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https://www.readbyqxmd.com/read/28090710/fibrillatory-wave-amplitude-on-transesophageal-ecg-as-a-marker-of-left-atrial-low-voltage-areas-in-patients-with-persistent-atrial-fibrillation
#1
Ran Yin, Yongnan Fu, Zhongming Yang, Bingong Li, Jintian Pen, Zeqi Zheng
BACKGROUND: Low-voltage areas (LVAs) are frequently observed in patients with persistent atrial fibrillation (PeAF) and may represent adverse atrial remodeling. However, noninvasive method of evaluating LAVs is not well established. METHODS: In a cohort of 68 patients with PeAF, endocardial voltage maps of left atrium (LA) were created during sinus rhythm after pulmonary vein isolation (PVI). LVAs were defined as areas with electrogram amplitudes <0.5 mV. LA-LVAs were correlated with clinical, echocardiographic, surface, and transesophageal electrocardiography (TE-ECG) variables...
January 16, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28073882/the-role-of-superior-vena-cava-in-catheter-ablation-of-long-standing-persistent-atrial-fibrillation
#2
Kai Xu, Yuanlong Wang, Shaohui Wu, Li Zhou, Liang Zhao, Weifeng Jiang, Xiaodong Zhang, Xu Liu
AIMS: The superior vena cava (SVC) has been established as an important source of atrial fibrillation (AF). The role of SVC in long-standing persistent AF and the efficacy of empiric electrical isolation of the SVC are still unclear. The purpose of this study was to judge the role of SVC in catheter ablation of long-standing persistent AF. METHODS AND RESULTS: A total of 102 consecutive patients with long-standing persistent AF were enrolled. All patients underwent circumferential pulmonary vein isolation, complex fractionated atrial electrograms ablation, and linear ablation during the index procedure...
January 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28063269/novel-mapping-technique-for-localization-of-focal-and-reentrant-activation-during-atrial-fibrillation
#3
Yoshihide Takahashi, Shinsuke Iwai, Syu Yamashita, Mayumi Masumura, Masahito Suzuki, Kento Yabe, Yasuhiro Sato, Kenzo Hirao, Mitsuaki Isobe
INTRODUCTION: Identification of wavefront propagation pattern during AF remains challenging in ablation procedures. We sought to test a novel combination of a new mapping technology called Ripple Map and high density mapping to distinguish focal and reentrant activation during atrial fibrillation (AF). METHODS AND RESULTS: Subjects were patients undergoing ablation for persistent AF. If AF remained after isolation of the pulmonary veins, the left atrium (LA) was mapped by a high-density mapping catheter for later analysis, after which ablation was continued using a conventional stepwise approach...
January 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28062531/epsilon-wave-on-an-electronic-loop-in-a-case-of-arrhythmogenic-right-ventricular-dysplasia-with-myocarditis-an-updated-definition-of-the-epsilon-wave
#4
Guy Hugues Fontaine, Guillaume Duthoit, Guoliang Li, L Andreoletti, Estelle Gandjbakhch, Robert Frank
A young man presented with a history of myocarditis with palpitations and dizziness. He had implantation of a loop recorder that showed repetitive short episodes of VT. In addition, there were fragmented potentials immediately following the large and sharp electrograms (EGMs) before as well as after episodes of VT suggesting an Epsilon wave. This signal can be observed in multiple cardiac conditions including coronary artery disease. It was originally recorded on the epicardium as well as on the endocardium...
January 6, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28044401/atrioventricular-synchrony-in-the-background-of-ventricular-noise-and-undersensing
#5
Paweł T Matusik, Andrzej Ząbek, Patrycja S Matusik, Barbara Małecka, Jacek Lelakowski
The 24-hr electrocardiogram (ECG) interpretation in patients with double-chamber pacemakers may be challenging. The difficulty increases if not well-known pacemaker algorithm and device malfunction coexist. We show atrial synchronization pace (ASP) in a patient with ventricular lead damage. We provide detailed description of electrocardiogram and intracardiac electrogram. ASP may confuse 24-hr ECG monitoring interpretation, especially in patients with ventricular lead dysfunction.
