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Atrial tachycardia

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https://www.readbyqxmd.com/read/28807079/syncope-during-competitive-events-interrogating-heart-rate-monitor-watches-may-be-useful
#1
Oscar Thabouillot, Kevin Bostanci, Francois Bouvier, Nicolae Dumitrescu, Maria Stéfuriac, Philippe Paule, Nicolas-Charles Roche
This is a case report of a 45-year-old man who reported complete amnesia during the very first kilometer of a 10-km run. He was wearing a heart rate monitor (HRM). The interrogation of his HRM watch showed 200 bpm tachycardia beginning in the first kilometer and increasing up to 220 bpm during the last kilometer. The patient was asked to wear a Holter-monitor (Holter Research Laboratory; Helena, Montana USA) electrocardiogram (ECG) while practicing a training session. This examination allowed for the diagnosis of an adrenergic paroxysmal atrial fibrillation (AF) with an impressive auriculo-ventricular conduction over 260 bpm...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28800192/efficacy-and-safety-of-driver-guided-catheter-ablation-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#2
F Daniel Ramirez, David H Birnie, Girish M Nair, Agnieszka Szczotka, Calum J Redpath, Mouhannad M Sadek, Pablo B Nery
INTRODUCTION: Targeting localized drivers (electrical rotors or focal impulses) during catheter ablation for atrial fibrillation (AF) has been proposed as a strategy to improve procedural success. However, the strength and quality of the evidence to support this approach is unclear. METHODS AND RESULTS: Clinical studies reporting efficacy or safety outcomes of driver-guided ablation for AF were identified in Medline, Embase, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Pubmed, and conference abstracts from major scientific meetings...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28800176/catheter-ablation-of-left-atrial-arrhythmias-on-uninterrupted-oral-anticoagulation-with-vitamin-k-antagonists-how-is-the-relationship-between-international-normalized-ratio-activated-clotting-time-and-procedure-related-complications
#3
Marc Kottmaier, Felix Bourier, Verena Semmler, Martha Telishevska, Katharina Koch-Büttner, Carsten Lennerz, Sarah Lengauer, Marielouise Kornmayer, Elena Rousseva, Stephanie Brooks, Amir Brkic, Christian Grebmer, Christoph Kolb, Gabriele Hessling, Isabel Deisenhofer, Tilko Reents
BACKGROUND: Ablation of atrial fibrillation (AF) on uninterrupted phenprocoumon reduces periprocedural thromboembolic and bleeding complications. Heparin is administered intraprocedurally to achieve activated clotting times (ACT) of 300-400 seconds. We investigated the effect of international normalized ratio (INR) on ACT and intraprocedural heparin requirements. Moreover, safety of a target ACT of 250-300 seconds was investigated. METHODS AND RESULTS: We studied 949 patients referred for AF or left atrial tachycardia ablation...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28797677/emergence-of-atrioventricular-nodal-reentry-tachycardia-after-surgical-or-catheter-ablation-for-atrial-fibrillation-are-we-creating-the-arrhythmia-substrate
#4
Jorge Romero, Saurabh Kumar, Fujii Akira, David F Briceño, Usha B Tedrow, Laurence Epstein, Roy John, William G Stevenson, Gregory F Michaud
BACKGROUND: Atrioventricular nodal reentry tachycardia (AVNRT) is common in adults and often involves reentry through two or more AV nodal-atrial connections. Although AVNRT can be a trigger for atrial fibrillation (AF), we have observed new onset AVNRT after AF ablation procedures. OBJECTIVE: To determine whether ablation involving the septum or proximal coronary sinus during AF ablation may create a substrate favorable for AVNRT METHODS: Cases of ablation for persistent AF who required a repeat ablation procedure between 2009 to 2016 were reviewed for diagnosis of AVNRT...
August 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28797676/electrogram-signature-of-specific-activation-patterns-analysis-of-atrial-tachycardias-at-high-density-endocardial-mapping
#5
Antonio Frontera, Masateru Takigawa, Ruairidh Martin, Nathaniel Thompson, Ghassen Cheniti, Gregoire Massouille, Josselin Duchateau, JeanYves Wielandts, Elvis Teijera, Takeshi Kitamura, Michael Wolf, Nora Al-Jefairi, Konstantinos Vlachos, Seigo Yamashita, Sana Amraoui, Arnaud Denis, Meleze Hocini, Hubert Cochet, Frederic Sacher, Pierre Jaïs, Michel Haïssaguerre, Nicolas Derval
BACKGROUND: The significance of fractionated electrograms (EGMs) is object of debate with multiple mechanisms described. OBJECTIVE: Using Rhythmia™, a high-density mapping system, we sought to investigate the relationship between specific electrophysiological phenomena and EGM characteristics at those sites. METHODS: 25 consecutive patients underwent High Density (HD) atrial mapping during Atrial Tachycardias (ATs). Bipolar EGMs were recorded with a 64-electrode basket catheter...
