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https://www.readbyqxmd.com/read/27909521/recurrent-atrial-fibrillation-after-catheter-ablation-considerations-for-repeat-ablation-and-strategies-to-optimize-success
#1
REVIEW
Andrew E Darby Md Fhrs
Recurrent AF after catheter ablation occurs in at least 20 to 40% of patients. Repeat ablation is primarily considered for those with symptomatic AF recurrences (often drug-refactory) occurring at least 3 months or more post-ablation. Pulmonary vein reconnection is almost universally encountered, and repeat isolation of electrically connected pulmonary veins should be the primary ablation strategy. Beyond repeat PVI and possible ablation of non-PV triggers, there is little to no evidence that additional substrate modification improves outcomes...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909503/first-and-second-generation-cryoballoon-ablation-efficacy-restoring-and-maintaining-sinus-rhythm-in-patients-electrically-selected-and-treated-for-long-standing-persistent-atrial-fibrillation-after-acute-complete-electrical-disconnection-of-pulmonary-veins
#2
Jesus M Paylos Md PhD, Luis Azcona Md, Lourdes Lacal Md, Marisol Paradela Md, Carmen Cilleros Md, Ildefonso Del Campo Md, Clara Ferrero Rn Carlos Martínez Md PhD, Aracelis Morales Md
Introduction Cryoballoon ablation (CB) has proven effective to treatment of patients (pts) with atrial fibrillation (AF). However, the isolated efficacy of CB to treat pts with long-standing persistent atrial fibrillation (LSPAF) is less know. We analyzed the acute results and the long-term follow-up of our pts suffering LSPAF and initially treated with CB. Methods A cohort of 44 pts, 37 male (84%) mean age (60±10 year) suffering LSPAF were treated with first (CB1): 15pts, and second (CB2): 29 pts, generation CB...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909473/cryoablation-for-the-treatment-of-drug-refractory-symptomatic-atrial-fibrillation-a-regional-medical-center-experience
#3
Robert Tonks Md, Hiba-Tul-Kareem Sayed Md, Ashley Adams Ba, William T Smith Md Facc
INTRODUCTION: PVI is an effective, guideline-based treatment for drug refractory symptomatic AF. Balloon cryoablation has been shown to be a safe and effective method for PVI. In the STOP-AF trial, data was produced from practitioners performing PVI with significant experience at high volume centers. This study evaluates the effectiveness and safety of treating symptomatic, drug refractory AF with PVI via cryoablation after implementation in a regional medical center. METHOD: This represents a retrospective analysis of outcomes after cryoablation treatment for AF in 71 patients over 354...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27893055/assessment-of-use-vs-discontinuation-of-oral-anticoagulation-after-pulmonary-vein-isolation-in-patients-with-atrial-fibrillation
#4
Sara Själander, Fredrik Holmqvist, J Gustav Smith, Pyotr G Platonov, Milos Kesek, Peter J Svensson, Carina Blomström-Lundqvist, Fariborz Tabrizi, Jari Tapanainen, Dritan Poci, Anders Jönsson, Anders Själander
Importance: Pulmonary vein isolation (PVI) is a recommended treatment for patients with atrial fibrillation, but it is unclear whether it results in a lower risk of stroke. Objectives: To investigate the proportion of patients discontinuing anticoagulation treatment after PVI in association with the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [doubled], diabetes, stroke [doubled], vascular disease, age 65-74 years, sex category [female]) score, identify factors predicting stroke after PVI, and explore the risk of cardiovascular events after PVI in patients with and without guideline-recommended anticoagulation treatment...
November 23, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27871986/second-generation-cryoballoon-ablation-without-the-use-of-real-time-recordings-a-novel-strategy-based-on-a-temperature-guided-approach-to-ablation
#5
Saverio Iacopino, Giacomo Mugnai, Ken Takarada, Gaetano Paparella, Erwin Ströker, Valentina De Regibus, Hugo Enrique Coutino-Moreno, Rajin Choudhury, Juan Pablo Abugattas de Torres, Pedro Brugada, Carlo de Asmundis, Gian-Battista Chierchia
BACKGROUND: The achievement of -40°C within 60 seconds has proven to independently predict durable PV isolation in the setting of second generation cryoballoon (CB-A; Medtronic; USA) ablation. OBJECTIVE: In the present study, we sought to evaluate a strategy based on the attainment of the specific parameter of -40°C within the first 60 seconds during cryoenergy applications in the setting of CB-A without the use of an inner lumen mapping catheter (ILMC) (Achieve; Medtronic, USA) for the visualisation of real time recordings (RTR)...
