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Margaux Alazard, Jérôme Lacotte, Jérôme Horvilleur, Mina Ait-Said, Fiorella Salerno, Vladimir Manenti, Jean-François Piechaud, Jérôme Garot, Damien Bonnet, Alice Maltret
PURPOSE: To evaluate various strategies in order to minimize the risk of coronary injury during posteroseptal accessory pathways ablation in children. METHODS: We retrospectively reviewed 68 posteroseptal accessory pathways ablation procedures (20 decremental and 48 typical accessory pathways) performed in 62 pediatric patients at our institution between July 2009 and December 2016. Only posteroseptal accessory pathways targeted near or within the coronary sinus were included and ablation was mostly performed using irrigated tip radiofrequency...
March 12, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Gianmarco Lombardi, Anna Rita Sorbo, Gianluigi Guida, Lara La Brocca, Riccardo Fenici, Donatella Brisinda
Ventricular arrhythmias (VAs) with left bundle-branch-block and inferior axis morphology (LBBB-IA), suggestive of outflow tract (OT) origin, are a challenge in sports medicine because they can be benign or expression of a silent cardiomyopathy. Non-invasive classification is essential to plan ablation strategy if required. We aimed to evaluating magnetocardiographic (MCG) discrimination of OT-VAs site of origin (SoO). MCG and ECG data of 26 sports activity practitioners, with OT-VAs were analyzed. OT-VAs-SoO was classified with discriminant analysis (DA) of 8 MCG parameters and with invasively-validated ECG algorithms...
February 16, 2018: Journal of Electrocardiology
David J Kim, Michael D Darcy, Naganathan B Mani, Auh Whan Park, Olaguoke Akinwande, Raja S Ramaswamy, Seung Kwon Kim
Gastric varices in the setting of portal hypertension occur less frequently than esophageal varices but occur at lower portal pressures and are associated with more massive bleeding events and higher mortality rate. Balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices has been well documented as an effective therapy for portal hypertensive gastric varices. However, BRTO requires lengthy, higher-level post-procedural monitoring and can have complications related to balloon rupture and adverse effects of sclerosing agents...
February 7, 2018: Cardiovascular and Interventional Radiology
Vishal Luther, Norman Qureshi, Phang Boon Lim, Michael Koa-Wing, Shahnaz Jamil-Copley, Fu Siong Ng, Zachary Whinnett, D Wyn Davies, Nicholas S Peters, Prapa Kanagaratnam, Nick Linton
BACKGROUND: Post ablation reentrant ATs depend upon conducting isthmuses bordered by scar. Bipolar voltage maps highlight scar as sites of low voltage, but the voltage amplitude of an electrogram depends upon the myocardial activation sequence. Furthermore, a voltage threshold that defines atrial scar is unknown. We used Ripple Mapping (RM) to test whether these isthmuses were anatomically fixed between different activation vectors and atrial rates. METHODS: We studied post-AF ablation ATs where > 1 rhythm was mapped...
January 17, 2018: Journal of Cardiovascular Electrophysiology
Mattias Duytschaever, Mark O'Neill, Martin Martinek
To improve the single-procedural success and long-term outcomes of catheter ablation techniques for AF, there is a need for durable, contiguous and transmural lesions encircling the pulmonary veins (PV). Measurement of contact force (CF) between the catheter tip and the target tissue can optimise ablation procedures. A new approach to obtain single-procedure durable PV isolation (PVI) using the latest CF technology combined with the CARTO VISITAG™ Module with Ablation Index (Biosense Webster) has been shown in small studies to almost eliminate recurrence of paroxysmal AF at 1-year follow up and to make PVI procedures more reproducible...
December 2017: Arrhythmia & Electrophysiology Review
Yoshihide Takahashi, Syu Yamashita, Masahito Suzuki, Kento Yabe, Kenzo Hirao
INTRODUCTION: Recent studies suggest that atrial fibrillation (AF) is maintained by electrical activity arising from focal sources. We sought to test whether catheter ablation that targets focal sources can improve on current ablation protocols for persistent AF. METHODS AND RESULTS: In patients with persistent AF whose AF did not terminate with pulmonary vein (PV) isolation, the left atrium was mapped with a 20-pole high-density mapping catheter using CARTO® 3 navigation...
January 9, 2018: Journal of Cardiovascular Electrophysiology
Emily N Guhl, Evan Adelstein, Andrew Voigt, Norman C Wang, Samir Saba, Sandeep K Jain
PURPOSE: The use of 3D mapping during cryoballoon pulmonary vein isolation (PVI) is optional with added cost but potential benefit in aiding vein identification, reducing fluoroscopy, and post-ablation testing. Data are limited evaluating procedural characteristics and outcomes in patients undergoing cryoballoon PVI with mapping vs. no mapping. In the present study, we compare procedural characteristics and recurrence-free rates in patients undergoing cryoballoon PVI among patients using CARTO®, NavX™, or no mapping system...
