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JACC. Clinical Electrophysiology

Margo Batie, Sarah Bitant, Janette F Strasburger, Vishal Shah, Orang Alem, Ronald T Wakai
No abstract text is available yet for this article.
February 2018: JACC. Clinical Electrophysiology
Tarek Zghaib, Ali Keramati, Jonathan Chrispin, Dong Huang, Muhammad A Balouch, Luisa Ciuffo, Ronald D Berger, Joseph E Marine, Hiroshi Ashikaga, Hugh Calkins, Saman Nazarian, David D Spragg
Background: Bipolar voltage mapping, as part of atrial fibrillation (AF) ablation, is traditionally performed in a point-by-point (PBP) approach using single-tip ablation catheters. Alternative techniques for fibrosis-delineation include fast-anatomical mapping (FAM) with multi-electrode circular catheters, and late gadolinium-enhanced magnetic-resonance imaging (LGE-MRI). The correlation between PBP, FAM, and LGE-MRI fibrosis assessment is unknown. Objective: In this study, we examined AF substrate using different modalities (PBP, FAM, and LGE-MRI mapping) in patients presenting for an AF ablation...
January 2018: JACC. Clinical Electrophysiology
Hubert Cochet, Rémi Dubois, Seigo Yamashita, Nora Al Jefairi, Benjamin Berte, Jean-Marc Sellal, Darren Hooks, Antonio Frontera, Sana Amraoui, Adlane Zemoura, Arnaud Denis, Nicolas Derval, Frederic Sacher, Olivier Corneloup, Valérie Latrabe, Stéphanie Clément-Guinaudeau, Jatin Relan, Sohail Zahid, Patrick M Boyle, Natalia A Trayanova, Olivier Bernus, Michel Montaudon, François Laurent, Mélèze Hocini, Michel Haïssaguerre, Pierre Jaïs
OBJECTIVES: This study sought to assess the relationship between fibrosis and re-entrant activity in persistent atrial fibrillation (AF). BACKGROUND: The mechanisms involved in sustaining re-entrant activity during AF are poorly understood. METHODS: Forty-one patients with persistent AF (age 56 ± 12 years; 6 women) were evaluated. High-resolution electrocardiographic imaging (ECGI) was performed during AF by using a 252-chest electrode array, and phase mapping was applied to locate re-entrant activity...
January 2018: JACC. Clinical Electrophysiology
Shohreh Honarbakhsh, Richard J Schilling, Gurpreet Dhillon, Waqas Ullah, Emily Keating, Rui Providencia, Anthony Chow, Mark J Earley, Ross J Hunter
Objectives: This study sought to use a novel panoramic mapping system (CARTOFINDER) to detect and characterize drivers in persistent atrial fibrillation (AF). Background: Mechanisms sustaining persistent AF remain uncertain. Methods: Patients undergoing catheter ablation for persistent AF were included. A 64-pole basket catheter was used to acquire unipolar signals, which were processed by the mapping system to generate wavefront propagation maps...
January 2018: JACC. Clinical Electrophysiology
Ethan J Anderson, Jimmy T Efird, Andy C Kiser, Patricia B Crane, Wesley T O'Neal, T Bruce Ferguson, Hazaim Alwair, Kendal Carter, J Mark Williams, Anil K Gehi, Alan P Kypson
OBJECTIVES: This study sought to determine whether plasma catecholamines and monoamine oxidase-B (MOA-B) are associated with post-operative atrial fibrillation (POAF) in patients undergoing elective cardiac surgery. BACKGROUND: Although intra- and post-operative adrenergic tone has been demonstrated to be an causative factor for POAF, the role and association of pre-operative plasma catecholamines remains unclear. METHODS: Prior to administration of anesthesia on the morning of surgery, blood samples were obtained from 324 patients undergoing nonemergent coronary artery bypass graft and/or aortic valve surgery with cardiopulmonary bypass at East Carolina Heart Institute...
December 11, 2017: JACC. Clinical Electrophysiology
David Vidmar, David E Krummen, Justin Hayase, Sanjiv M Narayan, Gordon Ho, Wouter-Jan Rappel
Objectives: The objective of this study was to evaluate the spatio-temporal organization and progression of human ventricular fibrillation (VF) in the left (LV) and right (RV) ventricles. Background: Studies suggest that localized sources contribute to VF maintenance, but the evolution of VF episodes has not been quantified. Methods: Synchrony between electrograms recorded from 25 patients with induced VF is computed and used to define the Asynchronous Index (ASI), indicating regions which are out-of-step with surrounding tissue...
