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Skala T, Moravec O, Santavy P, Steriovsky A, Taborsky M. Electrophysiological findings after bilateral thoracoscopic atrial fibrillation ablation using irrigated bipolar radiofrequency energy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Thoracoscopic atrial fibrillation (AF) ablation (TARAFS) using irrigated bipolar radiofrequency energy should result in posterior left atrial (LA) wall isolation.
Purpose
To assess the long-term durability of this “box” lesion and the extent of additional ablation needed to achieve AF non-inducibility.
Methods
22 patients with AF recurrence after bilateral TARAFS for persistent AF had a radiofrequency catheter ablation (RFA) at least three months after TARAFS. Electroanatomical voltage map was done in all patients prior to any ablation.
Results
Out of 22 patients, the box lesion was not completed in 15 (68.2%). In these 15 patients, 12 had no signs of any prior ablation in endocardium (voltage >0.5mV), 2 had right pulmonary veins (PVs) isolated and 1 had left PVs isolated.
At the end of RFA, box lesion was finished in all 15 patients and AF non-inducibility was achieved in 18 patients. For this endpoint, besides box lesion, mitral line and extensive coronary sinus ablation was necessary in 14, extensive CFAE ablation in 7 patients. Cavotricuspid isthmus line block was done in all patients.
Conclusion
A minimally invasive thoracoscopic box-lesion ablation is considered to be a safe and effective method of stand-alone AF treatment. However, in a considerable amount of patients no signs of prior ablation are found on electroanatomical voltage map. Gaps thus cannot be found and a completely new complex ablation must be done. In a lot of patients, additional ablation is needed besides box lesion to achieve non-inducibility.
Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): University Hospital Olomouc
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Affiliation(s)
- T Skala
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
| | - O Moravec
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
| | - P Santavy
- Palacky University- Faculty of Medicine and Dentistry, Department of Cardiosurgery, Olomouc, Czechia
| | - A Steriovsky
- Palacky University- Faculty of Medicine and Dentistry, Department of Cardiosurgery, Olomouc, Czechia
| | - M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
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Aubrecht J, Peterka P, Honzátko P, Moravec O, Kamrádek M, Kašík I. Broadband thulium-doped fiber ASE source. Opt Lett 2020; 45:2164-2167. [PMID: 32287182 DOI: 10.1364/ol.389397] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/09/2020] [Indexed: 06/11/2023]
Abstract
We report on a flat and broadband thulium-doped amplified spontaneous emission (ASE) fiber source working around 1.85 µm in the eye-safe spectral region. Core-pumped thulium fibers were prepared in-house using the modified chemical vapor deposition method. The amplified spontaneous emission source in a backward direction with respect to the pump and in a single-ended configuration produces stable, non-polarized radiation with an output power of up to 280 mW, corresponding to a slope efficiency of about 36% with respect to the pump power. To the best of our knowledge, the device reported herein is the broadest ASE source based on Tm-doped fiber without internal spectral filtering with an output power exceeding 90 mW and full width at half-maximum of the spectrum greater than 155 nm.
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Hetclova D, Hutyra M, Precek J, Moravec O, Skala T, Sanak D, Adam T, Taborsky T. 4034Distance from hospital as an early marker of outcomes in out of hospital cardiac arrest acute myocardial infarction survivors treated with endovascular mild therapeutic hypothermia. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The prediction of outcome in comatose patients after out of hospital cardiac arrest (OHCA) has major ethical and socioeconomic implications. At present, there is a lack of data comparing the predictive value from cardiac arrest localization to hospital distance in OHCA survivors treated with endovascular therapeutic hypothermia.
Methods
86 patients (64±14 years, 69 men) were evaluated after OHCA due to ventricular fibrillation (VF) during an acute myocardial infarction (MI). All patients (NSTEMI 28%, STEMI 72%) were indicated for urgent coronary angiography, echocardiography for left ventricular ejection fraction (LVEF) estimation using Simpson biplane formula and treated with mild therapeutic hypothermia (MTH) using intravascular temperature management to maintain target temperature (33 °C) for 24 hours. The Cerebral Performance Categories scale (CPC) was used as the outcome measure and was assessed 3 months post admission; a CPC of 3–5 was regarded as a poor outcome (n=45), and a CPC of 1–2 (n=41) as a good outcome.
