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https://www.readbyqxmd.com/read/29663562/atrial-fibrillation-ablation-using-cryoballoon-technology-recent-advances-and-practical-techniques
#1
REVIEW
Shaojie Chen, Boris Schmidt, Stefano Bordignon, Fabrizio Bologna, Laura Perrotta, Takahiko Nagase, K R Julian Chun
Atrial fibrillation (AF) affects 1-2% of the population, and its prevalence is estimated to double in the next 50 years as the population ages. AF results in impaired patients' life quality, deteriorated cardiac function and even increased mortality. Antiarrhythmic drugs frequently fail to restore sinus rhythm. Catheter ablation is a valuable treatment approach for AF, even as a first-line therapy strategy in selected patients. Effective electrical pulmonary vein isolation (PVI) is the cornerstone of all AF ablation strategies...
April 16, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29658207/ablation-induced-change-in-the-course-of-fascicular-tachycardia
#2
Avishag Laish-Farkash, Avi Sabbag, Michael Glikson, Aharon Glick, Vladimir Khalameizer, Amos Katz, Yoav Michowitz
BACKGROUND: Multiform fascicular tachycardia (FT) was recently described as a ventricular tachycardia (VT) that has a reentrant mechanism using multiple fascicular branches and produces alternate fascicular VT forms. Ablating the respective fascicle may cause a change in the reentrant circuit resulting in a change in morphology. Ablation of the septal fascicle is crucial for successful treatment. OBJECTIVES: To describe four cases of FT in which ablation induced a change in QRS morphologies and aggravated clinical course...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29618475/novel-measure-of-local-impedance-predicts-catheter-tissue-contact-and-lesion-formation
#3
Matthew S Sulkin, Jacob I Laughner, Sebastian Hilbert, Suraj Kapa, Jedrzej Kosiuk, Paul Younan, Iñaki Romero, Allan Shuros, Jason J Hamann, Gerhard Hindricks, Andreas Bollmann
BACKGROUND: Coupling between the ablation catheter and myocardium is critical to resistively heat tissue with radiofrequency ablation. The objective of this study was to evaluate whether a novel local impedance (LI) measurement on an ablation catheter identifies catheter-tissue coupling and is predictive of lesion formation. METHODS AND RESULTS: LI was studied in explanted hearts (n=10 swine) and in vivo (n=10; 50-70 kg swine) using an investigational electroanatomic mapping system that measures impedance from an ablation catheter with mini-electrodes incorporated in the distal electrode (Rhythmia and IntellaNav MiFi OI, Boston Scientific)...
April 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29617764/whole-human-heart-histology-to-validate-electroanatomical-voltage-mapping-in-patients-with-non-ischaemic-cardiomyopathy-and-ventricular-tachycardia
#4
Claire A Glashan, Alexander F A Androulakis, Qian Tao, Ross N Glashan, Lambertus J Wisse, Micaela Ebert, Marco C de Ruiter, Berend J van Meer, Charlotte Brouwer, Olaf M Dekkers, Daniel A Pijnappels, Jacques M T de Bakker, Marta de Riva, Sebastiaan R D Piers, Katja Zeppenfeld
Aims: Electroanatomical voltage mapping (EAVM) is an important diagnostic tool for fibrosis identification and risk stratification in non-ischaemic cardiomyopathy (NICM); currently, distinct cut-offs are applied. We aimed to evaluate the performance of EAVM to detect fibrosis by integration with whole heart histology and to identify the fibrosis pattern in NICM patients with ventricular tachycardias (VTs). Methods and results: Eight patients with NICM and VT underwent EAVM prior to death or heart transplantation...
March 29, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29603755/impact-of-left-atrial-size-on-isolation-area-in-the-acute-phase-of-pulmonary-vein-isolation-using-28-mm-cryoballoon
#5
Akio Chikata, Takeshi Kato, Kazuo Usuda, Shuhei Fujita, Michiro Maruyama, Yoshiki Nagata, Satoru Sakagami, Naomi Kanamori, Takanori Yaegashi, Takahiro Saeki, Takashi Kusayama, Soichiro Usui, Hiroshi Furusho, Shuichi Kaneko, Masayuki Takamura
BACKGROUND: The impact of left atrial (LA) size on isolation area (ISA) using a 28-mm second-generation cryoballoon (CB) in the acute phase after pulmonary vein isolation (PVI) and the differences of CB from contact force-guided radiofrequency (RF) ablation have not been fully investigated. METHODS: We examined 85 consecutive patients (CB group, 35; RF group, 50) with drug-refractory paroxysmal atrial fibrillation who underwent their first PVI procedure at two institutions...
