84 results on '"Vroomen M"'
Search Results
2. Syncope
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de Vroomen, M., Bartelds, B., Derksen-Lubsen, G., editor, Moll, H.A., editor, Oudesluys-Murphy, A.M., editor, Sprij, A.J., editor, Bolt-Wieringa, J.W., editor, van den Elzen, A.P.M., editor, Leeuwenburgh-Pronk, W.G., editor, Ropers, F.G., editor, and Verhoeven, J.J., editor
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- 2018
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3. Immunoglobulin G anti-endothelial cell antibodies: inducers of endothelial cell apoptosis in pulmonary arterial hypertension?
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Arends, S. J., Damoiseaux, J. G. M. C., Duijvestijn, A. M., Debrus-Palmans, L., Vroomen, M., Boomars, K. A., Rocca, Brunner-La H.-P., Reutelingsperger, C. P. M., Cohen Tervaert, J. W., and van Paassen, P.
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- 2013
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4. Profile specialization hand-occupational therapist
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van de Ven-Stevens, L, Boer-Vreeke, K, Vroomen, M, van de Ven-Stevens, L, Boer-Vreeke, K, and Vroomen, M
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- 2020
5. Induction of Endothelial Cell Apoptosis by IgG Antibodies from SLE Patients with Nephropathy: A Potential Role for Anti–Endothelial Cell Antibodies
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VAN PAASSEN, PIETER, DUIJVESTIJN, A., DEBRUS-PALMANS, L., DAMOISEAUX, J., VROOMEN, M., and COHEN TERVAERT, J. W.
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- 2007
6. Hybrid Ablation of Ventricular Tachycardia: a Single-Centre Experience
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Vroomen, M., Maesen, B., Meir, M. La, Luermans, J.G.L.M., Vernooy, K., Maessen, J.G., Crijns, H.J.G.M., Pison, L., Vroomen, M., Maesen, B., Meir, M. La, Luermans, J.G.L.M., Vernooy, K., Maessen, J.G., Crijns, H.J.G.M., and Pison, L.
- Abstract
Contains fulltext : 209448.pdf (publisher's version ) (Open Access), Background: The long-term results of endocardial and percutaneous epicardial catheter ablation of ventricular tachycardia (VT) in patients with structural heart disease are disappointing. Arrhythmia recurrence after ablation and VTs with an epicardial substrate remain a clinical challenge. The purpose of this manuscript is to elaborate on feasibility and potential advantages of a surgical hybrid ablation (i.e., combined endocardial and surgical epicardial ablation) based on our initial experience consisting of five cases. Methods: Endocardial electro-anatomical voltage and activation maps were created (Carto, Biosense Webster, California, USA), and endocardial radiofrequency (RF) applications were applied at exit sites, low voltage areas and isthmi. Next, after surgical access, epicardial voltage and activation maps were produced in combination with visual assessment of the epicardial substrate. Epicardial low voltage areas, isthmi and exit sites were identified and ablated using RF energy. Results: After the procedure, VT was non-inducible in 80% of the cases (4/5, in one case no induction was performed). No peri-procedural complications occurred. After a mean follow-up of 18 months, one patient remained in sinus rhythm without, and 2 with use of antiarrhythmic drugs. One patient needed a redo procedure after 21 months, and in one patient the amiodarone dose was raised because of 2 sustained VTs. After this additional treatment, both kept sinus rhythm. Conclusions: Hybrid VT ablation is a safe and effective patient tailored procedure that comprises the major advantage of combining direct anatomical visualization and enhanced catheter stability with high-density 3D mapping. As a consequence, this procedure should be considered as a valid treatment option in complex VT management.
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- 2019
7. Hybrid thoracoscopic surgical and transvenous catheter ablation versus transvenous catheter ablation in persistent and longstanding persistent atrial fibrillation (HARTCAP-AF): study protocol for a randomized trial
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Vroomen, M., Meir, M. La, Maesen, B., Luermans, J.G.L.M., Vernooy, K., Essers, B., Greef, B.T.A. de, Maessen, J.G., Crijns, H.J.G.M., Pison, L., Vroomen, M., Meir, M. La, Maesen, B., Luermans, J.G.L.M., Vernooy, K., Essers, B., Greef, B.T.A. de, Maessen, J.G., Crijns, H.J.G.M., and Pison, L.
- Abstract
Contains fulltext : 209449.pdf (publisher's version ) (Open Access), BACKGROUND: Success rates with conventional transvenous endocardial pulmonary vein isolation in patients with persistent and longstanding persistent atrial fibrillation (AF) are variable due to advanced electrical and structural remodeling of the atria. As a consequence, more extensive endocardial lesions, minimally invasive thoracoscopic surgical techniques, and hybrid ablation (combining thoracoscopic epicardial surgical and endocardial catheter ablation) have been developed. HYPOTHESIS: The HARTCAP-AF trial hypothesizes that hybrid AF ablation is more effective than (repeated) transvenous endocardial catheter ablation in (longstanding) persistent AF, without increasing the number of associated major adverse events. METHODS: This randomized controlled trial will include 40 patients with persistent or longstanding persistent AF who will be 1:1 randomized to either hybrid ablation or (repeated) catheter ablation. The procedures and follow-up are conducted according to the guidelines. The primary effectiveness endpoint is freedom from any supraventricular arrhythmia lasting longer than 5 min without the use of Vaughan-Williams class I or III antiarrhythmic drugs through 12 months of follow-up after the last procedure. In the catheter ablation arm, a second procedure planned within 6 months after the index procedure is allowed for obtaining the primary endpoint. Additionally, adverse events, cost-effectiveness, and quality of life data will be recorded. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02441738 . Registered on 12 May 2015.
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- 2019
8. Multi-functional T-DNA/Ds tomato lines designed for gene cloning and molecular and physical dissection of the tomato genome
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Gidoni, D., Fuss, E., Burbidge, A., Speckmann, G-J., James, S., Nijkamp, D., Mett, A., Feiler, J., Smoker, M., de Vroomen, M. J., Leader, D., Liharska, T., Groenendijk, J., Coppoolse, E., Smit, J. J.M., Levin, I., de Both, M., Schuch, W., Jones, J. D.G., Taylor, I. B., Theres, K., and van Haaren, M. J.J
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- 2003
9. Adipose Tissue Macrophages Induce Hepatic Neutrophil Recruitment And Macrophage Accumulation Without Affecting Atherosclerosis Development In Mice.
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Bijnen, M., primary, Josefs, T., additional, van de Gaar, J., additional, Vroomen, M., additional, Wijnands, E., additional, Rensen, S., additional, Greve, J.W., additional, Hofker, M., additional, Biessen, E., additional, de Winther, M., additional, Stehouwer, C., additional, Schalkwijk, C., additional, and Wouters, K., additional
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- 2019
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10. Three-year follow-up of hybrid ablation for atrial fibrillation
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Maesen, B., Pison, L., Vroomen, M., Luermans, J.G., Vernooy, K., Maessen, J.G., Crijns, H.J.G.M., Meir, M. La, Maesen, B., Pison, L., Vroomen, M., Luermans, J.G., Vernooy, K., Maessen, J.G., Crijns, H.J.G.M., and Meir, M. La
- Abstract
Item does not contain fulltext, OBJECTIVES: The single-step hybrid atrial fibrillation (AF) ablation procedure combines a transvenous endocardial and thoracoscopic epicardial approach in 1 procedure. Short-term results are encouraging, but long-term outcome data are not available. METHODS: Hybrid AF ablation was successfully performed in 64 consecutive patients (53% with persistent AF). The mean follow-up period was 1732 +/- 353 days. Perprocedural endocardial touch-up of incomplete epicardial lesions was performed in 17 (26%) patients. RESULTS: In paroxysmal AF patients, arrhythmia-free cumulative survival rates after 1 hybrid AF ablation without Class I or III antiarrhythmic drugs procedure and without redo catheter ablation were 83%, 80% and 80% after 1, 2 and 3 years, respectively. In (long-standing) persistent AF patients, these were 82%, 79% and 79% after 1, 2 and 3 years. Thirteen (20%) patients had at least 1 recurrent episode of supraventricular arrhythmia lasting longer than 30 s: the most frequent recurrent arrhythmias were left atrial flutter and AF. No mortality or conversion to cardiopulmonary bypass, no phrenic nerve palsy and no pacemaker implantation were reported. CONCLUSIONS: Hybrid AF ablation, combining a transvenous endocardial and thoracoscopic epicardial approach in a single procedure, results in a cumulative 3-year freedom from arrhythmia without Class I or III antiarrhythmic drugs and without redo catheter ablation of 80% in paroxysmal AF (24 of 30 patients) and 79% in non-paroxysmal AF (26 of 33 patients).
