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Atrial fibrillation; AF Ablation

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https://www.readbyqxmd.com/read/28806148/atrial-fibrillation-ablation
#1
Rakesh Latchamsetty, Fred Morady
The prevalence of atrial fibrillation (AF) has risen significantly over the past two decades. Catheter ablation is an increasingly utilized treatment strategy and has evolved significantly over the same time period. Successful ablation improves patient symptoms, reduces stroke risk, and can preserve or improve cardiac function. Recurrences following ablation can occur, particularly in patients with persistent AF. Procedural efficacy can best be improved through continued advancements in ablation technology and strategy, better understanding of the mechanisms of AF initiation and perpetuation, and rigorous integration of ablation into a multidisciplinary AF management approach...
August 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28800192/efficacy-and-safety-of-driver-guided-catheter-ablation-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#2
F Daniel Ramirez, David H Birnie, Girish M Nair, Agnieszka Szczotka, Calum J Redpath, Mouhannad M Sadek, Pablo B Nery
INTRODUCTION: Targeting localized drivers (electrical rotors or focal impulses) during catheter ablation for atrial fibrillation (AF) has been proposed as a strategy to improve procedural success. However, the strength and quality of the evidence to support this approach is unclear. METHODS AND RESULTS: Clinical studies reporting efficacy or safety outcomes of driver-guided ablation for AF were identified in Medline, Embase, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Pubmed, and conference abstracts from major scientific meetings...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28800176/catheter-ablation-of-left-atrial-arrhythmias-on-uninterrupted-oral-anticoagulation-with-vitamin-k-antagonists-how-is-the-relationship-between-international-normalized-ratio-activated-clotting-time-and-procedure-related-complications
#3
Marc Kottmaier, Felix Bourier, Verena Semmler, Martha Telishevska, Katharina Koch-Büttner, Carsten Lennerz, Sarah Lengauer, Marielouise Kornmayer, Elena Rousseva, Stephanie Brooks, Amir Brkic, Christian Grebmer, Christoph Kolb, Gabriele Hessling, Isabel Deisenhofer, Tilko Reents
BACKGROUND: Ablation of atrial fibrillation (AF) on uninterrupted phenprocoumon reduces periprocedural thromboembolic and bleeding complications. Heparin is administered intraprocedurally to achieve activated clotting times (ACT) of 300-400 seconds. We investigated the effect of international normalized ratio (INR) on ACT and intraprocedural heparin requirements. Moreover, safety of a target ACT of 250-300 seconds was investigated. METHODS AND RESULTS: We studied 949 patients referred for AF or left atrial tachycardia ablation...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28800169/global-multi-electrode-contact-mapping-plus-ablation-with-a-single-catheter-preclinical-and-preliminary-experience-in-humans-with-atrial-fibrillation
#4
Hans Kottkamp, Fabian Moser, Andreas Rieger, Doreen Schreiber, Christian Pönisch, Monica Trofin
INTRODUCTION: One question for the technological advancement of catheter ablation of atrial fibrillation (AF) is whether a creative new concept can combine and even improve the diagnostic mapping options of single-tip and basket catheters with the simplicity of the use of balloon catheters for ablation. Herein, we describe the first in-human experience with a single catheter offering such a complete solution. METHODS AND RESULTS: A new catheter (Globe®) with a distal multi-electrode array consisting of 16 ribs with 122 gold-plated electrodes was used...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28797677/emergence-of-atrioventricular-nodal-reentry-tachycardia-after-surgical-or-catheter-ablation-for-atrial-fibrillation-are-we-creating-the-arrhythmia-substrate
#5
Jorge Romero, Saurabh Kumar, Fujii Akira, David F Briceño, Usha B Tedrow, Laurence Epstein, Roy John, William G Stevenson, Gregory F Michaud
BACKGROUND: Atrioventricular nodal reentry tachycardia (AVNRT) is common in adults and often involves reentry through two or more AV nodal-atrial connections. Although AVNRT can be a trigger for atrial fibrillation (AF), we have observed new onset AVNRT after AF ablation procedures. OBJECTIVE: To determine whether ablation involving the septum or proximal coronary sinus during AF ablation may create a substrate favorable for AVNRT METHODS: Cases of ablation for persistent AF who required a repeat ablation procedure between 2009 to 2016 were reviewed for diagnosis of AVNRT...
