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Circulation. Arrhythmia and Electrophysiology

Jim W Cheung, Ilhwan Yeo, James E Ip, George Thomas, Christopher F Liu, Steven M Markowitz, Bruce B Lerman, Luke K Kim
BACKGROUND: Patients undergoing catheter ablation of myocardial infarction-associated ventricular tachycardia (VT) have significant comorbidities that can increase the risks of adverse outcomes. The rates of readmissions after VT ablation are unknown. We sought to examine in-hospital outcomes, costs, and 30-day readmissions after catheter ablation of myocardial infarction-associated VT. METHODS: Using the Nationwide Readmissions Database, we evaluated 4109 admissions for catheter ablation of myocardial infarction-associated VT occurring between 2010 and 2015...
November 2018: Circulation. Arrhythmia and Electrophysiology
Tomofumi Nakamura, Giovanni E Davogustto, Benjamin Schaeffer, Shinichi Tanigawa, Rahul G Muthalaly, Arvindh Kanagasundram, Roy M John, Gregory F Michaud, Usha B Tedrow, William G Stevenson
BACKGROUND: Percutaneous pericardial access for catheter ablation is associated with a bleeding risk. We sought to elucidate the relation of hemorrhagic and thromboembolic events associated with epicardial procedures to anticoagulation strategy. METHODS: Anticoagulation strategy before and during pericardial access for 355 patients (57±14 years old) who had ventricular arrhythmia mapping and ablation were reviewed. Oral anticoagulants were stopped perioperatively and heparin administered before the procedure...
November 2018: Circulation. Arrhythmia and Electrophysiology
Kedar K Aras, Ndeye Rokhaya Faye, Brianna Cathey, Igor R Efimov
BACKGROUND: Abnormal QT intervals, long QT or short QT, have been epidemiologically linked with sudden cardiac death because of ventricular fibrillation (VF). Consequently, Food and Drug Administration recommends testing all pharmacological agents for QT toxicity as a risk factor for cardiac toxicity. Such tests assess QT/QTc interval, which represents ventricular depolarization and repolarization. However, the current QT toxicity analysis does not account for the well-known anisotropy in cardiac tissue conductivity...
November 2018: Circulation. Arrhythmia and Electrophysiology
Thomas Deneke, Karin Nentwich, Artur Berkovitz, Kai Sonne, Elena Ene, Borche Pavlov, Franziska Fochler, Anne-Katrin Bötsch, Rainer Kuhn, Philipp Halbfaß
BACKGROUND: Endoscopically detected thermal esophageal lesions (EDEL) after ablation of atrial fibrillation may be precursors of atrioesophageal fistula and esophageal luminal temperature monitoring has previously failed to decrease thermal damage. METHODS: Sixty-three patients undergoing their first pulmonary vein isolation using radiofrequency point-by-point catheter ablation were prospectively included in the HEAT-AF study (High-Resolution Esophageal Assessment of Esophageal Temperature During Atrial Fibrillation Ablation) and esophageal temperatures were continuously monitored using a novel infrared thermography system (IRTS)...
November 2018: Circulation. Arrhythmia and Electrophysiology
Matthew C Hyman, David J Callans
No abstract text is available yet for this article.
October 2018: Circulation. Arrhythmia and Electrophysiology
(no author information available yet)
No abstract text is available yet for this article.
October 2018: Circulation. Arrhythmia and Electrophysiology
Ahmet Adiyaman, Thomas J Buist, Rypko J Beukema, Jaap Jan J Smit, Peter Paul H M Delnoy, Martin E W Hemels, Hauw T Sie, Anand R Ramdat Misier, Arif Elvan
BACKGROUND: Current guidelines recommend both percutaneous catheter ablation (CA) and surgical ablation in the treatment of atrial fibrillation, with different levels of evidence. No direct comparison has been made between minimally invasive thoracoscopic pulmonary vein isolation with left atrial appendage ligation (surgical MIPI) versus percutaneous CA comprising of pulmonary vein isolation as primary treatment of atrial fibrillation. We, therefore, conducted a randomized controlled trial comparing the safety and efficacy of these 2 treatment modalities...
October 2018: Circulation. Arrhythmia and Electrophysiology
Virginie Dubes, David Benoist, François Roubertie, Stephen H Gilbert, Marion Constantin, Sabine Charron, Delphine Elbes, Delphine Vieillot, Bruno Quesson, Hubert Cochet, Michel Haïssaguerre, Caroline Rooryck, Pierre Bordachar, Jean-Benoit Thambo, Olivier Bernus
BACKGROUND: Ventricular arrhythmias are frequent in patients with repaired tetralogy of Fallot (rTOF), but their origin and underlying mechanisms remain unclear. In this study, the involvement of left ventricular (LV) electrical and structural remodeling was assessed in an animal model mimicking rTOF sequelae. METHODS: Piglets underwent a tetralogy of Fallot repair-like surgery (n=6) or were sham operated (Sham, n=5). Twenty-three weeks post-surgery, cardiac function was assessed in vivo by magnetic resonance imaging...
