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https://www.readbyqxmd.com/read/28217229/evaluation-of-the-characteristics-of-rotational-activation-at-high-dominant-frequency-and-complex-fractionated-atrial-electrogram-sites-during-atrial-fibrillation
#1
Koji Kumagai, Kentaro Minami, Daisuke Kutsuzawa, Shigeru Oshima
BACKGROUND: High-dominant frequency (DF) and continuous complex fractionated atrial electrogram (CFAE) sites as surrogates for localized sources maintaining atrial fibrillation (AF) are potential AF ablation targets. This study aimed to evaluate the characteristics of a rotational activation at high-DF and continuous CFAE sites in AF patients. METHODS: Thirty-two consecutive AF patients (5 paroxysmal and 27 non-paroxysmal) underwent ablation using the NavX system...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28216515/particular-morphology-of-inferior-pulmonary-veins-and-difficulty-of-cryoballoon-ablation-in-patients-with-paroxysmal-atrial-fibrillation
#2
Ryobun Yasuoka, Takashi Kurita, Yasuhito Kotake, Naotaka Hashiguchi, Koichiro Motoki, Kazuhiro Kobuke, Yoshitaka Iwanaga, Shunichi Miyazaki
BACKGROUND: The CRYO-Japan PMS study indicated that cryoballoon ablation (Cryo-Abl) has a lower acute success rate of pulmonary vein isolation (PVI) for the right and left inferior PVs (RIPV and LIPV, respectively) than for the superior PVs. This study aimed to determine if the orientation and position of the inferior PVs are related to the difficulty of acute success of PVI.Methods and Results:We investigated 30 consecutive patients who underwent Cryo-Abl. A "difficult PV" was defined as the requirement for >2 cooling applications and/or touch-up ablation to achieve PVI...
February 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28216361/the-effect-of-ambulatory-status-on-outcomes-of-percutaneous-vascular-interventions-and-lower-extremity-bypass-for-critical-limb-ischemia-in-the-vascular-quality-initiative
#3
Kimberly Lu, Alik Farber, Marc L Schermerhorn, Virendra I Patel, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Ambulatory status has been shown to be an important predictor of postoperative morbidity and mortality for a variety of surgical procedures. We sought to assess contemporary practice patterns in treating critical limb ischemia (CLI) and outcomes based on ambulatory status. METHODS: The Vascular Quality Initiative (2010-2015) was queried for patients undergoing percutaneous vascular interventions (PVIs) or lower extremity bypass (LEB) for CLI. Ambulatory status was classified as ambulatory, ambulatory with assistance, and nonambulatory (composite of wheelchair bound and bedridden)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28215568/reduction-in-radiation-dose-for-atrial-fibrillation-ablation-over-time-a-12-year-single-centre-experience-of-2-344-patients
#4
Aleksandr Voskoboinik, Elana S Kalman, Yonatan Savicky, Paul B Sparks, Joseph B Morton, Geoffrey Lee, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Pulmonary vein isolation (PVI) is a well-established treatment for atrial fibrillation (AF), with contact force-sensing catheters joining 3D-mapping systems and image integration as technological advancements over the last decade. OBJECTIVE: To analyze trends in radiation exposure at our centre for AF ablation over the last 12 years. METHODS: We reviewed prospectively collected data of 2,344 consecutive PVI procedures for either paroxysmal or persistent AF between 1/2004 - 12/2015...
February 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28215479/lessons-from-individualized-cryoballoon-sizing-is-there-a-role-for-the-small-balloon
#5
Stefan Hartl, Uwe Dorwarth, Benedikt Bunz, Michael Wankerl, Ullrich Ebersberger, Ellen Hoffmann, Florian Straube
BACKGROUND: Cryoablation for paroxysmal atrial fibrillation (PAF) is well established. The single-big-balloon strategy has been preferred for pulmonary vein isolation (PVI) using the second generation cryoballoon (CBG2). Individual PV-morphologies raise the question if an individualized anatomic approach using the 23-mm or 28-mm CB is reasonable. METHODS: Consecutive patients were prospectively enrolled in the non-randomized single-center study. Patients were treated with the 28-mm CB, if any PV was >21mm, the 23-mm CB, if all PV were ≤21mm, or both sizes, if PVI was difficult...