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- 2018
11. Adipose tissue macrophages induce hepatic neutrophil recruitment and macrophage accumulation in mice
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Bijnen, M., primary, Josefs, T., additional, Cuijpers, I., additional, van de Gaar, J., additional, Vroomen, M., additional, Wijnands, E., additional, Rensen, S., additional, Greve, J.W., additional, Hofker, M., additional, Biessen, E., additional, Stehouwer, C., additional, Schalkwijk, C., additional, and Wouters, K., additional
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- 2017
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12. Certification: a sustainable solution? Insights from Dutch companies on the benefits and limitations of CSR certification in international supply chains
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Kawakami, M., Dijkstra, G., Charlemagne, E., Pitman, K., Su, P., Ungureanu, A., Vroomen, M., Private Law, RS: FdR IC Verbint/contractenrecht, RS: FdR Europees Privaatrecht, and RS: FdR Institute M-EPLI
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- 2014
13. The right ventricle from adaptation to maladaptation. Correlations in a rat model
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Borgdorff, M.A.J., Vroomen, M. de, Bartelds, B., Dickinson, M.G., Takens, J., Boersma, B., Steendijk, P., and Berger, R.M.F.
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- 2010
14. Definition of modulatory MHC class II binding acetylcholine receptor T cell epitope analogues to interfere in experimental autoimmune myasthenia gravis
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Wagenaar, J.P.A., primary, Hoedemaekers, A.C.W.E., additional, Vroomen, M., additional, Hoogerhout, P., additional, van Eden, W., additional, De Baets, M.H., additional, and Wauben, M.H.M., additional
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- 1997
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15. Endothelin-1 plasma concentration increases in the early phase of pulmonary hypertension development during respiratory distress syndrome: a study in newborn lambs
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Vroomen, M. de, Cardozo, R. H. Lopes, Steendijk, P., Frolich, M., Baan, J., and Bel, F. van
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- 2001
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16. Simultaneous measurement of right and left ventricular volume by the conductance catheter technique in the newborn lamb
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Rh, Cardozo, de Vroomen M, van Bel F, Baan J, and Paul Steendijk
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Original Articles - Abstract
Measurement of absolute ventricular volume with the conductance catheter technique has been documented extensively for the left ventricle (LV). More recently, the same technique has been applied in studies of right ventricular (RV) performance. In the present study we performed simultaneous measurements of LV and RV volumes. Conversion of measured conductances to absolute volumes requires the assessment of slope factor alpha (α) and parallel conductance correction volume (VIn five anaesthetised, ventilated newborn lambs, conductance catheters were introduced into the LV and RV and a thermodilution catheter was positioned in the pulmonary artery. Alphas and VDuring the course of the experiments all haemodynamic parameters were stable. There were no significant changes in VThese results show that calibration factors α and V
17. Outcomes of surgical ablation for atrial fibrillation in on- versus off-pump coronary artery bypass grafting.
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Vroomen M, Franke U, Senges J, Friedrich I, Fischlein T, Lewalter T, Ouarrak T, Niemann B, Liebold A, Hanke T, Doll N, and Albert M
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Objectives: A considerable number of patients undergoing coronary artery bypass grafting surgery suffer from atrial fibrillation and should be treated concomitantly. This manuscript evaluates the impact of on-pump versus off-pump bypass grafting on the applied lesion set and rhythm outcome., Methods: Between January 2017 and April 2020, patients who underwent combined bypass grafting and surgical ablation for atrial fibrillation were consecutively enrolled in the German CArdioSurgEry Atrial Fibrillation registry (CASE-AF, 17 centres). Data were prospectively collected. Follow-up was planned after one year., Results: A total of 224 patients were enrolled. No differences in baseline characteristics were seen between on- and off-pump bypass grafting, especially not in type of atrial fibrillation and left atrial size. In the on-pump group (n = 171, 76%), pulmonary vein isolation and an extended left atrial lesion set were performed more often compared to off-pump bypass grafting (58% vs 26%, 33 vs 9%, respectively, P < 0.001). In off-pump bypass grafting a box isolating the atrial posterior wall was the dominant lesion (72% off-pump vs 42% on-pump, P < 0.001). Left atrial appendage management was comparable in on-pump versus off-pump bypass grafting (94% vs 91%, P = 0.37). Sinus rhythm at follow-up was confirmed in 61% in the on-pump group and in 65% in the off-pump group (P = 0.66). No differences were seen in in-hospital or follow-up complication-rates between the two groups., Conclusions: In coronary artery bypass grafting patients undergoing concomitant atrial fibrillation ablation, our data suggests that the technique applied for myocardial revascularization (off-pump vs on-pump) leads to differences in the ablation lesion set, but not in safety and effectiveness., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
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- 2024
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18. How to establish a successful and sustainable surgical atrial fibrillation program: key considerations on the arrhythmia, training and treatment strategies.
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Weimar T and Vroomen M
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Establishing a successful and sustaining atrial fibrillation (AF) program should be current standard of care in cardiac surgery by providing not only sinus rhythm restoration but improving survival significantly. Recognition of AF as a serious cardiac disease impacting a considerable number of patients in terms of stroke, heart failure development and mortality is key when implementing a protocol to identify patients suitable for surgical ablation and a treatment standard according to the underlying pathology. The ablation strategy resulting in the best potential rhythm outcome should be chosen, and the applied access should follow this decision in a way that the optimal lesion set can be executed completely. A thorough follow-up is required to confirm results or make necessary adjustments to the implemented treatment protocol. This should be done in close collaboration with other treatment specialists such as cardiologists, electrophysiologists, primary care physicians, or neurologists. This collaboration might also facilitate an expansion of the program towards stand-alone ablation, ventricular tachycardia ablation, and inappropriate sinus tachycardia ablation., Competing Interests: Conflicts of Interest: T.W. declares a financial relationship with AtriCure Inc. The other author has no conflicts of interest to declare., (2024 Annals of Cardiothoracic Surgery. All rights reserved.)
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- 2024
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19. Hybrid Ablation Versus Repeated Catheter Ablation in Persistent Atrial Fibrillation: A Randomized Controlled Trial.
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van der Heijden CAJ, Weberndörfer V, Vroomen M, Luermans JG, Chaldoupi SM, Bidar E, Vernooy K, Maessen JG, Pison L, van Kuijk SMJ, La Meir M, Crijns HJGM, and Maesen B
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- Humans, Treatment Outcome, Prospective Studies, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation, Catheter Ablation adverse effects, Catheter Ablation methods
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Background: Although catheter ablation (CA) is successful for the treatment of paroxysmal atrial fibrillation (AF), results are less satisfactory in persistent AF. Hybrid ablation (HA) results in better outcomes in patients with persistent atrial fibrillation (persAF), as it combines a thoracoscopic epicardial and transvenous endocardial approach in a single procedure., Objectives: The purpose of this study was to compare the effectiveness and safety of HA with CA in a prospective, superiority, unblinded, randomized controlled trial., Methods: Forty-one ablation-naive patients with (long-standing)-persAF were randomized to HA (n = 19) or CA (n = 22) and received pulmonary vein isolation, posterior left atrial wall isolation and, if needed, a cavotricuspid isthmus ablation. The primary efficacy endpoint was freedom from any atrial tachyarrhythmia >5 minutes off antiarrhythmic drugs after 12 months. The primary and secondary safety endpoints included major and minor complications and the total number of serious adverse events., Results: After 12 months, the freedom of atrial tachyarrhythmias off antiarrhythmic drugs was higher in the HA group compared with the CA group (89% vs 41%, P = 0.002). There was 1 pericarditis requiring pericardiocentesis and 1 femoral arteriovenous-fistula in the HA group. In the CA arm, 1 bleeding from the femoral artery occurred. There were no deaths, strokes, need for pacemaker implantation, or conversions to sternotomy, and the number of (serious) adverse events was comparable between groups (21% vs 14%, P = 0.685)., Conclusions: Hybrid AF ablation is an efficacious and safe procedure and results in better outcomes than catheter ablation for the treatment of patients with persistent AF. (Hybrid Versus Catheter Ablation in Persistent AF [HARTCAP-AF]; NCT02441738)., Competing Interests: Funding Support and Author Disclosures Dr Maesen is a consultant to AtriCure and Medtronic. Dr La Meir is a consultant to AtriCure. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2023
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20. Reply: Hybrid Ablation for Persistent Atrial Fibrillation: The Approach Matters.
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van der Heijden CAJ, Weberndörfer V, Vroomen M, Luermans JG, Chaldoupi SM, Bidar E, Vernooy K, Maessen JG, Pison L, van Kuijk SMJ, La Meir M, Crijns HJGM, and Maesen B
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- Humans, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation
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- 2023
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21. A failed catheter ablation of atrial fibrillation is associated with more advanced remodeling and reduced efficacy of further thoracoscopic ablation.