October 2018: Circulation. Arrhythmia and Electrophysiology
Piotr Podziemski, Stef Zeemering, Pawel Kuklik, Arne van Hunnik, Bart Maesen, Jos Maessen, Harry J Crijns, Sander Verheule, Ulrich Schotten
BACKGROUND: Several recent studies suggest rotors detected by phase mapping may act as main drivers of persistent atrial fibrillation. However, the electrophysiological nature of detected rotors remains unclear. We performed a direct, 1:1 comparison between phase and activation time mapping in high-density, epicardial, direct-contact mapping files of human atrial fibrillation. METHODS: Thirty-eight unipolar electrogram files of 10 s duration were recorded in patients with atrial fibrillation (n=20 patients) using a 16×16 electrode array placed on the epicardial surface of the left atrial posterior wall or the right atrial free wall...
October 2018: Circulation. Arrhythmia and Electrophysiology
Meera Varshneya, Ryan A Devenyi, Eric A Sobie
BACKGROUND: The slow and rapid delayed rectifier K+ currents (IKs and IKr , respectively) are responsible for repolarizing the ventricular action potential (AP) and preventing abnormally long APs that may lead to arrhythmias. Although differences in biophysical properties of the 2 currents have been carefully documented, the respective physiological roles of IKr and IKs are less established. In this study, we sought to understand the individual roles of these currents and quantify how effectively each stabilizes the AP and protects cells against arrhythmias across multiple species...
October 2018: Circulation. Arrhythmia and Electrophysiology
Daniel A Duprez, Susan R Heckbert, Alvaro Alonso, Myron D Gross, Joachim H Ix, Jorge R Kizer, Russell P Tracy, Richard Kronmal, David R Jacobs
BACKGROUND: Atrial fibrosis is a hallmark of structural remodeling in atrial fibrillation (AF). Plasma procollagen type III N-terminal propeptide (PIIINP) reflects collagen synthesis and degradation while collagen type I carboxy-terminal telopeptide (ICTP) reflects collagen degradation. We aimed to study baseline plasma PIIINP and ICTP and their associations with incident AF in participants initially free of overt cardiovascular disease. METHODS: In a stratified sample of the Multi-Ethnic Study of Atherosclerosis, initially aged 45-84 years, 3071 participants had both PIIINP and ICTP measured at baseline...
October 2018: Circulation. Arrhythmia and Electrophysiology
Ruairidh Martin, Philippe Maury, Caterina Bisceglia, Tom Wong, Heidi Estner, Christian Meyer, Corentin Dallet, Claire A Martin, Rui Shi, Masateru Takigawa, Anne Rollin, Antonio Frontera, Nathaniel Thompson, Takeshi Kitamura, Konstantinos Vlachos, Michael Wolf, Ghassen Cheniti, Josselin Duchâteau, Grégoire Massoulié, Thomas Pambrun, Arnaud Denis, Nicolas Derval, Mélèze Hocini, Paolo Della Bella, Michel Haïssaguerre, Pierre Jaïs, Rémi Dubois, Frédéric Sacher
BACKGROUND: Ventricular tachycardia (VT) with structural heart disease is dependent on reentry within scar regions. We set out to assess the VT circuit in greater detail than has hitherto been possible, using ultra-high-density mapping. METHODS: All ultra-high-density mapping guided VT ablation cases from 6 high-volume European centers were assessed. Maps were analyzed offline to generate activation maps of tachycardia circuits. Topography, conduction velocity, and voltage of the VT circuit were analyzed in complete maps...
October 2018: Circulation. Arrhythmia and Electrophysiology
Michael Barkagan, Markus Rottmann, Eran Leshem, Changyu Shen, Alfred E Buxton, Elad Anter
BACKGROUND: Radiofrequency ablation using irrigated catheters is performed using a power-controlled mode. However, lesion size is dependent on current delivery at a particular impedance, such that a power value alone may not reflect actual energy delivery, resulting in lesion size variability at similar power settings. We hypothesized that modulating baseline impedance at fixed power settings affects ablation lesion dimensions. METHODS: In 20 ex vivo swine hearts, radiofrequency ablation was performed using an irrigated catheter at a fixed power setting of 30 W per 20 seconds and a multistepped impedance load (100-210Ω)...