February 16, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28211197/recurrences-in-the-blanking-period-and-12-month-success-rate-by-continuous-cardiac-monitoring-after-cryoablation-of-paroxysmal-and-non-paroxysmal-atrial-fibrillation
#6
Paolo Pieragnoli, Alessandro Paoletti Perini, Giuseppe Ricciardi, Luca Checchi, Andrea Giomi, Iacopo Muraca, Letizia Mannucci, Luigi Padeletti
INTRODUCTION: Recurrences within the blanking period (early recurrences) are common after atrial fibrillation (AF) ablation by pulmonary vein isolation (PVI), but their clinical significance is still controversial. We aimed at evaluating the significance of within-blanking recurrences at 12-month follow-up after cryoballoon (CB) PVI, and to assess the real procedural success rate by continuous monitoring of cardiac rhythm. METHODS AND RESULTS: Sixty consecutive AF patients (34 paroxysmal, 56...
February 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28185348/two-independent-mapping-techniques-identify-rotational-activity-patterns-at-sites-of-local-termination-during-persistent-atrial-fibrillation
#7
Mahmood Alhusseini, David Vidmar, Gabriela L Meckler, Christopher Kowalewski, Fatemah Shenasa, Paul J Wang, Sanjiv M Narayan, Wouter-Jan Rappel
: The mechanisms for atrial fibrillation (AF) are unclear in part because diverse mapping techniques yield diverse maps ranging from stable organized sources to highly disordered waves. We hypothesized that AF mechanisms may be clarified if mapping techniques were compared in the same patients, and referenced to a clinical endpoint. We compared 2 independent AF mapping techniques in patients in whom local ablation terminated persistent AF before pulmonary vein isolation (PVI). TECHNIQUES AND RESULTS: We identified 12 patients with persistent AF (61...
February 10, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28124593/the-short-and-long-term-efficacy-of-pulmonary-vein-isolation-as-a-sole-treatment-strategy-for-paroxysmal-atrial-fibrillation-a-systematic-review-and-meta-analysis
#8
Zsuzsanna Kis, Taulant Muka, Oscar H Franco, Wichor M Bramer, Lennart J De Vries, Attila Kardos, Tamas Szili-Torok
BACKGROUND: Pulmonary vein isolation (PVI) is an accepted treatment strategy for catheter ablation (CA) of paroxysmal atrial fibrillation (PAF). In this study we aimed to assess the short, mid- and long-term outcome of PVI as a sole treatment strategy for PAF. METHODS: Six bibliographic electronic databases were searched to identify all published relevant studies until December 14, 2015. Search of the scientific literature was performed for studies describing outcomes with mean follow-up > 24 months after PAF ablation...
January 17, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28122804/second-generation-cryoballoon-ablation-for-atrial-fibrillation-in-young-adults-midterm-outcome-in-patients-under-40-years-of-age
#9
Darragh Moran, Valentina De Regibus, Carlo de Asmundis, Ken Takarada, Giacomo Mugnai, Erwin Ströker, Arash Aryana, Saverio Iacopino, Diego Ruggiero, Hugo Enrique Coutiño-Moreno, Rajin Choudhury, Juan-Pablo Abugattas, Ebru Hacioglu, Gaetano Paparella, Pedro Brugada, Gian-Battista Chierchia
AIMS: Pulmonary vein isolation (PVI) has been demonstrated more effective in young patients, in which the substrate for atrial fibrillation (AF) is probably more confined to pulmonary vein potentials. The present study sought to focus on the midterm outcomes in patients under 40 years having undergone PVI with the Cryoballoon Advance because of drug resistant AF. METHODS AND RESULTS: Between June 2012 and December 2015, 57 patients having undergone Cryoballoon ablation (CB-A) below 40 years of age for AF in our centre were retrospectively analysed and considered for our analysis...
January 25, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28121963/the-effect-of-vancomycin-and-gentamicin-antibiotics-on-human-osteoblast-proliferation-metabolic-function-and-bone-mineralization
#10
Ashleigh M Philp, Saroop Raja, Andrew Philp, Matthew P Newton Ede, Simon W Jones
STUDY DESIGN: The present study investigates the effect of vancomycin and gentamicin antibiotics on primary human osteoblasts. Osteoblasts were incubated with vancomycin, gentamicin, or with povidone-iodine (PVI), at concentrations advocated for wound irrigation. Osteoblast proliferation, metabolic function, and bone mineralization were measured. OBJECTIVE: The aim of the study was to model gentamicin and vancomycin wound irrigation in vitro and to examine the effect on osteoblast viability and cellular function in comparison to 0...
