GW29-e1468 Pacing Parameters and Success Rate of Permanent His Bundle Pacing in Patients with Narrow QRS: From A Single Center Experience

Abstract The heart rate regularization is crucial for proper treatment of patients with atrial fibrillation and congestive heart failure. The standard resynchronization can be applied, but in patients with narrow QRS this procedure is of no use. The aim of our study is to assess the efficacy of direct His-bundle pacing in patients with congestive heart failure and chronic atrial fibrillation using dual chamber ICD implanted for prevention of sudden cardiac death. Methods The study population included 78 patients with CHF and chronic AF: group A - 56 pts treated with direct His-bundle pacing using atrial port of dual chamber ICD and group B - 22 patients implanted with single chamber ICD as recommended by the guidelines. The patients in group B constituting clinical controls were derived from the Heart Failure Outpatients Clinic with established clinical status and pharmacotherapy. Results The demographic data, clinical characteristics and echocardiography measurements at baseline and during follow-up were presented in the table: Table 1 Group A Group B P value Age (years) 69.7±6.9 66.7±11.3 n.s. Sex (% of male sex) 84.0 86.4 n.s. Ventricular pacing (%) – 46.3±31.2 – His-bundle pacing (%) 81.7±9.2 – – pre post pre post pre vs. post LVEDD (mm) 66.9±4.9 59.9±4.7 64.8±8.0 64.7±8.1 <0.01 n.s. EF (%) 29.6±3.8 43.6±5.9 28.1±6.1 28.8±7.3 <0.01 n.s. NYHA class 2.7±0.6 1.4±0.6 2.5±0.6 2.0±0.2 <0.05 n.s. B-blocker dose (metoprolol equivalent dose) 104.6±41.6 214.3±82.6 78.3±56.6 103.1±49.2 <0.001 <0.05 During 12-months of follow-up the mean values of NYHA functional class, EF and LV dimensions did not change in group B but significantly improved in group A. The physiological His-bundle based pacing enabled optimal beta-blocker dosing. The studied groups had no tachyarrhythmia at baseline so the presumable atrial fibrillation-related harm depends on the rhythm irregularity. Conclusions His-bundle-based pacing in CHF-chronic AF patients contributes to significant echocardiographic and clinical improvement. Standard single-chamber ICD implantation in CHF-chronic AF patients yields only SCD prevention without influence on remodeling process. The CHF-patients with narrow QRS and chronic AF benefit from substantially higher beta-blockade which can be instituted in His-bundle pacing group.

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Efficacy of Lift (Ligation of Intersphincteric Fistula Tract) for Complex and Recurrent Anal Fistulas - A Single-Center Experience and A Review of the Literature

Polish Journal of Surgery ◽

10.2478/pjs-2014-0094 ◽

2015 ◽

Vol 86 (11) ◽

Cited By ~ 3

Author(s):

Michał Romaniszyn ◽

Piotr Julian Walega ◽

Wojciech Nowak

Keyword(s):

Success Rate ◽

Current Literature ◽

Operating Time ◽

Late Complications ◽

Fistula Tract ◽

Single Center ◽

Anal Fistulas ◽

Single Center Experience ◽

Intersphincteric Fistula

AbstractLigation of intersphincteric fistula tract in treatment of anal fistulas (LIFT) is being said to have satisfactory results in short and long follow up, with low risk of complications. This study was designed to evaluate the results in patients with complex and recurrent fistulas in comparison with simple transsphincteric anal fistulas.was to present a single-center experience in LIFT procedure in treatment of both simple and complex anal fistulas, including recurrent fistulas, in comparison with a review of current literature.A series of 17 patients were qualified to LIFT procedure. 5 patients were treated for simple transsphincteric, 6 for complex fistulas, 6 with fistulas recurrent after fistulotomy. Median age was 47, most of the patients were male (16/17). Mean follow up was 11 months.Mean operating time was 55 minutes counting from surgical site disinfection to final dressing of the wound. Of the 17 patients the overall success rate was 53%. As expected, best results were achieved in patients with simple fistulas (80% success rate), then complex (50%), and recurrent fistulas (only 33%). There were no early nor late complications of the surgery.As expected, in simple transsphincteric fistulas the results were satisfactory, taking into account low complication rate. Complex and recurrent fistulas seem to be risk factors of LIFT failure. The results are consistent with data published by other authors, based on the review of the current literature, and it seems there is still room for improvement, so further research is required.