November 18, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27871493/diabetes-does-not-worsen-outcomes-following-infrageniculate-bypass-or-endovascular-intervention-for-patients-with-critical-limb-ischemia
#6
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE: Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee among patients with diabetes (DM) specifically. The purpose of this study is to compare outcomes following open bypass (lower extremity bypass [LEB]) and peripheral vascular intervention (PVI) at and below the knee in patients with DM vs patients without DM (non-DM) with critical limb ischemia...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27863291/adenosine-guided-pulmonary-vein-isolation-versus-conventional-pulmonary-vein-isolation-in-patients-undergoing-atrial-fibrillation-ablation-an-updated-meta-analysis
#7
Nikolaos Papageorgiou, Rui Providência, Neil Srinivasan, Kostas Bronis, Francisco Moscoso Costa, Diogo Cavaco, Pedro Adragão, Dimitris Tousoulis, Ross J Hunter, Richard J Schilling, Oliver R Segal, Anthony Chow, Edward Rowland, Martin Lowe, Pier D Lambiase
BACKGROUND: Recurrent atrial fibrillation episodes following pulmonary vein isolation (PVI) are frequently due to reconnection of PVs. Adenosine can unmask dormant conduction, leading to additional ablation to improve AF-free survival. We performed a meta-analysis of the literature to assess the role of adenosine testing in patients undergoing atrial fibrillation (AF) ablation. METHODS: PubMed, EMBASE, and Cochrane databases were searched through until December 2015 for studies reporting on the role of adenosine guided-PVI versus conventional PVI in AF ablation...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27862561/long-term-outcome-of-left-atrial-voltage-guided-substrate-ablation-during-atrial-fibrillation-a-novel-adjunctive-ablation-strategy
#8
Atsuhiko Yagishita, J Rod Gimbel, Samer DE Oliveira, Harish Manyam, Dina Sparano, Ivan Cakulev, Judith Mackall, Mauricio Arruda
INTRODUCTION: Left atrium (LA) low voltage area (LVA) on 3-D electroanatomic bipolar voltage mapping (EAVM), as a surrogate for scar, is associated with poor AF ablation outcome. We evaluated the long-term outcome of a LVA-guided atrial fibrillation (AF) substrate modification strategy as an adjunct to pulmonary vein isolation (PVI). METHODS AND RESULTS: Two hundred and one consecutive patients with AF (82% persistent / Non-PAF, age 65 years), who underwent EAVM during AF prior to PVI, were divided into two groups according to the presence or absence of LVA outside the PV antra, defined as bipolar voltage of < 0...
November 12, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27853943/endocardial-voltage-mapping-of-pulmonary-veins-with-an-ultra-high-resolution-system-to-evaluate-atrial-myocardial-extensions
#9
Francesco Santoro, Christian Sohns, Ardan M Saguner, Natale Daniele Brunetti, Christine Lemes, Shibu Mathew, Christian-H Heeger, Bruno Reißmann, Tilman Maurer, Johannes Riedl, Thomas Fink, Kentaro Hayashi, Feifan Ouyang, Matteo Di Biase, Karl-Heinz Kuck, Andreas Metzner
INTRODUCTION: Atrial fibrillation (AF) is mainly triggered by arrhythmogenic foci originating from atrial myocardial extensions (MEs) into the pulmonary veins (PVs). Aim of the study was to evaluate endocardial voltage maps of PVs as a surrogate parameter for the extent of MEs in subjects with AF through a ultra-high-density mapping system. METHODS: Sixty-four bipolar electrograms were recorded simultaneously from the Orion mini-basket catheter placed in 72 PVs of 18 consecutive patients with paroxysmal/persistent AF undergoing PV isolation (PVI)...
