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Focal Ablation

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https://www.readbyqxmd.com/read/28333640/integrated-hifu-drive-system-on-a-chip-for-cmut-based-catheter-ablation-system
#1
Omid Farhanieh, Ali Sahafi, Rupak Bardhan Roy, Arif Sanli Ergun, Ayhan Bozkurt
Conventional High Intensity Focused Ultrasound (HIFU) is a therapeutic modality which is extracorporeally administered. In applications where a relatively small HIFU lesion is required, an intravascular HIFU probe can be deployed to the ablation site. In this paper, we demonstrate the design and implementation a fully integrated HIFU drive system on a chip to be placed on a 6 Fr catheter probe. An 8-element capacitive micromachined ultrasound transducer (CMUT) ring array of 2 mm diameter has been used as the ultrasound source...
March 20, 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28329395/long-term-symptom-improvement-and-patient-satisfaction-following-catheter-ablation-of-supraventricular-tachycardia-insights-from-the-german-ablation-registry
#2
Johannes Brachmann, Thorsten Lewalter, Karl-Heinz Kuck, Dietrich Andresen, Stephan Willems, Stefan G Spitzer, Florian Straube, Burghard Schumacher, Lars Eckardt, Dejan Danilovic, Dierk Thomas, Matthias Hochadel, Jochen Senges
Aims: To analyse outcomes of supraventricular tachycardia (SVT) ablations performed within a prospective German Ablation Quality Registry. Methods and results: Data from 12 566 patients who underwent catheter ablation of SVT between January 2007 and January 2010 to treat atrial fibrillation (AFIB, 37.2% of procedures), atrial flutter (AFL, 29.9%), atrioventricular nodal re-entrant tachycardia (AVNRT, 23.2%), atrioventricular re-entrant tachycardia (6.3%), and focal atrial tachycardia (AT, 3...
March 17, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28320941/potent-neuroprotection-after-stroke-afforded-by-a-double-knot-spider-venom-peptide-that-inhibits-acid-sensing-ion-channel-1a
#3
Irène R Chassagnon, Claudia A McCarthy, Yanni K-Y Chin, Sandy S Pineda, Angelo Keramidas, Mehdi Mobli, Vi Pham, T Michael De Silva, Joseph W Lynch, Robert E Widdop, Lachlan D Rash, Glenn F King
Stroke is the second-leading cause of death worldwide, yet there are no drugs available to protect the brain from stroke-induced neuronal injury. Acid-sensing ion channel 1a (ASIC1a) is the primary acid sensor in mammalian brain and a key mediator of acidosis-induced neuronal damage following cerebral ischemia. Genetic ablation and selective pharmacologic inhibition of ASIC1a reduces neuronal death following ischemic stroke in rodents. Here, we demonstrate that Hi1a, a disulfide-rich spider venom peptide, is highly neuroprotective in a focal model of ischemic stroke...
March 20, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28301597/boiling-histotripsy-lesion-characterization-on-a-clinical-magnetic-resonance-imaging-guided-high-intensity-focused-ultrasound-system
#4
Avinash Eranki, Navid Farr, Ari Partanen, Karun V Sharma, Hong Chen, Christopher T Rossi, Satya V V N Kothapalli, Matthew Oetgen, AeRang Kim, Ayele H Negussie, David Woods, Bradford J Wood, Peter C W Kim, Pavel S Yarmolenko
PURPOSE: High intensity focused ultrasound (HIFU) is a non-invasive therapeutic technique that can thermally ablate tumors. Boiling histotripsy (BH) is a HIFU approach that can emulsify tissue in a few milliseconds. Lesion volume and temperature effects for different BH sonication parameters are currently not well characterized. In this work, lesion volume, temperature distribution, and area of lethal thermal dose were characterized for varying BH sonication parameters in tissue-mimicking phantoms (TMP) and demonstrated in ex vivo tissues...
