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Atrial fibrillation ablation

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https://www.readbyqxmd.com/read/28449532/the-future-of-hybrid-ablation-an-emerging-need-for-an-anticoagulation-protocol-for-thoracoscopic-ablation
#1
EDITORIAL
Pavel Osmancik, Petr Budera
The midterm efficacy of hybrid ablation of atrial fibrillation (AF) reported in recent papers is about 70% in terms of sinus rhythm maintenance without antiarrhythmic drugs. Bearing in mind that the majority of patients enrolled are patients with persistent and long-standing persistent AF, the reported efficacies seem to be very good. Despite the high efficacies, safety remains a critical issue in hybrid, and especially thoracoscopic ablations. The frequency of complications during thoracoscopic ablations is more than 10% in the majority of reports...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449531/ablation-of-atrial-fibrillation-single-shot-techniques-poised-to-dominate-rhythm-control-strategies-the-future-is-here
#2
EDITORIAL
Antonis S Manolis
Over the recent years, the advent of single-shot techniques, such as circular catheter and cryoballoon ablation, has ushered in a new era in the catheter ablation approach and rhythm control strategies of patients with atrial fibrillation (AF). These techniques make it easier to navigate the heart and have the potential to decrease the threshold for, expand the access to, and increase patient and physician acceptance of rhythm-control therapies, that may lead to reduction of the AF disease burden and its socioeconomic impact...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449433/fire-or-ice-for-paroxysmal-atrial-fibrillation-perspectives-from-the-largest-randomized-evaluation-of-cryoballoon-and-radiofrequency-ablation-to-date
#3
EDITORIAL
Konstantinos C Siontis, Peter A Noseworthy
No abstract text is available yet for this article.
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28447320/should-ablation-be-first-line-therapy-for-patients-with-paroxysmal-af
#4
REVIEW
Sergio Conti, Atul Verma
Atrial fibrillation is the most common cardiac arrhythmia and the number of patients is expected to continuously increase in the next years. Catheter ablation is an effective, safe, and well-established treatment for patient with symptomatic and drug-resistant paroxysmal atrial fibrillation (PAF). Over the last decade, there was an increasing body of evidence demonstrating superiority of catheter ablation over antiarrhythmic drugs (AADs) in maintaining sinus rhythm. However, randomized clinical trials have not been conclusive to consider catheter ablation as a first-line therapy for PAF...
May 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28447159/catheter-ablation-of-persistent-atrial-fibrillation-beneficial-effect-of-a%C3%A2-short-term-adjunctive-amiodarone-therapy-on-the-long-term-outcome
#5
Klaus Kettering, Felix Gramley
BACKGROUND: Catheter ablation has become the first line therapy in patients with symptomatic, recurrent, drug-refractory atrial fibrillation. Circumferential pulmonary vein ablation is still the standard approach in these patients. However, the results are not very favorable (especially in patients with persistent atrial fibrillation). Therefore, more complex ablation strategies and the usefulness of (short-term) adjunctive antiarrhythmic drug therapy are a matter of discussion. The aim of this study was to analyze whether short-term amiodarone therapy after catheter ablation (3 months) has a positive effect on the success rates after circumferential pulmonary vein ablation in patients with persistent atrial fibrillation...
April 26, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28444307/left-atrial-volume-predicts-atrial-fibrillation-recurrence-after-radiofrequency-ablation-a-meta-analysis
#6
Augustine Njoku, Munish Kannabhiran, Rishi Arora, Pratap Reddy, Rakesh Gopinathannair, Dhanunjaya Lakkireddy, Paari Dominic
Aims: Left atrial (LA) diameter is a predictor of atrial fibrillation (AF) recurrence following radiofrequency catheter ablation (RFA). However, LA volume (LAV) is more accurate in assessing LA size. Studies evaluating LAV as a predictor of AF recurrence are contradictory; therefore, we performed a meta-analysis to assess whether LAV is an independent predictor of AF recurrence following RFA. Methods and results: All studies reporting LAV/LAV index (LAVi) as a predictor of AF recurrence following RFA were included...
April 21, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28444228/improved-outcome-and-cost-effectiveness-in-ablation-of-persistent-atrial-fibrillation-under-general-anaesthetic
#7
Claire A Martin, James P Curtain, Parag R Gajendragadkar, David A Begley, Simon P Fynn, Andrew A Grace, Patrick M Heck, Kiran Salaunkey, Munmohan S Virdee, Sharad Agarwal
Aims: Outcome of persistent atrial fibrillation (AF) ablation remains suboptimal. Techniques employed to reduce arrhythmia recurrence rate are more likely to be embraced if cost-effectiveness can be demonstrated. A single-centre observational study assessed whether use of general anaesthesia (GA) in persistent AF ablation improved outcome and was cost-effective. Methods and results: Two hundred and ninety two patients undergoing first ablation procedures for persistent AF under conscious sedation or GA were followed...
