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Atrial Fibrillation and Radiation

P S Venkat, S Leuthold, W Jin, M Fradley, S E Hoffe, J P Fontaine, J M Pimiento, K Almhanna, J M Frakes
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Edgar Monroy, Jose Azpiri, Cuauhtémoc De La Peña, Carlos Cardona, Miguel Hinojosa, Rafael Zamarripa, Jose Assad
Pulmonary vein isolation using robotic radiosurgery system CyberKnife is a new non-invasive treatment of atrial fibrillation, currently in clinical phase. Robotic radiosurgical pulmonary vein isolation (RRPVI) uses stereotactic, non-invasive (painless) pinpoint radiation energy delivery to a small, precise area to accomplish ablation. The purpose of this report is to describe the finding of an increase in the enhancement of the left atrium demonstrated with the use of cardiac magnetic resonance imaging using late gadolinium enhancement (LGE-CMR) as a result of RRPVI in the first case in the world in humans using CyberKnife as a treatment for paroxysmal atrial fibrillation (PAF)...
2016: Curēus
Kenichiro Yamagata, Bashar Aldhoon, Josef Kautzner
Radiofrequency catheter ablation has become the treatment of choice for atrial fibrillation (AF) that does not respond to antiarrhythmic drug therapy. During the procedure, fluoroscopy imaging is still considered essential to visualise catheters in real-time. However, radiation is often ignored by physicians since it is invisible and the long-term risks are underestimated. In this respect, it must be emphasised that radiation exposure has various potentially harmful effects, such as acute skin injury, malignancies and genetic disease, both to patients and physicians...
August 2016: Arrhythmia & Electrophysiology Review
Cas Teunissen, Jesse Habets, Birgitta K Velthuis, Maarten J Cramer, Peter Loh
Prior to atrial fibrillation (AF) ablation, computed tomography angiography (CTA) is increasingly used for left atrial appendage (LAA) thrombus detection. LAA filling defects on CTA may represent thrombus or incomplete contrast mixing with blood. A pre-bolus of contrast material with delay before the CTA contrast bolus can help distinguish between thrombus and incomplete contrast mixing. We present results from a double-contrast, single-phase CTA protocol used in our daily clinical practice. In patients who underwent AF ablation between 2011 and 2015, double-contrast, single-phase CTA was performed prior to ablation...
September 6, 2016: International Journal of Cardiovascular Imaging
Peng Liu, Rijing Liu, Yan Zhang, Yingfeng Liu, Xiaoming Tang, Yanzhen Cheng
AIMS AND OBJECTIVES: The objective of this study was to assess the clinical feasibility of generating 3D printing models of left atrial appendage (LAA) using real-time 3D transesophageal echocardiogram (TEE) data for preoperative reference of LAA occlusion. BACKGROUND: Percutaneous LAA occlusion can effectively prevent patients with atrial fibrillation from stroke. However, the anatomical structure of LAA is so complicated that adequate information of its structure is essential for successful LAA occlusion...
August 19, 2016: Cardiology
Kevin Martell, Roderick Simpson, David Skarsgard
We present the case of a 62-year-old male originally diagnosed with squamous cell carcinoma (SCC) of the right retromolar trigone, Stage cT2N2bM0. He was treated radically with a pharyngotomy and segmental mandibular resection, right selective neck nodal dissection, and then reconstruction with a free fibular flap. The pathologic stage was T4aN1. He then received adjuvant chemoradiation therapy with a radiation dose of 6,000 cGy in 30 fractions, along with cisplatin, 100 mg/m(2) every three weeks. Good local control was repeatedly documented for two years...
2016: Curēus
Vanessa Rubesch-Kütemeyer, Stephan Molatta, Jürgen Vogt, Klaus-Jürgen Gutleben, Dieter Horstkotte, Georg Nölker
AIMS: The population treated with cryoballoon (CB) ablation is relatively young, and radiation protection is of major importance. We aimed to demonstrate that radiation exposure can be markedly reduced by intracardiac echocardiography (ICE) and optimized settings of the X-ray system. METHODS AND RESULTS: We analysed 100 patients undergoing CB pulmonary vein isolation (PVI) for treatment of paroxysmal atrial fibrillation. In 50 consecutive patients (25 male, 59 ± 13 years; Group 1), we used ICE, skipped PV angiography prior to CB inflation, and avoided fluoroscopy whenever possible...