2017: PloS One
https://www.readbyqxmd.com/read/28289639/clinical-efficacy-of-selective-focal-ablation-by-navigable-percutaneous-disc-decompression-device-in-patients-with-cervical-herniated-nucleus-pulposus
#5
Sung Hoon Kim, Sang-Heon Lee, Nack Hwan Kim, Min Hyun Kim, Hyeun Jun Park, Yong Jin Jung, Hyun-Joon Yoo, Won Jun Meng, Victoria Kim
OBJECTIVE: To evaluate the clinical efficacy and safety following percutaneous disc decompression, using navigable disc decompression device for cervical herniated nucleus pulposus (HNP). METHODS: Twenty subjects diagnosed with cervical HNP and refractory to conservative management were enrolled for the study. The herniated discs were decompressed under fluoroscopic guidance, using radiofrequency ablation device with navigable wand. The sagittal and axial plain magnetic resonance images of the clinically significant herniated disc, decided the space between the herniated base and outline as the target area for ablation...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28288961/feasibility-of-rapid-linear-endocardial-and-epicardial-ventricular-ablation-using-an-irrigated-multipolar-radiofrequency-ablation-catheter
#6
Babak Nazer, Tomos E Walters, Srikant Duggirala, Edward P Gerstenfeld
BACKGROUND: A common strategy for ablation of scar-based ventricular tachycardia is delivering multiple lesions in a linear pattern. METHODS AND RESULTS: We tested the efficacy of a novel linear irrigated multipolar ablation catheter capable of creating linear lesions with a single application. Healthy swine underwent endocardial and epicardial linear ablation using a novel linear irrigated ablation catheter; control animals underwent focal lesions in a linear pattern over 3...
March 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28285456/is-vf-an-ablatable-rhythm
#7
REVIEW
Ghassen Cheniti, Meleze Hocini, Ruairidh Martin, Frederic Sacher, Remi Dubois, Michel Haissaguerre, Pierre Jais
Ventricular fibrillation (VF) has traditionally been considered to be a disorganized arrhythmia not amenable to catheter ablation. However, a better understanding of the VF pathophysiology has allowed identification of targets for ablation. Ablation targeting the premature ventricular complexes which trigger VF was proven to be associated with high success rates and long-term freedom from VF recurrence. Recent mapping data has identified rotors, focal breakthroughs, and figure of eight re-entries as main drivers maintaining human VF...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28283739/persistent-tachycardia-within-isolated-pulmonary-veins-during-atrial-fibrillation-ablation
#8
Kenichiro Yamagata, Atsushi Doi, Hiro Kawata, Hisaki Makimoto, Teruki Yokoyama, Yuko Inoue, Hideo Okamura, Takashi Noda, Wataru Shimizu, Naohiko Aihara, Takayuki Maki, Shiro Kamakura, Kengo Kusano, Kazuhiro Satomi
During circumferential pulmonary vein (PV) isolation for ongoing atrial fibrillation (AF), distinguishing passive conduction to the pulmonary vein (PV) from rapid PV arrhythmia in the isolated PV is difficult. Hence, the purpose of this study is to investigate both the feasibility of distinguishing the PV tachycardia after circumferential PV isolation and the electrophysiological characteristics of these tachycardia. Among 178 consecutive patients who underwent circumferential PV isolation during ongoing AF, fibrillatory PV converted to a regular cycle length PV tachycardia independent of the atrial rhythm (=independent PV tachycardia) in 13 PVs among 12 (7%) patients...
March 10, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28279745/novel-algorithm-for-accelerated-electroanatomical-mapping-and-prediction-of-earliest-activation-of-focal-cardiac-arrhythmias-using-mathematical-optimization
#9
Tobias Weber, Hugo A Katus, Sebastian Sager, Eberhard P Scholz
BACKGROUND: Premature beats (PBs) are a common finding in patients suffering from structural heart disease, but they can also be present in healthy individuals. Catheter ablation represents a suitable therapeutic approach. However, the exact localization of the origin can be challenging, especially in cases of low PB burden during the procedure. OBJECTIVE: Based on the hypothesis that mathematical optimization would significantly accelerate the localization of earliest activation we developed an automated mapping algorithm...
March 6, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28279292/complexity-and-distribution-of-drivers%C3%A2-in%C3%A2-relation-to-duration-of-persistent%C3%A2-atrial%C3%A2-fibrillation
#10
Han S Lim, Mélèze Hocini, Remi Dubois, Arnaud Denis, Nicolas Derval, Stephan Zellerhoff, Seigo Yamashita, Benjamin Berte, Saagar Mahida, Yuki Komatsu, Matthew Daly, Laurence Jesel, Carole Pomier, Valentin Meillet, Sana Amraoui, Ashok J Shah, Hubert Cochet, Frédéric Sacher, Pierre Jaïs, Michel Haïssaguerre
BACKGROUND: The underlying mechanisms sustaining human persistent atrial fibrillation (PsAF) is poorly understood. OBJECTIVES: This study sought to investigate the complexity and distribution of AF drivers in PsAF of varying durations. METHODS: Of 135 consecutive patients with PsAF, 105 patients referred for de novo ablation of PsAF were prospectively recruited. Patients were divided into 3 groups according to AF duration: PsAF presenting in sinus rhythm (AF induced), PsAF <12 months, and PsAF >12 months...
