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Cardiac ablation

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https://www.readbyqxmd.com/read/28928979/ablation-of-a-left-sided-accessory-pathway-with-near-zero-fluoroscopy-in-a-9-year-old-boy
#1
Gabriel Cismaru, Lucian Muresan, Mihai Puiu, Radu Rosu, Gabriel Gusetu, Dana Pop, Dumitru Zdrenghea
Catheter ablation of cardiac arrhythmias in pediatric population is associated with the risk of ionizing radiation on the child. Due to a greater radiation sensitivity in children and a longer life expectancy newer techniques try to reduce the radiation exposure. A new technique for zero-fluoroscopy catheter ablation is described in a 9-year-old boy who had a left-sided concealed accessory pathway. The NAVX Ensite 3D mapping system permits catheter placement inside the venous system and movement inside the heart chambers without the use of X-rays...
September 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28917560/outcomes-of-rescue-cardiopulmonary-support-for-periprocedural-acute-hemodynamic-decompensation-in-patients-undergoing-catheter-ablation-of-electrical-storm
#2
Andres Enriquez, Jackson Liang, Javier Gentile, Robert Schaller, Gregory Supple, David S Frankel, Fermin Garcia, Joyce Wald, Edo Y Birati, J Eduardo Rame, Christian Bermudez, David Callans, Francis Marchlinski, Pasquale Santangeli
BACKGROUND: In patients with ventricular tachycardia/fibrillation (VT/VF) electrical storm (ES) undergoing catheter ablation (CA), hypotension due to refractory VT/VF, use of anesthesia and cardiac stunning due to repeated ICD shocks might precipitate acute hemodynamic decompensation (AHD). OBJECTIVE: We evaluated the outcomes of emergent cardiopulmonary support with extracorporeal membrane oxygenation (ECMO) to rescue AHD in patients undergoing CA of ES. METHODS: Between 2010 and 2016, 21 patients with ES (VT in 11 and PVC-triggered VF in 10) were referred for CA and had periprocedural AHD requiring emergent ECMO support...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28917558/cardiac-sympathectomy-for-the-management-of-ventricular-arrhythmias-refractory-to-catheter-ablation
#3
Travis Richardson, Ricardo Lugo, Pablo Saavedra, George Crossley, Walter Clair, Sharon Shen, Juan Carlos Estrada, Jay Montgomery, M Benjamin Shoemaker, Christopher Ellis, Gregory F Michaud, Eric Lambright, Arvindh Kanagasundram
BACKGROUND: Catheter ablation is now a mainstay of therapy for ventricular arrhythmias (VA). However, there are scenarios where either physiologic or anatomical factors make ablation less likely to be successful. OBJECTIVES: To demonstrate that cardiac sympathetic denervation (CSD) may be an alternate therapy for patients with difficult to ablate VA. METHODS: We identified all patients referred for CSD at a single center for indications other than LQTS and CPVT who had failed catheter ablation...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28917555/incidence-and-significance-of-adhesions-encountered-during-epicardial-mapping-and-ablation-of-ventricular-tachycardia-in-patients-with-no-history-of-prior-cardiac-surgery-or-pericarditis
#4
Anthony Li, Eric Buch, Noel G Boyle, Kalyanam Shivkumar, Jason S Bradfield
BACKGROUND: Pericardial adhesions can prevent epicardial access and restrict catheter movement during mapping and ablation of ventricular tachycardia (VT) . The incidence of adhesions in patients without prior cardiac surgery or clinically evident pericarditis is not known. OBJECTIVE: To describe the incidence of pericardial adhesions in patients without prior cardiac surgery or pericarditis and explore their impact. METHODS: A retrospective search of our ablation database containing patients who underwent epicardial ablation for VT was undertaken...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28904721/septal-alcoholization-in-hypertrophic-cardiomyopathy-about-11-cases
#5
Yibar Kambiré, Georges Rosario Christian Millogo, Claire Dauphin, Jean-René Lusson
Outcomes of septal alcoholization in hypertrophic obstructive cardiomyopathy are not enough studied in all centers. The purpose of this study was to determine the outcomes of septal alcoholization in hypertrophic obstructive cardiomyopathy in our hospital. A retrospective and prospective descriptive study focused on all patients aged at least 18 years treated by alcohol septal ablation between July 2005 and June 2010 in the cardiology unit of Clermont-Ferrand teaching Hospital. The inclusion criteria were, hypertrophic obstructive cardiomyopathy with left ventricular outflow tract obstruction ≥ 50 mmHg, symptomatic despite optimal medical therapy...
