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Mark N Belkin, Cesar E Soria, Albert L Waldo, C Jan Willem Borleffs, David L Hayes, Roderick Tung, Jagmeet P Singh, Gaurav A Upadhyay
BACKGROUND: Despite the clear association between atrial fibrillation and risk for thromboembolic events (TEs), the clinical significance of new-onset device-detected atrial tachyarrhythmia (DDAT) and TE remains disputed. We aimed to determine the risk of TE in patients with new-onset DDAT. METHODS AND RESULTS: The OVID Medline, Cochrane, and Scopus databases (inception to November 2016) were searched. Randomized controlled trials, prospective, or retrospective studies of pacemaker or defibrillator patients reporting incidence of DDAT were selected...
March 2018: Circulation. Arrhythmia and Electrophysiology
Ze-Wei Tao, Mohamed Mohamed, Jeffrey G Jacot, Ravi K Birla
Bioengineering cardiac tissue constructs with adult cardiomyocytes may help treat adult heart defects and injury. In this study, we fabricated cardiac tissue constructs by seeding adult rat cardiomyocytes on a fibrin gel matrix and analyzed the electromechanical properties of the formed cardiac tissue constructs. Adult rat cardiomyocytes were isolated with a collagenase type II buffer using an optimized Langendorff perfusion system. Cardiac tissue constructs were fabricated using either indirect plating with cardiomyocytes that were cultured for 1 week and dedifferentiated or with freshly isolated cardiomyocytes...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Xavier Chabin, Ouarda Taghli-Lamallem, Aurélien Mulliez, Pierre Bordachar, Frédéric Jean, Emmanuel Futier, Grégoire Massoullié, Marius Andonache, Géraud Souteyrand, Sylvain Ploux, Yves Boirie, Ruddy Richard, Bernard Citron, Jean-R Lusson, Thomas Godet, Bruno Pereira, Pascal Motreff, Guillaume Clerfond, Romain Eschalier
BACKGROUND & AIMS: There is an increase in the number of patients worldwide with cardiac implantable electronic devices (CIEDs). Current medical practice guidelines warn against performing bioimpedance analysis (BIA) in this group of patients in order to avoid any electromagnetic interference. These recommendations restrict using the BIA in patients undergoing heart failure or with nutrition disorders in whom BIA could be of major interest in detecting peripheral congestion and to help guide treatment...
March 2, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Abdulcebbar Şipal, Serdar Bozyel, Müjdat Aktaş, Emir Derviş, Tayyar Akbulut, Onur Argan, Umut Çelikyurt, Dilek Ural, Tayfun Şahin, Ayşen Ağır, Ahmet Vural
OBJECTIVE: Failure to select the optimal left ventricular (LV) segment for lead implantation is one of the most important causes of unresponsiveness to the cardiac resynchronization therapy (CRT). In our study, we aimed to investigate the echocardiographic and clinical benefits of LV lead implantation guided by an intraoperative 12-lead surface electrocardiogram (ECG) in patients with multiple target veins. METHODS: We included 80 [42 (62.5%) male] heart failure patients who successfully underwent CRT defibrillator (CRT-D) implantation...
March 2018: Anatolian Journal of Cardiology
Guoliang Li, Ardan M Saguner, Deniz Akdis, Guy H Fontaine
Atrioventricular (AV) block has been extensively studied. However, conduction inside the myocardium in patients with AV block has not been reported. In this study, we aimed to demonstrate the presence of intramyocardial block in patients with AV block. Five consecutive patients with spontaneous high-grade AV block and Torsades de pointes (TdP) were prospectively studied with standard United States Catheter Instruments (USCI) endocardial temporary catheter located at the right ventricle (RV) apex. The morphology of endocardial potentials observed in the basic QRS complexes as well as during episodes of TdP was studied...
March 7, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Rodrigo S Barbosa, Leon Glass, Riccardo Proietti, Barry Burstein, Ahmed Al-Turki, Lyndon Sobolik, Zhubo Zhang, Guillaume Viart, Michelle Samuel, Alvin Shrier, Vidal Essebag
Arrhythmia onset pattern may have important implications on morbidity, recurrent implantable cardioverter defibrillator (ICD) shocks, and mortality, given the proposed correlation between initiation pattern and arrhythmia mechanism. Therefore, we developed and tested a computer-based algorithm to differentiate the pattern of initiation based on the beat-to-beat intervals of the ventricular tachycardia (VT) episodes in ICD recordings from the Resynchronization-Defibrillation for Ambulatory Heart Failure Trial (RAFT)...
