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Electrophysiology ablation

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https://www.readbyqxmd.com/read/28917557/idiopathic-ventricular-arrhythmias-originating-from-the-right-coronary-sinus-prevalence-electrocardiographic-and-electrophysiologic-characteristics-and-catheter-ablation
#1
Yunlong Wang, Zhuo Liang, Shaoqin Wu, Zhihong Han, Xuejun Ren
BACKGROUND: Ventricular arrhythmias (VAs) of right coronary cusp (RCC) are not fully characterized. OBJECTIVES: To investigate the electrocardiographic and electrophysiologic characteristics, mapping and ablation of RCC-VAs. METHODS: Among 256 consecutive patients undergoing electrophysiologic evaluation and ablation of VAs of ventricular outflow tract origin, data were compared among 27 RCC-VAs, 50 VAs of the septal aspect of right ventricular outflow tract (RVOT, including from pulmonary artery) and 9 VAs of left coronary cusp (LCC)...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28903470/a-decade-of-information-on-the-use-of-cardiac-implantable-electronic-devices-and-interventional-electrophysiological-procedures-in-the-european-society-of-cardiology-countries-2017-report-from-the-european-heart-rhythm-association
#2
M J Pekka Raatikainen, David O Arnar, Bela Merkely, Jens Cosedis Nielsen, Gerhard Hindricks, Hein Heidbuchel, John Camm
Aims: The aim of this analysis was to provide comprehensive information on invasive cardiac arrhythmia therapies in the European Society of Cardiology (ESC) area over the past 10 years. Methods and results: The European Heart Rhythm Association (EHRA) has collected data on invasive arrhythmia therapies since 2008. This year 53 of the 56 ESC member countries provided data for the EHRA White Book. Here we present updated data on procedure rates together with information on demographics, economy, vital statistics, local healthcare systems and training activities...
August 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28899884/supraventricular-tachycardia-diagnosed-by-smartphone-ecg
#3
Ariana Tabing, Travis Edward Harrell, Steven Romero, Gregory Francisco
Diagnosis of paroxysmal supraventricular tachycardia (PSVT) may be difficult due to its episodic nature, which can be brief and self-limited, limiting the ability for clinicians to diagnose the specific rhythm disorder in a timely manner. We present a case of PSVT, which was unable to be diagnosed through typical evaluation with an event monitor despite several years of symptoms. The patient was ultimately diagnosed using the AliveCor Mobile ECG, a smartphone-based ECG device and application, which he purchased himself and captured a typical atrioventricular node re-entrant tachycardia...
September 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28894011/palpitations-in-a-72-year-old-woman
#4
Claire A Martin, Parag R Gajendragadkar, Sharad Agarwal
CLINICAL INTRODUCTION: A 72-year-old woman presented with an 8-year history of palpitations occurring every few weeks. They were sudden in onset, were associated with dizziness and could last for up to 2 hours. She was prescribed bisoprolol which reduced the frequency of events but did not abolish them. Baseline ECG and echocardiography were normal. She was referred for electrophysiological study. Despite initial difficulties, diagnostic catheters were placed in the right ventricular (RV) apex and in the coronary sinus (CS) via the right internal jugular vein and superior vena cava (SVC) (figure 1A)...
October 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28879778/percutaneous-extracorporeal-membrane-oxygenation-in-electrical-storm-five-case-reports-addressing-efficacy-transferring-allowance-or-radiofrequency-ablation-support
#5
Aitor Uribarri, Loreto Bravo, Javier Jimenez-Candil, Javier Martin-Moreiras, Eduardo Villacorta, Pedro L Sanchez
Extracorporeal membrane oxygenation systems have undergone rapid technological improvements and are now feasible options for medium-term support of severe cardiac or pulmonary failure. We report five cases of electrical storm that was rescued by the insertion of peripheral veno-arterial extracorporeal membrane oxygenation systems. This device could help to restore systemic circulation as well as permitting organ perfusion in patients with cardiogenic shock in relation to electrical storm thus achieving greater electrical stability...