November 16, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27844312/frequency-of-penile-vaginal-intercourse-is-associated-with-verbal-recognition-performance-in-adult-women
#10
Larah Maunder, Dorothée Schoemaker, Jens C Pruessner
Previous studies have identified a number of factors that contribute to improved cognitive function, and to memory function specifically, in cognitively normal individuals. One such factor, frequency of penile-vaginal intercourse (PVI), has been reported in a number of animal studies to be advantageous to memory for previously presented objects by increasing neurogenesis in the dentate gyrus of the hippocampus. However, studies investigating the potential benefits of frequent PVI on memory function in young women are to the best of our knowledge absent from the literature...
November 14, 2016: Archives of Sexual Behavior
https://www.readbyqxmd.com/read/27835656/the-association-of-peri-procedural-blood-transfusion-with-morbidity-and-mortality-in-patients-undergoing-percutaneous-lower-extremity-vascular-interventions-insights-from-bmc2-vic
#11
Peter K Henke, Yeo Jung Park, Sachinder Hans, Paul Bove, Robert Cuff, Andris Kazmers, Theodore Schreiber, Hitinder S Gurm, P Michael Grossman
OBJECTIVE: To determine the predictors of periprocedural blood transfusion and the association of transfusion on outcomes in high risk patients undergoing endoluminal percutaneous vascular interventions (PVI) for peripheral arterial disease. METHODS/RESULTS: Between 2010-2014 at 47 hospitals participating in a statewide quality registry, 4.2% (n = 985) of 23,273 patients received a periprocedural blood transfusion. Transfusion rates varied from 0 to 15% amongst the hospitals in the registry...
2016: PloS One
https://www.readbyqxmd.com/read/27826130/focal-impulse-and-rotor-modulation-acute-procedural-observations-and-extended-clinical-follow-up
#12
Jonathan S Steinberg, Yash Shah, Advay Bhatt, Tina Sichrovsky, Aysha Arshad, Emily Hansinger, Dan Musat
BACKGROUND: Focal impulse and rotor modulation (FIRM) was based on the premise that atrial fibrillation (AF) is sustained by rotors that are sufficiently stable to be eliminated by targeted ablation. Early experience reported high success as compared to conventional strategies. OBJECTIVE: The purpose of this study was to report on a single-center experience with extended follow-up by using FIRM in a variety of patients with AF. METHODS: All FIRM-guided ablation procedures were included...
November 5, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27826128/durability-of-wide-area-left-atrial-appendage-isolation-results-from-extensive-catheter-ablation-for-the-treatment-of-persistent-atrial-fibrillation
#13
Bruno Reissmann, Andreas Rillig, Erik Wissner, Roland Tilz, Michael Schlüter, Christian Sohns, Christian Heeger, Shibu Mathew, Tilman Maurer, Christine Lemes, Thomas Fink, Peter Wohlmuth, Francesco Santoro, Johannes Riedl, Feifan Ouyang, Karl-Heinz Kuck, Andreas Metzner
BACKGROUND: Extensive ablation strategies are currently performed in addition to pulmonary vein isolation (PVI) to improve the clinical outcome of patients with drug-refractory persistent atrial fibrillation (AF). Ablation of complex fractionated atrial electrograms (CFAE), linear lesions and/or isolation of the left atrial appendage (LAA) are thought to improve arrhythmia-free survival. OBJECTIVE: This study sought to assess the durability of wide-area LAA isolation (LAAI) achieved by PVI, an anterior line and a mitral isthmus line...
November 5, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27825542/histopathological-tumor-invasion-of-the-mesenterico-portal-vein-is-characterized-by-aggressive-biology-and-stromal-fibroblast-activation
#14
Hryhoriy Lapshyn, Louisa Bolm, Ilona Kohler, Martin Werner, Franck G Billmann, Dirk Bausch, Ulrich T Hopt, Frank Makowiec, Uwe A Wittel, Tobias Keck, Peter Bronsert, Ulrich F Wellner
BACKGROUND: Mesenterico-portal vein resection (PVR) during pancreatoduodenectomy for pancreatic head cancer was established in the 1990s and can be considered a routine procedure in specialized centers today. True histopathologic portal vein invasion is predictive of poor prognosis. The aim of this study was to examine the relationship between mesenterico-portal venous tumor infiltration (PVI) and features of aggressive tumor biology. METHODS: Patients receiving PVR for pancreatic ductal adenocarcinoma of the pancreatic head were identified from a prospectively maintained database...
