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Kardiologia Polska

Publisher:
—
ISSN:
0022-9032
Category:
CARDIAC & CARDIOVASCULAR SYSTEMS
Impact factor:
3.7
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12 parsed articles

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Transvenous leadless pacemaker extraction: When, who, where, and how?

2026-01-20

Mateusz Tajstra, Maciej Dyrbuś, Oskar Kowalski, Maciej Sterliński, Alexander Breitenstein, Daniel Hofer

The widespread adoption of leadless pacemakers has introduced new clinical and technical challenges related to device management at end-of-service and in the setting of device-related complications. While transvenous lead extraction is an established treatment strategy for conventional pacing systems, there is currently no standardized framework for transvenous leadless pacemaker extraction (TLLE). With increasing numbers of leadless pacemakers approaching end-of-service and expanding indications for leadless pacing, a structured approach to TLLE has become clinically relevant. This review proposes a systematic concept of TLLE, including definitions, clinical indications, procedural strategies, risk assessment, and institutional requirements. Indications for TLLE including device end-of-life, dislocation, interactions, infection, or the need for upgrade to a different device are summarized. Procedural strategies, primarily based on the extraction most frequently from the femoral approach, with the use of snare-based techniques, with the choice of other tools and access tailored to device type, dwell time, fixation mechanism, and degree of encapsulation, are summarized. Literature findings reporting high success rates are presented, with potential complications such as cardiac perforation, tamponade, tricuspid valve injury, embolization, and vascular access complications also summarized. Patient selection and pre-procedural imaging are evaluated, and factors influencing decision-making, including balance of periprocedural risk against long-term implications of device abandonment, are presented.

Left ventricular global longitudinal strain in patients with coronary microvascular dysfunction and preserved ejection fraction: A single-center study

2026-01-12

Lior Zornitzki, Yotam Barlev, Sheizaf Gefen, Ophir Freund, Shir Frydman, Maayan Zuniga, Jeremy Ben-Shoshan, Yaron Arbel, Shmuel Banai, Maayan Konigstein

Background: Left ventricular global longitudinal strain (LVGLS) detects myocardial injury. Reduced LVGLS is associated with worse outcomes in several cardiovascular conditions. Currently, there is a paucity of evidence regarding LVGLS in patients with coronary microvascular dysfunction (CMD). Aims: We assessed whether LVGLS is reduced in patients with CMD. Methods: We included patients who underwent clinically indicated invasive assessment of coronary microvascular function with ejection fraction >50%. LVGLS measurements were performed using semi-automated speckle-tracking software and are presented in absolute values. Associations between LVGLS, echocardiographic parameters, and coronary microvascular function were assessed using univariate and multivariable analyses. Results: Ninety-three patients were included in the analysis (58% female; median age 66 years, interquartile range [IQR] 58–74) of whom 49 (52.6%) had evidence of CMD. Median ejection fraction and LVGLS for the study cohort were 60% and 16.2%, respectively. Patients with CMD had worse LVGLS compared to those without CMD (15.0% [IQR 13–17] vs. 17.9% [IQR 15–21]; P = 0.04). Patients with structural CMD (14.4%; IQR 12.3–16.6) vs. functional CMD (16.5%; IQR 14.3–19.4), and no CMD (17.9%; IQR 15.2–21.3) had lower LVGLS (P for trend = 0.001). Reduced LVGLS (<17.5%) was associated with CMD (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.28–7.43) and remained significant after multivariable adjustment (adjusted OR, 3.61; 95% CI, 1.35–9.68; P = 0.01). Conclusions: Patients with CMD and preserved ejection function have lower LVGLS compared with patients without CMD, with worse LVGLS among patients with structural vs. functional CMD. Reduced LVGLS might emerge as an early non-invasive marker for CMD.

In-hospital and 1-year outcomes of mitral transcatheter edge-to-edge repair in Poland derived from an all-comers administrative database

2025-12-31

Wojciech Wojakowski, Michał Kozłowski, Daniel Cieśla, Zbigniew Kalarus, Witold Streb, Jarosław Trębacz, Krzysztof Reczuch, Jacek Piegza, Krzysztof Myrda, Dariusz Dudek, Adam Witkowski, Arkadiusz Pietrasik, Jerzy Pręgowski, Piotr Suwalski, Tomasz Hryniewiecki, Janina Stępińska, Waldemar Banasiak, Mariusz Gąsior, Marek Grygier

Background: Transcatheter mitral edge-to-edge repair (TEER) is an effective and safe therapeutic option for patients with severe mitral regurgitation (MR) and may be used in the treatment of both primary and secondary MR. Aims: To provide insights into patients’ characteristics, in-hospital procedural outcomes, and 1-year follow-up for 1204 patients with severe MR treated with TEER in Poland. Methods: A comprehensive, all-comers, administrative database that covers the whole population of Poland was searched for all reimbursed TEER procedures performed since 2019. Electronic health records provided details regarding baseline study group characteristics as well as the in-hospital and 1-year outcomes. Results: The in-hospital mortality was 3.2% with no difference between sexes. Blood transfusion was required in 7.8% of patients, more frequently in women (11.1% vs. 6.1%; P = 0.004). Patients with atrial fibrillation had a higher rate of in-hospital heart failure (HF) in New York Heart Association functional class II–IV vs. I (66.8% vs. 42.5%; P < 0.001). Mean follow-up was 336.7 days. The mortality rate was 13.9% and was comparable between males and females and between patients with and without atrial fibrillation. 54.5% of patients required a HF hospitalization and 65.0% a cardiovascular hospitalization. Mortality was comparable to other European registries, but rates of HF hospitalization were higher in the Polish population. Conclusions: The Polish TEER registry provides real-world data on transcatheter edge-to-edge repair procedures, demonstrating outcomes comparable to other European registries despite a higher-risk patient population.

Rationale, objectives, and design of the multicenter observational study — Mitral Valve Prolapse by Echocardiography and Arrhythmia (MITPROL AR-PL)

2025-07-04

Paulina Wejner-Mik, Katarzyna Mizia-Stec, Ludmiła Daniłowicz-Szymanowicz, Dominika Dziadosz, Anna Budaj-Fidecka, Barbara Brzezińska, Piotr Duchnowski, Andrzej Gackowski, Krzysztof Jaworski, Ireneusz Jedliński, Małgorzata Kamela, Małgorzata Kowalczyk-Domagała, Katarzyna Kurnicka, Dorota Kustrzycka-Kratochwil, Małgorzata Knapp, Jacek Bil, Zofia Oko-Sarnowska, Michał Plewka, Anna Polewczyk, Beata Uziębło-Życzkowska, Karina Wierzbowska-Drabik, Marek Koziński, Tomasz Kukulski, Danuta Sorysz, Kamil Barański, Jarosław D Kasprzak