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Cardiac ablation

Berardo Sarubbi, Gaetano Rea, Giuseppe Santoro, Enrico Melillo, Giancarlo Scognamiglio, Maria Giovannna Russo
One of the major complications of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) is pulmonary vein stenosis (PVS). The natural history of PVS, especially when it involves more than one vein, leads to severe and irreversible pulmonary hypertension with end-stage right heart failure that can require, in extreme cases, even heart-lung transplantation. We report the case of a young patient who underwent RFCA for a single lasting episode of AF and developed PVS years later. He was treated with ballon venoplasty followed by stent implantation in left pulmonary vein because of PVS relief...
March 9, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Aleksandra Aljakna, Estelle Lauer, Sébastien Lenglet, Silke Grabherr, Tony Fracasso, Marc Augsburger, Sara Sabatasso, Aurélien Thomas
Simultaneous assessment of a panel of protein markers is becoming essential in order to enhance biomarker research and improve diagnostics. Specifically, postmortem diagnostics of early myocardial ischemia in sudden cardiac death cases could benefit from a multiplex marker assessment in the same tissue section. Current analytical antibody-based techniques (immunohistochemistry and immunofluorescence) limit multiplex analysis usually to not more than three antibodies. In this study, mass spectrometry-immunohistochemistry (MS-IHC) was performed by combining laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) with rare-metal-isotope-tagged antibodies as a technique for multiplex analysis of human postmortem myocardial tissue samples...
March 19, 2018: International Journal of Legal Medicine
Signe S Risom, Johanne Lind, Pamela J McCabe, Selina Kikkenborg Berg
Purpose: The CopenHeartRFA trial was designed and conducted to explore the effects of rehabilitation on patients treated with ablation for atrial fibrillation (AF). It included a cardiac rehabilitation program consisting of physical exercise and psychoeducational consultations over 6 months. As part of the evaluation of the CopenHeartRFA trial, both quantitative and qualitative data were collected. The intervention was delivered by a multidisciplinary team. Aim: This study aimed to understand the experience of patients treated for AF with ablation who participated in the CopenHeartRFA cardiac rehabilitation program...
2018: Journal of Multidisciplinary Healthcare
Tolga Aksu, Tumer Erdem Guler, Kivanc Yalin, Ferit Onur Mutluer, Kazim Serhan Ozcan, Leonardo Calò
Enhanced parasympathetic tone may cause sinus bradycardia or pauses, transient or permanent atrioventricular block, with resultant vasovagal syncope. A substantial portion of these patients may be highly symptomatic and refractory to the conventional therapies and may require cardiac pacemaker implantation. Cardioneuroablation is a little known technique for management of patients with excessive vagal activation based on radiofrequency catheter ablation of main parasympathetic autonomic ganglia around the heart...
March 2018: American Journal of the Medical Sciences
Florence Dive, Jean-Benoit le Polain de Waroux, Sophie Pierard, Geoffrey C Colin
No abstract text is available yet for this article.
March 16, 2018: Intensive Care Medicine
Natalia A Trayanova, Patrick M Boyle, Plamen P Nikolov
The goal of this article is to review advances in computational modeling of the heart, with a focus on recent non-invasive clinical imaging- and simulation-based strategies aimed at improving the diagnosis and treatment of patients with arrhythmias and structural heart disease. Following a brief overview of the field of computational cardiology, we present recent applications of the personalized virtual-heart approach in predicting the optimal targets for infarct-related ventricular tachycardia and atrial fibrillation ablation, and in determining risk of sudden cardiac death in myocardial infarction patients...
March 2018: Current Opinion in Biomedical Engineering
Carina Carnlöf, Per Insulander, Mats Jensen-Urstad, Marie Iwarzon, Fredrik Gadler
OBJECTIVES: To explore sex differences regarding indication for atrio-ventricular junction ablation (AVJ), choice of pacing system, complications to pacemaker treatment, long-term outcome, and cause of death after AVJ ablation. DESIGN: 700 patients who had undergone AVJ ablation between January 1990 and December 2010 were included. Data were retrieved from the patients´ medical records and the Swedish Pacemaker and Implantable Cardioverter-Defibrillator Registry...
March 14, 2018: Scandinavian Cardiovascular Journal: SCJ
Shiwei Huang, Binglin Pan, He Zou, Wei Lin
BACKGROUND: Atrial fibrillation (AF) usually originates from pulmonary veins (PVs) but can also be caused by pulmonary veins outside, such as the coronary sinus (CS), the superior vena cava (SVC), and the ligament of Marshall. CASE PRESENTATION: A 69-year-old male with a history of palpitations for 10 years was referred to our institute because of its recurrence for half a day. A dynamic electrocardiogram revealed sinus rhythm (SR) and paroxysmal AF. Echocardiography demonstrated normal cardiac structure, and physical examination results were unremarkable...
