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https://www.readbyqxmd.com/read/28434446/revisiting-pulmonary-vein-isolation-alone-for-persistent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#1
Aleksandr Voskoboinik, Jeremy T Moskovitch, Nadav Harel, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Early studies demonstrated relatively low success rates for pulmonary vein isolation (PVI) alone in patients with persistent atrial fibrillation (PeAF). However, the advent of new technologies and the observation that additional substrate ablation does not improve outcomes have created a new focus on PVI alone for treatment of PeAF. OBJECTIVE: The purpose of this study was to systematically review the recent medical literature to determine current medium-term outcomes when a PVI-only approach is used for PeAF...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28433554/catheter-ablation-to-prevent-sudden-cardiac-death
#2
Josef Kautzner, Petr Peichl
Since ventricular arrhythmias are a common cause of sudden cardiac death (SCD), treatment for ventricular arrhythmias is the target area of interest in research field. Among different means to prevent ventricular arrhythmias, catheter ablation (CA) has emerged as an effective therapeutic method. CA can decrease the likelihood of SCD in the following arrhythmia categories: 1) idiopathic ventricular fibrillation (VF) that is usually triggered by premature ventricular beats originating in the Purkinje fibres; 2) VF in subjects with structural heart disease, especially after myocardial infarction, that is triggered by premature ventricular beats from surviving Purkinje fibres; 3) Brugada syndrome in which modification of an epicardial substrate in the right ventricular outflow tract might be the most promising strategy; 4) recurrent monomorphic ventricular tachycardias in the setting of structural heart disease; 5) ventricular preexcitation in which CA appears to be a method of choice in high risk patients, regardless of the presence or absence of symptoms...
April 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28431249/macrophages-facilitate-electrical-conduction-in-the-heart
#3
Maarten Hulsmans, Sebastian Clauss, Ling Xiao, Aaron D Aguirre, Kevin R King, Alan Hanley, William J Hucker, Eike M Wülfers, Gunnar Seemann, Gabriel Courties, Yoshiko Iwamoto, Yuan Sun, Andrej J Savol, Hendrik B Sager, Kory J Lavine, Gregory A Fishbein, Diane E Capen, Nicolas Da Silva, Lucile Miquerol, Hiroko Wakimoto, Christine E Seidman, Jonathan G Seidman, Ruslan I Sadreyev, Kamila Naxerova, Richard N Mitchell, Dennis Brown, Peter Libby, Ralph Weissleder, Filip K Swirski, Peter Kohl, Claudio Vinegoni, David J Milan, Patrick T Ellinor, Matthias Nahrendorf
Organ-specific functions of tissue-resident macrophages in the steady-state heart are unknown. Here, we show that cardiac macrophages facilitate electrical conduction through the distal atrioventricular node, where conducting cells densely intersperse with elongated macrophages expressing connexin 43. When coupled to spontaneously beating cardiomyocytes via connexin-43-containing gap junctions, cardiac macrophages have a negative resting membrane potential and depolarize in synchrony with cardiomyocytes. Conversely, macrophages render the resting membrane potential of cardiomyocytes more positive and, according to computational modeling, accelerate their repolarization...
April 20, 2017: Cell
https://www.readbyqxmd.com/read/28431070/emerging-molecular-therapies-targeting-myocardial-infarction-related-arrhythmias
#4
Helen E Driessen, Toon A B van Veen, Gerard J J Boink
Cardiac disease is the leading cause of death in the developed world. Ventricular arrhythmias associated with myocardial ischaemia and/or infarction are a major contributor to cardiovascular mortality, and require improved prevention and treatment. Drugs, devices, and radiofrequency catheter ablation have made important inroads, but have significant limitations ranging from incomplete success to undesired toxicities and major side effects. These limitations derive from the nature of the intervention. Drugs are frequently ineffective, target the entire heart, and often do not deal with the specific arrhythmia trigger or substrate...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28431061/high-prevalence-of-arrhythmic-and-myocardial-complications-in-patients-with-cardiac-glycogenosis-due-to-prkag2-mutations
#5
Julien Thevenon, Gabriel Laurent, Flavie Ader, Pascal Laforêt, Didier Klug, Anju Duva Pentiah, Laurent Gouya, Claude Alain Maurage, Salem Kacet, Jean-Christophe Eicher, Juliette Albuisson, Michel Desnos, Eric Bieth, Denis Duboc, Laurent Martin, Patricia Réant, François Picard, Claire Bonithon-Kopp, Elodie Gautier, Christine Binquet, Christel Thauvin-Robinet, Laurence Faivre, Patrice Bouvagnet, Philippe Charron, Pascale Richard
Aims: Mutations in PRKAG2, the gene encoding for the γ2 subunit of 5'-AMP-activated protein kinase (AMPK), are responsible for an autosomal dominant glycogenosis with a cardiac presentation, associating hypertrophic cardiomyopathy (HCM), ventricular pre-excitation (VPE), and progressive heart block. The aim of this study was to perform a retrospective time-to-event study of the clinical manifestations associated with PRKAG2 mutations. Methods and Results: A cohort of 34 patients from 9 families was recruited between 2001 and 2010...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28427082/perioperative-outcomes-and-safety-of-atrial-fibrillation-catheter-ablation-in-octogenarians-a-retrospective-study-and-review-of-the-benefits-of-rhythm-control
#6
Stephanie Hakimian, Juan C Camacho, Edwin Grajeda Silvestri, Farid AbdelMalak, Elie Donath, Robert Chait
OBJECTIVES: Catheter ablation for rhythm control has emerged as a successful therapeutic option for the treatment of atrial fibrillation (AF), though it has not been well studied in octogenarians. This study evaluates its safety in octogenarians in a community hospital and reviews the benefits of rhythm control. METHODS: Among 1,592 patients undergoing AF ablation, 84 octogenarian were identified. The primary outcome was normal sinus rhythm (NSR) on electrocardiogram at discharge...
