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Atrial fibrillation; AF Ablation

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https://www.readbyqxmd.com/read/28927960/a-comparison-between-multipolar-mapping-and-conventional-mapping-of-atrial-tachycardias-in-the-context-of-atrial-fibrillation-ablation
#1
Sok-Sithikun Bun, Tahar Delassi, Decebal Gabriel Latcu, Mohammed El Jamili, Anis Ayari, Abdelkarim Errahmouni, Benjamin Berte, Nadir Saoudi
BACKGROUND: Activation mapping can be challenging and time-consuming in patients with multiple atrial tachycardias (ATs). AIMS: To compare multielectrode mapping using a dedicated mapping catheter - PentaRay (Biosense Webster Inc.) - and the conventional technique for mapping ATs in the context of atrial fibrillation (AF) ablation. METHODS: All procedures where PentaRay mapping of AT were used - after or during persistent AF ablation - were analysed...
September 15, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28925907/atrial-fibrillation-ablation-increases-inflammation-chemokine-modulation-suppresses-activation-of-leukocytes-isolated-after-ablation
#2
Alexandra Lucas, Mohammad Al-Ani, Sriram Ambadapadi, Jordan R Yaron, Donghang Zheng, Adisson Fortunel, Maia Doroton-Guevara, Liying Liu, Sufi Morshed, Jay Fricker, William Miles, Matthew McKillop
AIMS: Atrial fibrillation (AF) ablation is associated with increased circulating markers of inflammation. Innate immune, or inflammation, pathways up-regulate mononuclear cell responses and may increase risk for recurrent arrhythmia. Chemokines and serine protease coagulation pathways both activate innate immune responses. Here, we measured inflammatory markers in peripheral blood samples from patients after cryoballoon and/or radiofrequency pulmonary vein isolation and assessed the capacity for inhibition of chemokine and serine protease pathways to block cell activation...
September 18, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28923248/symptom-challenges-after-atrial-fibrillation-ablation
#3
Kathryn A Wood, Angel H Barnes, Sudeshna Paul, Kristina A Hines, Kevin P Jackson
BACKGROUND: It is unclear what symptom challenges occur during the recovery phase after atrial fibrillation (AF) ablation. OBJECTIVES: This longitudinal pilot study explored the patient perspective of the first six months following an AF ablation. METHODS: Telephone interviews and questionnaires were used with 20 patients at baseline, at 1, 3, and 6 months after AF ablation. Telephone interview data were analyzed using content analysis. Longitudinal outcomes were analyzed using repeated measures analysis of variance (ANOVA)...
September 15, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28921408/catheter-ablation-for-af-improves-global-thrombotic-profile-and-enhances-fibrinolysis
#4
Maria Niespialowska-Steuden, Vias Markides, Mohamed Farag, David Jones, Wajid Hussain, Tom Wong, Diana A Gorog
Patients with atrial fibrillation (AF) are at increased risk of thrombotic events despite oral anticoagulation (OAC). Radiofrequency catheter ablation (RFCA) can restore and maintain sinus rhythm (SR) in patients with AF. To assess whether RFCA improves thrombotic status. 80 patients (71% male, 64 ± 12y) with recently diagnosed AF, on OAC and scheduled to undergo RFCA or DC cardioversion (DCCV) were recruited. Thrombotic status was assessed using the point-of-care global thrombosis test (GTT), before, and 4-6 weeks after DCCV and 3 months after RFCA...
September 18, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28921386/midterm-outcomes-of-two-staged-hybrid-ablation-of-persistent-and-long-standing-persistent-atrial-fibrillation-using-the-versapolar-epicardial-surgical-device-and-subsequent-catheter-ablation
#5
Petr Budera, Pavel Osmancik, Dalibor Herman, Jana Zdarska, David Talavera, Anna Mala, Radka Prochazkova, Zbynek Straka
PURPOSE: Hybrid ablation of atrial fibrillation (AF) is a promising treatment strategy for patients with non-paroxysmal AF, although, data regarding mid-term outcomes are limited. METHODS: Patients with persistent or long-standing persistent AF were enrolled. Initially, a thoracoscopic, right-sided, epicardial ablation was performed, with a goal of creating a box lesion on the posterior wall of the left atrium; a novel versapolar radiofrequency (RF) catheter was used...
