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Atrial fibrillation and right atria

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https://www.readbyqxmd.com/read/29174249/low-interatrial-septal-pacing-a-simple-method
#1
Asit Das, Dhiman Kahali, Shibananda Dutta
BACKGROUND: Sinus node disease is associated with widespread structural and electrophysiological changes in the atria in addition to abnormalities at the sinus node. The atrial conduction disorder in patients with atrial pacing results in higher incidence of atrial fibrillation. Studies have shown that low interatrial septal pacing is superior to right atrial appendage pacing in preventing persistent or permanent atrial fibrillation in these patients. However, implantation of active fixation lead in low interatrial septal position is difficult and time consuming with conventional stylet, inhibiting application of this method in routine practice...
November 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29166718/-value-of-two-left-atrium-and-pulmonary-vein-stereoscopic-imaging-reconstruction-methods-on-guiding-radiofrequency-ablation-for-atrial-fibrillation
#2
Y Tian, S Zhou, Y H Yin, Y X Zheng, R P Wang, X Q Liu, Z Q Liu, Q F Liu, W Liu, J Pang, Z Jiang, L H Tian, J Huang, L Yang
Objective: To compare the value of two 3D imaging reconstruction methods for left atria and pulmonary vein on guiding the catheter ablation for atrial fibrillation (AF). Methods: From January 2014 to January 2017, a total of 100 drug refractory paroxysmal AF patients were divided into left atria direct angiography group (n=50), and indirect angiography group (n=50). 3D CARTO system was applied for mapping and guiding the ablation procedure. Patients assigned to direct angiography group were treated as follows: intraoperative puncture of atrial septum, inject contrast agent directly into the left atrium, conduct left atrial and pulmonary venous rotation angiography, reconstruct three-dimensional image, integrate the image into real-time X-ray system to facilitate circumferential pulmonary vein isolation...
November 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29101618/%C3%AE-adrenergic-stimulation-induces-pro-arrhythmic-activity-in-the-caval-vein-myocardial-tissue
#3
A D Ivanova, V S Kuzmin, L V Rosenshtraukh
Electrical activity of the right superior vena cava (SVC) is considered as a source of the atrial fibrillation. We have shown that bioelectrical properties of the SVC myocardium differ from those of the working atrial myocardium. Electrically evoked action potential duration in SVC is significantly shorter, the resting membrane potential in both stimulated and quiescent SVC preparations is significantly more positive than in atria. Activation of β-adrenoreceptors in SVC myocardium leads to a series of action potentials, and this process depends on protein kinase A...
September 2017: Doklady Biological Sciences: Proceedings of the Academy of Sciences of the USSR, Biological Sciences Sections
https://www.readbyqxmd.com/read/29101544/anatomy-of-the-atria-a%C3%A2-road-map-to-the-left-atrial-appendage
#4
REVIEW
Umberto Barbero, Siew Yen Ho
The left atrial appendage (LAA) has received increasing attention in recent years because of thrombi formation in patients with atrial fibrillation, which increases the risk of stroke. In patients who have contraindications for long-term oral anticoagulation therapy, percutaneous procedures are used to occlude the LAA and there are now several devices available for implantation, both endocardially and epicardially. Despite the high-resolution imaging techniques on hand today, limitations remain in providing information about wall thickness and neighboring structures; therefore, in-depth knowledge of the normal atrial anatomy is mandatory when considering such interventions...
November 3, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29044861/comparison-of-bleeding-risk-scores-in-patients-with-atrial-fibrillation-insights-from-the-re-ly-trial
#5
M Proietti, Z Hijazi, U Andersson, S J Connolly, J W Eikelboom, M D Ezekowitz, D A Lane, J Oldgren, V Roldan, S Yusuf, L Wallentin
BACKGROUND: Oral anticoagulation is the mainstay of stroke prevention in atrial fibrillation (AF), but must be balanced against the associated bleeding risk. Several risk scores have been proposed for prediction of bleeding events in patients with AF. OBJECTIVES: To compare the performance of contemporary clinical bleeding risk scores in 18 113 patients with AF randomized to dabigatran 110 mg, 150 mg or warfarin in the RE-LY trial. METHODS: HAS-BLED, ORBIT, ATRIA and HEMORR2 HAGES bleeding risk scores were calculated based on clinical information at baseline...
