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https://www.readbyqxmd.com/read/29326838/increasing-the-single-procedure-success-rate-of-pulmonary-vein-isolation
#1
Mattias Duytschaever, Mark O'Neill, Martin Martinek
To improve the single-procedural success and long-term outcomes of catheter ablation techniques for AF, there is a need for durable, contiguous and transmural lesions encircling the pulmonary veins (PV). Measurement of contact force (CF) between the catheter tip and the target tissue can optimise ablation procedures. A new approach to obtain single-procedure durable PV isolation (PVI) using the latest CF technology combined with the CARTO VISITAG™ Module with Ablation Index (Biosense Webster) has been shown in small studies to almost eliminate recurrence of paroxysmal AF at 1-year follow up and to make PVI procedures more reproducible...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326835/ablation-of-atrial-fibrillation-drivers
#2
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/29316457/topical-chlorhexidine-povidone-iodine-and-erythromycin-in-the-repair-of-traumatic-ulcers-on-the-rat-tongue-clinical-histological-and-microbiological-evaluation
#3
Dieni da Silveira Teixeira, Maria Antonia Zancanaro de Figueiredo, Karen Cherubini, Maria Claudia Rosa Garcia, Sílvia Dias de Oliveira, Fernanda Gonçalves Salum
OBJECTIVE: This study investigated the effect of topical application of 0.12% chlorhexidine, 10% povidone-iodine and 50% erythromycin on the optimization of healing process of traumatic ulcers made on ventral tongue of rats. DESIGN: Forty-Eight Wistar rats were randomly divided into four groups: control, chlorhexidine (Chx), povidone-iodine (PvI) and erythromycin (Er). An ulcer of 5 mm in diameter was made on the ventral tongue of the animals. After 24 h, a microbiological sample was taken and daily application of the substances started...
January 4, 2018: Archives of Oral Biology
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
#4
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/29313865/evaluation-of-emdogain%C3%A2-antimicrobial-effectiveness-against-biofilms-containing-the-keystone-pathogen-porphyromonas-gingivalis
#5
Jérôme Lasserre, Selena Toma, Ana-Maria Dos Santos-Gonçalvez, Julian Leprince, Gaëtane Leloup, Michel Brecx
This study aimed to evaluate the antimicrobial activity of Emdogain® (EMD) against biofilms containing the periopathogen Porphyromonas gingivalis. A brain-Heart infusion broth inoculated with S. gordonii and P. gingivalis was perfused (7-d, anaerobiosis) through a closed circuit containing two Robbins devices as to form biofilms. The latter were then treated for 2 min with various antimicrobials (Chlorhexidine (CHX) 0.2%, Povidone iodine (PVI) 5%, PVI 10%, essential oils (EO), EO Zero™ or EMD)(n=8) and cell densities were calculated and compared...
January 9, 2018: New Microbiologica
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
#6
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
https://www.readbyqxmd.com/read/29305676/impact-of-3d-mapping-on-procedural-characteristics-and-outcomes-in-cryoballoon-pulmonary-vein-isolation-for-atrial-fibrillation
#7
Emily N Guhl, Evan Adelstein, Andrew Voigt, Norman C Wang, Samir Saba, Sandeep K Jain
PURPOSE: The use of 3D mapping during cryoballoon pulmonary vein isolation (PVI) is optional with added cost but potential benefit in aiding vein identification, reducing fluoroscopy, and post-ablation testing. Data are limited evaluating procedural characteristics and outcomes in patients undergoing cryoballoon PVI with mapping vs. no mapping. In the present study, we compare procedural characteristics and recurrence-free rates in patients undergoing cryoballoon PVI among patients using CARTO®, NavX™, or no mapping system...
January 5, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29289948/association-of-anemia-with-outcomes-in-patients-undergoing-percutaneous-peripheral-vascular-intervention-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2-vic
#8
Nikhil V Ambulgekar, Scott F Grey, Howard S Rosman, Hussein Othman, Thomas P Davis, Timothy J Nypaver, Theodore Schreiber, Hiroshi Yamasaki, Thomas A Lalonde, Peter K Henke, Hitinder S Gurm, Rajendra H Mehta, P Michael Grossman
OBJECTIVES: To evaluate the clinical features and outcomes of patients with anemia undergoing percutaneous peripheral vascular intervention (PVI) in a contemporary registry. METHODS: We evaluated the differences in the clinical features and outcomes of patients with and without anemia undergoing PVI in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2 VIC) registry. Anemia was defined using World Health Organization criteria. RESULTS: Baseline anemia was present in 42...
