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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
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
Mehmet Karacan, Nida Çelik, Celal Akdeniz, Volkan Tuzcu
BACKGROUND: Atrioventricular nodal reentrant tachycardia (AVNRT) is a common tachyarrhythmia substrate in children, which is successfully treated by catheter ablation using radiofrequency or cryothermal energy. In recent years, cryoablation (Cryo) using electroanatomical system guidance is more commonly preferred for use in children in order to decrease the risk of an atrioventricular block. However, there are concerns regarding the long-term efficacy of Cryo in treating AVNRT. We aimed to evaluate the feasibility, safety, and long-term efficacy of Cryo for AVNRT in children...
January 9, 2018: Pacing and Clinical Electrophysiology: PACE
Usama Boles, Enes E Gul, Andres Enriquez, Howard Lee, Dave Riegert, Adrian Andres, Adrian Baranchuk, Damian Redfearn, Benedict Glover, Chris Simpson, Hoshiar Abdollah, Kevin Michael
Background: Ablation of the pulmonary vein (PV) antrum using an electroanatomic mapping system is standard of care for point-by-point pulmonary vein isolation (PVI). Focused ablation at critical areas is more likely to achieve intra-procedural PV isolation and decrease the likelihood for reconnection and recurrence of atrial fibrillation (AF). Therefore this prospective pilot study is to investigate the short-term outcome of a voltage-guided circumferential PV ablation (CPVA) strategy...
February 2017: Journal of Atrial Fibrillation
Ping Guo, Jie Qiu, Yan Wang, Guangzhi Chen, Riccardo Proietti, Al-Selmi Fadhle, Chunxia Zhao, Dao Wen Wang
BACKGROUND: Fluoroscopy is the imaging modality routinely used for cardiac device implantation and electrophysiological procedures. Due to the rising concern regarding the harmful effects of radiation exposure to both the patients and operation staffs, novel 3D mapping systems have been developed and implemented in electrophysiological procedure for the navigation of catheters inside the heart chambers. Their applicability in cardiac device implantation has been rarely reported. Our aim is to evaluate the feasibility and safety of permanent pacemaker implantation without fluoroscopy...
February 2018: Pacing and Clinical Electrophysiology: PACE
Umberto Barbero, Carlo Budano, Pier Giorgio Golzio, Davide Castagno, Fiorenzo Gaita
Implantation of cardiac resynchronization therapy (CRT) devices can be challenging, time consuming, and associated with high-dose X-Ray exposure. We present the technique in which an electromagnetic navigation system (MediGuideTM, St. Jude Medical) and an electro-anatomical three-dimensional mapping system (EnSite NavX, St Jude Medical) are usefully combined for implanting ICD-CRT devices with strong reduction of X-ray exposure, and for targeting the most delayed regions in the activation maps avoiding scars for optimal CRT response...
October 4, 2017: Pacing and Clinical Electrophysiology: PACE
Gabriel Cismaru, Lucian Muresan, Mihai Puiu, Radu Rosu, Gabriel Gusetu, Dana Pop, Dumitru Zdrenghea
Catheter ablation of cardiac arrhythmias in pediatric population is associated with the risk of ionizing radiation on the child. Due to a greater radiation sensitivity in children and a longer life expectancy newer techniques try to reduce the radiation exposure. A new technique for zero-fluoroscopy catheter ablation is described in a 9-year-old boy who had a left-sided concealed accessory pathway. The NAVX Ensite 3D mapping system permits catheter placement inside the venous system and movement inside the heart chambers without the use of X-rays...
September 2017: Oxford Medical Case Reports
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
Masateru Takigawa, Atsushi Takahashi, Taishi Kuwahara, Kenji Okubo, Emiko Nakashima, Yuji Watari, Kazuya Yamao, Jun Nakajima, Yasuaki Tanaka, Katsumasa Takagi, Shigeki Kimura, Hiroyuki Hikita, Kenzo Hirao, Mitsuaki Isobe
BACKGROUND: The present study aimed to elucidate the safety and effectiveness of a noble and unique airway management technique in which a pediatric intubation tube is used in adult patients with atrial fibrillation (AF) undergoing catheter ablation (CA) under continuous deep sedation. METHODS: In total, 246 consecutive patients with AF (mean age, 65±10 years; 60 women) underwent CA under dexmedetomidine-based continuous deep sedation. A 4-mm pediatric intubation tube guided by a 10-French intratracheal suction tube was inserted smoothly, and the tip of the tube was located at the base of the epiglottis...
August 2017: Journal of Arrhythmia
Charitha D Reddy, Scott R Ceresnak, Kara S Motonaga, Kishor Avasarala, Christine Feller, Anthony Trela, Debra Hanisch, Anne M Dubin
BACKGROUND: Cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT) is associated with higher recurrence rates than radiofrequency ablation (RFA). Junctional tachycardia marks procedural success with RFA, but no such indicator exists for cryoablation. OBJECTIVE: The purpose of this study as to determine the impact of voltage mapping plus longer ablation lesions on midterm success of cryoablation for children with AVNRT. METHODS: We performed a single-center retrospective analysis of pediatric patients with AVNRT who underwent cryoablation from 2011 to 2015...
