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Yasuhiro Yoshiga, Akihiko Shimizu, Takeshi Ueyama, Makoto Ono, Tomoko Fumimoto, Hironori Ishiguchi, Masafumi Yano
A 79-year-old man with situs inversus and dextrocardia underwent catheter ablation of symptomatic paroxysmal atrial fibrillation. Pulmonary vein isolation (PVI), using second-generation cryoballoon under Ensite NavX system guidance, was performed successfully in a reverse manner, which required short procedure and fluoroscopy times, as required in a PVI performed on a normal heart without any complications. Cryoballoon-based PVI under Ensite NavX guidance was feasible and safe to achieve a favorable outcome in this patient with abnormal anatomy...
December 2016: Journal of Arrhythmia
Geoffrey Lee, Alex J A McLellan, Ross J Hunter, Matthew J Lovell, Malcolm Finlay, Waqas Ullah, Mehul B Dhinoja, Simon Sporton, Mark J Earley, Richard J Schilling
BACKGROUND: The relative importance of focal drivers, multiple wavelets, rotors and endocardial-epicardial circuits in the maintenance of persistent AF remains unclear. Our objective was to characterize AF wavefront (WF) dynamics during persistent AF. METHODS: The Ensite 3000 (St Jude Medical) non-contact mapping system was used to map the LA of 15 patients with persistent AF. Wavefronts were classified into planar WFs, rotors or focal WFs. For each new WF the site of origin, the unipolar electrogram, and propagation patterns were determined...
February 1, 2017: International Journal of Cardiology
Maurizio Del Greco, Massimiliano Maines, Massimiliano Marini, Andrea Colella, Massimo Zecchin, Laura Vitali-Serdoz, Alessandro Blandino, Lorella Barbonaglia, Giuseppe Allocca, Roberto Mureddu, Biondino Marenna, Paolo Rossi, Diego Vaccari, Roberto Chianca, Stefano Indiani, Irene DI Matteo, Carlo Angheben, Alessandro Zorzi
INTRODUCTION: Cardiac resynchronization therapy (CRT) device implantation guided by an electroanatomic mapping system (EAMS) is an emerging technique that may reduce fluoroscopy and angiography use and provide information on coronary sinus (CS) electrical activation. We evaluated the outcome of the EAMS-guided CRT implantation technique in a multicenter registry. METHODS: During the period 2011-2014 we enrolled 125 patients (80% males, age 74 [71-77] years) who underwent CRT implantation by using the EnSite system to create geometric models of the patient's cardiac chambers, build activation mapping of the CS, and guide leads positioning...
January 2017: Journal of Cardiovascular Electrophysiology
L Chu, J Zhang, Y N Li, D Y Long
: Objective: To investigate the risk of radiofrequency catheter ablation and maternal and infant in pregnant women with rapid arrhythmia during pregnancy. Methods: The clinical data of the 19 cases of pregnancy complicated with rapid arrhythmia were retrospectively analyzed and followed up, including the gestational week, the type of arrhythmia, the treatment, and the outcome of the mother and child in Beijing Anzhen Hospital of Capital Medical University from January 2002 to March 2016...
October 25, 2016: Zhonghua Fu Chan Ke za Zhi
Alexandre Costet, Elaine Wan, Ethan Bunting, Julien Grondin, Hasan Garan, Elisa Konofagou
Characterization and mapping of arrhythmias is currently performed through invasive insertion and manipulation of cardiac catheters. Electromechanical wave imaging (EWI) is a non-invasive ultrasound-based imaging technique, which tracks the electromechanical activation that immediately follows electrical activation. Electrical and electromechanical activations were previously found to be linearly correlated in the left ventricle, but the relationship has not yet been investigated in the three other chambers of the heart...
November 21, 2016: Physics in Medicine and Biology
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
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
Guangzhi Chen, Ge Sun, Renfan Xu, Xiaomei Chen, Li Yang, Yang Bai, Shanshan Yang, Ping Guo, Yan Zhang, Chunxia Zhao, Dao Wen Wang, Yan Wang
BACKGROUND: Cardiac arrhythmias can occur during pregnancy. Owing to radiation exposure and other uncertain risks for the mother and fetus, catheter ablation has rarely been performed and is often delayed until the postpartum period. We reported 2 pregnant women who were experiencing severe arrhythmias and were successfully ablated without fluoroscopic guidance. We also carried out a literature review of cases of pregnant women who underwent zero-fluoroscopy ablation. METHODS AND RESULTS: One woman had drug-resistant and poorly tolerated frequent premature ventricular contraction (PVC) and ventricular tachycardia (VT)...
