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Left atrial appendage isolation

Satoshi Miyazawa, Seiji Fukamizu, Iwanari Kawamura, Rintaro Hojo
A 79-year-old woman with a history of pulmonary vein isolation for persistent atrial fibrillation was admitted for recurrence of atrial tachycardia, with a tachycardia cycle length of 236 ms. The ultra-high-resolution mapping system revealed that tachycardia circuit detouring the epicardium at the anterior wall scar and breakthrough to the endocardium bellow the left atrial appendage. Radiofrequency energy was applied to this site, which successfully terminated the tachycardia. This case suggests that epicardial conduction could occur even at the left atrial anterior wall and identifies a variation in epicardial conduction around the left atrium, which could be a tachycardia circuit This article is protected by copyright...
October 4, 2018: Journal of Cardiovascular Electrophysiology
D A Lerman, M Diaz, B Peault
Introduction: Focussing on the potential role of cardiovascular cell therapy, we investigated the spatial relationship between pericytes (cells with cardiac repair capabilities that ensheath blood vessels) and endogenous cardiac progenitors within stem cells' niches. We explored possible changes in their co-localisation in developing human hearts from foetal to adult stage and following ischaemia. Methods: Foetal and adult human heart specimens, obtained under ethical consent (University of Edinburgh ethics committee), were used for immunohistochemistry, cell isolation, culture and differentiation...
August 28, 2018: European Heart Journal
Helena Domínguez, Christoffer Valdorff Madsen, Oliver Nøhr Hjorth Westh, Peter Appel Pallesen, Christian Lildal Carrranza, Akhmadjon Irmukhamedov, Jesper Park-Hansen
PURPOSE OF REVIEW: Stroke is the most feared complication of atrial fibrillation. To prevent stroke, left atrial appendage exclusion has been targeted, as it is the prevalent site for formation of heart thrombi during atrial fibrillation. We review the historic development of methods for exclusion of the left atrial appendage and the evidence to support its amputation during routine cardiac surgery. RECENT FINDINGS: Evidence is not yet sufficient to routinely recommend left atrial exclusion during heart surgery, despite a high prevalence of postoperative atrial fibrillation...
August 31, 2018: Current Cardiology Reports
James R Stewart
No abstract text is available yet for this article.
August 28, 2018: Annals of Thoracic Surgery
Malcolm C Finlay, Charles A Mosse, Richard J Colchester, Sacha Noimark, Edward Z Zhang, Sebastien Ourselin, Paul C Beard, Richard J Schilling, Ivan P Parkin, Ioannis Papakonstantinou, Adrien E Desjardins
High-frequency ultrasound imaging can provide exquisite visualizations of tissue to guide minimally invasive procedures. Here, we demonstrate that an all-optical ultrasound transducer, through which light guided by optical fibers is used to generate and receive ultrasound, is suitable for real-time invasive medical imaging in vivo . Broad-bandwidth ultrasound generation was achieved through the photoacoustic excitation of a multiwalled carbon nanotube-polydimethylsiloxane composite coating on the distal end of a 300-μm multi-mode optical fiber by a pulsed laser...
December 2017: Light, Science & Applications
N Ma, J Mei, R X Lu, Z L Jiang, M Tang, F B Ding
Objective: To evaluate the efficacy of Mei mini maze procedure for treating atrial fibrillation (AF) patients with previously failed catheter ablation. Methods: Between August 2010 and May 2016, 48 AF (8 proximal AF, 15 persistent AF and 25 long-standing persistent AF) patients (29 males, 19 females, mean age: (62.5±7.3) years old) with previously 1-3 failed catheter ablation results were treated with Mei mini maze procedure in our department. Under thoracoscopic assistance, the procedure was performed through three ports on left chest wall, pulmonary vein isolation and ablations of the roof and posterior wall of left atrium was made by bipolar radiofrequency ablation...
August 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Toshiya Ohtsuka, Takahiro Nonaka, Motoyuki Hisagi, Mikio Ninomiya
BACKGROUND: We evaluated the safety and rhythm-control effectiveness in en bloc isolation of the left pulmonary vein (PV) and appendage conducted as part of the thoracoscopic procedure for bilateral PV isolation, non-PV ablation, and appendage closure for atrial fibrillation (AF). METHODS: Procedural safety was evaluated by reviewing the surgical records. The rhythm-control was examined in accordance with the Heart Rhythm Society guidelines at postoperative months 1, 3, 6, and 12 and yearly thereafter...