September 18, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28917562/an-updated-meta-analysis-of-novel-oral-anticoagulants-versus-vitamin-k-antagonists-for-uninterrupted-anticoagulation-in-atrial-fibrillation-catheter-ablation
#6
Rhanderson Cardoso, Leonardo Knijnik, Aditya Bhonsale, Guilherme Nasi, Manuel Rivera, Vanessa Blumer, Hugh Calkins
BACKGROUND: Catheter ablation is recommended as a first or second-line rhythm control therapy for selected patients with atrial fibrillation (AF). There is a wide variability in the periprocedural management of oral anticoagulation for patients undergoing AF ablation. OBJECTIVE: We aimed to perform an updated meta-analysis of novel oral anticoagulants (NOACs) vs. vitamin K antagonists (VKAs) as uninterrupted anticoagulation for patients undergoing AF ablation. METHODS: Databases and conference abstracts were searched...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28916640/clinical-profile-and-consequences-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#7
Ethan J Rowin, Anais Hausvater, Mark S Link, Patrick Abt, William Gionfriddo, Wendy Wang, Hassan Rastegar, N A Mark Estes, Martin S Maron, Barry J Maron
Background -Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. Methods -Records were accessed of 1558 consecutive patients followed at the Tufts Medical Center Hypertrophic Cardiomyopathy Institute for 4.8 ± 3.4 years, from 2004 to 2014. Results -Of the 1558 HCM patients, 304 (20%) had episodes of AF, of which 226 (74%) were confined to symptomatic paroxysmal AF (PAF; average 5 ± 5; range 1 to > 20), while 78 (26%) developed permanent AF, preceded by 7 ± 6 PAF episodes...
September 15, 2017: Circulation
https://www.readbyqxmd.com/read/28901573/validation-of-a-novel-cartoseg%C3%A2-segmentation-module-software-for-contrast-enhanced-computed-tomography-guided-radiofrequency-ablation-in-patients-with-atrial-fibrillation
#8
EDITORIAL
Hasan Imanli, Shaun Bhatty, Jean Jeudy, Yousra Ghzally, Kiddy Ume, Rama Vunnam, Refael Itah, Mati Amit, John Duell, Vincent See, Stephen Shorofsky, Timm M Dickfeld
INTRODUCTION: Visualization of left atrial (LA) anatomy using image integration modules has been associated with decreased radiation exposure and improved procedural outcome when used for guidance of pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. We evaluated the CARTOSEG™ CT Segmentation Module (Biosense Webster, Inc.) that offers a new CT-specific semi-automatic reconstruction of the atrial endocardium. METHODS: The CARTOSEG™ CT Segmentation Module software was assessed prospectively in 80 patients undergoing AF ablation...
September 13, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28892174/a-quantitative-comparison-of-the-electrical-and-anatomical-definition-of-the-pulmonary-vein-ostium
#9
Florian Spies, Michael Kühne, Tobias Reichlin, Stefan Osswald, Christian Sticherling, Sven Knecht
BACKGROUND: Anatomically guided pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. However, the position where to confirm electrical isolation is ill-defined. The aim of the current study was to quantify the relationship between the anatomical and electrical definition of the pulmonary vein ostium. METHODS: We analyzed 20 patients with paroxysmal AF undergoing PVI using radiofrequency energy and an electroanatomical mapping system...
September 11, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28887742/efficacy-of-ganglionated-plexi-ablation-in-addition-to-pulmonary-vein-isolation-for-paroxysmal-versus-persistent-atrial-fibrillation-a-meta-analysis-of-randomized-controlled-clinical-trials
#10
Polydoros N Kampaktsis, Evangelos K Oikonomou, Daniel Y Choi, Jim W Cheung
PURPOSE: Adjunctive ganglionated plexi (GP) ablation may improve success rates for treatment of atrial fibrillation (AF) when combined with pulmonary vein (PV) isolation. Existing meta-analyses on GP ablation have included observational studies and have not incorporated more recent randomized clinical trial data. Moreover, the impact of AF subtype (paroxysmal vs. persistent) on outcomes of GP ablation has not been well established. METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) comparing GP ablation + pulmonary vein (PV) isolation versus PV isolation alone according to the subtype of AF...
