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Electrophysiology ablation

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https://www.readbyqxmd.com/read/28229201/-sudden-cardiac-death-epidemiology-pathophysiology-and-risk-stratification
#1
B Rudic, E Tülümen, V Liebe, J Kuschyk, I Akin, M Borggrefe
Sudden cardiac death (SCD) remains a major public health burden despite revolutionary progress in the last three decades in the treatment of ventricular tachyarrhythmia with the use of implantable cardioverter defibrillator (ICD) therapy. Survivors of sudden cardiac arrest are at high risk for recurrent tachyarrhythmia events. Early recognition of low left ventricular ejection fractions (≤35%) as a strong predictor of mortality and the causal association between ventricular tachyarrhythmia and SCD has led to a significant development of not only pharmacological antiarrhythmic therapy but also device-based prevention of SCD...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28226451/non-invasive-imaging-of-ventricular-activation-during-pacing-and-arrhythmia-methods-and-validation
#2
Long Yu, Steven Pogwizd, Bin He, Long Yu, Steven Pogwizd, Bin He, Bin He, Steven Pogwizd, Long Yu
Cardiovascular disease continued to be a leading killer world widely. Each year, about 400,000 cases of sudden cardiac arrest are reported in the U.S. alone. Clinically, radio-frequency ablative procedure has become widely applied in the treatment of ventricular arrhythmia. Non-invasive approaches have been demonstrated to be able to provide important information on the arrhythmogenesis and potentially assist in the clinical practice. In this work, we develop and validate a novel temporal sparse based imaging method, Cardiac Electrical Sparse Imaging (CESI)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28211133/an-unusual-short-rp-tachycardia-what-is-the-mechanism
#3
Joshua Balog
A 68-year-old man with a history of a structurally normal heart by echocardiography, an unsuccessful ablation of a narrow complex tachycardia and frequent symptoms of palpitations presents for an electrophysiology study and ablation. Baseline 12-lead EKG demonstrated sinus rhythm without ventricular preexcitation. This article is protected by copyright. All rights reserved.
February 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28196927/healthcare-utilization-and-expenditures-associated-with-appropriate-and-inappropriate-implantable-defibrillator-shocks
#4
Mintu P Turakhia, Steven Zweibel, Andrea L Swain, Sarah A Mollenkopf, Matthew R Reynolds
BACKGROUND: In patients with implantable cardioverter-defibrillators, healthcare utilization (HCU) and expenditures related to shocks have not been quantified. METHODS AND RESULTS: We performed a retrospective cohort study of patients with implantable cardioverter-defibrillators identified from commercial and Medicare supplemental claims databases linked to adjudicated shock events from remote monitoring data. A shock event was defined as ≥1 spontaneous shocks delivered by an implanted device...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28193688/compulsive-social-behavior-emerges-after-selective-ablation-of-striatal-cholinergic-interneurons
#5
Yanina V Martos, Barbara Y Braz, Juan P Beccaria, M Gustavo Murer, Juan E Belforte
The mechanisms underlying social dysfunction in neuropsychiatric conditions like obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) remain uncertain. Dysfunctions in basal ganglia, including reduced number of striatal cholinergic interneurons (SCIN), have been involved in their pathophysiology. To explore the role of SCIN in relation to perseverative behaviors we characterized a new transgenic mouse model in which inducible ablation of SCIN is achieved with high efficiency in a cell-type and region specific manner...
February 13, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28190736/diagnosis-and-management-of-phantom-tachycardias-based-on-an-electrophysiologically-guided-approach
#6
Dimitris Tsiachris, Iosif Koutagiar, Konstantinos A Gatzoulis, Petros Arsenos, Aggeliki Rigatou, Polychronis Dilaveris, Skevos Sideris, Achilleas Papadopoulos, Alekos Kritikos, Christodoulos Stefanadis, Dimitris Tousoulis
BACKGROUND: Non-documented palpitations, or phantom tachycardias, are palpitations deemed to be of unknown origin after evaluation with conventional diagnostic tools, such as 12-lead electrocardiogram and Holter recordings. Our aim was to determine the diagnostic value of an electrophysiologic study (EPS) and its role in the management of patients presenting with non-documented palpitations. METHODS: We performed EPS in 78 consecutive patients with repeatable, poorly tolerated symptoms of paroxysmal, non-documented tachycardia, the absence of structural heart disease and at least one 24-h Holter recording...
November 20, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28188971/wide-qrs-tachycardia-with-left-bundle-branch-block-morphology-what-is-the-mechanism
#7
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Krishna Chaitanya, Sreevilasam Pushpangadhan Abhilash, Anees Thajudeen, Ajitkumar Valaparambil
A 55-year-old woman was referred for radiofrequency catheter ablation of narrow QRS tachycardia that was terminated with intravenous adenosine. Twelve-lead ECG was normal during sinus rhythm. The electrophysiological study showed an AH interval of 114 ms and HV interval of 42 ms during sinus rhythm. This article is protected by copyright. All rights reserved.