2017: Pan African Medical Journal
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
#6
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/28901573/validation-of-a-novel-cartoseg%C3%A2-segmentation-module-software-for-contrast-enhanced-computed-tomography-guided-radiofrequency-ablation-in-patients-with-atrial-fibrillation
#7
EDITORIAL
Hasan Imanli, Shaun Bhatty, Jean Jeudy, Yousra Ghzally, Kiddy Ume, Rama Vunnam, Refael Itah, Mati Amit, John Duell, Vincent See, Stephen Shorofsky, Timm M Dickfeld
INTRODUCTION: Visualization of left atrial (LA) anatomy using image integration modules has been associated with decreased radiation exposure and improved procedural outcome when used for guidance of pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. We evaluated the CARTOSEG™ CT Segmentation Module (Biosense Webster, Inc.) that offers a new CT-specific semi-automatic reconstruction of the atrial endocardium. METHODS: The CARTOSEG™ CT Segmentation Module software was assessed prospectively in 80 patients undergoing AF ablation...
September 13, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28901158/hypertrophic-obstructive-cardiomyopathy-review-of-surgical-treatment
#8
Jonathan Price, Nicholas Clarke, Aslan Turer, Eduard Quintana, Carlos Mestres, Lynn Huffman, Matthias Peltz, Michael Wait, W Steves Ring, Michael Jessen, Pietro Bajona
Hypertrophic cardiomyopathy ranks among the most common congenital cardiac diseases, affecting up to 1 in 200 of the general population. When it causes left ventricular outflow tract obstruction, treatment is guided to reduce symptoms and the risk of sudden cardiac death. Pharmacologic therapy is the first-line treatment, but when it fails, surgical myectomy or percutaneous ablation of the hypertrophic myocardium are the standard therapies to eliminate subaortic obstruction. Both surgical myectomy and percutaneous ablation are proven safe and effective treatments; however, myectomy is the gold standard with a significantly lower complication rate and more complete and lasting reduction of left ventricular outflow tract obstruction...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28900864/ventricular-tachycardia-with-icd-shocks-when-to-medicate-and-when-to-ablate
#9
REVIEW
Amir AbdelWahab, John Sapp
PURPOSE OF REVIEW: Ventricular tachycardia occurrence in implantable cardioverter defibrillator (ICD) patients may result in shock delivery and is associated with increased morbidity and mortality. In addition, shocks may have deleterious mechanical and psychological effects. Prevention of ventricular tachycardia (VT) recurrence with the use of antiarrhythmic drugs or catheter ablation may be warranted. Antiarrhythmic drugs are limited by incomplete efficacy and an unfavorable adverse effect profile...
September 13, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28900153/genetic-ablation-of-fgf23-or-klotho-does-not-modulate-experimental-heart-hypertrophy-induced-by-pressure-overload
#10
Svetlana Slavic, Kristopher Ford, Magalie Modert, Amarela Becirovic, Stephan Handschuh, Andreas Baierl, Nejla Katica, Ute Zeitz, Reinhold G Erben, Olena Andrukhova
Left ventricular hypertrophy (LVH) ultimately leads to heart failure in conditions of increased cardiac pre- or afterload. The bone-derived phosphaturic and sodium-conserving hormone fibroblast growth factor-23 (FGF23) and its co-receptor Klotho have been implicated in the development of uremic LVH. Using transverse aortic constriction (TAC) in gene-targeted mouse models, we examine the role of Fgf23 and Klotho in cardiac hypertrophy and dysfunction induced by pressure overload. TAC profoundly increases serum intact Fgf23 due to increased cardiac and bony Fgf23 transcription and downregulation of Fgf23 cleavage...
