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Atrial fibrillation and ablation

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https://www.readbyqxmd.com/read/29331355/contemporary-procedural-complications-hospitalizations-and-emergency-visits-after-catheter-ablation-for-atrial-fibrillation
#1
James V Freeman, Grace H Tabada, Kristi Reynolds, Sue Hee Sung, Taylor I Liu, Nigel Gupta, Alan S Go
Contemporary data on complications and resource utilization after atrial fibrillation (AF) ablation are limited. We evaluated rates and risk factors for procedural complication, rehospitalization, and emergency department visits after AF ablation. We identified all adult patients who underwent isolated AF ablation between 2010 and June 2014 in 2 large integrated health-care delivery systems and evaluated rates of acute inpatient complication, 30-day, and 1-year readmission and emergency evaluation. We used multivariable logistic regression to identify predictors of procedural complications, 30-day readmission, or 30-day emergency department evaluation...
December 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29330332/identification-and-characterization-of-sites-where-persistent-atrial-fibrillation-is-terminated-by-localized-ablation
#2
Junaid A B Zaman, William H Sauer, Mahmood I Alhusseini, Tina Baykaner, Ryan T Borne, Christopher A B Kowalewski, Sonia Busch, Paul C Zei, Shirley Park, Mohan N Viswanathan, Paul J Wang, Johannes Brachmann, David E Krummen, John M Miller, Wouter Jan Rappel, Sanjiv M Narayan, Nicholas S Peters
BACKGROUND: The mechanisms by which persistent atrial fibrillation (AF) terminates via localized ablation are not well understood. To address the hypothesis that sites where localized ablation terminates persistent AF have characteristics identifiable with activation mapping during AF, we systematically examined activation patterns acquired only in cases of unequivocal termination by ablation. METHODS AND RESULTS: We recruited 57 patients with persistent AF undergoing ablation, in whom localized ablation terminated AF to sinus rhythm or organized tachycardia...
January 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29327638/hybrid-and-surgical-procedures-for-the-treatment-of-persistent-and-longstanding-persistent-atrial-fibrillation
#3
Jose M Sanchez, Ghannam Al-Dosari, Sherman Chu, Ramin Beygui, Tobias Deuse, Nitish Badhwar, Randall J Lee
Atrial fibrillation (AF) is the most common cardiac arrhythmia. The incidence of AF increases with age and is associated with increased stroke, heart failure and mortality. Persistent and long standing persistent AF is difficult to treat and often refractory to medical therapy and catheter ablation. Areas covered: This article reviews the historical development of the surgical Cox-MAZE procedure and current hybrid and minimally invasive surgical approaches for the treatment of persistent and long standing persistent AF...
January 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29326836/minimally-invasive-epicardial-surgical-ablation-alone-versus-hybrid-ablation-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#4
Charles M Pearman, Shi S Poon, Laura J Bonnett, Shouvik Haldar, Tom Wong, Neeraj Mediratta, Dhiraj Gupta
Maintaining sinus rhythm in patients with non-paroxysmal AF is an elusive goal. Some suggest that hybrid ablation, combining minimally invasive epicardial surgical ablation with endocardial catheter ablation, may be more effective than either modality alone. However, randomised trials are lacking. We investigated whether hybrid ablation is more effective than epicardial ablation alone at preventing recurrent AF by performing a systematic review and meta-analysis. The review was prospectively registered with PROSPERO (CRD42016043389)...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326835/ablation-of-atrial-fibrillation-drivers
#5
Tina Baykaner, Junaid A B Zaman, Paul J Wang, Sanjiv M Narayan
Pulmonary vein isolation (PVI) is central to ablation approaches for atrial fibrillation (AF), yet many patients still have arrhythmia recurrence after one or more procedures, despite evolving technologies for PVI. Ablation of localised AF drivers, which lie outside the pulmonary veins in many patients, is a practical approach that has been shown to improve success by many groups. Such localised drivers lie in atrial regions shown mechanistically to sustain AF in optical mapping and clinical studies of human AF, as well as computational and animal studies...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326834/ablation-of-atrial-fibrillation-in-patients-with-congenital-heart-disease