October 16, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29036603/identification-of-optimal-reference-genes-for-transcriptomic-analyses-in-normal-and-diseased-human-heart
#6
Cristina E Molina, Eric Jacquet, Prishila Ponien, Christian Muñoz-Guijosa, Istvan Baczkó, Lars S Maier, Patrick Donzeau-Gouge, Dobromir Dobrev, Rodolphe Fischmeister, Anne Garnier
Aims: Quantitative real-time RT-PCR (RT-qPCR) has become the method of choice for mRNA quantification, but requires an accurate normalization based on the use of reference genes showing invariant expression across various pathological conditions. Only few data exist on appropriate reference genes for the human heart. The objective of this study was to determine a set of suitable reference genes in human atrial and ventricular tissues, from right and left cavities in control and in cardiac diseases...
September 22, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28964116/revealing-kinetics-and-state-dependent-binding-properties-of-ikur-targeting-drugs-that-maximize-atrial-fibrillation-selectivity
#7
Nicholas Ellinwood, Dobromir Dobrev, Stefano Morotti, Eleonora Grandi
The KV1.5 potassium channel, which underlies the ultra-rapid delayed-rectifier current (IKur) and is predominantly expressed in atria vs. ventricles, has emerged as a promising target to treat atrial fibrillation (AF). However, while numerous KV1.5-selective compounds have been screened, characterized, and tested in various animal models of AF, evidence of antiarrhythmic efficacy in humans is still lacking. Moreover, current guidelines for pre-clinical assessment of candidate drugs heavily rely on steady-state concentration-response curves or IC50 values, which can overlook adverse cardiotoxic effects...
September 2017: Chaos
https://www.readbyqxmd.com/read/28888481/spatial-distribution-of-conduction-disorders-during-sinus-rhythm
#8
Eva A H Lanters, Ameeta Yaksh, Christophe P Teuwen, Lisette J M E van der Does, Charles Kik, Paul Knops, Denise M S van Marion, Bianca J J M Brundel, Ad J J C Bogers, Maurits A Allessie, Natasja M S de Groot
BACKGROUND: Length of lines of conduction block (CB) during sinus rhythm (SR) at Bachmann's bundle (BB) is associated with atrial fibrillation (AF). However, it is unknown whether extensiveness of CB at BB represents CB elsewhere in the atria. We aim to investigate during SR 1) the spatial distribution and extensiveness of CB 2) whether there is a predilection site for CB and 3) the association between CB and incidence of post-operative AF. METHODS: During SR, epicardial mapping of the right atrium (RA), BB and left atrium was performed in 209 patients with coronary artery disease...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28862969/three-dimensional-integrated-functional-structural-and-computational-mapping-to-define-the-structural-fingerprints-of-heart-specific-atrial-fibrillation-drivers-in-human-heart-ex-vivo
#9
Jichao Zhao, Brian J Hansen, Yufeng Wang, Thomas A Csepe, Lidiya V Sul, Alan Tang, Yiming Yuan, Ning Li, Anna Bratasz, Kimerly A Powell, Ahmet Kilic, Peter J Mohler, Paul M L Janssen, Raul Weiss, Orlando P Simonetti, John D Hummel, Vadim V Fedorov
BACKGROUND: Structural remodeling of human atria plays a key role in sustaining atrial fibrillation (AF), but insufficient quantitative analysis of human atrial structure impedes the treatment of AF. We aimed to develop a novel 3-dimensional (3D) structural and computational simulation analysis tool that could reveal the structural contributors to human reentrant AF drivers. METHODS AND RESULTS: High-resolution panoramic epicardial optical mapping of the coronary-perfused explanted intact human atria (63-year-old woman, chronic hypertension, heart weight 608 g) was conducted during sinus rhythm and sustained AF maintained by spatially stable reentrant AF drivers in the left and right atrium...
August 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28862787/panoramic-atrial-mapping-with-basket-catheters-a-quantitative-analysis-to-optimize-practice-patient-selection-and-catheter-choice
#10
Shohreh Honarbakhsh, Richard J Schilling, Rui Providência, Gurpreet Dhillon, Vinit Sawhney, Claire A Martin, Emily Keating, Malcolm Finlay, Syed Ahsan, Anthony Chow, Mark J Earley, Ross J Hunter
INTRODUCTION: Panoramic mapping with basket catheters has been used to map atrial fibrillation (AF). However, the limited tissue contact and coverage achieved has raised concerns. METHODS AND RESULTS: Patients undergoing catheter ablation for atrial tachycardia (AT) and persistent AF were recruited. Unipolar signals were recorded with the Constellation or FIRMap catheters. The proportion and distribution of anatomical coverage by the catheters was determined and tissue contact achieved measured...
