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Catheter ablation

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https://www.readbyqxmd.com/read/29342299/benefit-of-left-atrial-appendage-electrical-isolation-for-persistent-and-long-standing-persistent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#1
Jorge Romero, Gregory F Michaud, Ricardo Avendano, David F Briceño, Saurabh Kumar, Juan Carlos Diaz, Sanghamitra Mohanty, Chintan Trivedi, Carola Gianni, Domenico Della Rocca, Riccardo Proietti, Laura Perrotta, Stefano Bordignon, Julian K R Chun, Boris Schmidt, Mario Garcia, Andrea Natale, Luigi Di Biase
Aims: The long-term outcomes of left atrial appendage electrical isolation (LAAEI) in patients with non-paroxysmal atrial fibrillation (AF) have corroborated the significant role of the LAA in this arrhythmia. We sought to investigate the incremental benefit of LAAEI in patients undergoing catheter ablation for persistent AF or long-standing persistent AF (LSPAF). Methods and results: A systematic review of Medline, Cochrane, and Embase for all the clinical studies in which assessment LAAEI in non-paroxysmal AF patients was performed...
January 12, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29341322/isthmus-sites-identified-by-ripple-mapping-are-usually-anatomically-stable-a-novel-method-to-guide-atrial-substrate-ablation
#2
Vishal Luther, Norman Qureshi, Phang Boon Lim, Michael Koa-Wing, Shahnaz Jamil-Copley, Fu Siong Ng, Zachary Whinnett, D Wyn Davies, Nicholas S Peters, Prapa Kanagaratnam, Nick Linton
BACKGROUND: Post ablation reentrant ATs depend upon conducting isthmuses bordered by scar. Bipolar voltage maps highlight scar as sites of low voltage, but the voltage amplitude of an electrogram depends upon the myocardial activation sequence. Furthermore, a voltage threshold that defines atrial scar is unknown. We used Ripple Mapping (RM) to test whether these isthmuses were anatomically fixed between different activation vectors and atrial rates. METHODS: We studied post-AF ablation ATs where > 1 rhythm was mapped...
January 17, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29340161/direct-ice-imaging-from-inside-the-left-atrial-appendage-during-ablation-of-persistent-atrial-fibrillation
#3
Gabriel Cismaru, Mihai Puiu, Radu Rosu, Lucian Muresan, Gabriel Gusetu, Dana Pop, Dumitru Zdrenghea
We present the case of a 59-year-old patient with persistent atrial fibrillation, referred for atrial fibrillation ablation. The procedure was performed with the help of NAVX 3D mapping system (Saint Jude Medical) and iLAB Ultra ICE Plus ultrasound imaging catheter (Boston Scientific). The catheter permits cross-sectional images perpendicular to catheter's long axis. From inside left atrial appendage (LAA) looks trabeculated, due to pectinate muscles running parallel to each other. The presence of a thrombus was excluded from the appendage...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29339167/comparison-of-anticoagulant-therapy-for-atrial-fibrillation-novel-oral-anticoagulants-versus-vitamin-k-antagonists
#4
REVIEW
Sean T Chen, Manesh R Patel
In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation is important for prevention of stroke and systemic embolism (SE). While Vitamin K antagonists (VKAs) have historically been the standard of care, these medications are limited by numerous food and drug interactions with onerous requirements for frequent monitoring and dose adjustments. Over the past decade, several novel oral anticoagulants (NOACs) have been developed to directly inhibit factor IIa/thrombin (dabigatran) or activated factor X (apixaban, rivaroxaban, edoxaban)...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29338895/feasibility-of-total-intravenous-anesthesia-by-cardiologists-with-the-support-of-anesthesiologists-during-catheter-ablation-of-atrial-fibrillation
#5
Takanori Yamaguchi, Yusuke Shimakawa, Shinji Mitsumizo, Akira Fukui, Yuki Kawano, Toyokazu Otsubo, Yuya Takahashi, Kei Hirota, Takeshi Tsuchiya, Kenichi Eshima
BACKGROUND: The optimal methodology for sedation and anesthesia during atrial fibrillation (AF) ablation has not been well established. We assessed the feasibility of total intravenous anesthesia (TIVA) by cardiologists with support from anesthesiologists during AF ablation and quality of pulmonary vein isolation (PVI) and single procedure success rate at 12 months. METHODS: TIVA was performed by cardiologists using IV propofol and fentanyl under controlled ventilation via i-gel™ without neuromuscular blocking drugs in 160 consecutive patients (80 nonparoxysmal) with no anticipated difficult airway or other severe diseases...
January 12, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29338549/sedation-in-cardiac-arrhythmias-management
#6
Federico Guerra, Giulia Stronati, Alessandro Capucci
Procedural sedation is of paramount importance for a plethora of electrophysiological procedures. From electrical cardioversion to electrophysiology studies, device implantations, and catheter ablations, intraprocedural sedation and anesthesia have a pivotal role in allowing procedural success while ensuring patient safety and avoiding discomfort. Areas covered: The present review will discuss the current state-of-the-art in sedation and anesthesia during electrical cardioversion, cardiac implantable electronic device implantation, catheter ablation and electrophysiology studies...
