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Atrial fibrillation; AF Ablation

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https://www.readbyqxmd.com/read/29786530/meta-analysis-of-safety-and-efficacy-of-oral-anti-coagulants-in-patients-requiring-catheter-ablation-for-atrial-fibrillation
#1
Hammad Rahman, Safi U Khan, Michael DePersis, Tehseen Hammad, Fahad Nasir, Edo Kaluski
BACKGROUND: The ideal oral anticoagulant agent during catheter ablation (CA) for atrial fibrillation (AF) remained unclear. HYPOTHESIS: Novel oral anticoagulants (NOACs) are safer and effective compared to uninterrupted vitamin K antagonists (U-VKA) among patients requiring CA for AF. METHODS: Four randomized controlled trials (RCTs) and 9 observational studies (OS) were selected using PubMed/Medline, EMBASE and the CENTRAL data bases (Inception-December-2017)...
May 9, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29784485/p-wave-analysis-in-the-era-of-atrial-fibrillation-ablation
#2
REVIEW
Fabio M Leonelli, Emanuela T Locati, Giuseppe Bagliani, Roberto De Ponti, Luigi Padeletti, Laura Cipolletta, Alessandro Capucci
The common arrhythmia atrial fibrillation (AF) is incompletely understood. The mechanism of initiation and the perpetuation of AF remain speculative. This article summarizes current knowledge of the complex relationship between arrhythmias triggering AF and their long-term effects on atrial tissue, leading to perpetuation of tachycardia. It focuses on the role of the electrocardiogram (ECG) from AF diagnosis to identification of sinus P wave abnormalities predicting future occurrences. The role of ambulatory ECG recordings in managing AF and the use of frequency analysis determining degree of organization and identification of AF triggers are discussed...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29777140/different-responses-of-left-atrium-and-left-atrial-appendage-to-radiofrequency-catheter-ablation-of-atrial-fibrillation-a-follow-up-mri-study
#3
Yun Gi Kim, Jaemin Shim, Suk-Kyu Oh, Hee-Soon Park, Kwang-No Lee, Sung Ho Hwang, Jong-Il Choi, Young-Hoon Kim
Atrial fibrillation (AF) is known to cause adverse remodeling of left atrium (LA). Radiofrequency catheter ablation (RFCA) of AF is associated with decrease in LA volume. However, the impact of RFCA on left atrial appendage (LAA) volume and hemodynamic function is not fully understood. We analyzed 123 patients who underwent cardiac magnetic resonance imaging (MRI) evaluation before and after RFCA in Korea University Anam Hospital. LA and LAA volume were measured before and after RFCA based on cardiac MRI. Baseline LA volume was 99...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29773211/treating-obstructive-sleep-apnea-with-continuous-positive-airway-pressure-reduces-risk-of-recurrent-atrial-fibrillation-after-catheter-ablation-a-meta-analysis
#4
REVIEW
Feilong Deng, Ali Raza, Jun Guo
INTRODUCTION: Recent studies have suggested that there is a strong relationship between obstructive sleep apnea (OSA) and atrial fibrillation (AF). However, they have not identified whether treating OSA with continuous positive airway pressure (CPAP) might reduce rates of recurrent AF. OBJECTIVE: To investigate the recurrent risk of AF after catheter ablation among patients with OSA who did receive or did nor receive CPAP therapy. METHODS: A systematic review of PubMed, Embase, Medline, Cochrane library, China National Knowledge Infrastructure (CNKI) and Wan-fang databases was conducted to obtain relevant cohort studies and randomized controlled trials (RCTs)...
June 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29768672/catheter-ablation-for-atrial-fibrillation-on-uninterrupted-direct-oral-anticoagulants-a-safe-approach
#5
V Sawhney, M Shaukat, E Volkova, N Jones, R Providencia, S Honarbakhsh, G Dhillon, A Chow, M Lowe, P Lambiase, M Dhinoja, S Sporton, M J Earley, R J Schilling, R J Hunter
BACKGROUND: Current consensus guidelines suggest DOACs are interrupted peri-procedurally for catheter ablation (CA) of AF. However, this may predispose patients to thromboembolic complications. This study investigates the safety of CA for AF on uninterrupted DOACs compared to uninterrupted warfarin. METHODS: Single centre, retrospective study of consecutive patients undergoing CA for AF. All patients were heparinised prior to trans-septal puncture with a target activated clotting time (ACT) of 300-350 seconds...