November 5, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27801660/first-case-of-robotic-percutaneous-vascular-intervention-for-below-the-knee-peripheral-arterial-disease
#15
Omid Behnamfar, Ali Pourdjabbar, Ethan Yalvac, Ryan Reeves, Ehtisham Mahmud
Although the feasibility and safety of robotically assisted peripheral vascular intervention (PVI) for iliac and femoral peripheral arterial disease (PAD) have been demonstrated, robotic PVI for below-the-knee disease has never been reported. We present the first description of robotic PVI with the CorPath Vascular Robotic System (Corindus) for treating below-the-knee PAD. After contralateral sheath placement in the affected lower extremity, the entire procedure was performed robotically with remote control of the guidewire and angioplasty balloon...
November 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27793002/vasculogenic-mimicry-in-hepatocellular-carcinoma-contributes-to-portal-vein-invasion
#16
Chen Jue, Wu Zhifeng, Zhang Zhisheng, Cui Lin, Qian Yayun, Jin Feng, Gu Hao, Ishikawa Shintaro, Tadashi Hisamitsu, Guo Shiyu, Liu Yanqing
Portal vein invasion (PVI) is common in hepatocellular carcinoma (HCC) and largely contributes to tumor recurrence after radical tumor resection or liver transplantation. Vasculogenic mimicry (VM) was an independent vascular system lined with tumor cells and associated with poor prognosis of HCC. The present study was conducted to evaluate the relationship between VM and portal vein invasion. A total of 44 HCC cases receiving anatomic liver resection were included in the study and were divided into groups with and without PVI...
October 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/27789000/sinus-node-injury-during-adjunctive-superior-vena-cava-isolation-in-a-patient-with-triggered-atrial-fibrillation
#17
Andrés F Miranda-Arboleda, Jeffrey Munro, Komandoor Srivathsan
INTRODUCTION: Atrial fibrillation is the most common sustained heart arrhythmia. Premature beats arising from foci other than pulmonary veins have been related to its pathogenesis. METHODS AND RESULTS: A 64-year-old female underwent superior vena cava (SVC) isolation after triggers were identified originating from the SVC following pulmonary vein isolation; immediately after SVC isolation, she developed junctional rhythm with symptomatic hypotension requiring emergent management...
May 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/27788997/use-of-the-new-contact-force-sensing-ablation-catheter-dramatically-reduces-fluoroscopy-time-during-atrial-fibrillation-ablation-procedures
#18
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
https://www.readbyqxmd.com/read/27788791/intraoperative-pleth-variability-index-is-linked-to-delayed-graft-function-after-kidney-transplantation
#19
O Collange, L Jazaerli, A Lejay, C Biermann, S Caillard, B Moulin, N Chakfe, F Severac, M Schaeffer, P-M Mertes, A Steib
BACKGROUND: Delayed graft function (DGF) is an early postoperative complication of kidney transplantation (KT) predisposing to acute rejection and lower graft survival. Intraoperative arterial hypotension and hypovolemia are associated with DGF. Central venous pressure (CVP) is used to estimate volemia but its reliability has been criticized. Pleth variability index (PVI) is a hemodynamic parameter predicting fluid responsiveness. The aim of this study was to examine the relationship between intraoperative PVI and CVP values and the occurrence of DGF...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27766704/treatment-of-recurrent-non-paroxysmal-atrial-fibrillation-using-focal-impulse-and-rotor-mapping-firm-guided-rotor-ablation-early-recurrence-and-long-term-outcomes
#20
Stefan Georg Spitzer, László Károlyi, Carola Rämmler, Frank Scharfe, Thomas Weinmann, Mirko Zieschank, Anke Langbein
INTRODUCTION: A patient-tailored ablation approach focused on the elimination of both pulmonary vein triggers as well as substrate drivers may result in favourable outcomes with recurrent persistent AF patients. OBJECTIVE: We evaluated the long-term outcomes of rotor ablation combined with conventional pulmonary vein isolation (PVI) in patients with recurrent non-paroxysmal AF. METHODS: 58 consecutive patients underwent FIRM-guided rotor ablation followed by conventional PVI for the treatment of recurrent non-paroxysmal AF...
October 21, 2016: Journal of Cardiovascular Electrophysiology
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