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https://www.readbyqxmd.com/read/28514791/impact-of-targeting-adenosine-induced-transient-venous-reconnection-in-patients-undergoing-pulmonary-vein-isolation-for-atrial-fibrillation-a-meta-analysis-of-3524-patients
#1
Alessandro Blandino, Giuseppe Biondi-Zoccai, Alberto Battaglia, Stefano Grossi, Francesca Bianchi, Maria Rosa Conte, Francesco Rametta, Fiorenzo Gaita
AIMS: Atrial fibrillation recurrences after pulmonary vein isolation (PVI) are not uncommon and are frequently related to pulmonary vein reconnection. Adenosine/ATP can reveal dormant pulmonary vein conduction after PVI. Previous studies revealed that adenosine-guided Additional ablation could improve arrhythmia-free survival. We performed a meta-analysis to assess the impact of additional ablation to eliminate adenosine-induced transient pulmonary vein reconnection in terms of atrial fibrillation recurrence at follow-up...
July 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28513287/contact-force-technology-integrated-with-3d-navigation-system-for-atrial-fibrillation-ablation-improving-results
#2
Roberto Rordorf, Antonio Sanzo, Vincenzo Gionti
Pulmonary veins isolation (PVI) by radiofrequency (RF) ablation is currently an established treatment for symptomatic, drug-resistant paroxysmal atrial fibrillation. Although the effectiveness of the therapy has been clearly demonstrated, success rate after a single procedure is still sub-optimal. The main reason for recurrences after PVI is electrical pulmonary vein-atrium reconnection. In order to increase the likelihood of permanent PVI, the creation of a transmural, durable lesion is mandatory. The main determinants of lesion size and transmurality are power, stability, duration and contact-force during RF application...
May 17, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28513211/image-quality-of-low-radiation-dose-left-atrial-ct-using-filtered-back-projection-and-an-iterative-reconstruction-algorithm-intra-individual-comparison-in-unselected-patients-undergoing-pulmonary-vein-isolation
#3
Ute Lina Fahlenkamp, Ivan Diaz Ramirez, Moritz Wagner, Carsten Schwenke, Alexander Huppertz, Bernd Hamm, Alexander Lembcke
Background Computed tomography (CT) of the left atrium (LA) is performed prior to pulmonary vein isolation (PVI) to improve success of circumferential ablation for atrial fibrillation. The ablation procedure itself exposes patients to substantial radiation doses, therefore radiation dose reduction in pre-ablational imaging is of concern. Purpose To assess and compare diagnostic performance of low-radiation dose preprocedural CT in patients scheduled for PVI using two types of reconstruction algorithms. Material and Methods Forty-six patients (61 ± 10 years) scheduled for PVI were enrolled in this study irrespective of body-mass-index or cardiac rhythm at examination...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28506919/novel-dye-less-and-fluoro-less-approach-to-cryoballoon-pulmonary-vein-occlusion-assessment
#4
Boaz Avitall, Arthur Kalinski, G Stephen Kocheril, Timothy G Laske, Nicolas Coulombe
BACKGROUND: Occlusion of pulmonary veins is essential for PV isolation using the Cryo balloon. Currently occlusion is arbitrarily determined using fluoroscopy and contrast media. This study aimed to create an objective measure without utilizing excessive fluoroscopy and no contrast media. OBJECTIVE: Ensure PV occlusion without fluoroscopy and contrast dye. METHODS: In 4 in vivo hearts 113 PV occlusions were tested with a 50% cold dye saline mix at 4°C...
