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Catheter Mapping

Philippa R P Krahn, Sheldon M Singh, Venkat Ramanan, Labonny Biswas, Nicolas Yak, Kevan J T Anderson, Jennifer Barry, Mihaela Pop, Graham A Wright
BACKGROUND: Radiofrequency (RF) ablation has become a mainstay of treatment for ventricular tachycardia, yet adequate lesion formation remains challenging. This study aims to comprehensively describe the composition and evolution of acute left ventricular (LV) lesions using native-contrast cardiovascular magnetic resonance (CMR) during CMR-guided ablation procedures. METHODS: RF ablation was performed using an actively-tracked CMR-enabled catheter guided into the LV of 12 healthy swine to create 14 RF ablation lesions...
March 15, 2018: Journal of Cardiovascular Magnetic Resonance
Kenzie A Cameron, Elaine R Cohen, Joelle R Hertz, Diane B Wayne, Debi Mitra, Jeffrey H Barsuk
OBJECTIVES: The aims of the study were to identify perceived barriers and facilitators to central venous catheter (CVC) insertion among healthcare providers and to understand the extent to which an existing Simulation-Based Mastery Learning (SBML) program may address barriers and leverage facilitators. METHODS: Providers participating in a CVC insertion SBML train-the-trainer program, in addition to intensive care unit nurse managers, were purposively sampled from Veterans Administration Medical Centers located in geographically diverse areas...
March 14, 2018: Journal of Patient Safety
Taihei Itoh, Takumi Yamada
INTRODUCTION: Preferential conduction from an origin to breakout sites can occur during ventricular arrhythmias (VAs) originating from the left ventricular papillary muscles (LVPMs). The purpose of this study was to investigate the incidence, electrophysiological characteristics, and relevance to radiofrequency catheter ablation (RFCA) of such a preferential conduction demonstrated by pace mapping. METHODS AND RESULTS: We studied 34 consecutive patients undergoing RFCA of 40 LVPM VAs...
March 14, 2018: Journal of Cardiovascular Electrophysiology
Yoshinari Enomoto, Go Hashimoto, Naohiko Sahara, Hikari Hashimoto, Hiroki Niikura, Keijiro Nakamura, Raisuke Iijima, Hidehiko Hara, Makoto Suzuki, Mahito Noro, Masao Moroi, Kaoru Sugi, Masato Nakamura
A 70-years-old male with a history of hypertension and drug resistant paroxysmal atrial fibrillation (AF) presented to our hospital for catheter ablation to his symptomatic AF. He had no prior surgical or percutaneous procedure to close or exclude the left atrial appendage (LAA). A transesophageal echocardiography (TEE) was performed to rule out intra-cardiac thrombus prior to the ablation procedure. Although the TEE imaging at multiple acquisition angles was obtained, the LAA could not be visualized and an absence of the LAA was suspected...
March 12, 2018: International Heart Journal
Aleksandr Voskoboinik, Paul B Sparks, Joseph B Morton, Geoffrey Lee, Stephen A Joseph, Joshua J Hawson, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Despite technological advances, studies continue to report high complication rates for atrial fibrillation (AF) ablation. We sought to review complication rates for AF ablation at a high-volume centre over a 14-year period and identify predictors of complications. METHODS: We reviewed prospectively collected data from 2750 consecutive AF ablation procedures at our institution using radiofrequency energy (RF) between January 2004 and May 2017. All cases were performed under general anaesthetic with transoesophageal echocardiography (TEE), 3D-mapping and an irrigated ablation catheter...
February 3, 2018: Heart, Lung & Circulation
Tarek Zghaib, Ali Keramati, Jonathan Chrispin, Dong Huang, Muhammad A Balouch, Luisa Ciuffo, Ronald D Berger, Joseph E Marine, Hiroshi Ashikaga, Hugh Calkins, Saman Nazarian, David D Spragg
Background: Bipolar voltage mapping, as part of atrial fibrillation (AF) ablation, is traditionally performed in a point-by-point (PBP) approach using single-tip ablation catheters. Alternative techniques for fibrosis-delineation include fast-anatomical mapping (FAM) with multi-electrode circular catheters, and late gadolinium-enhanced magnetic-resonance imaging (LGE-MRI). The correlation between PBP, FAM, and LGE-MRI fibrosis assessment is unknown. Objective: In this study, we examined AF substrate using different modalities (PBP, FAM, and LGE-MRI mapping) in patients presenting for an AF ablation...