September 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28862806/initial-experience-of-a-novel-mapping-system-combined-with-remote-magnetic-navigation-in-the-catheter-ablation-of-atrial-fibrillation
#6
Changjian Lin, Steen Pehrson, Peter Karl Jacobsen, Xu Chen
BACKGROUND: There have been advancements of sophisticated mapping systems used for ablation procedures over the last decade. Utilization of these novel mapping systems in combination with remote magnetic navigation (RMN) needs to be established. We investigated the new EnSite Precisionۛ mapping system (St Jude Medical, Inc.), which collects magnetic data for checking navigation field stability and is built on an open platform, allowing physicians to choose diagnostic and ablation catheters...
September 1, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28862408/benefits-of-electroanatomic-ablation-of-conventional-cardiac-arrhytmias-from-fluoroscopy-to-zero-x-ray-mapping
#7
Michela Casella, Valentina Ribatti, Valentina Catto, Giulia Vettor, Gaetano Fassini, Viviana Biagioli, Antonio Dello Russo, Claudio Tondo
Electrophysiology procedures are traditionally performed under fluoroscopic guidance. Nowadays a growing interest in the radiation risk associated to these procedures has been cultivated, since radiation exposure has non-neglegible stochastic and deterministic effects on health. A correlation between radiation exposure and lifetime malignancy effect is difficult to establish and the threshold of a completely safe exposure dose is unknown. Thus, electrophisiologists have become aware of the use of fluoroscopy and they have tried to use all the complementary imaging technologies available in order to reduce the radiological exposure...
August 31, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28847952/trnas-and-proteins-use-the-same-import-channel-for-translocation-across-the-mitochondrial-outer-membrane-of-trypanosomes
#8
Moritz Niemann, Anke Harsman, Jan Mani, Christian D Peikert, Silke Oeljeklaus, Bettina Warscheid, Richard Wagner, André Schneider
Mitochondrial tRNA import is widespread, but the mechanism by which tRNAs are imported remains largely unknown. The mitochondrion of the parasitic protozoan Trypanosoma brucei lacks tRNA genes, and thus imports all tRNAs from the cytosol. Here we show that in T. brucei in vivo import of tRNAs requires four subunits of the mitochondrial outer membrane protein translocase but not the two receptor subunits, one of which is essential for protein import. The latter shows that it is possible to uncouple mitochondrial tRNA import from protein import...
August 28, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28845235/cardiac-electrophysiology-under-mri-guidance-an-emerging-technology
#9
Henry Chubb, Steven E Williams, John Whitaker, James L Harrison, Reza Razavi, Mark O'Neill
MR-guidance of electrophysiological (EP) procedures offers the potential for enhanced arrhythmia substrate assessment, improved procedural guidance and real-time assessment of ablation lesion formation. Accurate device tracking techniques, using both active and passive methods, have been developed to offer an interface similar to electroanatomic mapping platforms, and MR-compatible EP equipment continues to be developed. Progress to clinical implementation of these technically complex fields has been relatively slow over the last 10 years, but recent developments have led to successful clinical experience...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28836709/persistency-of-left-atrial-linear-lesions-after-radiofrequency-catheter-ablation-for-atrial-fibrillation-data-from-an-invasive-follow-up-electrophysiology-study
#10
Nebojša Mujović, Milan Marinković, Nebojša Marković, Goran Stanković, Gregory Y H Lip, Carina Blomstrom-Lundqvist, T Jared Bunch, Tatjana S Potpara
BACKGROUND: Data on the roof line (RL) and mitral isthmus line (MIL) reconnections after atrial fibrillation (AF) catheter-ablation (CA) are scarce. OBJECTIVE: We studied the RL and MIL completeness and localization of reconnection sites in consecutive patients after their first-ever AF-CA. METHODS: We prospectively included 41 consecutive AF patients who underwent predefined lesion sets of two circumferential lines (CLs) for ipsilateral pulmonary vein isolation (PVI) combined with a RL and lateral MIL...