August 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28795289/beyond-pulmonary-vein-isolation-the-role-of-additional-sites-in-catheter-ablation-of-atrial-fibrillation
#6
REVIEW
Li-Wei Lo, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Fa-Po Chung, Shih-Ann Chen
PURPOSE OF REVIEW: Pulmonary vein (PV) isolation is the cornerstone of atrial fibrillation (AF) ablation. However, the long-term procedural outcome remains suboptimal and there is a frequent need for repeat ablation procedure, especially in patients with non-paroxysmal AF. The review article summarizes the rationales, recent evidences, and strategies of ablation of extra-PV sites and its clinical outcomes. RECENT FINDINGS: It is a consensus that durable PV isolations are a definite therapy in patients with paroxysmal AF...
August 9, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28793059/comparative-efficacy-and-safety-of-contact-force-sensing-catheter-and-second-generation-cryoballoon-ablation-for-atrial-fibrillation-a-meta-analysis
#7
X Zhou, W Lv, W Zhang, Y Ye, Y Li, Q Zhou, J Zhang, Q Xing, Y Lu, L Zhang, H Wang, W Qin, B Tang
This meta-analysis compared the efficacy and safety of the contact force (CF)-sensing catheter and second-generation cryoballoon (CB) ablation for treating atrial fibrillation (AF). Six controlled clinical trials comparing ablation for AF using a CF-sensing catheter or second-generation CB were identified from PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure. The procedure duration was significantly lower in the CB group compared with that in the CF group [mean difference (MD)=29...
August 7, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28790169/disease-understanding-in-patients-newly-diagnosed-with-atrial-fibrillation
#8
Brystana G Kaufman, Sunghee Kim, Karen Pieper, Larry A Allen, Bernard J Gersh, Gerald V Naccarelli, Michael D Ezekowitz, Gregg C Fonarow, Kenneth W Mahaffey, Daniel E Singer, Paul S Chan, James V Freeman, Jack Ansell, Peter R Kowey, James A Rieffel, Jonathan Piccini, Eric Peterson, Emily C O'Brien
OBJECTIVE: To describe self-reported disease understanding for newly diagnosed patients with atrial fibrillation (AF) and assess (1) how disease understanding changes over the first 6 months after diagnosis and (2) the relationship between patient understanding of therapies at baseline and treatment receipt at 6 months among treatment-naïve patients. METHODS: We analysed survey data from SATELLITE (Survey of Patient Knowledge and Personal Priorities for Treatment), a substudy of patients with new-onset AF enrolled in the national Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT) II registry across 56 US sites...
August 8, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28774344/late-outcome-of-surgical-radiofrequency-ablation-for-persistent-valvular-atrial-fibrillation-in-china-a-single-center-study
#9
Hailong Cao, Yunxing Xue, Qing Zhou, Minggang Yu, Chenbin Tang, Dongjin Wang
BACKGROUND: Atrial fibrillation (AF) adversely affects surgical outcomes of cardiac valve surgery. Surgical ablation is an effective way to treat valvular AF. The aim of this study was to evaluate the late outcome of surgical radiofrequency ablation and explore the risk factors of AF recurrence in Chinese patients undergoing cardiac valve surgery. METHODS: Three hundred ninety six consecutive patients with persistent valvular AF were enrolled in this study. They underwent concomitant modified Maze IV and were completed follow-ups...
August 3, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28769816/signal-reconstruction-of-pulmonary-vein-recordings-using-a-phenomenological-mathematical-model-application-to-pulmonary-vein-isolation-therapy
#10
Harry D Green, Glyn Thomas, John R Terry
Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is commonly initiated by ectopic beats originating from a small myocardial sleeve extending over the pulmonary veins. Pulmonary vein isolation therapy attempts to isolate the pulmonary veins from the left atrium by ablating tissue, commonly by using radiofrequency ablation. During this procedure, the cardiologist records electrical activity using a lasso catheter, and the activation pattern recorded is used as a guide toward which regions to ablate...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28768468/predictive-value-of-exercise-induced-atrial-natriuretic-peptide-secretion-for-the-presence-of-left-atrial-low-voltage-areas-in-patients-with-persistent-atrial-fibrillation
#11
Ran Yin, Zhongming Yang, Jingtian Peng, Bingong Li, Yongnan Fu, Zheqi Zheng
Objectives Left atrial (LA) low-voltage areas (LVAs) are a strong predictor of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). However, a non-invasive method for evaluating LA-LAVs has not been established yet. The objective of our study was to assess the predictive value of the plasma atrial natriuretic peptide (ANP) level for the presence of LA-LVAs in patients with persistent AF (PeAF). Methods Seventy-two PeAF patients underwent an exercise stress test preprocedurally. LA voltage maps were created after PVI...
