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Focal Ablation

Sanghamitra Mohanty, Prasant Mohanty, Chintan Trivedi, Carola Gianni, Domenico G Della Rocca, Luigi Di Biase, Andrea Natale
BACKGROUND: This meta-analysis systematically evaluated the outcome of pulmonary vein isolation (PVI) with and without focal impulse and rotor modulation (FIRM) ablation in patients with atrial fibrillation. METHODS AND RESULTS: Extensive literature search was performed for studies reporting outcomes of PVI alone and PVI+FIRM procedures. For PVI alone, only randomized trials conducted in the past 3 years reporting single-procedure off-antiarrhythmic drugs success rate at ≥12-month follow-up were included...
March 2018: Circulation. Arrhythmia and Electrophysiology
Fabian Moser, Andreas Rieger, Christian Pönisch, Hans Kottkamp
INTRODUCTION: Box isolation of fibrotic areas (BIFA) is a promising ablation approach for atrial fibrillation (AF) patients. However, complete isolation of fibrotic anteroseptal left atrial area, where Bachmann's bundle is blending into the left atrial myocardium, is very specific and complex. METHODS AND RESULTS: In 34 AF patients with anteroseptal fibrosis, circumferential BIFA was performed in addition to pulmonary vein isolation. In 8/34 patients, complete isolation of the fibrotic area was achieved with BIFA alone...
March 14, 2018: Journal of Cardiovascular Electrophysiology
Francisco Pelaez, Navid Manuchehrabadi, Priyatanu Roy, Harishankar Natesan, Yiru Wang, Emilian Racila, Heather Fong, Kevin Zeng, Abby M Silbaugh, John C Bischof, Samira M Azarin
Currently, there are very few therapeutic options for treatment of metastatic disease, as it often remains undetected until the burden of disease is too high. Microporous poly(ε-caprolactone) biomaterials have been shown to attract metastasizing breast cancer cells in vivo early in tumor progression. In order to enhance the therapeutic potential of these scaffolds, they were modified such that infiltrating cells could be eliminated with non-invasive focal hyperthermia. Metal disks were incorporated into poly(ε-caprolactone) scaffolds to generate heat through electromagnetic induction by an oscillating magnetic field within a radiofrequency coil...
February 28, 2018: Biomaterials
A Boyde
Laser ablation machining or microtomy (LAM) is a relatively new approach to producing slide mounted sections of translucent materials. We evaluated the method with a variety of problems from the bone, joint and dental tissues fields where we require thin undecalcified and undistorted sections for correlative light microscopy (LM) and backscattered electron scanning electron microscopy (BSE SEM). All samples were embedded in poly-methylmethacrlate (PMMA) and flat block surfaces had been previously studied by BSE-SEM and confocal scanning light microscopy (CSLM)...
February 27, 2018: Journal of Microscopy
Adam Lee, Russell Denman, Haris M Haqqani
BACKGROUND: Ectopy-mediated cardiomyopathy (EMC) is a potentially reversible form of left ventricular systolic dysfunction. Various risk factors for the development of EMC have been proposed in the literature. We aim to assess medium term outcomes of focal ventricular arrhythmia (VA) ablation in the setting of cardiomyopathy (CMP) and to validate published risk factors for EMC. METHODS: Medium term recovery of left ventricular (LV) function and freedom from VA recurrence was assessed and compared between patients undergoing focal VA ablation in the setting of CMP and a control group with normal LV function...
February 12, 2018: Heart, Lung & Circulation
Wilber Su, G Joseph Orme, Robert Hoyt, James Baker, Steven Compton, Christopher Fellows, John Harding, J Thomas Svinarich, Marcin Kowalski, Bryan Piedad, David Kenigsberg, John Seger, Zeshan K Ahmad, Paul Wang
BACKGROUND: Pulmonary vein isolation (PVI) via catheter ablation is an approved therapy for patients with drug-refractory and symptomatic atrial fibrillation (AF). Furthermore, cryoballoon is now considered to be as effective as focal radiofrequency catheter ablation. This study examines the second-generation cryoballoon performance in a US multicenter review of real-world practices. METHODS: By retrospective chart collections, the long-term efficacy and safety of the cryoballoon procedure were assessed in 15 US centers...
February 24, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Dan O'Neal, Tal Cohen, Cynthia Peterson, Richard G Barr
Although only limited long-term studies evaluating thermal ablation of renal masses have been performed, it appears that thermal ablation has a comparable 5-year success rate to that of partial or total nephrectomy. This technique is often used in patients who are not good candidates for partial or total nephrectomy. Contrast-enhanced ultrasound (CEUS) has been recently approved by the Food and Drug Administration for characterization of focal liver lesions in adults and pediatric patients. CEUS can be used off label for renal applications and has been used for years in Europe and Asia...