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P1013Cardiac remodeling reversed by His-bundle pacing in CHF-patients with narrow QRS and chronic AF undergoing ICD implantation

EP Europace ◽

10.1093/ehjci/eux151.194 ◽

2017 ◽

Vol 19 (suppl_3) ◽

pp. iii215-iii215

Author(s):

A. Slawuta ◽

K. Boczar ◽

A. Zabek ◽

J. Gajek ◽

J. Lelakowski ◽

...

Keyword(s):

Icd Implantation ◽

His Bundle ◽

His Bundle Pacing ◽

Narrow Qrs

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High success rate and considerable adverse events of pelvic prolapse surgery with Prolift: A single center experience

Taiwanese Journal of Obstetrics and Gynecology ◽

10.1016/j.tjog.2013.01.026 ◽

2013 ◽

Vol 52 (3) ◽

pp. 389-394 ◽

Cited By ~ 5

Author(s):

Mun-Kun Hong ◽

Tang-Yuan Chu ◽

Yu-Chi Wei ◽

Dah-Ching Ding

Keyword(s):

Adverse Events ◽

Success Rate ◽

Prolapse Surgery ◽

High Success Rate ◽

Single Center ◽

Single Center Experience ◽

Pelvic Prolapse

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How effective is cyanoacrylate closure in small saphenous vein insufficiency? A single center experience

Vascular ◽

10.1177/17085381211051494 ◽

2021 ◽

pp. 170853812110514

Author(s):

Görkem Yiğit

Keyword(s):

Success Rate ◽

Saphenous Vein ◽

Treatment Method ◽

Technical Failure ◽

Single Center ◽

Single Center Experience ◽

Kaplan Meier ◽

The Mean ◽

Anatomic Success

Objectives The present study was aimed to evaluate the efficacy and early outcomes of n-butyl cyanoacrylate (NBCA) ablation in small saphenous vein (SSV) insufficiency. Methods In this single-center, retrospective, single-arm study, NBCA ablation was performed in 80 patients with SSV insufficiency between September 2018 and May 2020. Primary outcomes (anatomic success rate and occlusion rate) and secondary outcomes (VCSS and AVVQ scores) of the patients were analyzed. Results No technical failure and device-related complications were encountered. Anatomic success rate was 100% after procedures. Each treated SSV was occluded on colored Doppler ultrasonography immediately after the procedure, and all veins remained occluded at 2 weeks after the procedure. Partial recanalization was observed in five patients at 12-month follow-up. Kaplan–Meier analysis revealed an occlusion rates at 6 months and 12 months follow-up were 97.5% and 93.75%, respectively. The mean pretreatment VCSS (4.72 ± 2.04) decreased to 1.61 ± 0.93, 0.87 ± 0.58, and 0.73 ± 0.52 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The mean pretreatment AVVQ score (11.92 ± 2.23) decreased to 8.2 ± 1.89, 4.2 ± 1.16, and 3.32 ± 1.19 at 2 weeks, 6 months, and 12 months after treatment, respectively ( p < .001). The Clinical, Etiologic, Anatomic, and Pathophysiology clinical classification at 12 months demonstrated a significant reduction in disease severity compared with preoperative values ( p < .001). There was no mortality and major adverse events including anaphylaxis and pulmonary thromboembolism (PTE) related to procedure after follow-ups. Moreover, there were no symptoms or signs of any sural nerve injury and no cases of skin necrosis, infection, or hyperpigmentation. In addition, no hematoma, deep venous thrombosis, and hypersensitivity reactions were observed. Phlebitis-like abnormal reaction was observed in three patients (3.8%). Conclusions In conclusion, in patients with SSV insufficiency, NBCA ablation with VenaBlock® system appears to be an effective and reliable treatment method. At the 12-month follow-up, the NBCA of SSVs showed a low recanalization rate and had a satisfactory improvement on the VCSS and AVVQ scores.

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