Results
Distance to hospital was significantly higher (p=0.0473) in patients with poor outcomes (CPC 3–5) after OHCA (37.5±4.5 km) compared with CPC 1–2 patients (27.1±4.4 km). No significant differences in return of spontaneous circulation time (21; 10.5–47.5 95th percentile vs. 23; 10.0–50.0, p=0.738), lactate (7.8; 4.5–12.4 vs. 8.4; 5.4–13.5, p=0.54), LVEF (40; 22–50 vs. 40; 21–62%, p=0.208), peak cardiac troponin T (1.5; 0.08–10.00 vs. 0.64; 0.04–5.28 μg/L, p=0.078), NSE (29.2; 15.7–54.9 vs. 25.8; 13.6–52.3 μg/L, p=0.26) and S100-B (0.17; 0.09–1.69 vs. 0.19; 0.04–1.14 μg/L, p=0.734) were found in CPC 3–5 and CPC 1–2 groups comparison. Using an optimal cut-off value ≥33 km calculated from the receiver operating characteristic curve (area under curve = 0.62; p=0.004), the sensitivity of predicting survival with poor neurological outcome was 61% and the specificity was 62%.
Conclusions
In patients after OHCA for VF during MI, distance from cardiac arrest localization to hospital gives reliable and on return of spontaneous circulation time independent prognostic information concerning outcome after cardiopulmonary resuscitation.
Acknowledgement/Funding
Grant support FNOL RIV 87-85
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Affiliation(s)
- D Hetclova
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I - Cardiology, Olomouc, Czechia
| | - M Hutyra
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I - Cardiology, Olomouc, Czechia
| | - J Precek
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I - Cardiology, Olomouc, Czechia
| | - O Moravec
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I - Cardiology, Olomouc, Czechia
| | - T Skala
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I - Cardiology, Olomouc, Czechia
| | - D Sanak
- Palacky University, Faculty of Medicine and Dentistry, Dept. of Neurology, Olomouc, Czechia
| | - T Adam
- Palacky University, Faculty of Medicine and Dentistry, Department of Clinical Biochemistry, Olomouc, Czechia
| | - T Taborsky
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I - Cardiology, Olomouc, Czechia
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Skala T, Tudos Z, Homola M, Moravec O, Kocher M, Cerna M, Ctvrtlik F, Odstrcil F, Langova K, Klementova O, Taborsky M. The impact of ECG synchronization during acquisition of left‑atrium computed tomography model on radiation dose and arrhythmia recurrence rate after catheter ablation of atrial fibrillation - a prospective, randomized study. BRATISL MED J 2019; 120:177-183. [PMID: 31023034 DOI: 10.4149/bll_2019_033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The impact of ECG gating during computed tomography (CT) acquisition of left atrium (LA) model on radiation dose, image quality and ablation event-free survival rate after catheter ablation (CA) of atrial fibrillation (AF) is not well defined. METHODS Sixty-two patients with paroxysmal atrial fibrillation were randomized for two types of LA CT (with vs without ECG gating) before CA. Pulmonary veins isolation was performed in all patients. Patients were followed for 12 months after CA. RESULTS There was no difference between the groups in CA length (131.61±32.57 vs 119.84±33.18 min; p=0.108), CA fluoroscopy time (4.48±2.19 vs 3.89±1.83 min; p=0.251), CA fluoroscopy dose (3.99±2.79 vs 3.91 vs2.91 Gy*cm2; p=0.735), visual data quality (1.77±0.88 vs 2.0±0.63; p=0.102) and registration error (2.42±0.72 vs 2.43±0.46 mm; p=0.612). We found a significant difference in CT Dose index (89.55±5.99 vs 19.19±4.33 mGy; p<0.0001) and Dose Length product (1438.87±147.75 vs 328.21±73.83 mGy*cm; p<0.0001). Twelve months after CA, 25 of 31 patients in the gated group and 24 of 31 patients in the non-gated group were free of AF (80.65 vs 77.42 %; p=0.838). CONCLUSION ECG gating of computed tomography of LA before AF ablation burdens patients with a four times higher radiation dose while improving neither the quality of CT model or fusion of CT with the electroanatomic map. As a result, it has no significant impact on arrhythmia recurrence rate after ablation (Tab. 3, Fig. 3, Ref. 25).
