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https://www.readbyqxmd.com/read/28645806/brugada-syndrome-a-general-cardiologist-s-perspective
#1
REVIEW
Marija M Polovina, Milica Vukicevic, Bojan Banko, Gregory Y H Lip, Tatjana S Potpara
Brugada syndrome (BrS) is one of the commonest inherited primary arrhythmia syndromes typically presenting with arrhythmic syncope or sudden cardiac death (SCD) due to polymorphic ventricular tachycardia and ventricular fibrillation precipitated by vagotonia or fever in apparently healthy adults, less frequently in children. The prevalence of the syndrome (0.01%-0.3%) varies among regions and ethnicities, being the highest in Southeast Asia. BrS is diagnosed by the "coved type" ST-segment elevation≥2mm followed by a negative T-wave in ≥1 of the right precordial leads V1-V2...
June 20, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28645757/sympathetic-response-and-outcomes-following-renal-denervation-in-patients-with-chronic-heart-failure-12-month-outcomes-from-the-symplicity-hf-feasibility-study
#2
Ingrid Hopper, Edoardo Gronda, Uta C Hoppe, Bengt Rundqvist, Thomas H Marwick, Sharad Shetty, Christopher Hayward, Thomas Lambert, Dagmara Hering, Murray Esler, Markus Schlaich, Antony Walton, Flavio Airoldi, Mathias-Christoph Brandt, Sidney A Cohen, Pascalle Reiters, Henry Krum
BACKGROUND: Heart failure (HF) is associated with chronic sympathetic activation. Renal denervation (RDN) aims to reduce sympathetic activity by ablating the renal sympathetic nerves. We investigated the effect of RDN in patients with chronic HF and concurrent renal dysfunction, in a prospective, multicenter, single-arm feasibility study. METHODS AND RESULTS: Thirty-nine patients with chronic systolic HF (left ventricular ejection fraction [LVEF] <40%, New York Heart Association class II-III,) and renal impairment (estimated glomerular filtration rate [eGFR; assessed with Modification of Diet in Renal Disease equation] <75 mL/min/1...
June 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28644155/transvenous-before-surgical-hybrid-procedure
#3
Joseph J Tiano, Robert Drennan, John Novella, Rafael Squiteri, Malcolm Robinson, Albert DiMeo, Lindsey Scierka, Paul LeLorier
BACKGROUND: Historically, persistent atrial fibrillation (PeAF) and long standing persistent atrial fibrillation (LSPeAF) have demonstrated limited clinical success despite hybrid approaches. OBJECTIVE: We describe our experience with the endocardial-before-epicardial approach defined by a comprehensive endovascular approach preceding and guiding the epicardial approach which includes an extensive posterior wall ablation. METHODS: 40 patients were followed over a 12 month period...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28644151/ecg-based-4d-dose-reconstruction-of-cardiac-arrhythmia-ablation-with-carbon-ion-beams-application-in-a-porcine-model
#4
Daniel Richter, H Immo Lehmann, Anna Eichhorn, Anna M Constantinescu, Robert Kaderka, Matthias Prall, Patrick Lugenbiel, Mitsuru Takami, Dierk Thomas, Christoph Bert, Marco Durante, Douglas L Packer, Christian Graeff
Noninvasive ablation of cardiac arrhythmia by scanned particle radiotherapy is highly promising, but especially challenging due to cardiac and respiratory motion. Irradiations for catheter-free ablation in intact pigs were carried out at the GSI Helmholtz Center in Darmstadt using scanned carbon ions. Here, we present real-time electrocardiogram (ECG) data to estimate time-resolved (4D) delivered dose. For 11 animals, surface ECGs and temporal structure of beam delivery were acquired during irradiation. R waves were automatically detected from surface ECGs...
June 23, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28641381/supraventricular-tachyarrhythmias-in-patients-with-a-persistent-left-superior-vena-cava
#5
Jongmin Hwang, Hyoung-Seob Park, Jun Kim, Jeong Su Kim, Jong Sung Park, Ki-Hun Kim, Myung Hwan Bae, Sang-Hee Lee, Young Soo Lee, Seongwook Han, Dae-Kyeong Kim, Tae-Joon Cha, Dong Gu Shin, Byung Chun Jung, Yoon-Nyun Kim
Aims: A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. This venous anomaly can impact the evaluation and treatment of supraventricular tachyarrhythmia (SVA). The aim of this study was to assess the proportion and characteristics of PLSVC in adult SVA patients. Methods and results: From July 2002 to July 2012, clinical and procedural data from databases of 10 cardiac electrophysiology laboratories in the Yeungnam region of the Republic of Korea were reviewed...