January 5, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Onur Kaypakli, Hasan Koca, Durmus Yıldıray Sahin, Fadime Karataş, Suleyman Ozbicer, Mevlüt Koç
AIM: The correct estimation of the VA origin as RVOT or LVOT results in reduced ablation duration reduced radiation exposure and decreased number of vascular access. In our study, we aimed to detect the predictive value of S-R difference in V1-V2 for differentiating the left from right ventricular outflow tract arrhythmias. METHODS: We included 123 patients with symptomatic frequent premature ventricular outflow tract contractions who underwent successful catheter ablation (70 male, 53 female; mean age 46...
December 10, 2017: Annals of Noninvasive Electrocardiology
Y Tian, S Zhou, Y H Yin, Y X Zheng, R P Wang, X Q Liu, Z Q Liu, Q F Liu, W Liu, J Pang, Z Jiang, L H Tian, J Huang, L Yang
Objective: To compare the value of two 3D imaging reconstruction methods for left atria and pulmonary vein on guiding the catheter ablation for atrial fibrillation (AF). Methods: From January 2014 to January 2017, a total of 100 drug refractory paroxysmal AF patients were divided into left atria direct angiography group (n=50), and indirect angiography group (n=50). 3D CARTO system was applied for mapping and guiding the ablation procedure. Patients assigned to direct angiography group were treated as follows: intraoperative puncture of atrial septum, inject contrast agent directly into the left atrium, conduct left atrial and pulmonary venous rotation angiography, reconstruct three-dimensional image, integrate the image into real-time X-ray system to facilitate circumferential pulmonary vein isolation...
November 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
G A Zheng, C Y Lin, L Weng, J D Chen
Objective: To investigate the association between the left atrial appendage (LAA) volume and atrial fibrillation (AF) recurrence after radiofrequency catheter ablation. Methods: We prospectively enrolled sixty-two patients with AF (40 cases with paroxysmal AF, 22 cases with persistent AF) who successfully underwent a first AF catheter ablation and had performed contrast-enhanced cardiac computed tomography (CT) prior to the procedure to measure LAA volumes in our hospital from January 2012 to August 2015. Circumferential pulmonary vein isolation was performed under the guidance of three-dimension mapping system (CARTO system)...
November 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
Antonio Scarà, Luigi Sciarra, Ermenegildo De Ruvo, Alessio Borrelli, Domenico Grieco, Zefferino Palamà, Paolo Golia, Lucia De Luca, Marco Rebecchi, Leonardo Calò
BACKGROUND: The Amigo(®) Remote Catheter System is a relatively new robotic system for catheter navigation. This study compared feasibility and safety using Amigo (RCM) versus manual catheter manipulation (MCM) to treat paroxysmal atrial fibrillation (PAF). Contact force (CF) and force-time integral (FTI) values obtained during pulmonary vein isolation (PVI) ablation were compared. METHODS: Forty patients were randomly selected for either RCM (20) or MCM (20). All were studied with the Thermocool(®) SmartTouch(®) force-sensing catheter (STc)...
November 1, 2017: Indian Pacing and Electrophysiology Journal
R Wang, N Zhang, R H Wang, J Gao, Z Q Zhao, Y P Jia, M Sun
Objective: To explore the advantage of radiofrequency catheter ablation under the three-dimensional mapping in the treatment of atrioventricular nodal reentrant tachycardia (AVNRT) in reducing the X-ray exposure dose of interventional doctors. Methods: 79 patients with AVNRT, in the first hospital of Shanxi Medical University from January 2015 to June 2016, performed to do radiofrequency catheter ablation treatment were selected, and according to the random number method were divided into two-dimensional mapping group and three-dimensional mapping group...
August 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
Jan De Pooter, Milad El Haddad, Michael Wolf, Thomas Phlips, Frederic van Heuverswyn, Liesbeth Timmers, René Tavernier, Sebastien Knecht, Yves Vandekerckhove, Mattias Duytschaever
BACKGROUND: High-density automated mapping of regular atrial tachycardias (AT) requires accurate assessment of local activation times (LAT). OBJECTIVE: To evaluate high density mapping of ATs and compare the accuracy of different automated LAT annotation algorithms. METHODS: Fifteen patients underwent AT ablation guided by the automated ConfiDENSEۛ high-density mapping module (Carto 3 v4) allowing manual reannotation (edited maps). For each AT, unedited automated maps were re-constructed offline by three algorithms: maximum unipolar slope (LATSlope ), bipolar peak (LATPeak ) and a new hybrid annotation algorithm (LATHybrid )...