March 13, 2018: BMC Cardiovascular Disorders
Cristian A Linte, Jon J Camp, Maryam E Rettmann, Dieter Haemmerich, Mehmet K Aktas, David T Huang, Douglas L Packer, David R Holmes
In spite of significant efforts to improve image-guided ablation therapy, a large number of patients undergoing ablation therapy to treat cardiac arrhythmic conditions require repeat procedures. The delivery of insufficient thermal dose is a significant contributor to incomplete tissue ablation, in turn leading to the arrhythmia recurrence. Ongoing research efforts aim to better characterize and visualize RF delivery to monitor the induced tissue damage during therapy. Here, we propose a method that entails modeling and visualization of the lesions in real-time...
April 2018: Journal of Medical Imaging
Sami Viskin
Terror-Mori-Ex-Abrupto is the Latin term for "fear of dropping dead." Based on frequent email consultations I receive from patients with "suspected Brugada syndrome" (BrS), it seems that a terrifying anticipation of dying is more dominant among asymptomatic patients with BrS than in other arrhythmogenic diseases. The tragic death of a young British man that went viral over Facebook, led >10,000 British citizens to petition their Parliament, requesting that all patients with asymptomatic BrS be given the choice of an implantable defibrillator (ICD) even in the absence of markers indicating increased risk Already, 1 in 2 patients undergoing ICD implantation for BrS are asymptomatic and 1 in 5 are not only free of symptoms, but do not even have the Brugada electrocardiogram (ECG) spontaneously...
March 12, 2018: Circulation
Naoko Yamaguchi, Kentaro Yamakawa, Pradeep S Rajendran, Tatsuo Takamiya, Marmar Vaseghi
BACKGROUND: Neuraxial modulation with cardiac sympathetic denervation (CSD) can potentially reduce burden of ventricular tachy-arryhthmias (VT). Despite catheter ablation and CSD, however, VT can recur in patients with cardiomyopathy and the role of vagal nerve stimulation (VNS) in this setting is unclear. OBJECTIVE: The purpose of this study was to evaluate electrophysiological effects of VNS after CSD in normal and infarcted hearts. METHODS: In 10 normal and 6 infarcted pigs, electrophysiological and hemodynamic parameters were evaluated before and during intermittent VNS pre-CSD (bilateral stellectomy and T2-T4 thoracic ganglia removal) as well as post-CSD...
March 9, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Dennis W den Uijl, Nuno Cabanelas, Eva M Benito, Rosa Figueras, Francisco Alarcón, Roger Borràs, Susanna Prat, Eduard Guasch, Rosario Perea, Marta Sitges, Josep Brugada, Antonio Berruezo, Lluís Mont
INTRODUCTION: To investigate the relation between left atrial (LA) volume, sphericity and fibrotic content derived from contrast-enhanced cardiac magnetic resonance imaging (CE-CMR) and their impact on the outcome of catheter ablation for atrial fibrillation (AF). METHODS AND RESULTS: In 83 patients undergoing catheter ablation for AF, CE-CMR was used to assess LA volume, sphericity and fibrosis. There was a significant correlation between LA volume and sphericity (R = 0...
March 12, 2018: Journal of Cardiovascular Electrophysiology
Patrycja Pruszkowska, Radosław Lenarczyk, Jakub Gumprecht, Ewa Jedrzejczyk-Patej, Michał Mazurek, Oskar Kowalski, Adam Sokal, Tomasz Podolecki, Stanisław Morawski, Witold Streb, Katarzyna Mitręga, Zbigniew Kalarus
BACKGROUND: Pulmonary vein isolation with cryobaloon catheter ablation (CCB) is an effective method oftreatment in patients with atrial fibrillation (AF) but in patients with heart failure (HF) therole of CCB remains unknown. AIMS: To assess feasibility, effectiveness and safety of CCB in patients with HF and cardiac electronic devices (CIED), the impact of the procedure on symptoms and echocardiographic parameters. METHODS: Thirty consecutive HF patients with left ventricular ejection fraction (EF)≤40% and CIED, referred for CCB of AF were included...