June 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28641242/arrhythmia-mechanism-and-scaling-effect-on-the-spectral-properties-of-electroanatomical-maps-with-manifold-harmonics
#6
Margarita Sanroman-Junquera, Inmaculada Mora-Jimenez, Arcadi Garcia-Alberola, Antonio J Caamano, Beatriz Trenor, Jose Luis Rojo-Alvarez
Spatial and temporal processing of intracardiac electrograms provides relevant information to support the arrhythmia ablation during electrophysiological studies. Current Cardiac Navigation Systems (CNS) and Electrocardiographic Imaging (ECGI) build detailed three-dimensional electroanatomical maps (EAM), which represent the spatial anatomical distribution of bioelectrical features, such as activation time or voltage. We present a principled methodology for spectral analysis of both EAM geometry and bioelectrical feature in CNS or ECGI, including their spectral representation, cut-off frequency, or spatial sampling rate (SSR)...
June 15, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28640075/maximum-voltage-gradient-technique-for-optimization-of-ablation-for-typical-atrial-flutter-with-zero-fluoroscopy-approach
#7
Karol Deutsch, Janusz Śledź, Mariusz Mazij, Bartosz Ludwik, Michał Labus, Dariusz Karbarz, Bernadetta Pasicka, Michał Chrabąszcz, Arkadiusz Śledź, Monika Klank-Szafran, Laura Vitali-Sendoz, Tomasz Kameczura, Jerzy Śpikowski, Piotr Stec, Marek Ujda, Sebastian Stec
Radiofrequency catheter ablation (RFCA) is an established effective method for the treatment of typical cavo-tricuspid isthmus (CTI)-dependent atrial flutter (AFL). The introduction of 3-dimensional electro-anatomic systems enables RFCA without fluoroscopy (No-X-Ray [NXR]). The aim of this study was to evaluate the feasibility and effectiveness of CTI RFCA during implementation of the NXR approach and the maximum voltage-guided (MVG) technique for ablation of AFL.Data were obtained from prospective standardized multicenter ablation registry...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639873/anesthetic-management-of-patients-undergoing-percutaneous-endocardial-and-epicardial-left-atrial-appendage-occlusion
#8
Zeena Husain, Payam Safavi-Naeini, Abdi Rasekh, Mehdi Razavi, Charles D Collard, James M Anton, Daniel A Tolpin
Atrial fibrillation is the most common cardiac arrhythmia in adults affecting almost 6 million adults in the United States. The 2 most common comorbidities associated with atrial fibrillation are heart failure and thromboembolic events. Heart failure symptoms may be treated with rate control, antiarrhythmic medications or by catheter ablation. Unfortunately, despite optimal medical management, thromboembolic events still occur. Recently, there has been a great deal of interest and innovation in finding an alternative to chronic anticoagulation...
June 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28635147/life-threatening-aortic-dissection-with-cardiac-tamponade-during-catheter-ablation-for-ventricular-tachycardia-originating-from-left-coronary-cusp
#9
Kenji Kuroki, Akira Sato, Fumi Yamagami, Akihiko Nogami, Kazutaka Aonuma
No abstract text is available yet for this article.
June 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28626989/electrical-isolation-of-the-left-atrial-appendage-by-maze-like-catheter-substrate-modification-a-reproducible-strategy-for-pulmonary-vein-isolation-non-responders
#10
Stefano Bordignon, Laura Perrotta, Daniela Dugo, Fabrizio Bologna, Takahiko Nagase, Alexander Fuernkranz, Kr Julian Chun, Boris Schmidt
INTRODUCTION: The ablation strategy for atrial fibrillation (AF) despite pulmonary vein isolation (PVI) is controversial. Left atrial appendage isolation (LAAI) may contribute to improve outcome. We describe an ablation approach ("Maze-like"-LAAI) that (1) modifies the underlying LA substrate by linear ablation (2) eliminates the LAA as a putative AF trigger site and (3) incorporates an unambiguous procedural endpoint. The role of LAA closure (LAAC) after LAAI was investigated. METHODS: Patients with atrial tachyarrhythmias non-responsive to PVI underwent a LAAI ablation procedure...