March 31, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29600790/biatrial-electrical-and-structural-atrial-changes-in-heart-failure-electroanatomic-mapping-in-persistent-atrial-fibrillation-in-humans
#6
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
OBJECTIVES: This study sought to characterize the biatrial substrate in heart failure (HF) and persistent atrial fibrillation (PeAF). BACKGROUND: Atrial fibrillation (AF) and HF frequently coexist; however, the contribution of HF to the biatrial substrate in PeAF is unclear. METHODS: Consecutive patients with PeAF and normal left ventricular (NLV) systolic function (left ventricular ejection fraction [LVEF] >55%) or idiopathic cardiomyopathy (LVEF ≤45%) undergoing AF ablation were enrolled...
January 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29584897/magnetic-resonance-imaging-guidance-for-the-optimization-of-ventricular-tachycardia-ablation
#7
Rahul K Mukherjee, John Whitaker, Steven E Williams, Reza Razavi, Mark D O'Neill
Catheter ablation has an important role in the management of patients with ventricular tachycardia (VT) but is limited by modest long-term success rates. Magnetic resonance imaging (MRI) can provide valuable anatomic and functional information as well as potentially improve identification of target sites for ablation. A major limitation of current MRI protocols is the spatial resolution required to identify the areas of tissue responsible for VT but recent developments have led to new strategies which may improve substrate assessment...
March 23, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29580630/feasibility-of-performing-radiofrequency-catheter-ablation-and-endomyocardial-biopsy-in-the-same-setting
#8
J William Schleifer, Kevin K Manocha, Samuel J Asirvatham, Peter A Noseworthy, Rajiv Gulati, Paul A Friedman, Malini Madhavan, Thomas M Munger, Leslie T Cooper, Guy S Reeder, David R Holmes, Suraj Kapa
In patients with unexplained cardiomyopathy, electroanatomical mapping can identify abnormal tissue to target during electrophysiology-guided endomyocardial biopsy (EP-guided EMB). The objective of this study is to determine whether catheter ablation performed in the same setting as EP-guided EMB increases procedural risk. Sixty-seven patients (mean age 54.4 ± 13.8, 57% male) undergoing EP-guided EMB were included. Radiofrequency catheter ablation was performed in 17 patients (25%) for ventricular arrhythmias and in 2 (3%) for typical atrial flutter...
March 5, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29579583/the-role-of-electroanatomical-mapping-in-individualized-treatment-of-paroxysmal-atrial-fibrillation
#9
EDITORIAL
Jedrzej Kosiuk, Tom de Potter, Dominik Linz
No abstract text is available yet for this article.
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29572086/influence-of-contact-force-on-voltage-mapping-a-combined-magnetic-resonance-imaging-and-electroanatomic-mapping-study-in-patients-with-tetralogy-of-fallot
#10
Elvis Teijeira-Fernandez, Hubert Cochet, Felix Bourier, Masateru Takigawa, Ghassen Cheniti, Nathaniel Thompson, Antonio Frontera, Claudia Camaioni, Gregoire Massouille, Zakaria Jalal, Nicolas Derval, Xavier Iriart, Arnaud Denis, Meleze Hocini, Michel Haissaguerre, Pierre Jais, Jean-Benoit Thambo, Frederic Sacher
BACKGROUND: Voltage criteria for ventricular mapping have been obtained from small series of patients and prioritizing high specificity. OBJECTIVE: Using tetralogy of Fallot as a model of transmural right ventricular (RV) scar and MRI as reference, we aimed to study the potential influence of contact force (CF) on voltage mapping and to define voltage cutoff values for RV scar. METHODS: Fourteen patients (age 32.6±14.3, 5 female) with repaired tetralogy of Fallot underwent high resolution cardiac MRI (1...
March 20, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29545358/electrocardiographic-repolarization-abnormalities-and-electroanatomic-substrate-in-arrhythmogenic-right-ventricular-cardiomyopathy
#11
Maciej Kubala, Rajeev K Pathak, Shuanglun Xie, Ruben Casado Arroyo, Cory M Tschabrunn, Tatsuya Hayashi, Fermin C Garcia, Gregory E Supple, Pasquale Santangeli, David S Frankel, Erica S Zado, David J Callans, Francis E Marchlinski
BACKGROUND: Repolarization abnormalities in arrhythmogenic right ventricular (RV) cardiomyopathy and their relationship to ventricular tachycardia substrate are incompletely understood. METHODS AND RESULTS: In 40 patients (29 men, mean age 38 years) with arrhythmogenic RV cardiomyopathy, we compared the extent and location of abnormal T (NegT) waves ≥1 mm in depth (n=32) and downsloping elevated ST segment (n=13), in ≥2 adjacent leads, to area and location of endocardial bipolar (<1...