August 2016: Medicine (Baltimore)
Hung-Yu Chang, Li-Wei Lo, Yu-Hui Chou, Wei-Lun Lin, Yenn-Jiang Lin, Shinya Yamada, Shih-Ann Chen
BACKGROUND: Both extrinsic and intrinsic cardiac autonomic nervous systems are important for initiation and maintenance of atrial fibrillation (AF). We aimed to evaluate the effect of vagotomy on the activity of cardiac autonomic ganglionated plexi (GP) and the change of dominant frequency (DF) distribution in the left atrium (LA) during AF. METHODS: A mid-sternal thoracotomy was performed in 6 dogs. High frequency stimulation was applied to locate the GPs. There were four major LA GPs, which were located near the pulmonary vein ostia, and a superior vena cava-aorta (SVC-Ao) GP that was located near the superior vena cava-right atrial junction...
October 1, 2016: International Journal of Cardiology
Fawzy Farag, Martin Koens, Marij Tijssen, Sytse de Jong, Timon Fabius, Johnny Tromp, Hendrikje van Breda, Joep Smeets, Wout Feitz, John Heesakkers
A noncontact mapping system (EnSite) was used for electroanatomical mapping of the bladder simultaneously with pressure flow study in three women with lower urinary tract symptoms. We selected the periods of obvious detrusor activity. Data were processed to remove baseline drift, and an envelope of electrovesicography (EVG) data was created. The correlation coefficient for the correlation between between the EVG envelope and the detrusor pressure (Pdet) was calculated. Bladder geometry was successfully created in all 3 patients...
June 2016: International Neurourology Journal
Ibrahim Cansaran Tanidir, Yakup Ergul, Erkut Ozturk, Fuheda Dalgic, Neslihan Kiplapinar, Hasan Tahsin Tola, Celal Akdeniz, Volkan Tuzcu
BACKGROUND: Cryoablation is increasingly utilized in children because of its safety profile. Recently, larger catheter tips have been more widely used to improve long-term success rates. The aim of this study was to assess the safety and efficacy of 8-mm-tip catheters for cryoablation of right-sided accessory pathways (APs) in children. METHODS: Electrophysiological procedures were performed using the EnSite™ system (St. Jude Medical Inc., St. Paul, MN, USA). RESULTS: Between July 2010 and July 2014, 54 patients (mean age: 13...
August 2016: Pacing and Clinical Electrophysiology: PACE
Celal Akdeniz, Enes Elvin Gul, Nida Celik, Mehmet Karacan, Volkan Tuzcu
INTRODUCTION: Definitive therapy of idiopathic right ventricular arrhythmias (VA) remains a challenge in interventional electrophysiology. The aim of this study was to evaluate the utility of EnSite Velocity system in the catheter ablation of RV tachycardia in children. METHODS: Thirty-five children with idiopathic right VA underwent catheter ablation procedure using the EnSite Velocity system guidance. RESULTS: The mean patient age was 12...
September 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Apinya Bharmanee, Srinath Gowda, Harinder R Singh
BACKGROUND: Use of nonfluoroscopic 3-dimensional electroanatomic mapping (NF-3DEAM) in patients with congenital heart defects (CHDs) is not well reported. OBJECTIVE: The purpose of this study was to evaluate the feasibility, accuracy, and safety of NF-3DEAM in patients with CHDs. METHODS: Retrospective review of electrophysiologic study (EPS) in patients with CHD from 2009 to 2013 was conducted. Patients undergoing EPS with NF-3DEAM using the EnSite NavX system (St...
August 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Andrea Colella, Marzia Giaccardi, Tommaso Colella, Pietro Amedeo Modesti
BACKGROUND: Fluoroscopic guidance is the standard tool used in device implantation. This means that both the patient and the operator are exposed to radiation, which may sometimes be high. The possibility of single-lead permanent pacemaker implantation without fluoroscopy has already been demonstrated. OBJECTIVE: The aim of our study was to investigate the feasibility and reliability of biventricular device implantation guided only by an electroanatomic navigation system...
July 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Yasuo Okumura, Ichiro Watanabe, Koichi Nagashima, Kazumasa Sonoda, Naoko Sasaki, Rikitake Kogawa, Keiko Takahashi, Kazuki Iso, Kimie Ohkubo, Toshiko Nakai, Rie Takahashi, Yoshiki Taniguchi, Masako Mitsumata, Mizuki Nikaido, Atsushi Hirayama
BACKGROUND: Because obesity is an important risk factor for atrial fibrillation (AF), we conducted an animal study to examine the effect of a high-fat diet (HFD) on atrial properties and AF inducibility. METHODS: Ten 8-week-old pigs (weight, 18-23 kg) were divided into two groups. For 18 weeks, five pigs were fed a HFD (HFD group) and five were fed a normal diet (control group). Maps of atrial activation and voltages during sinus rhythm were created for all pigs using the EnSite NavX system...
