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Atrial fibrillation; AF Ablation

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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
#1
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/28642107/venous-thrombosis-after-electrophysiology-procedures-a-systematic-review
#2
Barry Burstein, Rodrigo S Barbosa, Eli Kalfon, Jacqueline Joza, Martin Bernier, Vidal Essebag
BACKGROUND: Femoral venous access for catheter introduction represents the cornerstone of electrophysiology (EP) procedures. Limited data are available regarding post-procedure venous thromboembolism. The aim of this systematic review is to determine the incidence of deep vein thrombosis (DVT) and pulmonary embolus (PE) associated with femoral vein catheterization during EP procedures. METHODS: An electronic search was conducted for studies documenting the incidence of DVT and PE after EP procedures...
June 19, 2017: Chest
https://www.readbyqxmd.com/read/28639773/-paradigm-shift-in-the-treatment-of-atrial-fibrillation-the-importance-of-risk-factor-management
#3
Stefania Aur, Patrizio Pascale
The prevalence of atrial fibrillation (AF) is constantly rising. Different studies have underlined the correlation between AF and modifiable risk factors such as obesity, obstructive sleep apnea, hypertension and sedentary lifestyle. Treatment of these comorbidities could significantly reduce the AF burden and the recurrence rate after cardioversion or ablation. These data should therefore lead to a paradigm shift in the management of AF. A strategy limited to catheter ablation or to the prescription of an antiarrhythmic drug is not sufficient...
May 24, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28639728/prospective-use-of-ablation-index-targets-improves-clinical-outcomes-following-ablation-for-atrial-fibrillation
#4
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
#5
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/28637187/identification-of-pulmonary-vein-reconnection-gaps-with-high-density-mapping-in-redo-atrial-fibrillation-ablation-procedures
#6
Ignacio García-Bolao, Gabriel Ballesteros, Pablo Ramos, Diego Menéndez, Ane Erkiaga, Renzo Neglia, Marta Jiménez Martín, Enrique Vives-Rodríguez
Aims: Maps obtained by means of electroanatomic high-density mapping (HDM) systems have shown their use in the identification of conduction gaps in experimental atrial linear lesion models. The objective of this study was to assess the use of HDM in the recognition of reconnection gaps in pulmonary veins (PV) in redo atrial fibrillation (AF) ablation procedures. Methods and results: One hundred and eight patients were included in a non-randomized study that assessed the recognition of reconnection gaps in PV by means of HDM compared to a control group that received conventional non-fluoroscopic guidance with a circular multipolar catheter (CMC)...
June 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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
#7
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/28631077/noninvasive-evaluation-of-reverse-atrial-remodeling-after-catheter-ablation-of-atrial-fibrillation-by-p-wave-dispersion
#8
Yuhi Fujimoto, Kenji Yodogawa, Kenta Takahashi, Ippei Tsuboi, Hiroshi Hayashi, Shunsuke Uetake, Yu-Ki Iwasaki, Meiso Hayashi, Yasushi Miyauchi, Wataru Shimizu
Atrial fibrillation (AF) itself creates structural and electrophysiological changes such as atrial enlargement, shortening of refractory period and decrease in conduction velocity, called "atrial remodeling", promoting its persistence. Although the remodeling process is considered to be reversible, it has not been elucidated in detail. The aim of this study was to assess the feasibility of P wave dispersion in the assessment of reverse atrial remodeling following catheter ablation of AF. Consecutive 126 patients (88 males, age 63...
June 19, 2017: Heart and Vessels
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/28625928/second-generation-cryoballoon-ablation-in-the-setting-of-left-common-pulmonary-veins-procedural-findings-and-clinical-outcome
#11
Erwin Ströker, Ken Takarada, Carlo de Asmundis, Juan-Pablo Abugattas, Giacomo Mugnai, Vedran Velagic, Valentina de Regibus, Hugo-Enrique Coutiño, Rajin Choudhury, Saverio Iacopino, Yves De Greef, Kaoru Tanaka, Pedro Brugada, Gian-Battista Chierchia
BACKGROUND: A left common pulmonary vein (LCPV) accounts as the most frequent PV variation. The use of the cryoballoon (CB) for isolating these veins, is still debatable. To date, no data are available regarding the feasibility, acute PV isolation, and clinical outcome of the second-generation CB (CB-A) in this setting. OBJECTIVE: To investigate the performance of the CB-A in patients with LCPVs. METHODS: In a total cohort of 433 patients having undergone CB-A ablation for drug-refractory atrial fibrillation (AF) together with pre-procedural CT-scanning, 146 patients presented a LCPV...
June 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28625512/first-experience-with-edoxaban-and-atrial-fibrillation-ablation-insights-from-the-engage-af-timi-48-trial
#12
Jan Steffel, Christian T Ruff, Rose A Hamershock, Sabina A Murphy, Roxy Senior, Denis Roy, Hans-Joachim Lanz, Michele F Mercuri, Elliott M Antman, Robert P Giugliano
BACKGROUND: Atrial fibrillation (AF) ablation procedures are increasingly being performed in patients receiving direct oral anticoagulants (DOACs). Experience regarding the safety of edoxaban in this context is limited. In an exploratory analysis we therefore investigated the outcome of patients undergoing transcatheter AF ablation in the ENGAGE AF-TIMI 48 trial. METHODS & RESULTS: During the trial, 193 transcatheter AF ablation procedures were performed in 169 patients...
