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Herzschrittmachertherapie & Elektrophysiologie

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https://www.readbyqxmd.com/read/30155562/-radiation-reduction-in-interventional-electrophysiology-results-from-operators-with-different-levels-of-experience
#1
Miriam Schnur, Severin Wannagat, Lena Loehr, Sebastian Lask, Andreas Mügge, Alexander Wutzler
BACKGROUND: Radiation exposure in the catherization laboratory is associated with significant health risks. It is unclear whether a reduction of radiation exposure with the use of "near-zero fluoroscopy" protocols is possible when applied by less experienced operators. METHODS: Consecutive ablation procedures with the use of a 3D mapping system were analyzed. Three time periods were analyzed. During the first period (standard), no specific radiation-reduction protocol was used...
August 28, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30019115/-high-resolution-3d-mapping-opportunities-and-limitations-of-the-rhythmia%C3%A2-mapping-system
#2
REVIEW
Christian Ellermann, Gerrit Frommeyer, Lars Eckardt
Three-dimensional mapping systems are used for the characterization and treatment of complex arrhythmias, such as atrial reentrant tachycardias, atrial fibrillation, or ventricular tachycardia. The Rhythmia™ mapping system (Boston Scientific, Natick, MA, USA) belongs to a novel generation of mapping systems that are able to rapidly create high-density and high-resolution three-dimensional maps in an automated manner. Mapping is performed with a magnetic- and impedance-based tracked bidirectional deflectable 64-pole basket catheter (IntellaMap Orion™, Boston Scientific)...
July 17, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29992405/non-contact-mapping-in-cardiac-electrophysiology
#3
REVIEW
Marcus Wieczorek
Catheter ablation of atrial and ventricular arrhythmias is now considered a standard technology for selected patients. In some patients, however, cure of the arrhythmia is hampered by the complexity of the arrhythmia or the way the arrhythmia presents in the electrophysiological laboratory: some focal atrial and ventricular arrhythmias are difficult to induce using electrical stimulation or medical provocation. Precise mapping of these arrhythmias is challenging or even impossible by contact mapping, while other arrhythmias are poorly tolerated and need early termination...
July 10, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29946891/-epicardial-vt-ablation-in-whom-when-how-and-why
#4
REVIEW
E Ene, P Halbfaß, K Nentwich, K Sonne, A Berkovitz, A-K Wolf, T Deneke
Ventricular tachycardia (VT) is a leading cause of cardiovascular death and remains the main cause of sudden cardiac death. Implanted cardiac defibrillators (ICD) improve survival but the recurrent ICD therapies, mostly ICD shocks, are associated with an increased mortality and deleterious psychological effects. In this regard and based on the results of multicenter studies, the current European guidelines recommend early referral for catheter ablation. The ablation strategy (isolated endocardial approach or combined epi-/endocardial) depends mostly on the underlying myocardial disease...
June 26, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29946890/-mapping-and-ablation-of-cardiac-arrhythmias-never-forget-where-you-are-coming-from
#5
REVIEW
Henning Jansen, Jürgen Siebels, Rodolfo Ventura, Joachim Hebe, Christian Sohns
With the rapid development of new mapping and imaging technologies as well as catheter ablation technologies, it is increasingly important to understand the basic concepts of conventional mapping and ablation of cardiac arrhythmias. Prerequisite for successful ablation is the exact identification of the tachycardia mechanism and subsequent localization of the origin or tachycardic substrate. Only intracardiac electrograms provide decisive information regarding activation time and signal morphology. In some arrhythmias, it is necessary to supplement conventional mapping with so-called pace and/or entrainment mapping...