March 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29535140/elevated-circulating-fibrocytes-is-a-marker-of-left-atrial-fibrosis-and-recurrence-of-persistent-atrial-fibrillation
#12
Yang Liu, Xiao-Hui Niu, Xiaomeng Yin, Yue-Jian Liu, Chao Han, Jie Yang, Xin Huang, Xiaohong Yu, Lianjun Gao, Yan-Zong Yang, Yun-Long Xia, Hui-Hua Li
BACKGROUND: In atrial fibrillation (AF), a more extensively fibrotic left atrium (LA) provides a substrate for arrhythmias and increases risk of relapse following ablation. Fibrocytes are bone marrow-derived circulating mesenchymal progenitors that have been identified in the atrium of patients with AF who have valvular diseases. The present study investigates the associations between circulating fibrocytes and LA fibrosis or the prevalence of recurrence after ablation in patients with persistent AF...
March 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29476203/first-experience-with-zero-fluoroscopic-ablation-for-supraventricular-tachycardias-using-a-novel-impedance-and-magnetic-field-based-mapping-system
#13
Katie A Walsh, Joseph Galvin, John Keaney, Edward Keelan, Gabor Szeplaki
AIMS: Zero- and near-zero-fluoroscopic ablation techniques reduce the harmful effects of ionizing radiation during invasive electrophysiology procedures. We aimed to test the feasibility and safety of a zero-fluoroscopic strategy using a novel integrated magnetic and impedance-based electroanatomical mapping system for radiofrequency ablation (RFA) of supraventricular tachycardias (SVTs). METHODS: We retrospectively studied 92 consecutive patients undergoing electrophysiology studies with/without RFA for supraventricular tachycardia (SVT) performed by a single operator at a single center...
February 23, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29464341/additional-cryoapplications-at-the-pulmonary-vein-antrum-using-a-28-mm-second-generation-cryoballoon-a-pilot-study-of-extra-pulmonary-vein-ablation
#14
Shinsuke Miyazaki, Takatsugu Kajiyama, Tomonori Watanabe, Sadamitsu Ichijo, Yoshito Iesaka
Isolation areas post-28-mm cryoballoon pulmonary vein isolation (CB-PVI) are smaller than post-radiofrequency PV antrum isolation at the left superior PV (LSPV) antrum and recurrent atrial fibrillation (AF) can originate from this area. This pilot study evaluated the impact of additional extra-PV CB applications at the LSPV antrum following conventional CB-PVI. Eighteen paroxysmal AF patients underwent CB-PVI with single 3-min freeze techniques. Following the CB-PVI, 2-min CB applications were added once or twice at the LSPV antrum...
February 20, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29449353/ten-year-clinical-outcome-after-circumferential-pulmonary-vein-isolation-utilizing-the-hamburg-approach-in-patients-with-symptomatic-drug-refractory-paroxysmal-atrial-fibrillation
#15
Roland Richard Tilz, Christian-Hendrik Heeger, Alexander Wick, Ardan M Saguner, Andreas Metzner, Andreas Rillig, Peter Wohlmuth, Bruno Reissmann, Christine Lemeš, Tilman Maurer, Francesco Santoro, Johannes Riedl, Christian Sohns, Shibu Mathew, Karl-Heinz Kuck, Feifan Ouyang
BACKGROUND: Circumferential pulmonary vein isolation (CPVI) is increasingly performed for the treatment of symptomatic drug-refractory paroxysmal atrial fibrillation. Long-term data for >10 years after CPVI are sparse. We investigated the long-term clinical outcome and progression of paroxysmal atrial fibrillation after double-lasso and 3-dimensional electroanatomical mapping-guided CPVI. METHODS AND RESULTS: From 2003 to 2004, 161 patients (mean age: 60±10 years) with symptomatic drug-refractory paroxysmal atrial fibrillation were prospectively enrolled and underwent electroanatomical mapping-guided CPVI...
