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https://www.readbyqxmd.com/read/28925907/atrial-fibrillation-ablation-increases-inflammation-chemokine-modulation-suppresses-activation-of-leukocytes-isolated-after-ablation
#1
Alexandra Lucas, Mohammad Al-Ani, Sriram Ambadapadi, Jordan R Yaron, Donghang Zheng, Adisson Fortunel, Maia Doroton-Guevara, Liying Liu, Sufi Morshed, Jay Fricker, William Miles, Matthew McKillop
AIMS: Atrial fibrillation (AF) ablation is associated with increased circulating markers of inflammation. Innate immune, or inflammation, pathways up-regulate mononuclear cell responses and may increase risk for recurrent arrhythmia. Chemokines and serine protease coagulation pathways both activate innate immune responses. Here, we measured inflammatory markers in peripheral blood samples from patients after cryoballoon and/or radiofrequency pulmonary vein isolation and assessed the capacity for inhibition of chemokine and serine protease pathways to block cell activation...
September 18, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28918444/left-atrial-volume-computed-by-3d-rotational-angiography-best-predicts-atrial-fibrillation-recurrence-after-circumferential-pulmonary-vein-isolation
#2
Teresa Strisciuglio, Giuseppe Di Gioia, Sofia Chatzikyriakou, Etel Silva Garcia, Emanuele Barbato, Peter Geelen, Tom De Potter
Left atrium (LA) size is a well-studied predictor of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). Yet, there is still little agreement on the best imaging technique to size the LA, and on the most appropriate sizing parameter. Volumetric assessment of LA with three-dimensional rotational angiography (3DRA LA volume index) might be a valid alternative to the commonly used transthoracic echocardiography (TTE LA volume index). The aim of our study was to investigate whether LA volume by 3DRA at the time of PVI is able to predict the risk of atrial fibrillation recurrence...
September 16, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28917494/early-dislodgment-and-migration-of-a-left-atrial-appendage-closure-device
#3
Mohamed Sanhoury, Gaetano Fassini, Antonio Dello Russo, Giuseppe Lumia, Antonio Bartorelli
A 68-year-old man underwent pulmonary vein isolation with cryoballoon combined with left atrial appendage closure using a LAmbre device. The device was dislodged and embolized early after implantation with no symptoms, and it was retrieved percutaneously. An early in-hospital check of the device position after implantation is important for early recognition of any possible device-related complication.
August 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28902647/isolated-left-sided-partial-anomalous-pulmonary-venous-connection-in-a-child
#4
İsmihan Selen Onan, Onur Sen, Selman Gökalp, Burak Onan
Isolated left-sided partial anomalous pulmonary venous connection with intact interatrial septum is a rare diagnosis in childhood. In these cases, a vertical vein drains the left upper pulmonary lobe into the brachiocephalic vein and finally to the right atrium. Surgical treatment is performed to prevent right ventricular failure and pulmonary artery disease in advanced age. In this report, the rare entity of isolated left-sided anomalous pulmonary venous connection in a 14-year-old girl and successful minimally invasive surgery without cardiopulmonary bypass are described...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28901573/validation-of-a-novel-cartoseg%C3%A2-segmentation-module-software-for-contrast-enhanced-computed-tomography-guided-radiofrequency-ablation-in-patients-with-atrial-fibrillation
#5
EDITORIAL
Hasan Imanli, Shaun Bhatty, Jean Jeudy, Yousra Ghzally, Kiddy Ume, Rama Vunnam, Refael Itah, Mati Amit, John Duell, Vincent See, Stephen Shorofsky, Timm M Dickfeld
INTRODUCTION: Visualization of left atrial (LA) anatomy using image integration modules has been associated with decreased radiation exposure and improved procedural outcome when used for guidance of pulmonary vein isolation (PVI) in atrial fibrillation (AF) ablation. We evaluated the CARTOSEG™ CT Segmentation Module (Biosense Webster, Inc.) that offers a new CT-specific semi-automatic reconstruction of the atrial endocardium. METHODS: The CARTOSEG™ CT Segmentation Module software was assessed prospectively in 80 patients undergoing AF ablation...
