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Electro Anatomical Mapping

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https://www.readbyqxmd.com/read/28873427/computational-assessment-of-the-functional-role-of-sinoatrial-node-exit-pathways-in-the-human-heart
#1
Sanjay R Kharche, Edward Vigmond, Igor R Efimov, Halina Dobrzynski
AIM: The human right atrium and sinoatrial node (SAN) anatomy is complex. Optical mapping experiments suggest that the SAN is functionally insulated from atrial tissue except at discrete SAN-atrial electrical junctions called SAN exit pathways, SEPs. Additionally, histological imaging suggests the presence of a secondary pacemaker close to the SAN. We hypothesise that a) an insulating border-SEP anatomical configuration is related to SAN arrhythmia; and b) a secondary pacemaker, the paranodal area, is an alternate pacemaker but accentuates tachycardia...
2017: PloS One
https://www.readbyqxmd.com/read/28832375/contemporary-diagnosis-and-management-of-atrial-flutter-a-continuum-of-atrial-fibrillation-and-vice-versa
#2
Antonis S Manolis
Atrial flutter (AFlu) is usually a fast (>240 bpm) and regular right atrial macroreentrant tachycardia, with a constrained critical region of the reentry circuit located at the cavotricuspid isthmus (CTI) (typical CTI-dependent AFlu). However, a variety of right and left atrial tachycardias, resulting from different mechanisms, can also present as AFlu (atypical non-CTI-dependent AFlu). The electrocardiogram can provide clues to its origin and location, however, additional entrainment and more sophisticated electro-anatomical mapping techniques may be required to identify its mechanism, location and target-area for a successful ablation...
August 18, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28744873/epicardial-ablation-of-tachyarrhythmia-in-children-experience-at-two-academic-centers
#3
Shailendra Upadhyay, Edward P Walsh, Frank Cecchin, John K Triedman, Juan Villafane, J Philip Saul
BACKGROUND: Experience with percutaneous epicardial ablation of tachyarrhythmia in pediatrics is limited. This case series addresses the feasibility, safety and complications of the procedure in children. METHODS: A total of 9 patients underwent 10 epicardial ablation procedures from 2002 to 2013 at two academic centers. Activation mapping was performed in all cases, and electro-anatomic map was utilized in 9 of the 10 procedures. Patients had undergone 1-3 failed endocardial catheter ablations in addition to medical management, and all had symptoms, a high-risk accessory pathway (AP), aborted cardiac arrest with Wolff-Parkinson-White syndrome (WPW) or ventricular dysfunction...
July 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28733782/catheter-ablation-of-atrial-fibrillation-an-overview-for-clinicians
#4
REVIEW
Nebojša Mujović, Milan Marinković, Radoslaw Lenarczyk, Roland Tilz, Tatjana S Potpara
Catheter ablation (CA) of atrial fibrillation (AF) is currently one of the most commonly performed electrophysiology procedures. Ablation of paroxysmal AF is based on the elimination of triggers by pulmonary vein isolation (PVI), while different strategies for additional AF substrate modification on top of PVI have been proposed for ablation of persistent AF. Nowadays, various technologies for AF ablation are available. The radiofrequency point-by-point ablation navigated by electro-anatomical mapping system and cryo-balloon technology are comparable in terms of the efficacy and safety of the PVI procedure...
July 21, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28678875/evaluation-of-the-use-of-unipolar-voltage-amplitudes-for-detection-of-myocardial-scar-assessed-by-cardiac-magnetic-resonance-imaging-in-heart-failure-patients
#5
Uyên Châu Nguyên, Francesco Maffessanti, Masih Mafi-Rad, Giulio Conte, Stef Zeemering, François Regoli, Maria Luce Caputo, Antonius M W van Stipdonk, Sebastiaan C A M Bekkers, Daniel Suerder, Tiziano Moccetti, Rolf Krause, Frits W Prinzen, Kevin Vernooy, Angelo Auricchio
BACKGROUND: Validation of voltage-based scar delineation has been limited to small populations using mainly endocardial measurements. The aim of this study is to compare unipolar voltage amplitudes (UnipV) with scar on delayed enhancement cardiac magnetic resonance imaging (DE-CMR). METHODS: Heart failure patients who underwent DE-CMR and electro-anatomic mapping were included. Thirty-three endocardial mapped patients and 27 epicardial mapped patients were investigated...
