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Pulmonary vein isolation

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https://www.readbyqxmd.com/read/29147788/dissociated-pulmonary-vein-activity-after-cryoballoon-ablation-and-radiofrequency-ablation-for-atrial-fibrillation-a-propensity-score-matched-analysis
#1
Kenichi Tokutake, Michifumi Tokuda, Seiichiro Matsuo, Ryota Isogai, Kenichi Yokoyama, Mika Kato, Ryohsuke Narui, Shinichi Tanigawa, Seigo Yamashita, Satoru Miyanaga, Michihiro Yoshimura, Teiichi Yamane
Cryoballoons (CBs) have proven to be effective for achieving pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Dissociated PV activity (DPVA) after successful radiofrequency PVI is sometimes observed inside the PV and has been found to prove the achievement of electrical disconnection from the left atrium. However, little is known about the incidence or characteristics of DPVA after CB-PVI. The aim of this study was to compare the incidence and characteristics of DPVA in patients undergoing CB and radiofrequency (RF) ablation for AF...
November 17, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29145517/which-patients-recur-as-atrial-tachycardia-rather-than-atrial-fibrillation-after-catheter-ablation-of-atrial-fibrillation
#2
Pil-Sung Yang, Young-Ah Park, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
INTRODUCTION: The ablation gaps have been known as the main mechanism of recurrence as atrial tachycardia (AT) rather than atrial fibrillation (AF) after AF catheter ablation. However, AF organization due to reduction of critical mass or focal trigger may also be the mechanism of AT recurrence. We sought to find out the main clinical factors of recurrence as AT rather than AF after AF ablation in the absence of antiarrhythmic drug effect. METHODS: We analyzed 521 patients (70...
2017: PloS One
https://www.readbyqxmd.com/read/29142855/single-port-thoracoscopic-treatment-of-thoracic-duct-injury-after-thyroidectomy-with-neck-dissection
#3
Serkan Teksoz, Ezel Ersen, Akif Enes Arikan, Sina Ferahman, Kamil Kaynak, Gianlorenzo Dionigi, Yusuf Bukey
Chylous leakage is a complication of thyroidectomy accompanied by bilateral neck dissection with incidence of 0.5-6.2%. A 51-year-old female patient underwent total thyroidectomy, bilateral and central neck dissection for papillary thyroid carcinoma. In post-operative 4(th) day, left sided chylous leakage was observed as 1,500 cc/day through neck drain. Leakage did not cease after 1-month conservative treatment so single port thoracoscopic intervention was performed. Under general anesthesia, patient was placed in left lateral decubitus position...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29141843/stable-sr-electrophysiological-substrate-ablation-in-the-left-atrium-during-sinus-rhythm-for-the-treatment-of-nonparoxysmal-atrial-fibrillation-a-prospective-multicenter-randomized-clinical-trial
#4
Bing Yang, Chenyang Jiang, Yazhou Lin, Gang Yang, Huimin Chu, Heng Cai, Fengmin Lu, Xianzhang Zhan, Jian Xu, Xinhua Wang, Chi-Keong Ching, Balbir Singh, Young-Hoon Kim, Minglong Chen
BACKGROUND: Circumferential pulmonary vein isolation (CPVI) alone or combined with adjuvant substrate modifications is unsatisfactory for atrial fibrillation (AF) control in nonparoxysmal AF patients. Ablation targeting the fibrotic areas after CPVI (STABLE-SR [Electrophysiological Substrate Ablation in the Left Atrium During Sinus Rhythm]) is a newly evolved substrate modification strategy. METHODS AND RESULTS: In this multicenter, randomized clinical trial, 229 symptomatic nonparoxysmal AF patients were 1:1 randomized to STABLE-SR group (n=114) or conventional STEPWISE group (n=115)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29136152/concomitant-thoracoscopic-surgery-for-solitary-pulmonary-nodule-and-atrial-fibrillation
#5
Rongxin Lu, Ju Mei, Dongfang Zhao, Zhaolei Jiang, Haibo Xiao, Mingsong Wang, Nan Ma
OBJECTIVES: The incidence of both solitary pulmonary nodules (SPN) and non-valvular atrial fibrillation (NVAF) has increased over the past decade. We performed concomitant video-assisted thoracoscopic surgery with modified epicardial radiofrequency ablation procedure for NVAF and SPN resection. METHODS: Sixteen patients (7 men, mean age 62.6 ± 11.2 years) with SPN and NVAF underwent this procedure. Of these patients, 10 had paroxysmal atrial fibrillation and 6 persistent atrial fibrillation...