May 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29768386/are-left-ventricular-ejection-fraction-and-left-atrial-diameter-related-to-atrial-fibrillation-recurrence-after-catheter-ablation-a-meta-analysis
#6
Xiao Jin, Jianke Pan, Huanlin Wu, Danping Xu
Atrial fibrillation (AF), the most common form of arrhythmia, is associated with the prevalence of many common cardiovascular and cerebrovascular diseases. Catheter ablation is considered the first-line therapy for AF; however, AF recurrence is very common after catheter ablation. Studies have been performed to analyze the factors associated with AF recurrence, but none have reached a consistent conclusion on whether left ventricular ejection fraction (LVEF) and left atrial diameter (LA diameter) affect AF recurrence after catheter ablation...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29765687/machine-learning-methods-for-locating-re-entrant-drivers-from-electrograms-in-a-model-of-atrial-fibrillation
#7
Max Falkenberg McGillivray, William Cheng, Nicholas S Peters, Kim Christensen
Mapping resolution has recently been identified as a key limitation in successfully locating the drivers of atrial fibrillation (AF). Using a simple cellular automata model of AF, we demonstrate a method by which re-entrant drivers can be located quickly and accurately using a collection of indirect electrogram measurements. The method proposed employs simple, out-of-the-box machine learning algorithms to correlate characteristic electrogram gradients with the displacement of an electrogram recording from a re-entrant driver...
April 2018: Royal Society Open Science
https://www.readbyqxmd.com/read/29761335/-biomarkers-and-atrial-fibrillation-prediction-of-recurrences-and-thromboembolic-events-after-rhythm-control-management
#8
REVIEW
Jelena Kornej, Katja Schumacher, Daniela Husser, Gerhard Hindricks
Atrial fibrillation (AF) is the most common arrhythmia in clinical praxis and is associated with an increased risk for cardio- and cerebrovascular complications leading to an increased mortality. Catheter ablation represents one of the most important and efficient therapy strategies in AF patients. Nevertheless, the high incidence of arrhythmia recurrences after catheter ablation leads to repeated procedures and higher treatment costs. Recently, several scores had been developed to predict rhythm outcomes after catheter ablation...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29759784/atrial-tachycardias-after-surgical-atrial-fibrillation-ablation-clinical-characteristics-electrophysiological-mechanisms-and-ablation-outcomes-from-a-large-multicenter-study
#9
Rakesh Gopinathannair, Philip L Mar, Muhammad Rizwan Afzal, Luigi Di Biase, Yixi Tu, Thanmay Lakkireddy, Jaimin R Trivedi, Mark S Slaughter, Andrea Natale, Dhanunjaya Lakkireddy
OBJECTIVES: The clinical characteristics, electrophysiological mechanisms, and ablation outcomes of post-surgical atrial fibrillation ablation (SAFA) atrial tachycardias (ATs) have not been studied in a large, multicenter cohort. BACKGROUND: ATs are often seen following SAFA. METHODS: Analysis was performed on 137 patients (age, 62 ± 10 years; 74% male) who underwent catheter ablation for symptomatic post-SAFA AT from 2004 to 2013 at 3 high-volume institutions in the United States...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759774/assessment-of-left-atrial-fibrosis-by-late-gadolinium-enhancement-magnetic-resonance-imaging-methodology-and-clinical-implications
#10
REVIEW
Johannes Siebermair, Eugene G Kholmovski, Nassir Marrouche
Recently, studies using late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) to identify structural changes of atrial tissue have contributed significantly to understanding the pathophysiology and progression of atrial fibrillation (AF). Moreover, imaging of atrial fibrosis using MRI has evolved to be a tool to improve clinical outcome of AF ablation procedures by allowing a patient-specific individualized management approach. LGE-MRI has been shown to predict AF ablation outcome based on pre-procedural imaging to define the extent of atrial fibrosis...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759716/atrial-fibrillation-in-athletes-a-lesson-in-the-virtue-of-moderation
#11
REVIEW
N A Mark Estes, Christopher Madias
Although the cardiovascular benefits of moderate exercise are well established, there is growing epidemiological support for the notion that high-intensity endurance athletics increases the risk of atrial fibrillation (AF). There are many gaps in evidence related to epidemiology and mechanisms of AF in endurance athletes. The proposed pathophysiological mechanisms include alterations of autonomic tone, electrical remodeling, anatomical remodeling, fibrosis, and inflammation. Clinical management of the athlete with AF often includes a period of decreased frequency, intensity, and duration of exercise with assessment for improvement in AF recurrence...
