Browsing by Author "Borras, Roger"

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    Left atrial size and function by three-dimensional echocardiography to predict arrhythmia recurrence after first and repeated ablation of atrial fibrillation
    (2014) Gabrielli, Luigi; Montserrat, Sílvia; Borras, Roger; Poyatos, Sílvia; Berruezo, Antonio; Bijnens, Bart; Brugada, Josep; Mont, Lluis; Sitges, Marta
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    Percutaneous or mini-invasive surgical radiofrequency re-ablation of atrial fibrillation: Impact on atrial function and echocardiographic predictors of short and long-term success
    (2022) Montserrat, Silvia; Gabrielli, Luigi; Borras, Roger; Cascos, Enric; Castella, Manel; Sanchis, Laura; Bijnens, Bart; Mont, Lluis; Sitges, Marta
    ObjectivesThe aim of this study was to compare percutaneous catheter ablation vs. minimally invasive surgical ablation, evaluating the impact of repeated ablation on atrial function, and evaluating predictors of atrial fibrillation (AF) recurrence. BackgroundWhen AF ablation fails, re-ablations are required in up to 40% of patients to treat recurrent arrhythmia; surgical ablation is more effective than catheter ablation. MethodsThirty-two patients with failed prior catheter ablation and referred for a second ablation (18 catheter and 14 surgical) were included in a descriptive observational study. Left atrial volumes, strain, and strain rate were measured with 2D speckle tracking echocardiography at baseline and 6 months after the procedures to assess left atrial functions. Patients received up to 1 year of clinical and Holter follow-up. ResultsAt the 12-month follow-up, catheter ablation was effective in 56% and surgical ablation in 72% of patients (OR 2 (CI 0.45-8.84), p 0.36). Left atrial booster function was similar in all patients, but left atrial reservoir function was more impaired in those patients who underwent surgical ablation. Left atrial booster function was predictive of arrhythmia recurrence after both catheter and surgical ablation: late diastolic strain rate (LASRa) cut-off <= -0.89 s(-1) (sensitivity 88%, specificity 70%, AUC 0.82) and <= -0.85 s(-1) (sensitivity 60%, specificity 100%, AUC 0.82), respectively. ConclusionSurgical ablation has a more negative impact on LA reservoir function despite being slightly more effective in arrhythmia suppression. LA booster function is not significantly impaired by either procedure. LA booster function predicts arrhythmia elimination after a re-ablation (catheter or surgical).
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    Prodromal phase: Differences in prodromal symptoms, risk factors and markers of vulnerability in first episode mania versus first episode psychosis with onset in late adolescence or adulthood
    (2022) Verdolini, Norma; Borras, Roger; Sparacino, Giulio; Garriga, Marina; Sague-Vilavella, Maria; Madero, Santiago; Palacios-Garran, Roberto; Serra, Maria; Forte, Maria Florencia; Salagre, Estela; Aedo, Alberto; Salgado-Pineda, Pilar; Montoro Salvatierra, Irene; Sanchez Gistau, Vanessa; Pomarol-Clotet, Edith; Ramos-Quiroga, Josep Antoni; Carvalho, Andre F.; Garcia-Rizo, Clemente; Undurraga, Juan; Reinares, Maria; Martinez Aran, Anabel; Bernardo, Miguel; Vieta, Eduard; Pacchiarotti, Isabella; Amoretti, Silvia
    Objective This study was aimed at identifying differences in the prodromal symptoms and their duration, risk factors and markers of vulnerability in patients presenting a first episode mania (FEM) or psychosis (FEP) with onset in late adolescence or adulthood in order to guide tailored treatment strategies. Methods Patients with a FEM or FEP underwent a clinical assessment. Prodromes were evaluated with the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R). Chi-squared tests were conducted to assess specific prodromal symptoms, risk factors or markers of vulnerability between groups. Significant prodromal symptoms were entered in a stepwise forward logistic regression model. The probabilities of a gradual versus rapid onset pattern of the prodromes were computed with logistic regression models. Results The total sample included 108 patients (FEM = 72, FEP = 36). Social isolation was associated with the prodromal stage of a FEP whilst Increased energy or goal-directed activity with the prodrome to a FEM. Physically slowed down presented the most gradual onset whilst Increased energy presented the most rapid. The presence of obstetric complications and difficulties in writing and reading during childhood were risk factors for FEP. As for markers of vulnerability, impairment in premorbid adjustment was characteristic of FEP patients. No specific risk factor or marker of vulnerability was identified for FEM. Conclusion Early characteristics differentiating FEP from FEM were identified. These findings might help shape early identification and preventive intervention programmes.