September 13, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28901235/low-dose-computed-tomographic-imaging-of-partial-anomalous-pulmonary-venous-connection-in-children
#6
Aysel Türkvatan, Hasan Tahsin Tola, Neşe Kutlutürk, Alper Güzeltaş, Yakup Ergül
BACKGROUND: In this study, we aimed to determine lobar distribution, drainage sites, and associated cardiovascular anomalies of partial anomalous pulmonary venous connection in pediatric patients using low-dose multidetector computed tomographic angiography. METHODS: Sixty-one cases (27 female, mean age: 4.7 years) with partial anomalous pulmonary venous connection diagnosed by multidetector computed tomographic angiography were included in this study. In all patients, multidetector computed tomographic angiography examinations were performed using dual-source 256-slice scanner without sedation...
September 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28892174/a-quantitative-comparison-of-the-electrical-and-anatomical-definition-of-the-pulmonary-vein-ostium
#7
Florian Spies, Michael Kühne, Tobias Reichlin, Stefan Osswald, Christian Sticherling, Sven Knecht
BACKGROUND: Anatomically guided pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. However, the position where to confirm electrical isolation is ill-defined. The aim of the current study was to quantify the relationship between the anatomical and electrical definition of the pulmonary vein ostium. METHODS: We analyzed 20 patients with paroxysmal AF undergoing PVI using radiofrequency energy and an electroanatomical mapping system...
September 11, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28887742/efficacy-of-ganglionated-plexi-ablation-in-addition-to-pulmonary-vein-isolation-for-paroxysmal-versus-persistent-atrial-fibrillation-a-meta-analysis-of-randomized-controlled-clinical-trials
#8
Polydoros N Kampaktsis, Evangelos K Oikonomou, Daniel Y Choi, Jim W Cheung
PURPOSE: Adjunctive ganglionated plexi (GP) ablation may improve success rates for treatment of atrial fibrillation (AF) when combined with pulmonary vein (PV) isolation. Existing meta-analyses on GP ablation have included observational studies and have not incorporated more recent randomized clinical trial data. Moreover, the impact of AF subtype (paroxysmal vs. persistent) on outcomes of GP ablation has not been well established. METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) comparing GP ablation + pulmonary vein (PV) isolation versus PV isolation alone according to the subtype of AF...
September 8, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28886122/alteration-of-endothelin-1-mcp-1-and-chromogranin-a-in-patients-with-atrial-fibrillation-undergoing-pulmonary-vein-isolation
#9
K Lackermair, S Clauss, T Voigt, I Klier, C Summo, B Hildebrand, T Nickel, H L Estner, S Kääb, R Wakili, U Wilbert-Lampen
BACKGROUND: The relation between arrhythmias and stress is known. The aim of our current study was to elucidate whether plasma levels of previously described stress parameters are altered in highly symptomatic patients with atrial fibrillation (AF) per se and in patients undergoing ablation therapy by pulmonary vein isolation (PVI). METHODS: 96 patients with AF undergoing PVI were recruited. Plasma levels of Endothelin-1 (ET-1), MCP-1 and Chromogranin-A (CGA) were measured before and three months after ablation completed with clinical follow-up with respect to AF recurrence...
2017: PloS One
https://www.readbyqxmd.com/read/28884923/low-voltage-areas-detected-by-high-density-electroanatomical-mapping-predict-recurrence-after-ablation-for-paroxysmal-atrial-fibrillation
#10
Konstantinos Vlachos, Michael Efremidis, Konstantinos P Letsas, George Bazoukis, Ruairidh Martin, Maria Kalafateli, Louiza Lioni, Stamatis Georgopoulos, Athanasios Saplaouras, Theodore Efremidis, Tong Liu, Kosmas Valkanas, Nikolaos Karamichalakis, Dimitrios Asvestas, Antonios Sideris
INTRODUCTION: We aimed to evaluate the extent of atrial fibrosis in paroxysmal atrial fibrillation (AF) and the correlation with ablation outcomes after pulmonary vein antral isolation (PVΑI) using a mapping system with high-resolution and high-spatial sampling. METHODS AND RESULTS: We prospectively enrolled 80 consecutive patients (45 males, median age 60.26 years) with symptomatic paroxysmal AF who were scheduled for PVAI. Prior to PVAI, high-density bipolar voltage mapping (median number of 2,485 points) was carried out during sinus rhythm in all patients...
