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https://www.readbyqxmd.com/read/28975636/combining-electromagnetic-navigation-and-3-d-mapping-to-reduce-fluoroscopy-time-and-achieve-optimal-crt-response
#1
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
https://www.readbyqxmd.com/read/28928979/ablation-of-a-left-sided-accessory-pathway-with-near-zero-fluoroscopy-in-a-9-year-old-boy
#2
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
https://www.readbyqxmd.com/read/28765755/airway-support-using-a-pediatric-intubation-tube-in-adult-patients-with-atrial-fibrillation-a-simple-and-unique-method-to-prevent-heart-movement-during-catheter-ablation-under-continuous-deep-sedation
#3
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
https://www.readbyqxmd.com/read/28716699/bridge-to-success-a-better-method-of-cryoablation-for-atrioventricular-nodal-reentrant-tachycardia-in-children
#4
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...
July 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28492985/catheter-ablation-of-paroxysmal-atrial-fibrillation-circumferential-pulmonary-vein-ablation-success-rates-with-and-without-exclusion-of-areas-adjacent-to-the-esophagus
#5
Klaus Kettering, Dag-Hau Yim, Alexander Benz, Felix Gramley
BACKGROUND: Catheter ablation has become the first line of therapy in patients with symptomatic, recurrent, drug-refractory paroxysmal atrial fibrillation. Circumferential pulmonary vein ablation is still the standard approach in these patients. The occurrence of an atrioesophageal fistula is a rare but life-threatening complication after such ablation procedures. This is due to the fact that the esophagus does frequently have a very close anatomical relationship to the left or right pulmonary vein ostia...
May 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28462889/radiofrequency-pulmonary-vein-isolation-in-a-patient-with-dextrocardia-with-situs-inversus-totalis
#6
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
https://www.readbyqxmd.com/read/28447159/catheter-ablation-of-persistent-atrial-fibrillation-beneficial-effect-of-a%C3%A2-short-term-adjunctive-amiodarone-therapy-on-the-long-term-outcome
#7
Klaus Kettering, Felix Gramley
BACKGROUND: Catheter ablation has become the first line therapy in patients with symptomatic, recurrent, drug-refractory atrial fibrillation. Circumferential pulmonary vein ablation is still the standard approach in these patients. However, the results are not very favorable (especially in patients with persistent atrial fibrillation). Therefore, more complex ablation strategies and the usefulness of (short-term) adjunctive antiarrhythmic drug therapy are a matter of discussion. The aim of this study was to analyze whether short-term amiodarone therapy after catheter ablation (3 months) has a positive effect on the success rates after circumferential pulmonary vein ablation in patients with persistent atrial fibrillation...
April 26, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28265215/nonfluoroscopic-imaging-as-guidance-for-radiofrequency-ablation-of-atrioventricular-nodal-reentrant-tachycardia-after-mustard-repair
#8
Jan Hluchy, Dinh Q Nguyen, Henrik Sobczak, Bodo Brandts
Most tachycardias in the pulmonary venous atrium are inaccessible by direct means and require either a retrograde approach or a transseptal approach for ablation. We present a case in which successful radiofrequency ablation of common atrioventricular nodal reentrant tachycardia was accomplished via a retrograde transaortic approach guided by nonfluoroscopic mapping with use of the NavX(™) mapping system. The patient was a 49-year-old woman who at the age of 4 years had undergone Mustard repair for complete dextrotransposition of the great arteries...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28217229/evaluation-of-the-characteristics-of-rotational-activation-at-high-dominant-frequency-and-complex-fractionated-atrial-electrogram-sites-during-atrial-fibrillation
#9
Koji Kumagai, Kentaro Minami, Daisuke Kutsuzawa, Shigeru Oshima
BACKGROUND: High-dominant frequency (DF) and continuous complex fractionated atrial electrogram (CFAE) sites as surrogates for localized sources maintaining atrial fibrillation (AF) are potential AF ablation targets. This study aimed to evaluate the characteristics of a rotational activation at high-DF and continuous CFAE sites in AF patients. METHODS: Thirty-two consecutive AF patients (5 paroxysmal and 27 non-paroxysmal) underwent ablation using the NavX system...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28217228/spatiotemporal-characteristics-of-atrial-fibrillation-electrograms-a-novel-marker-for-arrhythmia-stability-and-termination
#10
Shivshankar Thanigaimani, Anthony G Brooks, Pawel Kuklik, Darragh J Twomey, Samantha Franklin, Erik Noschka, Darius Chapman, Rajeev K Pathak, Rajiv Mahajan, Prashanthan Sanders, Dennis H Lau
BACKGROUND: Sequentially mapped complex fractionated atrial electrograms (CFAE) and dominant frequency (DF) sites have been targeted during catheter ablation for atrial fibrillation (AF). However, these strategies have yielded variable success and have not been shown to correlate consistently with AF dynamics. Here, we evaluated whether the spatiotemporal stability of CFAE and DF may be a better marker of AF sustenance and termination. METHODS: Eighteen sheep with 12 weeks of "one-kidney, one-clip" hypertension underwent open-chest studies...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28153795/relationship-between-lesion-formation-and-electrophysiological-responses-using-catheters-equipped-with-mini-electrodes-in-chronic-atrial-fibrillation
#11
Boaz Avitall, Arthur Kalinski, Piotr Horbal, Josef Koblish
BACKGROUND: The study focuses on the electrophysiological changes associated with lesion formation using 4.5-mm irrigated and 8-mm standard catheters equipped with mini-electrodes (MEs) positioned circumferentially on the tip. OBJECTIVE: The aim of the study was to test the relationship between the maximal electrogram (EGM) reduction, frequency spectrum shift, and their impact on atrial lesion formation in the atrial fibrillation (AF) model. Furthermore, we hypothesize that the high fidelity recording from the MEs allows improved discrimination of ablated tissues from nonablated tissues...
