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Quadripolar Catheter

Martin Manninger, Alessio Alogna, David Zweiker, Birgit Zirngast, Stefan Reiter, Viktoria Herbst, Heinrich Maechler, Burkert M Pieske, Frank R Heinzel, Helmut Brussee, Heiner Post, Daniel Scherr
OBJECTIVE: Application of therapeutic mild hypothermia in patients after resuscitation, often accompanied by myocardial infarction, cardiogenic shock, and systemic inflammation may impact on cardiac rhythm. We therefore tested susceptibility to atrial arrhythmias during hyperthermia (HT, 40.5°C), normothermia (NT, 38.0°C), and mild hypothermia (MH, 33.0°C). METHODS: Nine healthy, anesthetized closed-chest landrace pigs were instrumented with a quadripolar stimulation catheter in the high right atrium and a decapolar catheter in the coronary sinus...
April 16, 2018: Pacing and Clinical Electrophysiology: PACE
Wilber Su, Nicolas Coulombe, Nicole Kirchhof, Erin Grassl, Dan Wittenberger
BACKGROUND: Rigid time-based dosing protocol(s) currently used in the clinic for cryoballoon ablation of atrial fibrillation may be inadequate to guide the circumferential and transmural cryothermal energy transfer across the pulmonary vein (PV) and may result in injury to collateral tissues or electrical gaps between the PV and left atrium (LA). OBJECTIVE: A physiologic endpoint (e.g., acute time-to-PV isolation a.k.a. time-to-effect; TTE) may be effective in the determination of a transmural lesion formation and may allow for individualized ablation dosing across each PV...
April 14, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Dominique De Clercq, Barbara Broux, Lisse Vera, Annelies Decloedt, Gunther van Loon
BACKGROUND: In human and veterinary medicine, monophasic action potential (MAP) analysis and determination of local refractory periods by contact electrode technique gives valuable information about local cardiac electrophysiological properties. It is used to investigate dysrhythmias and the impact of drugs on the myocardium. Precise measurement of total MAP duration is difficult, therefore the MAP duration is usually determined at a repolarization level of 90% (APD90). Until now, no studies are published about the feasibility of this technique in the standing non-sedated horse...
March 20, 2018: BMC Veterinary Research
Kensuke Ihara, Koji Sugiyama, Kentaro Takahashi, Masahiro Yamazoe, Tetsuo Sasano, Tetsushi Furukawa
Recent genome-wide association studies targeting atrial fibrillation (AF) have indicated a strong association between the genotype and electrophysiological phenotype in the atria. That encourages us to utilize a genetically-engineered mouse model to elucidate the mechanism of AF. However, it is difficult to evaluate the electrophysiological properties in murine atria due to their small size. This protocol describes the electrophysiological evaluation of atria using an optical mapping system with a high temporal and spatial resolution in Langendorff perfused murine hearts...
February 22, 2018: Journal of Visualized Experiments: JoVE
Krishna Kumar Mohanan Nair, Anees Thajudeen, Narayanan Namboodiri, Ajitkumar Valaparambil
A 30year old patient presented to us with recurrent episodes of palpitation and documented tachycardia. In all his presentations a wide QRS tachycardia was recorded. The baseline ECG showed pre excitation. The 12 lead ECG of the tachycardia and the baseline ECG is shown in Fig. 1A. During EP study the patient had baseline pre excitation and the HV interval was 16 ms. A duo-decapolar halo (HL) catheter was used to map right atrium and a decapolar coronary sinus (CS) catheter was used to map coronary sinus...
March 2017: Indian Pacing and Electrophysiology Journal
Uğur Aksu, Kamuran Kalkan, Oktay Gülcü, Selim Topcu, Serdar Sevimli, Enbiya Aksakal, Emrah Ipek, Mahmut Açıkel, Ibrahim Halil Tanboğa
BACKGROUND: The atrioventricular (AV) dissociation, which is frequently used in differential diagnosis of wide QRS complex tachycardia (WQCT), is the most specific finding of ventricular tachycardia (VT) with lower sensitivity. Herein, we aimed to show the importance of Lewis lead ECG records to detect 'visible p waves' during WQCT. METHOD: A total of 21 consecutive patients who underwent electrophysiologic study (EPS) were included in the study. During EPS, by using a quadripolar diagnostic catheter directed to the right ventricular apex, a fixed stimulus was given and the ventriculoatrial (VA) Wenkebach point was found, and a VT was simulated by a RV apical stimulus at 300ms...