December 11, 2017: JACC. Clinical Electrophysiology
Lingjin Meng, Chi-Hong Tseng, Kalyanam Shivkumar, Olujimi Ajijola
BACKGROUND: The efficacy of percutaneous stellate ganglion block (SGB) for managing electrical storm (ES) is not well understood. OBJECTIVE: To characterize the efficacy of SGB as a treatment for ES. METHODS: We conducted literature searches using PubMed/Medline and Google Scholar, for mixed combinations of terms including "stellate ganglion block", *ganglion block (ade)", "sympathetic block (ade)" and "arrhythmia", "ventricular arrhythmia (VA)" or "tachycardia" (VT), "ventricular fibrillation" (VF), "electrical storm"...
September 2017: JACC. Clinical Electrophysiology
Steven E Williams, Nick W F Linton, James Harrison, Henry Chubb, John Whitaker, Jaswinder Gill, Christopher A Rinaldi, Reza Razavi, Steven Niederer, Matthew Wright, Mark O'Neill
OBJECTIVES: This study sought to characterize direction-dependent and coupling interval-dependent changes in left atrial conduction and electrogram morphology in uniformly classified patients with paroxysmal atrial fibrillation (AF) and normal bipolar voltage mapping. BACKGROUND: Although AF classifications are based on arrhythmia duration, the clinical course, and treatment response vary between patients within these groups. Electrophysiological mechanisms responsible for this variability are incompletely described...
September 2017: JACC. Clinical Electrophysiology
Junjie Zhang, Mélèze Hocini, Maria Strom, Phillip S Cuculich, Daniel H Cooper, Frédéric Sacher, Michel Haïssaguerre, Yoram Rudy
Background: The early repolarization (ER) pattern is a common ECG finding. Recent studies established a definitive clinical association between ER and fatal ventricular arrhythmias. However, the arrhythmogenic substrate of ER in the intact human heart has not been characterized. Objectives: To map the epicardial electrophysiological (EP) substrate in ER syndrome patients using noninvasive Electrocardiographic Imaging (ECGI), and to characterize substrate properties that support arrhythmogenicity...
August 2017: JACC. Clinical Electrophysiology
Dawood Darbar, Mark McCauley
No abstract text is available yet for this article.
July 2017: JACC. Clinical Electrophysiology
Tarvinder S Dhanjal, Nicolas Lellouche, Christopher J von Ruhland, Guillaume Abehsira, David H Edwards, Jean-Luc Dubois-Randé, Konstantinos Moschonas, Emmanuel Teiger, Alan J Williams, Christopher H George
OBJECTIVES: In this study the authors determined the extent of cellular infiltration and dispersion, and regional vascularization in electrophysiologically (EP) defined zones in post-myocardial infarction (MI) swine ventricle. BACKGROUND: The critical isthmus (CI) in post-MI re-entrant ventricular tachycardia (VT) is a target for catheter ablation. In vitro evidence suggests that myofibroblasts (MFB) within the scar border zone (BZ) may increase the susceptibility to slow conduction and VT, but whether this occurs in vivo remains unproven...
July 2017: JACC. Clinical Electrophysiology
Ammar M Killu, Niyada Naksuk, Zdeněk Stárek, Christopher V DeSimone, Faisal F Syed, Prakriti Gaba, Jiří Wolf, Frantisek Lehar, Martin Pesl, Pavel Leinveber, Michal Crha, Dorothy Ladewig, Joanne Powers, Scott Suddendorf, David O Hodge, Gaurav Satam, Miroslav Novák, Tomas Kara, Charles J Bruce, Paul A Friedman, Samuel J Asirvatham
INTRODUCTION: Epicardial defibrillation systems currently require surgical access. We aimed to develop a percutaneous defibrillation system with partially-insulated epicardial coils to focus electrical energy on the myocardium and prevent or minimize extra-cardiac stimulation. METHODS: We tested 2 prototypes created for percutaneous introduction into the pericardial space via a steerable sheath. This included a partially-insulated defibrillation coil and a defibrillation mesh with a urethane balloon acting as an insulator to the face of the mesh not in contact with the epicardium...
July 2017: JACC. Clinical Electrophysiology
Brian J Hansen, Jichao Zhao, Vadim V Fedorov
Recent studies strongly suggest that the majority of atrial fibrillation (AF) patients with diagnosed or subclinical cardiac diseases have established or even pre-existing fibrotic structural remodeling, which may lead to conduction abnormalities and reentrant activity that sustain AF. As conventional treatments fail to treat AF in far too many cases, an urgent need exists to identify specific structural arrhythmogenic fibrosis patterns, which may maintain AF, in order to identify effective ablation targets for AF treatment...
June 2017: JACC. Clinical Electrophysiology
Anuj Basil, Steven A Lubitz, Peter A Noseworthy, Matthew R Reynolds, Howard Gold, David Yassa, Daniel Kramer
No abstract text is available yet for this article.