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Wesselink R, Vroomen M, Overeinder I, Neefs J, van den Berg NWE, Meulendijks ER, Piersma FR, Al-Shama RFM, de Vries TAC, Verstraelen TE, Luermans J, Maesen B, de Asmundis C, Chierchia GB, La Meir M, Pison L, van Boven WJP, Driessen AHG, and de Groot JR
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- Humans, Treatment Outcome, Heart Atria, Fibrosis, Recurrence, Atrial Fibrillation complications, Atrial Fibrillation surgery, Catheter Ablation adverse effects
- Abstract
Introduction and Objectives: Recent observations suggest that patients with a previous failed catheter ablation have an increased risk of atrial fibrillation (AF) recurrence after subsequent thoracoscopic AF ablation. We assessed the risk of AF recurrence in patients with a previous failed catheter ablation undergoing thoracoscopic ablation., Methods: We included patients from 3 medical centers. To correct for potential heterogeneity, we performed propensity matching to compare AF freedom (freedom from any atrial tachyarrhythmia> 30 s during 1-year follow-up). Left atrial appendage tissue was analyzed for collagen distribution., Results: A total of 705 patients were included, and 183 had a previous failed catheter ablation. These patients had fewer risk factors for AF recurrence than ablation naïve controls: smaller indexed left atrial volume (40.9± 12.5 vs 43.0±12.5 mL/m
2 , P=.048), less congestive heart failure (1.5% vs 8.9%, P=.001), and less persistent AF (52.2% vs 60.3%, P=.067). However, AF history duration was longer in patients with a previous failed catheter ablation (6.5 [4-10.5] vs 4 [2-8] years; P<.001). In propensity matched analysis, patients with a failed catheter ablation were at a 68% higher AF recurrence risk (OR, 1.68; 95%CI, 1.20-2.15; P=.034). AF freedom was 61.1% in patients with a previous failed catheter ablation vs 72.5% in ablation naïve matched controls. On histology of the left atrial appendage (n=198), patients with a failed catheter ablation had a higher density of collagen fibers., Conclusions: Patients with a prior failed catheter ablation had fewer risk factors for AF recurrence but more frequently had AF recurrence after thoracoscopic AF ablation than ablation naïve patients. This may in part be explained by more progressed, subclinical, atrial fibrosis formation., (Copyright © 2022 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)- Published
- 2023
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22. Prevalence of congenital anomalies in the Dutch Caribbean islands of Aruba, Bonaire, and Curaçao.
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Verberne EA, Lo-A-Njoe SM, van Ginkel M, Zwolsman J, Nikkels S, Clement L, de Vroomen M, Wever MLG, Arends E, Holtsema H, Hajenius PJ, Moreta D, Ecury-Goossen GM, Mannens MMAM, de Walle HEK, Bergman JEH, and van Haelst MM
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- Pregnancy, Female, Humans, Child, Aruba, Curacao, Prevalence, Caribbean Netherlands, West Indies epidemiology, Polydactyly
- Abstract
Background: Congenital anomalies represent an important global health issue. Data on the prevalence and pattern of congenital anomalies in the Caribbean region are scarce and lacking altogether in Aruba, Bonaire and Curaçao (ABC islands)., Methods: We performed a population-based surveillance study to determine the prevalence of structural congenital anomalies in the ABC islands, including all live births and stillbirths between January 1, 2008 and December 31, 2017 with major congenital anomalies according to EUROCAT guide 1.5. Terminations of pregnancy for fetal anomaly were included as well. Cases were identified by active case ascertainment, using multiple sources including pediatric patient files and discharge letters, delivery records, and clinical genetic patient files. Total and subgroup prevalence rates were compared between the three islands and to the French West Indies and Northern Netherlands., Results: Total prevalence of congenital anomalies on the ABC islands was 242.97 per 10,000 births. Total prevalence of congenital anomalies in Bonaire (325.15 per 10,000 births) was higher compared to Aruba (233.29 per 10,000 births) and Curaçao (238.58 per 10,000 births), which was mainly attributable to a higher prevalence of limb anomalies, in particular polydactyly, in Bonaire. Total prevalence of congenital anomalies on the ABC islands was comparable to the French West Indies (248.69 per 10,000 births) but significantly lower compared to the Northern Netherlands (298.98 per 10,000 births). In the subgroup prevalence analysis, the prevalence of polydactyly and atrial septal defect on the ABC islands was significantly higher compared with the French West Indies and the Northern Netherlands, while the prevalence of congenital anomalies of the kidney and urinary tract and genetic disorders was significantly lower., Conclusions: This is the first study to establish the prevalence and pattern of congenital anomalies on the ABC islands, which is important to inform healthcare managers and policymakers and to provide a basis for continuous surveillance of congenital anomalies., (© 2023 The Authors. Birth Defects Research published by Wiley Periodicals LLC.)
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- 2023
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23. Hybrid ablation of atrial fibrillation: A unilateral left-sided thoracoscopic approach.
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van der Heijden CAJ, Weberndörfer V, Luermans JGLM, Chaldoupi SM, van Kuijk SMJ, Vroomen M, Bidar E, Maessen JG, Pison L, La Meir M, and Maesen B
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- Humans, Female, Middle Aged, Aged, Male, Retrospective Studies, Treatment Outcome, Thoracoscopy, Heart Atria surgery, Recurrence, Atrial Fibrillation etiology, Catheter Ablation adverse effects
- Abstract
Background: Hybrid ablation (HA) of atrial fibrillation (AF) combines minimally invasive thoracoscopic epicardial ablation with transvenous endocardial electrophysiologic validation and touch-up of incomplete epicardial lesions if needed. While studies have reported on a bilateral thoracoscopic HA approach, data on a unilateral left-sided approach are scarce., Aim: To evaluate the efficacy and safety of a unilateral left-sided thoracoscopic approach., Methods: Retrospective analysis of a prospectively gathered cohort of all consecutive patients undergoing a unilateral left-sided HA for AF between 2015 and 2018 in the Maastricht University Medical Centre., Results: One-hundred nineteen patients were analyzed (mean age 64 ± 8, 28% female, mean body mass index 28 ± 4 kg/m
2 , median CHA2 DS2 -VASc Score 2 [1-3], [longstanding]-persistent AF 71%, previous catheter ablation 44%). In all patients, a unilateral left-sided HA consisting of pulmonary vein (PV) isolation, posterior left atrial (LA) wall isolation, and LA appendage exclusion was attempted. Epicardial (n = 59) and/or endocardial validation (n = 81) was performed and endocardial touch-up was performed in 33 patients. Major peri-operative complications occurred in 5% of all patients. After 12 and 24 months, the probability of being free from supraventricular tachyarrhythmia recurrence was 80% [73-87] and 67% [58-76], respectively, when allowing antiarrhythmic drugs., Conclusion: Unilateral left-sided hybrid AF ablation is an efficacious and safe approach to treat patients with paroxysmal and (longstanding) persistent AF. Future studies should compare a unilateral with a bilateral approach to determine whether a left-sided approach is as efficacious as a bilateral approach and allows for less complications., (© 2022 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC.)- Published
- 2022
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24. Genetic care in geographically isolated small island communities: 8 years of experience in the Dutch Caribbean.
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Verberne EA, Westermann JM, de Vries TI, Ecury-Goossen GM, Lo-A-Njoe SM, Manshande ME, Faries S, Veenhuis HD, Philippi P, Falix FA, Rosina-Angelista I, Ponson-Wever M, Rafael-Croes L, Thorsen P, Arends E, de Vroomen M, Nagelkerke SQ, Tilanus M, van der Veken LT, Huijsdens-van Amsterdam K, van der Kevie-Kersemaekers AM, Alders M, Mannens MMAM, and van Haelst MM
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- Caribbean Region epidemiology, Child, Genetic Testing methods, Humans, Retrospective Studies, DNA Copy Number Variations, Intellectual Disability genetics
- Abstract
Worldwide, there are large inequalities in genetic service delivery. In 2011, we established a bi-annual joint pediatric-genetics clinic with a visiting clinical geneticist in the Dutch Caribbean. This retrospective study evaluates the yield of diagnostic testing and the clinical utility of a diagnosis for patients with rare diseases on these relatively isolated, resource-limited islands. A total of 331 patients that were referred to the clinical geneticist between November 2011 and November 2019 and had genetic testing were included in this study. A total of 508 genetic tests were performed on these patients. Microarray, next-generation sequencing gene panels, and single-gene analyses were the most frequently performed genetic tests. A molecularly confirmed diagnosis was established in 33% of patients (n = 108). Most diagnosed patients had single nucleotide variants or small insertions and/or deletions (48%) or copy number variants (34%). Molecular diagnostic yield was highest in patients referred for seizures and developmental delay/intellectual disability. The genetic diagnosis had an impact on clinical management in 52% of patients. Referrals to other health professionals and changes in therapy were the most frequently reported clinical consequences. In conclusion, despite limited financial resources, our genetics service resulted in a reasonably high molecular diagnostic yield. Even in this resource-limited setting, a genetic diagnosis had an impact on clinical management for the majority of patients. Our approach with a visiting clinical geneticist may be an example for others who are developing genetic services in similar settings., (© 2022 The Authors. American Journal of Medical Genetics Part A published by Wiley Periodicals LLC.)