August 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28766046/relationship-between-left-ventricular-diastolic-dysfunction-and-very-late-recurrences-after-multiple-procedures-for-atrial-fibrillation-ablation
#12
Naoaki Onishi, Kazuaki Kaitani, Masashi Amano, Sari Imamura, Jiro Sakamoto, Yodo Tamaki, Soichiro Enomoto, Makoto Miyake, Toshihiro Tamura, Hirokazu Kondo, Chisato Izumi, Yoshihisa Nakagawa
Although very late recurrences (VLRs) (first recurrence >12 months after the last catheter ablation) of atrial fibrillation (AF) after multiple catheter ablation procedures are rare, it remains a critical issue. The risk factors for VLRs remain largely unclear. From December 2011 to April 2014, 253 patients underwent an initial catheter ablation. Of the 253 patients, 21 had AF recurrences within 1 year after the last catheter ablation. The study was conducted in the remaining 232 patients. Left ventricular diastolic dysfunction (LVDD) was assessed by echocardiography using composite categories with tissue Doppler imaging and left atrial volume measurements, i...
August 1, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28765764/focal-ablation-for-atrial-tachycardia-from-the-double-exit-of-the-marshall-bundle-inducing-atrial-fibrillation
#13
Jung Yeon Chin, Jong Woo Kim, Ki-Woon Kang
Atrial fibrillation (AF) from the ligament/vein of Marshall (LOM/VOM) has previously been described. We report the case of a 23-year-old woman with an antiarrhythmic drug-resistant AF induced by two distinct atrial tachycardias (ATs). Focal ablation of these ATs from the double-exit of the Marshall bundle using a three-dimensional map eliminated AF triggering, even though pulmonary vein electrical isolation is the cornerstone for paroxysmal AF. Such mechanisms are important as triggering factors to plan ablation for paroxysmal AF...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765758/clinical-benefits-of-deep-sedation-with-a-supraglottic-airway-while-monitoring-the-bispectral-index-during-catheter-ablation-of-atrial-fibrillation
#14
Satoru Hida, Masao Takemoto, Akihiro Masumoto, Takahiro Mito, Kazuhiro Nagaoka, Hiroshi Kumeda, Yuki Kawano, Ryota Aoki, Honsa Kang, Atsushi Tanaka, Atsutoshi Matsuo, Kiyoshi Hironaga, Teiji Okazaki, Kiyonobu Yoshitake, Kei-Ichiro Tayama, Ken-Ichi Kosuga
BACKGROUND: Pulmonary vein antrum isolation (PVAI) under sedation has proven to be a useful strategy for catheter ablation of atrial fibrillation (AF). METHODS: To evaluate the clinical benefits of respiratory management using supraglottic airways (SGAs) under deep sedation while monitoring the bispectral (BIS) index during the PVAI and the durations from admission to the catheterization room to starting the radiofrequency energy delivery (Time α), and from starting the radiofrequency energy delivery to completion of the PVAI (Time β), X-ray time, frequency of dislocations of the three-dimensional maps (D3DM), procedure-related complications, and proportion of an AF-free rate 15 months after the PVAI (PAFFR) in patients who received deep sedation without SGAs (Group A: n=48) and those with SGAs (Group B: n=51) were evaluated...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765755/airway-support-using-a-pediatric-intubation-tube-in-adult-patients-with-atrial-fibrillation-a-simple-and-unique-method-to-prevent-heart-movement-during-catheter-ablation-under-continuous-deep-sedation
#15
Masateru Takigawa, Atsushi Takahashi, Taishi Kuwahara, Kenji Okubo, Emiko Nakashima, Yuji Watari, Kazuya Yamao, Jun Nakajima, Yasuaki Tanaka, Katsumasa Takagi, Shigeki Kimura, Hiroyuki Hikita, Kenzo Hirao, Mitsuaki Isobe
BACKGROUND: The present study aimed to elucidate the safety and effectiveness of a noble and unique airway management technique in which a pediatric intubation tube is used in adult patients with atrial fibrillation (AF) undergoing catheter ablation (CA) under continuous deep sedation. METHODS: In total, 246 consecutive patients with AF (mean age, 65±10 years; 60 women) underwent CA under dexmedetomidine-based continuous deep sedation. A 4-mm pediatric intubation tube guided by a 10-French intratracheal suction tube was inserted smoothly, and the tip of the tube was located at the base of the epiglottis...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765754/radiofrequency-catheter-ablation-is-effective-for-atrial-fibrillation-patients-with-hypertrophic-cardiomyopathy-by-decreasing-left-atrial-pressure
#16
Hiroki Ikenaga, Yukiko Nakano, Noboru Oda, Kazuyoshi Suenari, Akinori Sairaku, Takehito Tokuyama, Hiroshi Kawazoe, Hiroya Matsumura, Shunsuke Tomomori, Yasuki Kihara
