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    Effect of cryoballoon ablation parameters on recurrence in patients with paroxysmal atrial fibrillation
    (Türk Kardiyoloji Derneği, 2019) Demirtaş, Abdullah Orhan; İçen, Yahya Kemal; Dönmez, Yurdaer; Koca, Hasan; Kaypaklı, Onur; Şahin, Durmuş Yıldıray; Koç, Mevlüt
    Objective: The aim of this research was to investigate the relationship between atrial fibrillation (AF) recurrence and second generation cryoballoon ablation (CBA) procedural parameters in patients with non-valvular paroxysmal AF (PAF). Methods: A total of 131 patients with a PAF diagnosis who underwent second-generation CBA (59 male; mean age: 55.2±10.6 years) were enrolled. Recurrence was defined as the detection of AF on a 12-lead electrocardiography (ECG) recording, or an attack lasting at least 30 seconds observed on Holter ECG records. CBA procedural data and echocardiographic findings were recorded and compared. Results: After 1 year of follow-up, AF recurrence was detected in 27 patients. Patients with recurrence were older and had higher rates of hypertension and diabetes (p<0.05 for both). Left atrial diameter, left atrial volume (LaV), left atrial volume index, and the averaged warming angle (calculated by combining lowest temperature point and balloon temperature at 20°C point) were significantly higher in the recurrence group. Balloon warming time was significantly longer in the non-recurrence group (p<0.001). In binary logistic regression analysis, the averaged warming angle (odds ratio [OR]: 1.559, 95% confidence interval [CI]: 1.342– 1.811; p<0.001) and LaV (OR: 1.063, 95% CI: 1.028–1.100; p<0.001) were found to be independent parameters for predicting recurrence. The cutoff value of the warming angle obtained with ROC curve analysis was 50° for the prediction of recurrence (sensitivity: 94.3%, specificity: 88.5%, area under the curve: 0.909; p<0.001). The cutoff value of LaV obtained by ROC curve analysis was 53.5 for prediction of recurrence (sensitivity: 77.8%, specificity: 74.5%; p<0.001). Conclusion: Measurement of balloon warming angle during CBA and increased LaV may predict the AF recurrence.
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    Tp-e interval and Tp-e/QTc ratio are significantly Increased in patients with brain death
    (Hacettepe Üniversitesi, 2019) Demirtaş, Abdullah Orhan; Urgun, Örsan Deniz; Koca, Hasan; Kaypaklı, Onur; İçen, Yahya Kemal; Koç, Mevlüt
    Objective: We aimed to investigate whether there is a change in Tp-e interval, Tp-e/ QT and Tp-e/QTc ratios in patients with brain death. Materials and Methods: Fifty brain death patients and 50 age and sex matched healthy controls were included in the study. In addition to routine evaluation, Tp-e interval, Tp-e / QT and Tp-e / QTc ratios were measured in 12-lead electrocardiography. Tp-e was measured in the precordial leads using the Tail method; the time from the peak of the T wave to the point where the wave reached the isoelectric line. Results: White blood cell, aspartate aminotransferase, alanine aminotransferase and high sensitive c reactive protein levels were significantly higher in patients with brain death. The frequency of patients with QTc prolongation, Tp-e interval, Tp-e/QT and Tp-e/QTc values were significantly higher in patients with brain death (p <0.05). Tp-e interval, Tp-e/QT and Tp-e/QTc values were found to be positively correlated with HsCRP (p<0.001 for all). Conclusion: Tp-e interval, Tp-e / QT and Tp-e / QTc ratios are increased in patients with brain death compared to healthy controls. The mechanisms of this association and possible relationship with neuroendocrine changes should be investigated in future studies.
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    Tp-e Interval and Tp-e/QTc Ratio Are Significantly Increased in Patients with Brain Death
    (2019) Demirtaş, Abdullah Orhan; Urgun, Örsan Deniz; Koca, Hasan; Kaypaklı, Onur; İçen, Yahya Kemal; Koç, Mevlüt
    Objective: We aimed to investigate whether there is a change in Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in patients with brain death.Materials and Methods: Fifty brain death patients and 50 age and sex matched healthy controls were included in the study. In addition to routine evaluation, Tp-e interval, Tp-e / QT and Tp-e / QTc ratios were measured in 12-lead electrocardiography. Tp-e was measured in the precordial leads using the Tail method; the time from the peak of the T wave to the point where the wave reached the isoelectric line.Results: White blood cell, aspartate aminotransferase, alanine aminotransferase and high sensitive c reactive protein levels were significantly higher in patients with brain death. The frequency of patients with QTc prolongation, Tp-e interval, Tp-e/QT and Tp-e/QTc values were significantly higher in patients with brain death (p <0.05). Tp-e interval, Tp-e/QT and Tp-e/QTc values were found to be positively correlated with HsCRP (p<0.001 for all). Conclusion: Tp-e interval, Tp-e / QT and Tp-e / QTc ratios are increased in patients with brain death compared to healthy controls. The mechanisms of this association and possible relationship with neuroendocrine changes should be investigated in fu-ture studies.