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Catheter ablation

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https://www.readbyqxmd.com/read/29149500/ep-radiofrequency-generators-significant-offsets-between-selected-and-delivered-power
#1
Felix Bourier, Bernhard Schwarz, Amir Brkic, Lara Wolf, Verena Semmler, Marc Kottmaier, Elena Risse, Marta Telishevska, Stephanie Brooks, Sarah Lengauer, Marielouise Kornmayer, Katharina Koch-Büttner, Florian Berger, Gabriele Hessling, Isabel Deisenhofer, Tilko Reents
INTRODUCTION: For radiofrequency ablation, the EP Shuttle®, Ampere®, and SmartAblate® generator models are most frequently used in clinical practice. The aim of this study was to assess the correlation between selected and delivered RF power for different generators. METHODS AND RESULTS: In an experimental setup, ablation catheters were connected to the EP Shuttle®, Ampere®, and SmartAblate® generators. The power delivered by the generators was measured using a current converter and an oscilloscope...
November 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29147788/dissociated-pulmonary-vein-activity-after-cryoballoon-ablation-and-radiofrequency-ablation-for-atrial-fibrillation-a-propensity-score-matched-analysis
#2
Kenichi Tokutake, Michifumi Tokuda, Seiichiro Matsuo, Ryota Isogai, Kenichi Yokoyama, Mika Kato, Ryohsuke Narui, Shinichi Tanigawa, Seigo Yamashita, Satoru Miyanaga, Michihiro Yoshimura, Teiichi Yamane
Cryoballoons (CBs) have proven to be effective for achieving pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Dissociated PV activity (DPVA) after successful radiofrequency PVI is sometimes observed inside the PV and has been found to prove the achievement of electrical disconnection from the left atrium. However, little is known about the incidence or characteristics of DPVA after CB-PVI. The aim of this study was to compare the incidence and characteristics of DPVA in patients undergoing CB and radiofrequency (RF) ablation for AF...
November 17, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29147720/anticoagulation-in-atrial-fibrillation-current-evidence-and-guideline-recommendations
#3
J W Erath, S H Hohnloser
Atrial fibrillation (AF) is the most frequently encountered sustained arrhythmia with a prevalence of 0.5-10%, depending predominantly on age. The arrhythmia is associated with significant morbidity and mortality, mainly due to thromboembolic events including stroke and systemic embolisms. These complications can be effectively prevented with anticoagulation therapy either with vitamin K antagonists (VKA) or with non-vitamin K antagonists (NOAC). VKA therapy is effective in preventing strokes but these medications are difficult to use, are associated with significant bleeding risk, and have pharmacokinetic/dynamic properties that make their use cumbersome...
November 17, 2017: Herz
https://www.readbyqxmd.com/read/29146378/association-of-p-wave-duration-index-with-atrial-fibrillation-recurrence-after-cryoballoon-catheter-ablation
#4
Onur Kaypakli, Hasan Koca, Durmuş Yıldıray Şahin, Sefa Okar, Fadime Karataş, Mevlüt Koç
AIM: We aimed to investigate the relationship between the recurrence of AF and P wave duration index (PWDI) in patients with nonvalvular PAF. METHODS: We included 114 patients who underwent cryoballoon catheter ablation with the diagnosis of paroxysmal atrial fibrillation (PAF) (55 male, 59 female; mean age 55.5±10,9years). PWDI was calculated by dividing the Pwd by the PR interval in DII lead of 12‑lead ECG. Patients had regular follow-up visits with 12-lead ECG, medical history and clinical evaluation...
October 9, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29145517/which-patients-recur-as-atrial-tachycardia-rather-than-atrial-fibrillation-after-catheter-ablation-of-atrial-fibrillation
#5
Pil-Sung Yang, Young-Ah Park, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
INTRODUCTION: The ablation gaps have been known as the main mechanism of recurrence as atrial tachycardia (AT) rather than atrial fibrillation (AF) after AF catheter ablation. However, AF organization due to reduction of critical mass or focal trigger may also be the mechanism of AT recurrence. We sought to find out the main clinical factors of recurrence as AT rather than AF after AF ablation in the absence of antiarrhythmic drug effect. METHODS: We analyzed 521 patients (70...