BACKGROUND: Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) refractory to medical therapy remains controversial in patients with hypertrophic cardiomyopathy (HCM); the acute effects on the direct left atrial (LA) pressure are not completely understood. METHODS: We consecutively studied patients with HCM (n=15) and without HCM (NHCM, n=106) who underwent extensive encircling pulmonary vein isolation for drug-refractory AF. We compared clinical parameters, echocardiographic parameters, electrophysiological parameters, LA pressures using hemodynamic catheterization and recurrence rate in both groups...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765086/spectrum-of-atrial-arrhythmias-using-the-ligament-of-marshall-in-patients-with-atrial-fibrillation
#17
Aman Chugh, Hitinder S Gurm, Kavita Krishnasamy, Mohammed Saeed, Watchara Lohawijarn, Kyle Hornsby, Ryan Cunnane, Hamid Ghanbari, Rakesh Latchamsetty, Thomas Crawford, Krit Jongnarangsin, Frank Bogun, Hakan Oral, Fred Morady
BACKGROUND: The role of the ligament of Marshall (LOM) in patients with atrial fibrillation (AF) has not been well defined. OBJECTIVE: The purpose of this study was to describe the role of the LOM in patients with AF and related arrhythmias. METHODS: Fifty-six patients (mean age 63 ± 11 years; persistent AF in 48 [86%]; ejection fraction 0.49 ± 0.13; left atrial diameter 4.7 ± 0.6 cm) with LOM-mediated arrhythmias were included. RESULTS: A LOM-pulmonary vein (PV) connection was present in 18 patients (32%) and was eliminated with radiofrequency (RF) ablation at the left lateral ridge or crux (n = 12), at the mitral annulus (n = 3), or with alcohol/ethanol (EtOH) ablation of the vein of Marshall (VOM; n = 3)...
July 29, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28761672/adjunctive-interpulmonary-isthmus-ablation-has-no-added-effects-on-atrial-fibrillation-recurrence
#18
Shunichi Higashiya, Hirosuke Yamaji, Takashi Murakami, Kazuyoshi Hina, Hiroshi Kawamura, Masaaki Murakami, Shigeshi Kamikawa, Issei Komatsubara, Shozo Kusachi
OBJECTIVE: Data on the efficacy of adjunctive interpulmonary isthmus ablation following completion of extensive encircling pulmonary vein isolation (EEPVI) on atrial fibrillation (AF) recurrence have still been insufficient. We aimed to compare the AF recurrence between EEPVI with and without adjunctive interpulmonary isthmus ablation. METHODS: We enrolled 200 consecutive patients with paroxysmal AF (first session) who underwent EEPVI with double-Lasso technique...
2017: Open Heart
https://www.readbyqxmd.com/read/28761022/vagal-denervation-in-atrial-fibrillation-ablation-a-comprehensive-review
#19
Tolga Aksu, Tümer Erdem Güler, Ferit Onur Mutluer, Mehmet Ali Oto
Although pulmonary vein isolation is accepted as an established interventional treatment in paroxysmal atrial fibrillation (AF), alternative modalities are being investigated because of the high recurrence rates of nonparoxysmal forms. One of the alternative ablation approaches is ablation or modification of vagal ganglionated plexi (VGP). The technique has not only been used in vagally mediated AF but also investigated in paroxysmal and nonparoxysmal AF. Clinical studies demonstrate significant discrepancy related with detection of VGP sites or ablation targets and definition of procedurel end-points, so far...
July 25, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28754397/contemporary-atrial-fibrillation-management-a-comparison-of-the-current-aha-acc-hrs-ccs-and-esc-guidelines
#20
REVIEW
Jason G Andrade, Laurent Macle, Stanley Nattel, Atul Verma, John Cairns
In this article we compare and contrast the current recommendations, and highlight the important differences, in the American College of Cardiology/American Heart Association/Heart Rhythm Society, European Society of Cardiology, and Canadian Cardiovascular Society atrial fibrillation (AF) guidelines. Although many of the recommendations of the various societies are similar, there are important differences in the methodologies underlying their development and the specific content. Specifically, key differences can be observed in: (1) the definition of nonvalvular AF, which subsequently affects anticoagulation choices and candidacy for non-vitamin K antagonist oral anticoagulants; (2) the symptom score used to guide management decisions and longitudinal patient profiling; (3) the stroke risk stratification algorithm used to determine indications for oral anticoagulant therapy; (4) the role of acetylsalicylic acid in stroke prevention in AF; (5) the antithrombotic regimens used in the context of coronary artery disease, acute coronary syndromes, and percutaneous coronary intervention; (6) the rate control target and medications recommended to achieve the target; and (7) the role of "first-line" catheter ablation, open surgical ablation, and left atrial appendage exclusion...
August 2017: Canadian Journal of Cardiology
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