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https://www.readbyqxmd.com/read/28917552/crispr-correction-of-the-prkag2-gene-mutation-in-the-patient-s-ipsc-derived-cardiomyocytes-eliminates-the-electrophysiological-and-structural-abnormalities
#1
Ronen Ben Jehuda, Binyamin Eisen, Yuval Shemer, Lucy N Mekies, Agnes Szantai, Irina Reiter, Huanhuan Cui, Kaomei Guan, Shiraz Haron-Khun, Dov Freimark, Silke R Sperling, Mihaela Gherghiceanu, Michael Arad, Ofer Binah
BACKGROUND: Mutations in the PRKAG2 gene encoding the γ-subunit of adenosine monophosphate-kinase (AMPK) cause hypertrophic cardiomyopathy (HCM) and familial-Wolff-Parkinson-White syndrome (WPW). Patients carrying the R302Q mutation in PRKAG2 present sinus bradycardia, escape rhythms, ventricular pre-excitation, supraventricular tachycardia and atrioventricular block. This mutation affects AMPK activity and increases glycogen storage in cardiomyocytes. The link between glycogen storage, WPW, HCM and arrhythmias remains unknown...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28912976/electromagnetic-interference-from-swimming-pool-generator-current-causing-inappropriate-icd-discharges
#2
Edward Samuel Roberto, Thein Tun Aung, Atif Hassan, Abdul Wase
Electromagnetic interference (EMI) includes any electromagnetic field signal that can be detected by device circuitry, with potentially serious consequences: incorrect sensing, pacing, device mode switching, and defibrillation. This is a unique case of extracardiac EMI by alternating current leakage from a submerged motor used to recycle chlorinated water, resulting in false rhythm detection and inappropriate ICD discharge. A 31-year-old female with arrhythmogenic right ventricular cardiomyopathy and Medtronic dual-chamber ICD placement presented after several inappropriate ICD shocks at the public swimming pool...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28912205/epicardial-breakthrough-waves-during-sinus-rhythm-depiction-of-the-arrhythmogenic-substrate
#3
Elisabeth M J P Mouws, Eva A H Lanters, Christophe P Teuwen, Lisette J M E van der Does, Charles Kik, Paul Knops, Jos A Bekkers, Ad J J C Bogers, Natasja M S de Groot
BACKGROUND: Epicardial breakthrough waves (EBW) during atrial fibrillation are important elements of the arrhythmogenic substrate and result from endo-epicardial asynchrony, which also occurs to some degree during sinus rhythm (SR). We examined the incidence and characteristics of EBW during SR and its possible value in the detection of the arrhythmogenic substrate associated with atrial fibrillation. METHODS AND RESULTS: Intraoperative epicardial mapping (interelectrode distances 2 mm) of the right atrium, Bachmann's bundle, the left atrioventricular groove, and the pulmonary vein area was performed during SR in 381 patients (289 male, 67±10 years) with ischemic or valvular heart disease...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28889077/a-method-for-quantifying-recurrent-patterns-of-local-wavefront-direction-during-atrial-fibrillation
#4
James P Hummel, Alex Baher, Ben Buck, Manuel Fanarjian, Charles L Webber, Joseph G Akar
INTRODUCTION: Spiral wave reentry is a potential mechanism of atrial fibrillation (AF), but is difficult to differentiate clinically from multiple wavelet breakup using standard bipolar recordings. We developed a new methodology using bipolar recordings to estimate the direction of local activation wavefronts during AF by calculating the electrogram conformation (Egm-C). We subsequently used recurrence quantification analysis (RQA) of Egm-C to differentiate regions of spiral wave reentry from wavelet breakup...