February 3, 2018: Journal of Electrocardiology
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
Habib Hajimolahoseini, Javad Hashemi, Saeed Gazor, Damian Redfearn
OBJECTIVE: In this paper, we propose a novel algorithm to extract the active intervals of intracardiac electrograms during atrial fibrillation. METHODS: First, we show that the characteristics of the signal waveform at its inflection points are prominent features that are implicitly used by human annotators for distinguishing between active and inactive intervals of IEGMs. Then, we show that the natural logarithm of features corresponding to active and inactive intervals exhibits a mixture of two Gaussian distributions in three dimensional feature space...
March 1, 2018: Artificial Intelligence in Medicine
Shuanglun Xie, Benoit Desjardins, Maciej Kubala, Jackson Liang, Jiandu Yang, Rob J van der Geest, Robert Schaller, Michael Riley, David Callans, Erica Zado Pac, Francis Marchlinski, Saman Nazarian
BACKGROUND: Criteria for identification of anatomic ventricular tachycardia (VT) substrates in arrhythmogenic right ventricular cardiomyopathy (ARVC) on late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) are unclear. OBJECTIVE: We sought to define a) the association of regional RV epicardial voltage amplitude with the distribution of LGE, and b) appropriate image signal intensity (SI) thresholds for VT substrate identification, in ARVC. METHODS: Pre-procedural LGE-CMR and epicardial electrogram mapping were performed in 10 ARVC patients...
March 1, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Laura R Bear, Peter R Huntjens, Richard Walton, Olivier Bernus, Ruben Coronel, Rémi Dubois
BACKGROUND: Poor identification of electrical dyssynchrony is postulated to be a major factor contributing to the low success rate for cardiac resynchronization therapy (CRT). OBJECTIVE: To evaluate body surface mapping and electrocardiographic imaging (ECGi) to detect electrical dyssynchrony noninvasively. METHODS: Langendorff-perfused pig hearts (n=11) were suspended in a human torso-shaped tank, with LBBB induced through ablation. Recordings were taken simultaneously from a 108-electrode epicardial sock and 128 electrodes embedded in the tank surface during sinus rhythm and ventricular pacing...
February 22, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Lisette J M E van der Does, Paul Knops, Christophe P Teuwen, Corina Serban, Roeliene Starreveld, Eva A H Lanters, Elisabeth M J P Mouws, Charles Kik, Ad J J C Bogers, Natasja M S de Groot
BACKGROUND: Endo-epicardial asynchrony (EEA) and the interplay between these layers could be important in the pathophysiology of atrial arrhythmias. The morphological differences between epicardial and endocardial atrial electrograms have not been described so far and electrogram morphology may hold information about the presence of EEA. OBJECTIVE: This study directly compared epicardial to endocardial unipolar electrogram morphology during sinus rhythm (SR) and evaluated whether EEA contributes to electrogram fractionation by correlating fractionation to spatial activation patterns...
February 21, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Yuka Taguchi, Toshiyuki Ishikawa, Katsumi Matsumoto, Yutaka Ogino, Hirooki Matsushita, Kohei Iguchi, Junya Hosoda
A 17-year-old woman was resuscitated from cardiac arrest due to ventricular fibrillation and was diagnosed with concealed long QT syndrome. She underwent subcutaneous implantable cardiac defibrillator (S-ICD) implantation at our hospital. The device electrogram immediately after implantation was normal. Four days after implantation, she received an inappropriate shock. The device interrogation revealed a continuous baseline shift and frequent oversensing for low amplitude signals, followed by a shock. A chest radiograph in the orthogonal view showed entrapped subcutaneous air surrounding the distal electrode...
February 14, 2018: International Heart Journal
Kwang-No Lee, Seung-Young Roh, Yong-Soo Baek, Hee-Soon Park, Jinhee Ahn, Dong-Hyeok Kim, Dae In Lee, Jaemin Shim, Jong-Il Choi, Sang-Weon Park, Young-Hoon Kim
BACKGROUND: Pulmonary vein isolation (PVI) is effective for maintenance of sinus rhythm in 50% to 75% of patients with paroxysmal atrial fibrillation, and it is not uncommon for patients to require additional ablation after PVI. We prospectively evaluated the relative effectiveness of 2 post-PVI ablation strategies in paroxysmal atrial fibrillation. METHODS AND RESULTS: A total of 500 patients (mean age, 55.7±11.0 years; 74.6% male) were randomly assigned to undergo ablation by 2 different strategies after PVI: (1) elimination of non-PV triggers (group A, n=250) or (2) stepwise substrate modification including complex fractionated atrial electrogram or linear ablation until noninducibility of atrial tachyarrhythmia was achieved (group B, n=250)...