March 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28279291/clinical-benefit-of-ablating-localized-sources-for-human-atrial-fibrillation-the-indiana-university-firm-registry
#11
John M Miller, Vikas Kalra, Mithilesh K Das, Rahul Jain, Jason B Garlie, Jordan A Brewster, Gopi Dandamudi
BACKGROUND: Mounting evidence shows that localized sources maintain atrial fibrillation (AF). However, it is unclear in unselected "real-world" patients if sources drive persistent atrial fibrillation (PeAF), long-standing persistent atrial fibrillation (LPeAF), or paroxysmal atrial fibrillation (PAF); if right atrial sites are important; and what the long-term success of source ablation is. OBJECTIVES: The aim of this study was to analyze the role of rotors and focal sources in a large academic registry of consecutive patients undergoing source mapping for AF...
March 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28275856/-window-sliding-analysis-combined-with-high-density-and-rapid-electroanatomical-mapping-its-efficacy-and-the-outcome-of-catheter-ablation-of-atrial-tachycardia
#12
Kosuke Nakasuka, Koji Miyamoto, Takashi Noda, Tsukasa Kamakura, Mitsuru Wada, Ikutaro Nakajima, Kohei Ishibashi, Yuko Inoue, Hideo Okamura, Satoshi Nagase, Takeshi Aiba, Shiro Kamakura, Wataru Shimizu, Teruo Noguchi, Toshihisa Anzai, Satoshi Yasuda, Nobuyuki Ohte, Kengo Kusano
Atrial tachycardia (AT) is a clinically challenging arrhythmia that can occur based on atrial substrates. Nowadays, a rapid construction of three-dimensional electroanatomical maps, which has an analysis function for complex arrhythmias, named 'Window Sliding' (WS) is available. However, little data has revealed the efficacy of this mapping strategy. The aim of this study was to investigate the efficacy of the WS analysis for AT treatments. All patients underwent electrophysiological studies during ATs and the characteristics of the ATs were analyzed using rapid high-density mapping followed by the WS analysis...
March 8, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28273740/automatic-image-fusion-of-real-time-ultrasound-with-computed-tomography-images-a-prospective-comparison-between-two-auto-registration-methods
#13
Dong Ik Cha, Min Woo Lee, Ah Yeong Kim, Tae Wook Kang, Young-Taek Oh, Ja-Yeon Jeong, Jung-Woo Chang, Jiwon Ryu, Kyong Joon Lee, Jaeil Kim, Won-Chul Bang, Dong Kuk Shin, Sung Jin Choi, Dalkwon Koh, Bong Koo Seo, Kyunga Kim
Background A major drawback of conventional manual image fusion is that the process may be complex, especially for less-experienced operators. Recently, two automatic image fusion techniques called Positioning and Sweeping auto-registration have been developed. Purpose To compare the accuracy and required time for image fusion of real-time ultrasonography (US) and computed tomography (CT) images between Positioning and Sweeping auto-registration. Material and Methods Eighteen consecutive patients referred for planning US for radiofrequency ablation or biopsy for focal hepatic lesions were enrolled...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28271996/multi-detector-computed-tomography-mdct-findings-of-seven-cases-with-spontaneous-regression-of-hepatocellular-carcinoma
#14
Adel El-Badrawy
PURPOSE: To review Multi-detector CT findings of seven cases with spontaneous regression of hepatocellular carcinomas (HCC). MATERIALS AND METHODS: This retrospective study included 7 patients confirmed with diagnosis of HCC. Triphasic CT scan using multi-detector CT scanner was done for all patients. They were 2 women and 5 men. 1st patient presented with metastatic HCC underwent fine needle aspiration cytology (FNAC) from vertebral metastasis. 2nd patient underwent only one session of trans-arterial chemo-lipidol...
