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Focal Ablation

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https://www.readbyqxmd.com/read/29145517/which-patients-recur-as-atrial-tachycardia-rather-than-atrial-fibrillation-after-catheter-ablation-of-atrial-fibrillation
#1
Pil-Sung Yang, Young-Ah Park, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
INTRODUCTION: The ablation gaps have been known as the main mechanism of recurrence as atrial tachycardia (AT) rather than atrial fibrillation (AF) after AF catheter ablation. However, AF organization due to reduction of critical mass or focal trigger may also be the mechanism of AT recurrence. We sought to find out the main clinical factors of recurrence as AT rather than AF after AF ablation in the absence of antiarrhythmic drug effect. METHODS: We analyzed 521 patients (70...
2017: PloS One
https://www.readbyqxmd.com/read/29133753/transcatheter-arterial-chemoembolization-combined-with-simultaneous-computed-tomography-guided-radiofrequency-ablation-for-large-hepatocellular-carcinomas
#2
Tai-Yang Zuo, Feng-Yong Liu, Mao-Qiang Wang, Xian-Xian Chen
BACKGROUND: Currently, the treatment of large hepatocellular carcinoma (HCC) is still a challenging problem. Transcatheter arterial chemoembolization (TACE) is the main treatment for intermediate end-stage HCC, while it is only a palliative and not a curative treatment due to the existence of residual tumors, and radiofrequency ablation (RFA) has limitations in complete ablation of large HCC. We hypothesized that TACE combined with simultaneous RFA (herein referred to as TACE + RFA) could improve the efficacy and survival of large HCC...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29133062/anatomical-and-physiological-basis-of-continuous-spike-wave-of-sleep-syndrome-after-early-thalamic-lesions
#3
Alberto Leal, Eulália Calado, José P Vieira, Carla Mendonça, José C Ferreira, Hugo Ferreira, Daniel Carvalho, Fátima Furtado, Roseli Gomes, José P Monteiro
OBJECTIVE: Early neonatal thalamic lesions account for about 14% of continuous spike-wave of sleep (CSWS) syndrome, representing the most common etiology in this epileptic encephalopathy in children, and promise useful insights into the pathophysiology of the disease. METHODS: We describe nine patients with unilateral neonatal thalamic lesions which progressed to CSWS. Longitudinal whole-night and high-density electroencephalograms (EEGs) were performed, as well as detailed imaging and clinical evaluation...
November 10, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29126896/the-continuous-challenge-of-af-ablation-from-foci-to-rotational-activity
#4
REVIEW
Sanjiv M Narayan, Mohan N Vishwanathan, Christopher A B Kowalewski, Tina Baykaner, Miguel Rodrigo, Junaid A B Zaman, Paul J Wang
Pulmonary vein isolation (PVI) is central to ablation approaches for atrial fibrillation (AF), yet many patients still have arrhythmia recurrence after one or more procedures despite the latest technology for PVI. Ablation of rotational or focal sources for AF, which lie outside the pulmonary veins in many patients, is a practical approach that has been shown to improve success by many groups. Localized sources lie in atrial regions shown mechanistically to sustain AF in optical mapping and clinical studies of human AF, as well as computational and animal studies...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29123231/synergistic-combinations-of-short-high-voltage-pulses-and-long-low-voltage-pulses-enhance-irreversible-electroporation-efficacy
#5
Chenguo Yao, Yanpeng Lv, Yajun Zhao, Shoulong Dong, Hongmei Liu, Jianhao Ma
Irreversible electroporation (IRE) uses ~100 μs pulsed electric fields to disrupt cell membranes for solid tumor ablation. Although IRE has achieved exciting preliminary clinical results, implementing IRE could be challenging because of volumetric limitations at the ablation region. Combining short high-voltage (SHV: 1600V, 2 μs, 1 Hz, 20 pulses) pulses with long low-voltage (LLV: 240-480 V, 100 μs, 1 Hz, 60-80 pulses) pulses induces a synergistic effect that enhances IRE efficacy. Here, cell cytotoxicity and tissue ablation were investigated...