August 24, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28835838/evolution-of-force-sensing-technologies
#11
Dipen Shah
In order to Improve the procedural success and long-term outcomes of catheter ablation techniques for atrial fibrillation (AF), an Important unfulfilled requirement is to create durable electrophysiologically complete lesions. Measurement of contact force (CF) between the catheter tip and the target tissue can guide physicians to optimise both mapping and ablation procedures. Contact force can affect lesion size and clinical outcomes following catheter ablation of AF. Force sensing technologies have matured since their advent several years ago, and now allow the direct measurement of CF between the catheter tip and the target myocardium in real time...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28835836/atrial-flutter-typical-and-atypical-a-review
#12
Francisco G Cosío
Clinical electrophysiology has made the traditional classification of rapid atrial rhythms into flutter and tachycardia of little clinical use. Electrophysiological studies have defined multiple mechanisms of tachycardia, both re-entrant and focal, with varying ECG morphologies and rates, authenticated by the results of catheter ablation of the focal triggers or critical isthmuses of re-entry circuits. In patients without a history of heart disease, cardiac surgery or catheter ablation, typical flutter ECG remains predictive of a right atrial re-entry circuit dependent on the inferior vena cava-tricuspid isthmus that can be very effectively treated by ablation, although late incidence of atrial fibrillation remains a problem...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28833764/ganglionated-plexi-as-neuromodulation-targets-for-atrial-fibrillation
#13
Eue-Keun Choi, Ye Zhao, Thomas H Everett, Peng-Sheng Chen
The autonomic nervous system plays an important role in the genesis of atrial fibrillation and is one of the candidate targets for atrial fibrillation therapy. This review focuses on the role of the autonomic nervous system in atrial fibrillation development and discusses the results of the ganglionated plexi catheter and surgical ablation in preclinical and clinical studies. The heart is innervated by the extrinsic and intrinsic autonomic nervous systems. The intrinsic autonomic nervous system consists of multiple ganglionated plexi and axons, which innervate the neighboring atrial myocardium and control their electrophysiological properties...
August 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28832094/initial-experience-of-catheter-ablation-for-cardiac-arrhythmias-in-children-and-adolescents-at-a-newly-built-ablation-centre
#14
Radosław Pietrzak, Piotr Lodziński, Tomasz Książczyk, Paweł Balsam, Monika Gawałko, Grzegorz Opolski, Bożena Werner
BACKGROUND: Catheter ablation (CA) therapy is the first choice treatment in adults with heart rhythm disturbances. The arrhythmias in adults are mainly conditioned by coronary disease. Etiology of arrhythmias in children is mostly associated with inherited heart disorders. According to the current guidelines the CA is widely used in children, indicating the need to make it more achievable in pediatric population. AIM: To assess efficacy and safety of CA in children with different types of arrhythmias on the initial learning curve at newly built Ablation Center in The Independent Pediatric Hospital of Medical University of Warsaw...
August 23, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28827810/role-of-atrial-wall-thickness-in-wave-dynamics-of-atrial-fibrillation
#15
Jun-Seop Song, Jin Wi, Hye-Jeong Lee, Minki Hwang, Byounghyun Lim, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Jeong-Wook Seo, Hui-Nam Pak
BACKGROUND/AIMS: Atrial anatomy and thickness may affect the electrical wave-dynamics of atrial fibrillation (AF). We explored the relationship between left atrial (LA) wall thickness (LAWT) or LA geometry and AF wave-dynamics. METHODS: We included 15 patients with persistent AF (age, 62.3 ± 11.9 years) who underwent AF catheter ablation. We measured the LAWT, LA endocardial curvature, and SD-curvature (surface bumpiness) from preprocedural computed tomography images...
