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Electrophysiology ablation

Jedrzej Kosiuk, Romina Milani, Laura Ueberham, Tobias Uhe, Clara Stegmann, Gerhard Hindricks, Andreas Bollmann
Remote ischemic preconditioning (RIPC) has been studied in models of different cardiovascular entities. Recently, a beneficial effect of RIPC on incidence of atrial fibrillation (AF) in postsurgical patients has been suggested. However, the potential impact of RIPC on electrophysiological- and thrombogenesis-related parameters in the setting of paroxysmal nonvalvular AF has not been investigated. The aim of the study is to answer the following questions: (1) Does RIPC have impact on inducibility of AF in patients with known paroxysmal AF? If yes, what are the direct electrophysiological mechanisms of this phenomenon, and could RIPC be implemented to reduce AF burden? (2) Does RIPC have the potential to minimize thrombogenic effects of simulated episodes of AF? If so, what are inhibited components of thrombogenesis and can this be used to reduce thromboembolic risk related to paroxysmal AF? The presented study is a 2-arm, randomized, placebo-controlled, double-blinded, single-center trial in a cohort of 146 patients with paroxysmal AF referred for AF ablation in sinus rhythm...
October 24, 2016: Clinical Cardiology
Lois Choy, Jie Ming Yeo, Vivian Tse, Shing Po Chan, Gary Tse
The mouse is the second mammalian species, after the human, in which substantial amount of the genomic information has been analyzed. With advances in transgenic technology, mutagenesis is now much easier to carry out in mice. Consequently, an increasing number of transgenic mouse systems have been generated for the study of cardiac arrhythmias in ion channelopathies and cardiomyopathies. Mouse hearts are also amenable to physical manipulation such as coronary artery ligation and transverse aortic constriction to induce heart failure, radiofrequency ablation of the AV node to model complete AV block and even implantation of a miniature pacemaker to induce cardiac dyssynchrony...
September 2016: IJC Heart & Vasculature
Fahima Syeda, Andrew P Holmes, Ting Y Yu, Samantha Tull, Stefan Michael Kuhlmann, Davor Pavlovic, Daniel Betney, Genna Riley, Jan P Kucera, Florian Jousset, Joris R de Groot, Stephan Rohr, Nigel A Brown, Larissa Fabritz, Paulus Kirchhof
BACKGROUND: Antiarrhythmic drugs are widely used to treat patients with atrial fibrillation (AF), but the mechanisms conveying their variable effectiveness are not known. Recent data suggested that paired like homeodomain-2 transcription factor (PITX2) might play an important role in regulating gene expression and electrical function of the adult left atrium (LA). OBJECTIVES: After determining LA PITX2 expression in AF patients requiring rhythm control therapy, the authors assessed the effects of Pitx2c on LA electrophysiology and the effect of antiarrhythmic drugs...
October 25, 2016: Journal of the American College of Cardiology
Sandeep Prabhu, Vincent Mackin, Alex Ja McLellan, Tuong Phan, Desmond McGlade, Liang-Han Ling, Kah Y Peck, Alexandr Voskoboinik, Bupesh Pathik, Chrishan J Nalliah, Geoff R Wong, Sonia M Azzopardi, Geoffrey Lee, Justin Mariani, Andrew J Taylor, Jonathan M Kalman, Peter M Kistler
INTRODUCTION: The significance of adenosine induced dormant pulmonary vein (PV) conduction in AF ablation remains controversial. The optimal dose of adenosine to determine dormant PV conduction is yet to be systematically explored. METHODS AND RESULTS: Consecutive patients undergoing index AF ablation received 3 adenosine doses (12mg, 18mg, 24mg) in a randomized blinded order, immediately after PVI. Electrophysiological (PR prolongation, AV block (AVB) and PV reconnection) and hemodynamic (BP) parameters were measured...
October 19, 2016: Journal of Cardiovascular Electrophysiology
Mukund A Prabhu, B V Srinivas Prasad, Anees Thajudeen, Narayanan Namboodiri
INTRODUCTION: Bundle branch reentry as a mechanism of ventricular tachycardia (VT) in endomyocardial fibrosis (EMF) is not described. CASE REPORT: A 52-year-old woman with left ventricular (LV) EMF had VT needing cardioversion. She had mitral regurgitation and left bundle branch block, but no LV dilation or heart failure. During electrophysiological study, clinical VT could be easily induced, and it was confirmed to be bundle branch reentrant VT (BBRVT). She was treated with ablation of the right bundle branch...