November 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29135523/targeting-nonpulmonary-vein-triggers-during-atrial-fibrillation-ablation-is-the-game-worth-the-candle
#6
Ahmed AlTurki, Howard J Marshall, Riccardo Proietti
PURPOSE OF REVIEW: Triggers for atrial fibrillation are found outside the pulmonary veins in 12-20% of cases. The role of addressing these triggers during catheter ablations has not been well defined. Therefore, the aim of this review is to summarize the effect of ablation of nonpulmonary vein triggers in addition to pulmonary vein isolation across the spectrum of atrial fibrillation in patients receiving catheter ablation. RECENT FINDINGS: In paroxysmal atrial fibrillation, an inducible nonpulmonary vein trigger is an independent predictor of recurrence...
November 10, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29133380/atrial-substrate-and-triggers-of-paroxysmal-atrial-fibrillation-in-patients-with-obstructive-sleep-apnea
#7
Elad Anter, Luigi Di Biase, Fernando M Contreras-Valdes, Carola Gianni, Sanghamitra Mohanty, Cory M Tschabrunn, Juan F Viles-Gonzalez, Eran Leshem, Alfred E Buxton, Guy Kulbak, Rim N Halaby, Peter J Zimetbaum, Jonathan W Waks, Robert J Thomas, Andrea Natale, Mark E Josephson
BACKGROUND: Obstructive sleep apnea (OSA) is associated with atrial remodeling, atrial fibrillation (AF), and increased incidence of arrhythmia recurrence after pulmonary vein (PV) isolation. We aimed to characterize the atrial substrate, including AF triggers in patients with paroxysmal AF and OSA. METHODS AND RESULTS: In 86 patients with paroxysmal AF (43 with ≥moderate OSA [apnea-hypopnea index ≥15] and 43 without OSA [apnea-hypopnea index <5]), right atrial and left atrial voltage distribution, conduction velocities, and electrogram characteristics were analyzed during atrial pacing...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29133182/a-novel-method-for-localization-and-ablation-of-conduction-gaps-after-wide-antral-circumferential-ablation-of-pulmonary-veins
#8
Raoul Bacquelin, Raphaël P Martins, Nathalie Behar, Vincent Galand, Baptiste Polin, Jonathan Lacaze, Frédéric Sebag, Christophe Leclercq, Jean-Claude Daubert, Philippe Mabo, Dominique Pavin
BACKGROUND: Atrial fibrillation ablation is often performed by achieving pulmonary vein isolation using the "wide antral circumferential ablation" (WACA) technique, but many pulmonary veins remain connected because of conduction gaps in the ablation line. AIM: To analyse the efficacy of a novel technique based on pacing manoeuvres to detect gaps in an initial WACA lesion. METHODS: Patients referred for radiofrequency atrial fibrillation ablation were enrolled prospectively...
November 10, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29131442/increased-rates-of-atrial-fibrillation-recurrence-following-pulmonary-vein-isolation-in-overweight-and-obese-patients
#9
Bhradeev Sivasambu, Muhammad A Balouch, Tarek Zghaib, Rizma J Bajwa, Jonathan Chrispin, Ronald D Berger, Hiroshi Ashikaga, Saman Nazarian, Joseph E Marine, Hugh Calkins, David D Spragg
INTRODUCTION: Catheter ablation is common for patients with symptomatic, drug-refractory atrial fibrillation (AF). Obesity is a known risk factor for incident AF. The impact of obesity on AF ablation outcomes is incompletely understood. We sought to determine the impact of elevated body mass index (BMI) on pulmonary vein isolation (PVI) procedural outcomes and associated complications. METHODS AND RESULTS: We evaluated patients undergoing PVI from 2001 to 2015, dividing them into four groups: normal weight (BMI ≥ 18...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29130489/angiotensin-1-7-modulates-electrophysiological-characteristics-and-calcium-homeostasis-in-pulmonary-veins-cardiomyocytes-via-mas-pi3k-enos-signaling-pathway
#10
Yen-Yu Lu, Wen-Shiann Wu, Yung-Kuo Lin, Chen-Chuan Cheng, Yao-Chang Chen, Shih-Ann Chen, Yi-Jen Chen
BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia, and pulmonary veins (PVs) play a critical role in triggering AF. Angiotensin (Ang)-(1-7) regulates calcium (Ca(2+) ) homeostasis and also plays a critical role in cardiovascular pathophysiology. However, the role of Ang-(1-7) in PV arrhythmogenesis remains unclear. MATERIALS AND METHODS: Conventional microelectrodes, whole-cell patch-clamp, and the Fluo-3 fluorimetric ratio technique were used to record ionic currents and intracellular Ca(2+) in isolated rabbit PV preparations, and in single isolated PV cardiomyocytes, before and after administration of Ang-(1-7)...
