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Atrial fibrillation ablation

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https://www.readbyqxmd.com/read/28228467/gender-differences-in-clinical-presentation-and-1-year-outcomes-in-atrial-fibrillation
#1
Renate B Schnabel, Ladislav Pecen, Francisco M Ojeda, Markus Lucerna, Nargiz Rzayeva, Stefan Blankenberg, Harald Darius, Dipak Kotecha, Raffaele De Caterina, Paulus Kirchhof
OBJECTIVES: Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. METHODS: In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes. RESULTS: Men with AF were on average younger than women (mean±SD: 70...
February 22, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28228428/the-effect-of-aggressive-blood-pressure-control-on-the-recurrence-of-atrial-fibrillation-after-catheter-ablation-a-randomized-open-label-clinical-trial-substrate-modification-with-aggressive-blood-pressure-control-smac-af
#2
Ratika Parkash, George A Wells, John L Sapp, Jeffrey S Healey, Jean-Claude Tardif, Isabelle Greiss, Léna Rivard, Jean-Francois Roux, Lorne Gula, Isabelle Nault, Paul G Novak, David H Birnie, Andrew C Ha, Stephen B Wilton, Iqwal Mangat, Christopher J Gray, Martin J Gardner, Anthony S L Tang
Background -Radiofrequency catheter ablation for atrial fibrillation has become an important therapy for AF, however recurrence rates remain high. We proposed to determine whether aggressive blood pressure (BP) lowering prevents recurrent atrial fibrillation (AF) after catheter ablation in patients with AF and a high symptom burden. Methods -We randomly assigned 184 patients with AF and a BP greater than 130/80 mmHg to aggressive BP (target <120/80 mm Hg) or standard BP treatment (target <140/90 mmHg) prior to their scheduled AF catheter ablation...
February 22, 2017: Circulation
https://www.readbyqxmd.com/read/28227263/an-algorithm-for-rotor-tracking-in-atrial-fibrillation-using-graph-search-based-periodic-peak-detection
#3
Rupin Dalvi, Adrian Suszko, Vijay S Chauhan, Rupin Dalvi, Adrian Suszko, Vijay S Chauhan, Rupin Dalvi, Adrian Suszko, Vijay S Chauhan
Rotors are rotating electrical waves that may sustain atrial fibrillation (AF); thereby providing therapeutic targets for catheter ablation. We propose a method for identifying rotors from circular catheter recordings of bipolar intracardiac electrograms (EGM) during AF. We use dominant frequency-based periodicity detection along with a graph search algorithm to identify the most dominant periodic activations or peaks of interest in each bipolar EGM recorded by a multipolar circular catheter. We then track the activations across catheter bipoles to determine whether they conform to the rotational pattern of a rotor...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227088/detection-of-the-propagating-direction-of-electrical-wavefront-in-atrial-fibrillation
#4
Dongping Du, Yuncheng Du, Dongping Du, Yuncheng Du, Dongping Du, Yuncheng Du
Atrial Fibrillation (AF) is one of the most common sustained arrhythmia, which can increase the risk of heart failure and stroke. Understanding the complex electrical dynamics of AF and correctly targeting AF sources for ablation therapies remain challenging in clinical practice. This is due to the incapability to reconstruct the electrical dynamic of AF, and lack of efficient approach for AF source identification. This paper builds a multi-sale framework for modeling of the abnormal electrical propagation in AF initiated by triggers from Pulmonary Veins (PVs)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226545/a-novel-catheter-guidance-algorithm-for-localization-of-atrial-fibrillation-rotor-and-focal-sources
#5
Anthony J Salmin, Prasanth Ganesan, Kristina E Shillieto, Elizabeth M Cherry, David T Huang, Arkady M Pertsov, Behnaz Ghoraani, Anthony J Salmin, Prasanth Ganesan, Kristina E Shillieto, Elizabeth M Cherry, David T Huang, Arkady M Pertsov, Behnaz Ghoraani, Arkady M Pertsov, Behnaz Ghoraani, Anthony J Salmin, Kristina E Shillieto, Elizabeth M Cherry, Prasanth Ganesan, David T Huang
