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Zahra Emkanjoo - One of the best experts on this subject based on the ideXlab platform.

  • deep sedation in patients undergoing atrioventricular nodal reentry tachycardia ablation
    Research in Cardiovascular Medicine, 2013
    Co-Authors: Amir Farjam Fazelifar, Mohammadjafar Hashemi, Mostafa Alavi, Mohammadzia Totounchi, Azam Forghanian, Mahboubeh Zeighami, Ali Eskandari, Zahra Emkanjoo, Majid Haghjoo
    Abstract:

    Electrophysiological parameters were checked for the two groups and compared before and after the ablation. Results: Electrophysiological parameters were not significantly different in the two groups. In the anesthetic group, patients were more satisfied with the procedure (P value < 0. 001). Conclusions: Intravenous anesthesia could be done safely in patients who underwent Electrophysiological Procedures. It had no effect on arrhythmia induction or slow pathway ablation in patients with documented AVNRT.

  • Predictors of local venous complications resulting from Electrophysiological Procedures.
    Cardiology journal, 2012
    Co-Authors: Abolfath Alizadeh, Amir Hosein Yazdi, Mohammad Kafi, Mohammad Assadian Rad, Mehdi Moradi, Zahra Emkanjoo
    Abstract:

    Thromboembolic complications resulting from radiofrequency catheter ablation (RFCA) have an overall incidence of 0.6%. Multiple intracardiac catheters are often necessary for Electrophysiological study and RFCA therapy. Therefore, the placement of multiple venous sheaths in one femoral vein is always required for multiple intracardiac catheter insertion. The safety of the placement of multiple separate venous sheaths has been studied previously in a non-randomized study, but the placement of multiple sheaths via one venous line has not been fully studied. A randomized clinical trial was conducted with a total of 200 patients. We studied the safety of placing multiple sheaths via one venous line, and the effect of heparin on deep vein thrombosis (DVT) and on in situ thrombosis. DVT was not seen in our patients. We observed a significant decrease in the rate of in situ thrombosis in patients who received heparin during the procedure (28% vs 11%, p = 0.04). The type of cannulation changed the in situ thrombosis rate independently of the heparinization protocol. The rate of in situ thrombosis was higher when placing sheaths via one venous line regardless of the heparinization protocol used (16% vs 6%, p = 0.1 for the group on heparin, and 38% vs 18%, p = 0.04 for the other group). In the group cannulated with only one venous line (100 patients), heparinization significantly decreased the rate of in situ thrombosis (16% vs 38%, p = 0.023), but there was an insignificant decrease in the separate cannulation group (6% vs 18%, p = 0.12). Advanced age had no effect on thrombosis. Surprisingly, there was a significantly greater rate of in situ thrombosis (not DVT) among women than among men (26% vs 11%, p = 0.01), regardless of the heparinization protocolor the type of cannulation. Given the local venous complications and DVT after Electrophysiological Procedures, heparinization is not necessary for right-sided Electrophysiological Procedures. In situ thrombosis is a minor complication that can be reduced by heparinization in patients undergoing one-line cannulation and in women during longer Procedures.

  • predictors of local venous complications resulting from Electrophysiological Procedures
    Cardiology Journal, 2012
    Co-Authors: Abolfath Alizadeh, Amir Hosein Yazdi, Mohammad Kafi, Mohammad Assadian Rad, Mehdi Moradi, Zahra Emkanjoo
    Abstract:

    Background: Thromboembolic complications resulting from radiofrequency catheter ablation (RFCA) have an overall incidence of 0.6%. Multiple intracardiac catheters are often necessary for Electrophysiological study and RFCA therapy. Therefore, the placement of multiple venous sheaths in one femoral vein is always required for multiple intracardiac catheter insertion. The safety of the placement of multiple separate venous sheaths has been studied previously in a non-randomized study, but the placement of multiple sheaths via one venous line has not been fully studied. Methods and Results: A randomized clinical trial was conducted with a total of 200 patients. We studied the safety of placing multiple sheaths via one venous line, and the effect of heparin on deep vein thrombosis (DVT) and on in situ thrombosis. DVT was not seen in our patients. We observed a significant decrease in the rate of in situ thrombosis in patients who received heparin during the procedure (28% vs 11%, p = 0.04). The type of cannulation changed the in situ thrombosis rate independently of the heparinization protocol. The rate of in situ thrombosis was higher when placing sheaths via one venous line regardless of the heparinization protocol used (16% vs 6%, p = 0.1 for the group on heparin, and 38% vs 18%, p = 0.04 for the other group). In the group cannulated with only one venous line (100 patients), heparinization significantly decreased the rate of in situ thrombosis (16% vs 38%, p = 0.023), but there was an insignificant decrease in the separate cannulation group (6% vs 18%, p = 0.12). Advanced age had no effect on thrombosis. Surprisingly, there was a significantly greater rate of in situ thrombosis (not DVT) among women than among men (26% vs 11%, p = 0.01), regardless of the heparinization protocolor the type of cannulation. Conclusions: Given the local venous complications and DVT after Electrophysiological Procedures, heparinization is not necessary for right-sided Electrophysiological Procedures. In situ thrombosis is a minor complication that can be reduced by heparinization in patients undergoing one-line cannulation and in women during longer Procedures. (Cardiol J 2012; 19, 1: 15–19)

Carola Gianni - One of the best experts on this subject based on the ideXlab platform.

Patrick Hranitzky - One of the best experts on this subject based on the ideXlab platform.

