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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
#1
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/28895163/off-the-pedal-fluoroless-transseptal-puncture-in-pediatric-supraventricular-tachycardia-ablation
#2
Bradley C Clark, Kohei Sumihara, Charles I Berul, Jeffrey P Moak
BACKGROUND: Fluoroless transseptal (TS) puncture may represent the final step towards elimination of fluoroscopy in pediatric supraventricular tachycardia ablation in normal hearts. We aimed to demonstrate the safety and feasibility of fluoroless TS puncture in pediatric patients and compare procedural timing with the fluoroscopic approach. METHODS: We performed a retrospective cohort analysis of all TS procedures performed without fluoroscopy at our institution; fluoroless TS procedures were performed under intracardiac echocardiography (ICE) guidance after creation of 3D electroanatomic map and identification of fossa ovalis on 3D map...
September 12, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28892174/a-quantitative-comparison-of-the-electrical-and-anatomical-definition-of-the-pulmonary-vein-ostium
#3
Florian Spies, Michael Kühne, Tobias Reichlin, Stefan Osswald, Christian Sticherling, Sven Knecht
BACKGROUND: Anatomically guided pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. However, the position where to confirm electrical isolation is ill-defined. The aim of the current study was to quantify the relationship between the anatomical and electrical definition of the pulmonary vein ostium. METHODS: We analyzed 20 patients with paroxysmal AF undergoing PVI using radiofrequency energy and an electroanatomical mapping system...
September 11, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28884923/low-voltage-areas-detected-by-high-density-electroanatomical-mapping-predict-recurrence-after-ablation-for-paroxysmal-atrial-fibrillation
#4
Konstantinos Vlachos, Michael Efremidis, Konstantinos P Letsas, George Bazoukis, Ruairidh Martin, Maria Kalafateli, Louiza Lioni, Stamatis Georgopoulos, Athanasios Saplaouras, Theodore Efremidis, Tong Liu, Kosmas Valkanas, Nikolaos Karamichalakis, Dimitrios Asvestas, Antonios Sideris
INTRODUCTION: We aimed to evaluate the extent of atrial fibrosis in paroxysmal atrial fibrillation (AF) and the correlation with ablation outcomes after pulmonary vein antral isolation (PVΑI) using a mapping system with high-resolution and high-spatial sampling. METHODS AND RESULTS: We prospectively enrolled 80 consecutive patients (45 males, median age 60.26 years) with symptomatic paroxysmal AF who were scheduled for PVAI. Prior to PVAI, high-density bipolar voltage mapping (median number of 2,485 points) was carried out during sinus rhythm in all patients...
September 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28884216/standardized-unfold-mapping-a-technique-to-permit-left-atrial-regional-data-display-and-analysis
#5
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/28862408/benefits-of-electroanatomic-ablation-of-conventional-cardiac-arrhytmias-from-fluoroscopy-to-zero-x-ray-mapping
#6
Michela Casella, Valentina Ribatti, Valentina Catto, Giulia Vettor, Gaetano Fassini, Viviana Biagioli, Antonio Dello Russo, Claudio Tondo
Electrophysiology procedures are traditionally performed under fluoroscopic guidance. Nowadays a growing interest in the radiation risk associated to these procedures has been cultivated, since radiation exposure has non-neglegible stochastic and deterministic effects on health. A correlation between radiation exposure and lifetime malignancy effect is difficult to establish and the threshold of a completely safe exposure dose is unknown. Thus, electrophisiologists have become aware of the use of fluoroscopy and they have tried to use all the complementary imaging technologies available in order to reduce the radiological exposure...
August 31, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28845235/cardiac-electrophysiology-under-mri-guidance-an-emerging-technology
#7
Henry Chubb, Steven E Williams, John Whitaker, James L Harrison, Reza Razavi, Mark O'Neill
MR-guidance of electrophysiological (EP) procedures offers the potential for enhanced arrhythmia substrate assessment, improved procedural guidance and real-time assessment of ablation lesion formation. Accurate device tracking techniques, using both active and passive methods, have been developed to offer an interface similar to electroanatomic mapping platforms, and MR-compatible EP equipment continues to be developed. Progress to clinical implementation of these technically complex fields has been relatively slow over the last 10 years, but recent developments have led to successful clinical experience...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28842979/epicardial-ablation-utilising-remote-magnetic-navigation-in-a-patient-with-brugada-syndrome-and-inferior-early-repolarisation
#8
Paul Chun Yih Lim, Koonlawee Nademanee, Edward Chun Yi Lee, Wee Siong Teo
We report a case of epicardial ablation in a combined Brugada and inferior early repolarization syndrome patient with recurrent defibrillator therapy for spontaneous VF. Electroanatomic mapping and ablation were achieved with remote magnetic navigation. Highly fractionated electrograms were seen epicardially in the anterior RVOT and at the anterior-inferior right ventricle. Ablation of the RVOT region resulted in resolution Brugada pattern ECG. The inferior early repolarisation persisted despite ablation of the inferior right ventricular epicardium...