#6
Marwan M Refaat, Jad Ballout, Moussa Mansour
With improved surgical techniques and medical management for patients with congenital heart diseases, more patients are living longer and well into adulthood. This improved survival comes with a price of increased morbidity, mainly secondary to increased risk of tachyarrhythmias. One of the major arrhythmias commonly encountered in this subset of cardiac patients is AF. Similar to the general population, the risk of AF increases with advancing age, and is mainly secondary to the abnormal anatomy, abnormal pressure and volume parameters in the hearts of these patients and to the increased scarring and inflammation seen in the left atrium following multiple surgical procedures...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326833/ganglionated-plexi-ablation-physiology-and-clinical-applications
#7
Stavros Stavrakis, Sunny Po
Ganglionated plexi (GP), consisting of conglomerations of autonomic ganglia on the epicardial surface of the heart, have been shown to play a significant role in different arrhythmias, including atrial fibrillation. GP ablation has become an adjunctive procedure in the treatment of atrial fibrillation, while it has been used successfully in preliminary studies in vasovagal syncope. This review will present the current data on the physiology and clinical applications of GP ablation in the treatment of atrial fibrillation and other diseases...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29325697/early-stable-sinus-rhythm-associated-with-greater-success-five-years-following-surgical-ablation
#8
Niv Ad, Sari D Holmes
BACKGROUND: An important challenge in surgical ablation for atrial fibrillation (AF) is the scarcity of publications on credible predictors of long-term success in procedures performed with ablation tools that produce consistently reliable transmural lesions. We examined factors associated with 1-year success and no atrial arrhythmia (AA) recurrence during 1-5 years after surgical ablation for AF. METHODS: Surgical ablation patients with complete rhythm follow-up at 12 months after surgery were followed prospectively (N=743)...
January 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29325041/spontaneous-massive-hemothorax-presenting-as-a-late-complication-of-stent-implantation-in-a-patient-with-pulmonary-vein-stenosis-following-radiofrequency-ablation-for-atrial-fibrillation
#9
Andres Obeso, Amara Tilve, Alejandro Jimenez, Johannes Bonatti
Catheter ablation for symptomatic and drug-resistant atrial fibrillation is considered as the main acquired cause of pulmonary vein stenosis in adults. Controversy currently exists about the optimal treatment approach of this entity. Stenting seems to achieve lower vessel restenosis rates than isolated balloon angioplasty. However, these techniques are not exempt from complications. We present a case of spontaneous massive haemothorax presenting as a late complication of stent implantation in a patient with pulmonary vein stenosis...
January 6, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29325016/single-procedure-cure-with-atrial-fibrillation-ablation-may-the-force-be-with-you
#10
Dhiraj Gupta
No abstract text is available yet for this article.
January 9, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29324261/platelet-toll-like-receptor-and-its-ligand-hmgb-1-expression-is-increased-in-the-left-atrium-of-atrial-fibrillation-patients
#11
Kadri Murat Gurses, Duygu Kocyigit, Muhammed Ulvi Yalcin, Hande Canpinar, Banu Evranos, Ugur Canpolat, Hikmet Yorgun, Levent Sahiner, Dicle Guc, Kudret Aytemir
BACKGROUND: Atrial fibrillation(AF) is the most common sustained arrhythmia. Its most feared sequelae are stroke and peripheral thromboembolism due to atrial thrombi formation. Mechanisms underlying the relationship between platelet activation and left atrial thrombi have not been clearly elucidated yet. We aimed to investigate whether immune-mediated platelet activation occurred in AF patients in this cross-sectional study. METHODS: Persistent and paroxysmal AF patients who underwent cryoballoon-based AF ablation between March 2015 and July 2016 were included as the patient group...