January 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29285621/five-year-clinical-outcomes-of-visually-guided-laser-balloon-pulmonary-vein-isolation-for-the-treatment-of-paroxysmal-atrial-fibrillation
#9
Bruno Reissmann, Thorsten Budelmann, Erik Wissner, Michael Schlüter, Christian-Hendrik Heeger, Shibu Mathew, Tilman Maurer, Christine Lemes, Thomas Fink, Andreas Rillig, Francesco Santoro, Johannes Riedl, Feifan Ouyang, Karl-Heinz Kuck, Andreas Metzner
BACKGROUND: Visually guided laser balloon (VGLB) ablation allows for pulmonary vein isolation (PVI) under direct endoscopic control. Short- and midterm clinical outcomes are in accordance with results of radiofrequency current (RFC) ablation for the treatment of paroxysmal atrial fibrillation (PAF). OBJECTIVE: The current study sought to assess the long-term clinical outcomes of VGLB-based PVI for PAF. METHODS: A total of 90 patients [60 ± 10 years; 33 (37%) female, left atrial diameter 42 ± 4 mm] with drug-refractory PAF underwent VGLB ablation...
December 28, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29279459/does-size-matter-cryoballoon-based-pulmonary-vein-isolation-using-a-novel-25-mm-circular-mapping-catheter
#10
Bruno Reissmann, Michael Schlüter, Francesco Santoro, Tilman Maurer, Christian-Hendrik Heeger, Christine Lemes, Thomas Fink, Johannes Riedl, Andreas Rillig, Shibu Mathew, Feifan Ouyang, Karl-Heinz Kuck, Andreas Metzner
BACKGROUND: Real-time recording of pulmonary vein isolation (PVI) using a circular mapping catheter has become a key aspect of cryoballoon (CB) ablation. The aim of this study was to investigate the procedural safety, efficacy and rate of real-time pulmonary vein (PV) recording using a novel circular mapping catheter with a 25-mm loop size for CB-based PVI.Methods and Results:A total of 40 patients with symptomatic atrial fibrillation (AF) underwent PVI using a second-generation CB and a novel 25-mm circular mapping catheter...
December 27, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29274801/three-dimentional-electroanatomical-mapping-for-non-pulmonary-vein-foci-in-a-patient-with-complete-situs-inversus-and-dextrocardia
#11
Kentaro Minami, Koji Kumagai, Yoshinao Sugai, Kohki Nakamura, Shigeto Naito, Shigeru Oshima
In patients with atrial fibrillation (AF) having congenital anatomical abnormalities, such as complete situs inversus and dextrocardia, pulmonary vein isolation (PVI) ablation can be performed safety using a three-dimensional electroanatomical mapping system. However, it is not clear whether a three-dimensional electroanatomical mapping system can be used to detect non-PV ectopic beats initiating AF in patients with complete situs inversus and dextrocardia. Here, we report a 21-year-old man with complete situs inversus and dextrocardia, who showed AF caused by non-PV ectopic beats...
December 21, 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29273240/balloon-angioplasty-versus-stenting-for-pulmonary-vein-stenosis-after-pulmonary-vein-isolation-for-atrial-fibrillation-a-meta-analysis
#12
Alessandra Buiatti, Gesa von Olshausen, Eimo Martens, Karin Schinke, Karl-Ludwig Laugwitz, Petra Hoppmann, Tareq Ibrahim
BACKGROUND: The incidence of pulmonary vein stenosis (PVS) as complication after pulmonary vein isolation (PVI) for atrial fibrillation (AF) has decreased in the last decade. However, as PVI for AF is becoming more prevalent, the incidence remains considerable in absolute terms. The purpose of this meta-analysis is to investigate the optimal approach for management of PVS after PVI for AF. METHODS AND RESULTS: We searched electronic scientific databases for studies comparing plain balloon angioplasty (BA) versus stenting for PVS after PVI for AF...
December 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29250297/pulmonary-vein-isolation-with-the-multipolar-nmarq%C3%A2-ablation-catheter-efficacy-and-safety-in-acute-and-long-term-follow-up
#13
REVIEW
Siebermair Johannes, Michelle Silver, Wakili Reza
Pulmonary vein isolation (PVI) is an established therapy for atrial fibrillation (AF). One challenge in the catheter-based treatment of this arrhythmia is to develop an effective and safe ablation approach to achieve durable and consistent lesions around the PVs. The multipolar irrigated radiofrequency (RF) ablation catheter nMARQTM was designed as a single-shot device with the aim to achieve these goals. This article reviews the current literature with respect to acute- and long- term success rates after PVI with this circular mapping and ablation device...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250295/early-pulmonary-vein-conduction-recovery-after-catheter-ablation-of-atrial-fibrillation
#14
Ayman Mortada, Saeed Khaled, Samir Wafa, Hayam Eldamanhoury, Ahmed Nabil
Background: Pulmonary vein electrical isolation (PVI) is an effective treatment for atrial fibrillation (AF). However, recurrence of pulmonary vein (PV) conduction after ablation may limit long-term success. Early identification and treatment of acute PV conduction recovery during initial ablation may have an impact on subsequent clinical results. Objective: To assess the prevalence of acute PV conduction recovery during the observation time after PV isolation for paroxysmal AF, and to evaluate the impact of re-isolation treatment on long-term clinical results...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250292/comparison-of-the-efficacy-of-pvac%C3%A2-and-nmarq%C3%A2-for-paroxysmal-atrial-fibrillation