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Skala T, Tudos Z, Hutyra M, Moravec O, Kocher M, Klementova O, Taborsky M. P1909The impact of ECG synchronization during acquisition of left atrium computed tomography model on radiation dose and arrhythmia recurrence rate after catheter ablation of atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Skala
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - Z Tudos
- Palacky University, Faculty of Medicine and Dentistry, Department of Radiology, Olomouc, Czech Republic
| | - M Hutyra
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - O Moravec
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - M Kocher
- Palacky University, Faculty of Medicine and Dentistry, Department of Radiology, Olomouc, Czech Republic
| | - O Klementova
- Palacky University, Faculty of Medicine and Dentistry, Department of anesthesiology and resuscitation, Olomouc, Czech Republic
| | - M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
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Taborsky M, Ostadal P, Adam T, Moravec O, Gloger V, Schee A, Skala T. Red or white wine consumption effect on atherosclerosis in healthy individuals (In Vino Veritas study). ACTA ACUST UNITED AC 2017; 118:292-298. [PMID: 28516793 DOI: 10.4149/bll_2017_072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIMS Consumption of wine has a protective effect on cardiovascular diseases. Data from prospective, long-term, head-to-head comparisons of effects of different drinks on markers of atherosclerosis have been insufficient. METHODS AND RESULTS In Vino Veritas (IVV) study is long-term, prospective, multi-centre, randomized trial comparing effects of red and white wine on atherosclerosis. 157 healthy subjects were randomized to white or red wine consumption for one year. We did not find increase in HDL-cholesterol in the whole group (1.66±0.58 vs 1.62±0.49, p=0.180) or difference between both groups (1.60±0.53 vs 1.64±0.46, p=0.634). At 12 months there was reduction of LDL-cholesterol in both groups, but with no difference between the groups (3.37±0.75 vs 3.60±1.10, p=0.134); there was no difference between the groups in total cholesterol, CRP, fasting blood glucose and liver function tests. Both groups had comparable differences from baseline in levels of parameters of oxidative stress. CONCLUSION We did not find any clinically relevant differences in the lipid profile, CRP, fasting blood glucose and other markers of atherosclerosis, between long-term consumption of red and white wine. Moreover, we were unable to confirm the hypothesis that wine drinking is associated with an elevation of HDL (Tab. 7, Fig. 1, Ref. 30).
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Skala T, Tudos Z, Moravec O, Hutyra M, Kocher M, Cernicek V, Taborsky M. P814Comparison of computed tomography of the left atrium with and without ECG gating before atrial fibrillation catheter ablation - a prospective, randomized, double-blind study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Skala T, Hutyra M, Moravec O, Tudos Z, Klimes D, Taborsky M. P819Comparison of adenosine-mediated pulmonary vein dormant conduction absence and presence with its subsequent elimination in atrial fibrillation recurrence rate after catheter ablation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Moravec O, Maksymkczuk L. [A special trepanation drill]. Acta Chir Orthop Traumatol Cech 1986; 53:256-9. [PMID: 3727891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Moravec O, Lexa C, Sýkora F, Sedivý J. [Dynamic stabilization of acromioclavicular dislocation]. Acta Chir Orthop Traumatol Cech 1986; 53:225-7. [PMID: 3727887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Moravec O. [Osteoid osteoma and similar diseases]. Acta Chir Orthop Traumatol Cech 1984; 51:517-24. [PMID: 6524245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Moravec O, Kasal J. [Fatigue fracture with an uncommon localization (author's transl)]. Acta Chir Orthop Traumatol Cech 1981; 48:210-2. [PMID: 7282250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Moravec O. [Disruption of the insertion of the triceps muscle of the arm (author's transl)]. Acta Chir Orthop Traumatol Cech 1980; 47:226-8. [PMID: 7405494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Moravec O. [Treatment Results in patellar chondropathies of children and adolescents (author's transl)]. Acta Chir Orthop Traumatol Cech 1978; 45:506-12. [PMID: 154819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Moravec O, Khun K. [Pseudocyst of soft tissues in chronic osteomyelitis of femur (author's transl)]. Acta Chir Orthop Traumatol Cech 1974; 41:443-7. [PMID: 4440385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Moravec O, Vachtenheim J. [Synovitis villonodularis pigmentosa localisata of the knee joint]. Fysiatr Revmatol Vestn 1973; 51:343-5. [PMID: 4797796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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