September 1, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28840592/left-atrial-appendage-closure-for-primary-primary-prevention-during-percutaneous-closure-of-septal-defects-in-patients-with-large-atria-but-no-atrial-fibrillation
#11
Shingo Kuwata, Juliane Vierecke, Steffen Gloekler, Francesco Maisano, Bernhard Meier, Fabian Nietlispach
BACKGROUND: Percutaneous atrial septal defect (ASD) closure is a routine procedure to prevent right ventricular failure, pulmonary hypertension, or paradoxical embolism. The latter is the typical reason for percutaneous patent foramen ovale (PFO) closure. Atrial enlargement represents a risk for developing atrial fibrillation (AF). Percutaneous left atrial appendage (LAA) closure is emerging as a preventive therapy for patients in AF who suffered from a previous stroke or bleeding (secondary prevention) or patients without previous stroke or bleeding (primary prevention)...
August 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28807377/crem-transgene-mice-an-animal-model-of-atrial-fibrillation-and-thrombogenesis
#12
A Bukowska, M Felgendreher, B Scholz, C Wolke, J S Schulte, E Fehrmann, E Wardelmann, M D Seidl, U Lendeckel, K Himmler, A Gardemann, A Goette, F U Müller
BACKGROUND: The molecular pathomechanisms underlying atrial thrombogenesis are multifactorial and still require detailed investigations. Transgenic mice with cardiomyocyte-directed expression of the transcriptional repressor CREM-IbΔC-X (CREM-TG) represent an experimental model of atrial fibrillation (AF) that shows a gradual, age-dependent progression from atrial ectopy to persistent AF. Importantly, this model develops biatrial thrombi. The molecular characteristics related to the thrombogenesis in CREM-TG mice have not been studied, yet...
August 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28791857/antiarrhythmic-properties-of-atrial-pacing
#13
REVIEW
Magdalena Kliś, Agnieszka Sławuta, Jacek Gajek
Bradycardia, atrial stretch and dilatation, autonomic nervous system disorders, and the presence of triggers such as atrial premature contractions, are factors which predispose a person to paroxysmal AF. Atrial pacing not only eliminates bradycardia but also prevents atrial premature contractions and dispersion of refractoriness, which are a substrate for atrial fibrillation. As the prolonged duration of atrial activation during pacing, especially from locations changing the physiological pattern of this activation (right atrium lateral wall, right atrium appendage), negatively influences both a mechanical and an electrical function of the atria, the atrial pacing site affects an atrial arrhythmogenesis...
March 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28790104/first-in-man-analysis-of-the-relationship-between-electrical-rotors-from-noninvasive-panoramic-mapping-and-atrial-fibrosis-from-magnetic-resonance-imaging-in-patients-with-persistent-atrial-fibrillation
#14
Christian Sohns, Christine Lemes, Andreas Metzner, Thomas Fink, Mikhail Chmelevsky, Tilman Maurer, Margarita Budanova, Vladislav Solntsev, Walther H W Schulze, Wieland Staab, Shibu Mathew, Christian Heeger, Bruno Reißmann, Eugene Kholmovski, Dietmar Kivelitz, Feifan Ouyang, Karl-Heinz Kuck
BACKGROUND: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging can be used to evaluate characteristics of atrial fibrosis. The novel noninvasive epicardial and endocardial electrophysiology system (NEEES) allows for the identification of sources with rotor activity. This study describes a new technique to examine the relationship between rotors and LGE signal intensity in patients with persistent atrial fibrillation (PERS) scheduled for ablation. METHODS AND RESULTS: Ten consecutive patients underwent pulmonary vein isolation for persistent atrial fibrillation...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28765761/simulation-of-ventricular-rate-control-during-atrial-fibrillation-using-ionic-channel-blockers
#15
Shin Inada, Nitaro Shibata Md PhD, Michiaki Iwata PhD, Ryo Haraguchi PhD, Takashi Ashihara Md PhD, Takanori Ikeda Md PhD, Kazuyuki Mitsui PhD, Halina Dobrzynski PhD, Mark R Boyett PhD, Kazuo Nakazawa PhD
BACKGROUND: The atrioventricular (AV) node is the only compartment that conducts an electrical impulse between the atria and the ventricles. The main role of the AV node is to facilitate efficient pumping by conducting excitation slowly between the two chambers as well as reduce the ventricular rate during atrial fibrillation (AF). METHODS: Using computer simulations, we investigated excitation conduction from the right atrium to the bundle of His during high-rate atrial excitation with or without partial blocking of the calcium or potassium ionic current...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28761039/atrio-esophageal-fistula-a-case-series-and-literature-review
#16
Craig A Schuring, Luke J Mountjoy, Ashley B Priaulx, Robert J Schneider, Hayden L Smith, Geoffrey C Wall, Dipen Kadaria, Amik Sodhi
BACKGROUND Percutaneous catheter radiofrequency ablation (RFA) and cryoablation of the left atrium and pulmonary vein ostia have become successful therapeutic modalities in the management of atrial fibrillation. Atrio-esophageal fistula is a rare complication. Awareness of complication risk is imperative because without prompt diagnosis and urgent surgical intervention, the outcome is often fatal. We present 3 cases of atrio-esophageal fistula following percutaneous catheter radiofrequency ablation (RFA). CASE REPORT Case 1: A 72-year old white male presented 27 days after percutaneous RFA for atrial fibrillation with fever, altered mental status, and melena...