February 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28185081/-electrophysiologic-procedure-complications-in-the-elderly
#8
Dietrich Pfeiffer, Martin Neef, Daniel Jurisch, Andreas Hagendorff
Published registries give limited information on age-dependent complication rates. There are several reasons for this, including limited numbers of patients in subgroups (e.g., contractility management), experience-dependent procedures (e.g., catheter ablation), or in changing indications (e.g., resynchronization). Finally, severely ill and very old patients with limited prognosis are often excluded from electrophysiologic procedures. Therefore, published data are difficult to interpret. Meta-analyses of randomized trials give more precise information on included patient cohorts, but do not necessarily reflect daily practice because elderly patients are often excluded from trials...
February 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28178165/ablation-of-idiopathic-ventricular-arrhythmia-using-zero-fluoroscopy-approach-with-equivalent-efficacy-and-less-fatigue-a-multicenter-comparative-study
#9
Yan Wang, Guang Zhi Chen, Yan Yao, Yang Bai, Hui Min Chu, Ke Zhong Ma, Reginald Liew, Hao Liu, Guo Qiang Zhong, Yu Mei Xue, Shu Lin Wu, Yi Fu Li, Chun Xia Zhao, Qi Gong Liu, Li Lin, Lin Wang, Dao Wen Wang
The efficacy of a completely zero-fluoroscopy (ZF) approach for the catheter ablation of idiopathic ventricular arrhythmias (VAs) and whether it has advantages over the conventional fluoroscopy (F) approach are still unknown. The aim of this study was to compare the safety and efficacy of a completely ZF approach with those of the conventional F approach in the ablation of idiopathic VAs.We conducted a prospective study involving 7 centers in China. Consecutive patients (n = 489, mean age 45.3 ± 15...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28155995/sinus-node-dysfunction-and-atrial-fibrillation-a-reversible-phenomenon
#10
REVIEW
Larry R Jackson Ii, Bharath Rathakrishnan, Kristen Campbell, Kevin L Thomas, Jonathan P Piccini, Tristram Bahnson, Jonathan A Stiber, James P Daubert
BACKGROUND: Symptomatic sinus node dysfunction (SND) consists of a variety of manifestations including tachycardia-bradycardia syndrome. Atrial fibrillation (AF) is commonly associated with SND, which complicates the management of both conditions. This paper reviews the epidemiology, pathophysiology, and clinical trial data investigating therapeutic approaches for treatment of patients with both SND and AF. METHODS: The authors reviewed articles published in English describing the epidemiology, pathophysiology, and therapeutic approaches for patients with SND and AF...
February 3, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28153995/atrial-fibrillation-and-ventricular-arrhythmias-sex-differences-in-electrophysiology-epidemiology-clinical-presentation-and-clinical-outcomes
#11
Anne M Gillis
Sex-specific differences in the epidemiology, pathophysiology, clinical presentation, clinical treatment, and clinical outcomes of atrial fibrillation (AF), sustained ventricular arrhythmias, and sudden cardiac death are recognized. Sex hormones cause differences in cardiac electrophysiological parameters between men and women that may affect the risk for arrhythmias. The incidence and prevalence of AF is lower in women than in men. However, because women live longer and AF prevalence increases with age, the absolute number of women with AF exceeds that of men...
February 7, 2017: Circulation
https://www.readbyqxmd.com/read/28153795/the-relationship-between-lesion-formation-and-electrophysiological-responses-using-catheters-equipped-with-mini-electrodes-in-chronic-atrial-fibrillation
#12
Boaz Avitall, Arthur Kalinski, Piotr Horbal, Josef Koblish
INTRODUCTION: The study focuses on the electrophysiological changes associated with lesion formation using 4.5 irrigated and 8mm catheters equipped with mini electrodes positioned circumferentially on the tip. The studies aim was to test the relationship between the maximal EGM reduction, frequency spectral shift and their impact on atrial lesion formation in the AF model. Furthermore, we hypothesize that the high fidelity recording from the MEs allows improved discrimination of ablated from non-ablated tissues...
January 30, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28131769/suppression-of-inhibitory-g-protein-signaling-in-forebrain-pyramidal-neurons-triggers-plasticity-of-glutamatergic-neurotransmission-in-the-nucleus-accumbens-core
#13
Ezequiel Marron Fernandez de Velasco, Nicholas Carlblom, Zhilian Xia, Kevin Wickman
Cocaine and other drugs of abuse trigger long-lasting adaptations in excitatory and inhibitory neurotransmission in the mesocorticolimbic system, and this plasticity has been implicated in several key facets of drug addiction. For example, glutamatergic neurotransmission mediated by AMPA receptors (AMPAR) is strengthened in medium spiny neurons (MSNs) in the NAc core and shell during withdrawal following repeated in vivo cocaine administration. Repeated cocaine administration also suppresses inhibitory signaling mediated by G protein-gated inwardly rectifying K(+) (GIRK) channels in pyramidal neurons of the prelimbic cortex, an important source of glutamatergic input to the NAc core that has been implicated in cocaine-seeking and behavioral sensitization...