June 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28616550/is-hatch-score-a-reliable-predictor-of-atrial-fibrillation-after-cavotricuspid-isthmus-ablation-for-typical-atrial-flutter
#13
Javier García-Seara, Francisco Gude Sampedro, Jose L Martínez Sande, Xesus Alberte Fernández López, Moisés Rodríguez Mañero, Laila González Melchor, Belén Alvarez Alvarez, Diego Iglesias Alvarez, José Ramón González Juanatey
OBJECTIVE: We determined the effectiveness of the HATCH score in patients with typical atrial flutter (AFl) undergoing cavotricuspid isthmus (CTI) ablation to predict long-term atrial fibrillation (AF). METHODS: We conducted an observational retrospective single-center cohort study including all patients admitted to our hospital for a CTI ablation between 1998 and 2010. The patients were divided into four categories: 1) new-onset AF (no prior AF and AF during follow-up (FU)); 2) old AF (prior AF and no AF during FU); 3) prior and post AF (AF prior and post CTI ablation); and 4) no AF...
September 2016: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28615987/stroke-rates-before-and-after-ablation-of-atrial-fibrillation-and-in-propensity-matched-controls-in-the-uk
#14
Julian We Jarman, Tina D Hunter, Wajid Hussain, Jamie L March, Tom Wong, Vias Markides
BACKGROUND: We sought to determine whether catheter ablation of atrial fibrillation (AF) is associated with reduced occurrence of ischemic cerebrovascular events. METHODS AND RESULTS: Using routinely collected hospital data, ablation patients were matched to two control cohorts via direct and propensity score matching. A total of 4,991 ablation patients were matched 1:1 to general AF controls with no ablation, and 5,407 ablation patients were similarly matched to controls who underwent cardioversion...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28615986/mortality-stroke-and-heart-failure-in-atrial-fibrillation-cohorts-after-ablation-versus-propensity-matched-cohorts
#15
Julian We Jarman, Tina D Hunter, Wajid Hussain, Jamie L March, Tom Wong, Vias Markides
BACKGROUND: We sought to determine from key clinical outcomes whether catheter ablation of atrial fibrillation (AF) is associated with increased survival. METHODS AND RESULTS: Using routinely collected hospital data, ablation patients were matched to two control cohorts using direct and propensity score methodology. Four thousand nine hundred ninety-one ablation patients were matched 1:1 with general AF controls without ablation. Five thousand four hundred seven ablation patients were similarly matched to controls who underwent cardioversion...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28614264/extremely-low-frame-rate-digital-fluoroscopy-in-catheter-ablation-of-atrial-fibrillation-a-comparison-of-2-versus-4-frame-rate
#16
Ji Hyun Lee, Jun Kim, Minsu Kim, Jongmin Hwang, You Mi Hwang, Joon-Won Kang, Gi-Byoung Nam, Kee-Joon Choi, You-Ho Kim
Despite the technological advance in 3-dimensional (3D) mapping, radiation exposure during catheter ablation of atrial fibrillation (AF) continues to be a major concern in both patients and physicians. Previous studies reported substantial radiation exposure (7369-8690 cGy cm) during AF catheter ablation with fluoroscopic settings of 7.5 frames per second (FPS) under 3D mapping system guidance. We evaluated the efficacy and safety of a low-frame-rate fluoroscopy protocol for catheter ablation for AF.Retrospective analysis of data on 133 patients who underwent AF catheter ablation with 3-D electro-anatomic mapping at our institute from January 2014 to May 2015 was performed...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28613212/baseline-serum-globulin-as-a-predictor-of-the-recurrence-of-lone-atrial-fibrillation-after-radiofrequency-catheter-ablation
#17
Qing Zhou, Hailong Cao, Zhenjun Xu, Rongfang Lan, Xin Chen, Dongjin Wang, Wei Xu
OBJECTIVE: Inflammation and autoimmune responses play an important role in recurrence of atrial fibrillation (AF). Serum globulin levels are a commonly used clinical index that represents inflammation and autoimmune response. This study aimed to determine the relationship between baseline serum globulin levels and the risk of recurrence after ablation in lone AF patients. METHODS: We enrolled 348 lone AF patients undergoing radiofrequency catheter ablation for the first time for whom complete follow-up data were available...
May 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28612903/the-value-of-left-atrial-strain-and-strain-rate-in-predicting-left-atrial-appendage-stasis-in-patients-with-nonvalvular-atrial-fibrillation
#18
Mengruo Zhu, Man Wang, Xinxin Ma, Dongyan Zheng, Yueli Zhang
BACKGROUND: This study aimed to investigate the value of left atrial (LA) strain and strain rate (S/SR) by transthoracic echocardiography (TTE) in predicting left atrial appendage (LAA) stasis, in order to find a way for LAA stasis screening which is easily performed in patients with nonvalvular atrial fibrillation (NVAF). METHODS: One hundred and thirty NVAF patients prepared for AF ablation were enrolled. TTE and transesophageal echocardiography (TEE) were performed in all patients...
June 14, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28612230/right-atrial-diameter-and-outcome-of-catheter-ablation-of-atrial-fibrillation
#19
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/28611206/pulmonary-vein-isolation-alone-versus-additional-linear-ablation-in-patients-with-persistent-atrial-fibrillation-converted-to-paroxysmal-type-with-antiarrhythmic-drug-therapy-a-multicenter-prospective-randomized-study
#20
Hee Tae Yu, Jaemin Shim, Junbeom Park, In-Soo Kim, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Young-Hoon Kim, Hui-Nam Pak
BACKGROUND: Atrial fibrillation (AF) type can vary depending on condition and timing, and some patients who initially present with persistent AF may be changed to paroxysmal AF after antiarrhythmic drug medication and cardioversion. We investigated whether circumferential pulmonary vein isolation (CPVI) alone is an effective rhythm control strategy in patients with persistent AF to paroxysmal AF. METHODS AND RESULTS: We enrolled 113 patients with persistent AF to paroxysmal AF (male 75%, 60...
June 2017: Circulation. Arrhythmia and Electrophysiology
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