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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
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]
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)
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
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. CASE REPORT: A patient with frequent, symptomatic VE underwent an electrophysiologic study: VE origin was mapped by NavX 3D navigation. Incidental pressure applied manually to the sternum reproducibly eliminated VE for the time of exposure. RF-Ablation was successfully performed in the posterior RVOT...
May 16, 2016: Pacing and Clinical Electrophysiology: PACE
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
Kristina Wasmer, Dirk G Dechering, Julia Köbe, Gerold Mönnig, Christian Pott, Gerrit Frommeyer, Philipp S Lange, Simon Kochhäuser, Lars Eckardt
BACKGROUND: Assumption of different substrates is the basis for different ablation strategies in patients with paroxysmal and persistent atrial fibrillation (AF). We aimed to investigate pulmonary vein reconnection and influence on progression of initial paroxysmal (pAF) versus persistent atrial fibrillation (perAF). METHODS: Between January 2010 and November 2012, 149 patients (117 men, mean age 59 ± 11 years, range 27-80 years) underwent at least one redo antral pulmonary vein isolation (PVI) using NavX-guided irrigated-tip radiofrequency catheter ablation...
September 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Tiago P Almeida, Gavin S Chu, João L Salinet, Frederique J Vanheusden, Xin Li, Jiun H Tuan, Peter J Stafford, G André Ng, Fernando S Schlindwein
Ablation of persistent atrial fibrillation (persAF) targeting complex fractionated atrial electrograms (CFAEs) detected by automated algorithms has produced conflicting outcomes in previous electrophysiological studies. We hypothesize that the differences in these algorithms could lead to discordant CFAE classifications by the available mapping systems, giving rise to potential disparities in CFAE-guided ablation. This study reports the results of a head-to-head comparison of CFAE detection performed by NavX (St...
February 25, 2016: Medical & Biological Engineering & Computing
Bernard Abi-Saleh, Hadi Skouri, Daniel J Cantillon, Jeffery Fowler, Oussama Wazni, Patrick Tchou, Walid Saliba
BACKGROUND: Left atrial flutter following atrial fibrillation (AF) ablation is increasingly common and difficult to treat. We evaluated the safety and efficacy of ablation of the anteroseptal line connecting the right superior pulmonary vein (RSPV) to the anteroseptal mitral annulus (MA) for the treatment of perimitral flutter (PMF). METHODS: We systematically studied patients who were previously treated with AF ablation and who presented to the electrophysiology laboratory with atrial tachyarrhythmias between January 2000 and July 2010...
December 2015: Journal of Arrhythmia
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...
November 10, 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Kunihiko Kiuchi, Akihiro Yoshida, Asumi Takei, Koji Fukuzawa, Mitsuaki Itoh, Kimitake Imamura, Ryudo Fujiwara, Atsushi Suzuki, Tomoyuki Nakanishi, Soichiro Yamashita, Ken-Ichi Hirata, Gaku Kanda, Katsunori Okajima, Akira Shimane, Shinichiro Yamada, Yasuyo Taniguchi, Yoshinori Yasaka, Hiroya Kawai
BACKGROUND: Catheter ablation (CA) is an established therapy for atrial fibrillation (AF). However, the assessment of anatomical information and predictors of AF recurrence remain unclear. We investigated the relationship between anatomical information on the left atrium (LA) and pulmonary veins (PVs) from three-dimensional computed tomography images and the recurrence of AF after CA. METHODS: Sixty-seven consecutive AF patients (mean age: 62±10 years, median AF history: 42 (12; 60) months, mean LA size: 41±7 mm, paroxysmal: 56%) underwent CA and were followed for 19±10 months...