January 3, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28039280/selection-of-critical-isthmus-in-scar-related-atrial-tachycardia-using-a-new-automated-ultrahigh-resolution-mapping-system
#6
Decebal Gabriel Laţcu, Sok-Sithikun Bun, Frédéric Viera, Tahar Delassi, Mohammed El Jamili, Alaa Al Amoura, Nadir Saoudi
BACKGROUND: Accurate activation mapping of reentrant scar-related atrial tachycardias (AT) allows efficient radiofrequency ablation by targeting the critical isthmus (CI). We aimed to assess the electrophysiological properties of CI channels during mapping with the IntellaMap Orion basket and the Rhythmia system. METHODS AND RESULTS: We prospectively studied 33 AT (post- atrial fibrillation ablation or surgical mitral valve repair). The noise of bipolar electrogram (EGM) was systematically measured at 10 prespecified sites, as well as on a standard catheter and on the surface ECG...
January 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28017938/elucidation-of-hidden-slow-conduction-by-double-ventricular-extrastimuli-a-method-for-further-arrhythmic-substrate-identification-in-ventricular-tachycardia-ablation-procedures
#7
Juan Acosta, David Andreu, Diego Penela, Mario Cabrera, Alicia Carlosena, Viatcheslav Korshunov, Francesca Vassanelli, Roger Borras, Mikel Martínez, Juan Fernández-Armenta, Markus Linhart, José M Tolosana, Lluis Mont, Antonio Berruezo
AIMS: Identification of local abnormal electrograms (EGMs) during ventricular tachycardia substrate ablation (VTSA) is challenging when they are hidden within the far-field signal. This study analyses whether the response to a double ventricular extrastimulus during substrate mapping could identify slow conducting areas that are hidden during sinus rhythm. METHODS AND RESULTS: Consecutive patients (n = 37) undergoing VTSA were prospectively included. Bipolar EGMs with >3 deflections and duration <133 ms were considered as potential hidden slow conduction EGMs (HSC-EGM) if located within/surrounding the scar area...
December 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28017937/catheter-ablation-of-atrial-fibrillation-in-very-young-adults-a-5-year-follow-up-study
#8
Ardan M Saguner, Tilman Maurer, Erik Wissner, Francesco Santoro, Christine Lemes, Shibu Mathew, Christian Sohns, Christian H Heeger, Bruno Reißmann, Johannes Riedl, Thomas Fink, Kentaro Hayashi, Peter Wohlmuth, Karl-Heinz Kuck, Feifan Ouyang, Andreas Metzner
AIMS: Catheter ablation is an established therapy for symptomatic atrial fibrillation (AF). However, outcome data on catheter ablation for AF in young adults is scarce. METHODS AND RESULTS: From 2005-2014, 85 consecutive young adults (mean age 31 ± 4 years; 69% men) with symptomatic paroxysmal AF (PAF, n = 52) and persistent (Pers) AF (n = 33) underwent pulmonary vein isolation (PVI) [±ablation of complex fractionated atrial electrograms/linear lesions in PVI non-responders] at our centre...
December 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28011842/modelling-methodology-of-atrial-fibrosis-affects-rotor-dynamics-and-electrograms
#9
Caroline H Roney, Jason D Bayer, Sohail Zahid, Marianna Meo, Patrick M J Boyle, Natalia A Trayanova, Michel Haïssaguerre, Rémi Dubois, Hubert Cochet, Edward J Vigmond
AIMS: Catheter ablation is an effective technique for terminating atrial arrhythmia. However, given a high atrial fibrillation (AF) recurrence rate, optimal ablation strategies have yet to be defined. Computer modelling can be a powerful aid but modelling of fibrosis, a major factor associated with AF, is an open question. Several groups have proposed methodologies based on imaging data, but no comparison to determine which methodology best corroborates clinically observed reentrant behaviour has been performed...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28011797/reappraisal-and-new-observations-on-atrial-tachycardia-ablated-from-the-non-coronary-aortic-sinus-of-valsalva
#10
Shomu Bohora, Yash Lokhandwala, Eduardo Back Sternick, Robert H Anderson, Hein J J Wellens
AIMS: The clinical characteristics of atrial tachycardias (AT) ablated from the non-coronary aortic sinus (NCS) are thus far described only in small series. We aimed to outline, in a large cohort of patients, the clinical, electrocardiographic, electrophysiological characteristics of this tachycardia. METHODS AND RESULTS: We analysed data pertaining to clinical, electrocardiographic, and electrophysiological characteristics of 43 consecutive patients from an overall cohort of 441 with AT who were successfully ablated from the NCS...
