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Decapolar Catheter

Giuseppe Stabile, Matteo Anselmino, Ezio Soldati, Ermengildo De Ruvo, Francesco Solimene, Assunta Iuliano, Luigi Sciarra, Maria Grazia Bongiorni, Leonardo Calò, Fiorenzo Gaita
PURPOSE: Left atrial volume (LA) and pulmonary vein (PV) anatomy may potentially relate to technical challenges in achieving stable and effective catheter position in case of atrial fibrillation (AF) ablation by means of "one-shot" catheters. The aim of this study was to investigate whether LA volume and PV anatomy, evaluated by computed tomography (CT) or magnetic resonance (MR) prior to ablation, predict acute and midterm outcome of AF ablation by nMARQ™. METHODS: We included 75 patients (mean age 58 ± 11 years, 67 % male) with symptomatic paroxysmal AF...
March 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Neil T Srinivasan, Michele Orini, Ron B Simon, Rui Providência, Fakhar Z Khan, Oliver R Segal, Girish G Babu, Richard Bradley, Edward Rowland, Syed Ahsan, Anthony W Chow, Martin D Lowe, Peter Taggart, Pier D Lambiase
The spatial variation in restitution properties in relation to varying stimulus site is poorly defined. This study aimed to investigate the effect of varying stimulus site on apicobasal and transmural activation time (AT), action potential duration (APD) and repolarization time (RT) during restitution studies in the intact human heart. Ten patients with structurally normal hearts, undergoing clinical electrophysiology studies, were enrolled. Decapolar catheters were placed apex to base in the endocardial right ventricle (RVendo) and left ventricle (LVendo), and an LV branch of the coronary sinus (LVepi) for transmural recording...
September 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Concepción Alonso-Martin, Enrique Rodríguez-Font, Jose M Guerra, Xavier Viñolas
A 57-year-old man without prior history of cardiovascular disease was referred to our arrhythmia unit for ablation of recurrent episodes of typical atrial flutter. An echocardiogram ruled out structural heart disease. After informed consent was obtained the procedure was performed under conscious sedation. A decapolar catheter was introduced into the coronary sinus and a tetrapolar catheter was positioned at the His bundle region. This article is protected by copyright. All rights reserved.
June 1, 2016: Journal of Cardiovascular Electrophysiology
Eoin R Hyde, Jonathan M Behar, Andrew Crozier, Simon Claridge, Tom Jackson, Manav Sohal, Jaswinder S Gill, Mark D O'Neill, Reza Razavi, Steven A Niederer, Christopher A Rinaldi
BACKGROUND: Cardiac resynchronization therapy (CRT) with biventricular epicardial (BV-CS) or endocardial left ventricular (LV) stimulation (BV-EN) improves LV hemodynamics. The effect of CRT on right ventricular function is less clear, particularly for BV-EN. Our objective was to compare the simultaneous acute hemodynamic response (AHR) of the right and left ventricles (RV and LV) with BV-CS and BV-EN in order to determine the optimal mode of CRT delivery. METHODS: Nine patients with previously implanted CRT devices successfully underwent a temporary pacing study...
June 2016: Pacing and Clinical Electrophysiology: PACE
Matthew M Zipse, Duy Thai Nguyen
Clinicians must be mindful of the left ventricular lead when cannulating the coronary sinus with a decapolar catheter or an ablation catheter. Left atrial catheter ablation for the treatment of atrial fibrillation in patients with a mechanical mitral valve, when approached carefully, can be performed safely and effectively. Block across linear lines should be confirmed using differential activation and/or differential pacing to decrease risks of proarrhythmias.