September 1, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28887362/resolving-bipolar-electrogram-voltages-during-atrial-fibrillation-using-omnipolar-mapping
#5
Shouvik K Haldar, Karl Magtibay, Andreu Porta-Sanchez, Stéphane Massé, Nicholas Mitsakakis, Patrick F H Lai, Mohammed Ali Azam, John Asta, Marjan Kusha, Paul Dorian, Andrew C T Ha, Vijay Chauhan, D Curtis Deno, Kumaraswamy Nanthakumar
BACKGROUND: Low-voltage-guided substrate modification is an emerging strategy in atrial fibrillation (AF) ablation. A major limitation to contemporary bipolar electrogram (EGM) analysis in AF is the resultant lower peak-to-peak voltage (Vpp) from variations in wavefront direction relative to electrode orientation and from fractionation and collision events. We aim to compare bipole Vpp with novel omnipolar peak-to-peak voltages (Vmax) in sinus rhythm (SR) and AF. METHODS AND RESULTS: A high-density fixed multielectrode plaque was placed on the epicardial surface of the left atrium in dogs...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28887361/technical-considerations-on-phase-mapping-for-identification-of-atrial-reentrant-activity-in-direct-and-inverse-computed-electrograms
#6
Miguel Rodrigo, Andreu M Climent, Alejandro Liberos, Francisco Fernández-Avilés, Omer Berenfeld, Felipe Atienza, Maria S Guillem
BACKGROUND: Phase mapping has become a broadly used technique to identify atrial reentrant circuits for ablative therapy guidance. This work studies the phase mapping process and how the signal nature and its filtering affect the reentrant pattern characterization in electrogram (EGM), body surface potential mapping, and electrocardiographic imaging signals. METHODS AND RESULTS: EGM, body surface potential mapping, and electrocardiographic imaging phase maps were obtained from 17 simulations of atrial fibrillation, atrial flutter, and focal atrial tachycardia...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28884923/low-voltage-areas-detected-by-high-density-electroanatomical-mapping-predict-recurrence-after-ablation-for-paroxysmal-atrial-fibrillation
#7
Konstantinos Vlachos, Michael Efremidis, Konstantinos P Letsas, George Bazoukis, Ruairidh Martin, Maria Kalafateli, Louiza Lioni, Stamatis Georgopoulos, Athanasios Saplaouras, Theodore Efremidis, Tong Liu, Kosmas Valkanas, Nikolaos Karamichalakis, Dimitrios Asvestas, Antonios Sideris
INTRODUCTION: We aimed to evaluate the extent of atrial fibrosis in paroxysmal atrial fibrillation (AF) and the correlation with ablation outcomes after pulmonary vein antral isolation (PVΑI) using a mapping system with high-resolution and high-spatial sampling. METHODS AND RESULTS: We prospectively enrolled 80 consecutive patients (45 males, median age 60.26 years) with symptomatic paroxysmal AF who were scheduled for PVAI. Prior to PVAI, high-density bipolar voltage mapping (median number of 2,485 points) was carried out during sinus rhythm in all patients...
September 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28883795/atrial-electrogram-fractionation-distribution-before-and-after-pulmonary-vein-isolation-in-human-persistent-atrial-fibrillation-a-retrospective-multivariate-statistical-analysis
#8
Tiago P Almeida, Gavin S Chu, Xin Li, Nawshin Dastagir, Jiun H Tuan, Peter J Stafford, Fernando S Schlindwein, G André Ng
Purpose: Complex fractionated atrial electrograms (CFAE)-guided ablation after pulmonary vein isolation (PVI) has been used for persistent atrial fibrillation (persAF) therapy. This strategy has shown suboptimal outcomes due to, among other factors, undetected changes in the atrial tissue following PVI. In the present work, we investigate CFAE distribution before and after PVI in patients with persAF using a multivariate statistical model. Methods: 207 pairs of atrial electrograms (AEGs) were collected before and after PVI respectively, from corresponding LA regions in 18 persAF patients...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28862942/physiological-assessment-of-ventricular-myocardial-voltage-using-omnipolar-electrograms
#9
Karl Magtibay, Stéphane Massé, John Asta, Marjan Kusha, Patrick F H Lai, Mohammed Ali Azam, Andreu Porta-Sanchez, Shouvik Haldar, Daniel Malebranche, Christopher Labos, D Curtis Deno, Kumaraswamy Nanthakumar
BACKGROUND: Characterization of myocardial health by bipolar electrograms are critical for ventricular tachycardia therapy. Dependence of bipolar electrograms on electrode orientation may reduce reliability of voltage assessment along the plane of arrhythmic myocardial substrate. Hence, we sought to evaluate voltage assessment from orientation-independent omnipolar electrograms. METHODS AND RESULTS: We mapped the ventricular epicardium of 5 isolated hearts from each species-healthy rabbits, healthy pigs, and diseased humans-under paced conditions...