October 2018: Circulation. Arrhythmia and Electrophysiology
Richard Ang, Svetlana Mastitskaya, Patrick S Hosford, Marina Basalay, Mark Specterman, Qadeer Aziz, Yiwen Li, Michele Orini, Peter Taggart, Pier D Lambiase, Andrey Gourine, Andrew Tinker, Alexander V Gourine
BACKGROUND: Glucagon-like peptide-1 receptor (GLP-1R) agonists improve cardiovascular outcomes in patients with type 2 diabetes mellitus. However, systemic actions of these agents cause sympathetic activation, which is generally considered to be detrimental in cardiovascular disease. Despite significant research interest in cardiovascular biology of GLP-1, the presence of GLP-1R in ventricular cardiomyocytes remains a controversial issue, and the effects of this peptide on the electrical properties of intact ventricular myocardium are unknown...
October 2018: Circulation. Arrhythmia and Electrophysiology
Yang Liu, Feng Wang, Xin Chen, Yingcong Liang, Hai Deng, Hongtao Liao, Fang Rao, Wei Wei, Qianhuan Zhang, Bin Zhang, Xianzhang Zhan, Xianhong Fang, Sandeep Nair, Michael Shehata, Xunzhang Wang, Yumei Xue, Shulin Wu
No abstract text is available yet for this article.
September 2018: Circulation. Arrhythmia and Electrophysiology
Atsushi Hirayama, Tadahiro Goto, Yuichi J Shimada, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
Background Although emerging evidence has suggested the relationship of chronic obstructive pulmonary disease with atrial fibrillation (AF), little is known about whether acute exacerbation of chronic obstructive pulmonary disease (AECOPD) increases the risk of repeated AF-related healthcare utilization. Methods This is a self-controlled case series study using the population-based emergency department (ED) and inpatient databases of 5 US states from 2007 through 2012. Among patients with existing AF, we identified patients with an AECOPD hospitalization and at least 1 ED visit or hospitalization for AF during the observation period...
September 2018: Circulation. Arrhythmia and Electrophysiology
Namsik Yoon, Bence Patocskai, Charles Antzelevitch
BACKGROUND: Early repolarization syndrome (ERS) is an inherited cardiac arrhythmia syndrome associated with sudden cardiac death. Approaches to therapy are currently very limited. This study probes the mechanisms underlying the electrocardiographic and arrhythmic manifestation of experimental models of ERS and of the ameliorative effect of radiofrequency ablation. METHODS: Action potentials, bipolar electrograms, and transmural pseudo-ECGs were simultaneously recorded from coronary-perfused canine left ventricular wedge preparations (n=11)...
September 2018: Circulation. Arrhythmia and Electrophysiology
Parikshit S Sharma, Angela Naperkowski, Terry D Bauch, Joseph Y S Chan, Ahran D Arnold, Zachary I Whinnett, Kenneth A Ellenbogen, Pugazhendhi Vijayaraman
Background Cardiac resynchronization therapy utilizing biventricular pacing is an effective therapy for patients with left ventricular (LV) systolic dysfunction, left bundle branch block, and heart failure. Benefits of biventricular pacing may be limited in patients with right bundle branch block (RBBB). Permanent His bundle pacing (HBP) has recently been reported as an option for cardiac resynchronization therapy. The aim of the study was to assess the feasibility and outcomes of HBP in patients with RBBB and heart failure...
September 2018: Circulation. Arrhythmia and Electrophysiology
Shankar Baskar, Haikun Bao, Karl E Minges, David S Spar, Richard J Czosek
Background Implantable cardioverter defibrillators (ICDs) are an important part of therapy for many patients, yet there is little data on population characteristics, complications, or system survival in pediatric patients. Methods A retrospective review of ICD recipients in the National Cardiovascular Data Registry ICD Registry was performed from 2010 to 2016. Patient characteristics and complications between pediatric (≤21 years) and adult populations (>21 years) were compared. Variables associated with complications and early device interventions within the pediatric cohort were evaluated using multivariate modeling...
September 2018: Circulation. Arrhythmia and Electrophysiology
Justine Bhar-Amato, Malcolm Finlay, Diogo Santos, Michele Orini, Sanjay Chaubey, Vishal Vyas, Peter Taggart, Andrew A Grace, Christopher L-H Huang, Ron Ben Simon, Andrew Tinker, Pier D Lambiase
Background We explored the hypothesis that increased cholinergic tone exerts its proarrhythmic effects in Brugada syndrome (BrS) through increasing dispersion of transmural repolarization in patients with spontaneous and drug-induced BrS. Methods BrS and supraventricular tachycardia patients were studied after deploying an Ensite Array in the right ventricular outflow tract and a Cardima catheter in the great cardiac vein to record endo and epicardial signals, respectively. S1 -S2 restitution curves from the right ventricular apex were conducted at baseline and after edrophonium challenge to promote increased cholinergic tone...
September 2018: Circulation. Arrhythmia and Electrophysiology
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