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Pulmonary vein isolation

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https://www.readbyqxmd.com/read/28637187/identification-of-pulmonary-vein-reconnection-gaps-with-high-density-mapping-in-redo-atrial-fibrillation-ablation-procedures
#1
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
#2
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/28635085/venous-thromboembolism-management-in-northeast-melbourne-how-does-it-compare-to-international-guidelines-and-data
#3
Hui Yin Lim, Chong Chyn Chua, Mark Tacey, Matthew Sleeman, Geoffrey Donnan, Harshal Nandurkar, Prahlad Ho
BACKGROUND: Venous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and international guidelines. AIMS: To provide a holistic evaluation of "real-world" Australian experience in the warfarin era, including how we compare to international guidelines. METHODS: Retrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28630168/incidence-and-factors-associated-with-the-occurrence-of-pulmonary-vein-narrowing-after-cryoballoon-ablation
#4
Ryohsuke Narui, Michifumi Tokuda, Masato Matsushima, Ryota Isogai, Kenichi Tokutake, Kenichi Yokoyama, Mika Hioki, Keiichi Ito, Shin-Ichi Tanigawa, Seigo Yamashita, Keiichi Inada, Kenri Shibayama, Seiichiro Matsuo, Satoru Miyanaga, Kenichi Sugimoto, Michihiro Yoshimura, Teiichi Yamane
BACKGROUND: In contrast with traditional radiofrequency ablation, little is known about the influence of cryoballoon ablation on the morphology of pulmonary veins (PVs). We evaluated the influence of cryoballoon ablation on the PV dimension (PVD) and investigated the factors associated with a reduction of the PVD. METHODS AND RESULTS: Seventy-four patients who underwent cryoballoon ablation for paroxysmal atrial fibrillation were included in the present study. All subjects underwent contrast-enhanced computed tomography both before and at 3 months after the procedure...
June 2017: Circulation. Arrhythmia and Electrophysiology
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
#5
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
#6
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
#7
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/28622179/paucicellular-fibrointimal-proliferation-characterizes-pediatric-pulmonary-vein-stenosis-clinicopathologic-analysis-of-213-samples-from-97-patients
#8
Alexandra E Kovach, Philip M Magcalas, Christina Ireland, Kerry McEnany, Andre M Oliveira, Mark W Kieran, Christopher W Baird, Kathy Jenkins, Sara O Vargas
Pulmonary vein stenosis (PVS) is a luminal narrowing of extrapulmonary pulmonary veins. In pediatric patients, it arises following repair of congenital heart disease, particularly anomalous pulmonary venous return; in lung disease, especially prematurity; and rarely in isolation. The etiology is unknown and the course often fatal without lung transplantation. We hypothesized that systematic clinicopathologic review of pediatric PVS could provide further pathogenic insight. We included patients who underwent first resection of pulmonary venous tissue for symptomatic PVS at our pediatric referral center from 1995 to 2014...
June 15, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28618036/ultra-low-radiation-dose-during-electrophysiology-procedures-using-optimised-new-generation-fluoroscopy-technology
#9
James Crowhurst, Haris Haqqani, Daniel Wright, Daniel Wright, Mark Whitby, Adam Lee, John Betts, Russell Denman
BACKGROUND: Electrophysiology procedures require fluoroscopic guidance, with the associated potentially adverse effects of ionising radiation. Newer fluoroscopy systems have more features that enable dose-reduction strategies. This study aimed to investigate any reduction in radiation dose between an older fluoroscopy system (Philips Integris H5000) and one of the latest systems (Siemens Artis Q), optimised with dose-reduction strategies. METHODS: Radiation dose measures were collected over a two year period in a single electrophysiology laboratory...