March 2016: Cardiac Electrophysiology Clinics
Cristina Tutuianu, Vassil Traykov, Gábor Bencsik, Gergely Klausz, László Sághy, Robert Pap
BACKGROUND: Whether dissociated firing (DiFi) in isolated pulmonary veins (PVs) implies arrhythmogenicity of the particular PVand, therefore, a better outcome of PV isolation (PVI) for paroxysmal atrial fibrillation (PAF) is debated. METHODS: Thirty-one patients undergoing their first PVI for PAF were studied. Isoproterenol was infused for induction, and the triggering PV was identified. During sustained PAF, sequential recordings were made with a decapolar circular mapping catheter from each PV...
January 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Haran Burri, Chan-Il Park, Nana Poku, Philippe Giraudet, Carine Stettler, Marc Zimmermann
INTRODUCTION: The circular irrigated decapolar nMARQ ablation catheter designed for treating atrial fibrillation (AF) has recently been recalled following two deaths due to esoatrial fistula. Injury to the esophagus has been previously reported in up to 50% of patients using 20-25 W unipolar radiofrequency (RF) energy. Low power of 15 W has been proposed to prevent this complication, but the efficacy of this strategy to avoid AF recurrence is unknown. METHODS AND RESULTS: Consecutive patients with drug-refractory, symptomatic AF were included...
February 2016: Journal of Cardiovascular Electrophysiology
Christine A Capone, Scott R Ceresnak, Lynn Nappo, Gregory J Gates, Clyde B Schechter, Robert H Pass
PURPOSE: To compare the efficacy, safety, and cost-effectiveness of a three-catheter approach with a conventional five-catheter approach for the mapping and ablation of supraventricular tachycardia in pediatric patients with Wolff-Parkinson-White Syndrome (WPW) and concealed accessory pathways (APs). METHODS: A retrospective review from 2008 to 2012 of patients less than 21 years with WPW who underwent a three-catheter radiofrequency (RF) ablation of a left-sided AP (ablation, right ventricular [RV] apical, and coronary sinus [CS] decapolar catheters) was performed...
December 2015: Pacing and Clinical Electrophysiology: PACE
Giuseppe Stabile, Ermenegildo De Ruvo, Massimo Grimaldi, Giovanni Rovaris, Ezio Soldati, Matteo Anselmino, Francesco Solimene, Assunta Iuliano, Luigi Sciarra, Vincenzo Schillaci, Maria Grazia Bongiorni, Fiorenzo Gaita, Leonardo Calò
BACKGROUND: Pulmonary vein (PV) isolation is the cornerstone of catheter ablation in patients with atrial fibrillation (AF). "Single-shot" ablation devices have been recently engineered. OBJECTIVES: We report on the safety and efficacy of a novel ablation catheter for PV isolation in patients with AF. METHODS: One hundred eighty consecutive patients (58 ± 10 years, 125 male, 31% with structural heart disease) referred for paroxysmal (140) or persistent (40) AF underwent PV isolation by an open-irrigated mapping and radiofrequency (RF) decapolar ablation catheter in 7 centers...
August 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Keiichi Inada, Seiichiro Matsuo, Ken-ichi Tokutake, Ken-ichi Yokoyama, Mika Hioki, Ryohsuke Narui, Keiichi Ito, Shin-ichi Tanigawa, Seigo Yamashita, Michifumi Tokuda, Kenri Shibayama, Satoru Miyanaga, Ken-ichi Sugimoto, Michihiro Yoshimura, Teiichi Yamane
PURPOSE: Although catheter ablation targeting the pulmonary vein (PV) is a well-known therapy for patients with paroxysmal atrial fibrillation (PAF), ectopic firings from the superior vena cava (SVC) can initiate PAF. The purpose of this study was to investigate predictors of SVC firing. METHODS: The subjects included 336 consecutive PAF patients (278 males, age 56.1 ± 10.8 years) undergoing atrial fibrillation (AF) ablation. The appearance of SVC firing was monitored throughout the procedure using a decapolar catheter with multiple electrodes to record electrograms of the coronary sinus and SVC...