December 2015: Journal of Arrhythmia
A M W van Stipdonk, M Mafi Rad, J G L M Luermans, H J Crijns, F W Prinzen, K Vernooy
BACKGROUND: Delayed left ventricular (LV) lateral wall activation is considered the electrical substrate that characterises patients suitable for cardiac resynchronisation therapy (CRT). Although typically associated with left bundle branch block, delayed LV lateral wall activation may also be present in patients with non-specific intraventricular conduction delay (IVCD). We assessed LV lateral wall activation in a cohort of CRT candidates with IVCD using coronary venous electroanatomical mapping, and investigated whether baseline QRS characteristics on the ECG can identify delayed LV lateral wall activation in this group of patients...
January 2016: Netherlands Heart Journal
Jorge Romero, Florentino Lupercio, David Goodman-Meza, Juan Carlos Ruiz, David F Briceno, John D Fisher, Jay Gross, Kevin Ferrick, Soo Kim, Luigi Di Biase, Mario J Garcia, Andrew Krumerman
BACKGROUND: Three-dimensional electroanatomic mapping (EAM) systems reduce radiation exposure when radio frequency catheter ablation (RFCA) procedures are performed by well-trained senior operators. Given the steep learning curve associated with complex RFCA, trainees and their mentors must rely on multiple imaging modalities to maximize safety and success, which might increase procedure and fluoroscopy times. The objective of the present study is to determine if 3-D EAM (CARTO and ESI-NavX) improves procedural outcomes (fluoroscopy time, radio frequency time, procedure duration, complication, and success rates) during CA procedures as compared to fluoroscopically guided conventional mapping alone in an academic teaching hospital...
January 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Michela Casella, Antonio Dello Russo, Gemma Pelargonio, Maurizio Del Greco, Gianluca Zingarini, Marcello Piacenti, Andrea Di Cori, Victor Casula, Massimiliano Marini, Francesca Pizzamiglio, Martina Zucchetti, Stefania Riva, Eleonora Russo, Maria Lucia Narducci, Ezio Soldati, Luca Panchetti, Umberto Startari, Gianluigi Bencardino, Francesco Perna, Pasquale Santangeli, Luigi Di Biase, Fabrizio Cichocki, Giovanni Fattore, Mariagrazia Bongiorni, Eugenio Picano, Andrea Natale, Claudio Tondo
AIMS: Aim of this study was to compare a minimally fluoroscopic radiofrequency catheter ablation with conventional fluoroscopy-guided ablation for supraventricular tachycardias (SVTs) in terms of ionizing radiation exposure for patient and operator and to estimate patients' lifetime attributable risks associated with such exposure. METHODS AND RESULTS: We performed a prospective, multicentre, randomized controlled trial in six electrophysiology (EP) laboratories in Italy...
October 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
P Seizer, V Bucher, C Frische, D Heinzmann, M Gramlich, I Müller, A Henning, M Hofbeck, G Kerst, M Gawaz, J Schreieck
BACKGROUND: Conventional catheter ablation of cardiac arrhythmias is associated with radiation risks for patients and laboratory personnel. Widespread use of zero-fluoroscopic catheter ablation in clinical routine is limited by safety concerns. This study investigated the feasibility of zero-fluoroscopy catheter ablation using a three-dimensional mapping system and optional catheter contact force technology for an all-comers collective. PATIENTS AND METHODS: The study comprised 184 patients; 91 patients, including 29 pediatric patients, underwent a zero-fluoroscopic electrophysiology (EP) study using the EnSite NavX system with real-time visualization of all electrodes...
May 2016: Herz
Marzia Giaccardi, Attilio Del Rosso, Vincenzo Guarnaccia, Piercarlo Ballo, Giuseppe Mascia, Leandro Chiodi, Andrea Colella
BACKGROUND: Radiation exposure related to conventional tachyarrhythmia radiofrequency catheter ablation (RFCA) carries small but not negligible stochastic and deterministic effects on health. These effects are cumulative and potentially more harmful in younger individuals. Nonfluoroscopic mapping systems can significantly reduce the radiological exposure and in some cases it can completely eliminate it. OBJECTIVE: The aim of this study was to assess the safety, feasibility, and efficacy of a complete nonfluoroscopic approach for RFCA compared with ablation procedures performed under fluoroscopic guidance...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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