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759706/the-human-left-atrial-venous-circulation-as-a-vascular-route-for-atrial-pharmacological-therapies-effects-of-ethanol-infusion
#12
Miguel Valderrábano, Percy Francisco Morales, Moisés Rodríguez-Mañero, Candela Lloves, Paul A Schurmann, Amish S Dave
OBJECTIVES: This study catalogued the human venous left atrium (LA) circulation system and the ablative effects of ethanol in different branches. BACKGROUND: Vascular routes to target the LA could have significant therapeutic potential. Beyond the vein of Marshall (VOM), the fluoroscopic LA venous anatomy has not been described. METHODS: Patients undergoing ethanol infusion in the VOM as adjunctive therapy to atrial fibrillation (AF) catheter ablation were included in this study...
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759674/population-based-evaluation-of-major-adverse-events-after-catheter-ablation-for-atrial-fibrillation
#13
Michelle Samuel, Mohammad Almohammadi, Meytal Avgil Tsadok, Jacqueline Joza, Cynthia A Jackevicius, Maria Koh, Hassan Behlouli, Atul Verma, Louise Pilote, Vidal Essebag
OBJECTIVES: The purpose of this study was to evaluate the safety and incidence of periprocedural adverse events (AEs) among patients who underwent catheter ablation (CA) for atrial fibrillation (AF) in Quebec and Ontario, Canada. BACKGROUND: CA is evolving into the mainstay therapy for patients with symptomatic AF refractory to antiarrhythmic medication. However, the safety of CA at the population level over time requires further evaluation. METHODS: A population-based cohort was constructed using administrative databases of all patients who underwent CA between 1999 and 2014 in Quebec and Ontario, Canada...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759616/spatial-relationships-of-complex-fractionated-atrial-electrograms-and-continuous-electrical-activity-to-focal-electrical-sources-implications-for-substrate-ablation-in-human-atrial-fibrillation
#14
Simon Kochhäuser, Atul Verma, Rupin Dalvi, Adrian Suszko, Pouria Alipour, Prashanthan Sanders, Jean Champagne, Laurent Macle, Girish M Nair, Hugh Calkins, David J Wilber, Vijay S Chauhan
OBJECTIVES: This study sought to evaluate the spatial relationships of focal electrical sources (FSs) to complex fractionated atrial electrograms (CFAE) and continuous electrical activity (CEA). BACKGROUND: Fractionated atrial electrograms have been associated with atrial fibrillation (AF) drivers in computational studies and represent ablation targets in the management of persistent AF. METHODS: We included a subset of 66 patients (age: 63 [56, 67] years, 69% persistent AF) with electroanatomic data from the SELECT AF (Selective complex fractionated atrial electrograms targeting for atrial fibrillation) randomized control trial that compared the efficacy of CFAE with CEA ablation in AF patients undergoing pulmonary vein antral ablation...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759532/therapeutic-approaches-to-atrial-fibrillation-ablation-targeting-atrial-fibrosis
#15
REVIEW
Hans Kottkamp, Doreen Schreiber, Fabian Moser, Andreas Rieger
Atrial fibrosis is the fundamental histopathologic finding in atrial fibrillation (AF) patients and an important predictor of ablation failure beyond pulmonary vein isolation. There is wide variation in the extent and localization of left atrial fibrosis in patients with paroxysmal and nonparoxysmal AF. Box isolation of fibrotic areas is an effective rhythm control concept in patients with paroxysmal AF despite durable pulmonary vein isolation, and this strategy has recently been implemented successfully in initial AF ablation procedures in addition to pulmonary vein isolation for patients with nonparoxysmal AF...