Locating atrial fibrillation (AF) focal and rotor sources can help improve target ablation therapy for AF. However, it remains unclear how to use the information provided by multi-polar diagnostic catheters (MPDC) to locate AF sources. Our aim was to develop a catheter-guidance algorithm to locate AF focal and rotor sources using a conventional MPDC. We simulated a 10 cm × 10 cm atrial tissue with focal and rotor sources using the Nygren et al. ionic model. We modeled a Lasso MPDC with 20-unipole electrodes placed with a spacing of 4...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226544/kurtosis-as-a-statistical-approach-to-identify-the-pivot-point-of-the-rotor
#6
Shivaram P Arunachalam, Elizabeth M Annoni, Siva K Mulpuru, Paul A Friedman, Elena G Tolkacheva, Shivaram P Arunachalam, Elizabeth M Annoni, Siva K Mulpuru, Paul A Friedman, Elena G Tolkacheva, Elena G Tolkacheva, Paul A Friedman, Elizabeth M Annoni, Siva K Mulpuru, Shivaram P Arunachalam
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia that causes stroke affecting more than 2.3 million people in the US. Catheter ablation to terminate AF is successful for paroxysmal AF but suffers limitations with persistent AF patients as current mapping methods cannot identify AF active substrates outside of pulmonary vein region. In this work, we developed a novel Kurtosis based mapping technique that can accurately identify pivot points of the rotors that were induced in ex-vivo isolated rabbit heart...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226543/development-of-a-novel-probabilistic-algorithm-for-localization-of-rotors-during-atrial-fibrillation
#7
Prasanth Ganesan, Anthony Salmin, Elizabeth M Cherry, Behnaz Ghoraani, Prasanth Ganesan, Anthony Salmin, Elizabeth M Cherry, Behnaz Ghoraani, Elizabeth M Cherry, Prasanth Ganesan, Behnaz Ghoraani, Anthony Salmin
Atrial fibrillation (AF) is an irregular heart rhythm that can lead to stroke and other heart-related complications. Catheter ablation has been commonly used to destroy triggering sources of AF in the atria and consequently terminate the arrhythmia. However, efficient and accurate localization of the AF sustaining sources known as rotors is a major challenge in catheter ablation. In this paper, we developed a novel probabilistic algorithm that can adaptively guide a Lasso diagnostic catheter to locate the center of a rotor...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226542/towards-patient-specific-modelling-of-lesion-formation-during-radiofrequency-catheter-ablation-for-atrial-fibrillation
#8
Navjeevan Soor, Ross Morgan, Marta Varela, Oleg V Aslanidi, Navjeevan Soor, Ross Morgan, Marta Varela, Oleg V Aslanidi, Marta Varela, Navjeevan Soor, Ross Morgan, Oleg V Aslanidi
Radiofrequency catheter ablation procedures are a first-line method of clinical treatment for atrial fibrillation. However, they suffer from suboptimal success rates and are also prone to potentially serious adverse effects. These limitations can be at least partially attributed to the inter- and intra-patient variations in atrial wall thickness, and could be mitigated by patient-specific approaches to the procedure. In this study, a modelling approach to optimising ablation procedures in subject-specific 3D atrial geometries was applied...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28220472/renal-denervation-for-resistant-hypertension
#9
REVIEW
Giuseppe Coppolino, Anna Pisano, Laura Rivoli, Davide Bolignano
BACKGROUND: Resistant hypertension is highly prevalent among the general hypertensive population and the clinical management of this condition remains problematic. Different approaches, including a more intensified antihypertensive therapy, lifestyle modifications, or both, have largely failed to improve patients' outcomes and to reduce cardiovascular and renal risk. As renal sympathetic hyperactivity is a major driver of resistant hypertension, renal sympathetic ablation (renal denervation) has been recently proposed as a possible therapeutic alternative to treat this condition...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28217229/evaluation-of-the-characteristics-of-rotational-activation-at-high-dominant-frequency-and-complex-fractionated-atrial-electrogram-sites-during-atrial-fibrillation
#10
