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https://www.readbyqxmd.com/read/27922849/renal-denervation-for-uncontrolled-hypertension-critical-review-of-the-evidence
#1
Chongjia Chen, Ashish Upadhyay
PURPOSE OF REVIEW: Hypertension (HTN) is a major global public health problem. Endovascular catheter-based radiofrequency ablation of renal sympathetic nerve endings (renal denervation) is a novel treatment option for uncontrolled HTN. RECENT FINDINGS: Early clinical studies primarily in Australia and Europe established renal denervation as a well tolerated and feasible procedure that resulted in a sustained reduction in blood pressure among individuals with severe resistant HTN...
December 2, 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27920837/temporal-sinus-node-modification-by-high-dose-continuous-intravenous-administration-of-landiolol-in-a-patient-with-persistent-inappropriate-sinus-tachycardia
#2
Yuichi Hori, Shiro Nakahara, Naofumi Anjo, Yoshihiko Sakai, Isao Taguchi
A 20-year-old woman underwent an electrophysiological study for drug-resistant persistent inappropriate sinus tachycardia (IST). Use of a high-dose continuous intravenous administration of landiolol, a short-acting beta-adrenoreceptor blocker, made the patient׳s heart rate suddenly drop with a slight change in the P-wave morphology. Three-dimensional right atrial (RA) activation mapping revealed that the earliest activation site moved 8 mm to a lower anterior site around the high lateral RA. Radiofrequency energy applied to the earliest activation site during tachycardia was successful...
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27920836/successful-cryoballoon-pulmonary-vein-isolation-in-a-patient-with-situs-inversus-and-dextrocardia
#3
Yasuhiro Yoshiga, Akihiko Shimizu, Takeshi Ueyama, Makoto Ono, Tomoko Fumimoto, Hironori Ishiguchi, Masafumi Yano
A 79-year-old man with situs inversus and dextrocardia underwent catheter ablation of symptomatic paroxysmal atrial fibrillation. Pulmonary vein isolation (PVI), using second-generation cryoballoon under Ensite NavX system guidance, was performed successfully in a reverse manner, which required short procedure and fluoroscopy times, as required in a PVI performed on a normal heart without any complications. Cryoballoon-based PVI under Ensite NavX guidance was feasible and safe to achieve a favorable outcome in this patient with abnormal anatomy...
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27920835/atriofascicular-pathway-detection-with-novel-ablation-catheter
#4
Padmanabhan Shakkottai, Adrian Baranchuk, Neil Hobson, Jane Caldwell
Atriofascicular pathways are a rare cause of antidromic atrioventricular reciprocating tachycardia. The IntellaTip MiFi ablation catheter (Boston Scientific, MA, USA) is a novel ablation catheter that allows enhanced signal clarity with highly localized electrograms. This is the first report of this catheter being successfully used to map and ablate the atriofascicular pathway potentials.
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27920830/impact-of-catheter-ablation-of-ventricular-tachycardia-in-patients-with-prior-myocardial-infarctions
#5
Masato Fukunaga, Masahiko Goya, Kenichi Hiroshima, Kentaro Hayashi, Masatsugu Ohe, Yu Makihara, Michio Nagashima, Yoshimori An, Shinichi Shirai, Kenji Ando, Hiroyoshi Yokoi, Masashi Iwabuchi
BACKGROUND: Catheter ablation can reduce episodes of ventricular tachycardia (VT) after myocardial infarction (MI). However, the optimal endpoint of the ablation procedure remains unclear. METHODS: Fifty-one consecutive patients who received catheter ablation for VT after MI were included. The procedures targeted the isthmus of all the induced, sustained VTs. When the patients with induced VTs were hemodynamically stable, radiofrequency energy was delivered at the mid-diastolic potential recording site during VT...