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- 2022
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25. Genetic diagnosis for rare diseases in the Dutch Caribbean: a qualitative study on the experiences and associated needs of parents.
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Verberne EA, van den Heuvel LM, Ponson-Wever M, de Vroomen M, Manshande ME, Faries S, Ecury-Goossen GM, Henneman L, and van Haelst MM
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- Adaptation, Psychological, Child, Family, Humans, Qualitative Research, Parents psychology, Rare Diseases diagnosis, Rare Diseases genetics
- Abstract
Research on the perspectives of patients and parents regarding genetic testing and its implications has been performed mostly in Europe, Canada, the United States, Australia and New Zealand, even though genetic testing is becoming increasingly available worldwide. We aimed to fill this knowledge gap by exploring the experiences and needs of parents in the Dutch Caribbean who received a genetic diagnosis for the rare disease of their child. We conducted 23 semi-structured interviews with 30 parents of children diagnosed with various rare genetic diseases in Aruba, Bonaire and Curaçao (ABC-islands). Two researchers independently analyzed the interviews using a thematic approach. Main themes identified were: (1) getting a genetic diagnosis, (2) coping, support and perceived social stigma, (3) living on a small island, and (4) needs regarding genetic services. Our results indicate that, despite reported limitations regarding the availability of healthcare and support services, receiving a genetic diagnosis for their child was valuable for most participants. While some of the participants' experiences with and attitudes towards the genetic diagnosis of their child were similar to those reported in previous studies, we identified a number of aspects that are more specifically related to this Dutch Caribbean setting. These include coping through faith and religion, social stigma and being the only one on the island with a specific genetic disorder. The results of this study and the provided recommendations may be useful when developing genetic testing and counseling services in similar settings., (© 2022. The Author(s), under exclusive licence to European Society of Human Genetics.)
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- 2022
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26. Extended ECG Improves Classification of Paroxysmal and Persistent Atrial Fibrillation Based on P- and f-Waves.
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Zink MD, Laureanti R, Hermans BJM, Pison L, Verheule S, Philippens S, Pluymaekers N, Vroomen M, Hermans A, van Hunnik A, Crijns HJGM, Vernooy K, Linz D, Mainardi L, Auricchio A, Zeemering S, and Schotten U
- Abstract
Background: The standard 12-lead ECG has been shown to be of value in characterizing atrial conduction properties. The added value of extended ECG recordings (longer recordings from more sites) has not been systematically explored yet., Objective: The aim of this study is to employ an extended ECG to identify characteristics of atrial electrical activity related to paroxysmal vs. persistent atrial fibrillation (AF)., Methods: In 247 participants scheduled for AF ablation, an extended ECG was recorded (12 standard plus 3 additional leads, 5 min recording, no filtering). For patients presenting in sinus rhythm (SR), the signal-averaged P-wave and the spatiotemporal P-wave variability was analyzed. For patients presenting in AF, f-wave properties in the QRST (the amplitude complex of the ventricular electrical activity: Q-, R-, S-, and T-wave)-canceled ECG were determined., Results: Significant differences between paroxysmal ( N = 152) and persistent patients with AF ( N = 95) were found in several P-wave and f-wave parameters, including parameters that can only be calculated from an extended ECG. Furthermore, a moderate, but significant correlation was found between echocardiographic parameters and P-wave and f-wave parameters. There was a moderate correlation of left atrial (LA) diameter with P-wave energy duration ( r = 0.317, p < 0.001) and f-wave amplitude in lead A3 ( r = -0.389, p = 0.002). The AF-type classification performance significantly improved when parameters calculated from the extended ECG were taken into account [area under the curve (AUC) = 0.58, interquartile range (IQR) 0.50-0.64 for standard ECG parameters only vs. AUC = 0.76, IQR 0.70-0.80 for extended ECG parameters, p < 0.001]., Conclusion: The P- and f-wave analysis of extended ECG configurations identified specific ECG features allowing improved classification of paroxysmal vs. persistent AF. The extended ECG significantly improved AF-type classification in our analyzed data as compared to a standard 10-s 12-lead ECG. Whether this can result in a better clinical AF type classification warrants further prospective study., Competing Interests: AA was a consultant for Biosense Webster, Boston Scientific, Medtronic, and Microport CRM; Intellectual property: Biosense Webster, Boston Scientific, and Microport CRM; Speaker fees: Boston Scientific, Medtronic, Microport CRM, and Philips. US was shareholder of YourRhythmics BV and consultant for Roche, EP Solutions, and YourRhythmics BV. KV was a consultant for Biosense Webster, Medtronic, Philips, Abbott. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zink, Laureanti, Hermans, Pison, Verheule, Philippens, Pluymaekers, Vroomen, Hermans, van Hunnik, Crijns, Vernooy, Linz, Mainardi, Auricchio, Zeemering and Schotten.)
- Published
- 2022
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27. Clinical and community genetics services in the Dutch Caribbean.
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Verberne EA, Ecury-Goossen GM, Manshande ME, Ponson-Wever M, de Vroomen M, Tilanus M, Mannens MMAM, Henneman L, and van Haelst MM
- Abstract
The Caribbean part of the Kingdom of the Netherlands consists of six islands: Aruba, Bonaire, Curaçao, St. Maarten, St. Eustatius, and Saba. Because of their small size and relative remoteness, they face several economic and healthcare challenges, including limited access to genetics services. In this article, we provide an overview of the clinical and community genetics services that are available in the Dutch Caribbean. In particular, we describe our joint pediatric-genetics clinic with a visiting clinical geneticist that was established in 2011 to provide clinical genetics services for the pediatric population of the Dutch Caribbean.
- Published
- 2021
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28. Ten-year follow-up after endocardial point-by-point cryoablation for paroxysmal atrial fibrillation.
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Vroomen M, van Rosmalen F, Schröder J, Philippens S, Delhaas T, Crijns HJ, and Pison L
- Subjects
- Follow-Up Studies, Humans, Recurrence, Retrospective Studies, Treatment Outcome, Atrial Fibrillation diagnosis, Atrial Fibrillation surgery, Catheter Ablation, Cryosurgery, Pulmonary Veins surgery
- Abstract
Background: Since many years catheter ablation is widely used for the treatment of atrial fibrillation (AF), however, long-term follow-up data of ablation techniques are rare. This study presents a 10-year follow-up period in patients treated for paroxysmal AF (PAF) with point-by-point pulmonary vein isolation (PVI) using cryothermal energy (cryoPVI). The main objective is to investigate whether cryoPVI is able to create durable PVI., Methods: All consecutive patients with PAF who underwent a point-by-point cryoPVI were included. Information from the index procedure, anti-arrhythmic drug (AAD) use, recurrence of arrhythmias and re-ablation, was retrospectively analysed. Re-ablations were specifically evaluated for reconnection of PVs., Results: Seventy-three patients were included. Five (7%) were lost to follow-up and 55/73 (75%) reached 10-year follow-up (median follow-up duration: 11.3 years [10.0-12.4]). Thirteen (18%) did not reach 10-years follow-up (mean follow-up duration: 4.4 ± 3.3 years). All targeted PVs were successfully isolated during the index procedure. Only 10/68 patients (15%) kept sinus rhythm (SR) without the use of AAD or a re-ablation. Re-ablations were performed in 47/68 patients (69%). Reconnection was seen in 81% of the PVs., Conclusions: Ostial point-by-point cryoPVI has the ability to provide acute electrical isolation of arrhythmogenic PVs based on abolition of all PV potentials, but fails in long-term isolation and prevention of AF-recurrence in most patients.
- Published
- 2021
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29. Epicardial and Endocardial Validation of Conduction Block After Thoracoscopic Epicardial Ablation of Atrial Fibrillation.
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Vroomen M, Maesen B, Luermans JL, Maessen JG, Crijns HJ, La Meir M, and Pison L
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- Heart Rate, Humans, Pericardium surgery, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation, Pulmonary Veins surgery
- Abstract
Objective: It is unknown whether epicardial and endocardial validation of bidirectional block after thoracoscopic surgical ablation for atrial fibrillation is comparable. Epicardial validation may lead to false-positive results due to epicardial tissue edema, and thus could leave gaps with subsequent arrhythmia recurrence. It is the aim of the present study to answer this question in patients who underwent hybrid atrial fibrillation ablation (combined thoracoscopic epicardial and endocardial catheter ablation)., Methods: After epicardial ablation of the pulmonary veins (PVs) and connecting inferior and roof lines (box lesion), exit and entrance block were epicardially and endocardially evaluated using an endocardial His Bundle catheter and electrophysiological workstation. If incomplete lesions were found, endocardial touch-up ablation was performed. Validation results were also compared to predictions about conduction block based on tissue conductance measurements of the epicardial ablation device., Results: Twenty-five patients were included. Epicardial validation results were 100% equal to the endocardial results for the left superior, left inferior, and right inferior PVs and box lesion. For the right superior PV, 85% similarity was found. Based on tissue conductance measurements, 139 lesions were expected to be complete; however, in 5 (3.6%) a gap was present., Conclusions: Epicardial bidirectional conduction block in the PVs and the box lesion corresponded well with endocardial bidirectional conduction block. Conduction block predictions by changes in tissue conductance failed in few cases compared to block confirmation. This emphasizes that tissue conduction measurements can provide a rough indication of lesion effectiveness but needs endpoint confirmation by either epicardial or endocardial block testing.