2017: PloS One
https://www.readbyqxmd.com/read/28640075/maximum-voltage-gradient-technique-for-optimization-of-ablation-for-typical-atrial-flutter-with-zero-fluoroscopy-approach
#6
MULTICENTER STUDY
Karol Deutsch, Janusz Śledź, Mariusz Mazij, Bartosz Ludwik, Michał Labus, Dariusz Karbarz, Bernadetta Pasicka, Michał Chrabąszcz, Arkadiusz Śledź, Monika Klank-Szafran, Laura Vitali-Sendoz, Tomasz Kameczura, Jerzy Śpikowski, Piotr Stec, Marek Ujda, Sebastian Stec
Radiofrequency catheter ablation (RFCA) is an established effective method for the treatment of typical cavo-tricuspid isthmus (CTI)-dependent atrial flutter (AFL). The introduction of 3-dimensional electro-anatomic systems enables RFCA without fluoroscopy (No-X-Ray [NXR]). The aim of this study was to evaluate the feasibility and effectiveness of CTI RFCA during implementation of the NXR approach and the maximum voltage-guided (MVG) technique for ablation of AFL.Data were obtained from prospective standardized multicenter ablation registry...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614264/extremely-low-frame-rate-digital-fluoroscopy-in-catheter-ablation-of-atrial-fibrillation-a-comparison-of-2-versus-4-frame-rate
#7
COMPARATIVE STUDY
Ji Hyun Lee, Jun Kim, Minsu Kim, Jongmin Hwang, You Mi Hwang, Joon-Won Kang, Gi-Byoung Nam, Kee-Joon Choi, You-Ho Kim
Despite the technological advance in 3-dimensional (3D) mapping, radiation exposure during catheter ablation of atrial fibrillation (AF) continues to be a major concern in both patients and physicians. Previous studies reported substantial radiation exposure (7369-8690 cGy cm) during AF catheter ablation with fluoroscopic settings of 7.5 frames per second (FPS) under 3D mapping system guidance. We evaluated the efficacy and safety of a low-frame-rate fluoroscopy protocol for catheter ablation for AF.Retrospective analysis of data on 133 patients who underwent AF catheter ablation with 3-D electro-anatomic mapping at our institute from January 2014 to May 2015 was performed...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28592962/how-to-detect-atrial-fibrosis
#8
REVIEW
Juan Lacalzada-Almeida, Javier García-Niebla
In the last twenty years, new imaging techniques to assess atrial function and to predict the risk of recurrence of atrial fibrillation after treatment have been developed. The present review deals with the role of these techniques in the detection of structural and functional changes of the atrium and diagnosis of atrial remodeling, particularly atrial fibrosis. Echocardiography allows the detection of anatomical, functional changes and deformation of the atrial wall during the phases of the cardiac cycle...
March 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28568013/a-multicenter-review-of-ablation-in-the-aortic-cusps-in-young-people
#9
Minh B Nguyen, Scott R Ceresnak, Christopher M Janson, Steven B Fishberger, Barry A Love, Andrew D Blaufox, Kara S Motonaga, Anne M Dubin, Lynn Nappo, Robert H Pass
BACKGROUND: Ablation within the aortic cusp is safe and effective in adults. There are little data on aortic cusp ablation in the pediatric literature. We investigated the safety and efficacy of aortic cusp ablation in young patients. METHODS: A retrospective, descriptive study of aortic cusp ablation in five pediatric electrophysiology centers from 2008 to 2014 was performed. All patients <21 years of age who underwent ablation in the aortic cusps were included...
June 1, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28551945/targeting-ablation-strategies-and-electro-anatomical-systems-for-different-atrial-fibrillation-patterns
#10
Francesco Santoro, Christian H Heeger, Andreas Metzner, Natale D Brunetti, Matteo DI Biase, Karl-Heinz Kuck, Feifan Ouyang
INTRODUCTION: Catheter ablation (CA) is an established and widespread treatment option for drug refractory atrial fibrillation (AF). CA has undergone considerable improvements during the last years and several ablation strategies have been proposed for different AF patterns. EVIDENCE ACQUISITION: The main cornerstone is the electrical isolation of pulmonary veins (PVs) especially among patients with paroxysmal AF. This can be achieved mainly with the use of radiofrequency or cryo-energy...