2017: PloS One
https://www.readbyqxmd.com/read/29145303/epicardial-radiofrequency-catheter-ablation-of-brugada-syndrome-with-electrical-storm-during-ventricular-fibrillation-a-case-report
#6
Shufen Jiang, Xiaomeng Yin, Chang Dong, Yunlong Xia, Jinqiu Liu
RATIONALE: Brugada syndrome (BrS) is characterized by ST segment elevation at the J point ≥2 mm in the right precordial electrocardiogram (ECG) leads, in the absence of structural heart disease, electrolyte disturbances, or ischemia. It is a well-described cause of sudden death in young patients, especially in the age of between 30 and 40 years old. Here, we reported an unusual case of electrical storm (ES) of ventricular fibrillation (VF) caused by BrS with complete right bundle-branch block (CRBBB) in a 75-year-old male patient...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145266/catheter-ablation-of-ventricular-arrhythmia-originating-from-isolated-outflow-tract-diverticulum-two-case-reports-and-literature-review
#7
Xinbin Zhou, Haibin Xu, Zhijun Wang
RATIONALE: Congenital ventricular diverticulum is a rare cardiac malformation with a prevalence of about 0.26% in unselected adult patients during other diagnostic procedures. Ventricular arrhythmia originating from outflow tract diverticulum is even rarer and its etiology, epidemiology and proper treatment still remain controversial. PATIENT CONCERNS: We present 2 cases of isolated outflow tract diverticulum incidentally revealed by cardiac angiography during catheter ablation for ventricular arrhythmia...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144514/catheter-ablation-of-atrial-fibrillation-in-elderly-population
#8
Josef Kautzner, Petr Peichl, Marek Sramko, Robert Cihak, Bashar Aldhoon, Dan Wichterle
Background: Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinical benefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volume center focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods: Consecutive patients who underwent catheter ablation for AF between January 2001 and December 2016 were analysed...
September 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29140463/anatomic-investigation-of-the-trajectory-for-stereotactic-laser-amygdalohippocampectomy
#9
Vanessa M Holanda, Abuzer Gungor, Serhat Baydin, Erik H Middlebrooks, Shabbar F Danish
BACKGROUND: Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) has emerged as a promising treatment for mesial temporal lobe epilepsy. Surgeons must understand the relevant anatomy that is traversed by the catheter and affected by ablation. OBJECTIVE: To study the anatomic structures crossed by the LITT catheter until it reaches the amygdala. METHODS: Three human cadaveric heads were implanted with catheters using a frameless stereotactic technique...
November 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29138585/a-comparative-analysis-of-clinical-outcomes-and-disposable-costs-of-different-catheter-ablation-methods-for-the-treatment-of-atrioventricular-nodal-reentrant-tachycardia
#10
Adam E Berman, Harold Rivner, Robin Chalkley, Vahé Heboyan
Background: Catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) is a commonly performed electrophysiology (EP) procedure. Few data exist comparing conventional (CONV) versus novel ablation strategies from both clinical and direct cost perspectives. We sought to investigate the disposable costs and clinical outcomes associated with three different ablation methodologies used in the ablation of AVNRT. Methods: We performed a retrospective review of AVNRT ablations performed at Augusta University Medical Center from 2006 to 2014...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29138409/predicting-the-origin-of-ventricular-arrhythmia-using-acoustic-cardiography
#11
Chin-Yu Lin, Shih-Lin Chang, Yenn-Jiang Lin, Li-Wei Lo, Yu-Feng Hu, Tze-Fan Chao, Fa-Po Chung, Ta-Chuan Tuan, Jo-Nan Liao, Yao-Ting Chang, Abigail Louise D Te, Shinya Yamada, Hao-Min Cheng, Shih-Hsien Sung, Ling Kuo, Hsing-Yuan Li, Ting-Yung Chang, Hoang Quang Minh, Simon Salim, Ting-Chung Huang, Shih-Ann Chen
This study aimed to examine the relationship between measurements related to heart sounds and the origin of ventricular arrhythmia. We retrospectively evaluated 45 patients undergoing catheter ablation with contemporaneous digital acoustic cardiography of the first heart sound (S1) and the second heart sound (S2). The patients with baseline wide QRS morphology (>120 ms or aberrant conduction), heart failure, valvular heart disease, chronic pulmonary disease, and obesity were excluded. Ventricular arrhythmias from the left ventricle had an increased S1 complexity score and S1 duration in comparison to adjacent sinus beats...