#15
REVIEW
Avishag Laish-Farkash, Mahmoud Suleiman
Pulmonary vein isolation (PVI) has become the mainstay of therapy for atrial fibrillation (AF) and one of the most frequently performed procedures in the cardiac electrophysiology laboratory. PVI by a single-tip radiofrequency (RF) ablation catheter remains a complex and time-consuming procedure, especially in centers with limited experience. In order to simplify the PVI procedure, to shorten it and reduce the complication rate, circular multi-electrode catheters were introduced for simultaneous mapping and ablation...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250289/mechanistic-insights-into-durable-pulmonary-vein-isolation-achieved-by-second-generation-cryoballoon-ablation
#16
Yasuo Okumura, Ichiro Watanabe, Kazuki Iso, Keiko Takahashi, Koichi Nagashima, Kazumasa Sonoda, Hiroaki Mano, Naoko Yamaguchi, Rikitake Kogawa, Ryuta Watanabe, Masaru Arai, Kimie Ohkubo, Sayaka Kurokawa, Toshiko Nakai, Atsushi Hirayama
Background: The mechanism explaining the efficacy of cryoballoon ablation (CBA) for atrial fibrillation has not been clarified. Methods and Results: We compared lesion characteristics between patients in whom pulmonary vein isolation (PVI) was performed by CBA (n=56) and those by contact force (CF)-based RF ablation (n=56). We evaluated the 3-dimensional PV morphology before and after cryoballoon inflation. After PVI, a 3D left atrial voltage map was created. Pacing (10 mA and 2 ms) was performed within the low voltage area from the ablation line, and electrically unexcitable ablated tissue was identified...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250273/left-atrial-appendage-characteristics-in-patients-with-persistent-atrial-fibrillation-undergoing-catheter-ablation-laapaf-study
#17
Enes E Gul, Usama Boles, Sohaib Haseeb, Justin Flood, Ayuish Bansal, Benedict Glover, Damian Redfearn, Chris Simpson, Hoshiar Abdollah, Adrian Baranchuk, Kevin A Michael
Background: Despite technological and scientific efforts, the recurrence rate of persistent atrial fibrillation (AF) remains high. Several studies have shown that in addition to pulmonary vein (PV) isolation other non-PV triggers, particularly left atrial appendage may be the source of initiation and maintenance of AF. There are few studies showing the role of left atrial appendage (LAA) isolation in order to obtain higher success rate in persistent AF patients. Objective: We analyzed the LAA volume, volume index and shape relative to the LA in patients with persistent AF undergoing AF ablation...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250270/high-voltage-guided-pulmonary-vein-isolation-in-paroxysmal-atrial-fibrillation
#18
Usama Boles, Enes E Gul, Andres Enriquez, Howard Lee, Dave Riegert, Adrian Andres, Adrian Baranchuk, Damian Redfearn, Benedict Glover, Chris Simpson, Hoshiar Abdollah, Kevin Michael
Background: Ablation of the pulmonary vein (PV) antrum using an electroanatomic mapping system is standard of care for point-by-point pulmonary vein isolation (PVI). Focused ablation at critical areas is more likely to achieve intra-procedural PV isolation and decrease the likelihood for reconnection and recurrence of atrial fibrillation (AF). Therefore this prospective pilot study is to investigate the short-term outcome of a voltage-guided circumferential PV ablation (CPVA) strategy...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250269/bonus-vs-no-bonus-cryoballoon-isolation-for-paroxysmal-atrial-fibrillation-ablation
#19
Aysenur Ekizler, Dursun Aras, Serkan Cay, Ozcan Ozeke, Firat Ozcan, Serkan Topaloglu
Aims: To evaluate the benefit of Bonus freeze using second generation cryoballoon after pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF). Methods: A bonus freeze is performed after proven pulmonary vein isolation (PVI) for cryoballoon ablation of paroxysmal atrial fibrillation (PAF) as standard. In the current study, no additional freeze (No Bonus) after PVI was compared with additional freeze (Bonus) after PVI using second generation cryoballoon...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250268/reconnection-rate-and-long-term-outcome-with-adenosine-provocation-during-cryoballoon-ablation-for-pulmonary-vein-isolation
#20
Rachel M Kaplan, Sanjay Dandamudi, Martha Bohn, Nishant Verma, Todd T Tomson, Rishi Arora, Alexandru B Chicos, Jeffrey J Goldberger, Susan S Kim, Bradley P Knight, Albert C Lin, Rod S Passman
Background: Adenosine can unmask dormant conduction during pulmonary vein isolation (PVI) for atrial fibrillation (AF). Studies of adenosine use in radiofrequency PVI show high reconnection rates and conflicting results for long-term success, however there is limited data with cryoballoon ablation (CBA). Methods: A prospectively maintained database of patients undergoing first CBA at a single institution was analyzed. Adenosine use was at the discretion of the primary operator...
February 2017: Journal of Atrial Fibrillation
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