2018: Journal of Kidney Cancer and VHL
Weizhu Ju, Kai Gu, Bing Yang, Fengxiang Zhang, Hongwu Chen, Gang Yang, Mingfang Li, Linsheng Shi, Jinbo Yu, Fangyi Xiao, Qiang Xu, Ming Chu, Wenzhi Shen, Kejiang Cao, Minglong Chen
PURPOSE: Late cure after a previously failed ablation of ventricular arrhythmias (VAs) is a relatively common phenomenon. The present study sought to delineate the incidence and electrophysiological characteristics of late cure in idiopathic VA patients. METHODS: Totally, 45 idiopathic VA cases (mean age 44 ± 18 years, 27 males) either failed acutely or recurred within 12 h were enrolled in this study. Based on intensive clinical observations in the acute period, 19 (42%) patients demonstrated late cure in the first week after the procedure...
February 19, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Francesco Maria Di Matteo, Paola Saccomandi, Margareth Martino, Monica Pandolfi, Margherita Pizzicannella, Valerio Balassone, Emiliano Schena, Claudio Marcello Pacella, Sergio Silvestri, Guido Costamagna
BACKGROUND AND AIMS: Endoscopic ultrasound (EUS) has become an interventional technique in which a needle may be used as a vehicle to deliver therapeutic agents. Laser ablation (LA) has been used to treat many primary and secondary neoplasms. This study aimed to assess the feasibility of EUS-guided LA for unresectable (UR) pancreatic cancer. METHODS: Patients with a stage IIb-III pancreatic cancer underwent EUS-guided LA. All patients were unresponsive to previous chemo-radiotherapy...
February 13, 2018: Gastrointestinal Endoscopy
Wen-Lun Wang, I-Wei Chang, Chien-Chuan Chen, Chi-Yang Chang, Cheng-Hao Tseng, Chi-Ming Tai, Jaw-Town Lin, Hsiu-Po Wang, Ching-Tai Lee
BACKGROUND:  Endoscopic radiofrequency ablation (RFA) is a treatment option for early esophageal squamous cell neoplasia (ESCN); however, long-term follow-up studies are lacking. The risks of local recurrence and "buried cancer" are also uncertain. METHODS:  Patients with flat-type ESCN who were treated with balloon-type ± focal-type RFA were consecutively enrolled. Follow-up endoscopy was performed at 1, 3, and 6 months, and then every 6 months thereafter...
February 15, 2018: Endoscopy
Tina Baykaner, Steve Duff, James T Hasegawa, Michael S Mafilios, Mintu P Turakhia
BACKGROUND: Although ablation with focal impulse and rotor modulation (FIRM), as an adjunct to pulmonary vein isolation (PVI), has been shown to decrease atrial fibrillation (AF) recurrence, cost-effectiveness has not been assessed. OBJECTIVE: We aimed to evaluate the cost effectiveness of FIRM-guided ablation when added to PVI in a mixed AF population. METHODS AND RESULTS: We used a Markov model to estimate the costs, quality-adjusted survival, and cost effectiveness of adding FIRM ablation to PVI...
February 13, 2018: Journal of Cardiovascular Electrophysiology
Abdulrahman M Saadalla, Abu Osman, Michael F Gurish, Kristen L Dennis, Nichole R Blatner, Abdulmohammad Pezeshki, Kelly M McNagny, Hilde Cheroutre, Fotini Gounari, Khashayarsha Khazaie
Mast cells (MCs) are tissue resident sentinels that mature and orchestrate inflammation in response to infection and allergy. While they are also frequently observed in tumors, the contribution of MCs to carcinogenesis remains unclear. Here, we show that sequential oncogenic events in gut epithelia expand different types of MCs in a temporal-, spatial-, and cytokine-dependent manner. The first wave of MCs expands focally in benign adenomatous polyps, which have elevated levels of IL-10, IL-13, and IL-33, and are rich in type-2 innate lymphoid cells (ILC2s)...