November 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#12
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29138142/catheter-ablation-of-idiopathic-left-posterior-fascicular-ventricular-tachycardia-predicting-the-site-of-origin-via-mapping-and-electrocardiography
#13
Wei Ma, Fengmin Lu, Michael Shehata, Xunzhang Wang, Fan Zhang, Bingwei Chen, Dongyan Wu, Le He, Shan Sun, Aijuan Cheng, Jun Ding, Hongliang Cong, Jing Xu
BACKGROUND: We report the 12-lead ECG morphology of left posterior fascicular ventricular tachycardia (LPF-VT) and the relationship between His-ventricular (HV) interval and site of origin in LPF-VT. METHODS AND RESULTS: We studied 41 patients who underwent successful catheter ablation of LPF-VT with HV interval >0 ms (n=8; proximal-LPF group), HV interval 0 to -15 ms (n=15; middle-LPF group), and HV interval <-15 ms (n=18; distal-LPF group). The earliest mapped presystolic potential (PP)-QRS interval was 34...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29135523/targeting-nonpulmonary-vein-triggers-during-atrial-fibrillation-ablation-is-the-game-worth-the-candle
#14
Ahmed AlTurki, Howard J Marshall, Riccardo Proietti
PURPOSE OF REVIEW: Triggers for atrial fibrillation are found outside the pulmonary veins in 12-20% of cases. The role of addressing these triggers during catheter ablations has not been well defined. Therefore, the aim of this review is to summarize the effect of ablation of nonpulmonary vein triggers in addition to pulmonary vein isolation across the spectrum of atrial fibrillation in patients receiving catheter ablation. RECENT FINDINGS: In paroxysmal atrial fibrillation, an inducible nonpulmonary vein trigger is an independent predictor of recurrence...
November 10, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29134434/fluoroscopy-free-af-ablation-using-transesophageal-echocardiography-and-electroanatomical-mapping-technology
#15
Benjamin O'Brien, Damian C Balmforth, Ross J Hunter, Richard J Schilling
PURPOSE: Guidelines recommend that radiation exposure during AF catheter ablation procedures should be 'as low as reasonably achievable' (ALARA), particularly since many patients may have multiple procedures. Consequently, avoiding radiation exposure altogether must, if safe to do so, be the ultimate goal. The primary objective was to determine the feasibility and efficacy of fluoroscopy-free AF ablation compared to the fluoroscopy-assisted procedure. METHODS: Patients underwent AF ablation using commercially available technology with no routine pre-procedural imaging...
November 14, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29133182/a-novel-method-for-localization-and-ablation-of-conduction-gaps-after-wide-antral-circumferential-ablation-of-pulmonary-veins
#16
Raoul Bacquelin, Raphaël P Martins, Nathalie Behar, Vincent Galand, Baptiste Polin, Jonathan Lacaze, Frédéric Sebag, Christophe Leclercq, Jean-Claude Daubert, Philippe Mabo, Dominique Pavin
BACKGROUND: Atrial fibrillation ablation is often performed by achieving pulmonary vein isolation using the "wide antral circumferential ablation" (WACA) technique, but many pulmonary veins remain connected because of conduction gaps in the ablation line. AIM: To analyse the efficacy of a novel technique based on pacing manoeuvres to detect gaps in an initial WACA lesion. METHODS: Patients referred for radiofrequency atrial fibrillation ablation were enrolled prospectively...