January 2015: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Shinsuke Miyazaki, Noboru Ichihara, Hiroshi Taniguchi, Hitoshi Hachiya, Hiroaki Nakamura, Eisuke Usui, Yoshihisa Kanaji, Takamitsu Takagi, Jin Iwasawa, Akio Kuroi, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: The utility of compound motor action potential (CMAP) monitoring for anticipating phrenic nerve injury (PNI) during cryoballoon ablation has been reported. We sought to compare two different CMAP recording techniques and evaluated the feasibility during pulmonary vein antrum isolation (PVAI) and superior vena cava isolation (SVCI) using radiofrequency energy. METHODS AND RESULTS: Forty-two patients undergoing paroxysmal atrial fibrillation ablation were prospectively enrolled...
March 2015: Journal of Cardiovascular Electrophysiology
Vincent J H M van Driel, Kars G E J Neven, Harry van Wessel, Bastiaan C du Pré, Aryan Vink, Pieter A F M Doevendans, Fred H M Wittkampf
BACKGROUND: Radiofrequency ablation inside pulmonary vein (PV) ostia can cause PV stenosis. A novel alternative method of ablation is irreversible electroporation, but the long-term response of PVs to electroporation ablation is unknown. METHODS AND RESULTS: In ten 6-month-old pigs (60-75 kg), the response of PVs to circular electroporation and radiofrequency ablation was compared. Ten consecutive, nonarcing, electroporation applications of 200 J were delivered 5 to 10 mm inside 1 of the 2 main PVs, using a custom-deflectable, 18-mm circular decapolar catheter...
August 2014: Circulation. Arrhythmia and Electrophysiology
Rostislav Polasek, Ivo Skalsky, Dan Wichterle, Tomas Martinca, Jana Hanuliakova, Tomas Roubicek, Jan Bahnik, Helena Jansova, Jan Pirk, Josef Kautzner
BACKGROUND: The left ventricular (LV) lead local electrogram (EGM) delay from the beginning of the QRS complex (QLV) is considered a strong predictor of response to cardiac resynchronization therapy. We have developed a method for fast epicardial QLV mapping during video-thoracoscopic surgery to guide LV lead placement. METHODS: A three-port, video-thoracoscopic approach was used for LV free wall epicardial mapping and lead implantation. A decapolar electrophysiological catheter was introduced through one port and systematically attached to multiple accessible LV sites...
August 2014: Journal of Cardiovascular Electrophysiology
Dong-In Shin, Kiriakos Kirmanoglou, Christian Eickholt, Jan Schmidt, Lukas Clasen, Britta Butzbach, Tienush Rassaf, Marc Merx, Malte Kelm, Christian Meyer
BACKGROUND: Pulmonary vein isolation (PVI) as a cornerstone for catheter ablation of atrial fibrillation (AF) remains a complex and time-consuming procedure. OBJECTIVE: To assess feasibility, safety, and acute efficacy of a novel irrigated multielectrode ablation catheter guided by an electroanatomic mapping system for PVI in patients with paroxysmal AF. METHODS: Twenty-five consecutive patients (60 ± 10 years) with paroxysmal AF underwent PVI by using a novel decapolar mapping and ablation catheter (nMARQ catheter, Biosense Webster Inc, Diamond Bar, CA)...
March 2014: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Kotaro Fukumoto, Seiji Takatsuki, Takehiro Kimura, Nobuhiro Nishiyama, Kojiro Tanimoto, Yoshiyasu Aizawa, Yoko Tanimoto, Yukiko Fukuda, Shunichiro Miyoshi, Keiichi Fukuda
BACKGROUND: Although the superior vena cava (SVC) has been well known to be one of the important foci triggering atrial fibrillation (AF), its electrophysiological characteristics have received little research attention. The aim of this study was to investigate the electrophysiological properties of the SVC and venoatrial junction (VAJ). METHODS: Twenty-five consecutive AF patients without structural heart disease undergoing electrical SVC isolation were included in this study...