June 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Christian Blockhaus, Jan Schmidt, Muhammed Kurt, Lukas Clasen, Christoph Brinkmeyer, Efstratios Katsianos, Patrick Müller, Shqipe Gerguri, Malte Kelm, Dong-In Shin, Hisaki Makimoto
Pulmonary vein isolation (PVI) is a cornerstone therapy in patients with atrial fibrillation (AF). With increasing numbers of PVI procedures, demand arises to reduce the cumulative fluoroscopic radiation exposure for both the physician and the patient. New technologies are emerging to address this issue. Here, we report our first experiences with a new fluoroscopy integrating technology in addition to a current 3D-mapping system. The new fluoroscopy integrating system (FIS) with 3D-mapping was used prospectively in 15 patients with AF...
May 25, 2016: International Heart Journal
Thomas Kleemann, Johannes Brachmann, Thorsten Lewalter, Dietrich Andresen, Stephan Willems, Stefan G Spitzer, Ellen Hoffmann, Lars Eckardt, Matthias Hochadel, Jochen Senges, Karl-Heinz Kuck, Karlheinz Seidl, Ralf Zahn
AIM: The aim of this study was to analyze the radiation usage in patients undergoing pulmonary vein isolation (PVI) in Germany and to evaluate the possibility to reduce radiation dose. METHODS AND RESULTS: A total of 6617 patients with atrial fibrillation (AF) from the German ablation registry and the FREEZEplus registry (control group), who underwent first PVI between 2007 and 2014, were analyzed. In the second step, the effect of optimized conventional fluoroscopy and optimized 3D mapping use was evaluated in 526 consecutive patients with AF who underwent first PVI at the Klinikum Ludwigshafen (optimized group) between 2007 and 2014...
October 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Federico Viganego, Robin Singh, Michael G Fradley
Enhanced understanding of cancer biology has significantly increased treatment options and dramatically improved outcomes for patients with malignancies. Despite these advances, many therapies have cardiovascular toxicities which can affect morbidity and mortality independent of the oncologic prognosis. Arrhythmias and other electrophysiology issues are increasingly identified as common complications of cancer therapy. Atrial fibrillation and other supraventricular arrhythmias are frequently observed in cancer patients receiving chemotherapy, often due to their effects on intracellular signaling pathways...
June 2016: Current Cardiology Reports
David I Fielding, Daniel D Schuster
A 75-year-old woman presented with minor hemoptysis. Past history included atrial fibrillation and rheumatic mitral stenosis. Bronchoscopy revealed a striking abnormality of widespread dilated mucosal and submucosal vessels. Initially the concern was whether there was widespread endobronchial malignancy; however, narrow band imaging (NBI) demonstrated the symmetrical uniform nature of the vessels. In addition, there was a focal area of in situ carcinoma with classic NBI features of malignancy. Following external-beam radiation therapy, NBI features had dramatically changed in the treated area which was now biopsy negative...
April 11, 2016: Journal of Bronchology & Interventional Pulmonology
Hariharan Raju, John Whitaker, Carly Taylor, Matthew Wright
BACKGROUND: We evaluated Carto 3, transoesophageal echocardiography (TOE) and contact force (CF) sensing catheter in atrial fibrillation (AF) ablation. METHODS: Unselected consecutive ablations performed under general anaesthesia (GA) were studied with modified protocol (cases, n=11) and compared to retrospective consecutive controls (n=10). Patent foramen ovale (PFO) or single transseptal puncture enabled left atrial (LA) access; ablation strategy was stepwise approach...
July 2016: Heart, Lung & Circulation
Matthew Needleman, Hugh Calkins
Despite the increased burden of atrial fibrillation (AF), obese patients have similar, if not slightly improved, mortality, described as the "obesity paradox." Catheter ablation for AF in obese patients is a reasonable option, but patients should be screened for sleep apnea and counseled about the possibility of longer procedure times and repeat procedures to achieve similar success rates. Quality of life will likely improve after successful ablation. Although no statistically significant increases in procedural complications have occurred in obese subjects, patients should be counseled about the increased radiation dose and higher incidence of left atrial thrombus preablation...
September 2012: Cardiac Electrophysiology Clinics
Delphine Elbes, Julie Magat, Assaf Govari, Yaron Ephrath, Delphine Vieillot, Christopher Beeckler, Rukshen Weerasooriya, Pierre Jais, Bruno Quesson
AIMS: Interventional cardiac catheter mapping is routinely guided by X-ray fluoroscopy, although radiation exposure remains a significant concern. Feasibility of catheter ablation for common flutter has recently been demonstrated under magnetic resonance imaging (MRI) guidance. The benefit of catheter ablation under MRI could be significant for complex arrhythmias such as atrial fibrillation (AF), but MRI-compatible multi-electrode catheters such as Lasso have not yet been developed. This study aimed at demonstrating the feasibility and safety of using a multi-electrode catheter [magnetic resonance (MR)-compatible Lasso] during MRI for cardiac mapping...