February 2017: Spine
https://www.readbyqxmd.com/read/28120392/impact-of-rotor-temperospatial-stability-on-acute-and-one-year-atrial-fibrillation-ablation-outcomes
#11
Muhammad Balouch, Esra Gucuk Ipek, Jonathan Chrispin, Rizma J Bajwa, Tarek Zghaib, Ronald D Berger, Hiroshi Ashikaga, Saman Nazarian, Joseph E Marine, Hugh Calkins, David D Spragg
BACKGROUND: The utility of rotor ablation using commercially available systems as an adjunct to pulmonary vein isolation (PVI) is controversial. Variable results may stem from heterogeneous practice patterns. We investigated whether a prespecified protocol to determine temperospatial rotor stability improved acute and intermediate outcomes following rotor ablation. HYPOTHESIS: Protocolized rotor mapping and ablation, with prespecified metrics to determine temporal rotor stability prior to ablation, will improve short- and long-term PVI/rotor ablation outcomes...
January 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28106019/pulmonary-vein-anatomy-and-its-variations-in-a-turkish-atrial-fibrillation-cohort-undergoing-cryoballoon-based-catheter-ablation
#12
Duygu Koçyiğit, Kadri Murat Gürses, Muhammed Ulvi Yalçın, Gamze Türk, Banu Evranos, Uğur Canpolat, Hikmet Yorgun, Tuncay Hazırolan, Kudret Aytemir
OBJECTIVE: Pulmonary vein (PV) anatomy has drawn attention since assumption that atrial fibrillation (AF) may originate from PVs and that electrical isolation of PVs may be beneficial in eliminating these triggers. The present study aims to investigate PV anatomy and its variations in a sample of Turkish patients undergoing PV isolation (PVI) for AF. METHODS: 250 patients underwent multidetector computed tomography before cryoballoon-based PVI for AF. PV and left atrial (LA) anatomy were evaluated in 3-dimensional epicardial reconstructions...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28090710/fibrillatory-wave-amplitude-on-transesophageal-ecg-as-a-marker-of-left-atrial-low-voltage-areas-in-patients-with-persistent-atrial-fibrillation
#13
Ran Yin, Yongnan Fu, Zhongming Yang, Bingong Li, Jintian Pen, Zeqi Zheng
BACKGROUND: Low-voltage areas (LVAs) are frequently observed in patients with persistent atrial fibrillation (PeAF) and may represent adverse atrial remodeling. However, noninvasive method of evaluating LAVs is not well established. METHODS: In a cohort of 68 patients with PeAF, endocardial voltage maps of left atrium (LA) were created during sinus rhythm after pulmonary vein isolation (PVI). LVAs were defined as areas with electrogram amplitudes <0.5 mV. LA-LVAs were correlated with clinical, echocardiographic, surface, and transesophageal electrocardiography (TE-ECG) variables...
January 16, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28089454/the-role-of-adenosine-challenge-in-catheter-ablation-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#14
Alex J A McLellan, Saurabh Kumar, Catherine Smith, Liang-Han Ling, Sandeep Prabhu, Jonathan M Kalman, Peter M Kistler
AIMS: Adenosine may unmask dormant PV conduction and facilitate consolidation of PV isolation. We performed a meta-analysis to determine the impact of adenosine administration on clinical outcomes in patients undergoing PVI. METHODS: References and electronic databases reporting AF ablation and adenosine following PVI were searched through to 22nd November 2015. The impact of adenosine on freedom from AF was assessed in twenty publications after radiofrequency ablation (RFA), and in four publications after cryoablation to achieve PVI...
January 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28073885/reduction-of-atrial-fibrillation-burden-by-pulmonary-vein-isolation-leads-to-a-decrease-of-cd11b-expression-on-inflammatory-cells
#15
Daniel Tarnowski, Lina Plichta, Mathias Forkmann, Silvio Quick, Stefan Ulbrich, Felix Matthias Heidrich, Stephan Wiedemann, Marian Christoph, David Maximilian Poitz, Carsten Wunderlich, Karim Ibrahim, Ruth H Strasser, Christian Pfluecke
AIMS: It is hypothesized that inflammation could promote structural and electrical remodelling processes in atrial fibrillation (AF). Atrial infiltration of monocytes and granulocytes has been shown to be dependent on CD11b expression. The aim of this study was to investigate whether treatment of AF by pulmonary vein isolation (PVI) may lead to reduced inflammation, as indicated by a decrease of CD11b expression on monocytes and granulocytes. METHODS AND RESULTS: Flow-cytometric quantification analysis and determination of systemic inflammatory markers of peripheral blood were performed in 75 patients undergoing PVI 1 day before and 6 months after PVI...