May 25, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28409519/off-line-analysis-of-electro-anatomical-mapping-in-ventricular-arrhythmias
#11
Daniele Muser, Jackson J Liang, Pasquale Santangeli
Sudden cardiac death due to ventricular tachycardia (VT) is a major health issue in patients with structural heart disease and depressed ejection fraction. If from one side, implantable cardioverter defibrillator (ICD) therapy has significantly improved survival of these patients, on the other hand, it has led to frequent ICD shocks as an emerging problem, being associated with poor quality of life, frequent hospitalizations and increased mortality. Scar-related re-entry due to the coexistence of surviving myocardial fibers within fibrotic tissue is the most common mechanism subtending VT both in ischemic and non-ischemic cardiomyopathies...
August 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28370919/an-automatic-and-accurate-registration-method-for-electro-anatomical-map-and-ct-surface
#12
Lixia Shu, Jin Wang, Deyong Long, Changyan Lin
BACKGROUND: Electro-anatomical maps (EAM) and CT surface registration are widely used for catheter navigation in atrial fibrillation ablations. However, few studies have investigated the registration algorithm. Moreover, some of them are semiautomatic, so that physicians must be proficient; some are inaccurate for catheter navigation. A both automatic and accurate registration method is needed. METHOD: A Hausdorff distance based approach (HD) was proposed for EAM/CT registration...
March 29, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28343765/human-cardiac-progenitor-cells-with-regenerative-potential-can-be-isolated-and-characterized-from-3d-electro-anatomic-guided-endomyocardial-biopsies
#13
Domenico D'Amario, Antonio Maria Leone, Maria Lucia Narducci, Costantino Smaldone, Dalgisio Lecis, Frediano Inzani, Marco Luciani, Andrea Siracusano, Federica La Neve, Melissa Manchi, Gemma Pelargonio, Francesco Perna, Piergiorgio Bruno, Massimo Massetti, Dario Pitocco, Donato Cappetta, Grazia Esposito, Konrad Urbanek, Antonella De Angelis, Francesco Rossi, Roberto Piacentini, Giulia Angelini, Domenica Donatella Li Puma, Claudio Grassi, Elisa De Paolis, Ettore Capoluongo, Valentina Silvestri, Biagio Merlino, Riccardo Marano, Filippo Crea
AIMS: In the present study, we aimed to develop a percutaneous approach and a reproducible methodology for the isolation and expansion of Cardiac Progenitor Cells (CPCs) from EndoMyocardial Biopsies (EMB) in vivo. Moreover, in an animal model of non-ischemic heart failure (HF), we would like to test whether CPCs obtained by this methodology may engraft the myocardium and differentiate. METHODS AND RESULTS: EMB were obtained using a preformed sheath and a disposable bioptome, advanced via right femoral vein in 12 healthy mini pigs, to the right ventricle...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28340078/image-integration-into-3-dimensional-electro-anatomical-mapping-system-facilitates-safe-ablation-of-ventricular-arrhythmias-originating-from-the-aortic-root-and-its-vicinity
#14
Mario Jularic, Ruken Özge Akbulak, Benjamin Schäffer, Julia Moser, Jana Nuehrich, Christian Meyer, Christian Eickholt, Stephan Willems, Boris A Hoffmann
Aims: During ablation in the vicinity of the coronary arteries establishing a safe distance from the catheter tip to the relevant vessels is mandatory and usually assessed by fluoroscopy alone. The aim of the study was to investigate the feasibility of an image integration module (IIM) for continuous monitoring of the distance of the ablation catheter tip to the main coronary arteries during ablation of ventricular arrhythmias (VA) originating in the sinus of valsalva (SOV) and the left ventricular summit part of which can be reached via the great cardiac vein (GCV)...
March 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28318819/slow-pathway-radiofrequency-ablation-using-magnetic-navigation-a-description-of-technique-and-retrospective-case-analysis
#15
Abhishek Bhaskaran, Maha Albarri, Neil Ross, Sara Al Raisi, Rahul Samantha, Leonette Roode, Fazlur Nadri, Jeanette Ng, Stuart Thomas, Aravinda Thiagalingam, Pramesh Kovoor
BACKGROUND: The Magnetic Navigation System (MNS) catheter was shown to be stable in the presence of significant cardiac wall motion and delivered more effective lesions compared to manual control. This stability could potentially make AV junctional reentrant tachycardia (AVNRT) ablation safer. The aim of this study is to describe the method of mapping and ablation of AVNRT with MNS and 3-D electro-anatomical mapping system (CARTO, Biosense Webster, Diamond bar, CA, USA) anatomical mapping, with a view to improve the safety of ablation...
