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Contact force atrial

David S Demos, Mark F Berry, Leah M Backhus, Joseph B Shrager
OBJECTIVE: Surgeons have hesitated to adopt minimally invasive diaphragm plication techniques because of technical limitations rendering the procedure cumbersome or leading to early failure or reduced efficacy. We sought to demonstrate efficacy and durability of our thoracoscopic plication technique using a single running suture. METHODS: We retrospectively reviewed patients who underwent our technique for diaphragm plication since 2008. We used a single, buttressed, double-layered, to-and-fro running suture with additional plicating horizontal mattress sutures as needed...
December 21, 2016: Journal of Thoracic and Cardiovascular Surgery
Roberto De Ponti, Raffaella Marazzi, Lorenzo A Doni, Jacopo Marazzato, Claudia Baratto, Jorge A Salerno-Uriarte
AIMS: During pulmonary vein isolation (PVI), even if operators are aware of the contact force (CF), its values may greatly vary and the impact of cardiac rhythm has not been thoroughly investigated yet. This study aims at assessing the actual values of CF, the applications with suboptimal CF, and the impact of cardiac rhythm on CF during PVI. METHODS AND RESULTS: Twenty patients undergoing point-by-point PVI with a CF-sensing catheter were considered. CF target was between 6 and 40 g...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Chao-Feng Chen, Xiao-Fei Gao, Xu Duan, Bin Chen, Xiao-Hua Liu, Yi-Zhou Xu
PURPOSE: The present systematic review and meta-analysis aimed to assess and compare the safety and efficacy of radiofrequency (RF) and cryoballoon (CB) ablation for paroxysmal atrial fibrillation (PAF). RF and CB ablation are two frequently used methods for pulmonary vein isolation in PAF, but which is a better choice for PAF remains uncertain. METHODS: A systematic review was conducted in Medline, PubMed, Embase, and Cochrane Library. All trials comparing RF and CB ablation were screened and included if the inclusion criteria were met...
January 7, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Thomas Pambrun, Stéphane Combes, Pedro Sousa, Mathieu Le Bloa, Rim El Bouazzaoui, Delphine Grand-Larrieu, Nathaniel Thompson, Ruairidh Martin, Nicolas Combes, Serge Boveda, Michel Haïssaguerre, Jean-Paul Albenque
BACKGROUND: For conventional ablation of paroxysmal atrial fibrillation (AF), an ablation catheter in conjunction with a circular mapping catheter (CMC) is typically used for pulmonary vein isolation (PVI). OBJECTIVE: The purpose of this study was to evaluate an approach for PVI with a single contact-force (CF) ablation catheter in terms of procedural reliability, outcomes, and cost-effectiveness. METHODS: One hundred consecutive patients with paroxysmal AF were included in the study...
December 7, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Ullah W, Schilling Rj, Wong T
Catheters able to measure the force and vector of contact between the catheter tip and myocardium are now available. Pre-clinical work has established that the degree of contact between the radiofrequency ablation catheter and myocardium correlates with the size of the delivered lesion. Excess contact is associated with steam pops and perforation. Catheter contact varies within the left atrium secondary to factors including respiration, location, atrial rhythm and the trans-septal catheter delivery technology used...
February 2016: Journal of Atrial Fibrillation
Kimitaka Nishizaki, Taihei Itoh, Masaomi Kimura, Yuichi Tsushima, Yoshihiro Shoji, Takahiko Kinjo, Yuji Ishida, Kenichi Sasaki, Daisuke Horiuchi, Shingo Sasaki, Hirofumi Tomita, Ken Okumura
BACKGROUND: The safety and efficacy of the contemporary atrial fibrillation (AF) ablation in patients with a recent or previous history of cardioembolic stroke (CS) or transient ischemic attack (TIA) remain to be established. METHODS: A total of 447 patients who underwent first-ever contact force (CF)-guided AF ablation with circumferential pulmonary vein isolation were included. Of these, 17 had CS or TIA within 6 months before ablation (Group 1), 30 more than 6 months before ablation (Group 2), and the other 400 without CS or TIA (Group 3)...
November 2, 2016: Journal of Cardiology
Aditi Naniwadekar, Kamal Joshi, Allan Greenspan, Sumeet Mainigi
OBJECTIVES: To study the impact of contact force (CF) sensing on fluoroscopy, procedure, left atrial (LA) and ablation times and number of ablations during atrial fibrillation (AF) ablation. BACKGROUND: Catheter ablation is an effective treatment for symptomatic AF. Recently a new ablation catheter providing real-time CF has been approved for use. METHODS: A nested case-control study was performed comparing radiofrequency ablation of AF using the irrigated CF-sensing ThermoCool SmartTouch catheter versus open-irrigated ThermoCool SF catheter (Biosense Webster, Inc...