June 15, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28614148/race-and-ethnicity-has-a-mixed-effect-on-the-treatment-of-tibial-plateau-fractures
#10
Adam Driesman, Siddharth A Mahure, Albit Paoli, Christian A Pean, Sanjit R Konda, Kenneth A Egol
OBJECTIVES: To determine if racial or economic disparities are associated with short term complications and outcomes in tibial plateau fracture care. DESIGN: Retrospective cohort study SETTING:: All New York State hospital admissions from 2000 to 2014, as recorded by the New York Statewide Planning and Research Cooperative System database PATIENTS/PARTICIPANTS:: Thirteen thousand five hundred eighteen inpatients with isolated tibial plateau fractures (AO/OTA 44), stratified in four groups: Caucasian, African-American, Hispanic, and Other...
May 23, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28612230/right-atrial-diameter-and-outcome-of-catheter-ablation-of-atrial-fibrillation
#11
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
#12
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
https://www.readbyqxmd.com/read/28608980/safety-and-feasibility-of-percutaneous-skin-closure-using-purse-string-suture-compared-with-compression-bandage-after-pulmonary-vein-isolation
#13
Ersan Akkaya, Alexander Berkowitsch, Sergej Zaltsberg, Nikolas Deubner, Harald Greiss, Andreas Hain, Christian W Hamm, Johannes Sperzel, Thomas Neumann, Malte Kuniss
INTRODUCTION: This observational study was designed to analyze the safety and feasibility of percutaneous skin closure using a purse-string suture and compare it with the use of a compression bandage after pulmonary vein isolation. METHODS AND RESULTS: A total of 407 patients undergoing pulmonary vein isolation (217 with radiofrequency and 190 with cryoballoon ablation) were treated with either purse-string sutures or compression bandages. The purse-string suture was applied after ablation before withdrawal of the sheaths...
June 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28607614/pulmonary-vein-potential-mapping-in-atrial-fibrillation-with-high-density-and-standard-spiral-lasso-catheters-a-comparative-study
#14
Axel Meissner, Petra Maagh, Arnd Christoph, Ahmet Oernek, Gunnar Plehn
BACKGROUND: The dominant single-shot procedure for Pulmonary Vein Isolation (PVI) is the Cryoballoon Ablation (CBA) technique using a spiral catheter (Achieve™, AC) for mapping and monitoring purposes. We hypothesized that Basket Catheters, such as the High Density Mesh Mapper (HDMM), with its high-density mapping properties, could detect Pulmonary Vein Potentials (PVPs) that the octapolar AC would not be able to identify. METHODS: Twenty-four patients (average age 61...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28607612/anatomical-dilatation-of-the-superior-vena-cava-associated-with-an-arrhythmogenic-response-induced-by-svc-scan-pacing-after-atrial-fibrillation-ablation
#15
Hiroshi Imada, Koji Fukuzawa, Kunihiko Kiuchi, Akinori Matsumoto, Hiroki Konishi, Hirotoshi Ichibori, Kiyohiro Hyogo, Jun Kurose, Shumpei Mori, Tomofumi Takaya, Tatsuya Nishii, Kiyosumi Kagawa, Akihiro Yoshida, Hirata Ken-Ichi
BACKGROUND: The relationship between pulmonary vein (PV) arrhythmogenicity and its anatomy has been reported. However, that of the superior vena cava (SVC) has not been well discussed. Arrhythmogenic response induced by pacing stimulation at SVC might help with identifying SVC arrhythmogenicity. The purpose of this study was to investigate the relationship between the anatomical dilatation of SVC and the arrhythmogenic response induced by pacing at SVC. METHODS: Forty-three patients who underwent atrial fibrillation (AF) ablation were enrolled in this study...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28605437/anatomical-predisposing-factors-of-transmural-thermal-injury-after-pulmonary-vein-isolation
#16
Takashi Kaneshiro, Yoshiyuki Matsumoto, Minoru Nodera, Masashi Kamioka, Yoshiyuki Kamiyama, Akiomi Yoshihisa, Hiroshi Ohkawara, Hitoshi Suzuki, Yasuchika Takeishi
Aims: Transmural thermal injury (TTI), such as oesophageal erosion/ulcer and perioesophageal nerve injury leading to gastric hypomotility, is an important complication associated with pulmonary vein isolation (PVI). However, a predictor of TTI concerning anatomical structures surrounding the oesophagus has not yet been fully elucidated. Therefore, we sought to identify the predisposing factors of TTI after PVI. Methods: Consecutive 110 patients, who underwent PVI for atrial fibrillation, received oesophagogastroduodenoscopy 2 days later, were investigated...
