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Atrial fibrillation ablation

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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/28642107/venous-thrombosis-after-electrophysiology-procedures-a-systematic-review
#3
Barry Burstein, Rodrigo S Barbosa, Eli Kalfon, Jacqueline Joza, Martin Bernier, Vidal Essebag
BACKGROUND: Femoral venous access for catheter introduction represents the cornerstone of electrophysiology (EP) procedures. Limited data are available regarding post-procedure venous thromboembolism. The aim of this systematic review is to determine the incidence of deep vein thrombosis (DVT) and pulmonary embolus (PE) associated with femoral vein catheterization during EP procedures. METHODS: An electronic search was conducted for studies documenting the incidence of DVT and PE after EP procedures...
June 19, 2017: Chest
https://www.readbyqxmd.com/read/28641381/supraventricular-tachyarrhythmias-in-patients-with-a-persistent-left-superior-vena-cava
#4
Jongmin Hwang, Hyoung-Seob Park, Jun Kim, Jeong Su Kim, Jong Sung Park, Ki-Hun Kim, Myung Hwan Bae, Sang-Hee Lee, Young Soo Lee, Seongwook Han, Dae-Kyeong Kim, Tae-Joon Cha, Dong Gu Shin, Byung Chun Jung, Yoon-Nyun Kim
Aims: A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. This venous anomaly can impact the evaluation and treatment of supraventricular tachyarrhythmia (SVA). The aim of this study was to assess the proportion and characteristics of PLSVC in adult SVA patients. Methods and results: From July 2002 to July 2012, clinical and procedural data from databases of 10 cardiac electrophysiology laboratories in the Yeungnam region of the Republic of Korea were reviewed...
June 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28639873/anesthetic-management-of-patients-undergoing-percutaneous-endocardial-and-epicardial-left-atrial-appendage-occlusion
#5
Zeena Husain, Payam Safavi-Naeini, Abdi Rasekh, Mehdi Razavi, Charles D Collard, James M Anton, Daniel A Tolpin
Atrial fibrillation is the most common cardiac arrhythmia in adults affecting almost 6 million adults in the United States. The 2 most common comorbidities associated with atrial fibrillation are heart failure and thromboembolic events. Heart failure symptoms may be treated with rate control, antiarrhythmic medications or by catheter ablation. Unfortunately, despite optimal medical management, thromboembolic events still occur. Recently, there has been a great deal of interest and innovation in finding an alternative to chronic anticoagulation...
June 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28639773/-paradigm-shift-in-the-treatment-of-atrial-fibrillation-the-importance-of-risk-factor-management
#6
Stefania Aur, Patrizio Pascale
The prevalence of atrial fibrillation (AF) is constantly rising. Different studies have underlined the correlation between AF and modifiable risk factors such as obesity, obstructive sleep apnea, hypertension and sedentary lifestyle. Treatment of these comorbidities could significantly reduce the AF burden and the recurrence rate after cardioversion or ablation. These data should therefore lead to a paradigm shift in the management of AF. A strategy limited to catheter ablation or to the prescription of an antiarrhythmic drug is not sufficient...
May 24, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28639747/the-effect-of-activation-rate-on-left-atrial-bipolar-voltage-in-patients-with-paroxysmal-atrial-fibrillation
#7
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/28639728/prospective-use-of-ablation-index-targets-improves-clinical-outcomes-following-ablation-for-atrial-fibrillation
#8
Ahmed Hussein, Moloy Das, Vivek Chaturvedi, Issa Khalil Asfour, Niji Daryanani, Maureen Morgan, Christina Ronayne, Matthew Shaw, Richard Snowdon, Dhiraj Gupta
AIMS: Late recovery of ablated tissue leading to reconnection of pulmonary veins remains common following radiofrequency catheter ablation for AF. Ablation Index (AI), a novel ablation quality marker, incorporates contact force (CF), time and power in a weighted formula. We hypothesized that prospective use of our previously-published derived AI targets would result in better outcomes when compared to CF-guided ablation. METHODS: 89 consecutive drug-refractory AF patients (49% paroxysmal) underwent AI-guided ablation (AI-group)...
June 22, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28638008/-the-results-of-pulmonary-veins-isolation-to-prevent-postoperative-atrial-fibrillation
#9
P V Lednev, Yu V Belov, R N Komarov, A V Stonogin, A I Katkov
AIM: To compare an efficacy of primary surgical (epicardial bipolar pulmonary veins isolation) and pharmacological (amiodarone) prevention of postoperative atrial fibrillation. MATERIAL AND METHODS: The study included 117 patients with coronary artery disease without previous paroxysms of atrial fibrillation who were randomized into 3 groups. The first (I) group (n=39) included patients who underwent coronary artery bypass grafting without radiofrequency ablation of pulmonary veins and prophylactic amiodarone administration...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28637626/chromosome-4q25-variants-and-recurrence-after-second-generation-cryoballoon-ablation-in-patients-with-paroxysmal-atrial-fibrillation
#10
Shinsuke Miyazaki, Yusuke Ebana, Lian Liu, Hiroaki Nakamura, Hitoshi Hachiya, Hiroshi Taniguchi, Takamitsu Takagi, Takatsugu Kajiyama, Tomonori Watanabe, Miyako Igarashi, Shigeki Kusa, Takashi Niida, Yoshito Iesaka, Tetsushi Furukawa
BACKGROUND: Chromosome 4q25 single-nucleotide polymorphisms (SNPs) are associated with atrial fibrillation (AF) recurrence after radiofrequency catheter ablation, however the underlying mechanism is unknown. Pulmonary vein (PV) reconnections are common post-radiofrequency ablation. We explored the pre-procedural parameters, including AF susceptibility SNPs, predicting the response to PV isolation (PVI) using second-generation cryoballoons. METHODS: One hundred fifty-seven paroxysmal AF patients undergoing PVI using second-generation cryoballoons and genetic testing were enrolled...