May 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28505031/povidone-iodine-solutions-inhibit-cell-migration-and-survival-of-osteoblasts-fibroblasts-and-myoblasts
#5
James X Liu, Jordan A Werner, John A Buza, Thorsten Kirsch, Joseph D Zuckerman, Mandeep S Virk
STUDY DESIGN: In vitro laboratory study. OBJECTIVE: The purpose of this study was to identify the effect of dilute povidone-iodine (PVI) solutions on human osteoblast, fibroblast and myoblast cells in vitro. SUMMARY OF BACKGROUND DATA: Dilute PVI wound lavage has been used successfully in spine and joint arthroplasty procedures to prevent post-operative surgical site infection, but their biologic effect on host cells is largely unknown. METHODS: Human primary osteoblasts, fibroblasts, and myoblasts were expanded in cell culture and subjected to various concentrations of PVI (0%, 0...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28501100/comparison-of-direct-current-synchronized-cardioversion-to-ibutilide-guided-catheter-ablation-for-long-term-sinus-rhythm-maintenance-after-isolated-pulmonary-vein-isolation-of-persistent-atrial-fibrillation
#6
Maojing Wang, Qing Zhao, Wei Ding, Shanglang Cai
Use of the antiarrhythmic ibutilide after isolated pulmonary vein isolation (PVI) might distinguish atrial remodeling severity and cases requiring further substrate modification, thereby improving efficacy of persistent atrial fibrillation (AF) treatment. Ninety-six consecutive patients with persistent AF were randomized after PVI to either direct current synchronized cardioversion (DCC group, n = 48) or 1 mg of intravenous ibutilide (ibutilide group, n = 48) followed by no further intervention if AF converted to sinus rhythm (SR) within 30 minutes (ibutilide conversion subgroup) or by complex fractionated atrial electrogram (CFAE) ablation until SR recovery or complete CFAE elimination (ibutilide nonconversion subgroup)...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28500480/-pulmonary-vein-isolation-for-atrial-fibrillation-findings-from-long-term-follow-up
#7
C-H Heeger, K-H Kuck, F Ouyang
Atrial fibrillation is by far the most common cardiac arrhythmia in humans. The incidence of atrial fibrillation increases with age and will increase even more in the future due to the demographic changes in the population. Therefore, this arrhythmia will have a growing clinical and socioeconomic impact. Although there are established pharmaceutical treatment options, atrial fibrillation is one of the major causes of stroke, heart failure and cardiovascular morbidity and mortality. The latest guidelines recommend the invasive procedure of circumferential pulmonary vein isolation (PVI) as an effective treatment of paroxysmal and persistent atrial fibrillation...
May 12, 2017: Herz
https://www.readbyqxmd.com/read/28500479/-catheter-ablation-of-persistent-atrial-fibrillation-where-do-we-go
#8
C Lemeš, K-H Kuck, S Mathew
Despite the very promising initial results of clinical studies, catheter ablation of persistent atrial fibrillation (AF) remains a challenge in modern electrophysiology. On the basis of the hypothesized pathophysiological mechanisms, a variety of ablation strategies have been developed over the course of time. The current ablation strategies range from pulmonary vein isolation (PVI) alone as first-line therapy, through ablation of multiple linear lesions, ablation of complex fractionated atrial electrograms (CFAE), rotor ablation, isolation of fibrotic and scar tissue up to isolation of the left atrial appendage (LAA); however, it is unclear even to the present day whether these complex and time-consuming strategies actually improve the success rate of ablation therapy...
May 12, 2017: Herz
https://www.readbyqxmd.com/read/28497857/validation-of-electrical-ostial-pulmonary-vein-isolation-verified-with-a-spiral-inner-lumen-mapping-catheter-during-second-generation-cryoballoon-ablation
#9
Shinsuke Miyazaki, Takatsugu Kajiyama, Tomonori Watanabe, Hiroshi Taniguchi, Hiroaki Nakamura, Rikuta Hamaya, Shigeki Kusa, Miyako Igarashi, Hitoshi Hachiya, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: Achieve catheters are cryoballoon guidewires that enable pulmonary vein (PV) potential mapping. The single catheter approach in conjunction with the Achieve catheter is currently standard practice in second-generation cryoballoon ablation, yet circumferential mapping catheters are the gold standard for evaluating PV isolation (PVI). The study sought to validate the ostial PVI verified by an Achieve catheter alone. METHODS: One-hundred fifty-one paroxysmal atrial fibrillation patients undergoing PVI using exclusively 28-mm second-generation cryoballoons were enrolled...
May 12, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28495652/acute-efficacy-safety-and-long-term-clinical-outcomes-utilizing-the-second-generation-cryoballoon-for-pulmonary-vein-isolation-in-patients-with-a-left-common-pulmonary-vein-a-multicenter-study
#10
Christian-Hendrik Heeger, Verena Tscholl, Erik Wissner, Thomas Fink, Laura Rottner, Peter Wohlmuth, Barbara Bellmann, Mattias Roser, Shibu Mathew, Christian Sohns, Bruno Reißmann, Christine Lemeš, Tilman Maurer, Francesco Santoro, Johannes Riedl, Britta Goldmann, Ulf Landmesser, Feifan Ouyang, Karl-Heinz Kuck, Andreas Rillig, Andreas Metzner
BACKGROUND: Second-generation cryoballoon (CB2)-based pulmonary vein isolation (PVI) has demonstrated encouraging clinical results in the treatment of paroxysmal (PAF) and persistent atrial fibrillation (PersAF). However, the CB2 features a maximal diameter of 28mm and its adaptability to anatomical variations of the pulmonary veins (PVs) might be challenging. OBJECTIVE: To assess acute efficacy, safety and long-term clinical results of CB2-based PVI in patients with a left common PV (LCPV)...