August 14, 2018: Annals of Thoracic Surgery
Georgios Giannopoulos, Vasileios Kekeris, Dimitrios Vrachatis, Charalampos Kossyvakis, Charalampos Ntavelas, Georgios Tsitsinakis, Athanasios Koutivas, Christos Tolis, Christos Angelidis, Spyridon Deftereos
BACKGROUND: Left atrial appendage (LAA) functional modification in the context of pulmonary vein isolation has been a focus point of research and LAA emptying flow velocity (LAAEFV) is considered to reflect LAA contractility, stunning, and fibrosis. OBJECTIVE: In the present study, we sought to prospectively evaluate short-term LAAEFV changes after radiofrequency (RF) or cryoballoon ablation in paroxysmal AF. METHODS: This was a prospective substudy of the Effect of Cryoballoon and RF Ablation on Left Atrial Function (CryoLAEF) study (ClinicalTrials...
September 2018: Pacing and Clinical Electrophysiology: PACE
Heiko Lehrmann, Amir S Jadidi, Jan Minners, Juan Chen, Björn Müller-Edenborn, Reinhold Weber, Olaf Dössel, Thomas Arentz, Axel Loewe
OBJECTIVES: This study hypothesized that P-wave morphology and timing under left atrial appendage (LAA) pacing change characteristically immediately upon anterior mitral line (AML) block. BACKGROUND: Perimitral flutter commonly occurs following ablation of atrial fibrillation and can be cured by an AML. However, confirmation of bidirectional block can be challenging, especially in severely fibrotic atria. METHODS: The study analyzed 129 consecutive patients (66 ± 8 years, 64% men) who developed perimitral flutter after atrial fibrillation ablation...
July 2018: JACC. Clinical Electrophysiology
Mohammad Sahebjam, Vahide Montazeri, Arezoo Zoroufian, Ali Hosseinsabet, Masoumeh Lotfi-Tokaldany, Arash Jalali
AIM: We intended to assess the left atrial deformation parameters, using two-dimensional speckle tracking (2DSTE) and transesophageal echocardiography (TEE), and determine the correlation between these two techniques in order to recognize the patients at risk for cardioembolic events. METHOD: Strain and strain rate were measured using 2DSTE among 26 patients in sinus rhythm, with isolated moderate to severe mitral stenosis. Left atrial (LA) volume parameters (maximum, minimum and preatrial contraction) were measured...
October 2018: Echocardiography
Jorge Romero, Andrea Natale, Luigi Di Biase
No abstract text is available yet for this article.
October 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Shyam Kumar Singh Thingnam, Sachin Mahajan, Vikas Kumar
Background Percutaneous device closure of an ostium secundum atrial septal defect is associated with excellent outcomes and cosmetic results but at the cost of occasional serious and sometimes fatal complications as well as lifelong follow-up. Surgical intervention is required in cases of device-related complications, which carries a slightly higher risk compared to primary closure of an atrial septal defect. We present a surgical perspective of device closure of atrial septal defect. Methods Our database was searched over 4 years for complications related to percutaneous device closure of atrial septal defect, which required surgical retrieval of the device and closure of the defect...
June 2018: Asian Cardiovascular & Thoracic Annals
Yukun Cao, Tin Yang, Ma Hou, Hongcha Zhang, Xi Chen, Fe Zou
Partial anomalous pulmonary venous connection (PAPVC) is an uncommon congenital heart disease, which may be difficult to identify and often remains undiagnosed. Accurate diagnosis of major aortopulmonary collaterals and partial anomalous pulmonary venous drainage in patients with congenital heart disease is important but problematic. The goal of this publication is to present the diagnosis and surgical repair of this rare pathology in an eight-year-old boy. Atrial septal defect was found by echocardiography, but no anomalous pulmonary vein was found...
