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https://www.readbyqxmd.com/read/28644155/transvenous-before-surgical-hybrid-procedure
#1
Joseph J Tiano, Robert Drennan, John Novella, Rafael Squiteri, Malcolm Robinson, Albert DiMeo, Lindsey Scierka, Paul LeLorier
BACKGROUND: Historically, persistent atrial fibrillation (PeAF) and long standing persistent atrial fibrillation (LSPeAF) have demonstrated limited clinical success despite hybrid approaches. OBJECTIVE: We describe our experience with the endocardial-before-epicardial approach defined by a comprehensive endovascular approach preceding and guiding the epicardial approach which includes an extensive posterior wall ablation. METHODS: 40 patients were followed over a 12 month period...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28643171/elimination-of-the-negative-component-of-the-unipolar-electrogram-as-a-local-procedural-endpoint-during-paroxysmal-atrial-fibrillation-catheter-ablation-using-contact-force-sensing-the-uniforce-study
#2
Agustín Bortone, Philippe Lagrange, Bruno Cauchemez, Cyril Durand, Pierre Dieuzaide, Sébastien Prévot, Alexis Mechulan, Thomas Pambrun, Ruairidh Martin, Pauline Parlier, Alexandre Masse, Eloi Marijon, Jean-Paul Albenque
PURPOSE: Elimination of the negative component of the unipolar atrial electrogram is a reliable indicator of the creation of a transmural lesion. Contact-force (CF) sensing technology has the potential to increase the durability of pulmonary vein isolation (PVI). In the present multicenter study, we assessed the 2-year sinus rhythm (SR) maintenance rate in patients with paroxysmal atrial fibrillation (PAF) after PVI guided by these two approaches. METHODS: Two hundred fifteen consecutive PAF patients (62...
June 22, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28641242/arrhythmia-mechanism-and-scaling-effect-on-the-spectral-properties-of-electroanatomical-maps-with-manifold-harmonics
#3
Margarita Sanroman-Junquera, Inmaculada Mora-Jimenez, Arcadi Garcia-Alberola, Antonio J Caamano, Beatriz Trenor, Jose Luis Rojo-Alvarez
Spatial and temporal processing of intracardiac electrograms provides relevant information to support the arrhythmia ablation during electrophysiological studies. Current Cardiac Navigation Systems (CNS) and Electrocardiographic Imaging (ECGI) build detailed three-dimensional electroanatomical maps (EAM), which represent the spatial anatomical distribution of bioelectrical features, such as activation time or voltage. We present a principled methodology for spectral analysis of both EAM geometry and bioelectrical feature in CNS or ECGI, including their spectral representation, cut-off frequency, or spatial sampling rate (SSR)...
June 15, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28639747/the-effect-of-activation-rate-on-left-atrial-bipolar-voltage-in-patients-with-paroxysmal-atrial-fibrillation
#4
Steven E Williams, Nick Linton, Louisa O'Neill, James Harrison, John Whitaker, Rahul Mukherjee, Christopher A Rinaldi, Jaswinder Gill, Steven Niederer, Matthew Wright, Mark O'Neill
INTRODUCTION: Bipolar voltage is used during electroanatomic mapping to define abnormal myocardium, but the effect of activation rate on bipolar voltage is not known. We hypothesized that bipolar voltage may change in response to activation rate. By examining corresponding unipole signals we sought to determine the mechanisms of such changes. METHODS AND RESULTS: LA extrastimulus mapping was performed during CS pacing in 10 patients undergoing 1(st) time paroxysmal atrial fibrillation ablation...
June 22, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28630171/distinctive-left-ventricular-activations-associated-with-ecg-pattern-in-heart-failure-patients
#5
Nicolas Derval, Josselin Duchateau, Saagar Mahida, Romain Eschalier, Frederic Sacher, Joost Lumens, Hubert Cochet, Arnaud Denis, Xavier Pillois, Seigo Yamashita, Yuki Komatsu, Sylvain Ploux, Sana Amraoui, Adlane Zemmoura, Philippe Ritter, Mélèze Hocini, Michel Haissaguerre, Pierre Jaïs, Pierre Bordachar
BACKGROUND: In contrast to patients with left bundle branch block (LBBB), heart failure patients with narrow QRS and nonspecific intraventricular conduction delay (NICD) display a relatively limited response to cardiac resynchronization therapy. We sought to compare left ventricular (LV) activation patterns in heart failure patients with narrow QRS and NICD to patients with LBBB using high-density electroanatomic activation maps. METHODS AND RESULTS: Fifty-two heart failure patients (narrow QRS [n=18], LBBB [n=11], NICD [n=23]) underwent 3-dimensional electroanatomic mapping with a high density of mapping points (387±349 LV)...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28625400/successful-treatment-of-ventricular-fibrillation-storm-triggered-by-short-long-short-sequence-time-to-avoid-managed-ventricular-pacing
#6
Hilmi Alnsasra, Yuval Konstantino, Sergiy Bereza, Moti Haim
Sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) is caused by ventricular tachyarrhythmia that can be effectively treated by implantable cardioverter defibrillator (ICD) therapy. We report of a 28-year-old man with HCM and a dual chamber ICD, originally implanted for primary prevention of SCD, (programmed to AAI(R)-DDD(R); managed ventricular pacing (MVP) mode, Medtronic Inc. St Paul, MN USA). He presented with recurrent ICD shocks due to ventricular fibrillation (VF) despite antiarrhythmic therapy...