August 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28797355/increasing-prevalence-of-atrial-fibrillation-and-permanent-atrial-arrhythmias-in-congenital-heart-disease
#6
Fabien Labombarda, Robert Hamilton, Azadeh Shohoudi, Jamil Aboulhosn, Craig S Broberg, Marie A Chaix, Scott Cohen, Stephen Cook, Annie Dore, Susan M Fernandes, Anne Fournier, Joseph Kay, Laurent Macle, Blandine Mondésert, François-Pierre Mongeon, Alexander R Opotowsky, Anna Proietti, Lena Rivard, Jennifer Ting, Bernard Thibault, Ali Zaidi, Paul Khairy
BACKGROUND: Atrial arrhythmias are the most common complication encountered in the growing and aging population with congenital heart disease. OBJECTIVES: This study sought to assess the types and patterns of atrial arrhythmias, associated factors, and age-related trends. METHODS: A multicenter cohort study enrolled 482 patients with congenital heart disease and atrial arrhythmias, age 32.0 ± 18.0 years, 45.2% female, from 12 North American centers...
August 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28797351/implant-and-midterm-outcomes-of-the-subcutaneous-implantable-cardioverter-defibrillator-registry-the-effortless-study
#7
Lucas Boersma, Craig Barr, Reinoud Knops, Dominic Theuns, Lars Eckardt, Petr Neuzil, Marcoen Scholten, Margaret Hood, Juergen Kuschyk, Paul Jones, Elizabeth Duffy, Michael Husby, Kenneth Stein, Pier D Lambiase
BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to defibrillate ventricular arrhythmias, avoiding drawbacks of transvenous leads. The global EFFORTLESS S-ICD (Evaluation oF FactORs ImpacTing CLinical Outcome and Cost EffectiveneSS of the S-ICD) registry is collecting outcomes in 985 patients during a 5-year follow-up. OBJECTIVES: The primary goal of the EFFORTLESS registry is to determine the safety of the S-ICD by evaluating complications and inappropriate shock rate...
August 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28795289/beyond-pulmonary-vein-isolation-the-role-of-additional-sites-in-catheter-ablation-of-atrial-fibrillation
#8
REVIEW
Li-Wei Lo, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Fa-Po Chung, Shih-Ann Chen
PURPOSE OF REVIEW: Pulmonary vein (PV) isolation is the cornerstone of atrial fibrillation (AF) ablation. However, the long-term procedural outcome remains suboptimal and there is a frequent need for repeat ablation procedure, especially in patients with non-paroxysmal AF. The review article summarizes the rationales, recent evidences, and strategies of ablation of extra-PV sites and its clinical outcomes. RECENT FINDINGS: It is a consensus that durable PV isolations are a definite therapy in patients with paroxysmal AF...
August 9, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28794139/denervated-myocardium-is-preferentially-associated-with-sudden-cardiac-arrest-in-ischemic-cardiomyopathy-a-pilot-competing-risks-analysis-of-cause-specific-mortality
#9
James A Fallavollita, Jonathan D Dare, Randolph L Carter, Sunil Baldwa, John M Canty
BACKGROUND: Previous studies have identified multiple risk factors that are associated with total cardiac mortality. Nevertheless, identifying specific factors that distinguish patients at risk of arrhythmic death versus heart failure could better target patients likely to benefit from implantable cardiac defibrillators, which have no impact on nonsudden cardiac death. METHODS AND RESULTS: We performed a pilot competing risks analysis of the National Institutes of Health-sponsored PAREPET trial (Prediction of Arrhythmic Events with Positron Emission Tomography)...
August 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28781835/aberrant-coronary-artery-spasms-cause-st-t-segment-depression-during-endovascular-ablation-of-atrial-flutter
#10
Eva A H Lanters, Adriaan Coenen, Marisa M Lubbers, Koen Nieman, Natasja M S de Groot
ST-T segment depression during right-sided endovascular catheter ablation is not only caused by obstructive coronary artery disease or (induced) tachycardia. Clinicians should also consider coronary artery spasms evoked by manipulation of nearby catheters, especially in patients with abnormal coronary artery anatomy.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28776822/ripple-mapping-initial-multicenter-experience-of-an-intuitive-approach-to-overcoming-the-limitations-of-3d-activation-mapping
#11
Vishal Luther, Nuno Cortez-Dias, Luis Carpinteiro, João de Sousa, Richard Navaratnum Balasubramaniam, Sharad C Agarwal, David Farwell, Solomon Mark Sopher, Girish Babu, Richard Till, Nikki Jones, Stuart Tan, Anthony Chow, Martin Lowe, Jem Lane, Naveen Pappachan, Nick Wf Linton, Prapa Kanagaratnam
BACKGROUND: Ripple Mapping (RM) displays electrograms as moving bars over a 3D surface displaying bipolar voltage, and has shown in a single-center series to be effective for atrial tachycardia (AT) mapping without annotation of local activation time or window-of-interest assignment. We tested the reproducibility of these findings in operators naive to RM, using it for the first time in post ablation AT. METHODS: Maps were collected with multielectrode catheters and CARTO ConfiDENSE...
