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https://www.readbyqxmd.com/read/28654542/percutaneous-vascular-interventions-versus-bypass-surgeries-in-patients-with-critical-limb-ischemia-a-comprehensive-meta-analysis
#1
Jiarong Wang, Chi Shu, Zhoupeng Wu, Jichun Zhao, Yukui Ma, Bin Huang, Ding Yuan, Yi Yang, He Bian, Yazhou He, Ziqiang Wang
OBJECTIVE: The aim of our study was to compare percutaneous vascular interventions (PVI) versus bypass surgeries (BSX) in patients with critical limb ischemia (CLI). BACKGROUND: Previous relevant reviews with limited numbers of included studies did not strictly confine the inclusion criteria to CLI, also involving patients with severe claudication, which may introduce bias in the decision-making of CLI revascularization. Current treatment strategies for CLI still remain controversial...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28652028/cryoablation-for-atrial-fibrillation-in-2017-what-have-we-learned
#2
REVIEW
Padmanabhan Shakkottai, Raymond W Sy, Mark A McGuire
Catheter ablation has become a standard technique for the treatment of atrial fibrillation. Pulmonary vein isolation (PVI) is the most important component of catheter ablation of atrial fibrillation. Radiofrequency (RF) ablation and balloon cryoablation can be used to achieve PVI. This review examines the biophysics and clinical efficacy of balloon cryoablation and discusses the potential advantages and disadvantages compared to RF ablation.
May 26, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28649087/acute-hemodynamic-and-tissue-effects-of-cryoballoon-ablation-on-pulmonary-vessels-the-ivus-cryo-study
#3
Jakub Baran, Paweł Lewandowski, Krzysztof Smarż, Agnieszka Sikorska, Beata Zaborska, Piotr Kułakowski
BACKGROUND: Cryoballoon-based pulmonary vein isolation (CB-PVI) has been widely used for the treatment of atrial fibrillation. Although generally safe and effective, the procedure may be associated with pulmonary vein (PV) stenosis and bronchial or esophageal injury. The mechanisms leading to these complications have not been studied in detail. Our aim was to examine acute effects of cryoballoon on the pulmonary vessel and right heart pressures as well as PV wall morphology. METHODS AND RESULTS: In 8 patients (5 men, mean age 55±14 years) undergoing CB-PVI, pressure in each PV was measured by catheter located inside the PV directly before and after CB-PVI...
June 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28643171/elimination-of-the-negative-component-of-the-unipolar-electrogram-as-a-local-procedural-endpoint-during-paroxysmal-atrial-fibrillation-catheter-ablation-using-contact-force-sensing-the-uniforce-study
#4
Agustín Bortone, Philippe Lagrange, Bruno Cauchemez, Cyril Durand, Pierre Dieuzaide, Sébastien Prévot, Alexis Mechulan, Thomas Pambrun, Ruairidh Martin, Pauline Parlier, Alexandre Masse, Eloi Marijon, Jean-Paul Albenque
PURPOSE: Elimination of the negative component of the unipolar atrial electrogram is a reliable indicator of the creation of a transmural lesion. Contact-force (CF) sensing technology has the potential to increase the durability of pulmonary vein isolation (PVI). In the present multicenter study, we assessed the 2-year sinus rhythm (SR) maintenance rate in patients with paroxysmal atrial fibrillation (PAF) after PVI guided by these two approaches. METHODS: Two hundred fifteen consecutive PAF patients (62...