May 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28484522/cerebrospinal-fluid-dynamics-study-in-communicating-hydrocephalus
#11
Vengalathur Ganesan Ramesh, Vidhya Narasimhan, Chandramouli Balasubramanian
CONTEXT: Communicating hydrocephalus often poses a challenge in diagnosis and management decisions. AIMS: The objective of this study is to measure the opening pressure (Po), pressure volume index (PVI), and cerebrospinal fluid outflow resistance (Rout), in patients with communicating hydrocephalus using bolus lumbar injection method and to evaluate its diagnostic and prognostic value. MATERIALS AND METHODS: The study was conducted in 50 patients with communicating hydrocephalus, including normal pressure hydrocephalus (NPH) (19), post-meningitic hydrocephalus (23) and post-traumatic hydrocephalus (8)...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28479467/the-natural-history-and-outcomes-of-endovascular-therapy-for-claudication
#12
Julia T Saraidaridis, Emel A Ergul, W Darrin Clouse, Virendra I Patel, Richard P Cambria, Mark F Conrad
INTRODUCTION: The natural history of claudication is well characterized and traditional therapy includes risk factor modification and exercise protocols with revascularization reserved for patients who are severely impaired. However, the reduced peri-procedural morbidity with endovascular therapy has led physicians to broaden the indications for intervention for peripheral artery disease and more claudicants are undergoing procedures for disease that is moderately limiting to their lifestyle...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28471019/type-and-rate-of-atrial-fibrillation-termination-due-to-rotational-activity-ablation-combined-with-pulmonary-vein-isolation
#13
Zsuzsanna Kis, Dominic A Theuns, Rohit Bhagwandien, Sip Wijchers, Sing-Chien Yap, Tamas Szili-Torok
BACKGROUND: There remains controversy about the optimal ablation technique and termination rate of atrial fibrillation (AF) during catheter ablation in patients with persistent AF. The aim of this study was to determine the rate and timing of AF termination during combined pulmonary vein isolation (PVI) and focal impulse and rotor modulation (FIRM)-guided ablation of rotational activity (RoAc). METHODS: This single-center, prospective cohort study enrolled 38 consecutive patients (63% male, mean age 63 ± 11 years) with persistent AF (mean left atrial size: 46 ± 7 mm), who underwent FIRM mapping and ablation of the identified RoAcs followed by PVI...
May 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28460771/pressure-guided-cryoablation-of-pulmonary-veins-in-atrial-fibrillation-a-fast-and-effective-strategy
#14
Amol Raizada, Maheedhar Gedela, Kashif Abbas Shaikh, Nachiket Apte, Max DeHaan, Christopher Stanton
BACKGROUND: Cryoballoon ablation of atrial fibrillation (AF) involves successful electrical pulmonary vein isolation (PVI). Pulmonary vein (PV) ostial occlusion with cryoballoon is classically assessed using PV angiography. A pressure-guided technique to assess ostial occlusion has been evaluated in small cohorts with mixed results. We evaluated the efficacy of this pressure-guided PVI technique and its impact on reducing contrast and fluoroscopy time as compared to the traditional approach...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28458312/breakage-of-a-circular-catheter-wedged-in-a-right-pulmonary-vein-during-cryoballoon-pulmonary-vein-isolation
#15
Hisaki Makimoto, Malte Kelm, Dong-In Shin, Christian Blockhaus
A 50-year-old man with paroxysmal atrial fibrillation underwent pulmonary vein isolation (PVI) using a cryoballoon. During the PVI procedure, a circular diagnostic catheter (CDC) was wedged deeply into the right PV (RPV). The lung tissues seemed to be tightening around the CDC. After various attempts to resolve the situation, the shaft of the CDC was completely torn, and the circular part remained in the RPV. At a follow-up of three months, the patient showed neither atrial fibrillation events nor clinical symptoms...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28449531/ablation-of-atrial-fibrillation-single-shot-techniques-poised-to-dominate-rhythm-control-strategies-the-future-is-here
#16
EDITORIAL
Antonis S Manolis