November 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29122471/3d-registration-of-mpmri-for-assessment-of-prostate-cancer-focal-therapy
#6
Clément Orczyk, Andrew B Rosenkrantz, Artem Mikheev, Arnauld Villers, Myriam Bernaudin, Samir S Taneja, Samuel Valable, Henry Rusinek
RATIONALE AND OBJECTIVES: This study aimed to assess a novel method of three-dimensional (3D) co-registration of prostate magnetic resonance imaging (MRI) examinations performed before and after prostate cancer focal therapy. MATERIALS AND METHODS: We developed a software platform for automatic 3D deformable co-registration of prostate MRI at different time points and applied this method to 10 patients who underwent focal ablative therapy. MRI examinations were performed preoperatively, as well as 1 week and 6 months post treatment...
November 6, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29107274/focal-ablation-of-early-stage-prostate-cancer-candidate-selection-treatment-guidance-and-assessment-of-outcome
#7
REVIEW
Eric Edison, Taimur Tariq Shah, Hashim U Ahmed
Prostate cancer lesions smaller than 0.5 m(3), or Gleason pattern 3, are likely clinically insignificant. Clinically significant disease is often limited to a single index lesion. Focal ablation targets this index lesion, maintains oncological control, and minimizes complications by preserving healthy prostate tissue. Template mapping biopsy or multiparametric MRI-targeted biopsies are used to identify appropriate index lesions. Multiple energy modalities have been tested, including high-intensity frequency ultrasound, cryoablation, laser ablation, photodynamic therapy, focal brachytherapy, radiofrequency ablation, irreversible electroporation...
November 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/29107175/entrapment-of-focal-atrial-tachycardia-using-cryoballoon-ablation-sinus-rhythm-in-the-left-atrium-and-ongoing-atrial-tachycardia-in-the-left-atrial-appendage
#8
Hikmet Yorgun, Uğur Canpolat, Banu Evranos, Kudret Aytemir
Left atrial appendage (LAA) is a well-known source of focal atrial tachycardias (AT). Although radio-frequency (RF) energy is the most commonly used technique in such cases, there was an option other than epicardial approach when RF technique fails. Cryoballoon technology is primarily developed to be used for pulmonary vein isolation (PVI). Also, there was no report regarding the isolation of LAA by using cryo-balloon in patients with focal AT. In this case, for the first time in the literature, we successfully isolated the LAA because of failed attempts of RF ablation for focal AT in whom the surface electrogram showed a sinus rhythm while arrhythmia continues inside the LAA...
October 28, 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29106546/clinical-validation-of-automatic-local-activation-time-annotation-during-focal-premature-ventricular-complex-ablation-procedures
#9
Juan Acosta, David Soto-Iglesias, Juan Fernández-Armenta, Manuel Frutos-López, Beatriz Jáuregui, Eduardo Arana-Rueda, Marcos Fernández, Diego Penela, Alejandro Alcaine, Lucas Cano, Alonso Pedrote, Antonio Berruezo
Aims: Current navigation systems incorporate algorithms for automatic identification of local activation time (LAT). However, data about their utility and accuracy in premature ventricular complex (PVC) ablation procedures are scarce. This study analyses the accuracy of an algorithmic method based on automatic annotation of the maximal negative slope of the unipolar electrogram within the window demarcated by the bipolar electrogram compared with conventional manual annotation during PVC ablation procedures...
November 2, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29103620/an-unusual-cause-of-heart-failure-in-a-young-man
#10
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Arun Gopalakrishnan, Sreevilasam Pushpangadhan Abhilash, Ajitkumar Valaparambil
A 21year old gentleman was admitted with shortness of breath and heart failure. He was noted to have incessant supraventricular tachycardia which was refractory to pharmacological and electrical cardioversion. Electrophysiology study revealed focal atrial tachycardia from an unusual location which was successfully ablated.
October 5, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29103291/current-and-future-uses-of-transcranial-focused-ultrasound-in-neurosurgery
#11
David S Hersh, Howard M Eisenberg
Focused ultrasound (FUS) produces a region of high intensity at the focal zone of the beam but with minimal effects at adjacent areas, allowing the sonication of deep targets throughout the body. Despite early obstacles to transmitting ultrasound energy through the skull, recent advances in ultrasound technology, software, and real-time monitoring have resulted in a renewed interest in the clinical applications of transcranial FUS. Following extensive pre- clinical studies, ultrasound-induced thermal ablation has been approved by several countries for the treatment of essential tremor, Parkinson's disease, obsessive-compulsive disorder, depression, and neuropathic pain...