September 2016: Indian Heart Journal
Jeremiah Wasserlauf, Bradley P Knight, Zhi Li, Adin-Cristian Andrei, Rishi Arora, Alexandru B Chicos, Jeffrey J Goldberger, Susan S Kim, Albert C Lin, Nishant Verma, Martha M Bohn, Rod S Passman
BACKGROUND: Cryoballoon ablation (CBA) for paroxysmal atrial fibrillation (pAF) can be performed under general anesthesia (GA) or moderate sedation (MS). Our objective was to compare the effectiveness, safety, procedure duration, and time spent in the electrophysiology (EP) laboratory for CBA performed under GA and MS. METHODS: . Patients undergoing a first CBA for pAF were identified. Patients received either GA administered by an anesthesiologist or MS with midazolam and fentanyl administered by EP laboratory staff...
October 17, 2016: Pacing and Clinical Electrophysiology: PACE
Douglas Wildes, Warren Lee, Bruno Haider, Scott Cogan, Krishnakumar Sundaresan, David Mills, Christopher Yetter, Patrick Hart, Christopher Haun, Mikael Concepcion, Johan Kirkhorn, Marc Bitoun
We developed a 2.5 x 6.6 mm 2D array transducer with integrated transmit/receive ASIC for 4D ICE (real-time 3D IntraCardiac Echocardiography) applications. The ASIC and transducer design were optimized so that the high voltage transmit, low-voltage TGC (time-gain control) and preamp, subaperture beamformer, and digital control circuits for each transducer element all fit within the 0.019 mm2 area of the element. The transducer assembly was deployed in a 10 Fr (3.3 mm diameter) catheter, integrated with a GE Vivid1 E9 ultrasound imaging system, and evaluated in three pre-clinical studies...
October 12, 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Takumi Yamada, Harish Doppalapudi, Silvio H Litovsky, H Thomas McElderry, G Neal Kay
BACKGROUND: Radiofrequency catheter ablation (RFCA) of idiopathic ventricular arrhythmias (VAs) originating from the basal portion of the left ventricular (LV) summit, which is divided from the apical LV (A-LV) summit by the great cardiac vein (GCV), is challenging. This study investigated the efficacy of RFCA and electrocardiographic and electrophysiological characteristics of these VAs. METHODS AND RESULTS: Forty-five consecutive patients with symptomatic idiopathic LV summit VAs were studied...
October 2016: Circulation. Arrhythmia and Electrophysiology
Ahmed Karim Talib, Akihiko Nogami, Itsuro Morishima, Yasushi Oginosawa, Kenji Kurosaki, Shinya Kowase, Yuki Komatsu, Kenji Kuroki, Miyako Igarashi, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: The most common form of idiopathic Purkinje-related ventricular tachycardia (VT) is the reentrant type. We describe the clinical and electrophysiological characteristics of focal non-reentrant fascicular tachycardia. METHODS AND RESULTS: Among 530 idiopathic VT patients who were referred for ablation, we identified 15 (2.8%) with non-reentrant fascicular tachycardia (11 men, 45±21 years). Sinus rhythm ECG showed normal conduction intervals with a His-ventricular interval of 41±4 ms...
October 2016: Circulation. Arrhythmia and Electrophysiology
Cai-Ying Li, Bu-Lang Gao, Tong Pan, Cheng Xiang, Xue-Jing Zhang, Xiao-Wei Liu, Qiong-Ying Fan
PURPOSE: To quantitatively measure the morphology parameters of the right auricle with 256-slice multidetector computed tomography angiography (MDCTA) in healthy people. MATERIALS AND METHODS: A retrospective analysis of 200 patients who had undergone coronary MDCTA with negative findings was performed. The raw imaging data were reconstructed and the right auricular volume, right atrial volume, right auricle height, base long and short axes, base perimeter and area, normal angle, and distance were quantitatively measured...
October 7, 2016: Surgical and Radiologic Anatomy: SRA
Zhaoye Zhou, Qi Jin, Long Yu, Liqun Wu, Bin He
BACKGROUND: Knowledge of atrial electrophysiological properties is crucial for clinical intervention of atrial arrhythmias and the investigation of the underlying mechanism. This study aims to evaluate the feasibility of a novel noninvasive cardiac electrical imaging technique in imaging bi-atrial activation sequences from body surface potential maps (BSPMs). METHODS: The study includes 7 subjects, with 3 atrial flutter patients, and 4 healthy subjects with normal atrial activations...
2016: PloS One
Xinhua Wang, Zheng Li, Jialiang Mao, Ben He
AIMS: Frequent premature atrial contractions (PACs) are associated with increased risk of atrial fibrillation (AF), stroke, and death. This study aimed to explore the electrophysiological features of PACs with and without inducing AF and to evaluate the effectiveness of catheter ablation for PACs. METHODS AND RESULTS: Thirty-five consecutive patients with symptomatic, frequent, and drug-refractory PACs in the absence of AF (group A) and 35 patients with PACs-induced AF (group B) were enrolled...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Steven E Williams, Nick W F Linton, Steven Niederer, Mark D O'Neill
AIMS: Complex ablation procedures are supported by accurate representation of an increasing variety of electrophysiological and imaging data within electroanatomic mapping systems (EMS). This study aims to develop a novel method for representing multiple complementary datasets on a single cardiac chamber model. Validation of the system and its application to both atrial and ventricular arrhythmias is examined. METHODS AND RESULTS: Dot mapping was conceived to display multiple datasets by utilizing quantitative surface shading to represent one dataset and finely spaced dots to represent others...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Alonso Pedrote, Adolfo Fontenla, Javier García-Fernández
INTRODUCTION AND OBJECTIVES: This report presents the findings of the 2015 Spanish Catheter Ablation Registry. METHODS: For data collection, each center was allowed to choose freely between 2 systems: retrospective, requiring the completion of a standardized questionnaire, and prospective, involving reporting to a central database. RESULTS: Data were collected from 82 centers. A total of 12 863 ablation procedures were performed, for a mean of 157±119 and a median of 138 procedures per center...