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27920827/catheter-ablation-of-anteroseptal-accessory-pathways-from-the-aortic-cusps-a-case-series-and-a-review-of-the-literature
#6
REVIEW
Konstantinos P Letsas, Michael Efremidis, Konstantinos Vlachos, Stamatis Georgopoulos, Nikolaos Karamichalakis, Athanasios Saplaouras, Sotirios Xydonas, Kosmas Valkanas, Antonios Sideris
Data regarding catheter ablation of anteroseptal accessory pathways through the aortic cusps are limited. We describe two cases of true para-Hisian accessory pathways successfully ablated from the aortic cusps (right coronary cusp and non-coronary cusp, respectively) along with a review of the current literature. Due to the close proximity to the atrioventricular node and the high risk of complication, mapping of the aortic cusps should always be considered in the case of anteroseptal accessory pathways. Anteroseptal accessory pathways can be safely and effectively ablated from the aortic cusps with good long-term outcomes...
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27920450/catheter-ablation-for-ventricular-tachycardia-in-patients-with-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy-a-systematic-review-and-meta-analysis
#7
H Jiang, X -L Zhang, Q -L Yang, S -H Zhu, H -S Yu, B Xu, W Huang
No abstract text is available yet for this article.
2016: Acta Cardiologica
https://www.readbyqxmd.com/read/27919764/postoperative-atrial-tachycardias-following-mitral-valve-surgery-mechanisms-and-outcomes-of-catheter-ablation
#8
Andres Enriquez, Pasquale Santangeli, Erica Zado, Jackson Liang, Simon Castro, Fermin Garcia, Robert Schaller, Gregory Supple, David Frankel, David Callans, David Lin, Sanjay Dixit, Rajat Deo, Michael Riley, Francis Marchlinski
BACKGROUND: Atrial tachycardias (ATs) including atrial fibrillation (AF) are common arrhythmias late after mitral valve (MV) surgery and their management is challenging. OBJECTIVE: To determine the electrophysiological mechanisms of ATs in patients with prior MV surgery and the long-term outcomes of catheter ablation. METHODS: We studied 67 consecutive patients (age 59.4±10.6 years, 41 male) with a history of MV surgery who presented with ATs post-operatively between 2007-2015...
December 2, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27917710/peri-procedural-anticoagulation-in-catheter-ablation-for-atrial-fibrillation-a-review
#9
Dimitrios A Vrachatis, Georgios Giannopoulos, Charalambos Kossyvakis, Panagopoulou Vasiliki, Manolis Vavuranakis, Theodore G Papaioannou, Stamatina Pagoni, Vlasios N Pyrgakis, Michael W Cleman, Spyridon G Deftereos
Catheter ablation for rhythm control in atrial fibrillation has been recognized as an established treatment. Patients with atrial fibrillation suffer from an increased risk from thromboembolic events. Long-term stroke risk and mortality has been shown to be reduced after catheter ablation, still the procedure per se is associated with an additive peri-procedural thromboembolic risk. Maintenance of the thrombotic - bleeding equilibrium in such patients during interventional procedures is compelling. Lack of data from randomized studies along with the recent introduction of novel oral anticoagulants in clinical practice has resulted in a wide variance of antithrombotic treatment approaches...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27916745/transcatheter-non-contact-microwave-ablation-may-enable-circumferential-renal-artery-denervation-while-sparing-the-vessel-intima-and-media
#10
Pierre C Qian, Michael A Barry, Sara Al-Raisi, Pramesh Kovoor, Jim Pouliopoulos, Chrishan Nalliah, Abhishek Bhaskaran, William Chik, Rahul Kurup, Virginia James, Winny Varikatt, Alistair McEwan, Aravinda Thiagalingam, Stuart P Thomas
AIMS: Trials of transcatheter renal artery denervation (RDN) have failed to show consistent antihypertensive efficacy. Procedural factors and limitations of radiofrequency ablation can lead to incomplete denervation. We hypothesized that non-contact microwave catheter ablation could produce deep circumferential perivascular heating while avoiding the renal artery intima and media injury. METHOD AND RESULTS: A novel microwave catheter was designed and tested in a renal artery model consisting layers of phantom materials embedded with a thermochromic liquid crystal sheet, colour range 50-78°C...