April 21, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28441850/-clinical-application-of-one-stage-operation-of-epicardial-permanent-pacemaker-implantation-and-cardiac-surgery
#8
C L Ren, S L Jiang, C S Xiao, R Wang, C Q Gao
Objective: To summarize the results and clinical application experience of one-stage operation of epicardial permanent pacemaker implantation and cardiac surgery. Methods: From November 2014 to July 2016, 15 patients (9 males and 6 females) with ages ranging from 50 to 73 (63.5±6.2) years requiring cardiac surgery with bradycardia underwent one-stage operation of epicardial permanent pacemaker implantation and cardiac surgery. All operations were performed under general anesthesia with chest median incision approach...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28439660/catheter-ablation-of-persistent-atrial-fibrillation-long-term-results-of-circumferential-pulmonary-vein-ablation-in-combination-with-a-linear-lesion-at-the-roof-of-the-left-atrium
#9
Klaus Kettering, Dag-Hau Yim, Caroline Albert, Felix Gramley
BACKGROUND: Catheter ablation has become the first line of therapy in patients with symptomatic, recurrent, drug-refractory atrial fibrillation. However, catheter ablation of persistent atrial fibrillation is still a challenge. Various relatively complex ablation strategies exist and their results are not very favorable. Therefore, the aim of our study was to evaluate a well-defined reasonable approach to catheter ablation of persistent atrial fibrillation. The strategy consisted of a circumferential pulmonary vein ablation in combination with a linear lesion at the roof of the left atrium...
April 24, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28439618/-radiofrequency-current-or-cryoballoon-for-ablation-of-atrial-fibrillation-hot-or-cold
#10
B Reissmann, K-H Kuck, A Metzner
Atrial fibrillation (AF) is the most common form of cardiac arrhythmia. The aim of therapy in symptomatic patients is the establishment of a stable sinus rhythm (SR). Catheter ablation with isolation of the pulmonary veins is the essential component of all forms of ablation therapy and provides the most effective treatment option. The most frequently used technologies for pulmonary vein isolation (PVI) are radiofrequency current (RFC)-based and cryoballoon (CB)-guided ablation. Irrespective of the simplification of PVI, CB ablation is characterized by a short learning curve and short procedural times and demonstrated non-inferiority with respect to safety and efficacy when directly compared to RFC ablation for the treatment of patients with paroxysmal AF; however, the clinical outcome in patients with persistent AF is often insufficient when performing pulmonary vein isolation (PVI) alone for stabilization of SR...
April 24, 2017: Herz
https://www.readbyqxmd.com/read/28439617/-stroke-prophylaxis-in-atrial-fibrillation-when-how-and-for-whom
#11
T Maurer, C Sohns
In patients suffering from atrial fibrillation (AF), modern antithrombotic therapy and anticoagulation strategies should be individualized based on shared decision making including patient preferences and the absolute and relative risks of stroke and bleeding. Estimation of the individual risk for stroke is still based on the CHA2DS2-VASc score. Based on the most recent guidelines for the management of AF, oral anticoagulation therapy should be considered for men with a CHA2DS2-VASc score ≥1 and women with a score ≥2, balancing the expected stroke reduction, risk of bleeding and patient preference...
April 24, 2017: Herz
https://www.readbyqxmd.com/read/28438723/long-term-outcomes-of-minimally-invasive-surgical-ablation-for-atrial-fibrillation-a-single-center-experience
#12
Aditya Saini, Yuhning L Hu, Vigneshwar Kasirajan, Frederick T Han, Muhammad Z Khan, Luke Wolfe, Sampath Gunda, Jayanthi N Koneru, Kenneth A Ellenbogen
BACKGROUND: Minimally invasive surgical AF ablation delivers RF energy via a thoracoscopic approach to perform pulmonary vein isolation and LA ganglionic plexi ablation. Data on long term outcomes of MISAA is lacking. OBJECTIVE: We report 5 year follow-up data from a prospective cohort of patients who underwent MISAA at a single center. METHODS: One hundred nine consecutive patients (60 paroxysmal, 49 persistent, mean age 62.7±9.3 years) underwent MISAA with left atrial appendage exclusion by a single surgeon between 2006 and 2012...
April 21, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28438722/propagation-of-meandering-rotors-surrounded-by-high-dominant-frequency-areas-in-persistent-atrial-fibrillation
#13
João Salinet, Fernando S Schlindwein, Peter Stafford, Tiago P Almeida, Xin Li, Frederique J Vanheusden, María S Guillem, G André Ng
BACKGROUND: identification of arrhythmogenic regions remains a challenge in persistent atrial fibrillation (persAF). Frequency and phase analysis allows identification of potential ablation targets. OBJECTIVE: This study aims to investigate the spatiotemporal association between dominant frequency (DF) and re-entrant phase activation areas. METHODS: Eight persAF patients undergoing first-time catheter ablation procedure were enrolled. A non-contact array catheter was deployed into the left atrium (LA) and 2048 AF electrograms (AEG) were acquired for 15 seconds following ventricular far-field cancellation...