September 28, 2016: Revista Española de Cardiología
Maria Manfredi-Lozano, Juan Roa, Francisco Ruiz-Pino, Richard Piet, David Garcia-Galiano, Rafael Pineda, Aurora Zamora, Silvia Leon, Miguel A Sanchez-Garrido, Antonio Romero-Ruiz, Carlos Dieguez, Maria Jesus Vazquez, Allan E Herbison, Leonor Pinilla, Manuel Tena-Sempere
OBJECTIVE: Puberty is a key developmental phenomenon highly sensitive to metabolic modulation. Worrying trends of changes in the timing of puberty have been reported in humans. These might be linked to the escalating prevalence of childhood obesity and could have deleterious impacts on later (cardio-metabolic) health, but their underlying mechanisms remain unsolved. The neuropeptide α-MSH, made by POMC neurons, plays a key role in energy homeostasis by mediating the actions of leptin and likely participates in the control of reproduction...
October 2016: Molecular Metabolism
L Y Qian, H Zou, X D Che, L H Wang, X X Cen, Q Xu, B M Qu
Objective: To compare the therapeutic efficiency and safety of radiofrequency catheter ablation (RFCA) for paroxysmal ventricular tachycardia (PSVT) guided by three-dimensional navigation with X-ray. Methods: One hundred and seventy-six patients with PSVT hospitalized in Department of Cardiology, Zhejiang Provincial People's Hospital between January 2013 and December 2014 were enrolled in this study. RFCA was performed on 95 patients (Group A) guided by the three dimensional electric-field navigation system (NavX) and the procedures were done with the spatial localization method, unless X-ray was needed in some cases...
September 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Mahipat Soni, Deepak Bohara, Anup Taksande, Ajay Mahajan, Pratap Nathani, Yash Lokhandwala
We present a case of recurrent highly symptomatic atrial tachycardia. During electrophysiology (EP) study, this was found to arise close to the AV node. To avoid conduction system damage by radiofrequency (RF) ablation, the aortic cusps were mapped. The tachycardia focus was close to the non-coronary cusp and ablated safely and successfully from this site.
December 2015: Journal of the Association of Physicians of India
Konstantin V Zavadovsky, Victor V Saushkin, Mikhail S Khlynin, Sergey V Popov, Yuri B Lishmanov
BACKGROUND: The aim of the study was to evaluate the impact of idiopathic ventricular tachycardia and premature ventricular beats on cardiac function and dyssynchrony and to elucidate relationships between data of scintigraphic and intracardiac electrophysiology studies. METHODS: The study comprised 64 patients with idiopathic ventricular arrhythmias (VA) (median age of 14 years ranging from 8 to 18 years). Control group comprised 20 patients (median age of 12 ranging from 7 to 16 years) without cardiac arrhythmias...
September 23, 2016: Pacing and Clinical Electrophysiology: PACE
Patricia E Thomas, Scott L Macicek
BACKGROUND: Catheter ablation has been used to manage supraventricular arrhythmia in children since 1990. This article reviews the history of catheter ablation used to treat arrhythmia in children and discusses new frontiers in the field. We also address ablation in adult patients with a history of congenital heart disease (CHD) that was diagnosed and initially treated in childhood. METHODS: We conducted an evidence-based literature review to gather available data on ablation for supraventricular tachycardia in children and adult patients with CHD...
2016: Ochsner Journal
Yuichi Hori, Shiro Nakahara, Naofumi Anjo, Ayako Nakagawa, Naoki Nishiyama, Kouta Yamada, Akiko Hayashi, Takaaki Komatsu, Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi
PURPOSE: The atrial conduction time measured by echocardiography using tissue Doppler imaging (TDI) has been reported as a predictive factor of left atrial (LA) remodeling. We investigated the P wave to LA appendage (LAA) conduction time defined by transthoracic echocardiography using TDI (P-LAA TDI), and directly compared the actual LA electrical conduction time determined by the electrophysiological data. Additionally, we confirmed the clinical utility of the P-LAA TDI by examining the relationship to the electroanatomical LA remodeling data...
September 22, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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