December 6, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27916416/dosimetric-feasibility-of-ablative-dose-escalated-focal-monotherapy-with-mri-guided-high-dose-rate-hdr-brachytherapy-for-prostate-cancer
#11
Ali Hosni, Marco Carlone, Alexandra Rink, Cynthia Ménard, Peter Chung, Alejandro Berlin
PURPOSE: To determine the dosimetric feasibility of dose-escalated MRI-guided high-dose-rate brachytherapy (HDR-BT) focal monotherapy for prostate cancer (PCa). METHODS: In all patients, GTV was defined with mpMRI, and deformably registered onto post-catheter insertion planning MRI. PTV included the GTV plus 9mm craniocaudal and 5mm in every other direction. In discovery-cohort, plans were obtained for each PTV independently aiming to deliver ⩾16.5Gy/fraction (two fraction schedule) while respecting predefined organs-at-risk (OAR) constraints or halted when achieved equivalent single-dose plan (24Gy)...
December 1, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27915264/three-dimensional-rotational-angiography-of-the-left-atrium-and-the-oesophagus-the-short-term-mobility-of-the-oesophagus-and-the-stability-of-the-fused-three-dimensional-model-of-the-left-atrium-and-the-oesophagus-during-catheter-ablation-for-atrial-fibrillation
#12
Zdenek Starek, Frantisek Lehar, Jiri Jez, Martin Scurek, Jiri Wolf, Tomas Kulik, Alena Zbankova, Miroslav Novak
AIMS: The objective of this study was to evaluate the mobility of the oesophagus and the stability of the three-dimensional (3D) model of the oesophagus using 3D rotational angiography (3DRA) of the left atrium (LA) and the oesophagus, fused with live fluoroscopy during catheter ablation for atrial fibrillation. METHODS AND RESULTS: From March 2015 to September 2015, 3DRA of the LA and the oesophagus was performed in 33 patients before catheter ablation for atrial fibrillation...
December 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27915262/procedural-outcomes-of-fluoroless-catheter-ablation-outside-the-traditional-catheterization-lab
#13
Amee M Bigelow, Philip C Smith, Dylan T Timberlake, Neil L McNinch, Grace L Smith, John R Lane, John M Clark
AIMS: Non-fluoroscopic catheter ablation is becoming routine. In experienced centres, fluoroscopy is rarely required. The use of a traditional catheterization lab (cath lab) may no longer be necessary. We began performing catheter ablations at a paediatric centre outside the traditional cardiac cath lab in 2013. The purpose of this study was to compare procedural features of paediatric catheter ablation performed outside the cath lab to those performed within a cath lab. METHODS AND RESULTS: We prospectively looked at patients presenting to the paediatric centre with supraventricular tachycardia (SVT) undergoing catheter ablation outside the cath lab in a standard operating room (OR group)...
December 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27913399/development-of-time-and-voltage-domain-mapping-v-t-mapping-to-localize-ventricular-tachycardia-channels-during-sinus-rhythm
#14
Sachin Nayyar, Pawel Kuklik, Anand N Ganesan, Thomas R Sullivan, Lauren Wilson, Glenn D Young, Prashanthan Sanders, Kurt C Roberts-Thomson
BACKGROUND: In ventricular scar, impulse spread is slow because it traverses split and zigzag channels of surviving muscle. We aimed to evaluate scar electrograms to determine their local delay (activation time) and inequality in voltage splitting (entropy), and their relationship to channels. We reasoned that unlike innocuous channels, which are often short with multiple side branches, ventricular tachycardia (VT) supporting channels have very slow impulse spread and possess low entropy because of their longer protected length and relative lack of side-branching...
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27910092/management-of-atrial-fibrillation-in-elderly-adults
#15
Yaanik Desai, Mikhael F El-Chami, Angel R Leon, Faisal M Merchant
Driven in large part by the aging of the population and the increasing prevalence of cardiovascular comorbidities associated with atrial fibrillation (AF), there is a burgeoning epidemic of AF in elderly adults. Although there is a large body of literature to guide management of people with AF, elderly adults with AF are frequently underrepresented in clinical trials. This review provides a contemporary update on management of elderly adults with AF with a particular focus on the two main clinical challenges that AF poses: stroke risk reduction and control of symptoms...