October 23, 2017: Journal of Cardiovascular Electrophysiology
Artur Baszko, Mateusz Klaczynski, Piotr Kalmucki, Wojciech Telec, Andrzej Szyszka
No abstract text is available yet for this article.
August 4, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Larry A Chinitz, Daniel P Melby, Francis E Marchlinski, Craig Delaughter, Robert S Fishel, George Monir, Anshul M Patel, Douglas N Gibson, Charles A Athill, Lee Ming Boo, Robert Stagg, Andrea Natale
Aims: THERMOCOOL SMARTTOUCH® SF Catheter is a new contact-force (CF)-sensing catheter with 56-hole porous tip designed for improved cooling and reduced fluid delivery compared with a standard 6-hole open-irrigated catheter. The SMART SF study examined the periprocedural safety, acute effectiveness, and procedural efficiency of the catheter for drug-refractory symptomatic paroxysmal atrial fibrillation (PAF) ablation. Methods and results: The prospective, open-label, non-randomized SMART-SF was conducted at 17 US sites...
August 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Long Yu, Qi Jin, Zhaoye Zhou, Liqun Wu, Bin He
OBJECTIVE: Noninvasive imaging of cardiac electrical activity promises to provide important information regarding the underlying arrhythmic substrates for successful ablation intervention and further understanding of the mechanism of such lethal disease. The aim of this study is to evaluate the performance of a novel three-dimensional (3D) cardiac activation imaging technique to noninvasively localize and image origins of focal ventricular arrhythmias in patients undergoing radio frequency ablation...
October 2, 2017: IEEE Transactions on Bio-medical Engineering
Changjian Lin, Steen Pehrson, Peter Karl Jacobsen, Xu Chen
BACKGROUND: There have been advancements of sophisticated mapping systems used for ablation procedures over the last decade. Utilization of these novel mapping systems in combination with remote magnetic navigation (RMN) needs to be established. We investigated the new EnSite Precision mapping system (St. Jude Medical, Inc., St. Paul, MN, USA), which collects magnetic data for checking navigation field stability and is built on an open platform, allowing physicians to choose diagnostic and ablation catheters...
December 2017: Journal of Cardiovascular Electrophysiology
Jeffrey P Moak, Kohei Sumihara, Jonathan Swink, Sridhar Hanumanthaiah, Charles I Berul
BACKGROUND: Ablation of cardiac arrhythmias in children and teenagers often necessitates the use of anesthesia, which can suppress ventricular arrhythmias (VAs), making it difficult to map the site of origin using activation time (AT). Pace mapping, a technique employed to assist with VA origin localization, depends on subjective comparison of paced and targeted QRS morphology. We assessed the utility of a quantitative approach to paced QRS to VA morphology matching using the PaSo software (Carto 3, Biosense Webster), to localize the VA site of origin...
August 28, 2017: Pacing and Clinical Electrophysiology: PACE
Vishal Luther, Nuno Cortez-Dias, Luís Carpinteiro, João de Sousa, Richard Balasubramaniam, Sharad Agarwal, David Farwell, Mark Sopher, Girish Babu, Richard Till, Nikki Jones, Stuart Tan, Anthony Chow, Martin Lowe, Jem Lane, Naveen Pappachan, Nicholas Linton, Prapa Kanagaratnam
BACKGROUND: Ripple mapping (RM) displays electrograms as moving bars over a three-dimensional surface displaying bipolar voltage, and has shown in a single-center series to be effective for atrial tachycardia (AT) mapping without annotation of local activation time or window-of-interest assignment. We tested the reproducibility of these findings in operators naïve to RM, using it for the first time in postablation AT. METHODS: Maps were collected with multielectrode catheters and CARTO ConfiDENSE...
November 2017: Journal of Cardiovascular Electrophysiology
Klaus Kettering, Felix Gramley, Stephan von Bardeleben
AIM: To evaluate the long-term outcome of catheter ablation of atrial fibrillation (AF) facilitated by preprocedural three-dimensional (3-D) transesophageal echocardiography. METHODS: In 50 patients, 3D transesophageal echocardiography (3D TEE) was performed immediately prior to an ablation procedure (paroxysmal AF: 30 patients, persistent AF: 20 patients). The images were available throughout the ablation procedure. Two different ablation strategies were used. In most of the patients with paroxysmal AF, the cryoablation technique was used (Arctic Front Balloon, CryoCath Technologies/Medtronic; group A2)...
June 26, 2017: World Journal of Cardiology
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