- Published
- 2020
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30. Successful thoracoscopic clipping of a thrombus-containing left atrial appendage.
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Vroomen M, Luermans JGLM, Meir M, and Maesen B
- Abstract
Competing Interests: MLM and BM are consultant for Atricure.
- Published
- 2020
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31. Hybrid versus catheter ablation in patients with persistent and longstanding persistent atrial fibrillation: a systematic review and meta-analysis†.
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van der Heijden CAJ, Vroomen M, Luermans JG, Vos R, Crijns HJGM, Gelsomino S, La Meir M, Pison L, and Maesen B
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- Humans, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation methods
- Abstract
As the mechanisms underlying persistent atrial fibrillation (AF) are still incompletely understood, a 'gold standard' strategy for ablation is lacking. The results of catheter ablation, independent of the ablation strategy applied, are disappointing. Hybrid ablation, combining a thoracoscopic epicardial and transvenous endocardial approach, has shown more favourable outcomes. To date, studies comparing both techniques are lacking. Therefore, we conducted a systematic review and meta-analysis of hybrid versus catheter ablation in patients with persistent or longstanding persistent AF. A systematic literature search of studies reporting on catheter and hybrid ablation of persistent or longstanding persistent AF was performed in the PubMed database. All identified articles were screened and checked for eligibility. A meta-analysis was performed on inter-study heterogeneity and pooled correlation between baseline characteristics, primary and secondary outcomes of hybrid and catheter studies. From the 520 articles identified by the search, 34 articles could be included in the analysis. Hybrid ablation resulted in higher freedom of atrial arrhythmias in patients with persistent and longstanding-persistent AF than catheter ablation (70.7% vs 49.9%, P < 0.001). Although hybrid ablation had a slightly higher complication rate than catheter ablation, overall morbidity and mortality were low. In conclusion, hybrid ablation is more effective than catheter ablation in maintaining the sinus rhythm in patients with persistent or longstanding persistent AF. However, data directly comparing both techniques are lacking, and small, heterogenic, single-arm studies in a random-effects model prevent definite conclusions from being drawn. Therefore, larger randomized controlled trials directly comparing both techniques are needed., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2019
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32. Quantification of epicardial adipose tissue in patients undergoing hybrid ablation for atrial fibrillation.
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Vroomen M, Olsthoorn JR, Maesen B, L'Espoir V, La Meir M, Das M, Maessen JG, Crijns HJGM, Verheule S, and Pison L
- Subjects
- Aged, Atrial Fibrillation diagnostic imaging, Computed Tomography Angiography, Female, Heart Atria diagnostic imaging, Heart Atria surgery, Humans, Image Interpretation, Computer-Assisted, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Adipose Tissue diagnostic imaging, Atrial Fibrillation surgery, Catheter Ablation methods, Pericardium diagnostic imaging
- Abstract
Objectives: Epicardial adipose tissue volume (EAT-V) has been linked to atrial fibrillation (AF) recurrences after catheter ablation. We retrospectively studied the association between atrial EAT-V and outcome after hybrid AF ablation (epicardial surgical and endocardial catheter ablation)., Methods: On preoperative cardiac computed tomography angiography scans, the left atrium and right atrium were manually delineated using the open source ImageJ. With custom-made automated software, the number of pixels in the regions of interest on each slice was calculated. On the basis of the Hounsfield units, pixel size and slice thickness, EAT-V was computed and normalized in relation to the body surface area (BSA) and the myocardial tissue volume., Results: Eighty-five patients were included. Left atrial and right atrial EAT-V normalized to BSA were not significantly different between paroxysmal and persistent AF [0.84 (0.51-1.50) vs 0.81 (0.57-1.18), 1.74 (1.02-2.56) vs 1.55 (1.26-2.18), all P = 0.9], neither between the acute conduction block and no acute conduction block in the epicardial box lesion [0.92 (0.55-1.39) vs 0.72 (0.55-1.24), P = 0.5, right atrium not applicable], nor between the sinus rhythm and arrhythmia recurrence after 12 months [0.88 (0.55-1.48) vs 0.63 (0.47-1.10), 1.61 (1.11-2.50) vs 1.55 (1.20-2.20), all P > 0.1]. Left atrial EAT-V normalized to myocardial tissue volume was not different between the groups., Conclusions: This study could neither confirm that EAT-V was predictive of recurrence of supraventricular arrhythmias in patients undergoing a hybrid AF ablation, nor that EAT-V was different between patients with paroxysmal AF and persistent and long-standing persistent AF. This suggests that EAT-V might not affect the outcome in surgical ablation procedures and therefore should not influence preoperative or intraoperative decision-making., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2019
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33. Left Atrial Appendage Management with the Watchman Device during Hybrid Ablation of Atrial Fibrillation.
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Vroomen M, Maesen B, Luermans JG, Crijns HJ, Maessen JG, La Meir M, and Pison L
- Subjects
- Aged, Atrial Appendage diagnostic imaging, Echocardiography, Transesophageal, Female, Humans, Male, Pilot Projects, Prospective Studies, Thoracoscopy, Atrial Appendage surgery, Atrial Fibrillation surgery, Catheter Ablation methods, Septal Occluder Device
- Abstract
Background: In the recent ESC/EACTS guidelines, left atrial appendage (LAA) occlusion or exclusion in patients undergoing (thoracoscopic) atrial fibrillation (AF) ablation surgery is recommended. The Watchman device (WD, Boston Scientific, Minnesota) has proved to reduce the risk of thromboembolic events by closing of the LAA, yet no data exist on WD implantation during surgical AF ablation. The objective is to determine if WD implantation is safe and feasible in a hybrid AF ablation setting (i.e., combination of thoracoscopic epicardial surgical and endocardial catheter ablation) and could become subject of further testing to serve as a bail-out in cases in which surgical LAA occlusion methods cannot be applied, due to, for example, severe adhesions., Methods: In this prospective, single center, pilot study, 10 consecutive patients undergoing a hybrid ablation qualifying for LAA exclusion (CHA
2 DS2 -VASc ≥ 1) were included. At the end of the hybrid ablation, the LAA was occluded endocardially using the WD. The feasibility endpoint was successful implantation. The safety endpoint concerned major complications., Results: One patient was excluded and replaced because the LAA was insufficiently visible on transesophageal echocardiography. In 10/11 patients, device delivery was successful (mean time: 35 minutes). No major complications occurred. Transesophageal echocardiography after 6 weeks and 6 months showed successful occlusion of the LAA without significant peridevice flow., Conclusion: Implantation of the WD seems to be feasible and safe in the setting of hybrid AF ablation and could be an alternative to epicardial occlusion in surgical AF ablation procedures. Larger studies are required to confirm these findings. This trial is registered with NCT02471131., Competing Interests: To support the research presented herein Laurent Pison reports a grant from Boston Scientific to the Cardiovascular Research Institute Maastricht (CARIM) at the University of Maastricht. Dr. La Meir reports a relationship with AtriCure and Medtronic., (Copyright © 2019 Mindy Vroomen et al.)- Published
- 2019
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34. Hybrid thoracoscopic surgical and transvenous catheter ablation versus transvenous catheter ablation in persistent and longstanding persistent atrial fibrillation (HARTCAP-AF): study protocol for a randomized trial.
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Vroomen M, La Meir M, Maesen B, Luermans JGL, Vernooy K, Essers B, de Greef BTA, Maessen JG, Crijns HJ, and Pison L
- Subjects
- Atrial Fibrillation psychology, Cost-Benefit Analysis, Humans, Quality of Life, Atrial Fibrillation surgery, Catheter Ablation methods, Randomized Controlled Trials as Topic, Thoracoscopy methods
- Abstract
Background: Success rates with conventional transvenous endocardial pulmonary vein isolation in patients with persistent and longstanding persistent atrial fibrillation (AF) are variable due to advanced electrical and structural remodeling of the atria. As a consequence, more extensive endocardial lesions, minimally invasive thoracoscopic surgical techniques, and hybrid ablation (combining thoracoscopic epicardial surgical and endocardial catheter ablation) have been developed., Hypothesis: The HARTCAP-AF trial hypothesizes that hybrid AF ablation is more effective than (repeated) transvenous endocardial catheter ablation in (longstanding) persistent AF, without increasing the number of associated major adverse events., Methods: This randomized controlled trial will include 40 patients with persistent or longstanding persistent AF who will be 1:1 randomized to either hybrid ablation or (repeated) catheter ablation. The procedures and follow-up are conducted according to the guidelines. The primary effectiveness endpoint is freedom from any supraventricular arrhythmia lasting longer than 5 min without the use of Vaughan-Williams class I or III antiarrhythmic drugs through 12 months of follow-up after the last procedure. In the catheter ablation arm, a second procedure planned within 6 months after the index procedure is allowed for obtaining the primary endpoint. Additionally, adverse events, cost-effectiveness, and quality of life data will be recorded., Trial Registration: ClinicalTrials.gov, NCT02441738 . Registered on 12 May 2015.