April 21, 2017: Cardiology
https://www.readbyqxmd.com/read/28424545/efficacy-and-safety-of-alcohol-septal-ablation-in-patients-over-65-years-old-with-obstructive-hypertrophic-cardiomyopathy
#7
Laila Cheddadi, Olivier Lairez, Thibault Lhermusier, Francisco Campelo-Parada, Michel Galinier, Didier Carrié, Nicolas Boudou
BACKGROUND: The performance of alcohol septal ablation (ASA) in elderly symptomatic patients with drug-refractory obstructive hypertrophic cardiomyopathy is still to be confirmed. The objective of this study was to compare the efficacy and safety of ASA in patients under and over 65 years old. METHODS AND RESULTS: Fifty-one consecutive patients with obstructive hypertrophic cardio-myopathy who underwent ASA were retrospectively included and reviewed for in-hospital major acute cardiac events and follow-up...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28424445/management-of-tachyarrhythmia-during-pregnancy
#8
Emily Ann Enderlin, Khaldia Taufiq Khaled, Luke Oke, Mohammed Madmani, Hakan Paydak
Maternal tachyarrhythmia is a common complication during pregnancy due to hormonal changes that enhance pre-existing arrhythmias or induce new arrhythmias in the presence of congenital heart defects in pregnant females. Presence of tachyarrhythmia during pregnancy poses risk to the mother and fetus, calling for proper treatment with medications. Use of antiarrhythmic drugs in cases of maternal tachyarrhythmia must give due consideration of potential teratogenic side effects. Utilization of antiarrhythmic drugs during pregnancy has been well studied; some result in minimal fetal harm or none at all...
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28423126/chronic-atrial-fibrillation-ablation-with-harmonic-scalpel-during-mitral-valve-surgery
#9
Alexandre Visconti Brick, Domingo M Braile
Objective: To evaluate surgical treatment of chronic atrial fibrillation with ultrasound in patients with mitral valve disease, considering preoperative clinical characteristics of patients undergoing surgical procedure and follow-up in the immediate postoperative period, in hospital and up to 60 months after discharge. Methods: We studied 100 patients with chronic atrial fibrillation and mitral valve disease who underwent surgical treatment using ultrasound ablation...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28422368/safety-and-efficacy-of-pulmonary-vein-isolation-using-a-surround-flow-catheter-with-contact-force-measurement-capabilities-a-multicenter-registry
#10
Giuseppe Stabile, Paolo Di Donna, Vincenzo Schillaci, Antonio Di Monaco, Assunta Iuliano, Domenico Caponi, Francesco Urraro, Francesco Solimene, Massimo Grimaldi, Marco Scaglione
INTRODUCTION: Pulmonary vein (PV) isolation is the cornerstone of catheter ablation in patients with atrial fibrillation (AF). Surround flow and contact force (CF) measurement capabilities might enhance procedure efficacy and safety. We report on the safety and mid-term efficacy of a novel ablation catheter for PV isolation in patients with AF. METHODS AND RESULTS: Two hundred thirty-three consecutive patients (57±11 years, 76% males, 51% with structural heart disease) referred for paroxysmal (157) or persistent (76) AF, underwent PV isolation by a surround flow catheter with CF measurement capability in 4 centers...