January 2018: JACC. Clinical Electrophysiology
Catherine J A Williams, Aage K O Alstrup, Mads F Bertelsen, Heidi M Jensen, Cleo A C Leite, Tobias Wang
Alfaxalone is becoming a popular anesthetic for nonmammalian vertebrates, but the physiological effects of its administration remain largely unknown in these taxa. Therefore, the cardiovascular responses to a clinically relevant dose of alfaxalone (10 mg/kg) are reported in the bullfrog ( Lithobates catesbeianus), following intramuscular (IM) and intravascular (IV) administration (via a femoral artery catheter) and compared with an IV dose of propofol, another parenteral GABA (γ-aminobutyric acid) agonist in common veterinary use as an induction agent...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Prabhpreet Singh, Amit Noheria
Invasive electrophysiology (EP) mapping and catheter ablation has increasingly become the standard of care for many cardiac arrhythmias like supraventricular tachycardias, atrial fibrillation, premature ventricular complexes (PVC), and monomorphic ventricular tachycardia. In this review, we discuss the recent progress made in the mapping and ablation of ventricular fibrillation (VF). Ventricular activation during VF is apparently disorganized, making mapping and interpretation difficult. Prolonged mapping during VF would require mechanical circulatory support as VF causes complete hemodynamic collapse...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
Luca Luzzi, Federico Franchi, Annarita Dapoto, Marco Ghisalberti, Roberto Corzani, Daniele Marrelli, Luca Marchetti, Piero Paladini, Sabino Scolletta
Background: In the treatment of malignant pleural mesothelioma the Hyperthermic Intra THOracic Chemotherapy (HITHOC) can improve the efficacy of pleurectomy and decortication with a local cytotoxic effect. However its biological impact in patient's hemodynamic and microcirculatory changes were rarely investigated. Aim of this study is to describe our experience with HITHOC after pleurectomy and decortication evaluating the role of sublingual video-microscopy in assessing the microcirculatory changes in the perioperative period...
January 2018: Journal of Thoracic Disease
Masaharu Masuda, Masashi Fujita, Osamu Iida, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Takuya Tsujimura, Yasuhiro Matsuda, Shota Okuno, Takuya Ohashi, Aki Tsuji, Toshiaki Mano
BACKGROUND: Association between the presence of left atrial low-voltage areas and atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) has been shown mainly in persistent AF patients. We sought to compare the AF recurrence rate in paroxysmal AF patients with and without left atrial low-voltage areas. METHODS: This prospective observational study included 147 consecutive patients undergoing initial ablation for paroxysmal AF. Voltage mapping was performed after PVI during sinus rhythm, and low-voltage areas were defined as regions where bipolar peak-to-peak voltage was <0...
April 15, 2018: International Journal of Cardiology
Baptiste Maille, Moloy Das, Ahmed Hussein, Matthew Shaw, Vivek Chaturvedi, Maureen Morgan, Christina Ronayne, Richard L Snowdon, Dhiraj Gupta
INTRODUCTION: The ConfiDENSE™ module (Carto3 v4) allows rapid annotation of endocardial electrograms acquired by multi-electrode (ME) mapping. However, its accuracy in assessing atrial voltages is unknown. METHODS AND RESULTS: Two ConfiDENSE™ left atrial voltage maps were created during continuous pacing in 20 patients undergoing catheter ablation for persistent AF using a ME lasso catheter and a Contact Force (CF) sensing ablation catheter. The automated Tissue Proximity indicator (TPI) filter was then applied to the ME map to yield a TPI map...
March 5, 2018: Journal of Cardiovascular Electrophysiology
Laura Martinez-Mateu, Lucia Romero, Ana Ferrer-Albero, Rafael Sebastian, José F Rodríguez Matas, José Jalife, Omer Berenfeld, Javier Saiz
Anatomically based procedures to ablate atrial fibrillation (AF) are often successful in terminating paroxysmal AF. However, the ability to terminate persistent AF remains disappointing. New mechanistic approaches use multiple-electrode basket catheter mapping to localize and target AF drivers in the form of rotors but significant concerns remain about their accuracy. We aimed to evaluate how electrode-endocardium distance, far-field sources and inter-electrode distance affect the accuracy of localizing rotors...
March 5, 2018: PLoS Computational Biology
Hubert Cochet, Rémi Dubois, Seigo Yamashita, Nora Al Jefairi, Benjamin Berte, Jean-Marc Sellal, Darren Hooks, Antonio Frontera, Sana Amraoui, Adlane Zemoura, Arnaud Denis, Nicolas Derval, Frederic Sacher, Olivier Corneloup, Valérie Latrabe, Stéphanie Clément-Guinaudeau, Jatin Relan, Sohail Zahid, Patrick M Boyle, Natalia A Trayanova, Olivier Bernus, Michel Montaudon, François Laurent, Mélèze Hocini, Michel Haïssaguerre, Pierre Jaïs
OBJECTIVES: This study sought to assess the relationship between fibrosis and re-entrant activity in persistent atrial fibrillation (AF). BACKGROUND: The mechanisms involved in sustaining re-entrant activity during AF are poorly understood. METHODS: Forty-one patients with persistent AF (age 56 ± 12 years; 6 women) were evaluated. High-resolution electrocardiographic imaging (ECGI) was performed during AF by using a 252-chest electrode array, and phase mapping was applied to locate re-entrant activity...