2017: PloS One
https://www.readbyqxmd.com/read/28819954/contemporary-outcomes-of-catheter-ablation-of-accessory-pathways-complications-and-learning-curve
#16
Marek Jastrzębski, Paweł Moskal, Maciej Pitak, Kamil Fijorek, Andrzej Rudziński, Danuta Czarnecka
BACKGROUND AND AIM: The aim of this study was to examine contemporary results of accessory pathway (AP) ablation in a sizeable number of patients, focusing on periprocedural complications and the learning curve. METHODS: We performed a retrospective cohort study of consecutive AP ablation procedures at three centresby the same operator. In total 629 electrophysiological studies and 610 AP ablation procedures were performed in 570 patients (age: 33 ± 18.9 years)...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28797676/electrogram-signature-of-specific-activation-patterns-analysis-of-atrial-tachycardias-at-high-density-endocardial-mapping
#17
Antonio Frontera, Masateru Takigawa, Ruairidh Martin, Nathaniel Thompson, Ghassen Cheniti, Gregoire Massouille, Josselin Duchateau, Jean Yves Wielandts, Elvis Teijera, Takeshi Kitamura, Michael Wolf, Nora Al-Jefairi, Konstantinos Vlachos, Seigo Yamashita, Sana Amraoui, Arnaud Denis, Meleze Hocini, Hubert Cochet, Frederic Sacher, Pierre Jaïs, Michel Haïssaguerre, Nicolas Derval
BACKGROUND: The significance of fractionated electrograms (EGMs) is object of debate, with multiple mechanisms described. OBJECTIVE: Using Rhythmia, a high-density mapping system, we sought to investigate the relationship between specific electrophysiological phenomena and EGM characteristics at those sites. METHODS: Twenty-five consecutive patients underwent high-density atrial mapping during atrial tachycardias. Bipolar EGMs were recorded with a 64-electrode basket catheter...
August 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28794085/idiopathic-ventricular-arrhythmias-originating-from-the-parietal-band-electrocardiographic-and-electrophysiological-characteristics-and-outcome-of-catheter-ablation
#18
Takumi Yamada, Naoki Yoshida, Taihei Itoh, Silvio H Litovsky, Harish Doppalapudi, H Thomas McElderry, G Neal Kay
BACKGROUNDS: The parietal band is one of the muscle bands in the right ventricle. This study investigated the electrocardiographic and electrophysiological characteristics and ablation outcome of idiopathic ventricular arrhythmias (VAs) originating from the parietal band. METHODS AND RESULTS: We studied 14 patients with idiopathic VA origins in the parietal band among 294 consecutive patients with VA origins in the right ventricle. The QRS morphologies of the parietal band VAs were characterized by a left bundle branch block and left inferior (n=12) or superior (n=2) axis pattern with the presence of a notch in the middle of the QRS in all cases, precordial transition at ≤lead V3 in 7 patients, and a slow QRS onset in 4 patients...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28791747/ecg-morphology-of-premature-ventricular-contractions-predicts-presence-of-myocardial-fibrotic-substrate-on-cardiac-magnetic-resonance-imaging-in-patients-undergoing-ablation
#19
Sabrina Oebel, Borislav Dinov, Arash Arya, Sebastian Hilbert, Philipp Sommer, Andreas Bollmann, Gerhard Hindricks, Ingo Paetsch, Cosima Jahnke
BACKGROUND: The most likely origin of PVCs may be deduced from surface ECG analysis while planning an electrophysiological study (EPS). Apart from purely benign forms of increased ventricular ectopy, myocardial substrate (e.g., regional fibrosis) may be present in certain cases, which will significantly impact the ablation approach. CMR imaging can reliably identify fibrotic target lesions and, hence, may assist in adequate patient selection and procedural planning. METHODS AND RESULTS: We analyzed 101 patients (59% male, mean age 57...
August 9, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28790104/first-in-man-analysis-of-the-relationship-between-electrical-rotors-from-noninvasive-panoramic-mapping-and-atrial-fibrosis-from-magnetic-resonance-imaging-in-patients-with-persistent-atrial-fibrillation
#20
Christian Sohns, Christine Lemes, Andreas Metzner, Thomas Fink, Mikhail Chmelevsky, Tilman Maurer, Margarita Budanova, Vladislav Solntsev, Walther H W Schulze, Wieland Staab, Shibu Mathew, Christian Heeger, Bruno Reißmann, Eugene Kholmovski, Dietmar Kivelitz, Feifan Ouyang, Karl-Heinz Kuck
BACKGROUND: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging can be used to evaluate characteristics of atrial fibrosis. The novel noninvasive epicardial and endocardial electrophysiology system (NEEES) allows for the identification of sources with rotor activity. This study describes a new technique to examine the relationship between rotors and LGE signal intensity in patients with persistent atrial fibrillation (PERS) scheduled for ablation. METHODS AND RESULTS: Ten consecutive patients underwent pulmonary vein isolation for persistent atrial fibrillation...
August 2017: Circulation. Arrhythmia and Electrophysiology
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