November 3, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29102671/preliminary-diagnostic-accuracy-of-multiparametric-magnetic-resonance-imaging-to-detect-residual-prostate-cancer-following-focal-therapy-with-irreversible-electroporation
#12
Matthijs J Scheltema, John I Chang, Willemien van den Bos, Maret Böhm, Warick Delprado, Ilan Gielchinsky, Theo M de Reijke, Jean J de la Rosette, Amila R Siriwardana, Ron Shnier, Phillip D Stricker
BACKGROUND: It is recommended to perform multiparametric magnetic resonance imaging (mpMRI) in the follow-up following focal therapy of prostate cancer (PCa). OBJECTIVE: To determine the diagnostic accuracy of mpMRI to detect residual PCa following focal therapy with irreversible electroporation. DESIGN, SETTING, AND PARTICIPANTS: Seventy-six patients with biopsy-proven localized PCa consented for primary irreversible electroporation between February 2013 and March 2016...
November 1, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29076304/review-of-the-emerging-role-of-optical-polarimetry-in-characterization-of-pathological-myocardium
#13
Iftikhar Ahmad
Myocardial infarction (MI), a cause of significant morbidity and mortality, is typically followed by microstructural alterations where the necrotic myocardium is steadily replaced with a collagen scar. Engineered remodeling of the fibrotic scar via stem cell regeneration has been shown to improve/restore the myocardium function after MI. Nevertheless, the heterogeneous nature of the scar patch may impair the myocardial electrical integrity, leading to the formation of arrhythmogenesis. Radiofrequency ablation (RFA) offers an effective treatment for focal arrhythmias where local heating generated via electric current at specific spots in the myocardium ablate the arrhythmogenic foci...
October 2017: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29072796/atrial-tachycardias-cause-or-effect-with-ablation-of-persistent-atrial-fibrillation
#14
Seigo Yamashita, Darren A Hooks, Ashok Shah, Jatin Relan, Ghassen Cheniti, Takeshi Kitamura, Benjamin Berte, Saagar Mahida, Jean-Marc Sellal, Nora Al Jefairi, Antonio Frontera, Sana Amraoui, Arnaud Denis, Nicolas Derval, Frédéric Sacher, Hubert Cochet, Rémi Dubois, Mélèze Hocini, Michel Haïssaguerre, George Klein, Pierre Jaïs
INTRODUCTION: It is largely believed that atrial tachycardias (ATs) encountered during ablation of persistent atrial fibrillation (PsAF) are a byproduct of ablative lesions. We aimed to explore the alternative hypothesis that they may be priori drivers of AF remaining masked until other AF sources are reduced or eliminated. METHODS AND RESULTS: Radiofrequency ablation of fibrillatory drivers mapped by electrocardiographic imaging (ECGI; ECVUEۛ, Cardioinsight Technologies, US) terminated PsAF in 198(73%) out of 270 patients (61±10y, 9±9 m)...
October 26, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29068108/evaluation-of-sustained-tachyarrhythmia-in-children-younger-than-one-year-of-age
#15
Gulhan Tunca Sahin, Erkut Ozturk, Taner Kasar, Alper Guzeltas, Yakup Ergul
BACKGROUND: In this study, we aim to evaluate the results of non-operational sustained tachyarrhythmias in patients younger than 1 year of age in our center. METHODS: Between November 2010 and November 2016, the demographic characteristics, type and localization of the tachyarrhythmia, echocardiographic findings, and medical and/or ablation therapies applied for patients under 1 year of age who had sustained tachyarrhythmias were evaluated. RESULTS: Among 99 patients, 91 had sustained supraventricular tachycardia, and eight had sustained ventricular tachycardia...
