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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
#1
Sandeep Prabhu, Aleksandr Voskoboinik, Alex Ja McLellan, Kah Y Peck, Bupesh 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 bi-atrial electroanatomic mapping to determine the electrophysiological relationship between the atria. METHODS AND RESULTS: Consecutive patients with persistent AF underwent bi-atrial 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
#2
Charitha D Reddy, Scott R Ceresnak, Kara S Motonaga, Kishor Avasarala, Christine Feller, Anthony Trela, Debra Hanisch, Anne M Dubin
BACKGROUND: Cryoablation for AVNRT is associated with higher recurrence rates than radiofrequency ablation(RF). Junctional tachycardia marks procedural success with RF, but no such indicator exists for cryoablation. OBJECTIVE: To determine the impact of voltage mapping plus longer ablation lesions on mid-term success of cryoablation for children with AVNRT. METHODS: A single-center retrospective analysis was performed of pediatric patients with AVNRT who underwent cryoablation from 2011-2015...
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
#3
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
#4
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
#5
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
#6
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
#7
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/28639747/the-effect-of-activation-rate-on-left-atrial-bipolar-voltage-in-patients-with-paroxysmal-atrial-fibrillation
#8
Steven E Williams, Nick Linton, Louisa O'Neill, James Harrison, John Whitaker, Rahul Mukherjee, Christopher A Rinaldi, Jaswinder Gill, Steven Niederer, Matthew Wright, Mark O'Neill
INTRODUCTION: Bipolar voltage is used during electroanatomic mapping to define abnormal myocardium, but the effect of activation rate on bipolar voltage is not known. We hypothesized that bipolar voltage may change in response to activation rate. By examining corresponding unipole signals we sought to determine the mechanisms of such changes. METHODS AND RESULTS: LA extrastimulus mapping was performed during CS pacing in 10 patients undergoing 1(st) time paroxysmal atrial fibrillation ablation...
June 22, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28637187/identification-of-pulmonary-vein-reconnection-gaps-with-high-density-mapping-in-redo-atrial-fibrillation-ablation-procedures
#9
Ignacio García-Bolao, Gabriel Ballesteros, Pablo Ramos, Diego Menéndez, Ane Erkiaga, Renzo Neglia, Marta Jiménez Martín, Enrique Vives-Rodríguez
Aims: Maps obtained by means of electroanatomic high-density mapping (HDM) systems have shown their use in the identification of conduction gaps in experimental atrial linear lesion models. The objective of this study was to assess the use of HDM in the recognition of reconnection gaps in pulmonary veins (PV) in redo atrial fibrillation (AF) ablation procedures. Methods and results: One hundred and eight patients were included in a non-randomized study that assessed the recognition of reconnection gaps in PV by means of HDM compared to a control group that received conventional non-fluoroscopic guidance with a circular multipolar catheter (CMC)...
June 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28630171/distinctive-left-ventricular-activations-associated-with-ecg-pattern-in-heart-failure-patients
#10
Nicolas Derval, Josselin Duchateau, Saagar Mahida, Romain Eschalier, Frederic Sacher, Joost Lumens, Hubert Cochet, Arnaud Denis, Xavier Pillois, Seigo Yamashita, Yuki Komatsu, Sylvain Ploux, Sana Amraoui, Adlane Zemmoura, Philippe Ritter, Mélèze Hocini, Michel Haissaguerre, Pierre Jaïs, Pierre Bordachar
