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Tomos E Walters, Jonathan M Kalman, Sheila K Patel, Megan Mearns, Elena Velkoska, Louise M Burrell
AIM: Angiotensin converting enzyme 2 (ACE2) is an integral membrane protein whose main action is to degrade angiotensin II. Plasma ACE2 activity is increased in various cardiovascular diseases. We aimed to determine the relationship between plasma ACE2 activity and human atrial fibrillation (AF), and in particular its relationship to left atrial (LA) structural remodelling. METHODS AND RESULTS: One hundred and three participants from a tertiary arrhythmia centre, including 58 with paroxysmal AF (PAF), 20 with persistent AF (PersAF), and 25 controls, underwent clinical evaluation, echocardiographic analysis, and measurement of plasma ACE2 activity...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Christopher Piorkowski, Ole-A Breithardt, Hedi Razavi, Yelena Nabutovsky, Stuart P Rosenberg, Craig D Markovitz, Arash Arya, Sascha Rolf, Silke John, Jedrzej Kosiuk, Eric Olson, Charlotte Eitel, Yan Huo, Michael Döring, Sergio Richter, Kyungmoo Ryu, Thomas Gaspar, Frits W Prinzen, Gerhard Hindricks, Philipp Sommer
AIMS: In times of evolving cardiac resynchronization therapy, intra-procedural characterization of left ventricular (LV) mechanical activation patterns is desired but technically challenging with currently available technologies. In patients with normal systolic function, we evaluated the feasibility of characterizing LV wall motion using a novel sensor-based, real-time tracking technology. METHODS AND RESULTS: Ten patients underwent simultaneous motion and electrical mapping of the LV endocardium during sinus rhythm using electroanatomical mapping and navigational systems (EnSite™ NavX™ and MediGuide™, SJM)...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Martin Huemer, Daniel Qaiyumi, Philipp Attanasio, Abdul Parwani, Burkert Pieske, Florian Blaschke, Leif-Hendrik Boldt, Wilhelm Haverkamp, Alexander Wutzler
AIMS: In persistent atrial fibrillation (AF), left atrial low-voltage areas and complex fractionated atrial electrograms (CFAEs) have been thoroughly discussed as critical substrate points for AF perpetuation. Thus, in patients undergoing pulmonary vein isolation, these sites are often considered additional ablation targets. Currently, mapping techniques for these substrate indicators are still under discussion. The aim of this study was to evaluate the impact of different mapping catheters on the detection of low-voltage areas and CFAE...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Giuseppe Stabile, Matteo Anselmino, Ezio Soldati, Ermengildo De Ruvo, Francesco Solimene, Assunta Iuliano, Luigi Sciarra, Maria Grazia Bongiorni, Leonardo Calò, Fiorenzo Gaita
PURPOSE: Left atrial volume (LA) and pulmonary vein (PV) anatomy may potentially relate to technical challenges in achieving stable and effective catheter position in case of atrial fibrillation (AF) ablation by means of "one-shot" catheters. The aim of this study was to investigate whether LA volume and PV anatomy, evaluated by computed tomography (CT) or magnetic resonance (MR) prior to ablation, predict acute and midterm outcome of AF ablation by nMARQ™. METHODS: We included 75 patients (mean age 58 ± 11 years, 67 % male) with symptomatic paroxysmal AF...
October 6, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Steven E Williams, Nick W F Linton, Steven Niederer, Mark D O'Neill
AIMS: Complex ablation procedures are supported by accurate representation of an increasing variety of electrophysiological and imaging data within electroanatomic mapping systems (EMS). This study aims to develop a novel method for representing multiple complementary datasets on a single cardiac chamber model. Validation of the system and its application to both atrial and ventricular arrhythmias is examined. METHODS AND RESULTS: Dot mapping was conceived to display multiple datasets by utilizing quantitative surface shading to represent one dataset and finely spaced dots to represent others...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Aldo Bonso, Mauro Fantinel, Giovanna Scalchi, Sabrina Ferrara, Stefano Indiani, Federico Calore, Claudia Licciardello
AIMS: The effectiveness of atrial fibrillation (AF) ablation relies on detailed knowledge of the anatomy of the left atrium (LA) and pulmonary veins (PVs). It is common to combine computed tomography/magnetic resonance (CT/MR) with imaging by electroanatomical (EA) mapping systems. The aim of this study was to evaluate the accuracy of LA anatomical reconstruction by 'One Model' and 'VeriSense' tools (Ensite Velocity 3.0, St Jude Medical), compared with CT/MR imaging. METHODS AND RESULTS: Seventy-two patients with AF underwent pre-procedural imaging (97% CT-scan, 3% MR imaging) and transcatheter ablation of PVs...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Yuichi Hori, Shiro Nakahara, Naofumi Anjo, Ayako Nakagawa, Naoki Nishiyama, Kouta Yamada, Akiko Hayashi, Takaaki Komatsu, Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi
PURPOSE: The atrial conduction time measured by echocardiography using tissue Doppler imaging (TDI) has been reported as a predictive factor of left atrial (LA) remodeling. We investigated the P wave to LA appendage (LAA) conduction time defined by transthoracic echocardiography using TDI (P-LAA TDI), and directly compared the actual LA electrical conduction time determined by the electrophysiological data. Additionally, we confirmed the clinical utility of the P-LAA TDI by examining the relationship to the electroanatomical LA remodeling data...