August 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28798020/unipolar-endocardial-voltage-mapping-in-the-right-ventricle-optimal-cutoff-values-correcting-for-computed-tomography-derived-epicardial-fat-thickness-and-their-clinical-value-for-substrate-delineation
#9
Jeroen Venlet, Sebastiaan R D Piers, Gijsbert F L Kapel, Marta de Riva, Philippe F G Pauli, Rob J van der Geest, Katja Zeppenfeld
BACKGROUND: Low endocardial unipolar voltage (UV) at sites with normal bipolar voltage (BV) may indicate epicardial scar. Currently applied UV cutoff values are based on studies that lacked epicardial fat information. This study aimed to define endocardial UV cutoff values using computed tomography-derived fat information and to analyze their clinical value for right ventricular substrate delineation. METHODS AND RESULTS: Thirty-three patients (50±14 years; 79% men) underwent combined endocardial-epicardial right ventricular electroanatomical mapping and ablation of right ventricular scar-related ventricular tachycardia with computed tomographic image integration, including computed tomography-derived fat thickness...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28771538/a-novel-noninvasive-surface-ecg-analysis-using-interlead-qrs-dispersion-in-arrhythmogenic-right-ventricular-cardiomyopathy
#10
Wan-Hsin Hsieh, Chin-Yu Lin, Abigail Louise D Te, Men-Tzung Lo, Cheng-I Wu, Fa-Po Chung, Yi-Chung Chang, Shih-Lin Chang, Chen Lin, Li-Wei Lo, Yu-Feng Hu, Jo-Nan Liao, Yun-Yu Chen, Shih-Jie Jhuo, Sunu Budhi Raharjo, Yenn-Jiang Lin, Shih-Ann Chen
BACKGROUND: This study investigated the feasibility of using the precordial surface ECG lead interlead QRS dispersion (IQRSD) in the identification of abnormal ventricular substrate in arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS: Seventy-one consecutive patients were enrolled and reclassified into 4 groups: definite ARVC with epicardial ablation (Group 1), ARVC with ventricular tachycardia (VT, Group 2), idiopathic right ventricular outflow tract VT without ARVC (Group 3), and controls without VT (Group 4)...
2017: PloS One
https://www.readbyqxmd.com/read/28765763/elongated-ascending-aorta-predicts-a-short-distance-between-his-bundle-potential-recording-site-and-coronary-sinus-ostium
#11
Yuichi Momose, Kyoko Soejima, Akiko Ueda, Takahiro Arai, Masamichi Koyanagi, Yo Hagiwara, Ikuko Togashi, Yosuke Miwa, Kyoko Hoshida, Mutsumi Miyakoshi, Noriko Matsushita, Mika Nagaoka, Toshiaki Sato, Toshiaki Nitatori, Hideaki Yoshino
BACKGROUND: When performing catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT), it can be difficult to maintain a safe distance from the His recording site to avoid AV block in patients with a short distance between this recording site to the coronary sinus (CS) ostium (small triangle of Koch [TOK]). In this study, we sought to identify parameters predicting small TOK and test these parameters in patients undergoing AVNRT catheter ablation. METHODS: Twenty-eight patients who underwent catheter ablation of atrial fibrillation using a three-dimensional (3D) electroanatomical mapping system (EAM) with computed tomography (CT) merge (23 males; mean age, 65...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28760469/delayed-electroanatomic-mapping-after-surgical-ablation-for-persistent-atrial-fibrillation
#12
Alan Bulava, Ales Mokracek, Vojtech Kurfirst
BACKGROUND: Long-term efficacy of catheter-based treatment of persistent atrial fibrillation is unsatisfactory. Minimally invasive surgical ablation techniques have been developed recently but their true efficacy has never been systematically tested. METHODS: Seventy patients (median age 63.5 years) with persistent atrial fibrillation underwent epicardial thoracoscopic radiofrequency pulmonary vein (PV) isolation, linear ablation, Marshal ligament disruption, and exclusion of the left atrial appendage...
July 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28756424/cavotricuspid-isthmus-dependent-flutter-or-left-sided-atrial-tachycardia
#13
Kevin Ming Wei Leong, Fernando Guerrero, Phang Boon Lim
A 52-year-old man with previous mitral valve replacement, cavotricuspid isthmus, and left-sided roof-line ablation for previous typical atrial flutter and tachycardia presented with recurrence of symptoms with an atrial tachycardia measuring 260 ms cycle length on electrocardiogram. Rhythmia electroanatomical mapping (Boston Scientific) was performed to understand the mechanism of arrhythmia and to guide ablative treatment.