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28637187/identification-of-pulmonary-vein-reconnection-gaps-with-high-density-mapping-in-redo-atrial-fibrillation-ablation-procedures
#11
Ignacio García-Bolao, Gabriel Ballesteros, Pablo Ramos, Diego Menéndez, Ane Erkiaga, Renzo Neglia, Marta Jiménez Martín, Enrique Vives-Rodríguez
Aims: Maps obtained by means of electroanatomic high-density mapping (HDM) systems have shown their use in the identification of conduction gaps in experimental atrial linear lesion models. The objective of this study was to assess the use of HDM in the recognition of reconnection gaps in pulmonary veins (PV) in redo atrial fibrillation (AF) ablation procedures. Methods and results: One hundred and eight patients were included in a non-randomized study that assessed the recognition of reconnection gaps in PV by means of HDM compared to a control group that received conventional non-fluoroscopic guidance with a circular multipolar catheter (CMC)...
June 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28635196/direct-oral-anticoagulants-in-patients-undergoing-cardioversion-insight-from-randomized-clinical-trials
#12
Stefania Angela Di Fusco, Furio Colivicchi, Nadia Aspromonte, Marco Tubaro, Alessandro Aiello, Massimo Santini
Anticoagulation, reducing the risk of thromboembolic events in patients undergoing cardioversion, is a cornerstone of peri-cardioversion management in patients with atrial fibrillation. We aimed to analyse published data on the efficacy and safety of direct oral anticoagulants (DOACs) in patients undergoing cardioversion. We performed a systematic review of randomized prospective clinical trials (RCTs) comparing DOACs with warfarin and reporting data on post-cardioversion outcomes of interest. Outcomes of interest were stroke, systemic thromboembolic events and major bleeding...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28635186/catheter-ablation-of-atrial-fibrillation-with-box-isolation-of-fibrotic-areas-lessons-on-fibrosis-distribution-and-extent-clinical-characteristics-and-their-impact-on-long-term-outcome
#13
Doreen Schreiber, Andreas Rieger, Fabian Moser, Hans Kottkamp
INTRODUCTION: The BIFA concept (box isolation of fibrotic areas) supplementing pulmonary vein isolation (PVI) was implemented in atrial fibrillation (AF) patients with fibrotic atrial cardiomyopathy (FACM) to improve catheter ablation outcomes. METHODS AND RESULTS: 92 patients with FACM underwent PVI+BIFA. We investigated patient characteristics (58 persistent/34 paroxysmal,68±8y,LA 44±7mm,CHA2 DS2 -VASc 2.6±1.3,FACM I:15.2%,II:53.3%,III:26.1%,IV:5.4%), periprocedural data concerning fibrosis extent/distribution and their impact on outcome...
June 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28631212/erratum-to-use-of-three-dimensional-computed-tomography-overlay-for-real-time-cryoballoon-ablation-in-atrial-fibrillation-reduces-radiation-dose-and-contrast-dye
#14
B Oude Velthuis, M M D Molenaar, H G Reinhart Dorman, J Y Stevenhagen, M F Scholten, J van der Palen, J M van Opstal
No abstract text is available yet for this article.
June 19, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28631077/noninvasive-evaluation-of-reverse-atrial-remodeling-after-catheter-ablation-of-atrial-fibrillation-by-p-wave-dispersion
#15
Yuhi Fujimoto, Kenji Yodogawa, Kenta Takahashi, Ippei Tsuboi, Hiroshi Hayashi, Shunsuke Uetake, Yu-Ki Iwasaki, Meiso Hayashi, Yasushi Miyauchi, Wataru Shimizu
Atrial fibrillation (AF) itself creates structural and electrophysiological changes such as atrial enlargement, shortening of refractory period and decrease in conduction velocity, called "atrial remodeling", promoting its persistence. Although the remodeling process is considered to be reversible, it has not been elucidated in detail. The aim of this study was to assess the feasibility of P wave dispersion in the assessment of reverse atrial remodeling following catheter ablation of AF. Consecutive 126 patients (88 males, age 63...