February 13, 2018: Proceedings of the National Academy of Sciences of the United States of America
Avinash Eranki, Navid Farr, Ari Partanen, Karun V Sharma, Christopher T Rossi, Avi Z Rosenberg, AeRang Kim, Matthew Oetgen, Haydar Celik, David Woods, Pavel S Yarmolenko, Peter C W Kim, Bradford J Wood
PURPOSE: High intensity focused ultrasound (HIFU) can non-invasively treat tumors with minimal or no damage to intervening tissues. While continuous-wave HIFU thermally ablates target tissue, the effect of hundreds of microsecond-long pulsed sonications is examined in this work. The objective of this study was to characterize sonication parameter-dependent thermomechanical bioeffects to provide the foundation for future preclinical studies and facilitate clinical translation. METHODS AND MATERIALS: Acoustic power, number of cycles/pulse, sonication time, and pulse repetition frequency (PRF) were varied on a clinical magnetic resonance imaging (MRI) - guided HIFU (MR-HIFU) system...
February 11, 2018: International Journal of Hyperthermia
L Liu, L H Wang, Y B Ren, X S Rao, S M Yang
Objective: To investigate the clinicopathological features, differential diagnosis, treatment and prognosis of dedifferentiated liposarcoma with rhabdomyoblastic differentiation. Methods: Six cases of retroperitoneal dedifferentiated liposarcoma with rhabdomyoblastic features were collected from December 2014 to August 2017 at Peking University International Hospital. The clinical manifestations, histomorphology, immunophenotype, treatment and follow-up data were analyzed, and relevant literature reviewed. Results: The six patients included two males and four females, with age range of 47 to 66 years (mean 56 years)...
February 8, 2018: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Seok Young Ji, Wonsuk Choi, Hoon-Young Kim, Jin-Woo Jeon, Sung-Hak Cho, Won Seok Chang
The development of printing technologies has enabled the realization of electric circuit fabrication on a flexible substrate. However, the current technique remains restricted to single-layer patterning. In this paper, we demonstrate a fully solution-processable patterning approach for multi-layer circuits using a combined method of laser sintering and ablation. Selective laser sintering of silver (Ag) nanoparticle-based ink is applied to make conductive patterns on a heat-sensitive substrate and insulating layer...
February 9, 2018: Materials
Shaogang Sun, Hsin-Jung Wu, Jun-Lin Guan
Focal adhesion kinase (FAK) is essential in embryonic angiogenesis by regulating endothelial cell (EC) survival and barrier functions through its kinase-independent and -dependent activities. Here, we generated EC-specific tamoxifen-inducible FAK knockout and FAK kinase-defective (KD) mutant knockin mice to investigate the role of FAK and its kinase activity in angiogenesis of adult animals. Unlike previous observations of their differential defects in embryonic vascular development, both FAK ablation and inactivation of its kinase activity resulted in deficient angiogenesis in wound-healing as well as retinal angiogenesis models...
February 7, 2018: Scientific Reports
Dario J Englot
Epilepsy surgery has seen numerous technological advances in both diagnostic and therapeutic procedures in recent years. This has increased the number of patients who may be candidates for intervention and potential improvement in quality of life. However, the expansion of the field also necessitates a broader understanding of how to incorporate both traditional and emerging technologies into the care provided at comprehensive epilepsy centers. This review summarizes both old and new surgical procedures in epilepsy using an example algorithm...
February 1, 2018: Epilepsy & Behavior: E&B
Akifumi Nakamura, Teruhisa Takuwa, Masaki Hashimoto, Nobuyuki Kondo, Haruyuki Takaki, Masayuki Fujiwara, Koichiro Yamakado, Seiki Hasegawa
A 55-year-old man with malignant pleural mesothelioma underwent multimodality treatment comprising induction chemotherapy followed by extrapleural pneumonectomy and radiation therapy. After 2.5 years, focal recurrence occurred, with computed tomography revealing a tumor in the left cardiophrenic angle. Surgery was considered a problem for the patient because of the previous extrapleural pneumonectomy and difficult tumor location. Radiofrequency ablation was thus performed; the course was uneventful, and there was no recurrence...
February 1, 2018: Annals of Thoracic Surgery
Angelo Territo, Bear Foerster, Shahrokh F Shariat, Morgan Rouprêt, Jose M Gaya, Joan Palou, Alberto Breda
INTRODUCTION: Conservative management of upper tract urothelial cancer (UTUC) is becoming increasingly popular: the key to success is correct selection of patients with low-risk UTUC based on size (≤ 2 cm), focality (single lesion), stage (< T2), and grade (low grade). Despite the recent growing interest in the conservative approach to UTUC, the diagnostic process is still a challenge, and kidney-sparing surgery (KSS) is traditionally reserved for patients with contraindications to radical nephroureterectomy...
February 1, 2018: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
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
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