August 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28775185/frequency-of-exercise-induced-st-t-segment-deviations-and-cardiac-arrhythmias-in-recreational-endurance-athletes-during-a-marathon-race-results-of-the-prospective-observational-berlin-beat-of-running-study
#12
Juliane Herm, Agnieszka Töpper, Alexander Wutzler, Claudia Kunze, Matthias Krüll, Lars Brechtel, Jürgen Lock, Jochen B Fiebach, Peter U Heuschmann, Wilhelm Haverkamp, Matthias Endres, Gerhard Jan Jungehulsing, Karl Georg Haeusler
OBJECTIVES: While regular physical exercise has many health benefits, strenuous physical exercise may have a negative impact on cardiac function. The 'Berlin Beat of Running' study focused on feasibility and diagnostic value of continuous ECG monitoring in recreational endurance athletes during a marathon race. We hypothesised that cardiac arrhythmias and especially atrial fibrillation are frequently found in a cohort of recreational endurance athletes. The main secondary hypothesis was that pathological laboratory findings in these athletes are (in part) associated with cardiac arrhythmias...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28765764/focal-ablation-for-atrial-tachycardia-from-the-double-exit-of-the-marshall-bundle-inducing-atrial-fibrillation
#13
Jung Yeon Chin, Jong Woo Kim, Ki-Woon Kang
Atrial fibrillation (AF) from the ligament/vein of Marshall (LOM/VOM) has previously been described. We report the case of a 23-year-old woman with an antiarrhythmic drug-resistant AF induced by two distinct atrial tachycardias (ATs). Focal ablation of these ATs from the double-exit of the Marshall bundle using a three-dimensional map eliminated AF triggering, even though pulmonary vein electrical isolation is the cornerstone for paroxysmal AF. Such mechanisms are important as triggering factors to plan ablation for paroxysmal AF...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765763/elongated-ascending-aorta-predicts-a-short-distance-between-his-bundle-potential-recording-site-and-coronary-sinus-ostium
#14
Yuichi Momose, Kyoko Soejima, Akiko Ueda, Takahiro Arai, Masamichi Koyanagi, Yo Hagiwara, Ikuko Togashi, Yosuke Miwa, Kyoko Hoshida, Mutsumi Miyakoshi, Noriko Matsushita, Mika Nagaoka, Toshiaki Sato, Toshiaki Nitatori, Hideaki Yoshino
BACKGROUND: When performing catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT), it can be difficult to maintain a safe distance from the His recording site to avoid AV block in patients with a short distance between this recording site to the coronary sinus (CS) ostium (small triangle of Koch [TOK]). In this study, we sought to identify parameters predicting small TOK and test these parameters in patients undergoing AVNRT catheter ablation. METHODS: Twenty-eight patients who underwent catheter ablation of atrial fibrillation using a three-dimensional (3D) electroanatomical mapping system (EAM) with computed tomography (CT) merge (23 males; mean age, 65...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765737/local-atrial-ventricular-ratio-as-an-adjuvant-marker-for-catheter-ablation-of-atrioventricular-accessory-pathways
#15
Ki-Hun Kim, Dae-Kyeong Kim, Hyun-Ji Im, Jeong-Sook Seo, Han-Young Jin, Jae-Sik Jang, Tae-Hyun Yang, Dong-Soo Kim, So-Young Jeong, Yun Seok Song, Dong-Kie Kim, Pil-Sang Song, Sang-Hoon Seol, Doo-Il Kim
BACKGROUND AND OBJECTIVES: The earliest atrial (A)/ventricular (V) activation potential, or accessory pathway (AP) potential are commonly used as ablation targets for atrioventricular (AV) APs. However, these targets are sometimes ambiguous. SUBJECTS AND METHODS: We reviewed 119 catheter ablation cases in 112 patients diagnosed with orthodromic atrioventricular reentrant tachycardia (AVRT) or Wolff-Parkinson-White (WPW) syndrome. Local A/V amplitude potentials with the earliest activation or AP potential were measured shortly before achieving antegrade AP conduction block, ventriculoatrial block during right ventricle (RV) pacing, or AVRT termination with no AP conduction...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28765088/the-evolving-role-of-ankyrin-b-in-cardiovascular-disease
#16
Sara N Koenig, Peter J Mohler
Over the last decade, ankyrin-B has been identified as a prominent player in cardiac physiology. Ankyrin-B has a multitude of functions, with roles in expression, localization, and regulation of proteins critical for cardiac excitability, cytoskeletal integrity, and signaling. Further, human ANK2 variants that result in ankyrin-B loss-of-function are associated with 'Ankyrin-B syndrome', a complex cardiac phenotype that may include bradycardia and heart rate variability, conduction block, atrial fibrillation, QT interval prolongation, and potentially fatal catecholaminergic polymorphic ventricular tachycardia...