June 22, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28643058/prospective-randomized-comparison-of-the-use-of-floshield-air-system-%C3%A2-versus-the-reference-technique-water%C3%A2-%C3%A2-povidone-iodine-solution-during-gynecologic-endoscopic-surgery-to-evaluate-the-operative-lens-vision-quality
#5
S Bendifallah, E Salakos, I Naoura, P Aristizabal, E Furet, S Zilberman, M Ballester, E Darai
BACKGROUND: The FloShield Air System(®) is a new device for laparoscopic surgery that utilizes a continuous dry CO2 gas flow over the scope to defog the lens and protect it from condensation, debris and smoke. We set out to compare the performance and efficiency of the device in terms of operative lens vision quality (OLVQ) with the reference technique (water + povidone-iodine (PVI) solution) during gynecologic laparoscopic surgery. MATERIALS AND METHODS: We conducted a single-center randomized prospective study between March and June 2016 (Trials Database Registration NCT02702531) including 53 patients undergoing gynecologic laparoscopic surgery with water + PVI solution and 51 patients who underwent surgical procedures with the FloShield Air System...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28639728/prospective-use-of-ablation-index-targets-improves-clinical-outcomes-following-ablation-for-atrial-fibrillation
#6
Ahmed Hussein, Moloy Das, Vivek Chaturvedi, Issa Khalil Asfour, Niji Daryanani, Maureen Morgan, Christina Ronayne, Matthew Shaw, Richard Snowdon, Dhiraj Gupta
AIMS: Late recovery of ablated tissue leading to reconnection of pulmonary veins remains common following radiofrequency catheter ablation for AF. Ablation Index (AI), a novel ablation quality marker, incorporates contact force (CF), time and power in a weighted formula. We hypothesized that prospective use of our previously-published derived AI targets would result in better outcomes when compared to CF-guided ablation. METHODS: 89 consecutive drug-refractory AF patients (49% paroxysmal) underwent AI-guided ablation (AI-group)...
June 22, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28637626/chromosome-4q25-variants-and-recurrence-after-second-generation-cryoballoon-ablation-in-patients-with-paroxysmal-atrial-fibrillation
#7
Shinsuke Miyazaki, Yusuke Ebana, Lian Liu, Hiroaki Nakamura, Hitoshi Hachiya, Hiroshi Taniguchi, Takamitsu Takagi, Takatsugu Kajiyama, Tomonori Watanabe, Miyako Igarashi, Shigeki Kusa, Takashi Niida, Yoshito Iesaka, Tetsushi Furukawa
BACKGROUND: Chromosome 4q25 single-nucleotide polymorphisms (SNPs) are associated with atrial fibrillation (AF) recurrence after radiofrequency catheter ablation, however the underlying mechanism is unknown. Pulmonary vein (PV) reconnections are common post-radiofrequency ablation. We explored the pre-procedural parameters, including AF susceptibility SNPs, predicting the response to PV isolation (PVI) using second-generation cryoballoons. METHODS: One hundred fifty-seven paroxysmal AF patients undergoing PVI using second-generation cryoballoons and genetic testing were enrolled...
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28635186/catheter-ablation-of-atrial-fibrillation-with-box-isolation-of-fibrotic-areas-lessons-on-fibrosis-distribution-and-extent-clinical-characteristics-and-their-impact-on-long-term-outcome
#8
Doreen Schreiber, Andreas Rieger, Fabian Moser, Hans Kottkamp
INTRODUCTION: The BIFA concept (box isolation of fibrotic areas) supplementing pulmonary vein isolation (PVI) was implemented in atrial fibrillation (AF) patients with fibrotic atrial cardiomyopathy (FACM) to improve catheter ablation outcomes. METHODS AND RESULTS: 92 patients with FACM underwent PVI+BIFA. We investigated patient characteristics (58 persistent/34 paroxysmal,68±8y,LA 44±7mm,CHA2 DS2 -VASc 2.6±1.3,FACM I:15.2%,II:53.3%,III:26.1%,IV:5.4%), periprocedural data concerning fibrosis extent/distribution and their impact on outcome...