November 12, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29127542/left-atrial-function-after-epicardial-pulmonary-vein-isolation-in-patients-with-atrial-fibrillation
#11
Louise Bagge, Per Blomström, Lena Jidéus, Stefan Lönnerholm, Carina Blomström-Lundqvist
PURPOSE: Epicardial pulmonary vein isolation has become an increasingly used therapy for medically resistant atrial fibrillation. The purpose of the present study was therefore to evaluate if epicardial pulmonary vein isolation combined with ganglionated plexi ablation affects the size and mechanical function of the left atrium, and whether the effects are dependent on the extensiveness of the ablation applications. METHODS: A total of 42 patients underwent an echocardiographic examination prior to and 6 months after a minimal invasive epicardial pulmonary vein isolation procedure for the assessment of the effects on left atrial size and function...
November 10, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29126896/the-continuous-challenge-of-af-ablation-from-foci-to-rotational-activity
#12
REVIEW
Sanjiv M Narayan, Mohan N Vishwanathan, Christopher A B Kowalewski, Tina Baykaner, Miguel Rodrigo, Junaid A B Zaman, Paul J Wang
Pulmonary vein isolation (PVI) is central to ablation approaches for atrial fibrillation (AF), yet many patients still have arrhythmia recurrence after one or more procedures despite the latest technology for PVI. Ablation of rotational or focal sources for AF, which lie outside the pulmonary veins in many patients, is a practical approach that has been shown to improve success by many groups. Localized sources lie in atrial regions shown mechanistically to sustain AF in optical mapping and clinical studies of human AF, as well as computational and animal studies...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29126892/atrial-fibrillation-ablation-beyond-pulmonary-veins-the-role-of-left-atrial-appendage
#13
REVIEW
Jorge Romero, Andrea Natale, Luigi Di Biase
The role of pulmonary vein isolation in patients with non-paroxysmal atrial fibrillation (AF) is only modest. Several studies have demonstrated the role of the left atrial appendage (LAA) in initiating and maintaining of this arrhythmia. We review in this article the incremental benefit in free-arrhythmia recurrence of LAA electrical isolation in patients undergoing procedures for persistent AF or long standing persistent AF either using radiofrequency ablation, cryoablation or Lariat device implantation. Likewise, acute complications, anticoagulation and the risk of ischemic stroke after LAA electrical isolation (LAAEI) are analyzed...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29116663/higher-contact-force-energy-setting-and-impedance-rise-during-radiofrequency-ablation-predicts-charring-new-insights-from-contact-force-guided-in-vivo-ablation
#14
Hisaki Makimoto, Andreas Metzner, Roland Richard Tilz, Tina Lin, Christian-H Heeger, Andreas Rillig, Shibu Mathew, Christine Lemeš, Erik Wissner, Karl-Heinz Kuck, Feifan Ouyang
INTRODUCTION: Higher contact force (CF) theoretically increases the risk of blood charring, diminishing lesion formation. We aimed to investigate the relationship between CF, impedance change and char formation during pulmonary vein isolation (PVI). METHODS: CF was assessed during PVI in 65 patients. Radiofrequency ablation (RFA) with power-controlled mode was applied in the point-by-point manner. The RFA were divided into 5 groups: group-A [CF < 10 g], group-B (10 g≤CF < 20 g), group-C (20 g≤CF < 30 g), group-D (30 g≤CF < 40 g), and group-E (CF≥40 g)...
November 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29112729/single-freeze-per-vein-strategy-with-the-second-generation-cryoballoon-for-atrial-fibrillation-a-propensity-score-matched-study-between-180-and-240-s-application-time-in-a-large-cohort-of-patients
#15
Valentina De Regibus, Juan-Pablo Abugattas, Saverio Iacopino, Giacomo Mugnai, Cesare Storti, Giulio Conte, Angelo Auricchio, Erwin Ströker, Hugo-Enrique Coutiño, Ken Takarada, Francesca Salghetti, Ian Lusoc, Lucio Capulzini, Pedro Brugada, Carlo de Asmundis, Gian-Battista Chierchia
Aims: The single-freeze strategy using the second-generation cryoballoon (CB-A, Arctic Front Advance, Medtronic, Minneapolis, MN, USA) has been reported to be as effective as the recommended double-freeze approach in several single-centre studies. In this retrospective, international, multicentre study, we compare the 3-min single-freeze strategy with the 4-min single-freeze strategy. Methods and results: Four hundred and thirty-two patients having undergone pulmonary vein isolation (PVI) by means of CB-A using a single-freeze strategy were considered for this analysis...
