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https://www.readbyqxmd.com/read/28073882/the-role-of-superior-vena-cava-in-catheter-ablation-of-long-standing-persistent-atrial-fibrillation
#1
Kai Xu, Yuanlong Wang, Shaohui Wu, Li Zhou, Liang Zhao, Weifeng Jiang, Xiaodong Zhang, Xu Liu
AIMS: The superior vena cava (SVC) has been established as an important source of atrial fibrillation (AF). The role of SVC in long-standing persistent AF and the efficacy of empiric electrical isolation of the SVC are still unclear. The purpose of this study was to judge the role of SVC in catheter ablation of long-standing persistent AF. METHODS AND RESULTS: A total of 102 consecutive patients with long-standing persistent AF were enrolled. All patients underwent circumferential pulmonary vein isolation, complex fractionated atrial electrograms ablation, and linear ablation during the index procedure...
January 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28070820/development-of-a-new-catheter-prototype-for-laser-thrombolysis-under-guidance-of-optical-coherence-tomography-oct-validation-of-feasibility-and-efficacy-in-a-preclinical-model
#2
Rouven Berndt, Rene Rusch, Lars Hummitzsch, Matthias Lutz, Katharina Heß, Katharina Huenges, Bernd Panholzer, Christoph Otte, Assad Haneya, Georg Lutter, Alexander Schlaefer, Jochen Cremer, Justus Groß
In this feasibility study, a novel catheter prototype for laser thrombolysis under the guidance of optical coherence tomography (OCT) was designed and evaluated in a preclinical model. Human arteries and veins were integrated into a physiological flow model and occluded with thrombi made from the Chandler Loop. There were four experimental groups: placebo, 20 mg alteplase, laser, 20 mg alteplase + laser. The extent of thrombolysis was analyzed by weighing, OCT imaging and relative thrombus size. In the alteplase group, thrombus size decreased to 0...
January 9, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28069839/incidence-of-new-onset-atrial-fibrillation-after-cavotricuspid-isthmus-ablation-for-atrial-flutter
#3
Umut Celikyurt, Sven Knecht, Michael Kuehne, Tobias Reichlin, Aline Muehl, Florian Spies, Stefan Osswald, Christian Sticherling
AIMS: In patients with cavotricuspid isthmus (CTI) ablation for atrial flutter (AFL), the decision to hold oral anticoagulation (OAC) often becomes an issue. The purpose of this study was to describe the incidence of the development of atrial fibrillation (AF) after CTI ablation in patients with documented AFL with and without a previous history of AF and to identify risk predictors for the occurrence of AF after CTI. METHODS AND RESULTS: We included 364 consecutive patients undergoing successful CTI ablation...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28069837/high-sensitive-cardiac-troponin-t-as-a-novel-predictor-for-recurrence-of-atrial-fibrillation-after-radiofrequency-catheter-ablation
#4
Koki Nakanishi, Shota Fukuda, Hajime Yamashita, Toshifumi Hasegawa, Michihiko Kosaka, Naoya Shirai, Kenei Shimada, Junichi Yoshikawa, Atsushi Tanaka
AIMS: We aimed to determine whether elevated serum high-sensitive cardiac troponin T (hs-TnT) levels predict atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). METHODS AND RESULTS: We included 125 consecutive patients with AF (paroxysmal, n = 79; persistent, n = 46) who underwent first-time PVI. Serum hs-TnT, high-sensitive C-reactive protein (hs-CRP), atrial natriuretic peptide, and plasma B-type natriuretic peptide levels were measured in venous samples collected before PVI...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28065539/atlas-based-mosaicing-of-left-atrial-3-d-transesophageal-echocardiography-images
#5
Harriët W Mulder, Marijn van Stralen, Ben Ren, Alexander Haak, Max A Viergever, Johan G Bosch, Josien P W Pluim
Transesophageal echocardiography (TEE) is a promising imaging modality used to guide cardiac interventions, such as catheter ablation for the treatment of cardiac arrhythmias. These procedures rely on good visualization of the left atrium and pulmonary veins. To visualize these structures in a single volume, the acquisition, registration and fusion of multiple TEE views of the left atrium are required. We introduce atlas-based mosaicing as a method for the registration of images that are acquired according to a standardized protocol...