December 23, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28011328/impact-of-acute-atrial-fibrillation-af-termination-and-prolongation-of-af-cycle-length-afcl-on-the-outcome-of-ablation-of-persistent-af-a-sub-study-of-the-star-af-ii-trial
#11
Simon Kochhäuser, Chen-Yang Jiang, Timothy R Betts, Jian Chen, Isabel Deisenhofer, Roberto Mantovan, Laurent Macle, Carlos A Morillo, Wilhelm Haverkamp, Rukshen Weerasooriya, Jean-Paul Albenque, Stefano Nardi, Endrj Menardi, Paul Novak, Prashanthan Sanders, Atul Verma
BACKGROUND: There is controversy about the impact of acute AF termination and prolongation of AFCL during ablation on the long-term procedural outcome. OBJECTIVE: We analyzed the influence of AF termination and AFCL-prolongation on freedom from AF in patients from the STAR-AF II trial. METHODS: Acute changes in AFCL and AF termination were collected during the index procedure of the STAR-AF II trial and compared to recurrence of AF at 18 months...
December 20, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27989791/coronary-sinus-activation-patterns-in-patients-with-and-without-left-bundle-branch-block-undergoing-electroanatomic-mapping-system-guided-cardiac-resynchronization-therapy-device-implantation
#12
Maurizio Del Greco, Alessandro Zorzi, Irene Di Matteo, Anna Cima, Massimiliano Maines, Carlo Angheben, Domenico Catanzariti
BACKGROUND: implantation of the left ventricular (LV) lead in segments with delayed electrical activation may improve response to cardiac resynchronization therapy (CRT). OBJECTIVE: to evaluate amount and regional distribution of LV electrical delay (LVED) in patients with or without left bundle branch block (LBBB). METHODS: we enrolled 60 patients who underwent electroanatomic mapping system-guided CRT implantation. Activation mapping of the coronary sinus (CS) branches was performed using an insulated guide wire...
October 27, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27989790/using-wall-thickness-to-understand-both-sides-of-the-substrate-story-can-we-predict-electrograms-with-imaging
#13
EDITORIAL
Roderick Tung
No abstract text is available yet for this article.
October 27, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27968777/noninvasive-epicardial-and-endocardial-electrocardiographic-imaging-of-scar-related-ventricular-tachycardia
#14
Linwei Wang, Omar A Gharbia, B Milan Horáček, John L Sapp
BACKGROUND: The majority of life-threatening ventricular tachycardias (VTs) are sustained by heterogeneous scar substrates with narrow strands of surviving tissue. An effective treatment for scar-related VT is to modify the underlying scar substrate by catheter ablation. If activation sequence and entrainment mapping can be performed during sustained VT, the exit and isthmus of the circuit can often be identified. However, with invasive catheter mapping, only monomorphic VT that is hemodynamically stable can be mapped in this manner...
November 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27957764/mechanisms-of-undersensing-by-a-noise-detection-algorithm-that-utilizes-far-field-electrograms-with-near-field-bandpass-filtering
#15
Jayanthi N Koneru, Charles D Swerdlow, Sylvain Ploux, Parikshit S Sharma, Karoly Kaszala, Alex Y Tan, Jose F Huizar, Pugazhendi Vijayaraman, David Kenigsberg, Kenneth A Ellenbogen
BACKGROUND: Implantable cardioverter defibrillators (ICDs) must establish a balance between delivering appropriate shocks for ventricular tachyarrhythmias and withholding inappropriate shocks for lead-related oversensing ("noise"). To improve the specificity of ICD therapy, manufacturers have developed proprietary algorithms that detect lead noise. The SecureSense(TM) RV Lead Noise discrimination (St Jude Medical, St Paul, MN) algorithm is designed to differentiate oversensing due to lead failure from ventricular tachyarrhythmias and withhold therapies in the presence of sustained lead-related oversensing...