November 10, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29131442/increased-rates-of-atrial-fibrillation-recurrence-following-pulmonary-vein-isolation-in-overweight-and-obese-patients
#17
Bhradeev Sivasambu, Muhammad A Balouch, Tarek Zghaib, Rizma J Bajwa, Jonathan Chrispin, Ronald D Berger, Hiroshi Ashikaga, Saman Nazarian, Joseph E Marine, Hugh Calkins, David D Spragg
INTRODUCTION: Catheter ablation is common for patients with symptomatic, drug-refractory atrial fibrillation (AF). Obesity is a known risk factor for incident AF. The impact of obesity on AF ablation outcomes is incompletely understood. We sought to determine the impact of elevated body mass index (BMI) on pulmonary vein isolation (PVI) procedural outcomes and associated complications. METHODS AND RESULTS: We evaluated patients undergoing PVI from 2001 to 2015, dividing them into four groups: normal weight (BMI ≥ 18...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29131434/five-year-impact-of-catheter-ablation-for-atrial-fibrillation-in-patients-with-a-prior-history-of-stroke
#18
T Jared Bunch, Heidi T May, Tami L Bair, Brian G Crandall, Michael J Cutler, John D Day, Victoria Jacobs, Charles Mallender, Jeffrey S Osborn, J Peter Weiss
BACKGROUND: Catheter ablation of atrial fibrillation(AF) is an established therapeutic rhythm approach. Patients with a prior history of a stroke(CVA) represent a unique high-risk population for recurrent thromboembolic events. The role of antiarrhythmic treatment on the natural history of stroke recurrence in these patients is not fully understood. METHODS: Three patient groups with a prior CVA and 5 years of follow-up were matched 1:3:3 by propensity score(±0...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29129259/comparison-of-prevalence-and-management-of-left-atrial-appendage-thrombi-under-old-and-new-anticoagulants-prior-to-left-atrial-catheter-ablation
#19
Antoine Da Costa, Clarisse Delolme, Jean Baptiste Guichard, Antoine Gerbay, Romain Pierrard, Cécile Romeyer-Bouchard, Karl Isaaz
BACKGROUND: The prevalence and management of left atrial appendage (LAA) thrombi associated with new anticoagulants remain to be elucidated, especially prior to atrial fibrillation (AFib) ablation. This study sought to (1) compare the prevalence of LAA thrombi and/or severe LAA contrast under vitamin K antagonist (VKA) agents and novel oral anticoagulants (NOACs), (2) evaluate the rate of LAA thrombus resolution after anticoagulation modification, and (3) determine the predictive factors of LAA thrombi and severe LAA contrast in patients prior to LA AFib ablation...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29125704/left-atrial-ejection-force-predicts-the-outcome-after-catheter-ablation-for-paroxysmal-atrial-fibrillation
#20
Hideyuki Kishima, Takanao Mine, Satoshi Takahashi, Kenki Ashida, Masaharu Ishihara, Tohru Masuyama
INTRODUCTION: Left atrium (LA) systolic dysfunction is observed in the early stages of atrial fibrillation (AF) prior to LA anatomical change. We investigated whether LA systolic dysfunction predicts recurrent AF after catheter ablation (CA) in patients with paroxysmal AF. METHODS AND RESULTS: We studied 106 patients who underwent CA for paroxysmal AF. LA systolic function was assessed with the LA emptying volume = Maximum LA volume (LAVmax) - Minimum LA volume (LAVmin), LA emptying fraction = [(LAVmax - LAVmin) / LAVmax] × 100, and LA ejection force calculated with Manning`s method [LA ejection force = (0...
November 10, 2017: Journal of Cardiovascular Electrophysiology
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