March 8, 2018: Heart Surgery Forum
Faraz Pathan, Harvey Hecht, Jagat Narula, Thomas H Marwick
Evaluation of the left atrium and left atrial appendage for the presence of thrombus prior to cardioversion and pulmonary vein isolation, and of the entire heart for embolic sources in the setting of cryptogenic stroke, has long been standard medical care. Guidelines have uniformly recommended transesophageal echocardiography (TEE) to accomplish these goals. In recent years, computed tomographic angiography has demonstrated diagnostic accuracy similar to that of TEE for the detection of thrombus. Analysis of the pertinent data and relative merits of the 2 technologies leads to the conclusions that: 1) both modalities have some unique, nonoverlapping capabilities that may dictate their use in specific situations; 2) computed tomographic angiography is a reasonable alternative to TEE when the primary aim is to exclude left atrial and left atrial appendage thrombus and in patients in whom the risks associated with TEE outweigh the benefits; and 3) both options should be discussed with the patient in the setting of shared decision making...
April 2018: JACC. Cardiovascular Imaging
Roland R Tilz, Charlotte Eitel
No abstract text is available yet for this article.
January 2018: JACC. Clinical Electrophysiology
Daniel J Friedman, Eric W Black-Maier, Adam S Barnett, Sean D Pokorney, Sana M Al-Khatib, Kevin P Jackson, Tristram D Bahnson, Christopher R Ellis, Brett D Atwater, Robert K Lewis, Jonathan P Piccini
OBJECTIVES: In this study, the authors sought to perform a meta-analysis of controlled studies assessing the relationship between left atrial appendage (LAA) electrical isolation (EI) and recurrent atrial fibrillation (AF). BACKGROUND: LAA triggers could play an important role in AF and can be treated with complete EI of the LAA via surgical or percutaneous approaches. METHODS: We conducted a meta-analysis of all controlled studies published as of November 21, 2016, assessing the relationship between left atrial appendage electrical isolation (LAAEI) and recurrent AF...
January 2018: JACC. Clinical Electrophysiology
Markus Linhart, Jessica T Werner, Florian Stöckigt, Annika T Kohlmann, Pia C Lodde, Lutz P T Linneborn, Thomas Beiert, Christoph Hammerstingl, Roger Borràs, Georg Nickenig, René P Andrié, Jan W Schrickel
PURPOSE: Congenital atrial septal defect (ASD) is associated with increased morbidity, whereas little is known about the rate of spontaneous closure, associated clinical and echocardiographic parameters, or complications of iatrogenic atrial septal defect (iASD) beyond 1 year of follow-up. Persistent iASD after transseptal puncture for PVI has been described in up to 38% of small cohorts of patients in short-term follow-up after transseptal puncture. We sought to investigate the course of iASD after single transseptal puncture for first pulmonary vein isolation (PVI) with cryoballoon, along with possible risk factors for persistent iASD...
July 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Alessandro Satriano, Edward J Vigmond, David S Schwartzman, Elena S Di Martino
Mechanical stretch plays a major role in modulating atrial function, being responsible for beat-by-beat responses to changes in chamber preload, enabling a prompt regulation of cardiac function. Mechano-electric coupling (MEC) operates through many mechanisms and has many targets, making it experimentally difficult to isolate causes and effects especially under sinus conditions where effects are more transient and subtle. Therefore, modelling is a powerful tool to help understand the role of MEC with respect to the atrial electromechanical interaction...
May 1, 2018: Computers in Biology and Medicine
Yoshinari Enomoto, Go Hashimoto, Naohiko Sahara, Hikari Hashimoto, Hiroki Niikura, Keijiro Nakamura, Raisuke Iijima, Hidehiko Hara, Makoto Suzuki, Mahito Noro, Masao Moroi, Kaoru Sugi, Masato Nakamura
A 70-years-old male with a history of hypertension and drug resistant paroxysmal atrial fibrillation (AF) presented to our hospital for catheter ablation to his symptomatic AF. He had no prior surgical or percutaneous procedure to close or exclude the left atrial appendage (LAA). A transesophageal echocardiography (TEE) was performed to rule out intra-cardiac thrombus prior to the ablation procedure. Although the TEE imaging at multiple acquisition angles was obtained, the LAA could not be visualized and an absence of the LAA was suspected...
March 30, 2018: International Heart Journal
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