February 2018: Circulation. Arrhythmia and Electrophysiology
Jay A Montgomery, Christopher R Ellis
Battery depletion is the most common reason for device reoperation, which is associated with significant patient morbidity and mortality. This article describes the history of pacing and defibrillation power supplies and the factors that determine the longevity of pacing and defibrillator generators with a special emphasis on factors that can be adjusted or controlled by the implanting and following physician. Optimization of longevity is attained through device selection; shock minimization; avoidance of prolonged radiofrequency telemetry; selection of higher impedance vectors; avoidance of long pulse duration when possible; and avoidance of unnecessary feature activation, such as continuous electrogram storage...
March 2018: Cardiac Electrophysiology Clinics
Wen-Han Cheng, Li-Wei Lo, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Yuan Hung, Fa-Po Chung, Ting-Yung Chang, Ting-Chung Huang, Shinya Yamada, Simon Salim, Abigail Louise D Te, Jo-Nan Liao, Ta-Chuan Tuan, Tze-Fan Chao, Tseng-Ying Tsai, Shin-Huei Liu, Shih-Ann Chen
INTRODUCTION: Cigarette smoking contributes to the development of atrial fibrosis via nicotine. The impact of smoking on ablation results in persistent atrial fibrillation (AF) is unknown. We aimed to investigate the triggers and long-term outcome between smokers and non-smokers in the patients with persistent AF after catheter ablation. METHODS: This study included 201 (177 males, 53±10 years old) patients who received index catheter ablation, including pulmonary vein isolation (PVI) and complex fractionated atrial electrograms (CFAEs) ablation for persistent AF, retrospectively...
February 9, 2018: Journal of Cardiovascular Electrophysiology
Jonathan Chrispin, Ali Keramati, Fabrizio R Assis, Satish Misra, Tarek Zghaib, Ronald D Berger, Hugh Calkins, Harikrishna Tandri
AIMS: Prior studies identified a relationship between epicardial bipolar and endocardial unipolar voltage. Whether the relationship is valid with smaller multielectrode mapping catheters has not been reported. We explored the association of right ventricular (RV) endocardial unipolar voltage mapping with epicardial bipolar voltage mapping using a multielectrode mapping catheter. METHODS: Electrograms from patients who underwent multielectrode endocardial and epicardial RV electroanatomical mapping during ablation procedures were analyzed...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
Ahmed AlTurki, Riccardo Proietti
Recurrence of atrial fibrillation after pulmonary vein isolation is mainly due to pulmonary vein reconnection. Contact force sensing catheters that allow operators to assess and optimize the degree of contact as well as remote magnetic navigation which facilitates intracardiac catheter steering and improves catheter stability are two technological advances designed to improve catheter ablation outcomes by enhancing the ablation lesion. Lesion dimension can be assessed indirectly via electrogram signal attenuation and impedance drop...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
Shohreh Honarbakhsh, Richard J Schilling, Gurpreet Dhillon, Waqas Ullah, Emily Keating, Rui Providencia, Anthony Chow, Mark J Earley, Ross J Hunter
Objectives: This study sought to use a novel panoramic mapping system (CARTOFINDER) to detect and characterize drivers in persistent atrial fibrillation (AF). Background: Mechanisms sustaining persistent AF remain uncertain. Methods: Patients undergoing catheter ablation for persistent AF were included. A 64-pole basket catheter was used to acquire unipolar signals, which were processed by the mapping system to generate wavefront propagation maps...
January 2018: JACC. Clinical Electrophysiology
Michael Ghannam, Hubert Cochet, Pierre Jais, Maxime Sermesant, Smita Patel, Konstantinos C Siontis, Fred Morady, Frank Bogun
BACKGROUND: Myocardial wall thickness (WT) in patients with a prior myocardial infarction has been used to indicate scarring. However, the correlation of WT with sites critical to ventricular tachycardia (VT) has not been previously investigated. The purpose of this study was to correlate electroanatomic mapping data obtained during VT ablation with WT determined by cardiac computed tomography (CT). METHODS AND RESULTS: Cardiac CTs were performed in 15 consecutive patients (mean age 63±10 years, 86% male, left ventricular ejection fraction 27±12%) with a prior infarct referred for VT ablation...
January 30, 2018: Journal of Cardiovascular Electrophysiology
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