June 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28600672/significant-reduction-in-procedure-duration-in-remote-magnetic-guided-catheter-ablation-of-atrial-fibrillation-using-the-third-generation-magnetic-navigation-system
#17
Tilman Maurer, Christian Sohns, Sebastian Deiss, Laura Rottner, Peter Wohlmuth, Bruno Reißmann, Christian H Heeger, Christine Lemes, Johannes Riedl, Francesco Santoro, Shibu Mathew, Andreas Metzner, Feifan Ouyang, Karl-Heinz Kuck, Erik Wissner
PURPOSE: The magnetic navigation system (MNS) has shown to be safe and effective for catheter ablation of atrial fibrillation (AF). However, longer procedure duration as compared to manual catheter ablation may limit its widespread use. This study aimed to assess the impact of the newest generation MNS using an optimized mapping and ablation protocol on the efficacy and safety of remote magnetic catheter (RMC)-guided pulmonary vein isolation (PVI). METHODS: This observational study included 52 patients with symptomatic AF who underwent RMC-guided PVI using the second-generation MNS Niobe II (initial 28 patients, group I) or the third-generation MNS Niobe ES in combination with an optimized mapping and ablation protocol (24 patients, group II)...
June 10, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28600022/isolated-great-saphenous-vein-thrombus-is-associated-with-high-rates-of-complications-regardless-of-management
#18
Elizabeth Kudlaty, Babatunde Oriowo, J Yang Michael, R Go Michael, Bhagwan Satiani
OBJECTIVES: Isolated great saphenous vein thrombus (GSVT) is generally regarded as benign and treatment is heterogeneous. Complications include thrombus propagation, new saphenous vein thrombosis, deep vein thrombosis (DVT), pulmonary embolus (PE), and symptom persistence. Our objective was to review our institution's experience with isolated GSVT to understand its natural history, the frequency of complications, real world treatment, and the impact of proximity to the saphenofemoral junction (SFJ), on the rate of complications...
June 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28596994/recurrent-post-ablation-paroxysmal-atrial-fibrillation-shares-substrates-with-persistent-atrial-fibrillation-an-11-center-study
#19
Junaid A B Zaman, Tina Baykaner, Paul Clopton, Vijay Swarup, Robert C Kowal, James P Daubert, John D Day, John Hummel, Amir A Schricker, David E Krummen, Moussa Mansour, Gery F Tomassoni, Kevin R Wheelan, Mohan Vishwanathan, Shirley Park, Paul J Wang, Sanjiv M Narayan, John M Miller
INTRODUCTION: The role of atrial fibrillation (AF) substrates is unclear in patients with paroxysmal AF (PAF) that recurs after pulmonary vein isolation (PVI). We hypothesized that patients with recurrent post-ablation (redo) PAF despite PVI have electrical substrates marked by rotors and focal sources, and structural substrates that resemble persistent AF more than patients with (de novo) PAF at first ablation. METHODS: In 175 patients at 11 centers, we compared AF substrates in both atria using 64 pole-basket catheters and phase mapping, and indices of anatomical remodeling between patients with de novo or redo PAF and first ablation for persistent AF...
April 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28592338/prenatal-diagnosis-of-isolated-total-anomalous-systemic-venous-connection-to-the-left-atrium
#20
Béatrice Miltner, Alain Jean Poncelet, Catherine Barrea
We report the prenatal diagnosis and the neonatal follow-up of a patient with isolated total abnormal systemic venous connection to the left atrium. Right-sided and left-sided superior caval veins and the inferior caval vein were all connected to the left atrium. Pulmonary venous return was normal. This was associated with some right ventricular underdevelopment. To our knowledge, this is the first fetal description of this very rare congenital cardiac malformation.
June 8, 2017: Cardiology in the Young
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