June 26, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29946889/-modern-mapping-technologies-technical-background-and-clinical-use
#6
REVIEW
Felix Bourier, Frédéric Sacher
Successful mapping and ablation of arrhythmias can be a challenging clinical task. For many years, conventional pacing maneuvers and activation mapping were the gold standard to identify underlying arrhythmia mechanisms in ablation procedures. In the last decade, technology has dramatically improved. In parallel to high-density automated mapping, cardiac imaging and image integration tools are increasingly used to assess the arrhythmia substrate and identify reentrant circuits. The aim of this review is to describe the technologies underlying these new mapping systems and to discuss their possible role in providing new insights into identification and visualization of arrhythmia mechanisms...
June 26, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30229390/mapping-of-complex-arrhythmias-where-do-we-stand-and-where-do-we-go-from-here
#7
EDITORIAL
Felix Bourier, Pierre Jais
No abstract text is available yet for this article.
September 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30229389/-conventional-and-electroanatomical-mapping-a-pivotal-diagnostic-tool-to-provide-a-basis-for-ablative-therapy-of-complex-atrial-and-ventricular-arrhythmias
#8
EDITORIAL
Reinhard Höltgen, Philipp Sommer
No abstract text is available yet for this article.
September 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30215110/mapping-of-atrial-fibrillation-strategies-to-understand-an-enigmatic-arrhythmia
#9
REVIEW
Isabel Deisenhofer
The three-dimensional (3D) mapping of cardiac arrhythmias has evolved in recent years to an important and extremely useful tool, providing important insights into arrhythmia mechanisms and thus improving ablation success rates, especially in complex arrhythmias. In atrial fibrillation (AF), the most common but also one of the most complex cardiac arrhythmias, progress in mapping technology has been focusing on several aspects according to the type of AF.In paroxysmal AF, important progress in the exact anatomic reconstruction of the main ablation target, i...
September 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30128725/heart-on-a-string-a-novel-approach-to-managing-difficult-access-to-the-left-pericardiacophrenic-vein-for-phrenic-nerve-stimulation
#10
Dennis Lawin, Bert Hansky, Philipp Baumann, Christoph Stellbrink
This case highlights the difficulties in pacing lead implantation for transvenous phrenic nerve stimulation to treat central sleep apnea in heart failure. Cannulation of the left pericardiacophrenic vein (PPV) initially failed due to vessel tortuosity. On the basis of sound knowledge of collateral vessels, the inferior phrenic vein (IPV), which drains into the inferior vena cava, was intubated using a guide catheter. A guidewire could be retrogradely advanced via the IPV to the left PPV and brachiocephalic vein...
September 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30105608/-noninvasive-mapping-for-catheter-ablation-of-arrhythmias-using-the-cardioinsight%C3%A2-ecg-vest
#11
REVIEW
Kay Weipert, Malte Kuniss, Thomas Neumann
BACKGROUND: CardioInsight™ is a noninvasive three-dimensional mapping system technology which offers a unique method for arrhythmia characterization and localization. With a 252-lead ECG vest on the patient's torso and a noncontrast CT scan, epicardial potentials are detected and by means of reconstruction algorithms activation and phase maps are created, offering a deeper understanding of localization and mechanisms of arrhythmias including atrial fibrillation without the need for an endocardial catheter...
September 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30094659/-coronary-sinus-mapping-of-the-optimal-lv-electrode-position
#12
REVIEW
Thomas Gaspar
Cardiac resynchronization therapy (CRT) is an established pillar of treatment for patients with chronic heart failure. However, 30% of patients do not respond adequately to this type of therapy. One possible reason for this is a nonoptimal left ventricular stimulation site. This review focuses on possibilities of visualization of the coronary vein anatomy and its role in the determination of the electrical and mechanical dyssynchrony to optimize the therapeutic success of the resynchronization therapy. In addition, the clinical implication and the perspectives of a dedicated mapping of the coronary vein are discussed...
September 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30083979/rotor-mapping-black-box-or-very-simple-the-firm-approach
#13
REVIEW
Stefan Georg Spitzer, László Károlyi, Carola Rämmler, Frank Scharfe, Mirko Zieschank, Anke Langbein
Catheter ablation has become the most common therapy in patients with atrial fibrillation (AF). However, despite significant advances in technology and operators' experience, ablation outcomes remain suboptimal, especially in patients with persistent AF. Focal impulse and rotor modulation (FIRM) represents a new technology for mapping and ablation of patient-specific AF sources. This approach is based on the concept of localized sources, which can be understood as organized rotational waves or focal impulses driving disorganized AF...