June 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28623036/-arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-literature-review-and-case-report
#11
William Alejandro Camargo-Ariza, Silvia Juliana Galvis-Blanco, Tatiana Del Pilar Camacho-Enciso, Carlos Alberto Quiroz-Romero, Juan José Bermudez-Echeverry
Arrhythmogenic right ventricular cardiomyopathy/dysplasia is an inherited autosomal dominant pathology with an estimated prevalence of 1:2,500 to 1:5,000, being higher in males (3:1). It is characterized histologically by replacement of cardiomyocytes by fibro-adipose tissue, which predisposes to ventricular arrhythmias, right ventricular failure, and sudden cardiac death. The main goal of treatment is to reduce the risk of sudden death and improve the quality of life of patients. We present the case of a 23 year old woman whose clinical symptoms started with palpitations, chest pain with physical activity, syncope and headache 6 years ago during her first pregnancy...
June 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28617967/holter-monitored-sudden-cardiac-arrest-after-atrioventricular-junction-ablation
#12
Victor Waldmann, Eloi Marijon, Nicolas Combes
We present a case of sudden cardiac arrest seven hours after radiofrequency ablation of the atrioventricular junction for symptomatic permanent atrial fibrillation unresponsive to medical therapy. The Holter monitoring revealed a progressive increasing of QT interval after the procedure, highlighting the repolarization instability after acute changes in heart rates associated with modification of ventricular activation, leading to occurrence of short coupling interval ventricular extra beats and finally to a "Torsade de Pointes"...
June 15, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28615142/overexpression-of-kcnj2-in-induced-pluripotent-stem-cell-derived-cardiomyocytes-for-the-assessment-of-qt-prolonging-drugs
#13
Min Li, Yasunari Kanda, Takashi Ashihara, Tetsuo Sasano, Yuji Nakai, Masami Kodama, Erina Hayashi, Yuko Sekino, Tetsushi Furukawa, Junko Kurokawa
Human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes hold great potentials to predict pro-arrhythmic risks in preclinical cardiac safety screening, although the hiPSC cardiomyocytes exhibit rather immature functional and structural characteristics, including spontaneous activity. Our physiological characterization and mathematical simulation showed that low expression of the inward-rectifier potassium (IK1) channel is a determinant of spontaneous activity. To understand impact of the low IK1 expression on the pharmacological properties, we tested if transduction of hiPSC-derived cardiomyocytes with KCNJ2, which encodes the IK1 channel, alters pharmacological response to cardiac repolarization processes...
May 27, 2017: Journal of Pharmacological Sciences
https://www.readbyqxmd.com/read/28614264/extremely-low-frame-rate-digital-fluoroscopy-in-catheter-ablation-of-atrial-fibrillation-a-comparison-of-2-versus-4-frame-rate
#14
Ji Hyun Lee, Jun Kim, Minsu Kim, Jongmin Hwang, You Mi Hwang, Joon-Won Kang, Gi-Byoung Nam, Kee-Joon Choi, You-Ho Kim
Despite the technological advance in 3-dimensional (3D) mapping, radiation exposure during catheter ablation of atrial fibrillation (AF) continues to be a major concern in both patients and physicians. Previous studies reported substantial radiation exposure (7369-8690 cGy cm) during AF catheter ablation with fluoroscopic settings of 7.5 frames per second (FPS) under 3D mapping system guidance. We evaluated the efficacy and safety of a low-frame-rate fluoroscopy protocol for catheter ablation for AF.Retrospective analysis of data on 133 patients who underwent AF catheter ablation with 3-D electro-anatomic mapping at our institute from January 2014 to May 2015 was performed...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28605469/surgical-ablation-for-persistent-atrial-fibrillation-in-concomitant-cardiac-surgery-mid-long-term-result%C3%A2
#15
Wenda Gu, Huiming Guo, Cong Lu, Huanlei Huang, Jing Liu, Jian Liu, Bin Xie, Ruobin Wu, Jimei Chen, Jian Zhuang
OBJECTIVES: Surgical ablation is an option for patients with atrial fibrillation (AF) undergoing concomitant cardiac surgery. This study aims to evaluate the outcome of surgical ablation during concomitant cardiac surgery and to identify the independent predictors for a primary end-point consisting of AF or atrial flutter (AFL) recurrence, death, permanent pacemaker implantation and necessity for anti-arrhythmic drugs and the effects of reintervention for AF/AFL recurrence. METHODS: A retrospective analysis was performed for 1028 patients who underwent surgical ablation during concomitant cardiac surgery from October 2004 to April 2015...