G. Joseph Gallinghouse - One of the best experts on this subject based on the ideXlab platform.

Giuseppe Boriani - One of the best experts on this subject based on the ideXlab platform.

  • statistics on the use of cardiac electronic devices and Electrophysiological Procedures in 55 esc countries 2013 report from the european heart rhythm association ehra
    Europace, 2014
    Co-Authors: Fernando Arribas, Giuseppe Boriani, Josè L. Merino, Angelo Auricchio, Josep Brugada, Jean Claud Deharo, Gerhardt Hindriks, Karl Heinz Kuck, Panos E Vardas, Christian Wolpert
    Abstract:

    In the last year, for the first time since its initiation, the EHRA White Book on the status of electrophysiology in the European Society of Cardiology (ESC) member countries was published as a full EP Europace supplement and in the form of comparative statistics. Since in the past editions neither comparisons nor trends and changes had been reported, we started to take this further step that was long awaited. The way in which the data are presented gives us the opportunity this year, for instance, to see the impact of new training initiatives, the foundation of working groups, the change in the number of practising centres, and so on. It also helps us to understand and estimate the impact of the economic crisis on the use of cost-intensive therapy such as ablation or pacemaker/implantable cardioverter defibrillator (ICD) implantation. Since the reliability of the data seems to increase with every year, we can base our evaluation on firmer grounds. The methodology has been previously reported.1 It also provides an idea on how reimbursement systems may affect the use of ICDs or implantable pulse generators (IPGs) in terms of reducing or increasing implant rates. The 2012 data in the 2013 edition in fact reveal changes in quite a considerable number of countries and show, for example, that in some countries from the eastern European area the implant rates for ICDs and IPGs by far exceed those of some western countries, meaning that the Gross Domestic Product (GDP) is not necessarily the driver for high or low rates of therapy use. Whereas IPG use and ICD implantations are something that has been widely used in the majority of countries at least for the strongest immediate life-saving indications, catheter ablation is used rather to treat symptoms and therefore would be most likely to …

  • decrease in patient radiation exposure by a tantalum filter during Electrophysiological Procedures
    Pacing and Clinical Electrophysiology, 2009
    Co-Authors: B Pier Luca S Rossi, B S Matteo Mariselli, Mauro Biffi, B S Romano Zannoli, B Ivan S Corazza, B David S Bianchini, M Cristian D Martignani, Giuseppe Boriani
    Abstract:

    Aim: Minimization of X-ray exposure remains a primary issue in cardiac electrophysiology. The effectiveness of X-ray beam filtration during cardiac Electrophysiological Procedures was therefore studied, using a 0.05-mm-thick tantalum (Ta) foil, as a filter on the primary X-ray beam, to reduce the patient dose without degradation of image quality. Method: Preliminary tests were made on a phantom developed with polymethylmethacrylate, catheters, and guide wires. The filter was then used in patients during cardiac Procedures. Identical patient images were obtained with and without the Tafilter insertion and the ratio between image quality and patient dose was evaluated. Changes in patient dose and signal-to-noise ratio, as image quality index were measured on the phantom and in patients. Results and Conclusions: When the Ta filter was used, the mean effective individual patient dose decreased by 3 to 40% (mean reduction = 27%), with no perceivable difference in image quality estimated by electrophysiologists. This Ta filter may be useful to limit the radiation exposure of patients and operators during cardiac Procedures. (PACE 2009; 32:S109‐S112)

  • Decrease in patient radiation exposure by a tantalum filter during Electrophysiological Procedures.
    Pacing and Clinical Electrophysiology, 2009
    Co-Authors: B S Pier Luca Rossi, B S Matteo Mariselli, B S Ivan Corazza, B S David Bianchini, Mauro Biffi, Cristian Martignani, B S Romano Zannoli, Giuseppe Boriani
    Abstract:

    Minimization of X-ray exposure remains a primary issue in cardiac electrophysiology. The effectiveness of X-ray beam filtration during cardiac Electrophysiological Procedures was therefore studied, using a 0.05-mm-thick tantalum (Ta) foil, as a filter on the primary X-ray beam, to reduce the patient dose without degradation of image quality

  • Decrease in patient radiation exposure by a tantalum filter during Electrophysiological Procedures.
    Pacing and clinical electrophysiology : PACE, 2009
    Co-Authors: Pier Luca Rossi, Mauro Biffi, Cristian Martignani, Matteo Mariselli, Ivan Corazza, David Bianchini, Romano Zannoli, Giuseppe Boriani
    Abstract:

    Minimization of X-ray exposure remains a primary issue in cardiac electrophysiology. The effectiveness of X-ray beam filtration during cardiac Electrophysiological Procedures was therefore studied, using a 0.05-mm-thick tantalum (Ta) foil, as a filter on the primary X-ray beam, to reduce the patient dose without degradation of image quality. Preliminary tests were made on a phantom developed with polymethylmethacrylate, catheters, and guide wires. The filter was then used in patients during cardiac Procedures. Identical patient images were obtained with and without the Ta filter insertion and the ratio between image quality and patient dose was evaluated. Changes in patient dose and signal-to-noise ratio, as image quality index were measured on the phantom and in patients. When the Ta filter was used, the mean effective individual patient dose decreased by 3 to 40% (mean reduction = 27%), with no perceivable difference in image quality estimated by electrophysiologists. This Ta filter may be useful to limit the radiation exposure of patients and operators during cardiac Procedures.