POSTER SESSION 1

EP Europace, Jun 2015

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POSTER SESSION 1

Published on behalf of the European Society of Cardiology. All rights reserved. # The Author 2015. For permissions please email: . P. Bhagirath 1 2 3 A.W.M. Van Der Graaf 1 2 3 E. Van Dongen 1 2 3 S. Ghoerbien 1 2 3 V.J.H.M. Van Driel 1 2 3 H. Ramanna 1 2 3 N.M.S. De Groot 0 2 3 M.J.W. Gotte 1 2 3 K.J. Chun 1 2 3 S. Bordignon 0 2 3 L. Perrotta 0 2 3 A. Fuernkranz 0 2 3 D. Dugo 0 2 3 A. Konstantinou 0 2 3 B. Schmidt 0 2 3 0 Cardiology Centre Bethanien (CCB) , Frankfurt am Main , Germany 1 Asklepios Clinic St. Georg , Hamburg , Germany 2 T. Haruna , M. Funasako, I. Tanaka, M. Okano, T. Sekihara, Y. Kimura, H. Hayashi, M. Kimura, and M. Inoko 3 Overall 30-Day Rate,% Stroke/TIA Background: Multimodality imaging is a cornerstone of atrial fibrillation (AF) ablation workup. Advances in imaging modalities suggest a single modality approach could prove as effective as the current multimodality strategy. This could simplify the imaging workflow and reduce the financial and time burden. Methods: A literature review was performed to identify parameters used for AF ablation workup. Subsequently, the role of imaging modalities in performing this assessment was examined. A cost and time analysis was performed for three imaging strategies. Cost of examination was according to the Netherlands standard of care. Results: Five parameters were identified for ablation workup (Table 1). Out of 4 key imaging modalities, CMR provided the highest diagnostic yield. Cost of imaging ranged from E360 to E460. The multimodality approaches were more expensive and time consuming compared to a CMR only strategy (Figure 1). Conclusion: AF ablation workup using CMR is 1. Comprehensive, providing a thorough assessment. 2. Cost-efficient, saving up to E100 per patient. 3. Time efficient, acquiring all information in a single examination. - Background: Left atrial appendage closure (LAAC) has emerged as a viable treatment option for patients sharing a high thromboembolic and bleeding risk. Contemporary devices engage the LAA myocardium by radial forces thereby exposing the patient at risk for perforation. The novel COHEREX Wavecrest device is equipped with an active fixation mechanism dispensing the need for continuous mechanical wall stress. Methods: Between October 2013 and July 2014 patients eligible for LAAC were included in this study. In all patients a TEE was performed on the table to rule out left atrial thrombus, measure LAA extensions (landing zone, depth) and to guide a single transseptal puncture. LAA anatomy was visualized using selective LAA angiograms (RAO 30/20 caudal, RAO 30/15 cranial). No patient was excluded. The Coherex Wavecrest system (22mm, 27mm, 33mm) was deployed via a 17F sheath. Before release, correct device location ( position, compression, residual flow) was evaluated using tug testing, TEE measurements and LAA angiograms. Results: A total of 27 patients (77+9 years, 16 males, CHA2DS2VASC: 4 + 2, HASBLED: 4 + 1) were included in this study. LAAC was successful in 26/27 (96%) patients. Procedure and fluoroscopy time were 45 + 14min and 4.4 + 2.9min, respectively. In 16/27 (59%) patients 1-4 device repositioning maneuvers were performed. One device dislodgment required successful percutaneous retrieval. No further procedural complications (including cardiac tamponade) were observed. Patients were prescribed dual platelet inhibition (ASA 100mg þ clopidogrel 75mg) for at least 6 weeks. In 23/27 (85%) patients a follow up TEE was performed in our center. Post-implantation device related thrombus formation was never observed (0/23 patients, 0%) whereas minor leakage was detected in 2 patients. During 30 days F/U, 1 male patient (88 years, CHA2DS2VASC: 6, HASBLED: 5) died from hemorrhagic shock due to profuse GI bleeding despite of ceased antithrombotic treatment. Conclusion: LAA closure using the novel Wavecrest device appears to be safe and feasible. More data is required to confirm this initial experience in a larger patient cohort. LA dimensions (key) LA fibrosis (optional) LA geometry (optional) LAA thrombus (key) PV anatomy (key) TTE TEE CT CMR þ þþ þþ þ þ P293 NEUROPREVENTIVE EFFECT OF SITAGLIPTIN AFTER ATRIAL FIBRILLATION RELATED ISCHEMIC STROKE IN TYPE 2 DIABETIC PATIENTS: A NATIONWIDE COHORT STUDY Chang Gung Memorial Hospital, Taipei, Taiwan, ROC Objectives: The aim of this study was to assess the efficacy and safety of sitagliptin in type 2 diabetic patients with ischemic stroke. Background: The neuroprotective of sitagliptin, a dipeptidyl peptidase 4 inhibitor, in type 2 diabetic patients with atrial fibrillation and acute ischemic stroke remains uncertain. Methods: We analyzed data from the Taiwan National Health Insurance Research Database (NHIRD) between March 1st, 2009 and December 31st, 2011. Atrial fibrillation and ischemic stroke patients were identified from individuals with type 2 diabetes. Subjects using sitagliptin were compared with those not using sitagliptin for cardiovascular safe (...truncated)


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POSTER SESSION 1, EP Europace, 2015, pp. iii30-iii55, Volume 17, Issue suppl_3, DOI: 10.1093/europace/euv156