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Brenda Anna Kwambana-Adams, Franklin Asiedu-Bekoe, Badu Sarkodie, Osei Kuffour Afreh, George Khumalo Kuma, Godfred Owusu-Okyere, Ebenezer Foster-Nyarko, Sally-Ann Ohene, Charles Okot, Archibald Kwame Worwui, Catherine Okoi, Madikay Senghore, Jacob Kweku Otu, Chinelo Ebruke, Richard Bannerman, Kwame Amponsa-Achiano, David Opare, Gemma Kay, Timothy Letsa, Owen Kaluwa, Ebenezer Appiah-Denkyira, Victor Bampoe, Syed M A Zaman, Mark J Pallen, Umberto D'Alessandro, Jason M Mwenda, Martin Antonio
BACKGROUND: An outbreak of pneumococcal meningitis among non-infant children and adults occurred in the Brong-Ahafo region of Ghana between December 2015 and April 2016 despite the recent nationwide implementation of a vaccination programme for infants with the 13-valent pneumococcal conjugate vaccine (PCV13). METHODS: Cerebrospinal fluid (CSF) specimens were collected from patients with suspected meningitis in the Brong-Ahafo region. CSF specimens were subjected to Gram staining, culture and rapid antigen testing...
October 18, 2016: BMC Infectious Diseases
Mengqi Gong, Zhiwei Zhang, Nikolaos Fragakis, Panagiotis Korantzopoulos, Konstantinos P Letsas, Guangping Li, Gan-Xin Yan, Tong Liu
BACKGROUND: Randomized controlled trials (RCTs) regarding use of ranolazine (RN) for the prevention and cardioversion of atrial fibrillation (AF) have yielded conflicting results. OBJECTIVE: we conducted a meta-analysis of RCTs to examine the potential role of RN in the prevention and cardioversion of AF. METHODS: PubMed and EMBASE were searched until June 2016. Of 484 initially identified studies, eight RCTs were finally analyzed. RESULTS: The analysis of RCTs showed that RN significantly reduced the incidence of AF compared to the control group in various clinical settings as following cardiac surgery, in acute coronary syndromes, and post electrical cardioversion of AF (RR = 0...
October 13, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Michael Efremidis, Konstantinos P Letsas, Louiza Lioni, Konstantinos Vlachos, Stamatis Georgopoulos, Athanasios Saplaouras, Eleni Geladari, George Giannopoulos, Tong Liu, Spyridon Deftereos, Antonios Sideris
OBJECTIVES: The prognostic significance of adenosine-mediated pulmonary vein (PV) dormant conduction and whether such conduction should be eliminated still remain controversial. This randomized study aimed to investigate whether adenosine-guided ablation of the reconnection gaps improves the long-term outcomes of pulmonary vein antral isolation (PVAI) for paroxysmal atrial fibrillation (AF). METHODS AND RESULTS: Consecutive patients with paroxysmal AF were randomly assigned to undergo (n = 80, group 1) or not (n = 81, group 2) adenosine testing following PVAI...
August 1, 2016: Journal of Cardiovascular Electrophysiology
Konstantinos Vlachos, Konstantinos P Letsas, Panagiotis Korantzopoulos, Tong Liu, Stamatis Georgopoulos, Athanasios Bakalakos, Nikolaos Karamichalakis, Sotirios Xydonas, Michael Efremidis, Antonios Sideris
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Several conventional and novel predictors of AF development and progression (from paroxysmal to persistent and permanent types) have been reported. The most important predictor of AF progression is possibly the arrhythmia itself. The electrical, mechanical and structural remodeling determines the perpetuation of AF and the progression from paroxysmal to persistent and permanent forms. Common clinical scores such as the hypertension, age ≥ 75 years, transient ischemic attack or stroke, chronic obstructive pulmonary disease, and heart failure and the congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category scores as well as biomarkers related to inflammation may also add important information on this topic...