August 16, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28862806/initial-experience-of-a-novel-mapping-system-combined-with-remote-magnetic-navigation-in-the-catheter-ablation-of-atrial-fibrillation
#10
Changjian Lin, Steen Pehrson, Peter Karl Jacobsen, Xu Chen
BACKGROUND: There have been advancements of sophisticated mapping systems used for ablation procedures over the last decade. Utilization of these novel mapping systems in combination with remote magnetic navigation (RMN) needs to be established. We investigated the new EnSite Precisionۛ mapping system (St Jude Medical, Inc.), which collects magnetic data for checking navigation field stability and is built on an open platform, allowing physicians to choose diagnostic and ablation catheters...
September 1, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28862787/panoramic-atrial-mapping-with-basket-catheters-a-quantitative-analysis-to-optimize-practice-patient-selection-and-catheter-choice
#11
Shohreh Honarbakhsh, Richard J Schilling, Rui Providência, Gurpreet Dhillon, Vinit Sawhney, Claire A Martin, Emily Keating, Malcolm Finlay, Syed Ahsan, Anthony Chow, Mark J Earley, Ross J Hunter
INTRODUCTION: Panoramic mapping with basket catheters have been used to map atrial fibrillation (AF). However, the limited tissue contact and coverage achieved has raised concerns. METHODS AND RESULTS: Patients undergoing catheter ablation for atrial tachycardia (AT) and persistent AF were recruited. Unipolar signals were recorded with the Constellation or FIRMap catheters. The proportion and distribution of anatomical coverage by the catheters was determined and tissue contact achieved measured...
September 1, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28856145/ablation-of-long-standing-persistent-atrial-fibrillation
#12
REVIEW
Behram P Mody, Anoshia Raza, Jason Jacobson, Sei Iwai, Daniel Frenkel, Rhadames Rojas, Wilbert S Aronow
Atrial fibrillation (AF) is the most commonly encountered arrhythmia in the clinical setting affecting nearly 6 million people in United States and the numbers are only expected to rise as the population continues to age. Broadly it is classified into paroxysmal, persistent and longstanding persistent AF. Electrical, structural and autonomic remodeling are some of the diverse pathophysiological mechanisms that contribute to the persistence of AF. Our review article emphasizes particularly on long standing persistent atrial fibrillation (LSPAF) aspect of the disease which poses a great challenge for electrophysiologists...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28846147/cardiac-mapping-and-pulmonary-vein-isolation-using-a-novel-ablation-catheter-with-tip-mini-electrodes
#13
Florian Heringhaus, Tanja Lotz, Lena Loehr, Julia Gelep, Sebastian Lask, Kaffer Kara, Andreas Mügge, Alexander Wutzler
BACKGROUND: Pulmonary vein isolation (PVI) is a standard treatment for atrial fibrillation (AF). Identification of gaps in the ablation line is difficult. Tip-ring electrograms from ablation catheters represent relative large areas of myocardial tissue. Recently, an ablation catheter with three mini-electrodes (ME) on the catheter tip with closer interelectrode spacing was introduced. The aim of our study was to evaluate the novel electrodes during PVI. METHODS: PVI was performed with an irrigated ablation catheter equipped with conventional electrodes and three additional radial tip electrodes...
August 28, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28842979/epicardial-ablation-utilising-remote-magnetic-navigation-in-a-patient-with-brugada-syndrome-and-inferior-early-repolarisation
#14
Paul Chun Yih Lim, Koonlawee Nademanee, Edward Chun Yi Lee, Wee Siong Teo
We report a case of epicardial ablation in a combined Brugada and inferior early repolarization syndrome patient with recurrent defibrillator therapy for spontaneous VF. Electroanatomic mapping and ablation were achieved with remote magnetic navigation. Highly fractionated electrograms were seen epicardially in the anterior RVOT and at the anterior-inferior right ventricle. Ablation of the RVOT region resulted in resolution Brugada pattern ECG. The inferior early repolarisation persisted despite ablation of the inferior right ventricular epicardium...