October 2015: Journal of Arrhythmia
Jana-K Dieks, Matthias J Müller, Heike E Schneider, Ulrich Krause, Michael Steinmetz, Thomas Paul, Thomas Kriebel
Experience of catheter ablation of pediatric focal atrial tachycardia (FAT) is still limited. There are data which were gathered prior to the introduction of modern 3D mapping and navigation systems into the clinical routine. Accordingly, procedures were associated with significant fluoroscopy and low success rates. The aim of this study was to present clinical and electrophysiological details of catheter ablation of pediatric FAT using modern mapping systems. Since March 2003, 17 consecutive patients <20 years underwent electrophysiological study (EPS) for FAT using the NavX(®) system (n = 7), the non-contact mapping system (n = 6) or the LocaLisa(®) system (n = 4), respectively...
March 2016: Pediatric Cardiology
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
Kenji Okubo, Taishi Kuwahara, Katsumasa Takagi, Masateru Takigawa, Jun Nakajima, Yuji Watari, Emiko Nakashima, Kazuya Yamao, Tadashi Fujino, Hiroyuki Tsutsui, Atsushi Takahashi
INTRODUCTION: The mapping of atrial tachycardia (AT) can often be challenging and time-consuming, especially in patients with ATs that develop following cardiac surgery or are concomitant with atrial fibrillation. Recently, a new multielectrode basket catheter (MBC) has become available; we hypothesized that the MBC could be utilized to diagnose AT circuits. METHODS AND RESULTS: This study included 51 consecutive patients undergoing catheter ablation of clinically documented right-sided ATs (including 17 cases following cardiac surgery)...
January 2016: Journal of Cardiovascular Electrophysiology
Kazuki Iso, Koichi Nagashima, Yasuo Okumura, Ichiro Watanabe, Toshiko Nakai, Kimie Ohkubo, Kazumasa Sonoda, Rikitake Kogawa, Naoko Sasaki, Keiko Takahashi, Sayaka Kurokawa, Mizuki Nikaido, Atsushi Hirayama
BACKGROUND: Cryoballoon catheter ablation was developed to simplify ablation for atrial fibrillation (AF). Initial enthusiasm for its widespread use has been dampened by phrenic nerve (PN) injury (PNI). OBJECTIVE: The purpose of this study was to assess the effect of cryoballoon inflation at the right superior pulmonary vein (RSPV) orifice on PN location and to elucidate the potential mechanism of PNI. METHODS: Twenty patients with paroxysmal atrial fibrillation underwent ablation performed with a second-generation 28-mm cryoballoon catheter...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Masih Mafi Rad, Gilbert W M Wijntjens, Elien B Engels, Yuri Blaauw, Justin G L M Luermans, Laurent Pison, Harry J Crijns, Frits W Prinzen, Kevin Vernooy
BACKGROUND: Delayed left ventricular (LV) lateral wall (LVLW) activation is considered the electrical substrate underlying LV dysfunction amenable to cardiac resynchronization therapy (CRT). OBJECTIVE: The purpose of this study was to assess LVLW activation in CRT candidates using coronary venous electroanatomic mapping (EAM) and to investigate whether the QRS area (QRSAREA) on the vectorcardiogram (VCG) can identify delayed LVLW activation. METHODS: Fifty-one consecutive CRT candidates (29 left bundle branch block [LBBB], 15 intraventricular conduction delay [IVCD], 7 right bundle branch block [RBBB]) underwent intraprocedural coronary venous EAM using EnSite NavX...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Naoko Sasaki, Yasuo Okumura, Ichiro Watanabe, Andrew Madry, Yuki Hamano, Mizuki Nikaido, Koichi Nagashima, Kazumasa Sonoda, Rikitake Kogawa, Keiko Takahashi, Kazuki Iso, Kimie Ohkubo, Toshiko Nakai, Atsushi Hirayama
INTRODUCTION: High dominant frequency (DF) sites during atrial fibrillation (AF) play an important role in the perpetuation of AF. We investigated the relationship between the DFs from intracardiac electrograms (iEGM) and the surface electrocardiogram (ECG) during AF, and the relationship between the surface ECG DF and atrial remodeling. METHODS: In 48 patients (57±11 years, 47 males, 20 paroxysmal), the V1-6 precordial leads and specific V7-9 ECG leads were recorded for 8s for an off-line analysis before AF ablation...
November 2015: Journal of Cardiology
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