January 2014: Journal of Cardiovascular Electrophysiology
Vassil B Traykov, Róbert Pap, Zoltán Gingl, Szami Chadaide, Haris M Haqqani, Gergely Klausz, Rodrigo Gallardo, Tamás Forster, David J Callans, László Sághy
BACKGROUND: Triggers from thoracic veins have been implicated not only in the initiation, but also in the perpetuation of paroxysmal atrial fibrillation (PAF). To investigate their role we studied the distribution and stability of dominant frequencies (DFs) during PAF and the response to isolation of the triggering pulmonary vein (PV). METHODS AND RESULTS: Triggering structures inducing PAF were identified during isoproterenol challenge in 26 patients (15 males, 55 ± 8...
July 2013: Pacing and Clinical Electrophysiology: PACE
Massimiliano M Faustino, Donato Capuzzi, Tullio Agricola, Donatella Ciammetti, Piero Pecce, Luigi Santarella, Carmine Pizzi
OBJECTIVE: The origin and mechanisms of focal and macro-re-entrant atrial tachycardia occurring after ablation of paroxysmal or persistent atrial fibrillation are difficult to determine and are often the cause of distress for both patients and electrophysiologists. The purpose of this study was to describe a novel practical approach which would be helpful in planning the treatment of atrial tachycardia in patients who had received prior atrial fibrillation ablation. We used an algorithm which aims to facilitate mapping and ablation strategies, using both conventional electrophysiological tools and a three-dimensional electroanatomic approach...
December 2012: Journal of Cardiovascular Medicine
Thomas Deneke, Andreas Mügge, Osman Balta, Marc Horlitz, Peter H Grewe, Dong-In Shin
A novel ablation system consisting of a duty-cycled phased radiofrequency generator and multielectrode mapping and ablation catheters has been introduced to provide ablation therapy in patients with symptomatic atrial fibrillation (AF). Contiguous lesions may be created using anatomically designed ablation catheters maneuvered under fluoroscopic guidance without the use of a 3D electroanatomic mapping system. In addition to pulmonary vein isolation using a circular, decapolar ablation catheter, an ablation strategy targeting complex fractionated atrial electrograms can be performed using two supplemental multiarray catheters specifically designed for ablation at the left atrial septum and within the left atrial body...
August 2011: Expert Review of Cardiovascular Therapy
Sevasti-Maria Chaldoupi, Andre C Linnenbank, Fred H Wittkampf, Leif H Boldt, Harry VAN Wessel, Vincent J VAN Driel, Pieter A Doevendans, Richard N Hauer, Jacques M DE Bakker, Peter Loh
BACKGROUND: Complex fractionated atrial electrograms (CFAEs) are supposed to be related to structural and electrical remodeling. Animal studies suggest a role of the autonomic nervous system (ANS). However, this has never been studied in humans. OBJECTIVE: The goal of this study was to investigate the influence of ANS on CFAEs in patients with idiopathic atrial fibrillation (AF). METHODS: Thirty-six patients (28 men, 55 ± 9 years) were included before undergoing catheter ablation...
January 2012: Journal of Cardiovascular Electrophysiology
David Gareth Jones, James W McCready, Riyaz A Kaba, Syed Y Ahsan, Jonathan C Lyne, Jack Wang, Oliver R Segal, Vias Markides, Pier D Lambiase, Tom Wong, Anthony W C Chow
PURPOSE: There is an increasing need for catheter ablation procedures to treat complex atrial tachycardias (AT) and atrial fibrillation (AF), often requiring detailed endocardial mapping. The sequential point-to-point contact mapping of complex arrhythmias is time-consuming and may not always be feasible. We assessed the utility of a novel spiral duo-decapolar high-density (HD) mapping catheter to delineate complex arrhythmia substrates for ablation. METHODS: The patients underwent HD mapping using a spiral catheter (AFocusII) and the EnSite NavX system, during catheter ablation procedures, to treat atrial arrhythmias...
September 2011: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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