July 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759501/assessment-of-atrial-fibrillation-specific-symptoms-before-and-2-years-after-atrial-fibrillation-ablation-do-patients-and-physicians-differ-in-their-perception-of-symptom-relief
#16
Anna Björkenheim, Axel Brandes, Anders Magnuson, Alexander Chemnitz, Lena Svedberg, Nils Edvardsson, Dritan Poçi
OBJECTIVES: The aim of this study was to evaluate patient-reported and physician-assessed atrial fibrillation (AF)-related symptoms after AF ablation. BACKGROUND: Success of AF ablation is usually defined as freedom from AF, although symptom relief is often patients' desire. METHODS: Symptom relief was assessed as perceived by patients using the short, validated, AF-specific symptom questionnaire AF6 and as classified by physicians using the European Heart Rhythm Association (EHRA) classification at baseline and 6, 12, and 24 months after AF ablation...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759498/the-extent-of-mechanical-esophageal-deviation-to-avoid-esophageal-heating-during-catheter-ablation-of-atrial-fibrillation
#17
Chandrasekar Palaniswamy, Jacob S Koruth, Alexander J Mittnacht, Marc A Miller, Subbarao Choudry, Rahul Bhardwaj, Dinesh Sharma, Jonathan M Willner, Sujata S Balulad, Elizabeth Verghese, Georgios Syros, Anurag Singh, Srinivas R Dukkipati, Vivek Y Reddy
OBJECTIVES: This study sought to determine the extent of lateral esophageal displacement required during mechanical esophageal deviation (MED) and to eliminate luminal esophageal temperature elevation (LETElev ) during pulmonary vein (PV) isolation. BACKGROUND: MED is a conceptually attractive strategy of minimizing esophageal injury while allowing uninterrupted energy delivery along the posterior left atrium during PV isolation. METHODS: MED was performed using a malleable metal stylet within a plastic tube placed within the esophagus...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759434/pulmonary-vein-re-isolation-as-a-routine-strategy-regardless-of-symptoms-the-pressure-randomized-controlled-trial
#18
Moloy Das, Gareth J Wynn, Yawer Saeed, Sean Gomes, Maureen Morgan, Christina Ronayne, Laura J Bonnett, Johan E P Waktare, Derick M Todd, Mark C S Hall, Richard L Snowdon, Simon Modi, Dhiraj Gupta
OBJECTIVES: The goal of this study was to determine whether a strategy of early re-isolation of pulmonary vein (PV) reconnection in all patients, regardless of symptoms, would reduce the recurrence of atrial fibrillation (AF) and improve quality of life. BACKGROUND: Lasting pulmonary vein isolation (PVI) remains elusive. PV reconnection is strongly linked to the recurrence of arrhythmia. METHODS: A total of 80 patients with paroxysmal AF were randomized 1:1 after contact force-guided PVI to receive either standard care or undergo a repeat electrophysiology study after 2 months regardless of symptoms (repeat study)...
June 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759432/incidence-of-pulmonary-vein-stenosis-after-radiofrequency-catheter-ablation-of-atrial-fibrillation
#19
Cas Teunissen, Birgitta K Velthuis, Rutger J Hassink, Jeroen F van der Heijden, Evert-Jan P A Vonken, Nick Clappers, Pieter A Doevendans, Peter Loh
OBJECTIVES: This study aimed to determine incidence of pulmonary vein stenosis (PVS) and evaluate PVS-related symptoms. BACKGROUND: The real-life incidence of PVS after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is unknown. METHODS: All patients who underwent RFCA of AF from 2005 to 2016 with routine pre- and post-ablation screening by magnetic resonance imaging or computed tomography were included. Primary ablation strategy was PV antrum isolation alone in all patients...
June 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759428/atrial-fibrillation-and-pulmonary-venous-electrical-conduction-recovery-after-full-surgical-resection-and-anastomosis-of-the-pulmonary-veins-insights-from-follow-up-and-ablation-procedures-in-lung-transplant-recipients
#20
Ayman A Hussein, Tanmay S Panchabhai, Marie M Budev, Khaldoun Tarakji, Amr F Barakat, Walid Saliba, Bruce Lindsay, Oussama M Wazni
OBJECTIVES: The authors report their experience with atrial fibrillation (AF) rates and ablation findings in lung transplant recipients. BACKGROUND: Pulmonary venous (PV) conduction recovery accounts for most failed atrial fibrillation (AF) catheter ablation procedures. Lung transplantation involves full surgical resection and replacement of the recipient's PVs with donor's PVs, which may represent the ultimate PV ablation. METHODS: They followed 755 consecutive lung transplant recipients categorized based on transplant status (unilateral vs...
June 2017: JACC. Clinical Electrophysiology
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