June 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28626989/electrical-isolation-of-the-left-atrial-appendage-by-maze-like-catheter-substrate-modification-a-reproducible-strategy-for-pulmonary-vein-isolation-non-responders
#9
Stefano Bordignon, Laura Perrotta, Daniela Dugo, Fabrizio Bologna, Takahiko Nagase, Alexander Fuernkranz, Kr Julian Chun, Boris Schmidt
INTRODUCTION: The ablation strategy for atrial fibrillation (AF) despite pulmonary vein isolation (PVI) is controversial. Left atrial appendage isolation (LAAI) may contribute to improve outcome. We describe an ablation approach ("Maze-like"-LAAI) that (1) modifies the underlying LA substrate by linear ablation (2) eliminates the LAA as a putative AF trigger site and (3) incorporates an unambiguous procedural endpoint. The role of LAA closure (LAAC) after LAAI was investigated. METHODS: Patients with atrial tachyarrhythmias non-responsive to PVI underwent a LAAI ablation procedure...
June 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28625929/verification-of-a-novel-atrial-fibrillation-cryoablation-dosing-algorithm-guided-by-time-to-pulmonary-vein-isolation-results-from-the-cryo-dosing-study-cryoballoon-ablation-dosing-based-on-the-assessment-of-time-to-effect-and-pulmonary-vein-isolation-guidance
#10
Arash Aryana, David N Kenigsberg, Marcin Kowalski, Charles H Koo, Hae W Lim, Padraig Gearoid O'Neill, Mark R Bowers, Robert B Hokanson, Kenneth A Ellenbogen
BACKGROUND: There are no recommendations on the optimal dosing for cryoablation of atrial fibrillation (Cryo-AF). OBJECTIVE: We developed and prospectively tested a Cryo-AF dosing protocol guided exclusively by time-to-pulmonary vein (PV) isolation (TT-PVI) in patients undergoing a first-time Cryo-AF. METHODS: In this multicenter study, we examined the acute/long-term safety/efficacy of Cryo-AF using the proposed dosing algorithm (Cryo-AFDosing, n=355) against a conventional, non-standardized approach (Cryo-AFConventional, n=400) in a non-randomized fashion...
June 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28612230/right-atrial-diameter-and-outcome-of-catheter-ablation-of-atrial-fibrillation
#11
Song -Nan Wen, Nian Liu, Rong Bai, Ri-Bo Tang, Rong-Hui Yu, De-Yong Long, Cai-Hua Sang, Chen-Xi Jiang, Song-Nan Li, Jia-Hui Wu, Yan-Fei Ruan, Rong Hu, Xin Du, Xiao-Hui Liu, Jian-Zeng Dong, Chang-Sheng Ma
PURPOSE: While AF is considered more like a left atrial (LA) disease, to what extent the right atrium contributes to the pathogenesis and ablation outcome of AF remains unclear. This study aimed to identify if right atrial diameter (RAD) could predict arrhythmia recurrence after catheter ablation of atrial fibrillation (AF). METHODS: Four hundred and seventy patients with drug-resistant AF [paroxysmal AF (PAF) 196; non-PAF 274] who underwent primary catheter ablation were enrolled...
June 13, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28607614/pulmonary-vein-potential-mapping-in-atrial-fibrillation-with-high-density-and-standard-spiral-lasso-catheters-a-comparative-study
#12
Axel Meissner, Petra Maagh, Arnd Christoph, Ahmet Oernek, Gunnar Plehn
BACKGROUND: The dominant single-shot procedure for Pulmonary Vein Isolation (PVI) is the Cryoballoon Ablation (CBA) technique using a spiral catheter (Achieve™, AC) for mapping and monitoring purposes. We hypothesized that Basket Catheters, such as the High Density Mesh Mapper (HDMM), with its high-density mapping properties, could detect Pulmonary Vein Potentials (PVPs) that the octapolar AC would not be able to identify. METHODS: Twenty-four patients (average age 61...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28605437/anatomical-predisposing-factors-of-transmural-thermal-injury-after-pulmonary-vein-isolation
#13
Takashi Kaneshiro, Yoshiyuki Matsumoto, Minoru Nodera, Masashi Kamioka, Yoshiyuki Kamiyama, Akiomi Yoshihisa, Hiroshi Ohkawara, Hitoshi Suzuki, Yasuchika Takeishi
Aims: Transmural thermal injury (TTI), such as oesophageal erosion/ulcer and perioesophageal nerve injury leading to gastric hypomotility, is an important complication associated with pulmonary vein isolation (PVI). However, a predictor of TTI concerning anatomical structures surrounding the oesophagus has not yet been fully elucidated. Therefore, we sought to identify the predisposing factors of TTI after PVI. Methods: Consecutive 110 patients, who underwent PVI for atrial fibrillation, received oesophagogastroduodenoscopy 2 days later, were investigated...