October 25, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29065623/segmentation-method-for-magnetic-resonance-guided-high-intensity-focused-ultrasound-therapy-planning
#16
A Vargas-Olivares, O Navarro-Hinojosa, M Maqueo-Vicencio, L Curiel, M Alencastre-Miranda, J E Chong-Quero
High-intensity focused ultrasound (HIFU) is a minimally invasive therapy modality in which ultrasound beams are concentrated at a focal region, producing a rise of temperature and selective ablation within the focal volume and leaving surrounding tissues intact. HIFU has been proposed for the safe ablation of both malignant and benign tissues and as an agent for drug delivery. Magnetic resonance imaging (MRI) has been proposed as guidance and monitoring method for the therapy. The identification of regions of interest is a crucial procedure in HIFU therapy planning...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29065436/hot-avulsion-may-be-effective-as-salvage-treatment-for-focal-barrett-s-esophagus-remaining-after-endoscopic-therapy-for-dysplasia-or-early-cancer-a-preliminary-study
#17
Javier Aranda-Hernández, Yuto Shimamura, Andrea Grin, Yugo Iwaya, Maria Cirocco, Gabor Kandel, Gary May, Paul Kortan, Spiro Raftopoulos, Norman Marcon
Background and study aim Both endoscopic mucosal resection (EMR) and radiofrequency ablation (RFA) are used to treat Barrett's esophagus (BE) complicated by dysplasia and intramucosal cancer. However, focal areas of BE can remain after otherwise successful application of these techniques. We report the results of hot avulsion using a hot biopsy forceps to resect these residual focal areas. Patients and methods This was a retrospective study from a prospective database in a tertiary reference center from August 2013 to May 2015...
October 24, 2017: Endoscopy
https://www.readbyqxmd.com/read/29061480/the-use-of-mri-to-predict-oncological-control-among-candidates-for-focal-ablation-of-prostate-cancer
#18
Alexander P Kenigsberg, Elton Llukani, Fang-Ming Deng, Jonathan Melamed, Ming Zhou, Herbert Lepor
OBJECTIVE: To provide insights into the role of mpMRI for predicting oncological control following two focal ablation (FA) templates for selective cases of prostate cancer (PCa). MATERIALS AND METHODS: 59 radical prostatectomies were performed between 2012 and 2016 on cases that fulfilled criteria for FA. The Gleason score (GS), extent of Gleason pattern (GP) 4, maximum linear cross sectional length (MLCSL) and location of tumor foci were recorded and related to scale on corresponding 3mm transverse slice prostate maps...
October 20, 2017: Urology
https://www.readbyqxmd.com/read/29046984/spatial-tracking-of-targeted-prostate-biopsy-locations-moving-towards-effective-focal-partial-prostate-gland-ablation-with-improved-treatment-planning
#19
REVIEW
Steven Sidelsky, Shaan Setia, Srinivas Vourganti
The ability to selectively characterize, localize, and predict the specific areas of the prostate gland which harbor the worst biologic behavior is requisite for optimal prostate cancer therapy, especially in the emerging field of partial prostate gland ablation (focal therapy). In this manuscript, we highlight contemporary techniques in target tracking for focal therapy planning. Multiparametric magnetic resonance imaging has emerged as a dominant strategy to localize biopsy sites most likely to contain high-grade lesions...
October 18, 2017: Current Urology Reports
https://www.readbyqxmd.com/read/29044787/intracardiac-ablation-for-atrioventricular-nodal-reentry-tachycardia-using-a-6%C3%A2-mm-distal-electrode-cryoablation-catheter-prospective-multicenter-north-american-study-icy-avnrt-study
#20
Peter Wells, Marc Dubuc, George J Klein, Dan Dan, Jean-Francois Roux, Evan Lockwood, Marcio Sturmer, David Dunbar, Paul Novak, Arun Rao, Brett J Peterson, Fred Kueffer, Kenneth A Ellenbogen
INTRODUCTION: Radiofrequency (RF) ablation is effective for slow pathway ablation, but carries a risk of inadvertent AV block requiring permanent pacing. By comparison, cryoablation with a 4 mm distal electrode catheter has not been reported to cause permanent AV block but has been shown to be less effective than RF ablation. We sought to define the safety and efficacy of a 6 mm distal electrode cryoablation catheter for slow pathway ablation in patients with atrioventricular nodal reentry tachycardia (AVNRT)...
October 17, 2017: Journal of Cardiovascular Electrophysiology
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