March 26, 2016: World Journal of Cardiology
Zhiwei Zhang, Konstantinos P Letsas, Nixiao Zhang, Michael Efremidis, Gang Xu, Guangping Li, Tong Liu
Previous studies have given conflicting data regarding the long-term adjunctive efficacy of linear lesions (LLs) on top of pulmonary vein isolation (PVI) as an ablation strategy in patients with atrial fibrillation (AF). The aim of this meta-analysis was to provide a detailed analysis of the available randomized controlled trials (RCTs) regarding the efficacy of LL following PVI in AF patients. Current databases were searched until October 2015. The primary outcome end point of the meta-analysis was recurrence of any symptomatic or documented episode of AF or atrial tachycardia after a single ablation procedure with or without the use of antiarrhythmic drugs...
June 2016: Pacing and Clinical Electrophysiology: PACE
Jianping Zhao, Tong Liu, Panagiotis Korantzopoulos, Konstantinos P Letsas, Enyuan Zhang, Yajuan Yang, Zhiwei Zhang, Jiuchun Qiu, Jiao Li, Guangping Li
No abstract text is available yet for this article.
February 1, 2016: International Journal of Cardiology
Nikolaos Karamichalakis, Konstantinos P Letsas, Konstantinos Vlachos, Stamatis Georgopoulos, Athanasios Bakalakos, Michael Efremidis, Antonios Sideris
Atrial fibrillation (AF) is the most common arrhythmia affecting elderly patients. Management and treatment of AF in this rapidly growing population of older patients involve a comprehensive assessment that includes comorbidities, functional, and social status. The cornerstone in therapy of AF is thromboembolic protection. Anticoagulation therapy has evolved, using conventional or newer medications. Percutaneous left atrial appendage closure is a new invasive procedure evolving as an alternative to systematic anticoagulation therapy...
2015: Vascular Health and Risk Management
Konstantinos P Letsas, Michael Efremidis, Konstantinos Vlachos, Stamatis Georgopoulos, Sotirios Xydonas, Kosmas Valkanas, Antonios Sideris
Catheter ablation of idiopathic ventricular arrhythmias arising from the distal great cardiac vein represents a great challenge. We report data regarding the electrocardiographic and electrophysiologic characteristics in two patients with ventricular arrhythmias arising from the distal great cardiac vein. The technical difficulties to advance and navigate the ablation catheter within the coronary venous system as well as the close proximity to the major coronary vessels are discussed.
March 2016: Heart, Lung & Circulation
Zhiwei Zhang, Konstantinos P Letsas, Yajuan Yang, Panagiotis Korantzopoulos, Guangping Li, Gan-Xin Yan, Tong Liu
The aim of this of this meta-analysis was to examine the potential association between certain early repolarization (ER) characteristics and ventricular tachyarrhythmias (VTAs) in patients with acute myocardial infarction (AMI). We searched PubMed, Embase and Web of Science databases for records published until December 2014. Of the 658 initially identified records, 7 studies with a total of 1,565 patients (299 with ER and 1,266 without ER) were finally analyzed. Overall, patients with ER displayed a higher risk of VTAs following AMI compared to patients without ER [odds ratio (OR): 3...
2015: Scientific Reports
Konstantinos Vlachos, Konstantinos P Letsas, Panagiotis Korantzopoulos, Tong Liu, Michael Efremidis, Antonios Sideris
Atrioventricular junction ablation with permanent pacemaker implantation is a highly effective treatment approach in patients with atrial fibrillation and high ventricular rates resistant to other treatment modalities, especially in the elderly or those with severe comorbidities. Compared with pharmacological therapy alone, the so-called "ablate and pace" approach offers the potential for more robust control of ventricular rate. Atrioventricular junction ablation and pacing strategy is associated with improvement in symptoms, quality of life, and exercise capacity...