August 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28837600/recombinant-human-collagen-based-microspheres-mitigate-cardiac-conduction-slowing-induced-by-adipose-tissue-derived-stromal-cells
#15
Nicoline W Smit, Judith N Ten Sande, Mojtaba Parvizi, Shirley C M van Amersfoorth, Josée A Plantinga, Carolien A F M van Spreuwel-Goossens, Elisabeth M W M van Dongen, Pascal F H M van Dessel, Sebastianus G J M Kluijtmans, Veronique M F Meijborg, Jacques M T de Bakker, Martin C Harmsen, Ruben Coronel
BACKGROUND: Stem cell therapy to improve cardiac function after myocardial infarction is hampered by poor cell retention, while it may also increase the risk of arrhythmias by providing an arrhythmogenic substrate. We previously showed that porcine adipose tissue-derived-stromal cells (pASC) induce conduction slowing through paracrine actions, whereas rat ASC (rASC) and human ASC (hASC) induce conduction slowing by direct coupling. We postulate that biomaterial microspheres mitigate the conduction slowing influence of pASC by interacting with paracrine signaling...
2017: PloS One
https://www.readbyqxmd.com/read/28827810/role-of-atrial-wall-thickness-in-wave-dynamics-of-atrial-fibrillation
#16
Jun-Seop Song, Jin Wi, Hye-Jeong Lee, Minki Hwang, Byounghyun Lim, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Jeong-Wook Seo, Hui-Nam Pak
BACKGROUND/AIMS: Atrial anatomy and thickness may affect the electrical wave-dynamics of atrial fibrillation (AF). We explored the relationship between left atrial (LA) wall thickness (LAWT) or LA geometry and AF wave-dynamics. METHODS: We included 15 patients with persistent AF (age, 62.3 ± 11.9 years) who underwent AF catheter ablation. We measured the LAWT, LA endocardial curvature, and SD-curvature (surface bumpiness) from preprocedural computed tomography images...
2017: PloS One
https://www.readbyqxmd.com/read/28823052/sensitivity-analysis-of-ventricular-activation-and-electrocardiogram-in-tailored-models-of-heart-failure-patients
#17
C Sánchez, G D'Ambrosio, F Maffessanti, E G Caiani, F W Prinzen, R Krause, A Auricchio, M Potse
Cardiac resynchronization therapy is not effective in a variable proportion of heart failure patients. An accurate knowledge of each patient's electroanatomical features could be helpful to determine the most appropriate treatment. The goal of this study was to analyze and quantify the sensitivity of left ventricular (LV) activation and the electrocardiogram (ECG) to changes in 39 parameters used to tune realistic anatomical-electrophysiological models of the heart. Electrical activity in the ventricles was simulated using a reaction-diffusion equation...
August 19, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28819329/efficient-computation-of-electrograms-and-ecgs-in-human-whole-heart-simulations-using-a-reaction-eikonal-model
#18
Aurel Neic, Fernando O Campos, Anton J Prassl, Steven A Niederer, Martin J Bishop, Edward J Vigmond, Gernot Plank
Anatomically accurate and biophysically detailed bidomain models of the human heart have proven a powerful tool for gaining quantitative insight into the links between electrical sources in the myocardium and the concomitant current flow in the surrounding medium as they represent their relationship mechanistically based on first principles. Such models are increasingly considered as a clinical research tool with the perspective of being used, ultimately, as a complementary diagnostic modality. An important prerequisite in many clinical modeling applications is the ability of models to faithfully replicate potential maps and electrograms recorded from a given patient...
October 1, 2017: Journal of Computational Physics
https://www.readbyqxmd.com/read/28800183/unknown-intracardiac-electrogram
#19
Eric N Prystowsky
Watch a video presentation of this article. For additional educational resources, please visit Medtronic Academy .
August 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28800169/global-multielectrode-contact-mapping-plus-ablation-with-a-single-catheter-preclinical-and-preliminary-experience-in-humans-with-atrial-fibrillation
#20
Hans Kottkamp, Fabian Moser, Andreas Rieger, Doreen Schreiber, Christian Pönisch, Monica Trofin
INTRODUCTION: One question for the technological advancement of catheter ablation of atrial fibrillation (AF) is whether a creative new concept can combine and even improve the diagnostic mapping options of single-tip and basket catheters with the simplicity of the use of balloon catheters for ablation. Herein, we describe the first in-human experience with a single catheter offering such a complete solution. METHODS AND RESULTS: A new catheter (Globe(®) ) with a distal multielectrode array consisting of 16 ribs with 122 gold-plated electrodes was used...
August 11, 2017: Journal of Cardiovascular Electrophysiology
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