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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27686550/-comparison-of-radiofrequency-catheter-ablation-for-paroxysmal-supraventricular-tachycardia-guided-by-three-dimensional-navigation-with-x-ray
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27048420/pulmonary-vein-reconnection-and-arrhythmia-progression-after-antral-linear-catheter-ablation-of-paroxysmal-and-persistent-atrial-fibrillation
#15
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
https://www.readbyqxmd.com/read/26914407/minimizing-discordances-in-automated-classification-of-fractionated-electrograms-in-human-persistent-atrial-fibrillation
#16
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...
November 2016: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/26702315/efficacy-of-ablation-at-the-anteroseptal-line-for-the-treatment-of-perimitral-flutter
#17
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
https://www.readbyqxmd.com/read/26702314/effects-of-a-high-fat-diet-on-the-electrical-properties-of-porcine-atria
#18
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
https://www.readbyqxmd.com/read/26635130/identifying-delayed-left-ventricular-lateral-wall-activation-in-patients-with-non-specific-intraventricular-conduction-delay-using-coronary-venous-electroanatomical-mapping
#19
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
https://www.readbyqxmd.com/read/26560500/electroanatomic-mapping-systems-carto-ensite-navx-vs-conventional-mapping-for-ablation-procedures-in-a-training-program
#20
COMPARATIVE STUDY
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
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