September 2015: Journal of Geriatric Cardiology: JGC
Konstantinos Vlachos, Stamatis Georgopoulos, Michael Efremidis, Antonios Sideris, Konstantinos P Letsas
A variety of drugs, either anti-arrhythmics or non-antiarrhythmics, have been associated with drug-induced arrhythmias. Drug-induced arrhythmias are usually observed in the presence of long QT interval or Brugada electrocardiographic pattern. Clinical risk factors, such as female gender, structural heart disease, metabolic and electrolyte abnormalities, bradycardia and conduction disease, increased drug bioavailability, and silent channelopathies act as ''effect amplifiers'' which can make an otherwise relatively safe drug dangerous with regard to risk for polymorphic ventricular tachycardia in the setting of QT interval prolongation...
2016: Expert Review of Clinical Pharmacology
Michael Efremidis, Konstantinos Vlachos, Konstantinos P Letsas, Georgios Giannopoulos, Louiza Lioni, Stamatis Georgopoulos, Maria Vadiaka, Spyridon Deftereos, Antonios Sideris
BACKGROUND: Left atrial ablation for atrial fibrillation (AF) is associated with a transiently increased risk of thromboembolic and hemorrhagic events. We tested the hypothesis that the low dose dabigatran [110mg twice a day (bid)] can be safely used as an alternative to uninterrupted acenocoumarol for periprocedural anticoagulation in left atrial ablation procedures. METHODS AND RESULTS: A total of 149 consecutive patients undergoing pulmonary vein antral isolation for AF were included; 64 patients were on low dose dabigatran (110mg bid) and 85 patients were on acenocoumarol with therapeutic international normalized ratios...
September 2015: Journal of Electrocardiology
Kallirhoe Kalinderi, Nikolaos Fragakis, Konstantinos C Koskinas, Demosthenes Katritsis, Konstantinos Letsas, Michalis Efremidis, Panagiotis Korantzopoulos, Konstantinos Rossios, Efstathios Pagourelias, Pinelopi Giannakopoulou, Melaxrini Mavroudi, Panagiota Kyriakou, Vassileios Skeberis, Paraschos Geleris, Vassileios Vassilikos, Liana Fidani
INTRODUCTION: Atrial fibrillation (AF) is a common arrhythmia with evidence of genetic susceptibility. The rs2200733 single-nucleotide polymorphism (SNP) in a non-coding region on chromosome 4q25 has been associated with AF. The purpose of this case-control study was to examine the possible association of the rs2200733 polymorphism with AF in the Greek population. METHODS: A total of 295 individuals, 167 AF patients and 128 controls, were genotyped for the presence of the rs2200733 polymorphism using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLPs) method...
May 2015: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Konstantinos P Letsas, Tong Liu, Qingmiao Shao, Panagiotis Korantzopoulos, Georgios Giannopoulos, Konstantinos Vlachos, Stamatis Georgopoulos, Athanasios Trikas, Michael Efremidis, Spyridon Deftereos, Antonios Sideris
The prognosis of asymptomatic subjects remains the most controversial issue in Brugada syndrome (BS). A meta-analysis on the prognostic role of spontaneous type 1 electrocardiographic (ECG) pattern and programmed ventricular stimulation (PVS) in asymptomatic subjects with Brugada electrocardiogram was performed. Current databases were searched until March 2014. Fourteen prospective observational studies were included in the present meta-analysis, accumulating data on 3,536 asymptomatic subjects (2,820 men) with BS phenotype...
July 1, 2015: American Journal of Cardiology
Kofi Issah, Kennedy Nartey, Richard Amoah, Emmanuel George Bachan, Jacob Aleeba, Enuamah Yeetey, Timothy Letsa
BACKGROUND: This study assessed the quality, core and support functions of the integrated disease surveillance and response (IDSR) system relating to 18 suspected cases of Ebola virus disease (EVD) in the Brong Ahafo Region, Ghana. METHODS: Data was collected on selected indicators of the surveillance system relating to 18 suspected cases of EVD, from epidemiological week 19 to 45 of 2014. We conducted in-depth interviews with seven medical directors and two district directors of health services, and also reviewed documentation on the implementation of the core, support and quality functions of the IDSR system...