January 5, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28064250/novel-method-for-electrode-tissue-contact-measurement-with-multi-electrode-catheters
#6
René van Es, John Hauck, Vincent Jhm van Driel, Kars Neven, Harry van Wessel, Pieter A Doevendans, Fred Hm Wittkampf
AIMS: With multi-electrode catheters, measuring contact force (CF) on each electrode is technically challenging. Present electrical methods, like the electrical coupling index (ECI) may yield false positive values in pulmonary veins. We developed a novel method that measures electrode-interface resistance (IR) by applying a very local electrical field between neighbouring catheter electrodes while measuring voltage between each catheter electrode and a skin patch. The aim of this study was to evaluate the new IR method to measure electrode-tissue contact...
January 6, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28063269/novel-mapping-technique-for-localization-of-focal-and-reentrant-activation-during-atrial-fibrillation
#7
Yoshihide Takahashi, Shinsuke Iwai, Syu Yamashita, Mayumi Masumura, Masahito Suzuki, Kento Yabe, Yasuhiro Sato, Kenzo Hirao, Mitsuaki Isobe
INTRODUCTION: Identification of wavefront propagation pattern during AF remains challenging in ablation procedures. We sought to test a novel combination of a new mapping technology called Ripple Map and high density mapping to distinguish focal and reentrant activation during atrial fibrillation (AF). METHODS AND RESULTS: Subjects were patients undergoing ablation for persistent AF. If AF remained after isolation of the pulmonary veins, the left atrium (LA) was mapped by a high-density mapping catheter for later analysis, after which ablation was continued using a conventional stepwise approach...
January 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28063111/comparison-of-catheter-ablation-for-paroxysmal-atrial-fibrillation-between-cryoballoon-and-radiofrequency-a-meta-analysis
#8
REVIEW
Chao-Feng Chen, Xiao-Fei Gao, Xu Duan, Bin Chen, Xiao-Hua Liu, Yi-Zhou Xu
PURPOSE: The present systematic review and meta-analysis aimed to assess and compare the safety and efficacy of radiofrequency (RF) and cryoballoon (CB) ablation for paroxysmal atrial fibrillation (PAF). RF and CB ablation are two frequently used methods for pulmonary vein isolation in PAF, but which is a better choice for PAF remains uncertain. METHODS: A systematic review was conducted in Medline, PubMed, Embase, and Cochrane Library. All trials comparing RF and CB ablation were screened and included if the inclusion criteria were met...
January 7, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28056580/utility-of-adjunctive-digital-subtraction-venography-for-the-treatment-of-saphenous-vein-insufficiency
#9
Ramon L Varcoe, Shannon D Thomas, Victor Bourke, Nicole M K Rübesamen, Andrew F Lennox
PURPOSE: To report the use of adjunctive venography for the treatment of superficial venous reflux. METHODS: Two hundred consecutive patients (mean age 60.9 years, range 33-86; 128 women) with chronic venous disease underwent saphenous or perforator vein ablation in 268 limbs (305 venous trunks) guided by adjunctive venography and fluoroscopy in addition to ultrasound between October 2010 and May 2016. Intraprocedural venograms were independently evaluated by 2 vascular specialists to identify the presence of venous anomalies and the need for fluoroscopy-guided maneuvers to successfully complete venous ablation...
January 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28054738/radiofrequency-catheter-ablation-targeting-the-vein-of-marshall-in-difficult-mitral-isthmus-ablation-or-pulmonary-vein-isolation
#10
Ji Hyun Lee, Gi-Byoung Nam, Minsu Kim, You Mi Hwang, Jongmin Hwang, Jun Kim, Kee-Joon Choi, You-Ho Kim
INTRODUCTION: The ligament of Marshall may hinder the creation of mitral isthmus (MI) block or pulmonary vein (PV) isolation (PVI) in radiofrequency (RF) catheter ablation of atrial fibrillation (AF). We aimed to assess the benefit of RF ablation targeting the vein of Marshall (VOM) in failed cases of MI block or PVI. METHODS AND RESULTS: We reviewed the medical records of patients who underwent RF ablation targeting the VOM after failed MI ablation or left PVI using the conventional method, which included circumferential point-by-point ablation around the PV antrum and carina, or endocardial MI and epicardial distal coronary sinus (CS) ablation for MI block...