March 12, 2018: Kardiologia Polska
Yoshinari Enomoto, Go Hashimoto, Naohiko Sahara, Hikari Hashimoto, Hiroki Niikura, Keijiro Nakamura, Raisuke Iijima, Hidehiko Hara, Makoto Suzuki, Mahito Noro, Masao Moroi, Kaoru Sugi, Masato Nakamura
A 70-years-old male with a history of hypertension and drug resistant paroxysmal atrial fibrillation (AF) presented to our hospital for catheter ablation to his symptomatic AF. He had no prior surgical or percutaneous procedure to close or exclude the left atrial appendage (LAA). A transesophageal echocardiography (TEE) was performed to rule out intra-cardiac thrombus prior to the ablation procedure. Although the TEE imaging at multiple acquisition angles was obtained, the LAA could not be visualized and an absence of the LAA was suspected...
March 12, 2018: International Heart Journal
Guy Rozen, Jeena Vaid, Seyed Mohammadreza Hosseini, M Ihsan Kaadan, Allon Rafael, Attila Roka, Yukkee C Poh, Ming-Zher Poh, Edwin Kevin Heist, Jeremy Neil Ruskin
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with significant morbidity, increased mortality, and rising health-care costs. Simple and available tools for the accurate detection of arrhythmia recurrence in patients after electrical cardioversion (CV) or ablation procedures for AF can help to guide therapeutic decisions. We conducted a prospective, single-center study to evaluate the accuracy of Cardiio Rhythm Mobile Application (CRMA) for AF detection. Patients >18 years of age who were scheduled for elective CV for AF were enrolled in the study...
February 13, 2018: American Journal of Cardiology
Aleksandr Voskoboinik, Paul B Sparks, Joseph B Morton, Geoffrey Lee, Stephen A Joseph, Joshua J Hawson, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Despite technological advances, studies continue to report high complication rates for atrial fibrillation (AF) ablation. We sought to review complication rates for AF ablation at a high-volume centre over a 14-year period and identify predictors of complications. METHODS: We reviewed prospectively collected data from 2750 consecutive AF ablation procedures at our institution using radiofrequency energy (RF) between January 2004 and May 2017. All cases were performed under general anaesthetic with transoesophageal echocardiography (TEE), 3D-mapping and an irrigated ablation catheter...
February 3, 2018: Heart, Lung & Circulation
Grzegorz Suwalski, Robert Emery, Jakub Mróz, Kamil Kaczejko, Leszek Gryszko, Andrzej Cwetsch, Andrzej Skrobowski
OBJECTIVES: In patients undergoing cardiac surgical procedures, pulmonary vein isolation may be easily accomplished, and it is important to achieve bidirectional conduction block across created lesions. The primary aim of this study was to assess the risk of pulmonary vein stenosis (PVS) after multiple applications of epicardial bipolar radiofrequency energy. METHODS: Thirty-five consecutive patients who were referred for off-pump coronary revascularization with concomitant pulmonary vein isolation and left atrial appendage occlusion were prospectively included in the study...
March 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Richard A Gray, Pras Pathmanathan
Patient-specific computer models have been developed representing a variety of aspects of the cardiovascular system spanning the disciplines of electrophysiology, electromechanics, solid mechanics, and fluid dynamics. These physiological mechanistic models predict macroscopic phenomena such as electrical impulse propagation and contraction throughout the entire heart as well as flow and pressure dynamics occurring in the ventricular chambers, aorta, and coronary arteries during each heartbeat. Such models have been used to study a variety of clinical scenarios including aortic aneurysms, coronary stenosis, cardiac valvular disease, left ventricular assist devices, cardiac resynchronization therapy, ablation therapy, and risk stratification...
March 6, 2018: Journal of Cardiovascular Translational Research
William A Huang, Maereg A Wassie, Olujimi A Ajijola
His bundle pacing (HBP) has been shown to be a feasible, beneficial, and safe way to achieve cardiac resynchronization therapy (CRT) with recruitment of the heart's physiological conduction system. HBP should be considered for those with unfavorable coronary sinus (CS) anatomy, and nonresponders to biventricular (BiV) pacing. HBP CRT may also help patients with the nonleft bundle branch block form of conduction delay and heart failure (HF). HBP CRT should be considered strongly in preventing right ventricular (RV) pacing-induced cardiomyopathy, especially after atrioventricular nodal ablation given the discrete nature of the block and the low likelihood of distal block...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
Prabhpreet Singh, Amit Noheria
Invasive electrophysiology (EP) mapping and catheter ablation has increasingly become the standard of care for many cardiac arrhythmias like supraventricular tachycardias, atrial fibrillation, premature ventricular complexes (PVC), and monomorphic ventricular tachycardia. In this review, we discuss the recent progress made in the mapping and ablation of ventricular fibrillation (VF). Ventricular activation during VF is apparently disorganized, making mapping and interpretation difficult. Prolonged mapping during VF would require mechanical circulatory support as VF causes complete hemodynamic collapse...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
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