May 2016: Indian Pacing and Electrophysiology Journal
Girish M Nair, Roshan Raut, Karan Bami, Pablo B Nery, Calum J Redpath, Mouhannad M Sadek, Martin S Green, David H Birnie
PURPOSE OF REVIEW: Pulmonary vein reconnection leading to recurrence of atrial arrhythmias after pulmonary vein isolation (PVI) for atrial fibrillation remains a significant challenge. A number of adjunctive measures during PVI have been used to attempt to reduce pulmonary vein reconnection and recurrence of atrial arrhythmias. We performed a systematic review of the literature and meta-analysis of studies evaluating the efficacy of adjunctive measures used during PVI in reducing recurrent atrial arrhythmias...
January 2017: Current Opinion in Cardiology
Melanie A Gunawardene, Boris A Hoffmann, Benjamin Schaeffer, Da-Un Chung, Julia Moser, Ruken Oezge Akbulak, Mario Jularic, Christian Eickholt, Jana Nuehrich, Christian Meyer, Stephan Willems
INTRODUCTION: Comparative data of early recurrence rates of atrial fibrillation (ERAF) following second-generation cryoballoon (CB-G2) and radiofrequency current (RFC) ablation for pulmonary vein isolation (PVI) in paroxysmal AF (PAF) are rare. We randomized PAF patients into either PVI with CB-G2 (group 1) or PVI with a combined RFC-approach applying contact force (CF) with the endpoint of unexcitability (group 2) to investigate ERAF. METHODS: In group 1 (n = 30), CB-G2-PVI was performed...
October 14, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jingbo Jiang, Jinyi Li, Guoqiang Zhong, Junjun Jiang
PURPOSE: Currently, radiofrequency (RF) and cryoballoon are the most commonly used ablation technologies for atrial fibrillation (AF). We performed a meta-analysis to assess the efficacy and safety of the second-generation cryoballoons (CB-2) compared with RF for paroxysmal atrial fibrillation (PAF) ablation. METHODS: The PubMed, Cochrane Library, and Embase databases were searched and qualified studies were identified. The primary clinical outcome was the recurrence rate of atrial tachyarrhythmia (AT), and the secondary clinical outcomes were procedure time, fluoroscopy time, and the complications that followed...
September 28, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Paul A Gould, Cameron Booth, Kieran Dauber, Kevin Ng, Andrew Claughton, Gerald C Kaye
INTRODUCTION: This study sought to investigate specific contact force (CF) parameters to guide cavotricuspid isthmus (CTI) ablation and compare the outcome with a historical control cohort. METHODS AND RESULTS: Patients (30) undergoing CTI ablation were enrolled prospectively in the Study cohort and compared with a retrospective Control cohort of 30 patients. Ablation in the Study cohort was performed using CF parameters >10 g and <40 g and a Force Time Integral (FTI) of 800 ± 10 g...
December 2016: Journal of Cardiovascular Electrophysiology
Edouard Gitenay, Gilles Edouard O' Hara, Jean-François Sarrazin, Isabelle Nault, François Philippon, Marie Sadron Blaye-Felice, Jamal Laaouaj, Jean Champagne
Contact-force (CF) catheters appear to be more effective compared to standard ablation catheters for complex radiofrequency ablation including atrial fibrillation (AF) ablation when optimal CF >10 g is achieved. Some have suggested that this technology could also improve procedural safety. We report 2 cases of atrioesophageal fistulae (AEF), a rare but catastrophic complication of AF ablation. These are to our knowledge the first cases of AEF described after using CF catheters.
December 2016: Journal of Cardiovascular Electrophysiology
Philipp Halbfass, Patrick Müller, Karin Nentwich, Joachim Krug, Markus Roos, Karsten Hamm, Sebastian Barth, Attila Szöllösi, Andreas Mügge, Bernhard Schieffer, Thomas Deneke
AIMS: Oesophageal probes to monitor luminal oesophageal temperature (LET) during atrial fibrillation (AF) catheter ablation have been proposed, but their effects remain unclear. Aim of this study is to evaluate the effects of an oesophageal temperature probe with insulated thermocouples. METHODS AND RESULTS: Patients with symptomatic, drug-refractory paroxysmal or persistent AF who underwent left atrial radiofrequency (RF) catheter ablation were prospectively enrolled...
August 18, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Alex J A McLellan, Matthew G D Bates, Shane D F Young, Paul B Sparks
Deglutition-induced atrial tachycardia is a rare arrhythmia with a poor response to medical therapy. Electrophysiological study is challenging due to the dependence of induction on swallowing. We present a novel approach to management of deglutition-induced atrial tachycardia arising from right superior pulmonary vein. Use of minimal conscious sedation and repeated swallow challenge inductions, together with contact force-guided mapping were key determinants of success. We review published cases, discussing potential mechanisms including oesophageal distension and neural reflexes...
