Téma: 

Antithrombotic therapy management in catheter ablation of arrhythmias

Peter Hlivák, Robert Hatala

Catheter ablation represents highly effective treatment for patients with symptomatic supraventricular or ventricular arrhythmias. It has become the treatment of choice for some type of arrhythmias. Patients undergoing this treatment are usually younger and often with no structural heart disease comparing with other interventions in cardiology. Accordingly, the issue of utmost safety plays a crucial role. Despite a relatively low complication rate during these procedures in general, thromboembolic events belong to the most feared complications of catheter ablations. They have a potential for lifelong disability, or even threat of fatal outcome. Because of this reason clinical electrophysiology pays a great attention to implementation of all measures aiming to minimize or eliminate the possibility of thromboembolic events in the whole periprocedural period. It is mandatory to individualize the risks between thromboembolism and bleeding. Risk stratification should be based on the procedure itself and the patient’s individual hazards. In general, thromboembolic risk during catheter ablation in the absence of structural heart disease is relatively low. Consequently, antithrombotic management does not need to be aggressive. In contrast, complex ablation procedures in atrial fibrillation or in the presence of structural heart disease are associated with significantly higher thromboembolisk risk. This requires the combination of complex intra and periprocedural antithrombotic management usually based on the anticoagulation therapy. The present article reviews the contemporary antithrombotic strategies in the setting of all types of ablation procedures in adults. It is very important to become familiar with its management for general cardiologists too, since in the majority of cases the ablation procedure represents only 24-72 hours “episode” comparing to several months lasting pre- and postprocedural time period.

Ročník 2010  Témy časopisu Cardiology for practice 3 / 2010

CHAIRMAN OF THE EDITORIAL BOARD
doc. MUDr. Oľga Jurkovičová, CSc.

CHIEF CONSULTANT
prof. MUDr. Robert Hatala, PhD., FESC

MEMBERS OF THE EDITORIAL BOARD
MUDr. Peter Dědič
MUDr. Juraj Dúbrava, PhD., FESC
MUDr. Viliam Fridrich, PhD.
doc. MUDr. Ján Kmec, PhD.
MUDr. Gabriela Kaliská, PhD., FESC
MUDr. Pavol Lesný
MUDr. Monika Kaldarárová, PhD.
MUDr. Peter Margitfalvi
prof. MUDr. Daniel Pella, PhD.
prof. MUDr. Iveta Šimková, CSc., FESC
MUDr. Viera Vršanská, CSc.

PROFESSIONAL EDITOR
MUDr. Juraj Dúbrava, PhD., FESC

EDITOR-IN-CHIEF
Ing. Danica Paulenová
e-mail: paulenova@amedi.sk

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Lucia Vecseiová
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SECTIONS

OVERVIEW PAPERS
The latest knowledge on disease and disease groups aetiology, pathogenesis, diagnoses and therapy. Maximum size is 8 pages (font size 12, line spacing 1.5) with maximum five pictures (graphs). In case of more extensive theme elaboration it is possible to divide the paper to several parts after agreement with editorial office. Write the article with emphasis on its practical usage for cardiologists.

CASE STUDY 
Maximum extent is 7 pages. Structuring: summary, introduction, case study, discussion, conclusion, bibliography.

DIAGNOSTIC AND THERAPEUTICAL ALGORITHMS
Diagnosis and therapy processed into tables and schemes, with minimum text, with emphasis on conciseness and clarity.

MISCELLANEOUS
Reaction to overview articles, news in the field of diagnostics, therapy, trial results (maximum 3 pages), reports from professional events, abstracts from scientific work published abroad, not older than 1 year. Maximum extend is 1 page. Write the title of the paper in Slovak/Czech, authors, workplace, than title of the paper in English with full citation.

FROM BORDERLINE OF CARDIOLOGY
Inter sectional theme elaborated complexly, well-arranged, clear (extent up to 8 pages).


MANUSCRIPT ELABORATION

Write the paper on computer in any common text editor.
- write full length of lines (do not use ENTER at the end of a line)
- do not arrange text into columns
- do not do page make-up, put tables at the end of the paper
- distinguish precisely numbers 1, 0 and letters l, O
- use always parentheses ( )
- explain abbreviations always when first used


MANUSCRIPT REQUIREMENTS

1. An accurate paper title, names and surnames of all authors including academic titles, authors` workplace. The first author address including the phone number, fax and e-mail address.
2. Summary - concise content summary in the extent maximum 10 lines (only at overview papers, case studies from borderline of cardiology). Write in 1st or 3rd person singular or plural (unify according the type of an article).
3. Key words - in the extent of 3-6 (just at overview papers, From borderline of cardiology).
4. English translation: paper title, summary, key words (only at overview papers, case studies and From borderline of cardiology)
5. Text
If you insert pictures into a document, send also their original files in "jpg" format, create graphs in Excel and send also their original files. If you send photo documentation via post office, please, send just high-class originals. Mark each original by a number, under which it is mentioned in the text. Write in 1st or 3rd person singular or plural (unify according the type of an article).
6. Bibliography
Citations are numbered chronologically in bold, references in the text are stated by the number of citations in parentheses. Use maximum 30 citations.

Examples of citations:
1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett´ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285: 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
5. Osborne BE. The electrocardiogram of the rat. In: Budden R, Detweiler DK, Zbinden G. The rat electrocardiogram in pharmacology and toxicology. Oxford: Pergamon Press 1981: 15-27.

Do not use dots after first names in citations. Do not use colon but dot after names of authors. Use semi-colon after the year of publishing, colon is before pages. If an author is one, two or three - it is necessary to state all. If there are more than three authors it is necessary to write first three and "et all", in Slovak and Czech citations "a spol."

Due to publishing of autodidactic tests it is necessary to add 4 questions to your article and 4 answers with marking of one correct answer, e.g.:

In which patients, after overcoming of a thromboembolic cerebral or peripheral event, the least suitable catheter closure is foramen ovale patents:
a. a woman before planned pregnancy
b. paroxysmal fibrillation of the atrium
c. aneurysm of the atrium septum
d. origination of an event after cough

The editorial office reserves the right to make small stylistic changes in the paper. If it is necessary to shorten the paper, the consent of the author will be required. All articles are double reviewed.

All published papers are paid.

Due to practical focus of the journal we would like to ask you write the paper comprehensively, with emphasis on practical use of provided information in out-patient practice of cardiologists, internists and other professionals who deal with cardiovascular medicine.

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