January 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28054729/comparison-of-the-efficacy-of-empiric-thoracic-vein-isolation-for-the-treatment-of-paroxysmal-and-persistent-atrial-fibrillation-in-patients-without-structural-heart-disease
#11
Koichiro Ejima, Ryuta Henmi, Yuji Iwanami, Daigo Yagishita, Morio Shoda, Nobuhisa Hagiwara
INTRODUCTION: The guidelines suggest that an adjuvant substrate modification in addition to pulmonary vein isolation (PVI) may be needed for persistent atrial fibrillation (PerAF) assuming that catheter ablation is less successful for PerAF than paroxysmal AF (PAF). To revisit the above assumption, we compared the outcome of the same catheter ablation strategy between PAF and PerAF. METHODS AND RESULTS: Two-hundred and thirty-three consecutive patients (mean age 60±10 years, 53 PerAF and 8 long-lasting PerAF) without structural heart disease underwent catheter ablation of AF by the same strategy using an empiric thoracic vein isolation (a wide circumferential PVI plus empiric superior vena cava isolation) as a major part of the strategy without any adjuvant substrate modification...
January 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28054727/direct-comparison-of-point-by-point-and-rapid-ultra-high-resolution-electroanatomical-mapping-in-patients-scheduled-for-ablation-of-atrial-fibrillation
#12
Laura Rottner, Andreas Metzner, Feifan Ouyang, Christian Heeger, Kentaro Hayashi, Thomas Fink, Christine Lemes, Shibu Mathew, Tilman Maurer, Bruno REIßMANN, Enida Rexha, Johannes Riedl, Ardan M Saguner, Francesco Santoro, Karl-Heinz Kuck, Christian Sohns
INTRODUCTION: 3D electroanatomical mapping (EAM) is an established tool facilitating catheter ablation. In this context the novel Rhythmia system sets a new bar in fast high-resolution mapping. The aim of this study was to directly compare point-by-point versus rapid ultra high-resolution EAM in patients scheduled for ablation of atrial fibrillation (AF) with focus on procedural data, acute success and mid-term clinical outcome. METHODS AND RESULTS: A total number of 74 consecutive patients (48/74 male) with symptomatic AF were scheduled to undergo pulmonary vein isolation (PVI) using either Carto or Rhythmia...
January 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28054377/left-atrial-substrate-modification-targeting-low-voltage-areas-for-catheter-ablation-of-atrial-fibrillation-a-systematic-review-and-meta-analysis
#13
REVIEW
Alessandro Blandino, Francesca Bianchi, Stefano Grossi, Giuseppe Biondi-Zoccai, Maria Rosa Conte, Luca Gaido, Fiorenzo Gaita, Marco Scaglione, Francesco Rametta
BACKGROUND: This meta-analysis aims to assess the impact of a voltage-guided substrate modification by targeting low-voltage area (LVA) in addition to pulmonary vein isolation (PVI) in patients undergoing catheter ablation for atrial fibrillation (AF). METHODS: MEDLINE/PubMed, Cochrane Library and references reporting AF ablation and 'voltage* OR substrate* OR fibrosis OR fibrotic area* were screened and studies included if matching inclusion and exclusion criteria...
January 5, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28054365/mapping-for-acute-transvenous-phrenic-nerve-stimulation-study-maps-study
#14
Lukas R C Dekker, Bart Gerritse, Avram Scheiner, Lilian Kornet
AIMS: Central Sleep Apnea Syndrome, correlated with the occurrence of heart failure, is characterized by periods of insufficient ventilation during sleep. This acute study in 15 patients aims to map the venous system and determine, if diaphragmatic movement can be achieved by phrenic nerve stimulation at various locations within the venous system. METHODS: Subjects underwent a scheduled catheter ablation procedure. During the procedural waiting time, one multi-electrode EP catheter was subsequently placed at the the superior and inferior vena cava and the junctions of the left jugular and left brachiocephalic vein and right jugular and right brachiocephalic vein, for phrenic nerve stimulation (1-2 seconds ON / 2-3 seconds OFF, 40 Hz, pulse width 210 μs)...
January 5, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28054100/total-absence-of-pulmonary-vein-potentials-in-a-patient-with-paroxysmal-atrial-fibrillation-was-it-really-isolated
#15
Kenichi Yokoyama, Seigo Yamashita, Kenichi Tokutake, Ryohsuke Narui, Mika Kato, Shinichi Tanigawa, Michifumi Tokuda, Keiichi Inada, Seiichiro Matsuo, Kenri Shibayama, Satoru Miyanaga, Michihiro Yoshimura, Teiichi Yamane
We herein present a case (72 years, male) with total absence of pulmonary veins (PVs) potentials at the beginning of the first procedure for paroxysmal atrial fibrillation (AF), demonstrating dormant conduction between the left atrium and all PVs revealed by adenosine triphosphate provocation with relation to the incidence of AF. He was free from atrial arrhythmias during 1 year follow-up after complete PV isolation with the elimination of multiple transient dormant conductions by circular mapping catheter guide ablation...