September 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28883795/atrial-electrogram-fractionation-distribution-before-and-after-pulmonary-vein-isolation-in-human-persistent-atrial-fibrillation-a-retrospective-multivariate-statistical-analysis
#11
Tiago P Almeida, Gavin S Chu, Xin Li, Nawshin Dastagir, Jiun H Tuan, Peter J Stafford, Fernando S Schlindwein, G André Ng
Purpose: Complex fractionated atrial electrograms (CFAE)-guided ablation after pulmonary vein isolation (PVI) has been used for persistent atrial fibrillation (persAF) therapy. This strategy has shown suboptimal outcomes due to, among other factors, undetected changes in the atrial tissue following PVI. In the present work, we investigate CFAE distribution before and after PVI in patients with persAF using a multivariate statistical model. Methods: 207 pairs of atrial electrograms (AEGs) were collected before and after PVI respectively, from corresponding LA regions in 18 persAF patients...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28882497/pulmonary-vein-isolation-for-atrial-fibrillation-can-be-achieved-with-low-radiation-exposure
#12
Alex L Huang, Nadeem Mughal, Ferdinand Tabas, Natalie L Patterson, Wen Kai Wong, David Whalley, Logan Kanagaratnam
BACKGROUND: Atrial fibrillation is common and management by pharmacotherapy is limited by modest efficacy and significant toxicities. Pulmonary vein isolation (PVI) is a safe and effective alternative in select patients with atrial fibrillation. However, prolonged procedure time raises concerns of health risks from radiation exposure. This study aims to determine the significance of radiation exposure from PVI. METHODS: In this study, we retrospectively reviewed patient demographics, fluoroscopy time, entrance skin dose and dose area product in 80 cases of PVI, radiofrequency ablation for atrial flutter and diagnostic coronary angiogram performed in our institution...
August 8, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28880943/non-pulmonary-vein-mediated-atrial-fibrillation-a-novel-sub-phenotype
#13
Maureen Farrell, Zachary Yoneda, Jay Montgomery, Diane Crawford, Lauren Lee Wray, Meng Xu, Matthew J Kolek, Travis Richardson, Ricardo Lugo, Mohamed Metawee, Greg Michaud, Juan Carlos Estrada, Pablo Saavedra, Sharon Shen, Arvindh Kanagasundram, Christopher R Ellis, George Crossley, Dan Roden, M Benjamin Shoemaker
BACKGROUND: Atrial fibrillation (AF) is a mechanistically heterogeneous disorder, and the ability to identify sub-phenotypes ("endophenotypes") of AF would assist in the delivery of personalized medicine. We used the clinical response to pulmonary vein isolation (PVI) to identify a sub-group of patients with non-PV mediated AF and sought to define the clinical associations. METHODS: Subjects enrolled in the Vanderbilt AF Ablation Registry who underwent a repeat AF ablation due to arrhythmia recurrence were analyzed on the basis of PV reconnection...
2017: PloS One
https://www.readbyqxmd.com/read/28877099/risk-of-pulmonary-embolism-in-patients-with-isolated-great-saphenous-vein-thrombus
#14
Akshya Gupta, Vijay Pandya, Timothy Baran, Vikram S Dogra
Risks associated with isolated great saphenous vein (GSV) thrombosis remain controversial. The purpose of this study is to identify the risk of pulmonary embolism (PE) in patients with isolated GSV thrombosis, particularly those with thrombus within 3 cm of the sapheno-femoral junction. A retrospective chart review of color flow Doppler lower extremity venous ultrasound examinations from an academic hospital from 2011 to 2016 was conducted. Seventy-eight patients were identified as having acute thrombus in their GSV and were then further stratified based on the presence or absence of concomitant deep venous thrombosis (DVT)...
September 4, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28875448/clinical-outcomes-of-af-patients-treated-with-the-first-and-second-generation-of-circular-mapping-and-ablation-catheter-insights-from-a-real-world-multicenter-experience
#15
Giovanni Rovaris, Paolo De Filippo, Francesco Laurenzi, Gabriele Zanotto, Nicola Bottoni, Mattia Pozzi, Fabrizio Giofrè, Piergiuseppe De Girolamo, Emanuela Visentin, Elena Piazzi, Paola Ferrari
PURPOSE: Complete pulmonary vein isolation (PVI) is the best documented target for catheter ablation, and different technologies have shown comparable outcomes. The multielectrode phased-RF/duty cycled (PhRF/DC) pulmonary vein ablation catheter (PVAC) and its second generation (PVAC-GOLD) have shown promising clinical results in single and multicenter experiences. Our aim is to assess and compare the safety and efficacy in the real clinical practice among two generations of circular PhRF/DC catheters by performing PVI in patients suffering from recurrent atrial fibrillation (AF)...