BACKGROUND: In contrast to patients with left bundle branch block (LBBB), heart failure patients with narrow QRS and nonspecific intraventricular conduction delay (NICD) display a relatively limited response to cardiac resynchronization therapy. We sought to compare left ventricular (LV) activation patterns in heart failure patients with narrow QRS and NICD to patients with LBBB using high-density electroanatomic activation maps. METHODS AND RESULTS: Fifty-two heart failure patients (narrow QRS [n=18], LBBB [n=11], NICD [n=23]) underwent 3-dimensional electroanatomic mapping with a high density of mapping points (387±349 LV)...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28630168/incidence-and-factors-associated-with-the-occurrence-of-pulmonary-vein-narrowing-after-cryoballoon-ablation
#11
Ryohsuke Narui, Michifumi Tokuda, Masato Matsushima, Ryota Isogai, Kenichi Tokutake, Kenichi Yokoyama, Mika Hioki, Keiichi Ito, Shin-Ichi Tanigawa, Seigo Yamashita, Keiichi Inada, Kenri Shibayama, Seiichiro Matsuo, Satoru Miyanaga, Kenichi Sugimoto, Michihiro Yoshimura, Teiichi Yamane
BACKGROUND: In contrast with traditional radiofrequency ablation, little is known about the influence of cryoballoon ablation on the morphology of pulmonary veins (PVs). We evaluated the influence of cryoballoon ablation on the PV dimension (PVD) and investigated the factors associated with a reduction of the PVD. METHODS AND RESULTS: Seventy-four patients who underwent cryoballoon ablation for paroxysmal atrial fibrillation were included in the present study. All subjects underwent contrast-enhanced computed tomography both before and at 3 months after the procedure...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28626939/technical-note-a-3-d-rendering-algorithm-for-electromechanical-wave-imaging-of-a-beating-heart
#12
Pierre Nauleau, Lea Melki, Elaine Wan, Elisa Konofagou
PURPOSE: Arrhythmias can be treated by ablating the heart tissue in the regions of abnormal contraction. The current clinical standard provides electroanatomic 3- D maps to visualize the elec-trical activation and locate the arrhythmogenic sources. However, the procedure is time-consuming and invasive. Electromechanical Wave Imaging is an ultrasound- based non-invasive technique that can provide 2-D maps of the electromechanical activation of the heart. In order to fully visualize the complex 3-D pattern of activation, several 2-D views are acquired and processed separately They are then manually registered with a 3-D rendering software to generate a pseudo-3-D map However, this last step is operator-dependent and time-consuming...
June 19, 2017: Medical Physics
https://www.readbyqxmd.com/read/28612907/safety-and-efficacy-of-cryoablation-without-the-use-of-fluoroscopy
#13
Edward Kozluk, Dariusz Rodkiewicz, Agnieszka Piątkowska, Grzegorz Opolski
BACKGROUND: Development of electroanatomical systems make it possible to perform ablations without the use of fluoroscopy. The aim of this study was to evaluate the efficacy and safety of cryoablation procedures without the use of fluoroscopy. METHODS: The study group consisted of 45 patients (14 female; age 36 ± 15 years) treated with cryoablation using the EnSite electroanatomical system: 10 with ventricular extrasystoly from the right ventricle, 6 with the arrhythmogenic site near the left coronary artery, 17 patients with Wolff-Parkinson-White syndrome (WPW), 2 patients with atrioventricular nodal reentrant tachycardia (AVNRT) type 2, 7 patients with AVNRT type 1, 3 patients with atrial tachycardia...
June 14, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28610723/pathophysiology-of-paroxysmal-and-persistent-atrial-fibrillation-rotors-foci-and-fibrosis
#14
REVIEW
Dennis H Lau, Dominik Linz, Ulrich Schotten, Rajiv Mahajan, Prashanthan Sanders, Jonathan M Kalman
Recent advances in our understanding of the mechanisms underlying atrial fibrillation (AF) have further underscored the complex pathophysiological basis of the arrhythmia. It has become apparent that the current clinical classification of AF does not reflect the severity of the underlying atrial disease. Atrial fibrosis has been identified as the key structural change in different substrates that are responsible for the perpetuation of AF. Three-dimensional electroanatomical mapping and late gadolinium-enhanced magnetic resonance imaging are novel modalities that can be used to facilitate identification and quantitation of atrial fibrosis for improved delineation of the AF substrate...