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28730651/a-comparison-of-the-electrophysiologic-and-electroanatomic-characteristics-between-the-right-and-left-atrium-in-persistent-atrial-fibrillation-is-the-right-atrium-a-window-into-the-left
#14
Sandeep Prabhu, Aleksandr Voskoboinik, Alex J A McLellan, Kah Y Peck, Bhupesh Pathik, Chrishan J Nalliah, Geoff R Wong, Sonia M Azzopardi, Geoffrey Lee, Justin Mariani, Liang-Han Ling, Andrew J Taylor, Jonathan M Kalman, Peter M Kistler
INTRODUCTION: The right atrium (RA) is readily accessible; however, it is unclear whether changes in the RA are representative of the LA. We performed detailed biatrial electroanatomic mapping to determine the electrophysiological relationship between the atria. METHODS AND RESULTS: Consecutive patients with persistent AF underwent biatrial electroanatomical mapping with a contact force catheter acquiring points with a CF >10 g prior to ablation. Points were analyzed for tissue voltage, complex electrograms, low voltage (<0...
July 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28716699/bridge-to-success-a-better-method-of-cryoablation-for-atrioventricular-nodal-reentrant-tachycardia-in-children
#15
Charitha D Reddy, Scott R Ceresnak, Kara S Motonaga, Kishor Avasarala, Christine Feller, Anthony Trela, Debra Hanisch, Anne M Dubin
BACKGROUND: Cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT) is associated with higher recurrence rates than radiofrequency ablation (RFA). Junctional tachycardia marks procedural success with RFA, but no such indicator exists for cryoablation. OBJECTIVE: The purpose of this study as to determine the impact of voltage mapping plus longer ablation lesions on midterm success of cryoablation for children with AVNRT. METHODS: We performed a single-center retrospective analysis of pediatric patients with AVNRT who underwent cryoablation from 2011 to 2015...
July 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28680604/atrial-flutter-in-a-patient-with-atrial-septal-defect-and-anomalous-venous-drainage-unusual-approach-for-ablation
#16
Ivo Roca-Luque, Nuria Rivas, Laura Dos, Jaume Francisco, Jordi Pérez-Rodon, Antònia Pijuan, David Garcia-Dorado, Àngel Moya
Atrial flutter ablation in CHD (Congenital Heart Disease) patients is a challenging procedure because of the possibility of multiple circuits. Electroanatomical mapping and pacing maneuvers are crucial to determine critical isthmus. Moreover, vascular abnormalities and residual cardiac defects need to be known before the ablation to decide the better strategy for ablation.
July 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28678556/electroanatomical-mapping-systems-and-intracardiac-echo-integration-for-guided-endomyocardial-biopsy
#17
Michela Casella, Antonio Dello Russo, Giulia Vettor, Giuseppe Lumia, Valentina Catto, Elena Sommariva, Valentina Ribatti, Viviana Biagioli, Fabrizio Tundo, Corrado Carbucicchio, Luigi Di Biase, Andrea Natale, Claudio Tondo
During the past years, endomyocardial biopsy (EMB) has gradually spread into clinical practice. However, the role of EMB in the diagnosis and treatment of cardiovascular diseases remains a controversial issue, especially in the setting of unexplained ventricular arrhythmias. Areas covered: This review describes the methodology of EMB guided by combined use of three-dimensional electroanatomical mapping systems and intracardiac echo and summarizes the classical, fluoroscopy-guided EMB technique. Finally, the personal experience acquired with the 'electrophysiologist-made' integration methodology has been reported...
July 11, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28677887/inferior-lead-discordance-in-ventricular-arrhythmias-a-specific-marker-for-certain-arrhythmia-locations
#18
Andres Enriquez, Rajeev K Pathak, Pasquale Santangeli, Jackson Jeikai Liang, Mohammed Al Rawahi, Tatsuya Hayashi, Danielle Muser, David S Frankel, Gregory Supple, Robert Schaller, David Lin, Saman Nazarian, Erica Zado, Francis E Marchlinski, Fermin C Garcia
BACKGROUND: Most idiopathic ventricular arrhythmias (VAs) originate from the outflow tracts and are characterized by an inferior axis on the 12-lead ECG. A group of patients will exhibit inferior lead discordance (ILD), demonstrating a positive QRS in lead II with negative QRS in III or the opposite finding. METHODS AND RESULTS: We identified patients undergoing ablation of idiopathic premature ventricular contractions (PVCs) or ventricular tachycardia (VT) between 2013 and 2015...
July 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28677509/therapy-of-cardiac-arrhythmias-in-children-an-emerging-role-of-electroanatomical-mapping-systems
#19
Casale Matteo, Mezzetti Maurizio, Tulino Viviana, Michele Scarano, Busacca Paolo, Dattilo Giuseppe
INTRODUCTION: Cardiac arrhythmias are challenging diseases in childhood. Most of them in pediatric subjects (90.2%) are atrioventricular reentrant tachycardias and atrioventricular nodal reentrant tachycardias. The standard 12-lead ECG is a highly accurate diagnostic tool but an invasive electrophysiological study is often required. The main concern about this kind of procedures is their invasive nature and the need of radiations, so antiarrhythmic agents are currently the first line therapy...
July 5, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28641242/arrhythmia-mechanism-and-scaling-effect-on-the-spectral-properties-of-electroanatomical-maps-with-manifold-harmonics
#20
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
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