February 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29420216/myocardial-scar-delineation-using-diffusion-tensor-magnetic-resonance-tractography
#16
Choukri Mekkaoui, Marcel P Jackowski, William J Kostis, Christian T Stoeck, Aravinda Thiagalingam, Timothy G Reese, Vivek Y Reddy, Jeremy N Ruskin, Sebastian Kozerke, David E Sosnovik
BACKGROUND: Late gadolinium enhancement (LGE) is the current standard for myocardial scar delineation. In this study, we introduce the tractographic propagation angle (PA), a metric of myofiber curvature (degrees/unit distance) derived from diffusion tensor imaging (DTI), and compare its use to LGE and invasive scar assessment by endocardial voltage mapping. METHODS AND RESULTS: DTI was performed on 7 healthy human volunteers, 5 patients with myocardial infarction, 6 normal mice, and 7 mice with myocardial infarction...
February 2, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29405366/correlation-of-right-ventricular-multielectrode-endocardial-unipolar-mapping-and-epicardial-scar
#17
Jonathan Chrispin, Ali Keramati, Fabrizio R Assis, Satish Misra, Tarek Zghaib, Ronald D Berger, Hugh Calkins, Harikrishna Tandri
AIMS: Prior studies identified a relationship between epicardial bipolar and endocardial unipolar voltage. Whether the relationship is valid with smaller multielectrode mapping catheters has not been reported. We explored the association of right ventricular (RV) endocardial unipolar voltage mapping with epicardial bipolar voltage mapping using a multielectrode mapping catheter. METHODS: Electrograms from patients who underwent multielectrode endocardial and epicardial RV electroanatomical mapping during ablation procedures were analyzed...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29388068/characterizing-left-ventricular-mechanical-and-electrical-activation-in-patients-with-normal-and-impaired-systolic-function-using-a-non-fluoroscopic-cardiovascular-navigation-system
#18
Christopher Piorkowski, Arash Arya, Craig D Markovitz, Hedi Razavi, Chunlan Jiang, Stuart Rosenberg, Ole-A Breithardt, Sascha Rolf, Silke John, Jedrzej Kosiuk, Yan Huo, Michael Döring, Sergio Richter, Kyungmoo Ryu, Thomas Gaspar, Frits W Prinzen, Gerhard Hindricks, Philipp Sommer
PURPOSE: Cardiac disease frequently has a degenerative effect on cardiac pump function and regional myocardial contraction. Therefore, an accurate assessment of regional wall motion is a measure of the extent and severity of the disease. We sought to further validate an intra-operative, sensor-based technology for measuring wall motion and strain by characterizing left ventricular (LV) mechanical and electrical activation patterns in patients with normal (NSF) and impaired systolic function (ISF)...
January 31, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29380921/correlation-between-computer-tomography-derived-scar-topography-and-critical-ablation-sites-in-post-infarction-ventricular-tachycardia
#19
Michael Ghannam, Hubert Cochet, Pierre Jais, Maxime Sermesant, Smita Patel, Konstantinos C Siontis, Fred Morady, Frank Bogun
BACKGROUND: Myocardial wall thickness (WT) in patients with a prior myocardial infarction has been used to indicate scarring. However, the correlation of WT with sites critical to ventricular tachycardia (VT) has not been previously investigated. The purpose of this study was to correlate electroanatomic mapping data obtained during VT ablation with WT determined by cardiac computed tomography (CT). METHODS AND RESULTS: Cardiac CTs were performed in 15 consecutive patients (mean age 63±10 years, 86% male, left ventricular ejection fraction 27±12%) with a prior infarct referred for VT ablation...
January 30, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29380563/cd34-cell-transplantation-improves-right-ventricular-function-in-patients-with-nonischemic-dilated-cardiomyopathy
#20
Sabina Frljak, Martina Jaklic, Gregor Zemljic, Andraz Cerar, Gregor Poglajen, Bojan Vrtovec
We investigated the effects of CD34+cell therapy on right ventricular (RV) function in patients with nonischemic dilated cardiomyopathy (DCM). We enrolled 60 patients with DCM who were randomized to CD34+cell therapy (Stem Cells (SC) Group n = 30), or no cell therapy (Controls, n = 30). The SC Group received granulocyte-colony stimulating factor, and CD34+cells were collected by apheresis and injected transendocardially. Patients were followed for 6 months. At baseline, the groups did not differ in age, gender, left ventricular ejection fraction, N-terminal probrain natriuretic peptide, or parameters of RV function...
February 2018: Stem Cells Translational Medicine
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