December 15, 2016: International Journal of Cardiology
Robert S Kelley, Michael D Vardy, Grant R Simons, Henry Chen, Charles Ascher-Walsh, Michael Brodman
AIMS: This is a pilot study to evaluate the feasibility of using diagnostic cardiac electrophysiology catheters for recording intrinsic urinary bladder electrical activity and for electrical pacing capture of bladder tissue. METHODS: During cystoscopy, a curved quadripolar catheter was introduced and contact was made with the right and left halves of the dome and trigone in adult female patients undergoing cystoscopy. Electrical activity was recorded, using a commercially available cardiac electrophysiologic recording system, before and during pacing at 0...
April 2017: Neurourology and Urodynamics
Bahij Kreidieh, Moisés Rodríguez-Mañero, Paul Schurmann, Sergio Hugo Ibarra-Cortez, Amish S Dave, Miguel Valderrábano
BACKGROUND: Radiofrequency ablation (RFA) of ventricular tachycardia (VT) can fail because of inaccessibility to the VT substrate. Transarterial coronary ethanol ablation can be effective but entails arterial instrumentation risk. We hypothesized that retrograde coronary venous ethanol ablation can be an alternative bail-out approach to failed VT RFA. METHODS AND RESULTS: Out of 334 consecutive patients undergoing VT/premature ventricular contraction ablation, 7 patients underwent retrograde coronary venous ethanol ablation...
July 2016: Circulation. Arrhythmia and Electrophysiology
Volkan Tuzcu, Enes Elvin Gul, Abdullah Erdem, Hacer Kamali, Turkay Saritas, Cem Karadeniz, Celal Akdeniz
INTRODUCTION: Cardiac interventions with fluoroscopy during pregnancy carry significant risks for the fetus. This report reviews three pregnant patients: two of them requiring pacemaker implantation and one underwent diagnostic cardiac catheterization without fluoroscopy. METHODS: The cases were performed using EnSite system (St. Jude Medical Inc., MN, USA) guidance. The necessary cardiac structure geometries were reconstructed with a deflectable quadripolar electrophysiology catheter without fluoroscopy...
August 2015: Pediatric Cardiology
Frédéric Franceschi, Linda Koutbi, Edouard Gitenay, Jérome Hourdain, Baptiste Maille, Lory Trévisan, Jean-Claude Deharo
BACKGROUND: Electromyography-guided phrenic nerve (PN) monitoring using a catheter positioned in a hepatic vein can aid in preventing phrenic nerve palsy (PNP) during cryoballoon ablation for atrial fibrillation. We wanted to evaluate the feasibility and efficacy of PN monitoring during procedures using second-generation cryoballoons. METHODS AND RESULTS: This study included 140 patients (43 women) in whom pulmonary vein isolation was performed using a second-generation cryoballoon...
April 2015: Circulation. Arrhythmia and Electrophysiology
George H Crossley, Mauro Biffi, Ben Johnson, Albert Lin, Daniel Gras, Azlan Hussin, Allen Cuffio, Jack L Collier, Mikhael El-Chami, Shelby Li, Keith Holloman, Derek V Exner
BACKGROUND: The Medtronic Attain Performa quadripolar leads provide 16 pacing vectors with steroid on every electrode. This includes a short bipolar configuration between the middle 2 electrodes. OBJECTIVE: A prospective clinical study was conducted to investigate the safety and effectiveness of these new leads in 27 countries. METHODS: Cardiac resynchronization therapy with defibrillator candidates were enrolled (mean age 68 years; 71% men)...
April 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
P Gal, M R de Jong, J J J Smit, A Adiyaman, J A Staessen, A Elvan
During renal sympathetic denervation (RDN), no mapping of renal nerves is performed and there is no clear end point of RDN. We hypothesized high-frequency renal nerve stimulation (RNS) may increase blood pressure (BP), and this increase is significantly blunted after RDN. The aim of this study was to determine the feasibility of RNS in patients undergoing RDN. Eight patients with resistant hypertension undergoing RDN were included. A quadripolar catheter was positioned at four different sites in either renal artery...
May 2015: Journal of Human Hypertension
Malini Madhavan, Christopher V Desimone, Elisa Ebrille, Siva K Mulpuru, Susan B Mikell, Susan B Johnson, Scott H Suddendorf, Dorothy J Ladewig, Emily J Gilles, Andrew J Danielsen, Samuel J Asirvatham
BACKGROUND: Neurocardiogenic syncope (NCS) is a common and sometimes debilitating disorder, with no consistently effective treatment. NCS is due to a combination of bradycardia and vasodilation leading to syncope. Although pacemaker devices have been tried in treating the bradycardic aspect of NCS, no device-based therapy exists to treat the coexistent vasodilation that occurs. The renal sympathetic innervation has been the target of denervation to treat hypertension. We hypothesized that stimulation of the renal sympathetic nerves can increase blood pressure and counteract vasodilation in NCS...