June 8, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28624975/deleterious-acute-and-chronic-effects-of-bradycardic-right-ventricular-apex-pacing-consequences-for-arrhythmic-outcome
#7
T R G Stams, A Dunnink, W M van Everdingen, H D M Beekman, R van der Nagel, B Kok, M F A Bierhuizen, M J Cramer, M Meine, M A Vos
In the chronic complete atrioventricular (AV) block dog (CAVB) model, both bradycardia and altered ventricular activation due to the uncontrolled idioventricular rhythm contribute to ventricular remodeling and the enhanced susceptibility to Torsade de Pointes (TdP) arrhythmias. We investigated the effect of permanent bradycardic right ventricular apex (RVA) pacing on mechanical and electrical remodeling and TdP. In 23 anesthetized dogs, serial experiments were performed at sinus rhythm (SR), acutely after AV block (AAVB) and 3 weeks of remodeling CAVB at a fixed pacing rate of 60/min...
July 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28607623/long-rp-interval-tachycardia-what-is-the-mechanism
#8
Javier Jiménez-Díaz, María-Arantzazu González-Marín, Juan J González-Ferrer, Felipe Higuera-Sobrino
A 41-year-old man with a history of tachycardia refractory to multiple antiarrhythmic drugs was sent to our institution. His 12-lead electrocardiogram demonstrated incessant narrow QRS complex tachycardia with negative P waves in the inferior leads and long RP interval. Occasionally, the tachycardia terminated after a P wave and then was restarted after a sinusal beat. An EP study was performed during tachycardia. Intracardiac electrograms during tachycardia and response to pacing maneuvers are shown. What is the tachycardia mechanism?...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28607617/influence-of-myopotential-interference-on-the-wavelet-discrimination-algorithm-in-implantable-cardioverter-defibrillator
#9
Kazuya Mizukami, Hisashi Yokoshiki, Hirofumi Mitsuyama, Masaya Watanabe, Taro Tenma, Rui Kamada, Masayuki Takahashi, Ryo Sasaki, Motoki Maeno, Hiroyuki Tsutsui
BACKGROUND: Wavelet is a morphology-based algorithm for detecting ventricular tachycardia. The electrogram (EGM) source of the Wavelet algorithm is nominally programmed with the Can-RV coil configuration, which records a far-field ventricular potential. Therefore, it may be influenced by myopotential interference. METHODS: We performed a retrospective review of 40 outpatients who had an implantable cardioverter-defibrillator (ICD) with the Wavelet algorithm. The percent-match score of the Wavelet algorithm was measured during the isometric chest press by pressing the palms together...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28607613/complex-fractionated-atrial-electrograms-high-dominant-frequency-regions-and-left-atrial-voltages-during-sinus-rhythm-and-atrial-fibrillation
#10
Naoko Sasaki, Ichiro Watanabe, Yasuo Okumura, Koichi Nagashima, Rikitake Kogawa, Kazumasa Sonoda, Kazuki Iso, Keiko Takahashi, Masaru Arai, Ryuta Watanabe, Sayaka Kurokawa, Kimie Ohkubo, Toshiko Nakai, Atsushi Hirayama, Mizuki Nikaido
BACKGROUND: Ablation targeting complex fractionated atrial electrograms (CFAEs) or high dominant frequency (DF) sites is generally effective for persistent atrial fibrillation (AF). CFAEs and/or high DF sites may exist in low-voltage regions, which theoretically represent abnormal substrates. However, whether CFAEs or high DF sites reflect low voltage substrates during sinus rhythm (SR) is unknown. METHODS: Sixteen patients with AF (8 with paroxysmal AF; 8, persistent AF) underwent high-density mapping of the left atrium (LA) with a 3-dimensional electroanatomic mapping system before ablation...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28599350/unknown-intracardiac-electrogram
#11
Eric N Prystowsky
Watch a video presentation of this article. For additional educational resources, please visit Medtronic Academy .
June 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28588014/different-approaches-for-catheter-ablation-of-para-hisian-accessory-pathways-implications-for-mapping-and-ablation
#12
Ming Liang, Zulu Wang, Yanchun Liang, Guitang Yang, Zhiqing Jin, Mingyu Sun, Yaling Han
BACKGROUND: Catheter ablation of para-Hisian accessory pathways (APs) can be challenging because of adjacent conduction tissue. Some different approaches for ablation, including the inferior vena cava approach (IVC-A), the noncoronary cusp approach (NCC-A), or the superior vena cava approach (SVC-A), have been reported. However, when should para-Hisian APs be mapped and ablated by the IVC-A, NCC-A, or SVC-A is not well established. METHODS AND RESULTS: This study included 55 consecutive patients (mean age, 53±11 years, 36 males) with para-Hisian APs...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28569391/permanent-his-bundle-pacing-electrophysiological-and-echocardiographic-observations-from-long-term-follow-up
#13
Pugazhendhi Vijayaraman, Gopi Dandamudi, Daniel Lustgarten, Kenneth A Ellenbogen
BACKGROUND: Permanent His bundle pacing (HBP) is a physiological alternative to right ventricular pacing (RVP). It is not known whether HBP can cause His-Purkinje conduction (HPC) disease. The aim of our study is to assess His bundle capture and its effect on LV function in long-term follow-up and to determine HPC at the time of pulse generator change (GC) in patients with chronic HBP. METHODS: HB electrograms were recorded from the pacing lead at implant and GC...