January 17, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29338326/diabetes-mellitus-and-atrial-remodelling-in-patients-with-paroxysmal-atrial-fibrillation-role-of-electroanatomical-mapping-and-catheter-ablation
#7
Domenico Grieco, Zefferino Palamà, Alessio Borrelli, Ermenegildo De Ruvo, Luigi Sciarra, Antonio Scarà, Emilia Goanta, Vito Calabrese, Paolo Pozzilli, Germano Di Sciascio, Leonardo Calò
Complex fractionated atrial electrograms (CFAEs) are related to atrial fibrosis, but their ablation has not yet shown superiority. The aim of the study was to compare, in terms of clinical outcome, two strategies of paroxysmal atrial fibrillation (AF) ablation in patients with type 1 diabetes mellitus (DM): pulmonary vein isolation (PVI) vs. PVI + CFAEs. Compared to an historical population of patient with paroxysmal AF and without DM, a higher percentage of patients with DM showed more than 25% of atrial area interested by CFAEs (study population, 58% vs historical group, 15%; p < 0...
January 1, 2018: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/29336757/radiofrequency-thermal-ablation-heat-energy-transfer-in-an-ex-vivo-model
#8
Shivani Thakur, Sandi Lavito, Elizabeth Grobner, Mark Grobner
Little work has been done to consider the temperature changes and energy transfer that occur in the tissue outside the vein with ultrasound-guided vein ablation therapy. In this experiment, a Ex-Vivo model of the human calf was used to analyze heat transfer and energy degradation in tissue surrounding the vein during endovascular radiofrequency ablation (RFA). A clinical vein ablation protocol was used to determine the tissue temperature distribution in 10 per cent agar gel. Heat energy from the radiofrequency catheter was measured for 140 seconds at fixed points by four thermometer probes placed equidistant radially at 0...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29335195/periprocedural-anticoagulation-for-catheter-ablation-of-atrial-fibrillation-practical-implications-for-perioperative-management
#9
REVIEW
David F Briceno, Nidhi Madan, Pedro A Villablanca, Florentino Lupercio, Nicole Cyrille, Harish Ramakrishna, Luigi Di Biase
No abstract text is available yet for this article.
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29333794/ablation-induced-change-in-the-course-of-fascicular-tachycardia
#10
Avishag Laish-Farkash, Avi Sabbag, Michael Glikson, Aharon Glick, Vladimir Khalameizer, Amos Katz, Yoav Michowitz
BACKGROUND: Multiform fascicular tachycardia (FT) was recently described as a ventricular tachycardia (VT) that has a reentrant mechanism using multiple fascicular branches and produces alternate fascicular VT forms. Ablating the respective fascicle may cause a change in the reentrant circuit resulting in a change in morphology. Ablation of the septal fascicle is crucial for successful treatment. OBJECTIVES: To describe four cases of FT in which ablation induced a change in QRS morphologies and aggravated clinical course...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29331355/contemporary-procedural-complications-hospitalizations-and-emergency-visits-after-catheter-ablation-for-atrial-fibrillation
#11
James V Freeman, Grace H Tabada, Kristi Reynolds, Sue Hee Sung, Taylor I Liu, Nigel Gupta, Alan S Go
Contemporary data on complications and resource utilization after atrial fibrillation (AF) ablation are limited. We evaluated rates and risk factors for procedural complication, rehospitalization, and emergency department visits after AF ablation. We identified all adult patients who underwent isolated AF ablation between 2010 and June 2014 in 2 large integrated health-care delivery systems and evaluated rates of acute inpatient complication, 30-day, and 1-year readmission and emergency evaluation. We used multivariable logistic regression to identify predictors of procedural complications, 30-day readmission, or 30-day emergency department evaluation...
December 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29331231/successful-catheter-ablation-of-atrioventricular-reentrant-tachycardia-with-left-lateral-bypass-tract-in-a-patient-with-unroofed-coronary-sinus-atrial-septal-defect
#12
Ji-Eun Ban, Woo-Hyeuk Choi, So-Young Bak
No abstract text is available yet for this article.
December 13, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29330332/identification-and-characterization-of-sites-where-persistent-atrial-fibrillation-is-terminated-by-localized-ablation
#13
Junaid A B Zaman, William H Sauer, Mahmood I Alhusseini, Tina Baykaner, Ryan T Borne, Christopher A B Kowalewski, Sonia Busch, Paul C Zei, Shirley Park, Mohan N Viswanathan, Paul J Wang, Johannes Brachmann, David E Krummen, John M Miller, Wouter Jan Rappel, Sanjiv M Narayan, Nicholas S Peters
BACKGROUND: The mechanisms by which persistent atrial fibrillation (AF) terminates via localized ablation are not well understood. To address the hypothesis that sites where localized ablation terminates persistent AF have characteristics identifiable with activation mapping during AF, we systematically examined activation patterns acquired only in cases of unequivocal termination by ablation. METHODS AND RESULTS: We recruited 57 patients with persistent AF undergoing ablation, in whom localized ablation terminated AF to sinus rhythm or organized tachycardia...