January 25, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28128201/disruption-of-cardiac-cholinergic-neurons-enhances-susceptibility-to-ventricular-arrhythmias
#14
Christiane Jungen, Katharina Scherschel, Christian Eickholt, Pawel Kuklik, Niklas Klatt, Nadja Bork, Tim Salzbrunn, Fares Alken, Stephan Angendohr, Christiane Klene, Janos Mester, Nikolaj Klöcker, Marieke W Veldkamp, Udo Schumacher, Stephan Willems, Viacheslav O Nikolaev, Christian Meyer
The parasympathetic nervous system plays an important role in the pathophysiology of atrial fibrillation. Catheter ablation, a minimally invasive procedure deactivating abnormal firing cardiac tissue, is increasingly becoming the therapy of choice for atrial fibrillation. This is inevitably associated with the obliteration of cardiac cholinergic neurons. However, the impact on ventricular electrophysiology is unclear. Here we show that cardiac cholinergic neurons modulate ventricular electrophysiology. Mechanical disruption or pharmacological blockade of parasympathetic innervation shortens ventricular refractory periods, increases the incidence of ventricular arrhythmia and decreases ventricular cAMP levels in murine hearts...
January 27, 2017: Nature Communications
https://www.readbyqxmd.com/read/28123066/fast-propagation-regions-cause-self-sustained-reentry-in-excitable-media
#15
Vladimir Zykov, Alexei Krekhov, Eberhard Bodenschatz
Self-sustained waves of electrophysiological activity can cause arrhythmia in the heart. These reentrant excitations have been associated with spiral waves circulating around either an anatomically defined weakly conducting region or a functionally determined core. Recently, an ablation procedure has been clinically introduced that stops atrial fibrillation of the heart by destroying the electrical activity at the spiral core. This is puzzling because the tissue at the anatomically defined spiral core would already be weakly conducting, and a further decrease should not improve the situation...
February 7, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28113394/4d-ice-a-2d-array-transducer-with-integrated-asic-in-a-10-fr-catheter-for-real-time-3d-intracardiac-echocardiography
#16
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
https://www.readbyqxmd.com/read/28108547/characterising-the-difference-in-electrophysiological-substrate-and-outcomes-between-heart-failure-and-non-heart-failure-patients-with-persistent-atrial-fibrillation
#17
Shouvik K Haldar, David G Jones, Habib Khan, Sandeep Panikker, Julian W E Jarman, Charlie Butcher, Eric Lim, Gareth Wynn, Dhiraj Gupta, Wajid Hussain, Vias Markides, Tom Wong
AIMS: Characterizing the differences in substrate and clinical outcome between heart failure (HF) and non-heart failure (non-HF) patients undergoing persistent atrial fibrillation (AF) ablation. METHODS AND RESULTS: Using complex fractionated electrograms (CFE) as a surrogate marker of substrate complexity, we compared the bi-atrial substrate in patients with persistent AF with and without HF, at baseline and after ablation, to determine its impact on clinical outcome...
January 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28108086/long-term-risk-of-wolff-parkinson-white-pattern-and-syndrome
#18
REVIEW
Susan S Kim, Bradley P Knight
For years, conventional wisdom has held that patients with asymptomatic ventricular pre-excitation (asymptomatic WPW or WPW pattern) were at low risk for adverse outcomes. This assumption has been challenged more recently in a number of observational/natural history studies as well as in prospective trials in which patients were more aggressively studied via invasive electrophysiology study (EPS) and more aggressively treated, in some cases, with pre-emptive catheter ablation, despite the lack of symptoms. In sum, the data do not definitively support one approach (early, up-stream EPS and/or ablation) vs...
December 5, 2016: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28104483/inhomogeneity-and-complexity-in-defining-fractionated-electrograms
#19
Lisette J M E van der Does, Natasja M S de Groot
Ablation strategies targeting areas of complex fractionated atrial electrograms are not successful for treatment of atrial fibrillation. Fractionation of atrial electrograms may have multiple causes of both pathologic and nonpathologic origin. In order to gain insight into the definitions used for determining areas of fractionation, a literature search was performed using a systematic approach. A PubMed search for studies describing fractionation during human atrial electrophysiologic measurements resulted in 348 articles that were screened for new definitions of fractionation...
January 17, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28104089/prediction-of-radiofrequency-ablation-lesion-formation-using-a-novel-temperature-sensing-technology-incorporated-in-a-force-sensing-catheter
#20
Guy Rozen, Leon Ptaszek, Israel Zilberman, Kevin Cordaro, E Kevin Heist, Christopher Beeckler, Andres Altmann, Zhang Ying, Zhenjiang Liu, Jeremy N Ruskin, Assaf Govari, Moussa Mansour
BACKGROUND: Real-time radiofrequency (RF) ablation lesion assessment is a major unmet need in cardiac electrophysiology. OBJECTIVE: The purpose of this study was to assess whether improved temperature measurement using a novel thermocoupling (TC) technology combined with information derived from impedance change, contact force (CF) sensing, and catheter orientation allows accurate real-time prediction of ablation lesion formation. METHODS: RF ablation lesions were delivered in the ventricles of 15 swine using a novel externally irrigated-tip catheter containing 6 miniature TC sensors in addition to force sensing technology...
February 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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