April 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28421621/presence-of-ganglia-and-telocytes-in-proximity-to-myocardial-sleeve-tissue-in-the-porcine-pulmonary-veins-wall
#11
T Vandecasteele, P Cornillie, K Vandevelde, A Logothetidou, L Couck, G van Loon, W Van den Broeck
Ganglia and telocytes were identified inside the porcine pulmonary veins wall near myocardial sleeve tissue at the atriopulmonary junction. These structures are reported to play a role in the initiation of pulses from outside the heart, which potentially can cause cardiac conduction disorders such as atrial fibrillation. In-depth knowledge on the fine structure of the pulmonary vein wall is a pre-requisite to better understand the underlying pathophysiology of atrial fibrillation and the origin and conduction of ectopic pulses...
April 19, 2017: Anatomia, Histologia, Embryologia
https://www.readbyqxmd.com/read/28419246/quality-assurance-for-a-multicenter-phase-ii-study-of-stereotactic-ablative-radiotherapy-for-hepatocellular-carcinoma-%C3%A2-5-cm-a-planning-dummy-run
#12
Sun Hyun Bae, Mi-Sook Kim, Won Il Jang, Kum Bae Kim, Kwang Hwan Cho, Woo Chul Kim, Chang Yeol Lee, Eun Seog Kim, Chul Won Choi, A Ram Chang, Sunmi Jo, Jin-Young Kim
Objective: The Korean Radiation Oncology Group (12-02) investigated the outcome of stereotactic ablative radiotherapy for hepatocellular carcinoma ≤5 cm using 60 Gy in three fractions. To evaluate dosimetric differences and compliance in a multicenter trial, a planning dummy run procedure was performed. Methods: All six participating institutions were provided the contours of two dummy run cases. Plans were performed following the study protocol to cover the planning target volume with a minimum of 90% of the prescription dose and to satisfy the constraints for organs at risk...
April 13, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28413114/left-atrial-appendage-thrombi-relate-to-easily-accessible-clinical-parameters-in-patients-undergoing-atrial-fibrillation-transcatheter-ablation-a-multicenter-study
#13
Matteo Anselmino, Lucia Garberoglio, Sebastiano Gili, Emanuele Bertaglia, Giuseppe Stabile, Raffaella Marazzi, Sakis Themistoclakis, Franceso Solimene, Simone Frea, Walter Grosso Marra, Mara Morello, Marco Scaglione, Roberto De Ponti, Fiorenzo Gaita
BACKGROUND: Transesophageal echocardiography (TEE) is routinely performed before atrial fibrillation (AF) transcatheter ablation to exclude the presence of left atrial (LA) or LA appendage (LAA) thrombi. The aim of the study is to evaluate if easily accessible clinical parameters may relate to the presence of LA or LAA thrombi to identify patients who could potentially avoid TEE. METHODS AND RESULTS: Between January 2012 and September 2014, data from 1539 consecutive patients undergoing TEE, as a work-up before AF transcatheter ablation, in six large volume centers were collected...
April 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28403080/characteristics-of-diurnal-ventricular-premature-complex-variation-in-right-ventricular-outflow-tract-arrhythmias-after-catheter-ablation
#14
Shih-Jie Jhuo, Li-Wei Lo, Shih-Lin Chang, Yenn-Jiang Lin, Fa-Po Chung, Yu-Feng Hu, Tze-Fan Chao, Ta-Chuan Tuan, Jo-Nan Liao, Chin-Yu Lin, Yao-Ting Chang, Chung-Hsing Lin, Rohit Walia, Abigail Louise D Te, Shinya Yamada, Sunu Budhi Raharjo, Wei-Hua Tang, Kun-Tai Lee, Wen-Ter Lai, Shih-Ann Chen
Diurnal variations in ventricular tachyarrhythmias (VAs) have been demonstrated in idiopathic arrhythmogenic heart disease. The electrophysiological characteristics of diurnal variations in idiopathic right ventricular outflow tract (RVOT) VA have not previously been elucidated. Sixty-two consecutive patients undergoing catheter ablation for idiopathic RVOT VA (mean age: 42.8 ± 12.3 years, 35 females) were enrolled. The diurnal variation type (group 1, n = 36) was defined as those patients who had most ventricular premature contractions (VPCs) during the night hours by preprocedure Holter recordings...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28396501/mechanism-of-progressive-heart-failure-and-significance-of-pulmonary-hypertension-in-obstructive-hypertrophic-cardiomyopathy
#15
Michele Covella, Ethan J Rowin, Nicholas S Hill, Ioana R Preston, Alberto Milan, Alexander R Opotowsky, Barry J Maron, Martin S Maron, Bradley A Maron
BACKGROUND: There are limited data on the prevalence, pathophysiology, and management implications of pulmonary hypertension in patients with obstructive hypertrophic cardiomyopathy and advanced heart failure. METHODS AND RESULTS: To assess the clinical significance of measured cardiopulmonary hemodynamics in hypertrophic cardiomyopathy patients with heart failure, we retrospectively assessed right heart catheterization data in 162 consecutive patients with outflow tract gradients (median [interquartile range], 90 mm Hg [70-110 mm Hg]), 59±11 years old, and 49% men, predominately New York Heart Association class III/IV status...