November 2, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29108897/cryoballoon-ablation-in-atrial-fibrillation-advantages-and-drawbacks
#16
REVIEW
Serge Boveda
Pulmonary vein isolation is the cornerstone of atrial fibrillation ablation and is effective for preventing arrhythmias recurrences, especially in patients with paroxysmal atrial fibrillation. During the last years, cryoballoon ablation has emerged as an unquestionable alternative approach to radiofrequency ablation. Many non-randomized and randomized trials have proven undoubtedly that cryoballoon ablation displays similar efficacy and overall safety profile, when compared to radiofrequency ablation for the treatment of patients with drug-refractory paroxysmal atrial fibrillation...
November 3, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29107190/pulmonary-vein-isolation-cryoablation-for-persistent-and-long-standing-persistent-atrial-fibrillation-patients-clinical-outcomes-from-real-word-multicentric-observational-project
#17
Claudio Tondo, Saverio Iacopino, Paolo Pieragnoli, Giulio Molon, Roberto Verlato, Antonio Curnis, Maurizio Landolina, Giuseppe Allocca, Giuseppe Arena, Gaetano Fassini, Luigi Sciarra, Mario Luzi, Massimiliano Manfrin, Luigi Padeletti
BACKGROUND: Pulmonary vein isolation (PVI) is a cornerstone ablation strategy in the management of patients with atrial fibrillation (AF). Consensus guidelines and statements recommend PVI during the index catheter ablation procedure in patients with paroxysmal and persistent AF. OBJECTIVE: The objective of this analysis was to evaluate patients with persistent and long-standing persistent AF who were treated with the cryoballoon ablation catheter by PVI technique...
October 26, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29107175/entrapment-of-focal-atrial-tachycardia-using-cryoballoon-ablation-sinus-rhythm-in-the-left-atrium-and-ongoing-atrial-tachycardia-in-the-left-atrial-appendage
#18
Hikmet Yorgun, Uğur Canpolat, Banu Evranos, Kudret Aytemir
Left atrial appendage (LAA) is a well-known source of focal atrial tachycardias (AT). Although radio-frequency (RF) energy is the most commonly used technique in such cases, there was an option other than epicardial approach when RF technique fails. Cryoballoon technology is primarily developed to be used for pulmonary vein isolation (PVI). Also, there was no report regarding the isolation of LAA by using cryo-balloon in patients with focal AT. In this case, for the first time in the literature, we successfully isolated the LAA because of failed attempts of RF ablation for focal AT in whom the surface electrogram showed a sinus rhythm while arrhythmia continues inside the LAA...
October 28, 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29106529/transseptal-puncture-and-catheter-ablation-of-atrial-fibrillation-in-patients-with-atrial-septal-occluder-initial-experience-of-a-single-centre
#19
Cai-Hua Sang, Jian-Zeng Dong, De-Yong Long, Rong-Hui Yu, Rong Bai, Mohamed Salim, Ri-Bo Tang, Man Ning, Chen-Xi Jiang, Nian Liu, Song-Nan Li, Song-Nan Wen, Jia-Hui Wu, Ke Chen, Ying-Wei Chen, Chang-Sheng Ma
Aims: Catheter ablation is underutilized in atrial septal defect (ASD) patients who have undergone implantation of an atrial septal occluder (ASO). This study evaluates the feasibility and safety of catheter ablation of atrial fibrillation (AF) in this subset of patients. Methods and results: Sixteen patients (age 56 ± 12 years, 10 men) with drug-refractory AF (10 paroxysmal and 6 persistent) and previously implanted ASO were enrolled. Balloon dilatation of the closure device was performed if the native septum passage could not be achieved...
November 2, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29102650/safety-and-feasibility-of-atrial-fibrillation-ablation-using-amigo-%C3%A2-system-versus-manual-approach-a-pilot-study
#20
Antonio Scarà, Luigi Sciarra, Ermenegildo De Ruvo, Alessio Borrelli, Domenico Grieco, Zefferino Palamà, Paolo Golia, Lucia De Luca, Marco Rebecchi, Leonardo Calò
BACKGROUND: The Amigo(®) Remote Catheter System is a relatively new robotic system for catheter navigation. This study compared feasibility and safety using Amigo (RCM) versus manual catheter manipulation (MCM) to treat paroxysmal atrial fibrillation (PAF). Contact force (CF) and force-time integral (FTI) values obtained during pulmonary vein isolation (PVI) ablation were compared. METHODS: Forty patients were randomly selected for either RCM (20) or MCM (20). All were studied with the Thermocool(®) SmartTouch(®) force-sensing catheter (STc)...
November 1, 2017: Indian Pacing and Electrophysiology Journal
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