May 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28607613/complex-fractionated-atrial-electrograms-high-dominant-frequency-regions-and-left-atrial-voltages-during-sinus-rhythm-and-atrial-fibrillation
#15
Naoko Sasaki, Ichiro Watanabe, Yasuo Okumura, Koichi Nagashima, Rikitake Kogawa, Kazumasa Sonoda, Kazuki Iso, Keiko Takahashi, Masaru Arai, Ryuta Watanabe, Sayaka Kurokawa, Kimie Ohkubo, Toshiko Nakai, Atsushi Hirayama, Mizuki Nikaido
BACKGROUND: Ablation targeting complex fractionated atrial electrograms (CFAEs) or high dominant frequency (DF) sites is generally effective for persistent atrial fibrillation (AF). CFAEs and/or high DF sites may exist in low-voltage regions, which theoretically represent abnormal substrates. However, whether CFAEs or high DF sites reflect low voltage substrates during sinus rhythm (SR) is unknown. METHODS: Sixteen patients with AF (8 with paroxysmal AF; 8, persistent AF) underwent high-density mapping of the left atrium (LA) with a 3-dimensional electroanatomic mapping system before ablation...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28605524/prevalence-and-predictors-of-low-voltage-zones-in-the-left-atrium-in-patients-with-atrial-fibrillation
#16
Yan Huo, Thomas Gaspar, Matthias Pohl, Judith Sitzy, Utz Richter, Sebastian Neudeck, Julia Mayer, Mads Brix Kronborg, Christopher Piorkowski
Aims: To describe the extent and distribution of low voltage zones (LVZ) in a large cohort of patients undergoing ablation for paroxysmal and persistent atrial fibrillation (AF), and to explore baseline predictors of LVZ in these patients. Methods and results: Consecutive patients who underwent a bipolar voltage map guided AF ablation, were enrolled. Voltage maps were conducted for each patient using 3-dimensional electroanatomical mapping system and LVZ were defined as areas of bipolar voltage < 0...
June 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28588820/endocardial-and-epicardial-focal-activation-pattern-due-to-microreentry-ventricular-tachycardia-in-a-patient-with-cardiac-sarcoidosis
#17
Hiroshi Kawakami, Ikutaro Nakajima, Mitsuru Wada, Kazuhiro Satomi, Kengo Kusano
Majority of ventricular tachycardias (VTs) are caused by scar-related macroreentry in patients with cardiac sarcoidosis. These VTs usually exhibit the reentry circuit on electroanatomic maps. We here describe a rare case of VT that exhibits a focal activation pattern on the electroanatomic map despite reentrant VT.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28541507/current-management-and-clinical-outcomes-for-catheter-ablation-of-atrioventricular-nodal-re-entrant-tachycardia
#18
Jonathan Chrispin, Satish Misra, Joseph E Marine, John Rickard, Andreas Barth, Aravindan Kolandaivelu, Hiroshi Ashikaga, Harikrishna Tandri, David D Spragg, Jane Crosson, Ronald D Berger, Gordon Tomaselli, Hugh Calkins, Sunil K Sinha
Aims: Historical studies of ablation of atrioventricular nodal re-entrant tachycardia (AVNRT) have shown high long-term success rates and low complication rates. The potential impact of several recent practice trends has not been described. This study aims to characterize recent clinical practice trends in AVNRT ablation and their associated success rates and complications. Methods and results: Patients undergoing initial ablation of AVNRT between 1 July 2005 and 30 June 2015 were included in this study...
May 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28541417/family-history-of-atrial-fibrillation-as-a-predictor-of-atrial-substrate-and-arrhythmia-recurrence-in-patients-undergoing-atrial-fibrillation-catheter-ablation
#19
Sunil Kapur, Saurabh Kumar, Roy M John, William G Stevenson, Usha B Tedrow, Bruce A Koplan, Laurence M Epstein, Calum A MacRae, Gregory F Michaud
Aims: A commonly held notion is that patients with a family history of atrial fibrillation (AF) have worse atrial substrate and higher rates of arrhythmia recurrence following ablation. We sought to examine differences in atrial substrate and catheter ablation outcomes in patients with a 1st degree family member with paroxysmal or persistent AF (PeAF) compared to those without. Methods and results: A total of 256 consecutive patients undergoing their 1st ablation for AF (123 paroxysmal, 133 persistent) with >1 year follow up were included...
May 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28541006/focal-atrial-tachycardia-arising-from-the-inferior-vena-cava
#20
Yeong Min Lim, Jae Sun Uhm, Hui Nam Pak
The inferior vena cava (IVC) is a rare site of focal atrial tachycardia (AT). Here, we report a 20-year-old woman who underwent catheter ablation for anti-arrhythmic drug-resistant AT originating from the IVC. She had undergone open-heart surgery for patch closure of an atrial septal defect 17 years previously and permanent pacemaker implantation for sinus node dysfunction 6 years previously. The AT focus was at the anterolateral aspect of the IVC-right atrial junction, and it was successfully ablated under three-dimensional electroanatomical-mapping guidance...
July 2017: Yonsei Medical Journal
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