September 8, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28887362/resolving-bipolar-electrogram-voltages-during-atrial-fibrillation-using-omnipolar-mapping
#11
Shouvik K Haldar, Karl Magtibay, Andreu Porta-Sanchez, Stéphane Massé, Nicholas Mitsakakis, Patrick F H Lai, Mohammed Ali Azam, John Asta, Marjan Kusha, Paul Dorian, Andrew C T Ha, Vijay Chauhan, D Curtis Deno, Kumaraswamy Nanthakumar
BACKGROUND: Low-voltage-guided substrate modification is an emerging strategy in atrial fibrillation (AF) ablation. A major limitation to contemporary bipolar electrogram (EGM) analysis in AF is the resultant lower peak-to-peak voltage (Vpp) from variations in wavefront direction relative to electrode orientation and from fractionation and collision events. We aim to compare bipole Vpp with novel omnipolar peak-to-peak voltages (Vmax) in sinus rhythm (SR) and AF. METHODS AND RESULTS: A high-density fixed multielectrode plaque was placed on the epicardial surface of the left atrium in dogs...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28886992/study-on-the-effect-of-irbesartan-on-atrial-fibrillation-recurrence-in-kumamoto-atrial-fibrillation-suppression-trial-silk-study
#12
Hiroshige Yamabe, Koichi Kaikita, Toshiyuki Matsumura, Atsushi Iwasa, Junjiro Koyama, Takashi Uemura, Yasuhiro Morikami, Ryusuke Tsunoda, Kenji Morihisa, Kazuteru Fujimoto, Ichiro Kajiwara, Kunihiko Matsui, Kenichi Tsujita, Hisao Ogawa
BACKGROUND: Experimental studies suggest that angiotensin II-receptor blockers can influence atrial remodeling and may prevent atrial fibrillation (AF). Therefore, we hypothesized that irbesartan may prevent the recurrence of AF following either catheter ablation or electrical cardioversion of AF. METHODS: Study on the Effect of Irbesartan on Atrial Fibrillation Recurrence in Kumamoto (SILK study) is a prospective, multicenter, randomized, and open-label comparative evaluation of the effects of irbesartan and amlodipine on AF recurrence in hypertensive patients with AF who are scheduled to undergo catheter ablation or electrical cardioversion of AF...
September 5, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28886855/effect-of-ablation-for-atrial-fibrillation-on-heart-failure-readmission-rates
#13
Parijat Saurav Joy, Rakesh Gopinathannair, Brian Olshansky
Atrial fibrillation (AF) and heart failure (HF) cause numerous hospital admissions. We investigated if AF increases readmissions in patients with HF and whether AF ablation alters readmissions for HF exacerbations. The 2013 Nationwide Readmissions Database was analyzed for all-cause 90-day readmissions, after discharge for HF exacerbation. Kaplan-Meier analysis was used to compare hazard rates for readmissions due to HF exacerbation, after recent ablation versus no ablation. There were 885,270 admissions for HF exacerbation of which 364,447 had coexisting AF...
July 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28886122/alteration-of-endothelin-1-mcp-1-and-chromogranin-a-in-patients-with-atrial-fibrillation-undergoing-pulmonary-vein-isolation
#14
K Lackermair, S Clauss, T Voigt, I Klier, C Summo, B Hildebrand, T Nickel, H L Estner, S Kääb, R Wakili, U Wilbert-Lampen
BACKGROUND: The relation between arrhythmias and stress is known. The aim of our current study was to elucidate whether plasma levels of previously described stress parameters are altered in highly symptomatic patients with atrial fibrillation (AF) per se and in patients undergoing ablation therapy by pulmonary vein isolation (PVI). METHODS: 96 patients with AF undergoing PVI were recruited. Plasma levels of Endothelin-1 (ET-1), MCP-1 and Chromogranin-A (CGA) were measured before and three months after ablation completed with clinical follow-up with respect to AF recurrence...
2017: PloS One
https://www.readbyqxmd.com/read/28884923/low-voltage-areas-detected-by-high-density-electroanatomical-mapping-predict-recurrence-after-ablation-for-paroxysmal-atrial-fibrillation
#15
Konstantinos Vlachos, Michael Efremidis, Konstantinos P Letsas, George Bazoukis, Ruairidh Martin, Maria Kalafateli, Louiza Lioni, Stamatis Georgopoulos, Athanasios Saplaouras, Theodore Efremidis, Tong Liu, Kosmas Valkanas, Nikolaos Karamichalakis, Dimitrios Asvestas, Antonios Sideris
INTRODUCTION: We aimed to evaluate the extent of atrial fibrosis in paroxysmal atrial fibrillation (AF) and the correlation with ablation outcomes after pulmonary vein antral isolation (PVΑI) using a mapping system with high-resolution and high-spatial sampling. METHODS AND RESULTS: We prospectively enrolled 80 consecutive patients (45 males, median age 60.26 years) with symptomatic paroxysmal AF who were scheduled for PVAI. Prior to PVAI, high-density bipolar voltage mapping (median number of 2,485 points) was carried out during sinus rhythm in all patients...