September 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30076446/-three-dimensional-mapping-special-aspects-and-new-features-of-carto%C3%A2
#14
REVIEW
Livio Bertagnolli, Federica Torri, Sergio Richter, Borislav Dinov, Andreas Müssigbrodt, Arash Arya, Philipp Sommer, Andreas Bollmann, Gerhard Hindricks, Sebastian Hilbert
The precise target location for radiofrequency energy delivery was initially determined through electrophysiological signals and with the help of fluoroscopy. The introduction of the 3D mapping system CARTO® (Biosense Webster Inc., Diamond Bar, CA, USA) in recent years for radiofrequency ablation of arrhythmias has provided new therapeutic options. These improvements have led to reduced procedural and fluoroscopic times. The introduction of new software and technology has also improved clinical outcome and helped to understand the substrate of complex arrhythmias...
September 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/30076445/-catheter-ablation-of-persistent-atrial-fibrillation-possibilities-of-dipole-density-mapping
#15
REVIEW
Christian Meyer, Stephan Willems
Voltage-based methods currently form the diagnostic and therapeutic basis of clinical cardiac electrophysiology. These include both noncontact-based approaches (e.g., body surface electrocardiogram) and established, contact-based 3D mapping systems. At the physiological level, voltage is the measure of an electric field that includes both the local and the sum of the surrounding activation sources. As a result, details of complex rhythm patterns like those observed in atrial fibrillation may be obscured. Dipole density mapping represents an alternative approach to detect and visualize the electrical activity of the heart...
September 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29876875/bradycardia-in-a-newborn
#16
Ismail Al Abri, Ghaliah Al Mohani, Carsten W Israel
No abstract text is available yet for this article.
June 6, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29904794/-syncope-update-2018
#17
EDITORIAL
Carsten W Israel, Malte Meesmann
No abstract text is available yet for this article.
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29904793/-tips-for-taking-the-medical-history-in-patients-with-syncope
#18
REVIEW
Carsten W Israel
Transient loss of consciousness represents one of the most frequent reasons for patients to present in the emergency room. Already at the very beginning, the diagnostic work-up is faced with fundamental questions: (1) Was it really a loss of consciousness? (2) Which department (neurology, cardiology, or others) should check the patient? (3) Is an in-hospital diagnostic work-up required? These questions can be answered from a meticulous patient history which needs to be adjusted to the individual case but also has to systematically go through a list of questions...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29845316/adenosine-hypersensitivity-and-atrioventricular-block
#19
REVIEW
Jean-Claude Deharo, Michele Brignole, Régis Guieu
Adenosine is a ubiquitous substance that is released under several physiological and pathological conditions and has cardiovascular effects including cardioinhibition and vasodilation. It has been shown to be an important modulator implicated in several forms of syncope. In patients with chronic low plasma levels of adenosine, a transient release of endogenous adenosine can be sufficient to block conduction in the atrioventricular node and induce prolonged asystole; conversely, when plasma adenosine levels are chronically high, adenosine release is responsible for vasodepression...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29802445/pacing-in-neurocardiogenic-vasovagal-syncope
#20
REVIEW
Richard Sutton
Pacing for neurocardiogenic or vasovagal syncope (VVS) has been practised for five decades, but the 1986 advent of tilt testing provided a means of diagnosis frequently revealing, in the early days, asystole caused by VVS. This was the basis for pacing these patients and the first studies created enthusiasm followed by randomised controlled trials, which were imperfectly designed, "confirming" benefit. When better trial design was employed, there was no obvious benefit. However, some cardiologists had seen patients experience a huge positive difference with pacing, so they set out to identify them...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
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