Koji Kumagai, Kentaro Minami, Daisuke Kutsuzawa, Shigeru Oshima
BACKGROUND: High-dominant frequency (DF) and continuous complex fractionated atrial electrogram (CFAE) sites as surrogates for localized sources maintaining atrial fibrillation (AF) are potential AF ablation targets. This study aimed to evaluate the characteristics of a rotational activation at high-DF and continuous CFAE sites in AF patients. METHODS: Thirty-two consecutive AF patients (5 paroxysmal and 27 non-paroxysmal) underwent ablation using the NavX system...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28217228/spatiotemporal-characteristics-of-atrial-fibrillation-electrograms-a-novel-marker-for-arrhythmia-stability-and-termination
#11
Shivshankar Thanigaimani, Anthony G Brooks, Pawel Kuklik, Darragh J Twomey, Samantha Franklin, Erik Noschka, Darius Chapman, Rajeev K Pathak, Rajiv Mahajan, Prashanthan Sanders, Dennis H Lau
BACKGROUND: Sequentially mapped complex fractionated atrial electrograms (CFAE) and dominant frequency (DF) sites have been targeted during catheter ablation for atrial fibrillation (AF). However, these strategies have yielded variable success and have not been shown to correlate consistently with AF dynamics. Here, we evaluated whether the spatiotemporal stability of CFAE and DF may be a better marker of AF sustenance and termination. METHODS: Eighteen sheep with 12 weeks of "one-kidney, one-clip" hypertension underwent open-chest studies...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28217225/immediate-discontinuation-of-ablation-during-pulmonary-vein-isolation-remarkably-decreases-the-incidence-of-esophageal-thermal-lesions-even-when-using-steerable-sheaths
#12
Norikazu Watanabe, Yuta Chiba, Yoshimi Onishi, Shiro Kawasaki, Yumi Munetsugu, Yoshimasa Onuma, Hiroyuki Itou, Tatsuya Onuki, Yoshino Minoura, Taro Adachi, Mitsuharu Kawamura, Taku Asano, Kaoru Tanno, Yutarou Kubota, Kazuo Konishi, Youichi Kobayashi
BACKGROUND: Left atrial-esophageal fistulas (LAEFs) are serious complications with high mortality after atrial fibrillation radiofrequency ablation (AFRA). Decreasing the incidence of esophageal thermal lesions (EsoTLs) that may lead to LAEFs is important. The aim of this study was to suppress EsoTL development and determine the appropriate alarm setting for a temperature-monitoring probe by using steerable sheath (STS) methods. METHODS: We enrolled 82 consecutive patients (mean, 61...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28216515/particular-morphology-of-inferior-pulmonary-veins-and-difficulty-of-cryoballoon-ablation-in-patients-with-paroxysmal-atrial-fibrillation
#13
Ryobun Yasuoka, Takashi Kurita, Yasuhito Kotake, Naotaka Hashiguchi, Koichiro Motoki, Kazuhiro Kobuke, Yoshitaka Iwanaga, Shunichi Miyazaki
BACKGROUND: The CRYO-Japan PMS study indicated that cryoballoon ablation (Cryo-Abl) has a lower acute success rate of pulmonary vein isolation (PVI) for the right and left inferior PVs (RIPV and LIPV, respectively) than for the superior PVs. This study aimed to determine if the orientation and position of the inferior PVs are related to the difficulty of acute success of PVI.Methods and Results:We investigated 30 consecutive patients who underwent Cryo-Abl. A "difficult PV" was defined as the requirement for >2 cooling applications and/or touch-up ablation to achieve PVI...
February 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28215568/reduction-in-radiation-dose-for-atrial-fibrillation-ablation-over-time-a-12-year-single-centre-experience-of-2-344-patients
#14
Aleksandr Voskoboinik, Elana S Kalman, Yonatan Savicky, Paul B Sparks, Joseph B Morton, Geoffrey Lee, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Pulmonary vein isolation (PVI) is a well-established treatment for atrial fibrillation (AF), with contact force-sensing catheters joining 3D-mapping systems and image integration as technological advancements over the last decade. OBJECTIVE: To analyze trends in radiation exposure at our centre for AF ablation over the last 12 years. METHODS: We reviewed prospectively collected data of 2,344 consecutive PVI procedures for either paroxysmal or persistent AF between 1/2004 - 12/2015...