September 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28899954/differentiating-the-qrs-morphology-of-posterior-fascicular-ventricular-tachycardia-from-right-bundle-branch-block-and-left-anterior-hemiblock-aberrancy
#11
Yoav Michowitz, Oholi Tovia-Brodie, Ishai Heusler, Avi Sabbag, Michael Rahkovich, Hezzy Shmueli, Aharon Glick, Bernard Belhassen
BACKGROUND: Left posterior fascicular ventricular tachycardia (LPF-VT) is frequently misdiagnosed as supraventricular tachycardia with aberrant right bundle branch block (RBBB) and left anterior hemiblock (LAHB). The purpose of the present study was to define the morphological ECG characteristics of LPF-VT and attempt to differentiate it from RBBB and LAHB aberrancy. METHODS AND RESULTS: A systematic Medline search was used to identify or locate ECG tracings from patients with LPF-VTs...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28884341/-current-strategies-in-the-treatment-of-ventricular-tachycardia-by-catheter-ablation-a%C3%A2-review
#12
REVIEW
S Koenig, A Arya, G Hindricks, B Dinov
The treatment of ventricular tachycardia has recently undergone relevant changes as certain interventional treatment options, such as radiofrequency catheter ablation, have gained in importance. Numerous current publications have demonstrated the advantages of catheter ablation compared to conventional therapy with antiarrhythmic drugs in terms of effectiveness and morbidity. Improving the ablation technique and identifying those patient collectives who are most likely to benefit from ablation are still the objectives of current research...
September 7, 2017: Herz
https://www.readbyqxmd.com/read/28884216/standardized-unfold-mapping-a-technique-to-permit-left-atrial-regional-data-display-and-analysis
#13
Steven E Williams, Catalina Tobon-Gomez, Maria A Zuluaga, Henry Chubb, Constantine Butakoff, Rashed Karim, Elena Ahmed, Oscar Camara, Kawal S Rhode
PURPOSE: Left atrial arrhythmia substrate assessment can involve multiple imaging and electrical modalities, but visual analysis of data on 3D surfaces is time-consuming and suffers from limited reproducibility. Unfold maps (e.g., the left ventricular bull's eye plot) allow 2D visualization, facilitate multimodal data representation, and provide a common reference space for inter-subject comparison. The aim of this work is to develop a method for automatic representation of multimodal information on a left atrial standardized unfold map (LA-SUM)...
September 7, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28882497/pulmonary-vein-isolation-for-atrial-fibrillation-can-be-achieved-with-low-radiation-exposure
#14
Alex L Huang, Nadeem Mughal, Ferdinand Tabas, Natalie L Patterson, Wen Kai Wong, David Whalley, Logan Kanagaratnam
BACKGROUND: Atrial fibrillation is common and management by pharmacotherapy is limited by modest efficacy and significant toxicities. Pulmonary vein isolation (PVI) is a safe and effective alternative in select patients with atrial fibrillation. However, prolonged procedure time raises concerns of health risks from radiation exposure. This study aims to determine the significance of radiation exposure from PVI. METHODS: In this study, we retrospectively reviewed patient demographics, fluoroscopy time, entrance skin dose and dose area product in 80 cases of PVI, radiofrequency ablation for atrial flutter and diagnostic coronary angiogram performed in our institution...