January 2018: JACC. Clinical Electrophysiology
J Fedida, T Strisciuglio, M Sohal, M Wolf, K Van Beeumen, A Neyrinck, P Taghji, C Lepiece, A Almorad, Y Vandekerckhove, R Tavernier, M Duytschaever, S Knecht
PURPOSE: Catheter ablation is an effective treatment for premature ventricular complexes (PVCs). Activation mapping is accurate but requires PVCs at the time of the ablation. Pace-mapping correlation (PMC) is a supplemental tool recently developed as an integrated module for an electro-anatomical mapping platform. Our study sought to investigate whether pace-mapping technology provides similar ablation results in patients with low versus high idiopathic PVC burden at the time of ablation and the relationship between sites with the highest PMC and the earliest local activation time (LAT)...
February 24, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Eric Pillado, Mina Behdad, Russell Williams, Samuel E Wilson
INTRODUCTION: Construction of radiocephalic AV fistula (RC- AVF) results in successful hemodialysis (HD) in approximately 40 percent of ESRD patients. We investigated whether RC-AVF flow measured by ultrasound 30 days postoperative predicted successful HD. METHODS: In this prospective study color Doppler ultrasound (DUS) was used to measure cephalic vein outflow volume at three forearm sites one and three months postoperative. RESULTS: Of 45 consecutive patients screened for feasibility of RC-AVF by physical exam and US arterial and vein mapping, 41 were considered suitable for construction of RC-AVF...
February 22, 2018: Annals of Vascular Surgery
Iain Findlay, Tamsin Morris, Ruiqi Zhang, Colin McCowan, Sarah Shield, Brian Forbes, Alex McConnachie, Kenneth Mangion, Colin Berry
Aims: To implement secondary care electronic record linkage for patients hospitalised with suspected or known acute coronary syndrome (ACS) in a complex regional healthcare system and evaluate this e-Registry in terms of patterns of service delivery and 1-year outcomes. Methods and Results: Existing electronic hospital records were linked to create episodes of care using (1) a patient administration system, (2) invasive cardiovascular procedure referrals and (3) a catheter laboratory record...
February 16, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
Severin Wannagat, Lena Loehr, Sebastian Lask, Katharina Völk, Tamer Karaköse, Cemil Özcelik, Andreas Mügge, Alexander Wutzler
PURPOSE: Catheter ablation is performed under fluoroscopic guidance. Reduction of radiation dose for patients and staff is emphasized by current recommendations. Previous studies have shown that lower operator experience leads to increased radiation dose. On the other hand, less experienced operators may depend even more on fluoroscopic guidance. Our study aimed to evaluate feasibility and efficacy of a non-fluoroscopic approach in different training levels. METHODS: From January 2017, a near-zero fluoroscopy approach was established in two centers...
February 19, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Matthew G Daly, Iain Melton, Graham Roper, Gary Lim, Ian G Crozier
BACKGROUND: Catheter ablation for atrial fibrillation has potential to cause esophageal thermal injury. Esophageal temperature monitoring during ablation is commonly used; however, it has not eliminated thermal injuries, possibly because conventional sensors have poor spatial sampling and response characteristics. To enhance understanding of temperature dynamics that may underlie esophageal injury, we tested a high-resolution, intrabody, infrared thermography catheter to continuously image esophageal temperatures during ablation...
February 2018: Circulation. Arrhythmia and Electrophysiology
Roland Richard Tilz, Christian-Hendrik Heeger, Alexander Wick, Ardan M Saguner, Andreas Metzner, Andreas Rillig, Peter Wohlmuth, Bruno Reissmann, Christine Lemeš, Tilman Maurer, Francesco Santoro, Johannes Riedl, Christian Sohns, Shibu Mathew, Karl-Heinz Kuck, Feifan Ouyang
BACKGROUND: Circumferential pulmonary vein isolation (CPVI) is increasingly performed for the treatment of symptomatic drug-refractory paroxysmal atrial fibrillation. Long-term data for >10 years after CPVI are sparse. We investigated the long-term clinical outcome and progression of paroxysmal atrial fibrillation after double-lasso and 3-dimensional electroanatomical mapping-guided CPVI. METHODS AND RESULTS: From 2003 to 2004, 161 patients (mean age: 60±10 years) with symptomatic drug-refractory paroxysmal atrial fibrillation were prospectively enrolled and underwent electroanatomical mapping-guided CPVI...
February 2018: Circulation. Arrhythmia and Electrophysiology
Zhuo Liang, Wang Yunlong, Tao Zhang, Zhihong Han, Jianzeng Dong, Xuejun Ren
BACKGROUND: There is a close anatomical relationship between aortic sinus cusp (ASC) and the left pulmonary sinus cusp (LPSC). PURPOSE: The study was to investigate the significance of mapping and ablation of LPSC for VAs with QRS morphology resembling that of ASC arrhythmias. METHODS: In 33 consecutive patients undergoing successful catheter ablation of idiopathic VAs with ASC arrhythmia-like QRS morphology, LPSC was mapped carefully. RESULTS: Among the 33 patients studied, QRS morphology resembled that of arrhythmias of either right or left coronary cusp (LCC or RCC) origin in 17 and 16 patients, respectively...
February 15, 2018: Journal of Cardiovascular Electrophysiology
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