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- Multielectrode mapping for premature ventricular contraction ablation: a prospective, multicenter studyPublication . Sousa, Pedro A.; Barra, Sérgio; Cortez-Dias, Nuno; Khoueiry, Ziad; Paulo, José; António, Natália; Ferreira, Afonso Nunes; Pereira, Mariana; Lagrange, Philippe; De Sousa, João; Elvas, Luís; Garcia, Fermin C.; Gonçalves, LinoPurpose: We aim to evaluate whether the use of a multielectrode mapping catheter could lead to higher efficacy of premature ventricular contraction (PVC) ablation. Methods: Prospective, multicenter nonrandomized study of consecutive patients referred for PVC ablation from January 2018 to June 2021. Patients were separated into two groups: activation map performed with the PentaRay catheter (Study group) or with the ablation catheter (Control group). PMF software was used in both groups. Procedural endpoints and 1-year freedom from ventricular arrhythmia were assessed. Results: During the enrollment period 136 patients (60% males, mean age of 55 ± 17 years, 60% left-sided origin) fulfilled the inclusion criteria - 68 patients in each group. Patients in the Study Group had a sevenfold higher number of acquired activation points (768 ± 728 vs. 110 ± 79, p < 0.01), a shorter mapping time (28 ± 19 min vs. 49 ± 32 min, p < 0.01) and a quicker procedure time (110 ± 33 min vs. 134 ± 50 min, p < 0.01), compared to patients in the Control Group. While there were no significant differences in the acute success (95.6% in the Study Group vs. 90.1% in Control group, p = 0.49), or adverse events (4% in the Study group vs. 7% in the Control group, p = 0.72), patients in the Study group had a higher freedom from ventricular arrhythmia at 1-year (89.7% vs. 70.6%, p = 0.01). The use of the PentaRay catheter was an independent predictor of success (HR = 6.20 [95% CI, 1.08-35.47], p = 0.003). Conclusions: The use of the PentaRay catheter may improve the outcome of PVC ablation while reducing procedure time.
- Optimizing prognosis in atrial fibrillation: a call to action in PortugalPublication . Ferreira, Jorge; António, Natália; Cortez-Dias, Nuno; Gonçalves, Luciana Ricca; Sargento-Freitas, João; von Hafe, Pedro; Gil, VictorAtrial fibrillation (AF), the most common arrhythmia in the adult population worldwide, represents a significant burden in terms of cardiovascular mortality and morbidity and has repercussions on health economics. Oral anticoagulation (OAC) is key to stroke prevention in AF and, in recent years, results from landmark clinical trials of non-vitamin K oral anticoagulants (NOAC) have triggered a paradigm shift in thrombocardiology. Despite these advances, there is still a significant residual vascular risk associated with silent AF, bleeding, premature sudden death and heart failure. The authors review AF epidemiologic data, the importance of new tools for early AF detection, the current role of catheter ablation for rhythm control in AF, the state-of-the-art in periprocedural OAC, the optimal management of major bleeding, the causes of residual premature death and future strategies for improvements in AF prognosis.