June 2017: JACC. Clinical Electrophysiology
Dileep Raman, Farhad Kaffashi, Li-Yung Lui, William H Sauer, Susan Redline, Peter Stone, Peggy M Cawthon, Katie L Stone, Kristine E Ensrud, Sonia Ancoli-Israel, Kenneth Loparo, Reena Mehra
BACKGROUND: Autonomic dysfunction contributes to atrial fibrillation (AF). OBJECTIVE: We hypothesized that polysomnogram (PSG)-based heart rate variability (HRV) autonomic function biomarkers are associated with incident AF and these associations are modified by measures of sleep disordered breathing (SDB). METHODS: 2350 participants of a multi-center prospective study (Outcomes of Sleep Disorders in Older Men Study) without baseline AF underwent sleep studies with incident adjudicated AF follow up (8...
May 2017: JACC. Clinical Electrophysiology
Bence Patocskai, Namsik Yoon, Charles Antzelevitch
OBJECTIVES: This study sought to test the hypothesis that elimination of sites of abnormal repolarization, via epicardial RFA, suppresses the electrocardiographic and arrhythmic manifestations of BrS. BACKGROUND: Brugada syndrome (BrS) is associated with ventricular tachycardia and ventricular fibrillation leading to sudden cardiac death. Nademanee et al. reported that radiofrequency ablation (RFA) of right ventricular outflow tract epicardium significantly reduced the electrocardiogram and arrhythmic manifestations of BrS...
April 2017: JACC. Clinical Electrophysiology
Junaid A B Zaman, Tina Baykaner, Paul Clopton, Vijay Swarup, Robert C Kowal, James P Daubert, John D Day, John Hummel, Amir A Schricker, David E Krummen, Moussa Mansour, Gery F Tomassoni, Kevin R Wheelan, Mohan Vishwanathan, Shirley Park, Paul J Wang, Sanjiv M Narayan, John M Miller
INTRODUCTION: The role of atrial fibrillation (AF) substrates is unclear in patients with paroxysmal AF (PAF) that recurs after pulmonary vein isolation (PVI). We hypothesized that patients with recurrent post-ablation (redo) PAF despite PVI have electrical substrates marked by rotors and focal sources, and structural substrates that resemble persistent AF more than patients with (de novo) PAF at first ablation. METHODS: In 175 patients at 11 centers, we compared AF substrates in both atria using 64 pole-basket catheters and phase mapping, and indices of anatomical remodeling between patients with de novo or redo PAF and first ablation for persistent AF...
April 2017: JACC. Clinical Electrophysiology
Wayne C Levy, Yanhong Li, Shelby D Reed, Michael R Zile, Ramin Shadman, Todd Dardas, David J Whellan, Kevin A Schulman, Stephen J Ellis, Matthew Neilson, Christopher M O'Connor
BACKGROUND: Prediction of which heart failure patients are most likely to die of sudden death vs. non-sudden death is an important factor in determining who will benefit the most from an ICD. OBJECTIVE: We developed the Seattle Proportional Risk Model (SPRM) to estimate the proportion of total mortality due to sudden death. We prospectively validated the model in HF-ACTION and tested whether the ICD benefit varied with the SPRM. METHODS: Among 2331 patients enrolled, 1947 patients were retained for analysis over a median follow-up of 2...
March 2017: JACC. Clinical Electrophysiology
Jonathan M Behar, Hui Men Selina Chin, Steve Fearn, Julian O M Ormerod, James Gamble, Paul W X Foley, Julian Bostock, Simon Claridge, Tom Jackson, Manav Sohal, Antonios P Antoniadis, Reza Razavi, Tim R Betts, Neil Herring, Christopher Aldo Rinaldi
OBJECTIVES: The objective of this study was to evaluate the cost-effectiveness of quadripolar versus bipolar cardiac resynchronization defibrillator therapy systems. BACKGROUND: Quadripolar left ventricular (LV) leads for cardiac resynchronization therapy reduce phrenic nerve stimulation (PNS) and are associated with reduced mortality compared with bipolar leads. METHODS: A total of 606 patients received implants at 3 UK centers (319 Q, 287 B), between 2009 and 2014; mean follow-up was 879 days...
February 2017: JACC. Clinical Electrophysiology
James E Tisdale, Heather A Jaynes, Brian R Overholser, Kevin M Sowinski, David A Flockhart, Richard J Kovacs
OBJECTIVES: We tested the hypothesis that oral progesterone administration attenuates drug-induced QT interval lengthening. BACKGROUND: Evidence from preclinical and human investigations suggests that higher serum progesterone concentrations may be protective against drug-induced QT interval lengthening. METHODS: In this prospective, double-blind, crossover study, 19 healthy female volunteers (21-40 years) were randomized to receive progesterone 400 mg or matching placebo orally once daily for 7 days timed to the menses phase of the menstrual cycle (between-phase washout period = 49 days)...
December 2016: JACC. Clinical Electrophysiology
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