February 18, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Ichiro Ogino, Shigenobu Watanabe, Noriaki Iwahashi, Masami Kosuge, Kentaro Sakamaki, Chikara Kunisaki, Kazuo Kimura
PURPOSE: To evaluate clinical and dosimetric factors retrospectively affecting the risk of symptomatic cardiac disease (SCD) in esophageal cancer patients treated with radiotherapy. PATIENTS AND METHODS: A total of 343 patients with newly diagnosed esophageal cancer were managed with concurrent chemoradiotherapy or radiotherapy alone. Of these, 58 patients were followed at our hospital for at least 4 years. Median clinical follow-up was 79 months. Cardiac toxicity was determined by Common Terminology Criteria for Adverse Events (CTCAE) v...
June 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Rishi Anand, Maxim V Gorev, Hermine Poghosyan, Lindsay Pothier, John Matkins, Gregory Kotler, Sarah Moroz, James Armstrong, Sergei V Nemtsov, Michael V Orlov
PURPOSE: To compare the efficacy and accuracy of rotational angiography with three-dimensional reconstruction (3DATG) image merged with electro-anatomical mapping (EAM) vs. CT-EAM. METHODS: A prospective, randomized, parallel, two-center study conducted in 36 patients (25 men, age 65 ± 10 years) undergoing AF ablation (33 % paroxysmal, 67 % persistent) guided by 3DATG (group 1) vs. CT (group 2) image fusion with EAM. 3DATG was performed on the Philips Allura Xper FD 10 system...
August 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Michael Kühne, Sven Knecht, Aline Mühl, Tobias Reichlin, Nikola Pavlović, Arnheid Kessel-Schaefer, Beat A Kaufmann, Beat Schaer, Christian Sticherling, Stefan Osswald
INTRODUCTION: The advent of electroanatomical mapping (EAM) systems for pulmonary vein isolation (PVI) has dramatically decreased radiation exposure. However, the need for some fluoroscopy remains for obtaining left atrial (LA) access. The aim was to test the feasibility of fluoroscopy-free PVI in patients with atrial fibrillation (AF) and a patent foramen ovale (PFO) guided solely by an EAM system. METHODS: Consecutive patients with AF undergoing PVI and documented PFO were studied...
2016: PloS One
Reza Wakili, Johannes Siebermair, Stephanie Fichtner, Moritz F Sinner, Eva Klocker, Lucia Olesch, Jan N Hilberath, Samira Sarai, Sebastian Clauss, Stefan Sattler, Stefan Kääb, Heidi L Estner
AIMS: Pulmonary vein isolation (PVI) is an established therapy for atrial fibrillation (AF). However, PVI remains a time-consuming procedure. A novel multipolar irrigated radiofrequency (RF) ablation catheter (nMARQ™) is aiming to improve PVI. We investigated the influence on procedural parameters and assessed clinical outcomes after PVI using this novel catheter. METHODS AND RESULTS: Fifty-eight consecutive patients with paroxysmal AF were equally allocated (n = 29/group) to PVI treatment with (i) the novel multipolar ablation catheter (nMARQ™) and (ii) a standard single-tip ablation catheter (SAC)...
August 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Shigenobu Seguchi, Takaya Saijo, Yoshinobu Ishikawa, Tatsuji Nagao
BACKGROUND: Our aim in this study was to estimate entrance skin doses (ESDs) to patients who underwent catheter ablation procedures, by using a reference air-kerma (RAK) displayed on the monitor of an angiography system (displayed RAK). METHODS: The displayed RAK was calibrated with use of an air-kerma value measured on a 20-cm-thick acrylic plate at the interventional reference point for the inclusion of backscattered x-rays (calibrated RAK). The ESD evaluated from the calibrated RAK (evaluated ESD) was verified through direct ESD measurements on an anthropomorphic phantom...
March 2016: Pacing and Clinical Electrophysiology: PACE
Anna Constantinescu, H Immo Lehmann, Douglas L Packer, Christoph Bert, Marco Durante, Christian Graeff
INTRODUCTION: Catheter ablation with isolation of the pulmonary veins is a common treatment option for atrial fibrillation but still has insufficient success rates and carries several interventional risks. These treatment planning studies assessed if high-dose single fraction treatment with scanned carbon ions (12C) can be reliably delivered for AF ablation, while sparing risk structures and considering respiratory and contractile target motion. METHODS AND RESULTS: Time resolved CT scans of complete respiratory and cardiac cycles of 9 and 5 patients, respectively, were obtained...
March 2016: Journal of Cardiovascular Electrophysiology
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