December 13, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27932238/gender-differences-in-patients-with-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy-clinical-manifestations-electrophysiological-properties-substrate-characteristics-and-prognosis-of-radiofrequency-catheter-ablation
#16
Chin-Yu Lin, Fa-Po Chung, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Yao-Ting Chang, Yun-Yu Chen, Rohit Walia, Abigail Louise D Te, Shinya Yamada, Shih-Ann Chen
BACKGROUND: Gender differences in the penetrance and clinical expression of genetic mutations have been reported in patients with arrhythmogenic right ventricular (RV) dysplasia/cardiomyopathy (ARVD/C). Our study aimed at clarifying the impact of gender on ventricular substrates and clinical outcomes after radiofrequency catheter ablation (RFCA). METHODS: Patients with ARVD/C underwent RFCA for drug-refractory ventricular arrhythmias (VAs) were consecutively enrolled...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27930354/simultaneous-non-invasive-epicardial-and-endocardial-mapping-in-patients-with-brugada-syndrome-new-insights-into-arrhythmia-mechanisms
#17
Boris Rudic, Maria Chaykovskaya, Alexey Tsyganov, Vitaly Kalinin, Erol Tülümen, Theano Papavassiliu, Christina Dösch, Volker Liebe, Jürgen Kuschyk, Susanne Röger, Ibrahim El-Battrawy, Ibrahim Akin, Marina Yakovleva, Elena Zaklyazminskaya, Anna Shestak, Stanislav Kim, Mikhail Chmelevsky, Martin Borggrefe
BACKGROUND: The underlying mechanisms of Brugada syndrome (BrS) are not completely understood. Recent studies provided evidence that the electrophysiological substrate, leading to electrocardiogram abnormalities and/or ventricular arrhythmias, is located in the right ventricular outflow tract (RVOT). The purpose of this study was to examine abnormalities of epicardial and endocardial local unipolar electrograms by simultaneous noninvasive mapping in patients with BrS. METHODS AND RESULTS: Local epicardial and endocardial unipolar electrograms were analyzed using a novel noninvasive epi- and endocardial electrophysiology system (NEEES) in 12 patients with BrS and 6 with right bundle branch block for comparison...
November 14, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27921187/rotor-tracking-using-phase-of-electrograms-recorded-during-atrial-fibrillation
#18
Caroline H Roney, Chris D Cantwell, Norman A Qureshi, Rasheda A Chowdhury, Emmanuel Dupont, Phang Boon Lim, Edward J Vigmond, Jennifer H Tweedy, Fu Siong Ng, Nicholas S Peters
Extracellular electrograms recorded during atrial fibrillation (AF) are challenging to interpret due to the inherent beat-to-beat variability in amplitude and duration. Phase mapping represents these voltage signals in terms of relative position within the cycle, and has been widely applied to action potential and unipolar electrogram data of myocardial fibrillation. To date, however, it has not been applied to bipolar recordings, which are commonly acquired clinically. The purpose of this study is to present a novel algorithm for calculating phase from both unipolar and bipolar electrograms recorded during AF...
December 5, 2016: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27920835/atriofascicular-pathway-detection-with-novel-ablation-catheter
#19
Padmanabhan Shakkottai, Adrian Baranchuk, Neil Hobson, Jane Caldwell
Atriofascicular pathways are a rare cause of antidromic atrioventricular reciprocating tachycardia. The IntellaTip MiFi ablation catheter (Boston Scientific, MA, USA) is a novel ablation catheter that allows enhanced signal clarity with highly localized electrograms. This is the first report of this catheter being successfully used to map and ablate the atriofascicular pathway potentials.
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27920828/detection-of-sequential-activation-of-left-atrium-and-coronary-sinus-musculature-in-the-general-population
#20
Masaki Ota, Yoshiaki Kaneko, Tadashi Nakajima, Tadanobu Irie, Takafumi Iijima, Akihiro Saito, Masahiko Kurabayashi
BACKGROUND: The direction of impulse propagation across the coronary sinus (CS) musculature (CSM) is an important piece of the mechanistic puzzle underlying atrial tachyarrhythmias. We hypothesized that in the general population, the sequence of left atrial (LA) to CSM electrograms recorded in the CS reflects the direction of impulse propagation over the CSM. METHODS: We studied 19 patients with atrioventricular (AV) reentrant tachycardia (RT) utilizing a left-sided accessory pathway (AP) and 21 patients with typical counterclockwise atrial flutter (AFL)...
December 2016: Journal of Arrhythmia
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