April 21, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28436566/atrial-fibrillation-originating-from-superior-vena-cava-with-atrial-flutter-electrocardiogram-pattern
#14
Hung-Kai Huang, Shih-Lin Chang, Yenn-Jiang Lin, Li-Wei Lo, Yu-Feng Hu, Fa-Po Chung, Yen-Chang Huang, Chung-Hsing Lin, Chao-Shun Chan, Hung-Yu Chang, Chin-Yu Lin, Yao-Ting Chang, Ching-Hui Huang, Shih-Ann Chen
BACKGROUNDS: Substrate property is related to the genesis and maintenance of atrial fibrillation (AF). The aim of the study was to investigate the impact of substrate property on the electrocardiogram (ECG) in patients with AF originating from the superior vena cava (SVC). METHODS AND RESULTS: Seventy-six patients with AF originating from SVC underwent catheter ablation were included from 2004 to 2013. Of these patients, 16 had a presentation of atrial flutter (AFL)-pattern ECG during AF (group 1), and 60 patients did not (group 2)...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28434449/electrical-superior-vena-cava-isolation-using-a-novel-pace-and-ablate-technique-under-diaphragmatic-electromyography-monitoring
#15
Shinsuke Miyazaki, Shigeki Kusa, Hitoshi Hachiya, Hiroshi Taniguchi, Takayuki Niida, Sadamitsu Ichijo, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: Diaphragmatic compound motor action potential (CMAP) amplitude monitoring is a standard technique to anticipate phrenic nerve injury during cryoballoon ablation. OBJECTIVE: The purpose of this study was to evaluate the feasibility of a novel superior vena cava isolation (SVCI) technique using simultaneous pacing and ablation through the tip of a single mapping/ablation catheter. METHODS: Fifty-four patients with atrial fibrillation were included...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28434448/gastric-hypomotility-after-second-generation-cryoballoon-ablation-unrecognized-silent-nerve-injury-after-cryoballoon-ablation
#16
Shinsuke Miyazaki, Hiroaki Nakamura, Hiroshi Taniguchi, Hitoshi Hachiya, Takamitsu Takagi, Miyako Igarashi, Takatsugu Kajiyama, Tomonori Watanabe, Takashi Niida, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: Few data are available on gastric hypomotility (GH) after cryoballoon pulmonary vein isolation. Also, the use of esophageal temperature monitoring for the prevention of endoscopically detected esophageal lesions (EDELs) is not well established. OBJECTIVE: The purpose of this study was to investigate GH and the impact of an esophageal probe on EDELs during second-generation cryoballoon ablation. METHODS: One hundred four patients with paroxysmal atrial fibrillation undergoing second-generation cryoballoon ablation under conscious sedation followed by esophagogastroscopy were prospectively included...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28434447/could-less-be-more-in-catheter-ablation-for-persistent-atrial-fibrillation-pulmonary-vein-isolation-reconsidered
#17
EDITORIAL
Eric Buch, Kalyanam Shivkumar
No abstract text is available yet for this article.
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28434446/revisiting-pulmonary-vein-isolation-alone-for-persistent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#18
Aleksandr Voskoboinik, Jeremy T Moskovitch, Nadav Harel, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Early studies demonstrated relatively low success rates for pulmonary vein isolation (PVI) alone in patients with persistent atrial fibrillation (PeAF). However, the advent of new technologies and the observation that additional substrate ablation does not improve outcomes have created a new focus on PVI alone for treatment of PeAF. OBJECTIVE: The purpose of this study was to systematically review the recent medical literature to determine current medium-term outcomes when a PVI-only approach is used for PeAF...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28433558/spatial-relationship-of-organized-rotational-and-focal-sources-in-human-atrial-fibrillation-to-autonomic-ganglionated-plexi
#19
Tina Baykaner, Theodoros A Zografos, Junaid A B Zaman, Ioannis Pantos, Mahmood Alhusseini, Rachita Navara, David E Krummen, Sanjiv M Narayan, Demosthenes G Katritsis
BACKGROUND: One approach to improve ablation for atrial fibrillation (AF) is to focus on physiological targets including focal or rotational sources or ganglionic plexi (GP). However, the spatial relationship between these potential mechanisms has never been studied. We tested the hypothesis that rotors and focal sources for AF may co-localize with ganglionated plexi (GP). METHODS: We prospectively identified locations of AF rotors and focal sources, and correlated these to GP sites in 97 consecutive patients (age 59...
April 19, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28433223/risk-of-intraatrial-thrombi-after-thoracoscopic-ablation-in-absence-of-heparin-and-appendage-closure
#20
Petr Budera, Pavel Osmancik, Dalibor Herman, David Talavera, Robert Petr, Zbynek Straka
BACKGROUND: Catheter and surgical ablation of atrial fibrillation (AF) can be associated with a risk of thromboembolic events. The goal of this study was to assess optimal anticoagulation management during thoracoscopic ablation of AF. METHODS: Fifty-two patients with persistent or long-standing persistent AF underwent hybrid ablation consisting of thoracoscopic ablation followed by electrophysiologic (EP) evaluation and consecutive ablation if indicated. The thoracoscopic ablation was performed using three different anticoagulation protocols: (1) without periprocedural heparin and without occlusion of the left atrial appendage; (2) with periprocedural heparin but without left atrial appendage occlusion; and (3) with periprocedural heparin and left atrial appendage occlusion...
April 19, 2017: Annals of Thoracic Surgery
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