April 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28395022/optogenetic-manipulation-of-anatomical-re-entry-by-light-guided-generation-of-a-reversible-local-conduction-block
#16
Masaya Watanabe, Iolanda Feola, Rupamanjari Majumder, Wanchana Jangsangthong, Alexander S Teplenin, Dirk L Ypey, Martin J Schalij, Katja Zeppenfeld, Antoine A F de Vries, Daniël A Pijnappels
Aims: Anatomical re-entry is an important mechanism of ventricular tachycardia, characterized by circular electrical propagation in a fixed pathway. It's current investigative and therapeutic approaches are non-biological, rather unspecific (drugs), traumatizing (electrical shocks), or irreversible (ablation). Optogenetics is a new biological technique that allows reversible modulation of electrical function with unmatched spatiotemporal precision using light-gated ion channels. We therefore investigated optogenetic manipulation of anatomical re-entry in ventricular cardiac tissue...
March 1, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28393926/a-strategy-for-precise-treatment-of-cardiac-malignant-neoplasms
#17
Wenshuo Wang, Jinqiang Shen, Hongyue Tao, Yun Zhao, Hui Nian, Lai Wei, Xiaoyuan Ling, Ye Yang, Limin Xia
The prevalence of cardiac malignant neoplasms in the general population has been shown to be significant higher than what was previously estimated, yet their treatment has remained difficult and effective therapies are lacking. In the current study, we developed a novel thermotherapy in which PEG-functionalized carbon nanotubes were injected into the tumor regions to assist in the targeted delivery of infrared radiation energy with minimal hyperthermic damage to the surrounding normal tissues. In a mouse model of cardiac malignant neoplasms, the injected carbon nanotubes could rapidly induce coagulative necrosis of tumor tissues when exposed to infrared irradiation...
April 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28387462/identification-and-electrophysiological-characterization-of-early-left-atrial-structural-remodeling-as-a-predictor-for-atrial-fibrillation-recurrence-after-pulmonary-vein-isolation
#18
Atsuhiko Yagishita, Dina Sparano, Ivan Cakulev, J Rod Gimbel, Timothy Phelan, Hossam Mustafa, Samer De Oliveira, Judith Mackall, Mauricio Arruda
BACKGROUND: Voltage-guided substrate ablation following pulmonary vein isolation (PVI) improves atrial fibrillation (AF) ablation outcomes. However, by setting upper voltage cutoff of 0.5 mV during sinus rhythm (SR) to guided substrate ablation using electroanatomic voltage mapping (EAVM), mildly affected low voltage area (maLVA) may be undetected. We sought to determine the optimal bipolar voltage cutoff to identify maLVA, its electrogram complexity, and the implication on ablation outcome...
April 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28385314/management-of-ventricular-arrhythmias-in%C3%A2-patients-with-advanced-heart-failure
#19
REVIEW
Pasquale Santangeli, J Eduardo Rame, Edo Y Birati, Francis E Marchlinski
Advanced heart failure (A-HF) is characterized by progressive symptoms of heart failure despite optimal therapy. In patients with A-HF, ventricular arrhythmias (VAs) are common. Clinical studies evaluating different therapies to prevent VAs had very limited representation of patients with A-HF. Among antiarrhythmic drugs, only amiodarone reduces VAs, although its use may be associated with increased mortality. Catheter ablation with substrate modification is effective to achieve VA suppression in patients with A-HF, including those with left ventricular assist devices...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28367392/radiosurgical-ablation-of-the-renal-nerve-in-a-porcine-model-a-minimally-invasive-therapeutic-approach-to-treat-refractory-hypertension
#20
Nikhilesh Bhatt, Sarah A Long, Edward A Gardner, Jonathan Tay, Elena Ladich, David Chamberlain, Thomas J Fogarty, Patrick J Maguire
BACKGROUND: Hypertension is strongly associated with cardiovascular diseases such as heart failure, stroke, kidney disease, and has been correlated with an increased risk for heart attack. Current treatment regimens for hypertension are highly inadequate, with reports indicating that only 50.1% of the clinical population with the disease has their blood pressure under control. OBJECTIVE: To study the feasibility of using minimally invasive radiosurgery to ablate the renal nerves as a novel treatment for refractory hypertension, and to assess the safety and efficacy of such an approach...
February 26, 2017: Curēus
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