June 1, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28554962/local-transmural-action-potential-gradients-are-absent-in-the-isolated-intact-dog-heart-but-present-in-the-corresponding-coronary-perfused-wedge
#14
Bastiaan J Boukens, Veronique M F Meijborg, Charly N Belterman, Tobias Opthof, Michiel J Janse, Richard B Schuessler, Ruben Coronel, Igor R Efimov
The left ventricular (LV) coronary-perfused canine wedge preparation is a model commonly used for studying cardiac repolarization. In wedge studies, transmembrane potentials typically are recorded; whereas, extracellular electrical recordings are commonly used in intact hearts. We compared electrically measured activation recovery interval (ARI) patterns in the intact heart with those recorded at the same location in the LV wedge preparation. We also compared electrically recorded and optically obtained ARIs in the LV wedge preparation...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28554514/remodeling-of-ventricular-repolarization-in-experimental-right-ventricular-hypertrophy
#15
S N Kharin, V V Krandycheva, A S Tsvetkova, K V Shumikhin
BACKGROUND: To understand electrophysiological mechanisms that underlie the progression of compensated right ventricular hypertrophy (RVH) to heart failure, the purpose of the study was to evaluate remodeling of ventricular repolarization in connection with hemodynamic abnormalities and vulnerability of the heart ventricles to arrhythmias in RVH rats with pulmonary arterial hypertension (PAH) and heart failure. METHODS: PAH followed by heart failure was induced by monocrotaline in adult female Wistar rats...
May 18, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28553365/mini-electrodes-on-ablation-catheters-valuable-addition-or-redundant-information-insights-from-a-computational-study
#16
Stefan Pollnow, Joachim Greiner, Tobias Oesterlein, Eike M Wülfers, Axel Loewe, Olaf Dössel
Radiofrequency ablation has become a first-line approach for curative therapy of many cardiac arrhythmias. Various existing catheter designs provide high spatial resolution to identify the best spot for performing ablation and to assess lesion formation. However, creation of transmural and nonconducting ablation lesions requires usage of catheters with larger electrodes and improved thermal conductivity, leading to reduced spatial sensitivity. As trade-off, an ablation catheter with integrated mini electrodes was introduced...
2017: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/28543823/unknown-intracardiac-electrogram
#17
Eric N Prystowsky
Watch a video presentation of this article. For additional educational resources, please visit Medtronic Academy .
May 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28543788/automated-verification-of-pulmonary-vein-isolation-in-radiofrequency-and-cryoballoon-guided-ablation
#18
Jan De Pooter, Thomas Phlips, Milad El Haddad, Frederic van Heuverswyn, Liesbeth Timmers, René Tavernier, Sebastien Knecht, Yves Vandekerckhove, Mattias Duytschaever
BACKGROUND: Verification of pulmonary vein isolation (PVI) can be challenging due to the coexistence of pulmonary vein potentials (PVP) and far field potentials. This study aimed to prospectively validate a novel algorithm for automated verification of PVI in radiofrequency-guided (RF) and cryoballoon-guided (CB) ablation strategies. METHODS: A dataset of 620 (RF: 516 EGMs and CB: 104 EGMs) bipolar electrograms (EGM), recorded by circular mapping catheter (CMC) placed at the left atrium-pulmonary vein (PV) junction, were prospectively analyzed by a two-step algorithm...
May 25, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28543277/experimental-study-of-cryofreezing-energy-applications-on-the-ventricular-myocardium-using-sheep-hearts
#19
Kaoru Okishige, Peter L Friedman
BACKGROUND: Cryofreezing energy has been utilized to abolish arrhythmogenic substrates of various kinds of tachyarrhythmias. However, systematic electrophysiological and histological investigations of cryothermia have never been performed. The aim of this study was to clarify those aspects using sheep beating hearts. METHODS: A total of eight adult sheep were utilized under total anesthesia, and a pericardial cradle was made by opening the pericardium. Eight epicardial plaque electrodes were sutured on the epicardial surface of the left ventricle 2∼3 cm apart from each other...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28525921/a-new-electrogram-based-diagnostic-algorithm-to-improve-the-left-ventricular-effective-pacing-detection-corrected-a-non-response-to-cardiac-resynchronization-therapy-pacing
#20
Roberto Matía, Antonio Hernández-Madrid, Ruth Nicholson Klepfer, Subham Ghosh, Gonzalo Sánchez-Huete, Javier Moreno
No abstract text is available yet for this article.
May 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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