August 1, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28733070/spatial-relationship-of-sites-for-atrial-fibrillation-drivers-and-atrial-tachycardia-in-patients-with-both-arrhythmias
#17
Tina Baykaner, Junaid A B Zaman, Albert J Rogers, Rachita Navara, Mahmood AlHusseini, Ryan T Borne, Shirley Park, Paul J Wang, David E Krummen, William H Sauer, Sanjiv M Narayan
INTRODUCTION: Atrial fibrillation (AF) often converts to and from atrial tachycardia (AT), but it is undefined if these rhythms are mechanistically related in such patients. We tested the hypothesis that critical sites for AT may be related to regional AF sources in patients with both rhythms, by mapping their locations and response to ablation on transitions to and from AF. METHODS: From 219 patients undergoing spatial mapping of AF prior to ablation at 3 centers, we enrolled 26 patients in whom AF converted to AT by ablation (n=19) or spontaneously (n=7; left atrial size 42±6cm, 38% persistent AF)...
December 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28730651/a-comparison-of-the-electrophysiologic-and-electroanatomic-characteristics-between-the-right-and-left-atrium-in-persistent-atrial-fibrillation-is-the-right-atrium-a-window-into-the-left
#18
Sandeep Prabhu, Aleksandr Voskoboinik, Alex J A McLellan, Kah Y Peck, Bhupesh Pathik, Chrishan J Nalliah, Geoff R Wong, Sonia M Azzopardi, Geoffrey Lee, Justin Mariani, Liang-Han Ling, Andrew J Taylor, Jonathan M Kalman, Peter M Kistler
INTRODUCTION: The right atrium (RA) is readily accessible; however, it is unclear whether changes in the RA are representative of the LA. We performed detailed biatrial electroanatomic mapping to determine the electrophysiological relationship between the atria. METHODS AND RESULTS: Consecutive patients with persistent AF underwent biatrial electroanatomical mapping with a contact force catheter acquiring points with a CF >10 g prior to ablation. Points were analyzed for tissue voltage, complex electrograms, low voltage (<0...
October 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28721223/atrial-fibrillation-in-a-preterm-newborn-with-structurally-normal-heart
#19
Pier Paolo Bassareo, Andrea Raffaele Marras, Mariangela Marras, Silvia Marras, Giuseppe Mercuro
Atrial fibrillation (AF) is a really uncommon arrhythmia in newborns. Here, we report the case of a 1-day-old infant who was recovered in Neonatal Intensive Care Unit for a twin-to-twin transfusion. The appearance of an unexpected AF was registered at his continuous electrocardiographic monitoring. Both chest X-ray and echocardiographic examination revealed the anomalous insertion of the tip of a central venous catheter (CVC) into the heart ('umbilical artery → inferior vena cava → right atrium → patent foramen ovale → left atrium')...
March 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28719150/can-principles-of-the-surface-potential-be-combined-with-knowledge-of-natural-products-to-reduce-atrial-rhythm-disturbances
#20
EDITORIAL
H Ni, K Narsingani, H Zhang, W R Giles
Long lasting or chronic electrophysiological abnormalities in human atria are significant contributors to morbidity during healthy aging. Although both paroxysmal (brief) and chronic atrial fibrillation (AF) were considered to be benign; the notable association between maintained AF and stroke has resulted in AF now being a target for surgical intervention (ablation) and/or drug therapy. An interesting, forward looking paper from the Elinder Group(1) in this issue of Acta Physiologica reveals novel pharmacological agents and principles that could be the basis for more effective antiarrhythmic therapies for AF...
July 18, 2017: Acta Physiologica
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