January 8, 2018: Cytokine
https://www.readbyqxmd.com/read/29323823/atrioesophageal-fistula-a-rare-complication-of-radiofrequency-ablation
#12
Inbar Saporta, Adithya Chennamadhavuni, Michael J Dolan
75-year-old woman was admitted with fever, chills, altered mentation, and right-sided weakness. A month earlier, she had undergone catheter radiofrequency ablation for treatment of chronic atrial fibrillation. A magnetic resonance imaging scan of her brain revealed septic emboli with multiple bilateral cerebral and cerebellar infarcts, as well as extensive bilateral leptomeningeal enhancement. Blood cultures were positive for Streptococcus mitis, Rothia mucilaginosa, Streptococcus pneumonia, and Candida albicans, which suggested a connection between gastrointestinal and cardiovascular systems...
June 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29315991/efficacy-of-catheter-ablation-of-focal-sources-in-persistent-atrial-fibrillation
#13
Yoshihide Takahashi, Syu Yamashita, Masahito Suzuki, Kento Yabe, Kenzo Hirao
INTRODUCTION: Recent studies suggest that atrial fibrillation (AF) is maintained by electrical activity arising from focal sources. We sought to test whether catheter ablation that targets focal sources can improve on current ablation protocols for persistent AF. METHODS AND RESULTS: In patients with persistent AF whose AF did not terminate with pulmonary vein isolation, the left atrium was mapped with a 20-pole high-density mapping catheter using CARTO®3 navigation...
January 9, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29315961/reduction-of-thromboembolic-events-during-ablation-using-the-laserballoon-the-rethreva-registry
#14
Martin Eichenlaub, Arne Pfeufer, Lars Behrens, Volker Klauss, Michael Roettinger, Turgut Brodherr, Thorsten Lewalter
INTRODUCTION: Cerebral events (CE), including silent (SCE), are a known complication of left atrial catheter ablation (LACA) in patients with atrial fibrillation. The aim of this prospective registry was to gain more information about CE during laserballoon LACA and to reduce the risk of their occurrence. METHODS AND RESULTS: We enrolled 74 patients (age 61 ± 11 years; 74% male; CHA2 DS2 -VASc 1.9 ± 1.4). Cerebral MRI (1.5 Tesla) was performed to detect CE...
January 9, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29315665/effect-of-remote-ischemic-preconditioning-on-left-atrial-remodeling-and-prothrombotic-response-after-radiofrequency-catheter-ablation-for-atrial-fibrillation
#15
Ruijuan Han, Xiaoqing Liu, Meili Zheng, RuiPing Zhao, XiaoYan Liu, Xiandong Yin, Xingpeng Liu, Ying Tian, Liang Shi, Kai Sun, Xinchun Yang
BACKGROUND: Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is known to induce left atrial remodeling and prothrombotic response. AIMS: This study aimed to evaluate the effect of remote ischemic preconditioning (RIPC) on left atrial remodeling and prothrombotic response induced by radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). METHODS: Forty-four patients with drug-refractory paroxysmal AF undergoing RFCA were randomized into RIPC (4 short episodes of forearm ischemia) and control groups before the procedure...
January 5, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29315645/a-preliminary-study-of-pulmonary-vein-implant-applicability-and-safety-as-a-potential-ablation-platform-in-a-follow-up-study-in-pigs
#16
Tim Vandecasteele, Stijn Schauvliege, Matthew Philpott, Eli Clement, Gunther van Loon, Lisse Vera, Tim Boussy, Thomas van Bergen, Wim Van Den Broeck, Pieter Cornillie, Glenn Van Langenhove
BACKGROUND: Recurrence of atrial fibrillation after an ablation procedure remains a major problem which emphasizes the need for improved pulmonary vein isolation techniques. AIMS: The aim of this study was to describe an implantation procedure of a pulmonary vein-stent which may possibly serve as an ablation technique in the future and to examine stent safety in a follow-up study in pigs. METHODS AND RESULTS: Eight pigs were catheterized and nine self-expanding nitinol stents were implanted through a transfemoral or transatrial approach into the antra of the pulmonary veins...