- Published
- 2019
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35. Hybrid Ablation of Ventricular Tachycardia: a Single-Centre Experience.
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Vroomen M, Maesen B, La Meir M, Luermans JGL, Vernooy K, Maessen JG, Crijns HJ, and Pison L
- Abstract
Background: The long-term results of endocardial and percutaneous epicardial catheter ablation of ventricular tachycardia (VT) in patients with structural heart disease are disappointing. Arrhythmia recurrence after ablation and VTs with an epicardial substrate remain a clinical challenge. The purpose of this manuscript is to elaborate on feasibility and potential advantages of a surgical hybrid ablation (i.e., combined endocardial and surgical epicardial ablation) based on our initial experience consisting of five cases., Methods: Endocardial electro-anatomical voltage and activation maps were created (Carto, Biosense Webster, California, USA), and endocardial radiofrequency (RF) applications were applied at exit sites, low voltage areas and isthmi. Next, after surgical access, epicardial voltage and activation maps were produced in combination with visual assessment of the epicardial substrate. Epicardial low voltage areas, isthmi and exit sites were identified and ablated using RF energy., Results: After the procedure, VT was non-inducible in 80% of the cases (4/5, in one case no induction was performed). No peri-procedural complications occurred. After a mean follow-up of 18 months, one patient remained in sinus rhythm without, and 2 with use of antiarrhythmic drugs. One patient needed a redo procedure after 21 months, and in one patient the amiodarone dose was raised because of 2 sustained VTs. After this additional treatment, both kept sinus rhythm., Conclusions: Hybrid VT ablation is a safe and effective patient tailored procedure that comprises the major advantage of combining direct anatomical visualization and enhanced catheter stability with high-density 3D mapping. As a consequence, this procedure should be considered as a valid treatment option in complex VT management.
- Published
- 2019
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36. Adipose tissue macrophages do not affect atherosclerosis development in mice.
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Bijnen M, van de Gaar J, Vroomen M, Gijbels MJ, de Winther M, Schalkwijk CG, and Wouters K
- Subjects
- Animals, Antigens, Ly blood, Aortic Diseases immunology, Aortic Diseases metabolism, Aortic Diseases pathology, Atherosclerosis immunology, Atherosclerosis metabolism, Atherosclerosis pathology, B-Lymphocytes immunology, B-Lymphocytes metabolism, Cytokines blood, Diet, High-Fat, Disease Models, Animal, Inflammation Mediators blood, Intra-Abdominal Fat immunology, Intra-Abdominal Fat pathology, Intra-Abdominal Fat transplantation, Macrophages immunology, Macrophages pathology, Male, Mice, Inbred C57BL, Mice, Knockout, Monocytes immunology, Monocytes metabolism, Obesity immunology, Obesity metabolism, Obesity pathology, Plaque, Atherosclerotic, Receptors, LDL, Triglycerides blood, Aortic Diseases etiology, Atherosclerosis etiology, Intra-Abdominal Fat metabolism, Macrophages metabolism, Obesity complications
- Abstract
Background and Aims: Obese individuals have a higher risk of developing atherosclerosis, possibly driven by adipose tissue (AT) inflammation. We recently showed that AT macrophages (ATMs), which accumulate in the expanding obese AT, produce mediators causing immune cell recruitment from the bone marrow. In the current study, we evaluated whether ATMs are directly involved in atherosclerotic plaque development., Methods: Lean ldlr
-/- acceptor mice received visceral AT (vAT) from lean, obese, or ATM-depleted obese ldlr-/- mice. Acceptor mice were fed high cholesterol diet (HCD) for 4 weeks before and 8 weeks after AT transplantation to induce atherosclerosis. Atherosclerotic plaque development was studied 8 weeks after transplantation., Results: Transplanting donor vAT from obese mice increased circulating triglycerides and B-cells, but decreased Ly6c- monocytes. Plasma cholesterol, Ly6c+ monocytes, T-cells, NK-cells and eosinophils were unaffected. Depleting ATMs from obese AT using clodronate liposomes prior to vAT transplantation prevented the increase in triglycerides and B-cells and decrease in Ly6c- monocytes, but did increase eosinophils. Circulating Cxcl1 was reduced by obese AT transplantation and Ifn-γ tended to be increased while Tnf and Il-1β were unaffected. ATM-depleted obese AT transplantation also reduced Cxcl1, but increased circulating Tnf levels. However, obese AT transplantation with or without depletion of ATMs did not influence atherosclerotic plaque size, phenotype, or stability., Conclusions: ATMs from obese vAT do not affect atherosclerotic plaque development or phenotype., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)- Published
- 2019
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37. RAGE deficiency does not affect non-alcoholic steatohepatitis and atherosclerosis in Western type diet-fed Ldlr -/- mice.
- Author
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Bijnen M, Beelen N, Wetzels S, Gaar JV, Vroomen M, Wijnands E, Scheijen JL, van de Waarenburg MPH, Gijbels MJ, Cleutjens JP, Biessen EAL, Stehouwer CDA, Schalkwijk CG, and Wouters K
- Subjects
- Animals, Atherosclerosis etiology, Atherosclerosis pathology, Diet, Western adverse effects, Disease Models, Animal, Glycation End Products, Advanced genetics, Humans, Inflammation pathology, Kupffer Cells metabolism, Kupffer Cells pathology, Liver metabolism, Liver pathology, Macrophages metabolism, Macrophages pathology, Mice, Non-alcoholic Fatty Liver Disease complications, Non-alcoholic Fatty Liver Disease pathology, Risk Factors, Atherosclerosis genetics, Inflammation genetics, Non-alcoholic Fatty Liver Disease genetics, Receptor for Advanced Glycation End Products genetics, Receptors, LDL genetics
- Abstract
Non-alcoholic fatty liver disease is a spectrum of liver diseases ranging from steatosis only to non-alcoholic steatohepatitis (NASH). The latter is characterized by hepatic inflammation, which increases the risk of cardiovascular disease. It is poorly understood which factors contribute to the onset of hepatic inflammation characterizing the progression from steatosis to NASH. Previously, we demonstrated increased advanced glycation endproducts (AGEs) in the livers of NASH patients. We hypothesise that AGEs play a key role in NASH development by activating their proinflammatory receptor, RAGE. RAGE-deficient mice and wildtype littermates, both on Ldlr
-/- background, were fed a Western type diet (WTD) for 3 or 12 weeks. Flow cytometry, histology, gene expression and AGE measurements were performed to evaluate the effects of RAGE deficiency. RAGE-deficient mice displayed reduced weight gain and visceral fat expansion compared to control mice. No difference in adipose tissue inflammation was observed between groups. RAGE deficiency did not affect WTD-induced monocytosis, circulating lipids or hepatic steatosis. WTD-induced hepatic neutrophil and macrophage accumulation and atherosclerotic plaque development was comparable between control and RAGE-deficient mice. No difference in AGE levels was observed. RAGE does not seem to play a major role in the development of NASH or atherosclerosis in a hyperlipidemic mouse model.- Published
- 2018
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38. Adipose tissue macrophages induce hepatic neutrophil recruitment and macrophage accumulation in mice.
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Bijnen M, Josefs T, Cuijpers I, Maalsen CJ, van de Gaar J, Vroomen M, Wijnands E, Rensen SS, Greve JWM, Hofker MH, Biessen EAL, Stehouwer CDA, Schalkwijk CG, and Wouters K
- Subjects
- Adipose Tissue metabolism, Animals, CD11 Antigens metabolism, Cytokines metabolism, Liver metabolism, Liver pathology, Male, Mice, Mice, Inbred C57BL, Mice, Obese, Non-alcoholic Fatty Liver Disease etiology, Non-alcoholic Fatty Liver Disease metabolism, Obesity metabolism, Obesity pathology, Adipose Tissue pathology, Macrophages physiology, Neutrophil Infiltration physiology, Non-alcoholic Fatty Liver Disease pathology, Obesity complications
- Abstract
Objective: Obesity is a risk factor for non-alcoholic steatohepatitis (NASH). This risk has been attributed to visceral adipose tissue (vAT) expansion associated with increased proinflammatory mediators. Accumulation of CD11c
+ proinflammatory adipose tissue macrophages (ATM) is an important driver of vAT inflammation. We investigated the role of ATMs in hepatic inflammation during NASH development., Design: vAT isolated from lean, obese or ATM-depleted (using clodronate liposomes) obese mice was transplanted to lean ldlr-/- acceptor mice. Systemic and hepatic inflammation was assessed either after 2 weeks on standard chow or after 8 weeks on high cholesterol diet (HCD) to induce NASH., Results: Transplanting donor vAT from obese mice increased HCD-induced hepatic macrophage content compared with lean-transplanted mice, worsening liver damage. ATM depletion prior to vAT transplantation reduced this increased hepatic macrophage accumulation. On chow, vAT transplantation induced a more pronounced increase in circulating and hepatic neutrophil numbers in obese-transplanted than lean-transplanted mice, while ATM depletion prior to vAT transplantation reversed this effect. Microarray analysis of fluorescence-activated cell sorting of CD11c+ and CD11c- macrophages isolated from donor adipose tissue showed that obesity resulted in enhanced expression of neutrophil chemotaxis genes specifically in CD11c+ ATMs. Involvement of the neutrophil chemotaxis proteins, CXCL14 and CXCL16, was confirmed by culturing vAT. In humans, CD11c expression in vAT of obese individuals correlated with vAT expression of neutrophil chemotactic genes and with hepatic expression of neutrophil and macrophage marker genes., Conclusion: ATMs from obese vAT induce hepatic macrophage accumulation during NASH development, possibly by enhancing neutrophil recruitment., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)- Published
- 2018
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39. Three-year follow-up of hybrid ablation for atrial fibrillation.