Over the recent years, the advent of single-shot techniques, such as circular catheter and cryoballoon ablation, has ushered in a new era in the catheter ablation approach and rhythm control strategies of patients with atrial fibrillation (AF). These techniques make it easier to navigate the heart and have the potential to decrease the threshold for, expand the access to, and increase patient and physician acceptance of rhythm-control therapies, that may lead to reduction of the AF disease burden and its socioeconomic impact...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28439618/-radiofrequency-current-or-cryoballoon-for-ablation-of-atrial-fibrillation-hot-or-cold
#17
B Reissmann, K-H Kuck, A Metzner
Atrial fibrillation (AF) is the most common form of cardiac arrhythmia. The aim of therapy in symptomatic patients is the establishment of a stable sinus rhythm (SR). Catheter ablation with isolation of the pulmonary veins is the essential component of all forms of ablation therapy and provides the most effective treatment option. The most frequently used technologies for pulmonary vein isolation (PVI) are radiofrequency current (RFC)-based and cryoballoon (CB)-guided ablation. Irrespective of the simplification of PVI, CB ablation is characterized by a short learning curve and short procedural times and demonstrated non-inferiority with respect to safety and efficacy when directly compared to RFC ablation for the treatment of patients with paroxysmal AF; however, the clinical outcome in patients with persistent AF is often insufficient when performing pulmonary vein isolation (PVI) alone for stabilization of SR...
April 24, 2017: Herz
https://www.readbyqxmd.com/read/28434446/revisiting-pulmonary-vein-isolation-alone-for-persistent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#18
Aleksandr Voskoboinik, Jeremy T Moskovitch, Nadav Harel, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Early studies demonstrated relatively low success rates for pulmonary vein isolation (PVI) alone in patients with persistent atrial fibrillation (PeAF). However, the advent of new technologies and the observation that additional substrate ablation does not improve outcomes have created a new focus on PVI alone for treatment of PeAF. OBJECTIVE: The purpose of this study was to systematically review the recent medical literature to determine current medium-term outcomes when a PVI-only approach is used for PeAF...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28432503/high-voltage-zones-within-the-pulmonary-vein-antra-major-determinants-of-acute-pulmonary-vein-reconnections-after-atrial-fibrillation-ablation
#19
Koichi Nagashima, Ichiro Watanabe, Yasuo Okumura, Kazuki Iso, Keiko Takahashi, Ryuta Watanabe, Masaru Arai, Sayaka Kurokawa, Toshiko Nakai, Kimie Ohkubo, Shunichi Yoda, Atsushi Hirayama
PURPOSE: Recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) is mainly due to PV reconnections. Patient-specific tissue characteristics that may contribute remain unidentified. This study aimed to assess the relationship between the bipolar electrogram voltage amplitudes recorded from the PV-left atrial (LA) junction and acute PV reconnection sites. METHODS: Three-dimensional LA voltage maps created before an extensive encircling PVI in 47 AF patients (31 men; mean age 62 ± 11 years) were examined for an association between the EGM voltage amplitude recorded from the PV-LA junction and acute post-PVI PV reconnections (spontaneous PV reconnections and/or ATP-provoked dormant PV conduction)...
April 21, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28432449/enteroparasitoses-and-toxocarosis-affecting-children-from-mar-del-plata-city-argentina
#20
Carla Lavallén, Beatriz Brignani, Karina Riesgo, Amalia Rojas, Gabriela Colace, Martín Biscaychipi, Estela Chicote, Cristian Giuntini, Mariela Kifer, María Eugenia Del Río, Guillermo Denegri, Marcela Dopchiz
This study evaluated the existence of enteroparasitoses and toxocarosis in children of peripheral (PC) and urban communities (UC) from Mar del Plata city (Argentina) and their associations with socio-environmental conditions. A Parasite Vulnerability Index (PVI) was elaborated using variables such as overcrowding, floor type, drinking water source, wastewater disposal, solid waste disposal, presence of animals and schooling level. The PC evidenced statistically significant higher frequencies of families with high (38...
April 21, 2017: EcoHealth
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