September 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28882334/meta-analysis-of-safety-and-efficacy-of-uninterrupted-non-vitamin-k-antagonist-oral-anticoagulants-versus-vitamin-k-antagonists-for-catheter-ablation-of-atrial-fibrillation
#16
Akram Y Elgendy, Dhruv Mahtta, Amr F Barakat, Ahmed Abuzaid, Ahmad Mahmoud, Amgad Mentias, Ahmed N Mahmoud, Islam Y Elgendy
This meta-analysis sought to assess the safety and efficacy of uninterrupted non-vitamin K antagonist oral anticoagulants (NOACs) versus uninterrupted vitamin K antagonists in atrial fibrillation (AF) patients undergoing catheter ablation. Electronic databases were searched for randomized trials (RCTs) and observational studies that compared uninterrupted NOACs versus uninterrupted vitamin K antagonists in the catheter ablation of AF. Safety outcomes included major bleeding, total bleeding, minor bleeding, and cardiac tamponade...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28882227/left-atrial-fibrosis-and-risk-of-cerebrovascular-and-cardiovascular-events-in-patients-with%C3%A2-atrial-fibrillation
#17
MULTICENTER STUDY
Jordan B King, Peyman N Azadani, Promporn Suksaranjit, Adam P Bress, Daniel M Witt, Frederick T Han, Mihail G Chelu, Michelle A Silver, Joseph Biskupiak, Brent D Wilson, Alan K Morris, Eugene G Kholmovski, Nassir Marrouche
BACKGROUND: Severity of left atrial (LA) fibrosis is a strong predictor of atrial fibrillation (AF) ablation success and has been associated with a history of stroke, hypertension, and heart failure (HF). However, it is unclear whether more severe LA fibrosis independently increases the risk of major adverse cardiovascular and cerebrovascular events (MACCE) among those with AF. OBJECTIVES: The goal of this study was to evaluate the occurrence and frequency of MACCE by strata of LA fibrosis severity in patients with AF...
September 12, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28881845/gender-differences-in-fibrosis-remodeling-in-patients-with-long-standing-persistent-atrial-fibrillation
#18
Zhi Li, Zengwei Wang, Zongtao Yin, Yuji Zhang, Xiaodong Xue, Jinsong Han, Yan Zhu, Jian Zhang, Maximilian Y Emmert, Huishan Wang
The success rate of catheter ablation in atrial fibrillation (AF) is known to be lower in females than in males. However, while the exact mechanism for this phenomenon remains to be elucidated, tissue fibrosis may play an important role in this regard. It has been shown that fibrosis promotes AF and its recurrence, thereby substantially reducing the efficacy of catheter ablation in AF patients. Thus, we hypothesized that fibrosis may contribute to gender differences in the outcomes of AF catheter ablation. Here we systematically assessed pulmonary vein sleeves obtained from 166 patients with and without long-standing persistent-AF (LSP-AF) in order to identify gender-specific mechanistic differences in fibrosis remodeling of AF patients...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28881765/mitral-isthmus-ablation-using-a-circular-mapping-catheter-positioned-in-the-left-atrial-appendage-as-a-reference-for-conduction-block
#19
Takahiko Nishiyama, Takehiro Kimura, Taishi Fujisawa, Kazuaki Nakajima, Akira Kunitomi, Shin Kashimura, Yoshinori Katsumata, Nobuhiro Nishiyama, Yoshiyasu Aizawa, Keiichi Fukuda, Seiji Takatsuki
BACKGROUND: For perimitral atrial flutter (PMFL) developing after catheter ablation of atrial fibrillation (AF), to create a complete conduction block at the mitral isthmus (MI) is mandatory to terminate it, however, it is still challenging. METHODS: This study consisted of 80 patients (74 male, 61 ± 8.1 years) undergoing MI ablation. After a circular mapping catheter was positioned at the neck of the left atrial appendage (LAA), the MI ablation was performed on the MI line just below the LAA neck targeting the earliest activation recording site of the LAA catheter during pacing from the coronary sinus (CS)...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28880943/non-pulmonary-vein-mediated-atrial-fibrillation-a-novel-sub-phenotype
#20
Maureen Farrell, Zachary Yoneda, Jay Montgomery, Diane Crawford, Lauren Lee Wray, Meng Xu, Matthew J Kolek, Travis Richardson, Ricardo Lugo, Mohamed Metawee, Greg Michaud, Juan Carlos Estrada, Pablo Saavedra, Sharon Shen, Arvindh Kanagasundram, Christopher R Ellis, George Crossley, Dan Roden, M Benjamin Shoemaker
BACKGROUND: Atrial fibrillation (AF) is a mechanistically heterogeneous disorder, and the ability to identify sub-phenotypes ("endophenotypes") of AF would assist in the delivery of personalized medicine. We used the clinical response to pulmonary vein isolation (PVI) to identify a sub-group of patients with non-PV mediated AF and sought to define the clinical associations. METHODS: Subjects enrolled in the Vanderbilt AF Ablation Registry who underwent a repeat AF ablation due to arrhythmia recurrence were analyzed on the basis of PV reconnection...
2017: PloS One
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