September 5, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28871623/clinical-course-of-patients-with-symptomatic-isolated-superficial-vein-thrombosis-the-icaro-follow-up-study
#16
S Barco, F Pomero, M N D Di Minno, E Tamborini Permunian, A Malato, S Pasca, G Barillari, L Fenoglio, S Siragusa, G Di Minno, W Ageno, F Dentali
BACKGROUND: Studies of long-term thromboembolic complications and death following acute isolated superficial vein thrombosis (iSVT) of the lower extremities are scarce. OBJECTIVES: To investigate the course of iSVT in the setting of an observational multicenter study. METHODS: We collected longitudinal data of 411 consecutive outpatients with acute, symptomatic, objectively-diagnosed iSVT previously included in the cross-sectional ICARO study...
September 4, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28862806/initial-experience-of-a-novel-mapping-system-combined-with-remote-magnetic-navigation-in-the-catheter-ablation-of-atrial-fibrillation
#17
Changjian Lin, Steen Pehrson, Peter Karl Jacobsen, Xu Chen
BACKGROUND: There have been advancements of sophisticated mapping systems used for ablation procedures over the last decade. Utilization of these novel mapping systems in combination with remote magnetic navigation (RMN) needs to be established. We investigated the new EnSite Precisionۛ mapping system (St Jude Medical, Inc.), which collects magnetic data for checking navigation field stability and is built on an open platform, allowing physicians to choose diagnostic and ablation catheters...
September 1, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28856145/ablation-of-long-standing-persistent-atrial-fibrillation
#18
REVIEW
Behram P Mody, Anoshia Raza, Jason Jacobson, Sei Iwai, Daniel Frenkel, Rhadames Rojas, Wilbert S Aronow
Atrial fibrillation (AF) is the most commonly encountered arrhythmia in the clinical setting affecting nearly 6 million people in United States and the numbers are only expected to rise as the population continues to age. Broadly it is classified into paroxysmal, persistent and longstanding persistent AF. Electrical, structural and autonomic remodeling are some of the diverse pathophysiological mechanisms that contribute to the persistence of AF. Our review article emphasizes particularly on long standing persistent atrial fibrillation (LSPAF) aspect of the disease which poses a great challenge for electrophysiologists...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28846806/apixaban-rivaroxaban-and-dabigatran-use-in-patients-undergoing-catheter-ablation-for-atrial-fibrillation-using-the-second-generation-cryoballoon
#19
Verena Tscholl, Abdullah Khaled-A Lsharaf, Tina Lin, Barbara Bellmann, Patrick Nagel, Klaus Lenz, Ulf Landmesser, Mattias Roser, Andreas Rillig
BACKGROUND: Data are limited on the safety of periprocedural anticoagulation with novel oral anticoagulants (NOACs) in patients undergoing pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB) for the treatment of atrial fibrillation. HYPOTHESIS: We hypothesized that the incidence of acute periprocedural complications in patients undergoing PVI do not differ between patients treated with VKA compared to NOACs. METHODS: In 200 consecutive patients (mean age, 64...
August 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28846147/cardiac-mapping-and-pulmonary-vein-isolation-using-a-novel-ablation-catheter-with-tip-mini-electrodes
#20
Florian Heringhaus, Tanja Lotz, Lena Loehr, Julia Gelep, Sebastian Lask, Kaffer Kara, Andreas Mügge, Alexander Wutzler
BACKGROUND: Pulmonary vein isolation (PVI) is a standard treatment for atrial fibrillation (AF). Identification of gaps in the ablation line is difficult. Tip-ring electrograms from ablation catheters represent relative large areas of myocardial tissue. Recently, an ablation catheter with three mini-electrodes (ME) on the catheter tip with closer interelectrode spacing was introduced. The aim of our study was to evaluate the novel electrodes during PVI. METHODS: PVI was performed with an irrigated ablation catheter equipped with conventional electrodes and three additional radial tip electrodes...
August 28, 2017: Pacing and Clinical Electrophysiology: PACE
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