January 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28070875/atrial-fibrillation-inducibility-during-cavotricuspid-isthmus-dependent-atrial-flutter-ablation-as-a-predictor-of-clinical-atrial-fibrillation-a-meta-analysis
#16
Jorge Romero, Juan Carlos Diaz, Luigi Di Biase, Saurabh Kumar, David Briceno, Usha B Tedrow, Carolina R Valencia, Samuel H Baldinger, Bruce Koplan, Laurence M Epstein, Roy John, Gregory F Michaud, William G Stevenson
BACKGROUND: Atrial fibrillation (AF) and cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) are two separate entities that coexist in a significant percentage of patients. We sought to investigate whether AF inducibility during CTI AFL ablation predicted the occurrence of AF at follow-up after successful AFL ablation. METHODS: A systemic review of Medline, Cochrane, and Embase was done for all the clinical studies in which assessment of AF inducibility in patients undergoing ablation for CTI AFL was performed...
January 9, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28069837/high-sensitive-cardiac-troponin-t-as-a-novel-predictor-for-recurrence-of-atrial-fibrillation-after-radiofrequency-catheter-ablation
#17
Koki Nakanishi, Shota Fukuda, Hajime Yamashita, Toshifumi Hasegawa, Michihiko Kosaka, Naoya Shirai, Kenei Shimada, Junichi Yoshikawa, Atsushi Tanaka
AIMS: We aimed to determine whether elevated serum high-sensitive cardiac troponin T (hs-TnT) levels predict atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). METHODS AND RESULTS: We included 125 consecutive patients with AF (paroxysmal, n = 79; persistent, n = 46) who underwent first-time PVI. Serum hs-TnT, high-sensitive C-reactive protein (hs-CRP), atrial natriuretic peptide, and plasma B-type natriuretic peptide levels were measured in venous samples collected before PVI...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28069836/optimization-of-catheter-tissue-contact-during-pulmonary-vein-isolation-the-impact-of-atrial-rhythm
#18
Roberto De Ponti, Raffaella Marazzi, Lorenzo A Doni, Jacopo Marazzato, Claudia Baratto, Jorge A Salerno-Uriarte
AIMS: During pulmonary vein isolation (PVI), even if operators are aware of the contact force (CF), its values may greatly vary and the impact of cardiac rhythm has not been thoroughly investigated yet. This study aims at assessing the actual values of CF, the applications with suboptimal CF, and the impact of cardiac rhythm on CF during PVI. METHODS AND RESULTS: Twenty patients undergoing point-by-point PVI with a CF-sensing catheter were considered. CF target was between 6 and 40 g...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28054738/radiofrequency-catheter-ablation-targeting-the-vein-of-marshall-in-difficult-mitral-isthmus-ablation-or-pulmonary-vein-isolation
#19
Ji Hyun Lee, Gi-Byoung Nam, Minsu Kim, You Mi Hwang, Jongmin Hwang, Jun Kim, Kee-Joon Choi, You-Ho Kim
INTRODUCTION: The ligament of Marshall may hinder the creation of mitral isthmus (MI) block or pulmonary vein (PV) isolation (PVI) in radiofrequency (RF) catheter ablation of atrial fibrillation (AF). We aimed to assess the benefit of RF ablation targeting the vein of Marshall (VOM) in failed cases of MI block or PVI. METHODS AND RESULTS: We reviewed the medical records of patients who underwent RF ablation targeting the VOM after failed MI ablation or left PVI using the conventional method, which included circumferential point-by-point ablation around the PV antrum and carina, or endocardial MI and epicardial distal coronary sinus (CS) ablation for MI block...
January 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28054729/comparison-of-the-efficacy-of-empiric-thoracic-vein-isolation-for-the-treatment-of-paroxysmal-and-persistent-atrial-fibrillation-in-patients-without-structural-heart-disease
#20
Koichiro Ejima, Ryuta Henmi, Yuji Iwanami, Daigo Yagishita, Morio Shoda, Nobuhisa Hagiwara
INTRODUCTION: The guidelines suggest that an adjuvant substrate modification in addition to pulmonary vein isolation (PVI) may be needed for persistent atrial fibrillation (PerAF) assuming that catheter ablation is less successful for PerAF than paroxysmal AF (PAF). To revisit the above assumption, we compared the outcome of the same catheter ablation strategy between PAF and PerAF. METHODS AND RESULTS: Two-hundred and thirty-three consecutive patients (mean age 60±10 years, 53 PerAF and 8 long-lasting PerAF) without structural heart disease underwent catheter ablation of AF by the same strategy using an empiric thoracic vein isolation (a wide circumferential PVI plus empiric superior vena cava isolation) as a major part of the strategy without any adjuvant substrate modification...
January 5, 2017: Journal of Cardiovascular Electrophysiology
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