January 4, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28050474/technique-efficiency-and-safety-of-different-nerve-blocks-for-analgesia-in-laser-ablation-and-sclerotherapy-for-lower-limb-superficial-venous-insufficiency-a-multicentre-experience
#16
Krishna Prasad Premnath Bellam, Binu Joy, Abhilash Sandhyala, Kiran Naiknaware, Brijesh Ray, Vijayakumar
INTRODUCTION: Laser ablation and sclerotherapy, as minimally invasive alternatives to surgery for varicose veins, have good efficacy, safety and cosmetic result. Some form of anaesthesia is generally used for pain control. AIM: To describe the technique and evaluate the efficacy and safety of femoral, saphenous and sciatic nerve blocks in isolation or in combination for analgesia during laser ablation and sclerotherapy for lower limb varicose veins. MATERIALS AND METHODS: In this prospective observational study, over a period of 33 months, in 856 limbs of 681 patients with varicose veins, ultrasound guided femoral, saphenous and sciatic nerve blocks for analgesia were performed in 769, 808 and 52 instances respectively; following which, endovenous laser ablation, sclerotherapy or combination of both were carried out using standard practice...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049923/unexpected-electrical-isolation-of-the-superior-vena-cava-during-radiofrequency-hot-balloon-ablation-in-the-right-superior-pulmonary-vein
#17
Hiro Yamasaki, Toru Adachi, Yuki Komatsu, Kenji Kuroki, Yukio Sekiguchi, Akihiko Nogami, Kazutaka Aonuma
No abstract text is available yet for this article.
December 28, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28043211/comparison-of-heat-induced-damage-at-the-saphenofemoral-junction-after-ablation-with-1-470-nm-laser-or-radiofrequency
#18
Evren Ozcinar, Mehmet Cakici, Oktay Korun, Unsal Han, Ugursay Kiziltepe
BACKGROUND: The aim of this study was to evaluate the heat induced damage at the saphenofemoral junction level according to histopathological changes after radiofrequency or 1,470 nm radial tip laser ablation. PATIENTS AND METHODS: Varicose vein segments of 6-10 mm in diameter were exposed to radiofrequency (Closure Fast catheter, 7 cm heat segment, one cycle, 15 seconds, 10 Watt, 120 °C) or laser ablation (1,470 nm radial tip, continuous wave, vein diameter: 6 cm/8 cm/10 cm-power: 10 Watt-pullback speed: 2...
January 3, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28040291/substantial-superiority-of-niobe-es-over-niobe-ii-system-in-remote-controlled-magnetic-pulmonary-vein-isolation
#19
Antoine Da Costa, Jean Baptiste Guichard, Nicolas Maillard, Cécile Romeyer-Bouchard, Antoine Gerbay, Karl Isaaz
BACKGROUND: Catheter ablation of atrial fibrillation (AFib) primarily relies upon pulmonary vein isolation (PVI), but such procedures are associated with significant X-ray exposure. The newer Epoch system has been developed so as to enable more precise magnetic navigation whilst limiting X-ray exposure. OBJECTIVES: This study was aimed at quantifying both exposure time and X-ray reduction with the newer Epoch system compared to Niobe II during AFib ablation procedures...
December 22, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28039924/focal-impulse-and-rotor-modulation-for-the-treatment-of-atrial-fibrillation-locations-and-one-year-outcomes-of-human-rotors-identified-using-a-64-electrode-basket-catheter
#20
Roland Richard Tilz, Tina Lin, Andreas Rillig, Christian-H Heeger, Leonie Scholz, Peter Wohlmuth, Tudor Bucur, Andreas Metzner, Shibu Mathew, Erik Wissner, Feifan Ouyang, Karl-Heinz Kuck
INTRODUCTION: Pulmonary vein isolation (PVI) is currently the gold standard for catheter ablation of atrial fibrillation (AF). The mechanism for AF-maintenance is still controversial. The concept of rapidly-activating spiral rotors perpetuating AF has led to the development of several rotor-mapping systems. We present our experience with focal impulse and rotor modulation (FIRM) using a 64-electrode basket catheter and computational system and evaluate its feasibility in conjunction with PVI to treat AF...
December 31, 2016: Journal of Cardiovascular Electrophysiology
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