February 21, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28318665/the-relation-between-local-repolarization-and-t-wave-morphology-in-heart-failure-patients
#16
Francesco Maffessanti, Joris Wanten, Mark Potse, Francois Regoli, Maria Luce Caputo, Giulio Conte, Daniel Sürder, Annekatrin Illner, Rolf Krause, Tiziano Moccetti, Angelo Auricchio, Frits W Prinzen
BACKGROUND: Both duration and morphology of the T-wave are regarded important parameters describing repolarization of the ventricles. Conventionally, T-wave concordance is explained by an inverse relation between the time of depolarization (TD) and repolarization (TR). Little is known about T-wave morphology and TD-TR relations in patients with heart failure. METHODS: Electro-anatomic maps were obtained in the left (LV) and right ventricle (RV) and in the coronary sinus (CS) in patients with heart failure with narrow (nQRS, n=8) and wide QRS complex with (LBBB, n=15) and without left bundle branch block (non-LBBB, n=7)...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28202257/radiofrequency-catheter-ablation-of-atrioventricular-node-reentrant-tachycardia-in-children-with-limited-fluoroscopy
#17
Moshe Swissa, Einat Birk, Tamir Dagan, Sody Abby Naimer, Michal Fogelman, Tom Einbinder, Elchanan Bruckheimer, Rami Fogelman
BACKGROUND: Limited fluoroscopy cryo-ablation using a 3D electro-anatomical system (3DS) has been used for AVNRT in children. We aimed to facilitate a fluoroscopy limited approach of RF ablation of AVNRT in children. METHODS: A retrospective study was performed of procedure parameters in children undergoing RF ablation of AVNRT in 75 consecutive children (June 2011 to November 2013 - Group A) using standard fluoroscopy techniques compared to those of 64 consecutive children (December 2013 to May 2015 - Group B), using a fluoroscopy limited approach with 3DS...
January 31, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28120237/hibernating-substrate-of-ventricular-tachycardia-a-three-dimensional-metabolic-and-electro-anatomic-assessment
#18
Ayman A Hussein, Michelle Niekoop, Vasken Dilsizian, Yousra Ghzally, Mohammed Abdulghani, Ramazan Asoglu, Wengen Chen, Mark Smith, Vincent See, Stephen R Shorofsky, Timm-Michael Dickfeld
PURPOSE: Hibernating myocardium (HM) is associated with sudden cardiac death (SCD). Little is known about the electrophysiological properties of HM and the basis of its association with SCD. We aimed to electrophysiologically characterize HM in patients with ventricular tachycardia (VT). METHODS: Endocardial voltage mapping, metabolic (18)FDG-positron emission tomography (PET) and perfusion (82)Rb, (201)Tl, or (99m)Tc scans were performed in 61 ischemic heart disease patients with VT...
January 25, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28113454/cryo-balloon-catheter-localization-based-on-a-support-vector-machine-approach
#19
Tanja Kurzendorfer, Philip W Mewes, Andreas Maier, Norbert Strobel, Alexander Brost
Cryo-balloon catheters have attracted an increasing amount of interest in the medical community as they can reduce patient risk during left atrial pulmonary vein ablation procedures. As cryo-balloon catheters are not equipped with electrodes, they cannot be localized automatically by electro-anatomical mapping systems. As a consequence, X-ray fluoroscopy has remained an important means for guidance during the procedure. Most recently, image guidance methods for fluoroscopy-based procedures have been proposed, but they provide only limited support for cryo-balloon catheters and require significant user interaction...
March 9, 2016: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/27943299/a-nonfluoroscopic-technique-for-coronary-arteries-three-dimensional-mapping-during-epicardial-ventricular-tachycardia-ablation
#20
Vittorio Calzolari, Gaetano Barbato, Martino Crosato, Luca DE Mattia, Alessandro Daniotti, Stefano Indiani, Paolo Antonio Maria Squasi, Zoran Olivari
When performing epicardial ablation of ventricular tachycardia (VT), caution must be taken not to damage the coronary arteries. We report a case in which a new, nonfluoroscopic technique for incorporating an accurate, real-time reconstruction of the main coronary vessels into a three-dimensional electroanatomic map was used for epicardial VT ablation.
March 2017: Pacing and Clinical Electrophysiology: PACE
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