June 12, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28603002/association-of-pre-procedural-cardiac-magnetic-resonance-imaging-with-outcomes-of-ventricular-tachycardia-ablation-in-patients-with-idiopathic-dilated-cardiomyopathy
#16
Konstantinos C Siontis, Hyungjin Myra Kim, Ghaith Sharaf Dabbagh, Rakesh Latchamsetty, Jadranka Stojanovska, Krit Jongnarangsin, Fred Morady, Frank M Bogun
BACKGROUND: Knowledge of complex arrhythmogenic substrates can help plan ventricular tachycardia (VT) ablation in idiopathic dilated cardiomyopathy (DCM). OBJECTIVE: We sought to assess whether pre-procedural late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) can improve ablation outcomes in DCM. METHODS: Consecutive patients (n=96) with idiopathic DCM underwent VT ablation with open-irrigated catheters (2006-2016). Before 2012, LGE-MRI was not performed at our institution in patients with implanted devices, but it has been performed routinely in all patients after the implementation of a new MRI protocol in 2012...
June 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28602374/treatment-of-ventricular-arrhythmias-and-use-of-implantable-cardioverter-defibrillators-to-improve-survival-in-older-adult-patients-with-cardiac-disease
#17
REVIEW
Jason T Jacobson, Sei Iwai, Wilbert S Aronow
Ventricular arrhythmia (VA) and sudden cardiac death (SCD) are well-recognized problems in the overall heart failure population, but treatment decisions can be more complex and nuanced in older patients. Sustained VA does not always lead to SCD, but identifies a higher risk population and may cause significant symptoms. Antiarrhythmic drugs (AAD) and catheter ablation are the mainstays for prevention of VA, but have not been shown to improve mortality. The value of implantable cardiac defibrillators (ICDs) may be influenced by patient age...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602206/strain-rate-in-children-and-young-piglets-mirrors-changes-in-contractility-and-demonstrates-a-force-frequency-relationship
#18
Silvia V Alvarez, Etienne Fortin-Pellerin, Mohammed Alhabdan, Jesus S Lomelin, Michal Kantoch, Joseph Atallah, Lisa K Hornberger, James Y Coe, Po-Yin Cheung, Edythe B Tham, Kandice Mah, Lily Lin, Lindsay Mills, Nee S Khoo
BACKGROUND: In adult humans and pig models, strain rate (SR) correlates strongly with invasive measures of contractility but does not demonstrate a force-frequency relationship, which is a fundamental behavior of myocardial contraction. Given the considerable maturational changes of the myocardium from fetal stages to adulthood, extrapolation of adult findings to the young heart may not be appropriate. We sought to evaluate the SR response of the immature heart to increased heart rate (HR) and inotropic stimulation...
June 8, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28600096/alcohol-septal-ablation-to-reduce-heart-failure
#19
REVIEW
Joshua McKay, Sherif F Nagueh
Hypertrophic cardiomyopathy is a commonly encountered inheritable cardiac disorder with variable phenotypic expression. Although most patients will have no or mild symptoms, 10% will develop heart failure symptoms refractory to medical management. This article discusses the mechanisms through which hypertrophic cardiomyopathy induces heart failure and how alcohol septal ablation can reverse each of these mechanisms to lead to clinical improvement.
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28596553/hematopoietic-id-deletion-triggers-endomyocardial-fibrotic-and-vascular-defects-in-the-adult-heart
#20
Corey Chang, Qingshi Zhao, J Patrick Gonzalez, Jung H Kim, Kamal Alzahrani, Dominic Del Re, Diego Fraidenraich
Inhibitor of DNA binding (Id) proteins play important roles in regulating cardiac development via paracrine signaling. Id1/Id3 knockout mice die at mid-gestation with multiple cardiac defects. Single Id knockout studies have not reported cardiomyopathies. To bypass embryonic lethality we used Tie2CRE-mediated recombination to conditionally delete Id1 against global Id3 ablation (Id cDKOs), which develops adult-onset dilated cardiomyopathy. We confirm upregulation of thrombospondin-1 (TSP1) in Id cDKO hearts...
June 8, 2017: Scientific Reports
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