January 2017: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28268380/a-novel-catheter-guidance-algorithm-for-localization-of-atrial-fibrillation-rotor-and-focal-sources
#15
Anthony J Salmin, Prasanth Ganesan, Kristina E Shillieto, Elizabeth M Cherry, David T Huang, Arkady M Pertsov, Behnaz Ghoraani
Locating atrial fibrillation (AF) focal and rotor sources can help improve target ablation therapy for AF. However, it remains unclear how to use the information provided by multi-polar diagnostic catheters (MPDC) to locate AF sources. Our aim was to develop a catheter-guidance algorithm to locate AF focal and rotor sources using a conventional MPDC. We simulated a 10 cm × 10 cm atrial tissue with focal and rotor sources using the Nygren et al. ionic model. We modeled a Lasso MPDC with 20-unipole electrodes placed with a spacing of 4...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28265208/effectiveness-of-early-invasive-therapy-for-atrial-tachycardia-in-adult-atrial-baffle-survivors
#16
Elisa A Bradley, Ali N Zaidi, Justin Morrison, Curt J Daniels, Steven Kalbfleisch, Naomi J Kertesz
Adults who underwent complex atrial baffling as children via Mustard or Senning procedures are at heightened risk for atrial arrhythmias. Antiarrhythmic therapies are typically ineffective in this population. Accordingly, our team of pediatric and adult electrophysiologists investigated the effectiveness of early invasive transbaffle-access techniques to perform early radiofrequency ablation at the source of these clinically significant arrhythmias. For this retrospective study, we selected 11 adult survivors of atrial baffling (mean age, 34 ± 9 yr) who underwent clinically indicated electrophysiologic study after no more than one trial of antiarrhythmic therapy...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28259696/comparison-of-strategies-for-catheter-ablation-of-focal-atrial-tachycardia-originating-near-the-his-bundle-region
#17
Evgeny Lyan, Mauro Toniolo, Alexey Tsyganov, Luca Rebellato, Alessandro Proclemer, Massimiliano Manfrin, Anatoly Nechepurenko, Alexandr Morozov, Ayan Abdrahmanov, Grigory Gromyko, Vitaly Lyashenko, Marina Yakovleva
BACKGROUND: Recent studies have suggested that para-Hisian atrial tachycardia (AT) can be successfully ablated from the right atrium (RA), left atrium (LA) or non-coronary cusp (NCC) in the aorta; however, the best approach remains unclear. OBJECTIVE: This study aimed to compare different approaches to radiofrequency catheter ablation (RFCA) of para-Hisian AT. METHODS: We retrospectively analyzed 68 consecutive patients (72% females, aged 61±13 years) treated with RFCA for this type of AT...
March 1, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28259694/techniques-for-provocation-localization-and-ablation-of-nonpulmonary-vein-triggers-for-atrial-fibrillation
#18
Pasquale Santangeli, Francis E Marchlinski
The endpoint of current catheter-based ablation approaches for the treatment of atrial fibrillation (AF) is the elimination of all the possible triggers with the least amount of ablation necessary. Once all the triggers have been eliminated, the incremental value of any additional lesion sets remains to be proven. Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation approaches for eliminating AF triggers. However, up to 11% of patients demonstrate reproducible sustained AF initiation from non-PV foci...
March 1, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28257035/rnase-l-suppresses-androgen-receptor-signaling-cell-migration-and-matrix-metalloproteinase-activity-in-prostate-cancer-cells
#19
Shubham Dayal, Jun Zhou, Praveen Manivannan, Mohammad Adnan Siddiqui, Omaima Farid Ahmad, Matthew Clark, Sahezeel Awadia, Rafael Garcia-Mata, Lirim Shemshedini, Krishnamurthy Malathi
The interferon antiviral pathways and prostate cancer genetics converge on a regulated endoribonuclease, RNase L. Positional cloning and linkage studies mapped Hereditary Prostate Cancer 1 (HPC1) to RNASEL. To date, there is no correlation of viral infections with prostate cancer, suggesting that RNase L may play additional roles in tumor suppression. Here, we demonstrate a role of RNase L as a suppressor of androgen receptor (AR) signaling, cell migration and matrix metalloproteinase activity. Using RNase L mutants, we show that its nucleolytic activity is dispensable for both AR signaling and migration...
March 1, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28256178/adjunctive-ablation-strategies-improve-the-efficacy-of-pulmonary-vein-isolation-in-non-paroxysmal-atrial-fibrillation-a-systematic-review-and-meta-analysis
#20
REVIEW
Muhammad R Afzal, Anweshan Samanta, Jawaria Chatta, Brihh Ansari, Sam Atherton, Syed Sabzwari, Mohit Turagam, Dhanunjaya Lakkireddy, Mahmoud Houmsse
BACKGROUND: Pulmonary vein (PV) isolation (PVI) has suboptimal outcomes in patients with non-paroxysmal atrial fibrillation (AF). Adjunctive strategies employed to ablate non-PV triggers have shown favorable outcomes. AIMS: To delineate the incremental benefit of adjunctive ablation in patients with non-paroxysmal AF through a meta-analysis. METHODS AND RESULTS: Database searches through August 2016 identified five non-randomized and seven randomized controlled trials (enrolling 1694 patients)...
March 2017: Expert Review of Cardiovascular Therapy
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