August 8, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28882334/meta-analysis-of-safety-and-efficacy-of-uninterrupted-non-vitamin-k-antagonist-oral-anticoagulants-versus-vitamin-k-antagonists-for-catheter-ablation-of-atrial-fibrillation
#15
Akram Y Elgendy, Dhruv Mahtta, Amr F Barakat, Ahmed Abuzaid, Ahmad Mahmoud, Amgad Mentias, Ahmed N Mahmoud, Islam Y Elgendy
This meta-analysis sought to assess the safety and efficacy of uninterrupted non-vitamin K antagonist oral anticoagulants (NOACs) versus uninterrupted vitamin K antagonists in atrial fibrillation (AF) patients undergoing catheter ablation. Electronic databases were searched for randomized trials (RCTs) and observational studies that compared uninterrupted NOACs versus uninterrupted vitamin K antagonists in the catheter ablation of AF. Safety outcomes included major bleeding, total bleeding, minor bleeding, and cardiac tamponade...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28882227/left-atrial-fibrosis-and-risk-of-cerebrovascular-and-cardiovascular-events-in-patients-with%C3%A2-atrial-fibrillation
#16
MULTICENTER STUDY
Jordan B King, Peyman N Azadani, Promporn Suksaranjit, Adam P Bress, Daniel M Witt, Frederick T Han, Mihail G Chelu, Michelle A Silver, Joseph Biskupiak, Brent D Wilson, Alan K Morris, Eugene G Kholmovski, Nassir Marrouche
BACKGROUND: Severity of left atrial (LA) fibrosis is a strong predictor of atrial fibrillation (AF) ablation success and has been associated with a history of stroke, hypertension, and heart failure (HF). However, it is unclear whether more severe LA fibrosis independently increases the risk of major adverse cardiovascular and cerebrovascular events (MACCE) among those with AF. OBJECTIVES: The goal of this study was to evaluate the occurrence and frequency of MACCE by strata of LA fibrosis severity in patients with AF...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28879778/percutaneous-extracorporeal-membrane-oxygenation-in-electrical-storm-five-case-reports-addressing-efficacy-transferring-allowance-or-radiofrequency-ablation-support
#17
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/28878117/tead1-is-required-for-maintaining-adult-cardiomyocyte-function-and-its-loss-results-in-lethal-dilated-cardiomyopathy
#18
Ruya Liu, Jeongkyung Lee, Byung S Kim, Qiongling Wang, Samuel K Buxton, Nikhil Balasubramanyam, Jean J Kim, Jianrong Dong, Aijun Zhang, Shumin Li, Anisha A Gupte, Dale J Hamilton, James F Martin, George G Rodney, Cristian Coarfa, Xander Ht Wehrens, Vijay K Yechoor, Mousumi Moulik
Heart disease remains the leading cause of death worldwide, highlighting a pressing need to identify novel regulators of cardiomyocyte (CM) function that could be therapeutically targeted. The mammalian Hippo/Tead pathway is critical in embryonic cardiac development and perinatal CM proliferation. However, the requirement of Tead1, the transcriptional effector of this pathway, in the adult heart is unknown. Here, we show that tamoxifen-inducible adult CM-specific Tead1 ablation led to lethal acute-onset dilated cardiomyopathy, associated with impairment in excitation-contraction coupling...
September 7, 2017: JCI Insight
https://www.readbyqxmd.com/read/28878116/inhibition-of-nadph-oxidase-2-nox2-prevents-sepsis-induced-cardiomyopathy-by-improving-calcium-handling-and-mitochondrial-function
#19
Leroy C Joseph, Dimitra Kokkinaki, Mesele-Christina Valenti, Grace J Kim, Emanuele Barca, Dhanendra Tomar, Nicholas E Hoffman, Prakash Subramanyam, Henry M Colecraft, Michio Hirano, Adam J Ratner, Muniswamy Madesh, Konstantinos Drosatos, John P Morrow
Cardiomyopathy frequently complicates sepsis and is associated with increased mortality. Increased cardiac oxidative stress and mitochondrial dysfunction have been observed during sepsis, but the mechanisms responsible for these abnormalities have not been determined. We hypothesized that NADPH oxidase 2 (NOX2) activation could be responsible for sepsis-induced oxidative stress and cardiomyopathy. Treatment of isolated adult mouse cardiomyocytes with low concentrations of the endotoxin lipopolysaccharide (LPS) increased total cellular reactive oxygen species (ROS) and mitochondrial superoxide...
September 7, 2017: JCI Insight
https://www.readbyqxmd.com/read/28876642/outcome-of-liver-resection-for-carcinoid-neuroendocrine-metastases
#20
M D Polkinghorne, J E J Krige, E Jonas, U K Kotze, M M Bernon
BACKGROUND: Gastrointestinal carcinoid tumours, despite their low malignant potential, frequently metastasize to the liver. While liver resection improves survival and provides symptomatic relief, multifocal bilobar disease complicates surgical management. METHOD: All patients with carcinoid liver secondaries managed by resection from 1990-2015 were identified from a prospective departmental database. Demographic data, operative management, morbidity using the Accordion classification and mortality were analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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