October 2014: Journal of Cardiovascular Electrophysiology
Ferdi Akca, Bruno Schwagten, Dominic A J Theuns, Marieke Takens, Paul Musters, Tamas Szili-Torok
OBJECTIVE: Ablation of atrioventricular nodal re-entrant tachycardia (AVNRT) is a highly effective procedure both with radiofrequency (RF) and cryoenergy (CE). Conventionally, it requires several diagnostic catheters and hospital admission. This study assessed the safety and efficacy of a highly simplified approach using the magnetic navigation system (MNS) compared to CE and manual RF ablation (MAN). METHODS AND RESULTS: In the MNS group a single magnetic-guided quadripolar catheter was inserted through the internal jugular vein to perform ablation...
December 2013: Acta Cardiologica
Anoop K Shetty, Manav Sohal, Zhong Chen, Matthew R Ginks, Julian Bostock, Sana Amraoui, Kyungmoo Ryu, Stuart P Rosenberg, Steven A Niederer, Jas Gill, Gerry Carr-White, Reza Razavi, C Aldo Rinaldi
AIMS: Alternative forms of cardiac resynchronization therapy (CRT), including biventricular endocardial (BV-Endo) and multisite epicardial pacing (MSP), have been developed to improve response. It is unclear which form of stimulation is optimal. We aimed to compare the acute haemodynamic response (AHR) and electrophysiological effects of BV-Endo with MSP via two separate coronary sinus (CS) leads or a single-quadripolar CS lead. METHODS AND RESULTS: Fifteen patients with a previously implanted CRT system received a second temporary CS lead and left ventricular (LV) endocardial catheter...
June 2014: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Frédéric Franceschi, Linda Koutbi, Julien Mancini, Shahram Attarian, Sébastien Prevôt, Jean-Claude Deharo
BACKGROUND: Right phrenic nerve palsy (PNP) is the most frequent complication of cryoballoon ablation. Diaphragmatic electromyography can predict PNP with a comfortable safety margin. Our goal was to evaluate the feasibility, efficacy, and safety of electromyography-guided PN monitoring using a novel hepatic vein approach for prevention of PNP. METHODS AND RESULTS: This study includes 57 patients (47 males) indicated for cryoballoon ablation for treatment of atrial fibrillation...
December 2013: Circulation. Arrhythmia and Electrophysiology
Nicolas Derval, Allan C Skanes, Lorne J Gula, Chris Gray, Arnaud Denis, Han S Lim, Andrew D Krahn, Raymond Yee, Frederic Sacher, Michel Haïssaguerre, George J Klein
BACKGROUND: Distinguishing retrograde nodal conduction from extranodal conduction using an accessory pathway (AP) can sometimes be challenging. OBJECTIVE: To distinguish nodal from extranodal ventriculoatrial (VA) conduction regardless of AP location by proposing a simple method. This method is based on the principle that moving the pacing site progressively from the basal region toward the entrance of the His-Purkinje system should shorten VA time for nodal but not for AP conduction...
December 2013: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Malini Madhavan, Christopher V DeSimone, Siva Mulpuru, Samuel J Asirvatham
Neurocardiogenic syncope is a common disorder resulting from a transient increase in vagal tone and central sympathetic withdrawal leading to varying degrees of vasodilation and bradycardia. Hence an effective treatment should address both the bradycardia and vasodilation. We hypothesized that, stimulation of the renal sympathetic nerves using high frequency stimulation in the renal vein will increase blood pressure through an increase in sympathetic output and therefore may be of use in treating neurocardiogenic syncope...
May 2013: Cardiovascular Revascularization Medicine: Including Molecular Interventions
V Patton, L Wiklendt, J W Arkwright, D Z Lubowski, P G Dinning
BACKGROUND: Sacral nerve stimulation (SNS) is an effective treatment for neurogenic faecal incontinence (FI). However, the clinical improvement that patients experience cannot be explained adequately by changes in anorectal function. The aim of this study was to examine the effect of SNS on colonic propagating sequences (PSs) in patients with FI in whom urgency and incontinence was the predominant symptom. METHODS: In patients with FI a high-resolution fibre-optic manometry catheter, containing 90 sensors spaced at 1-cm intervals, was positioned colonoscopically and clipped to the caecum...
June 2013: British Journal of Surgery
Bernard Thibault, Marc Dubuc, Paul Khairy, Peter G Guerra, Laurent Macle, Lena Rivard, Denis Roy, Mario Talajic, Edward Karst, Kyungmoo Ryu, Patrice Paiement, Taraneh G Farazi
AIMS: Pacing from multiple sites in the left ventricle (LV) may bring about further resynchronization of the diseased heart compared with biventricular (BiV) pacing. We compared acute haemodynamic response (LV dP/dtmax) of multisite and BiV pacing using a quadripolar LV lead. METHODS AND RESULTS: In 21 patients receiving cardiac resynchronization therapy, a quadripolar LV lead and conventional right atrial and ventricular leads were connected to an external pacing system...
July 2013: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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