November 2016: Heart, Lung & Circulation
Stefan Asbach, Corinna Lang, Luca Trolese, Christoph Bode, Fabienne Schluermann
PURPOSE: Recovery of pulmonary vein (PV) conduction is a common mechanism of atrial fibrillation recurrence after PV isolation (PVI), underscoring the need for durable lesion formation. We aimed to evaluate the utility of an automated lesion annotation algorithm (ALAA) on acute isolation rates and resulting lesion characteristics. METHODS: Fifty patients underwent PVI using a contact force (CF) sensing catheter and ALAA. Single antral circles around ipsilateral PVs were performed with ALAA-1 settings including catheter stability (range of motion ≤2 mm, duration >10 s)...
December 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Naofumi Anjo, Shiro Nakahara, Yasuo Okumura, Yuichi Hori, Koichi Nagashima, Takaaki Komatsu, Akiko Hayashi, Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi
BACKGROUND: A high catheter tip-tissue contact force (CF) with the myocardium may cause 3-dimensional (3D) map distortion, however, the influence of external structures surrounding the left atrium (LA) on that distortion remains unknown. This study characterized the impact of high CF mapping on the local LA geometry distortion. METHODS: Thirty AF patients underwent 3D-ultrasound merged with CT images (3D-Merge-CT). The LA area in contact with external structures was identified by enhanced CT...
November 1, 2016: International Journal of Cardiology
Arash Aryana, Sheldon M Singh, Giacomo Mugnai, Carlo de Asmundis, Marcin Kowalski, Deep K Pujara, Andrew I Cohen, Steve K Singh, Charles E Fuenzalida, Nelson Prager, Mark R Bowers, Padraig Gearoid O'Neill, Pedro Brugada, André d'Avila, Gian-Battista Chierchia
PURPOSE: Catheter ablation of atrial fibrillation (CAAF) using the cryoballoon has emerged as an alternate strategy to point-by-point radiofrequency. However, there is little comparative data on long-term durability of pulmonary vein (PV) isolation comparing these two modalities. METHODS: In this multicenter, retrospective analysis, the incidences/patterns of late PV reconnection following an index CAAF using the second-generation cryoballoon versus open-irrigated, non-force-sensing radiofrequency were examined...
December 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Raphael Rosso, Ehud Chorin, Yuval Levi, Ori Rogowski, Sami Viskin
INTRODUCTION: Pulmonary vein isolation (PVI) with radiofrequency (RF) ablation is now standard care for atrial fibrillation (AF). New improvements in PVI techniques include use of catheters that measure contact-force and circular ablation catheters. These techniques have not been compared. METHODS AND RESULTS: We compared the success rate of circumferential pulmonary vein isolation (CPVI) with: (1) "point by point" RF using an irrigated tip ablation catheter with "smart touch" contact-force; (2) irrigated nMARQ circular ablation catheter in 86 patients with AF...
July 29, 2016: Journal of Cardiovascular Electrophysiology
Rhanderson Cardoso, Rodrigo Mendirichaga, Gilson Fernandes, Chris Healy, Litsa K Lambrakos, Juan F Viles-Gonzalez, Jeffrey J Goldberger, Raul D Mitrani
INTRODUCTION: Radiofrequency (RF) and cryoballoon (CB) catheter ablation are effective for pulmonary vein isolation (PVI) in atrial fibrillation (AF). This report presents an updated meta-analysis comparing the efficacy and safety of CB versus RF ablations in AF. METHODS: Databases and conference abstracts were systematically searched for studies that directly compared CB and RF PVI, and reported safety or efficacy outcomes in follow-up ≥12 months. Recurrent atrial tachyarrhythmias (AT) were defined as AF, atrial flutter, or atrial tachycardia...
July 16, 2016: Journal of Cardiovascular Electrophysiology
Kohki Nakamura, Shigeto Naito, Takehito Sasaki, Kentaro Minami, Yutaka Take, Satoru Shimizu, Yoshiaki Yamaguchi, Toshiaki Yano, Michiharu Senga, Eiji Yamashita, Yoshinao Sugai, Koji Kumagai, Nobusada Funabashi, Shigeru Oshima
PURPOSE: We aimed to identify the predictors of chronic pulmonary vein reconnections (CPVRs) after contact force (CF)-guided circumferential PV isolation (CPVI) of atrial fibrillation (AF). METHODS: Forty-nine consecutive patients undergoing second ablation procedures for recurrent AF after CF-guided ablation were retrospectively studied. The CPVI was performed by point-by-point ablation with a target CF of 15-20 g. The incidence of CPVRs was evaluated along the right- and left-sided anterior and posterior CPVI regions (Ant-RPVs, Post-RPVs, Ant-LPVs, and Post-LPVs)...
December 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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