January 31, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27920836/successful-cryoballoon-pulmonary-vein-isolation-in-a-patient-with-situs-inversus-and-dextrocardia
#12
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
https://www.readbyqxmd.com/read/27862594/three-dimensional-electroanatomic-mapping-system-enhanced-cardiac-resynchronization-therapy-device-implantation-results-from-a-multicenter-registry
#13
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
https://www.readbyqxmd.com/read/27788744/-clinical-analysis-of-19-cases-of-pregnant-women-with-rapid-arrhythmia-in-the-treatment-of-radiofrequency-catheter-ablation
#14
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. Results: (1)Clinical characteristics: the ages of the 19 cases were(31±4)years old(ranged from 26 to 35 years old), the onset gestational ages were(21±4)weeks(ranged from 15 to 32 weeks)...
October 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27738070/mapping-guided-characterization-of-mechanical-and-electrical-activation-patterns-in-patients-with-normal-systolic-function-using-a-sensor-based-tracking-technology
#15
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 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27686550/-comparison-of-radiofrequency-catheter-ablation-for-paroxysmal-supraventricular-tachycardia-guided-by-three-dimensional-navigation-with-x-ray
#16
COMPARATIVE STUDY
L Y Qian, H Zou, X D Che, L H Wang, X X Cen, Q Xu, B M Qu
Objective: To compare the therapeutic efficiency and safety of radiofrequency catheter ablation (RFCA) for paroxysmal ventricular tachycardia (PSVT) guided by three-dimensional navigation with X-ray. Methods: One hundred and seventy-six patients with PSVT hospitalized in Department of Cardiology, Zhejiang Provincial People's Hospital between January 2013 and December 2014 were enrolled in this study. RFCA was performed on 95 patients (Group A) guided by the three dimensional electric-field navigation system (NavX) and the procedures were done with the spatial localization method, unless X-ray was needed in some cases...
September 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27512864/zero-fluoroscopy-catheter-ablation-of-severe-drug-resistant-arrhythmia-guided-by-ensite-navx-system-during-pregnancy-two-case-reports-and-literature-review
#17
REVIEW
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)
https://www.readbyqxmd.com/read/27491316/fluoroless-catheter-ablation-of-various-right-and-left-sided-supra-ventricular-tachycardias-in-children-and-adolescents
#18
Matevž Jan, David Žižek, Katja Rupar, Uroš Mazić, Dimitrij Kuhelj, Nikola Lakič, Borut Geršak
Electrophysiology study (EPS) and catheter ablation (CA) in children and adolescents carries a potentially harmful effect of radiation exposure when performed with the use of fluoroscopy. Our aim was to evaluate the feasibility, safety and effectiveness of fluoroless EPS and CA of various supra-ventricular tachycardias (SVTs) with the use of the 3D mapping system and intracardiac echocardiography (ICE). Forty-three consecutive children and adolescents (age 13 ± 3 years) underwent fluoroless EPS and CA for various supra-ventricular tachycardias...
November 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27196746/transient-elimination-of-posterior-right-ventricular-outflow-tract-ectopy-by-sternal-pressure
#19
Marcus Wieczorek, Reinhard Hoeltgen
BACKGROUND: Ventricular ectopy (VE) originating in the right ventricular outflow tract (RVOT) is a common arrhythmia. Mechanisms triggering or eliminating VE from RVOT are not entirely understood. METHODS AND RESULTS: A patient with frequent, symptomatic VE underwent an electrophysiologic study: VE origin was mapped by NavX 3D navigation (St. Jude Medical, Inc., St. Paul, MN, USA). Incidental pressure applied manually to the sternum reproducibly eliminated VE for the time of exposure...
October 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27108940/feasibility-accuracy-%C3%A2-and-safety-of-3-dimensional-electroanatomic-mapping-without-fluoroscopy-in-patients-with-congenital-heart-defects
#20
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
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