February 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28215479/lessons-from-individualized-cryoballoon-sizing-is-there-a-role-for-the-small-balloon
#15
Stefan Hartl, Uwe Dorwarth, Benedikt Bunz, Michael Wankerl, Ullrich Ebersberger, Ellen Hoffmann, Florian Straube
BACKGROUND: Cryoablation for paroxysmal atrial fibrillation (PAF) is well established. The single-big-balloon strategy has been preferred for pulmonary vein isolation (PVI) using the second generation cryoballoon (CBG2). Individual PV-morphologies raise the question if an individualized anatomic approach using the 23-mm or 28-mm CB is reasonable. METHODS: Consecutive patients were prospectively enrolled in the non-randomized single-center study. Patients were treated with the 28-mm CB, if any PV was >21mm, the 23-mm CB, if all PV were ≤21mm, or both sizes, if PVI was difficult...
February 16, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28215065/application-of-computer-models-on-atrial-fibrillation-research
#16
Michela Masè
Atrial fibrillation (AF) is a multifactorial and multiscale disease, where electrical, structural, anatomical and genetic factors contribute to the emergence of a complex and dynamic macroscopic phenotype. The incomplete understanding of AF mechanisms and the diversity and multiplicity of factors promoting the arrhythmia in humans have hampered the development of effective therapeutic approaches. Computer models and simulation of atrial arrhythmias may represent an unique allied to investigate AF mechanisms and direct therapeutic strategies, being able to merge and provide interpretation for multiscale data from cellular to entire organ scale levels...
February 17, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28214567/fluoroless-catheter-ablation-of-atrial-fibrillation
#17
Bruce B Lerman, Steven M Markowitz, Christopher F Liu, George Thomas, James Ip, Jim Cheung
No abstract text is available yet for this article.
February 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28214001/comparison-of-pulmonary-venous-and-left-atrial-remodeling-in-patients-with-atrial-fibrillation-with-hypertrophic-cardiomyopathy-versus-with-hypertensive-heart-disease
#18
Kentaro Yoshida, Hideyuki Hasebe, Yasuaki Tsumagari, Hidekazu Tsuneoka, Mari Ebine, Yoshiko Uehara, Yoshihiro Seo, Kazutaka Aonuma, Noriyuki Takeyasu
Left ventricular diastolic dysfunction in hypertrophic cardiomyopathy (HC) increases susceptibility to atrial fibrillation. Although phenotypical characteristics of the hypertrophied left ventricle are clear, left atrial (LA) and pulmonary venous (PV) remodeling has rarely been investigated. This study aimed to identify differences in LA and PV remodeling between HC and hypertensive heart disease (HHD) using 3-dimensional computed tomography. Included were 33 consecutive patients with HC, 25 with HHD, and 29 without any co-morbidities who were referred for catheter ablation of atrial fibrillation...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28211197/recurrences-in-the-blanking-period-and-12-month-success-rate-by-continuous-cardiac-monitoring-after-cryoablation-of-paroxysmal-and-non-paroxysmal-atrial-fibrillation
#19
Paolo Pieragnoli, Alessandro Paoletti Perini, Giuseppe Ricciardi, Luca Checchi, Andrea Giomi, Iacopo Muraca, Letizia Mannucci, Luigi Padeletti
INTRODUCTION: Recurrences within the blanking period (early recurrences) are common after atrial fibrillation (AF) ablation by pulmonary vein isolation (PVI), but their clinical significance is still controversial. We aimed at evaluating the significance of within-blanking recurrences at 12-month follow-up after cryoballoon (CB) PVI, and to assess the real procedural success rate by continuous monitoring of cardiac rhythm. METHODS AND RESULTS: Sixty consecutive AF patients (34 paroxysmal, 56...
February 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28211132/comparison-of-left-atrial-voltage-between-sinus-rhythm-and-atrial-fibrillation-in-association-with-electrogram-wave-form
#20
Masaharu Masuda, Masashi Fujita, Osamu Iida, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Akihiro Sunaga, Takuya Tsujimura, Yasuhiro Matsuda, Takuya Ohashi, Masaaki Uematsu
BACKGROUND: The efficacy of low-voltage-guided ablation in addition to pulmonary vein (PV) isolation for atrial fibrillation (AF) has been reported with voltage mapping being performed during sinus rhythm (SR) or AF. The study aimed to compare the left atrial voltage between SR and AF in association with the electrogram wave form. METHODS: This prospective observational study included 30 consecutive patients with persistent AF. After completion of PV isolation, electrogram points were taken during both SR and AF at the identical locations evenly throughout the left atrium...
February 16, 2017: Pacing and Clinical Electrophysiology: PACE
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