June 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28602895/risk-factors-for-sub-optimal-utilization-of-statins-and-antiplatelet-therapy-in-patients-undergoing-revascularization-for-symptomatic-peripheral-arterial-disease
#14
Andrew J Meltzer, Art Sedrakyan, Peter H Connolly, Sharif Ellozy, Darren B Schneider
OBJECTIVE: The objective of this study is to identify risk factors for sub-optimal medical therapy (defined as reported antiplatelet and statin use) among patients undergoing lower extremity bypass (LEB) and percutaneous interventions (PVI) for symptomatic peripheral arterial disease (PAD). METHODS: The Vascular Study Group of Greater New York (VSGGNY) database was used to identify all patients undergoing PVI or LEB for PAD (2011-2013). Bivariate analyses were performed to identifycharacteristics of patients who were not prescribed statins and/or antiplatelet agents prior to revascularization...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28600672/significant-reduction-in-procedure-duration-in-remote-magnetic-guided-catheter-ablation-of-atrial-fibrillation-using-the-third-generation-magnetic-navigation-system
#15
Tilman Maurer, Christian Sohns, Sebastian Deiss, Laura Rottner, Peter Wohlmuth, Bruno Reißmann, Christian H Heeger, Christine Lemes, Johannes Riedl, Francesco Santoro, Shibu Mathew, Andreas Metzner, Feifan Ouyang, Karl-Heinz Kuck, Erik Wissner
PURPOSE: The magnetic navigation system (MNS) has shown to be safe and effective for catheter ablation of atrial fibrillation (AF). However, longer procedure duration as compared to manual catheter ablation may limit its widespread use. This study aimed to assess the impact of the newest generation MNS using an optimized mapping and ablation protocol on the efficacy and safety of remote magnetic catheter (RMC)-guided pulmonary vein isolation (PVI). METHODS: This observational study included 52 patients with symptomatic AF who underwent RMC-guided PVI using the second-generation MNS Niobe II (initial 28 patients, group I) or the third-generation MNS Niobe ES in combination with an optimized mapping and ablation protocol (24 patients, group II)...
June 10, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28596994/recurrent-post-ablation-paroxysmal-atrial-fibrillation-shares-substrates-with-persistent-atrial-fibrillation-an-11-center-study
#16
Junaid A B Zaman, Tina Baykaner, Paul Clopton, Vijay Swarup, Robert C Kowal, James P Daubert, John D Day, John Hummel, Amir A Schricker, David E Krummen, Moussa Mansour, Gery F Tomassoni, Kevin R Wheelan, Mohan Vishwanathan, Shirley Park, Paul J Wang, Sanjiv M Narayan, John M Miller
INTRODUCTION: The role of atrial fibrillation (AF) substrates is unclear in patients with paroxysmal AF (PAF) that recurs after pulmonary vein isolation (PVI). We hypothesized that patients with recurrent post-ablation (redo) PAF despite PVI have electrical substrates marked by rotors and focal sources, and structural substrates that resemble persistent AF more than patients with (de novo) PAF at first ablation. METHODS: In 175 patients at 11 centers, we compared AF substrates in both atria using 64 pole-basket catheters and phase mapping, and indices of anatomical remodeling between patients with de novo or redo PAF and first ablation for persistent AF...