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Maesen B, Pison L, Vroomen M, Luermans JG, Vernooy K, Maessen JG, Crijns HJ, and La Meir M
- Subjects
- Adult, Aged, Atrial Appendage surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pericardium surgery, Treatment Outcome, Atrial Fibrillation surgery, Cardiac Catheterization methods, Catheter Ablation methods, Thoracoscopy methods
- Abstract
Objectives: The single-step hybrid atrial fibrillation (AF) ablation procedure combines a transvenous endocardial and thoracoscopic epicardial approach in 1 procedure. Short-term results are encouraging, but long-term outcome data are not available., Methods: Hybrid AF ablation was successfully performed in 64 consecutive patients (53% with persistent AF). The mean follow-up period was 1732 ± 353 days. Perprocedural endocardial touch-up of incomplete epicardial lesions was performed in 17 (26%) patients., Results: In paroxysmal AF patients, arrhythmia-free cumulative survival rates after 1 hybrid AF ablation without Class I or III antiarrhythmic drugs procedure and without redo catheter ablation were 83%, 80% and 80% after 1, 2 and 3 years, respectively. In (long-standing) persistent AF patients, these were 82%, 79% and 79% after 1, 2 and 3 years. Thirteen (20%) patients had at least 1 recurrent episode of supraventricular arrhythmia lasting longer than 30 s: the most frequent recurrent arrhythmias were left atrial flutter and AF. No mortality or conversion to cardiopulmonary bypass, no phrenic nerve palsy and no pacemaker implantation were reported., Conclusions: Hybrid AF ablation, combining a transvenous endocardial and thoracoscopic epicardial approach in a single procedure, results in a cumulative 3-year freedom from arrhythmia without Class I or III antiarrhythmic drugs and without redo catheter ablation of 80% in paroxysmal AF (24 of 30 patients) and 79% in non-paroxysmal AF (26 of 33 patients).
- Published
- 2018
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40. Adenosine administration during hybrid atrial fibrillation ablation to test dormant pulmonary vein conduction.
- Author
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Vroomen M, La Meir M, Maessen JG, Crijns HJ, and Pison L
- Subjects
- Adult, Aged, Atrial Fibrillation physiopathology, Catheter Ablation methods, Electrocardiography methods, Female, Heart Conduction System drug effects, Heart Conduction System physiopathology, Heart Conduction System surgery, Humans, Male, Middle Aged, Treatment Outcome, Adenosine administration & dosage, Atrial Fibrillation diagnosis, Atrial Fibrillation surgery, Electrocardiography drug effects, Monitoring, Intraoperative methods, Pulmonary Veins drug effects, Pulmonary Veins physiopathology
- Abstract
Background: Adenosine administration after initial pulmonary vein isolation (PVI) reveals dormant conduction and predicts atrial fibrillation (AF) recurrence. Elimination of dormant conduction when present may increase a long-term success rate of AF ablation procedures. There are no studies till date using adenosine to reveal acute reconduction of pulmonary veins (PVs) after epicardial PVI during a hybrid AF ablation procedure., Methods: We included 24 patients (21 male, 55 ± 9 years) undergoing hybrid ablation for symptomatic paroxysmal (n = 12) and persistent (n = 12) AF, using an epicardial bipolar radiofrequency clamp to perform PVI. All antiarrhythmic medications were discontinued 5 days prior to the procedure, except for patients on amiodarone. Thirty minutes after PVI and once sinus rhythm was obtained, a bolus of adenosine (12 to 36 mg) was administered intravenously. The subsequent response was assessed for each PV (n = 96) using an in situ circular mapping catheter., Results: Dormant conduction (i.e., the reappearance of PV potentials during at least one beat) was seen in 1 out of 96 PVs (1%). If reconduction was seen, further endocardial ablation using a 3.5-mm irrigated tip catheter was performed until no more reconduction occurred after repeating the adenosine bolus., Conclusions: Adenosine administration after PVI with the use of an epicardial bipolar radiofrequency clamp in the setting of hybrid AF ablation reveals acute reconduction in 1% of the PVs.
- Published
- 2017
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41. Hybrid ablation for atrial fibrillation: a systematic review.
- Author
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Vroomen M and Pison L
- Subjects
- Ablation Techniques methods, Adult, Aged, Aged, 80 and over, Cardiovascular Surgical Procedures methods, Cardiovascular Surgical Procedures statistics & numerical data, Causality, Combined Modality Therapy methods, Combined Modality Therapy mortality, Combined Modality Therapy statistics & numerical data, Comorbidity, Female, Humans, Male, Middle Aged, Risk Factors, Survival Rate, Ablation Techniques mortality, Ablation Techniques statistics & numerical data, Atrial Fibrillation mortality, Atrial Fibrillation surgery, Cardiovascular Surgical Procedures mortality, Postoperative Complications mortality
- Abstract
Purpose: Hybrid ablation for AF is performed in a growing number of centers. Due to absence of guidelines, operative approaches and perioperative care differ per center. In this review, an overview of findings from published studies on hybrid ablations is given, and related topics are discussed (e.g., one- and two-stage approaches, lesion sets, and patient management)., Methods: A systematic literature search was performed in the PubMed and Embase databases. All identified articles were screened and checked for eligibility by the two authors., Results: Twelve studies describing a total of 563 patients were selected. Due to substantial differences in approaches (one-stage, two-stage, sequential), surgical techniques (bilateral or monolateral thoracoscopy, subxiphoideal, transabdominal), energy sources (unipolar, bipolar), lesion sets (applying left or right atrial lesions), periprocedural care and endpoints (monitoring, definition of recurrence), and success rates (sinus rhythm after a mean of 26 months) are difficult to compare and varied from 27 % (without antiarrhythmic drugs, AADs) to 94 % (with AADs). For studies using bipolar devices, success rates with the use of antiarrhythmic drugs were at least 71 %. Major complications such as bleeding, sternotomy, and death occurred in 7 % of the total population (of which ten complications, 16 %, occurred in the concomitant cardiac surgery hybrid group)., Conclusion: The field of AF ablation has dramatically changed over the past years, with one of the most recent developments the hybrid AF ablation. Lack of matching data hinders drawing conclusions and creating guidelines. Early results however are encouraging. More data are awaiting and needed., Competing Interests: Laurent Pison is a consultant to Atricure.
- Published
- 2016
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42. Letter by Vroomen et al Regarding Article, "Left Atrial Appendage Electrical Isolation and Concomitant Device Occlusion to Treat Persistent Atrial Fibrillation: A First-in-Human Safety, Feasibility, and Efficacy Study".
- Author
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Vroomen M, Maesen B, and Pison L
- Subjects
- Anticoagulants, Catheter Ablation, Humans, Stroke, Treatment Outcome, Atrial Appendage surgery, Atrial Fibrillation
- Published
- 2016
- Full Text
- View/download PDF
43. Collateral damage after endocardial catheter ablation.
- Author
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Vroomen M, La Meir M, and Pison L
- Subjects
- Endocardium surgery, Hemorrhage etiology, Humans, Atrial Fibrillation surgery, Catheter Ablation adverse effects, Endocardium injuries
- Published
- 2016
- Full Text
- View/download PDF
44. Absence of exit block due to direct capture of the left atrial appendage: A visual confirmation.
- Author
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Vroomen M, La Meir M, Crijns HJ, and Pison L
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- 2016
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45. Catheter Ablation for Persistent Atrial Fibrillation.