January 8, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29315411/improving-procedural-and-one-year-outcome-after-contact-force-guided-pulmonary-vein-isolation-the-role-of-interlesion-distance-ablation-index-and-contact-force-variability-in-the-close-protocol
#17
Thomas Phlips, Philippe Taghji, Milad El Haddad, Michael Wolf, Sébastien Knecht, Yves Vandekerckhove, René Tavernier, Mattias Duytschaever
Aims: We have recently shown that a contact force (CF)-guided ablation protocol respecting region-specific criteria of lesion contiguity and lesion depth ('CLOSE' protocol) is associated with high incidence of acute durable pulmonary vein (PV) isolation (PVI) and a high single-procedure arrhythmia-free survival at 1 year. In the present study, we compared efficiency, safety, and efficacy of 'CLOSE'-guided PVI to conventional CF-guided PVI (CONV-CF). Methods and results: Fifty consecutive paroxysmal atrial fibrillation (AF) patients underwent PV encircling using a CF-sensing catheter targeting an interlesion distance (ILD) ≤6 mm and ablation index (AI) ≥400 and ≥550 at posterior and anterior wall ('CLOSE' group)...
January 4, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29315382/safety-and-long-term-effectiveness-of-paroxysmal-atrial-fibrillation-ablation-with-a-contact-force-sensing-catheter-real-world-experience-from-a-prospective-multicentre-observational-cohort-registry
#18
Tom De Potter, Hugo Van Herendael, Richard Balasubramaniam, Matthew Wright, Sharad C Agarwal, Prashanthan Sanders, Yaariv Khaykin, Decebal-Gabriel Latcu, Philippe Maury, Antonio Pani, John Hayes, Jonathan Kalman, Pablo Nery, Edward Duncan
Aims: Real-time contact force (CF)-sensing radiofrequency ablation catheter for treatment of paroxysmal atrial fibrillation (PAF) allows optimization of electrode-tissue contact, which correlates with long-term success. This prospective, multicentre observational registry assessed the real-world clinical effectiveness of a CF-sensing catheter for ablation of drug-refractory PAF. Methods and results: Patients were followed-up at 3, 6, and 12 months after ablation...
January 4, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29314148/3d-reconstruction-of-the-porcine-and-equine-pulmonary-veins-supplemented-with-the-identification-of-telocytes-in-the-horse
#19
T Vandecasteele, W Van Den Broeck, H Tay, L Couck, G van Loon, P Cornillie
The myocardial sleeve of the porcine and equine pulmonary veins were histologically investigated and reconstructed three dimensionally. Moreover, the localization of neuron cell bodies at the veno-atrial junction and alongside the myocardial sleeve was light microscopically visualized to depict the organization of nerve, myocardial and fat tissue. Finally, the presence of telocytes inside the equine pulmonary veins was demonstrated by use of transmission electron microscopy. These structures are thought to play a role in the induction of atrial fibrillation, which is frequently seen in horses, while pigs are often used as a cardiovascular model in this context...
January 3, 2018: Anatomia, Histologia, Embryologia
https://www.readbyqxmd.com/read/29312704/the-absence-of-effect-of-ganglionated-plexi-ablation-on-heart-rate-variability-parameters-in-patients-after-thoracoscopic-ablation-for-atrial-fibrillation
#20
Jana Zdarska, Pavel Osmancik, Petr Budera, Dalibor Herman, Radka Prochazkova, David Talavera, Zbynek Straka
Background: Hybrid ablation [thoracoscopic ablation (TA) of atrial fibrillation (AF) followed by catheter ablation (CA)] is an increasingly common method of the treatment for patients with AF. The aim of this study was to assess the response to ganglionated plexi (GP) ablation in patients with a previous TA (i.e., to assess whether TA had resulted in damage to the GP. Heart rate variability (HRV) was used as a marker of the autonomic response. Methods: Twenty AF patients underwent pulmonary vein isolation (PVI) plus GP ablation (GP group) and 18 AF patients underwent CA including GP ablation as a part of hybrid ablation (i...
December 2017: Journal of Thoracic Disease
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