September 22, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Mrinal Yadava, Michael D Shapiro
Imaging modalities such as computed tomography, magnetic resonance, positron emission tomography, and single-photon emission computed tomography are an indispensable component of cardiac arrhythmia management. Over the last two decades, developments in imaging techniques have facilitated safer and more effective cardiac ablation and device implantation procedures. Pre-procedural assessment of arrhythmogenic substrate and integration with electroanatomic data has significantly impacted the management of atrial fibrillation and ventricular tachycardia...
November 2016: Current Treatment Options in Cardiovascular Medicine
Nicholas McKeag, Jonathan Dalzell, Benjamin Szwejkowski, Allan McPhaden, Derek Connelly, Gary Wright, Roy Gardner
No abstract text is available yet for this article.
September 1, 2016: QJM: Monthly Journal of the Association of Physicians
Charlotte Brouwer, Mark G Hazekamp, Katja Zeppenfeld
Advances in surgical repair techniques for various types of congenital heart disease have improved survival into adulthood over the past decades, thus exposing these patients to a high risk of atrial and ventricular arrhythmias later in life. These arrhythmias arise from complex arrhythmogenic substrates. Substrate formation may depend on both pathological myocardial remodelling and variable anatomical boundaries, determined by the type and timing of prior corrective surgery. Accordingly, arrhythmogenic substrates after repair have changed as a result of evolving surgical techniques...
August 2016: Arrhythmia & Electrophysiology Review
José Amado, Nuno Marques, Rui Candeias, Paula Gago, Ilídio de Jesus
The authors present the case of a 34-year-old male patient seen in our department due to palpitations. On the electrocardiogram monomorphic ventricular tachycardia (VT) was documented, treated successfully with amiodarone. The subsequent study revealed a normal echocardiogram and an apical aneurysm of the left ventricle on magnetic resonance imaging, confirmed by computed tomography coronary angiography that also excluded coronary disease. He underwent an electrophysiological study to determine the origin of the VT and to perform catheter ablation using electroanatomical mapping...
October 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
David S Frankel, Roderick Tung, Pasquale Santangeli, Wendy S Tzou, Marmar Vaseghi, Luigi Di Biase, Koichi Nagashima, Usha Tedrow, T Jared Bunch, Venkatakrishna N Tholakanahalli, Raghuveer Dendi, Madhu Reddy, Dhanunjaya Lakkireddy, Timm Dickfeld, J Peter Weiss, Nilesh Mathuria, Pasquale Vergara, Mehul Patel, Shiro Nakahara, Kairav Vakil, William H Sauer, David J Callans, Andrea Natale, William G Stevenson, Paolo Della Bella, Kalyanam Shivkumar, Francis E Marchlinski
Importance: Significant differences have been described between women and men regarding presentation, mechanism, and treatment outcome of certain arrhythmias. Previous studies of ventricular tachycardia (VT) ablation have not included sufficient women for meaningful comparison. Objective: To compare outcomes between women and men with structural heart disease undergoing VT ablation. Design, Setting, and Participants: Investigator-initiated, multicenter, observational study performed between 2002 and 2013, conducted by the International VT Ablation Center Collaborative Group, consisting of 12 high-volume ablation centers...
August 24, 2016: JAMA Cardiology
Gregor Zemljic, Gregor Poglajen, Matjaz Sever, Marko Cukjati, Sabina Frljak, Vesna Androcec, Peter Cernelc, François Haddad, Bojan Vrtovec
BACKGROUND: We investigated a correlation between electromechanical properties of the myocardium and response to CD34+ cell therapy in patients with chronic heart failure. METHODS AND RESULTS: We enrolled 40 patients with ischemic cardiomyopathy (ICM) and 40 with non-ischemic dilated cardiomyopathy (DCM). All patients were NYHA class III and had LVEF<40%. CD34+ cells were mobilized by G-CSF and collected via apheresis. Electroanatomical mapping was performed to define areas of myocardial scar and hibernation and CD34+ cells were injected transendocardially in the hibernating areas...
August 11, 2016: Journal of Cardiac Failure
Christopher F Liu, Jim W Cheung, James E Ip, George Thomas, Hua Yang, Sandeep Sharma, Steven M Markowitz, Bruce B Lerman
BACKGROUND: No existing criteria unequivocally differentiate focal atrial tachycardia (AT) caused by microreentry, triggered activity, or enhanced automaticity. Although macroreentrant AT is readily diagnosed based on entrainment criteria, the smaller circuit dimension associated with microreentrant AT makes it challenging to validate the presence of reset with fusion. An algorithm was, therefore, developed that is independent of entrainment but which reliably identifies specific mechanisms of focal AT...