- Author
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Pison L, Vroomen M, and Crijns HJ
- Subjects
- Female, Humans, Male, Atrial Fibrillation surgery, Catheter Ablation methods
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- 2015
- Full Text
- View/download PDF
46. Long-term follow-up of 82 patients after surgical excision of atrial myxomas.
- Author
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Vroomen M, Houthuizen P, Khamooshian A, Soliman Hamad MA, and van Straten AH
- Subjects
- Aged, Atrial Fibrillation etiology, Cardiac Surgical Procedures adverse effects, Cardiac Surgical Procedures mortality, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Retrospective Studies, Treatment Outcome, Heart Atria surgery, Heart Neoplasms surgery, Myxoma surgery
- Abstract
Objectives: Literature reporting on large patient groups with the long-term follow-up is limited due to the low incidence of myxomas. This single-centre, retrospective study reports on the long-term follow-up (e.g. complications, recurrence and survival) of a substantial patient group operated for cardiac myxomas., Methods: Patients were retrospectively selected from a prospectively obtained database comprising patients who had undergone cardiac surgery in the Catharina Hospital from 1990 onwards. Baseline characteristics and perioperative data were obtained from the database. In case of insufficient information, medical reports were analysed. The echocardiogram and clinical follow-up data were collected at outpatient clinics., Results: Eighty-two patients were included, of which 48 were females with a mean age of 61.3 years (±13.8). The main presenting symptom was dyspnoea (29.3%), followed by chest pain (24.4%), palpitations (19.5%) and embolism (15.9%). Atrial fibrillation was the most frequent complication; directly postoperative (22%) and at the long-term follow-up (26.3%). The follow-up was completed in 95.1%, with a mean echocardiographic follow-up time of 72 months and with a longest follow-up of almost 23 years. There were no myxoma recurrences. Thirteen patients (16.5%) deceased during the follow-up, with a mean time of 9 years after surgery., Conclusions: Myxomas carry the risk of severe complications. Surgical excision is the only option of treatment and gives excellent early and long-term results. Recurrence rates are low in case of non-hereditary myxomas, even in case of irradical excision. The echocardiographic follow-up therefore could be called into question., (© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
47. Surgical Ablation for Atrial Fibrillation.
- Author
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Pison L, Vroomen M, and Crijns HJ
- Subjects
- Female, Humans, Male, Atrial Fibrillation surgery, Catheter Ablation methods, Heart Valve Diseases surgery, Mitral Valve surgery
- Published
- 2015
- Full Text
- View/download PDF
48. Lone Atrial Fibrillation: Risk Factors, Triggers And Ablation Techniques.
- Author
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Vroomen M and Pison L
- Abstract
Background: Since its introduction in 1953, lone atrial fibrillation (LAF) has not been defined with any consistency, resulting in an enormous variation in the way the term is used. Inherent to this, results from studies vary considerably. Many predisposing factors and pathogenic influences have been discovered over the past years, which raise the question if the term LAF should still be used and if the treatment should be different from non-lone atrial fibrillation (non-LAF). Therefore this systematic review on LAF provides an overview of risk factors and triggers, the second part focuses on the application of catheter and surgical ablation techniques., Methods: A systematic literature search was performed in the PubMed database. All identified articles were screened and checked for eligibility by the two authors. Additional literature was sought by screening the references of eligible articles., Conclusions: Insufficient evidence exists to consider LAF as a real, isolated and useful entity. A re-definition or even avoiding the use of the term LAF might be appropriate.
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- 2015
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49. Sildenafil treatment in established right ventricular dysfunction improves diastolic function and attenuates interstitial fibrosis independent from afterload.
- Author
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Borgdorff MA, Bartelds B, Dickinson MG, van Wiechen MP, Steendijk P, de Vroomen M, and Berger RM
- Subjects
- Animals, Diastole, Disease Models, Animal, Exercise Tolerance drug effects, Fibrosis, Heart Ventricles pathology, Heart Ventricles physiopathology, Hypertrophy, Right Ventricular pathology, Hypertrophy, Right Ventricular physiopathology, Male, Purines pharmacology, Rats, Wistar, Recovery of Function, Sildenafil Citrate, Stroke Volume drug effects, Time Factors, Ventricular Dysfunction, Right pathology, Ventricular Dysfunction, Right physiopathology, Ventricular Pressure drug effects, Cardiotonic Agents pharmacology, Heart Ventricles drug effects, Piperazines pharmacology, Sulfones pharmacology, Ventricular Dysfunction, Right drug therapy, Ventricular Function, Right drug effects
- Abstract
Right ventricular (RV) function is an important determinant of prognosis in congenital heart diseases, pulmonary hypertension, and heart failure. Preventive sildenafil treatment has been shown to enhance systolic RV function and improve exercise capacity in a model of fixed RV pressure load. However, it is unknown whether sildenafil has beneficial effects when treatment is started in established RV dysfunction, which is clinically more relevant. Our aim was to assess the effects of sildenafil treatment on RV function and fibrosis in a model of established RV dysfunction due to fixed afterload. Rats were subjected to pulmonary artery banding (PAB), which induced RV dysfunction after 4 wk, characterized by reduced exercise capacity, decreased tricuspid annular plane systolic excursion, and RV dilatation. From week 4 onward, 50% of rats were treated with sildenafil (100 mg·kg(-1)·day(-1), n = 9; PAB-SIL group) or vehicle (n = 9; PAB-VEH group). At 8 wk, exercise capacity was assessed using cage wheels, and RV function was assessed using invasive RV pressure-volume measurements under anesthesia. Sildenafil treatment, compared with vehicle, improved RV ejection fraction (44 ± 2% vs. 34 ± 2%, P < 0.05, PAB-SIL vs. PAB-VEH groups), reduced RV end-diastolic pressure (2.3 ± 0.5 vs. 5.1 ± 0.9 mmHg, P < 0.05), and RV dilatation (end-systolic volume: 468 ± 45 vs. 643 ± 71 μl, P = 0.05). Sildenafil treatment also attenuated RV fibrosis (30 ± 6 vs. 17 ± 3‰, P < 0.05) but did not affect end-systolic elastance, exercise capacity, or PKG or PKA activity. In conclusion, sildenafil improves RV diastolic function and attenuates interstitial fibrosis in rats with established RV dysfunction, independent from afterload. These results indicate that sildenafil treatment has therapeutic potential for established RV dysfunction., (Copyright © 2014 the American Physiological Society.)
- Published
- 2014
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50. Distinct loading conditions reveal various patterns of right ventricular adaptation.
- Author
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Borgdorff MA, Bartelds B, Dickinson MG, Steendijk P, de Vroomen M, and Berger RM
- Subjects
- Adaptation, Physiological, Animals, Arteriovenous Shunt, Surgical, Constriction, Disease Models, Animal, Familial Primary Pulmonary Hypertension, Gene Expression Regulation, Heart Failure diagnosis, Heart Failure etiology, Heart Failure genetics, Heart Ventricles diagnostic imaging, Hemodynamics, Hypertension, Pulmonary chemically induced, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary etiology, Hypertension, Pulmonary genetics, Hypertrophy, Right Ventricular etiology, Hypertrophy, Right Ventricular physiopathology, Male, Models, Cardiovascular, Monocrotaline, Myocardial Contraction, Physical Exertion, Pulmonary Artery physiopathology, Pulmonary Artery surgery, Rats, Rats, Wistar, Stroke Volume, Time Factors, Ultrasonography, Ventricular Dysfunction, Right diagnosis, Ventricular Dysfunction, Right etiology, Ventricular Dysfunction, Right genetics, Ventricular Pressure, Heart Failure physiopathology, Heart Ventricles physiopathology, Hypertension, Pulmonary physiopathology, Ventricular Dysfunction, Right physiopathology, Ventricular Function, Right
- Abstract
Right ventricular (RV) failure due to chronically abnormal loading is a main determinant of outcome in pulmonary hypertension (PH) and congenital heart disease. However, distinct types of RV loading have been associated with different outcomes. To determine whether the adaptive RV response depends on loading type, we compared hemodynamics, exercise, and hypertrophy in models of pressure overload due to pulmonary artery banding (PAB), pressure overload due to PH, combined pressure and volume overload, and isolated volume load. Ninety-four rats were subjected to either PAB, monocrotaline-induced PH (PH), aortocaval shunt (shunt), or combined monocrotaline and aortocaval shunt (PH + shunt). We performed pressure-volume analysis and voluntary exercise measurements at 4 wk. We compared PAB to PH (part I) and PH + shunt to either isolated PH or shunt (part II). In part I, enhanced contractility (end-systolic elastance and preload recruitable stroke work) was present in PH and PAB, but strongest in PAB. Frank-Starling mechanism was active in both PAB and PH. In PAB this was accompanied by diastolic dysfunction (increased end-diastolic elastance, relaxation constant), clinical signs of RV failure, and reduced exercise. These distinct responses were not attributable to differences in hypertrophy. In part II, in PH + shunt the contractility response was blunted compared with PH, which caused pseudonormalization of parameters. Additional volume overload strongly enhanced hypertrophy in PH. We conclude that different types of loading result in distinct patterns of RV adaptation. This is of importance for the approach to patients with chronically increased RV load and for experimental studies in various types of RV failure.
- Published
- 2013
- Full Text
- View/download PDF
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