December 2, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27910083/radiofrequency-catheter-ablation-of-accessory-pathways-in-patients-with-ebstein-s-anomaly-at-8-years-of-follow-up
#16
Michał Orczykowski, Paweł Derejko, Robert Bodalski, Piotr Urbanek, Joanna Zakrzewska-Koperska, Radosław Sierpiński, Katarzyna Kalin, Andrzej Hasiec, Grzegorz Warmiński, Maria Miszczak-Knecht, Katarzyna Bieganowska, Rafał Baranowski, Maria Bilińska, Elżbieta Biernacka, Piotr Hoffman, Łukasz Szumowski
BACKGROUND: Data regarding long-term follow-up of radiofrequency catheter ablation (RFCA) of accessory pathways (APs) in patients with Ebstein's anomaly (EA) are limited. The procedures are challenging due to multiple or wide APs. METHODS: Analysis was performed on clinical and periprocedural data of patients with EA referred to the centre in order to perform catheter ablation of accessory pathway (AP). The group consisted of 22 patients (female 40.9%, mean age 33...
December 2, 2016: Cardiology Journal
https://www.readbyqxmd.com/read/27909521/recurrent-atrial-fibrillation-after-catheter-ablation-considerations-for-repeat-ablation-and-strategies-to-optimize-success
#17
REVIEW
Andrew E Darby Md Fhrs
Recurrent AF after catheter ablation occurs in at least 20 to 40% of patients. Repeat ablation is primarily considered for those with symptomatic AF recurrences (often drug-refactory) occurring at least 3 months or more post-ablation. Pulmonary vein reconnection is almost universally encountered, and repeat isolation of electrically connected pulmonary veins should be the primary ablation strategy. Beyond repeat PVI and possible ablation of non-PV triggers, there is little to no evidence that additional substrate modification improves outcomes...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909520/surgical-ablation-of-atrial-fibrillation-is-electrical-isolation-of-the-pulmonary-veins-a-must
#18
REVIEW
Bart Maesen Md PhD, Ines Van Loo Md, Laurent Pison Md PhD, Mark La Meir Md PhD
Ablation of atrial fibrillation (AF) is a well-established treatment option for patients with symptomatic AF refractory to antiarrhythmic drugs. The cornerstone of catheter ablation is electrical isolation of the pulmonary veins, since the pulmonary veins are the most common location for triggers of AF. Electrical reconnection of the pulmonary veins is associated with arrhythmia recurrence and therefore diminishes long-term success of catheter ablation of AF. Therefore, durable pulmonary vein isolation remains a condition sine qua non for catheter ablation of AF...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909513/assessment-of-sinoatrial-node-function-in-patients-with-persistent-and-long-standing-persistent-forms-of-atrial-fibrillation-after-maze-iii-procedure-combined-with-mitral-valve-operation
#19
Kulikov Aleksei A, Bokeria Leo A
RESEARCH OBJECTIVE: Assessment of sinoatrial node function after Maze III procedure combined with a mitral valve operation. METHODS: 100 patients were included in the research with persistent and long-standing persistent forms of atrial fibrillation (AF) and need of operative treatment concerning valve disease. The following preoperative preparation methods were executed to all patients: Electrocardiogram in 12 standard assignments;Two-dimensional echocardiographic with assessment of systolic and diastolic functions of the left ventricle, size of the left atrium and grade of valve disease;Transesophageal echocardiography for exclusion of blood clots in the left atrium and left atrial appendage;Coronary angiography for exclusion of coronary heart disease;Computer tomography for examination of cardiac chambers and anatomic characteristics of pulmonary veins...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909510/interactive-in-vitro-training-in-physics-of-radiofrequency-ablation-for-physicians-and-medical-engineering-students
#20
REVIEW
Haber T, Kleister G, Selman B, Härtig J, Melichercik J, Ismer B
Radiofrequency (RF) ablation requires a complex set of devices as well as profound electrophysiological experience and substantial knowledge of physical science basics. To establish RF ablation in-vitro teaching-system, six workstations were equipped with computer-controlled RF ablation generators. Universal connection boxes allow ablation-essays with catheters of different make and model. Special wetlabs were developed combining a basin containing isotonic saline solution with a thermostat and a pump to simulate blood flow...
June 2016: Journal of Atrial Fibrillation
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