August 2016: Circulation. Arrhythmia and Electrophysiology
Moshe Rav-Acha, Chee Yuan Ng, E Kevin Heist, Guy Rozen, Fadi Chalhoub, William J Kostis, Jeremy Ruskin, Moussa Mansour
INTRODUCTION: The treatment of atrial tachycardia (AT) occurring after ablation for atrial fibrillation (AF) is challenging. The most common ablation strategy relies on entrainment, and electroanatomic activation mapping (EAM) using a conventional window of interest (WOI), centered on the easily detectable atrial signal on the coronary sinus catheter. We describe a novel EAM annotation technique that uses a WOI starting 40 ms prior to the P wave in order to detect the reentrant AT exit site...
August 10, 2016: Journal of Cardiovascular Electrophysiology
Fabrizio Drago, Vincenzo Pazzano, Corrado Di Mambro, Mario Salvatore Russo, Rosalinda Palmieri, Massimo Stefano Silvetti, Salvatore Giannico, Benedetta Leonardi, Antonio Amodeo, Vincenzo Maria Di Ciommo
BACKGROUND: The post-surgical history of repaired congenital heart disease (rCHD), in particular tetralogy of Fallot (TOF), is often complicated by sudden death. Electrical myocardial abnormalities could be a substrate for malignant ventricular arrhythmias. METHODS AND RESULTS: 146 patients with TOF or other rCHD involving a subpulmonary right ventricle, considered to be at high arrhythmic risk, underwent right ventricular (RV) electroanatomic voltage mapping (EVM)...
November 1, 2016: International Journal of Cardiology
Naofumi Anjo, Shiro Nakahara, Yasuo Okumura, Yuichi Hori, Koichi Nagashima, Takaaki Komatsu, Akiko Hayashi, Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi
BACKGROUND: A high catheter tip-tissue contact force (CF) with the myocardium may cause 3-dimensional (3D) map distortion, however, the influence of external structures surrounding the left atrium (LA) on that distortion remains unknown. This study characterized the impact of high CF mapping on the local LA geometry distortion. METHODS: Thirty AF patients underwent 3D-ultrasound merged with CT images (3D-Merge-CT). The LA area in contact with external structures was identified by enhanced CT...
November 1, 2016: International Journal of Cardiology
Riccardo Proietti, Santiago Rivera, Charles Dussault, Vidal Essebag, Martin L Bernier, Felix Ayala-Paredes, Mariano Badra-Verdu, Jean-François Roux
AIMS: Ventricular arrhythmias (VA) originating from a papillary muscle (PM) have recently been described as a distinct clinical entity with peculiar features that make its treatment with catheter ablation challenging. Here, we report our experience using an intracardiac echo-facilitated 3D electroanatomical mapping approach in a case series of patients undergoing ablation for PM VA. METHODS AND RESULTS: Sixteen patients who underwent catheter ablation for ventricular tachycardia (VT) or symptomatic premature ventricular contractions originating from left ventricular PMs were included in the study...
August 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Pei Zhang, Roderick Tung, Zuwen Zhang, Xia Sheng, Qiang Liu, Ruhong Jiang, Yaxun Sun, Shiquan Chen, Lu Yu, Yang Ye, Guosheng Fu, Kalyanam Shivkumar, Chenyang Jiang
BACKGROUND: Catheter ablation in the right ventricular outflow tract (RVOT) may modify the electrophysiologic substrate for recurrent ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with Brugada syndrome (BrS). OBJECTIVE: The purpose of this study was to investigate the mechanism and arrhythmogenic substrate of VT/VF and to evaluate the long-term outcomes of catheter ablation in patients with BrS. METHODS: Eleven consecutive patients with BrS referred to 2 academic medical centers underwent combined epicardial-endocardial electroanatomic mapping...
July 22, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Alessia Gimelli, Francesca Menichetti, Ezio Soldati, Riccardo Liga, Andrea Vannozzi, Paolo Marzullo, Maria Grazia Bongiorni
PURPOSE: To assess the relationship between regional myocardial perfusion and sympathetic innervation parameters at myocardial scintigraphy and intra-cavitary electrophysiological data in patients with ventricular arrhythmias (VA) submitted to invasive electrophysiological study and ablation procedure. METHODS: Sixteen subjects underwent invasive electrophysiological study with electroanatomical mapping (EAM) followed by trans-catheter ablations of VA. Before ablation all patients were studied with a combined evaluation of regional myocardial perfusion and sympathetic innervation by means of tomographic (99m)Tc-tetrofosmin and (123)I- metaiodobenzylguanidine cadmium-zinc-telluride (CZT) scintigraphies, respectively...
July 19, 2016: European Journal of Nuclear Medicine and Molecular Imaging
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