January 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29327638/hybrid-and-surgical-procedures-for-the-treatment-of-persistent-and-longstanding-persistent-atrial-fibrillation
#14
Jose M Sanchez, Ghannam Al-Dosari, Sherman Chu, Ramin Beygui, Tobias Deuse, Nitish Badhwar, Randall J Lee
Atrial fibrillation (AF) is the most common cardiac arrhythmia. The incidence of AF increases with age and is associated with increased stroke, heart failure and mortality. Persistent and long standing persistent AF is difficult to treat and often refractory to medical therapy and catheter ablation. Areas covered: This article reviews the historical development of the surgical Cox-MAZE procedure and current hybrid and minimally invasive surgical approaches for the treatment of persistent and long standing persistent AF...
January 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29326838/increasing-the-single-procedure-success-rate-of-pulmonary-vein-isolation
#15
Mattias Duytschaever, Mark O'Neill, Martin Martinek
To improve the single-procedural success and long-term outcomes of catheter ablation techniques for AF, there is a need for durable, contiguous and transmural lesions encircling the pulmonary veins (PV). Measurement of contact force (CF) between the catheter tip and the target tissue can optimise ablation procedures. A new approach to obtain single-procedure durable PV isolation (PVI) using the latest CF technology combined with the CARTO VISITAG™ Module with Ablation Index (Biosense Webster) has been shown in small studies to almost eliminate recurrence of paroxysmal AF at 1-year follow up and to make PVI procedures more reproducible...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326836/minimally-invasive-epicardial-surgical-ablation-alone-versus-hybrid-ablation-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#16
Charles M Pearman, Shi S Poon, Laura J Bonnett, Shouvik Haldar, Tom Wong, Neeraj Mediratta, Dhiraj Gupta
Maintaining sinus rhythm in patients with non-paroxysmal AF is an elusive goal. Some suggest that hybrid ablation, combining minimally invasive epicardial surgical ablation with endocardial catheter ablation, may be more effective than either modality alone. However, randomised trials are lacking. We investigated whether hybrid ablation is more effective than epicardial ablation alone at preventing recurrent AF by performing a systematic review and meta-analysis. The review was prospectively registered with PROSPERO (CRD42016043389)...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326834/ablation-of-atrial-fibrillation-in-patients-with-congenital-heart-disease
#17
Marwan M Refaat, Jad Ballout, Moussa Mansour
With improved surgical techniques and medical management for patients with congenital heart diseases, more patients are living longer and well into adulthood. This improved survival comes with a price of increased morbidity, mainly secondary to increased risk of tachyarrhythmias. One of the major arrhythmias commonly encountered in this subset of cardiac patients is AF. Similar to the general population, the risk of AF increases with advancing age, and is mainly secondary to the abnormal anatomy, abnormal pressure and volume parameters in the hearts of these patients and to the increased scarring and inflammation seen in the left atrium following multiple surgical procedures...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326827/premature-ventricular-contraction-induced-cardiomyopathy
#18
David J Callans
Premature ventricular contractions (PVCs) are very common and usually do not require treatment. However, in the clinical setting of troublesome symptoms, or when PVCs trigger polymorphic ventricular tachycardia or cause cardiomyopathy, proper treatment is critical. In this review, the clinical syndrome of PVC-induced cardiomyopathy, including risk factors for development and treatment, is discussed. Although PVC-induced cardiomyopathy is typically associated with frequent PVCs there are also patients with this burden that do not develop cardiomyopathy, suggesting a differential susceptibility...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326128/idiopathic-ventricular-arrhythmias-originating-from-the-vicinity-of-the-communicating-vein-of-cardiac-venous-systems-at-the-left-ventricular-summit
#19
Yuki Komatsu, Akihiko Nogami, Yasutoshi Shinoda, Keita Masuda, Takeshi Machino, Kenji Kuroki, Hiro Yamasaki, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: The communicating vein (CV) between the great cardiac vein and small cardiac venous systems passes between the aortic and pulmonary annulus and is located in close association with the left ventricular summit (summit CV). METHODS AND RESULTS: Thirty-one patients with idiopathic ventricular arrhythmias (VAs) underwent mapping of the left ventricular summit by using a 2F microcatheter introduced into the summit CV with coronary sinus venographic guidance...
January 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29325697/early-stable-sinus-rhythm-associated-with-greater-success-five-years-following-surgical-ablation
#20
Niv Ad, Sari D Holmes
BACKGROUND: An important challenge in surgical ablation for atrial fibrillation (AF) is the scarcity of publications on credible predictors of long-term success in procedures performed with ablation tools that produce consistently reliable transmural lesions. We examined factors associated with 1-year success and no atrial arrhythmia (AA) recurrence during 1-5 years after surgical ablation for AF. METHODS: Surgical ablation patients with complete rhythm follow-up at 12 months after surgery were followed prospectively (N=743)...
January 8, 2018: Annals of Thoracic Surgery
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