2015: Infectious Diseases of Poverty
Georgios Giannopoulos, Charalampos Kossyvakis, Christos Angelidis, Michael Efremidis, Vasiliki Panagopoulou, Konstantinos Letsas, Georgios Bouras, Vassilios P Vassilikos, John Goudevenos, Dimitrios Tousoulis, John Lekakis, Spyridon Deftereos
BACKGROUND: Amino-terminal B-type natriuretic peptide (NT-proBNP) has been shown to predict postablation recurrences of atrial fibrillation (AF); however, given the associations of natriuretic peptides with various cardiovascular parameters potentially related to AF, whether the observed association with recurrence is truly an independent one is not clear. OBJECTIVE: The purpose of this analysis was to assess the association of NT-proBNP levels with AF recurrence after radiofrequency ablation...
July 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Konstantinos P Letsas, Michael Efremidis, Nikolaos P Sgouros, Konstantinos Vlachos, Dimitrios Asvestas, Antonios Sideris
Accumulating data have shown that elimination of atrial fibrillation (AF) sources should be the goal in persistent AF ablation. Pulmonary vein isolation, linear lesions and complex fractionated atrial electrograms (CFAEs) ablation have shown limited efficacy in patients with persistent AF. A combined approach using voltage, CFAEs and dominant frequency (DF) mapping may be helpful for the identification of AF sources and subsequent focal substrate modification. The fibrillatory activity is maintained by intramural reentry centered on fibrotic patches...
March 26, 2015: World Journal of Cardiology
Michael Efremidis, Konstantinos Letsas, Georgios Giannopoulos, Louisa Lioni, Konstantinos Vlachos, Dimitrios Asvestas, Dimitrios Karlis, Vasileios Kareliotis, Hrysoula Geladari, Antonios Sideris, Spyridon Deftereos
AIM: The objective of the study was to investigate whether early pulmonary vein reconnection (PVR) is a predictor of late arrhythmia recurrence after a single ablation procedure for paroxysmal atrial fibrillation (AF). Further ablation was delivered to patients with acute PVR to test whether this strategy could reduce recurrences. METHODS AND RESULTS: One hundred and forty-four consecutive patients with symptomatic, drug-refractory paroxysmal AF, undergoing pulmonary vein isolation (PVI), were assigned to the 'PVR30 test' group, where PVR was monitored for 30 min after initial PVI and further ablation was applied if needed, and compared with a control group of 128 patients, where the procedure was terminated after initial successful isolation...
May 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Louiza Lioni, Konstantinos P Letsas, Michael Efremidis, Konstantinos Vlachos, Georgios Giannopoulos, Vasileios Kareliotis, Spyridon Deftereos, Antonios Sideris
BACKGROUND: Atrial fibrillation (AF) catheter ablation has emerged as a promising treatment strategy for AF, but has not been widely adopted in the elderly population. The present study aimed to determine the safety and efficacy of AF catheter ablation in the elderly population. METHODS AND RESULTS: The study population consisted of 316 patients with paroxysmal AF who underwent left atrial ablation. Ninety-five patients were ≥ 65 years (48 males, mean age 68.9 ± 3...
December 2014: Journal of Geriatric Cardiology: JGC
Louiza Lioni, Konstantinos Vlachos, Konstantinos P Letsas, Michael Efremidis, Dimitrios Karlis, Dimitrios Asvestas, Vasilios Kareliotis, Sotirios Xydonas, Nikolaos Dimopoulos, Panagiotis Korantzopoulos, Athanasios Trikas, Antonios Sideris
INTRODUCTION: The aim of this study was to evaluate the differences in quality of life and psychosocial stress parameters among patients with paroxysmal atrial fibrillation (AF) and common forms of atrioventricular reentry supraventricular tachycardias (SVTs). METHODS AND RESULTS: The total study population included 106 patients, 54 patients with paroxysmal AF (32 males, age 56.64±12.50 years) and 52 with SVTs (25 males, age 40.46±14.96 years). General health (p<0...
September 2014: Indian Pacing and Electrophysiology Journal
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