November 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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
Volkan Tuzcu, Enes Elvin Gul, Mehmet Karacan, Hacer Kamali, Nida Celik, Celal Akdeniz
Due to its safety profile, cryoablation (Cryo) for atrioventricular nodal reentrant tachycardia (AVNRT) is more commonly preferred over radiofrequency (RF) ablation in children in recent years. Recent studies demonstrated high long-term success rates comparable to radiofrequency ablation. The aim of this prospective study was to compare the efficacy and safety of an 8-mm-tip versus 6-mm-tip Cryo catheter in the treatment of AVNRT in children. A total of 125 consecutive patients over 10 years of age with AVNRT were included...
August 2017: Pediatric Cardiology
John Meulet, Geoffrey Trim, Ben Hunt, Kang-Teng Lim, Andrew James, Albert Henry, Wayne Pirihi, Paul Davies, Jason Brabant
BACKGROUND: We present a case report of a 67-year-old male with dextrocardia situs inversus totalis and persistent atrial fibrillation who presented for radiofrequency pulmonary vein isolation. METHODS: Pulmonary vein isolation was performed using the St Jude Medical Ensite NavX 3D mapping system with AccuNav ICE guidance. RESULTS: All pulmonary veins were successfully isolated. The procedure time was 125 mins with a fluoroscopy time of 44...
November 19, 2016: Heart, Lung & Circulation
Gabriel Ballesteros, Pablo Ramos, Renzo Neglia, Diego Menéndez, Ignacio García-Bolao
INTRODUCTION AND OBJECTIVES: Rhythmia is a new nonfluoroscopic navigation system that is able to create high-density electroanatomic maps. The aim of this study was to describe the acute outcomes of atrial fibrillation (AF) ablation guided by this system, to analyze the volume provided by its electroanatomic map, and to describe its ability to locate pulmonary vein (PV) reconnection gaps in redo procedures. METHODS: This observational study included 62 patients who underwent AF ablation with Rhythmia compared with a retrospective cohort who underwent AF ablation with a conventional nonfluoroscopic navigation system (Ensite Velocity)...
September 2017: Revista Española de Cardiología
Huan Zhang, Li Li, Xiao Li Liu, Ju Jiao, Cheng-Teng Ng, Jia Bao Yi, Yan E Luo, Boon-Huat Bay, Ling Yun Zhao, Ming Li Peng, Ning Gu, Hai Ming Fan
Large-scale synthesis of monodisperse ultrasmall metal ferrite nanoparticles as well as understanding the correlations between chemical composition and MR signal enhancement is critical for developing next-generation, ultrasensitive T1 magnetic resonance imaging (MRI) nanoprobes. Herein, taking ultrasmall MnFe2O4 nanoparticles (UMFNPs) as a model system, we report a general dynamic simultaneous thermal decomposition (DSTD) strategy for controllable synthesis of monodisperse ultrasmall metal ferrite nanoparticles with sizes smaller than 4 nm...
April 25, 2017: ACS Nano
Akihiro Masumoto, Masao Takemoto, Takahiro Mito, Atsushi Tanaka, Yuki Kawano, Hiroshi Kumeda, Honsa Kang, Atsutoshi Matsuo, Satoru Hida, Teiji Okazaki, Kei-Ichiro Tayama, Kiyonobu Yoshitake, Kenichi Kosuga
We experienced a man in his 20s with inappropriate sinus tachycardia (IST) initially diagnosed and treated as depression who was steadily treated with radiofrequency catheter ablation (RFCA) using an EnSite™ system. The patient has remained well without any symptoms or medications, including antidepressants, for two years since the RFCA. To avoid missing IST and treating it as an emotional problem and/or mental illness such as depression, physicians - including cardiologists - should be aware of these conditions when examining patients with multiple and incapacitating complaints including palpitations and general fatigue and/or tachycardia, especially characterized by an elevated resting heart rate or a disproportionate increase in the heart rate with minimal exertion...
2017: Internal Medicine
Xin Li, João L Salinet, Tiago P Almeida, Frederique J Vanheusden, Gavin S Chu, G André Ng, Fernando S Schlindwein
BACKGROUND AND OBJECTIVE: Optimal targets for persistent atrial fibrillation (persAF) ablation are still debated. Atrial regions hosting high dominant frequency (HDF) are believed to participate in the initiation and maintenance of persAF and hence are potential targets for ablation, while rotor ablation has shown promising initial results. Currently, no commercially available system offers the capability to automatically identify both these phenomena. This paper describes an integrated 3D software platform combining the mapping of both frequency spectrum and phase from atrial electrograms (AEGs) to help guide persAF ablation in clinical cardiac electrophysiological studies...
April 2017: Computer Methods and Programs in Biomedicine
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
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