results: The study population comprised 106 subjects (age 52 +/- 13 years, 63.2% women) with paroxysmal (84.9%, n = 90) or persistent (15.1%, n = 16) atrial fibrillation. age, cre- atinine, and ejection fraction, left atrium score was significantly higher in subjects with atrial fibrillation recurrence in comparison to those with the maintenance of sinus rhythm. However, on multivariate logistic regression analysis, only the age, creatinine, and ejection fraction, left atrium score (OR = 12.93, 95% CI: 2.22-75.21, P = .004) served as an independent predictor of atrial fibrillation recurrence following cryoballoon catheter ablation. Conclusion: Age, creatinine, and ejection fraction, left atrium score had an independent association with the risk of atrial fibrillation recurrence in subjects with atrial fibrillation undergoing cryoballoon catheter ablation. Therefore, this score might potentially serve as a useful tool for risk stratification of patients with atrial fibrillation.