April 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28595885/the-effect-of-clinical-care-location-on%C3%A2-clinical-outcomes-after-peripheral%C3%A2-vascular-intervention-in-medicare-beneficiaries
#17
Ryan S Turley, Xiaojuan Mi, Laura G Qualls, Sreekanth Vemulapalli, Eric D Peterson, Manesh R Patel, Lesley H Curtis, W Schuyler Jones
OBJECTIVES: Modifications in reimbursement rates by Medicare in 2008 have led to peripheral vascular interventions (PVI) being performed more commonly in outpatient and office-based clinics. The objective of this study was to determine the effects of this shift in clinical care setting on clinical outcomes after PVI. BACKGROUND: Modifications in reimbursement have led to peripheral vascular intervention (PVI) being more commonly performed in outpatient hospital settings and office-based clinics...
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28583892/preoperative-chlorhexidine-versus-povidone-iodine-antisepsis-for-preventing-surgical-site-infection-a-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#18
REVIEW
Dan Zhang, Xi-Chen Wang, Zeng-Xi Yang, Jian-Xin Gan, Jie-Bin Pan, Lan-Ning Yin
BACKGROUNDS: Updated guidelines for surgical site infections (SSIs) suggested that chlorhexidine (CH) or povidone-iodine (PVI) product was equally appropriate to be applied in preoperative disinfection, but which one was optimal remained ambiguous. Moreover, recent studies reported inconsistent results. Thus, an updated meta-analysis was conducted to clarify the superiority of CH or PVI for prevention of SSIs in clean and clean-contaminated surgery. METHODS: From the inception to November 2016, Pubmed, Embase, and the Cochrane library were systematically searched for randomized controlled trials (RCTs) which explored preoperative antisepsis schemes (CH or PVI) for prevention of SSIs in clean and clean-contaminated surgery...
June 2, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28579576/automated-ablation-annotation-algorithm-reduces-re-conduction-of-isolated-pulmonary-vein-and-improves-outcome-after-catheter-ablation-for-atrial-fibrillation
#19
Nobuaki Tanaka, Koichi Inoue, Koji Tanaka, Yuko Toyoshima, Takafumi Oka, Masato Okada, Hiroyuki Inoue, Ryo Nakamaru, Yasushi Koyama, Atsunori Okamura, Katsuomi Iwakura, Yasushi Sakata, Kenshi Fujii
BACKGROUND: Durable pulmonary vein isolation (PVI) is critical in reducing recurrence after radiofrequency catheter ablation for atrial fibrillation (AF). The VISITAG Module, an automatic annotation system that takes account of catheter stability and contact force (CF), might be useful in accomplishing this.Methods and Results:In 49 patients undergoing VISITAG-guided AF ablation (group A), we set the following automatic annotation criteria: catheter stability range of motion ≤1...
June 2, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28570019/clinical-assessment-of-cryoballoon-ablation-in-cases-with-atrial-fibrillation-and-a-left-common-pulmonary-vein
#20
Takatoshi Shigeta, Kaoru Okishige, Yasuteru Yamauchi, Hideshi Aoyagi, Tomofumi Nakamura, Mitsumi Yamashita, Takuro Nishimura, Naruhiko Ito, Yusuke Tsuchiya, Mitsutoshi Asano, Tsukasa Shimura, Hidetoshi Suzuki, Manabu Kurabayashi, Takehiko Keida, Tetsuo Sasano, Kenzo Hirao
INTRODUCTION: Pulmonary vein isolation (PVI) using a cryoballoon (CB) is a useful tool for treating atrial fibrillation (AF); however, the clinical efficacy of the CB has never been fully investigated in patients with a left common pulmonary vein (LCPV). METHODS AND RESULTS: Three hundred twenty-four consecutive paroxysmal AF patients underwent PVI with a CB. Three-dimensional computed tomography was performed in all patients before the ablation. The clinical outcomes of the AF ablation between patients with (Group A) and without an LCPV (Group B) were compared...
June 1, 2017: Journal of Cardiovascular Electrophysiology
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