June 19, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28630373/incidence-and-time-course-for-developing-heart-failure-with-high-burden-right-ventricular-pacing
#16
Faisal M Merchant, Michael H Hoskins, Dan L Musat, Julie B Prillinger, Gregory J Roberts, Yelena Nabutovsky, Suneet Mittal
BACKGROUND: Although right ventricular pacing can contribute to cardiomyopathy, the impact of complete atrioventricular block (cAVB) on heart failure (HF) development in pacemaker patients has not been well characterized. We evaluated the incidence and time course for developing HF after pacemaker implantation for cAVB. METHODS AND RESULTS: A MarketScan database identified patients undergoing dual-chamber pacemaker implantation from 2008 to 2014. Patients with cAVB were identified by an atrioventricular node ablation or diagnosis of third-degree AVB...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28630168/incidence-and-factors-associated-with-the-occurrence-of-pulmonary-vein-narrowing-after-cryoballoon-ablation
#17
Ryohsuke Narui, Michifumi Tokuda, Masato Matsushima, Ryota Isogai, Kenichi Tokutake, Kenichi Yokoyama, Mika Hioki, Keiichi Ito, Shin-Ichi Tanigawa, Seigo Yamashita, Keiichi Inada, Kenri Shibayama, Seiichiro Matsuo, Satoru Miyanaga, Kenichi Sugimoto, Michihiro Yoshimura, Teiichi Yamane
BACKGROUND: In contrast with traditional radiofrequency ablation, little is known about the influence of cryoballoon ablation on the morphology of pulmonary veins (PVs). We evaluated the influence of cryoballoon ablation on the PV dimension (PVD) and investigated the factors associated with a reduction of the PVD. METHODS AND RESULTS: Seventy-four patients who underwent cryoballoon ablation for paroxysmal atrial fibrillation were included in the present study. All subjects underwent contrast-enhanced computed tomography both before and at 3 months after the procedure...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28626989/electrical-isolation-of-the-left-atrial-appendage-by-maze-like-catheter-substrate-modification-a-reproducible-strategy-for-pulmonary-vein-isolation-non-responders
#18
Stefano Bordignon, Laura Perrotta, Daniela Dugo, Fabrizio Bologna, Takahiko Nagase, Alexander Fuernkranz, Kr Julian Chun, Boris Schmidt
INTRODUCTION: The ablation strategy for atrial fibrillation (AF) despite pulmonary vein isolation (PVI) is controversial. Left atrial appendage isolation (LAAI) may contribute to improve outcome. We describe an ablation approach ("Maze-like"-LAAI) that (1) modifies the underlying LA substrate by linear ablation (2) eliminates the LAA as a putative AF trigger site and (3) incorporates an unambiguous procedural endpoint. The role of LAA closure (LAAC) after LAAI was investigated. METHODS: Patients with atrial tachyarrhythmias non-responsive to PVI underwent a LAAI ablation procedure...
June 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28625929/verification-of-a-novel-atrial-fibrillation-cryoablation-dosing-algorithm-guided-by-time-to-pulmonary-vein-isolation-results-from-the-cryo-dosing-study-cryoballoon-ablation-dosing-based-on-the-assessment-of-time-to-effect-and-pulmonary-vein-isolation-guidance
#19
Arash Aryana, David N Kenigsberg, Marcin Kowalski, Charles H Koo, Hae W Lim, Padraig Gearoid O'Neill, Mark R Bowers, Robert B Hokanson, Kenneth A Ellenbogen
BACKGROUND: There are no recommendations on the optimal dosing for cryoablation of atrial fibrillation (Cryo-AF). OBJECTIVE: We developed and prospectively tested a Cryo-AF dosing protocol guided exclusively by time-to-pulmonary vein (PV) isolation (TT-PVI) in patients undergoing a first-time Cryo-AF. METHODS: In this multicenter study, we examined the acute/long-term safety/efficacy of Cryo-AF using the proposed dosing algorithm (Cryo-AFDosing, n=355) against a conventional, non-standardized approach (Cryo-AFConventional, n=400) in a non-randomized fashion...
June 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28625928/second-generation-cryoballoon-ablation-in-the-setting-of-left-common-pulmonary-veins-procedural-findings-and-clinical-outcome
#20
Erwin Ströker, Ken Takarada, Carlo de Asmundis, Juan-Pablo Abugattas, Giacomo Mugnai, Vedran Velagic, Valentina de Regibus, Hugo-Enrique Coutiño, Rajin Choudhury, Saverio Iacopino, Yves De Greef, Kaoru Tanaka, Pedro Brugada, Gian-Battista Chierchia
BACKGROUND: A left common pulmonary vein (LCPV) accounts as the most frequent PV variation. The use of the cryoballoon (CB) for isolating these veins, is still debatable. To date, no data are available regarding the feasibility, acute PV isolation, and clinical outcome of the second-generation CB (CB-A) in this setting. OBJECTIVE: To investigate the performance of the CB-A in patients with LCPVs. METHODS: In a total cohort of 433 patients having undergone CB-A ablation for drug-refractory atrial fibrillation (AF) together with pre-procedural CT-scanning, 146 patients presented a LCPV...
June 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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