Nuestros investigadores

Gabriel Alejandro Ballesteros Derbenti

Publicaciones científicas más recientes (desde 2010)

Autores: Ramos, P.; et al.
Revista: CIRCULATION
ISSN 0009-7322  Vol. 137  Nº 7  2018  págs. 743 - 746
Autores: Rodriguez-Manero, M., (Autor de correspondencia); Oloriz, T.; de Waroux, J. B. L.; et al.
Revista: EUROPACE
ISSN 1099-5129  Vol. 20  Nº 5  2018  págs. 851 - 858
Aims Coronary artery spasm (CAS) is associated with ventricular arrhythmias (VA). Much controversy remains regarding the best therapeutic interventions for this specific patient subset. We aimed to evaluate the clinical outcomes of patients with a history of life-threatening VA due to CAS with various medical interventions, as well as the need for ICD placement in the setting of optimal medical therapy. Methods and results A multicentre European retrospective survey of patients with VA in the setting of CAS was aggregated and relevant clinical and demographic data was analysed. Forty-nine appropriate patients were identified: 43 (87.8%) presented with VF and 6 (12.2%) with rapid VT. ICD implantation was performed in 44 (89.8%). During follow-up [59 (17117) months], appropriate ICD shocks were documented in 12. In 8/12 (66.6%) no more ICD therapies were recorded after optimizing calcium channel blocker (CCB) therapy. SCD occurred in one patient without ICD. Treatment with beta-blockers was predictive of appropriate device discharge. Conversely, non-dihydropyridine CCB therapy was significantly protective against VAs. Conclusion Patients with life-threatening VAs secondary to CAS are at particularly high-risk for recurrence, especially when insufficient medical therapy is administered. Non-dihydropyridine CCBs are capable of suppressing episodes, whereas beta-blocker treatment is predictive of VAs. Ultimately, in spite of medical intervention, some patients exhibited arrhythmogenic events in the long-term, suggesting that ICD implantation may still be indicated for all.
Autores: Ramos, P.; et al.
Revista: CIRCULATION
ISSN 0009-7322  Vol. 138  Nº 4  2018  págs. 439 - 440
Autores: Ramos, P.; et al.
Revista: REVISTA ESPAÑOLA DE CARDIOLOGÍA (ENGLISH ED.)
ISSN 1885-5857  Vol. 70  Nº 9  2017  págs. 706 - 712
INTRODUCTION AND OBJECTIVES: Rhythmia is a new nonfluoroscopic navigation system that is able to create high-density electroanatomic maps. The aim of this study was to describe the acute outcomes of atrial fibrillation (AF) ablation guided by this system, to analyze the volume provided by its electroanatomic map, and to describe its ability to locate pulmonary vein (PV) reconnection gaps in redo procedures. METHODS: This observational study included 62 patients who underwent AF ablation with Rhythmia compared with a retrospective cohort who underwent AF ablation with a conventional nonfluoroscopic navigation system (Ensite Velocity). RESULTS: The number of surface electrograms per map was significantly higher in Rhythmia procedures (12 125 ± 2826 vs 133 ± 21 with Velocity; P < .001), with no significant differences in the total procedure time. The Orion catheter was placed for mapping in 99.5% of PV (95.61% in the control group with a conventional circular mapping catheter; P = .04). There were no significant differences in the percentage of PV isolation between the 2 groups. In redo procedures, an ablation gap could be identified on the activation map in 67% of the reconnected PV (40% in the control group; P = .042). The measured left atrial volume was lower than that calculated by computed tomography (109.3 v 15.2 and 129.9 ± 13.2 mL, respectively; P < .001). There were no significant differences in the number of complications. CONCLUSIONS: The Rhythmia system is effective for AF ablation procedures, with procedure times and safety profiles similar to conventional nonfluoroscopic navigation systems. In redo procedures, it appears to be more effective in identifying reconnected PV conduction gaps.
Autores: Ramos, P.; et al.
Revista: REVISTA ESPAÑOLA DE CARDIOLOGÍA (ENGLISH ED.)
ISSN 1885-5857  Vol. 70  Nº 7  2017  págs. 598 - 600
Autores: Ramos, P.; et al.
Revista: PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
ISSN 0147-8389  Vol. 40  Nº 5  2017  págs. 545 - 550
BackgroundFirst description of a technique for left atrium transseptal puncture (TSP) with minimal radiation exposure by using the nonfluoroscopic MediGuide tracking system (MG; St. Jude Medical, St. Paul, MN, USA) without the assistance of intracardiac echocardiography. MethodsThis study included 31 consecutive patients with atrial fibrillation undergoing an MG-assisted percutaneous catheter ablation procedure. A Brockenbrough transseptal needle (BRK) is connected to a standard pressure transducer through a two-input valve. Then, an MG-enabled guidewire is inserted so that its tip exactly matches the BRK's distal tip. After the acquisition of two short radioscopic cine-loops we are able to trace the needle tip on the MG screen, performing the usual TSP maneuver but without fluoroscopy. Successful left atrium access is confirmed by noticing the change in the pressure curve and by advancing the guidewire into the left pulmonary veins. As a control group, 31 matched patients who underwent atrial fibrillation ablation with fluoroscopically guided, pressure-monitored TSP were included. ResultsSixty-two MG-assisted TSP attempts were performed; all but two were successfully accomplished without changing to the conventional technique (96.7%). The mean total fluoroscopy time, until the double transseptal access was performed, was 26.65 37.97 seconds in the MG group and 129.13 +/- 37.77 seconds in the conventional-TSP group (P < 0.001). No major complications occurred during any of the procedures. ConclusionThis new technique for TSP using MG is feasible and can be performed with minimal radiation exposure without the need for additional imaging techniques, achieving a significant reduction of fluoroscopy time.
Autores: Garcia-Bolao, I; Calvo, N; et al.
Revista: JOURNAL OF ATRIAL FIBRILLATION
ISSN 1941-6911  Vol. 8  Nº 5  2016  págs. 61-66