July 29, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28765086/spectrum-of-atrial-arrhythmias-using-the-ligament-of-marshall-in-patients-with-atrial-fibrillation
#17
Aman Chugh, Hitinder S Gurm, Kavita Krishnasamy, Mohammed Saeed, Watchara Lohawijarn, Kyle Hornsby, Ryan Cunnane, Hamid Ghanbari, Rakesh Latchamsetty, Thomas Crawford, Krit Jongnarangsin, Frank Bogun, Hakan Oral, Fred Morady
BACKGROUND: The role of the ligament of Marshall (LOM) in patients with atrial fibrillation (AF) has not been well defined. OBJECTIVE: The purpose of this study was to describe the role of the LOM in patients with AF and related arrhythmias. METHODS: Fifty-six patients (mean age 63 ± 11 years; persistent AF in 48 [86%]; ejection fraction 0.49 ± 0.13; left atrial diameter 4.7 ± 0.6 cm) with LOM-mediated arrhythmias were included. RESULTS: A LOM-pulmonary vein (PV) connection was present in 18 patients (32%) and was eliminated with radiofrequency (RF) ablation at the left lateral ridge or crux (n = 12), at the mitral annulus (n = 3), or with alcohol/ethanol (EtOH) ablation of the vein of Marshall (VOM; n = 3)...
July 29, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28764236/clinical-significance-of-the-forsaken-avr-in-evaluation-of-tachyarrhythmias-a-reminder
#18
Dharmendra Jain, Pradeep Nigam, Manoj Indurkar, Riyas Chiramkara
INTRODUCTION: Mechanism of a regular, monomorphic Wide QRS Complex Tachycardia (WCT) is an important diagnostic challenge in day to day practice for the clinicians and affects further management and prognosis. Many of the WCT and Narrow Complex Tachycardia (NCT) produce certain characteristic changes in lead aVR by which we can differentiate between them. AIM: The present study was aimed to evaluate tachyarrhythmias in relation to lead aVR and to highlight the clinical significance of lead aVR, "The Neglected Lead"...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28760211/implantable-cardiac-monitors-in-high-risk-post-infarction-patients-with-cardiac-autonomic-dysfunction-and-moderately-reduced-left-ventricular-ejection-fraction-design-and-rationale-of-the-smart-mi-trial
#19
RANDOMIZED CONTROLLED TRIAL
Wolfgang Hamm, Konstantinos D Rizas, Lukas von Stülpnagel, Nikolay Vdovin, Steffen Massberg, Stefan Kääb, Axel Bauer
BACKGROUND: Most deaths after myocardial infarction (MI) occur in patients with left ventricular ejection fraction (LVEF) >35%, for whom no specific prophylactic strategies exist. Deceleration capacity (DC) of heart rate and periodic repolarization dynamics (PRD) are noninvasive electrophysiological markers depending on the vagal and sympathetic tone. The combination of abnormal DC and/or PRD identifies a new high-risk group among postinfarction patients with LVEF 36%-50%. This new high-risk group has similar characteristics with respect to prognosis and patient numbers to those of the established high-risk group identified by LVEF ≤ 35%...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28756424/cavotricuspid-isthmus-dependent-flutter-or-left-sided-atrial-tachycardia
#20
Kevin Ming Wei Leong, Fernando Guerrero, Phang Boon Lim
A 52-year-old man with previous mitral valve replacement, cavotricuspid isthmus, and left-sided roof-line ablation for previous typical atrial flutter and tachycardia presented with recurrence of symptoms with an atrial tachycardia measuring 260 ms cycle length on electrocardiogram. Rhythmia electroanatomical mapping (Boston Scientific) was performed to understand the mechanism of arrhythmia and to guide ablative treatment.
August 2017: Journal of Invasive Cardiology
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