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Authors = Panagiota Manolakou

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15 pages, 612 KiB  
Review
Multipoint Left Ventricular Pacing as Alternative Approach in Cases of Biventricular Pacing Failure
by Christos-Konstantinos Antoniou, Christina Chrysohoou, Panagiota Manolakou, Dimitrios Tsiachris, Athanasios Kordalis, Konstantinos Tsioufis and Konstantinos A. Gatzoulis
J. Clin. Med. 2025, 14(4), 1065; https://doi.org/10.3390/jcm14041065 - 7 Feb 2025
Viewed by 1009
Abstract
Cardiac resynchronization therapy (CRT) is a cornerstone in the treatment of dyssynchronous heart failure with reduced ejection fraction. However, the phenomenon of non-response has plagued CRT since its initial application. Notwithstanding issues such as failure to capture the left ventricle, lower-than-required pacing delivery [...] Read more.
Cardiac resynchronization therapy (CRT) is a cornerstone in the treatment of dyssynchronous heart failure with reduced ejection fraction. However, the phenomenon of non-response has plagued CRT since its initial application. Notwithstanding issues such as failure to capture the left ventricle, lower-than-required pacing delivery percent, and failure to optimize atrioventricular and interventricular delays, there are patients who fail to exhibit an adequate response to CRT in its classical biventricular pacing (BiVP) form. Several modalities have been proposed as a means to remedy this issue, including pacing the conduction system itself—His or left bundle branch pacing, allowing for intrinsic conduction in some myocardial segments, pacing the left ventricle from multiple points in the coronary sinus (multipoint pacing), or even combining the above (e.g., His/left bundle pacing and BiVP leading to His/left bundle-optimized CRT). In the present review, we present recent evidence for the advantages and disadvantages of each modality and attempt to formulate a pathophysiology and simulation-based strategy to determine the best way forward for delivering CRT in non-responders to BiVP. Full article
(This article belongs to the Section Cardiology)
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20 pages, 1866 KiB  
Review
Best Practice Guide for Cryoballoon Ablation in Atrial Fibrillation: The Compilation Experience of More than 1000 Procedures
by Dimitriοs Tsiachris, Christos-Konstantinos Antoniou, Ioannis Doundoulakis, Panagiota Manolakou, Demetrios Sougiannis, Athanasios Kordalis, Konstantinos A. Gatzoulis, Gian-Battista Chierchia, Carlo de Asmundis, Christodoulos Stefanadis and Konstantinos Tsioufis
J. Cardiovasc. Dev. Dis. 2023, 10(2), 55; https://doi.org/10.3390/jcdd10020055 - 30 Jan 2023
Cited by 4 | Viewed by 5450
Abstract
Nowadays, the cryoballoon (CB) constitutes an established alternative to radio frequency (RF) ablation for pulmonary vein isolation (PVI), which offers the possibility to isolate the PVs with a single application. Since the introduction of the second-generation CB, we prospectively collected our data to [...] Read more.
Nowadays, the cryoballoon (CB) constitutes an established alternative to radio frequency (RF) ablation for pulmonary vein isolation (PVI), which offers the possibility to isolate the PVs with a single application. Since the introduction of the second-generation CB, we prospectively collected our data to optimize the procedure on >1000 consecutive patients who underwent CB PVI performed in our center. It is expected that subsequent guidelines will suggest first-line PVI through CB in patients with paroxysmal AF with a class I indication. Indeed, in the long-term follow-up (36 months) of the EARLY-AF trial, CB had a lower incidence of persistent atrial fibrillation episodes compared to the anti-arrhythmic drugs group. We now review the current best practices in an effort to drive consistent outcomes and minimize complications. PV isolation through CB is the most studied single-shot technique for atrial fibrillation ablation, having shown the potential to alter the natural history of the arrhythmia. Several procedural tips and tricks can improve procedural flow and effectiveness. In the present article we provided not only technical details but measurable biophysical parameters that can reliably guide the operator into achieving the best outcome for his patients. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prevention of Atrial Fibrillation)
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