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Pulmonary vein isolation

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https://www.readbyqxmd.com/read/28317330/long-term-risk-of-venous-thromboembolism-recurrence-after-isolated-superficial-vein-thrombosis
#1
Jean-Philippe Galanaud, Marie-Antoinette Sevestre, Gilles Pernod, Susan R Kahn, Céline Genty, Hugo Terrisse, Dominique Brisot, Jean-Luc Gillet, Isabelle Quéré, Jean-Luc Bosson
BACKGROUND: Isolated superficial vein thrombosis (iSVT) (without concomitant deep vein thrombosis (DVT) or pulmonary embolism (PE)) is a frequent event but available data on long-term outcomes are scarce and retrospective. Therefore, we aimed to determine prospectively the risk and type of venous thromboembolic (VTE) recurrence after iSVT and compare it with that of proximal DVT. METHODS: Using data from the prospective, multicentre, observational, OPTIMEV study, we assessed at three years and after anticoagulants were stopped, the incidence and the type of VTE recurrence (iSVT/DVT/PE) of patients with a first objectively confirmed iSVT without cancer (n=285) and compared this to patients with a first proximal DVT without cancer (n=262)...
March 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28316148/ablation-of-complex-fractionated-electrograms-with-or-without-additional-linear-lesions-for-persistent-atrial-fibrillation-the-adline-trial
#2
Sonia Ammar-Busch, Felix Bourier, Tilko Reents, Verena Semmler, Marta Telishevska, Susanne Kathan, Monika Hofmann, Gabriele Hessling, Isabel Deisenhofer
BACKGROUND: For persistent atrial fibrillation (AF) ablation, different strategies including complex fractionated atrial electrograms (CFAE) ablation and linear lesions (LL) have been used in addition to pulmonary vein isolation (PVI). However, it is still a matter of debate if extended substrate modification improves long-term outcome. The aim of this study was to determine the benefit of LL in addition to PVI and CFAE ablation regarding freedom from arrhythmia recurrence in patients with persistent AF...
March 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28316124/anticoagulation-in-patients-with-isolated-distal-deep-vein-thrombosis-a-meta-analysis
#3
Laura Franco, Michela Giustozzi, Giancarlo Agnelli, Cecilia Becattini
BACKGROUND: The optimal management of patients with isolated distal deep vein thrombosis (IDDVT) concerning both the need for anticoagulation and its duration is undefined. OBJECTIVES: We performed a meta-analysis of randomized and cohort studies in patients with IDDVT to assess the clinical benefit of i) anticoagulation versus no anticoagulation and ii) anticoagulant treatment for 6 weeks vs. more than 6 weeks. METHODS: The primary outcome of this analysis was recurrent venous thromboembolism (proximal propagation, recurrence of deep vein thrombosis and pulmonary embolism)...
March 17, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28315135/repeat-procedures-using-the-second-generation-cryoballoon-for-recurrence-of-atrial-fibrillation-after-initial-ablation-with-conventional-radiofrequency
#4
Valentina De Regibus, Saverio Iacopino, Juan-Pablo Abugattas, Giacomo Mugnai, Darragh Moran, Erwin Ströker, Hugo-Enrique Coutino, Ken Takarada, Rajin Choudhury, Gaetano Paparella, Vincent Umbrain, Pedro Brugada, Carlo de Asmundis, Gian-Battista Chierchia
PURPOSE: Pulmonary vein isolation is now widely accepted for the treatment of symptomatic atrial fibrillation refractory to antiarrhythmic drugs. However, multiple procedures are often required to significantly reduce atrial fibrillation (AF) recurrence. In the present study, we analyzed the acute results and the midterm clinical outcome of a second-generation cryoballoon ablation (CB-A) performed during repeat procedures for recurrence of AF after an initial procedure performed with conventional radiofrequency (RF)...
March 17, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28314981/time-trends-in-incidence-rates-of-venous-thromboembolism-in-a-large-cohort-recruited-from-the-general-population
#5
Nadia Arshad, Trond Isaksen, John-Bjarne Hansen, Sigrid K Brækkan
Changes in the incidence of venous thromboembolism (VTE) during the last two decades have not been extensively studied. Therefore, we studied time trends in the incidence rates (IRs) of deep vein thrombosis (DVT) and pulmonary embolism (PE) in a cohort of 26,855 subjects, aged 25-97 years, enrolled in the Tromsø study in 1994/1995. The subject were followed-up throughout 2012, and all symptomatic, objectively confirmed, incident VTEs were identified using multiple sources (hospital discharge-, radiology procedure- and autopsy registry) and validated by review of medical records...
March 17, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/28306170/impact-of-atrial-fibrillation-on-platelet-gene-expression
#6
Waldemar E Wysokinski, Alfonso Tafur, Naser Ammash, Samuel J Asirvatham, Yanhong Wu, Izabella Gosk-Bierska, Diane E Grill, Joshua P Slusser, Jozef Mruk, Robert D McBane
AIMS: Platelets retain cytoplasmic messenger RNA and are capable of protein biosynthesis. Several diseases are known to impact the platelet transcriptome but the effect of non-valvular atrial fibrillation (NVAF) on platelet RNA transcript is essentially unknown. The aim of this study was to evaluate the impact of NVAF on platelet RNA transcript by measuring platelet genes expression in consecutive NVAF patients before and 3-4 months after pulmonary vein isolation (PVI) and compared to normal sinus rhythm controls (NSR)...
March 17, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28301685/conventional-versus-3d-echocardiography-to-predict-arrhythmia-recurrence-after-atrial-fibrillation-ablation
#7
Matthias Bossard, Sven Knecht, Stefanie Aeschbacher, Ronny R Buechel, Thomas Hochgruber, Andreas J Zimmermann, Arnheid Kessel-Schaefer, Frank-Peter Stephan, Gian Völlmin, Maurice Pradella, Christian Sticherling, Stefan Osswald, Beat A Kaufmann, David Conen, Michael Kühne
BACKGROUND: Arrhythmia recurrence after atrial fibrillation (AF) ablation remains high and requires repeat interventions in a substantial number of patients. We assessed the value of conventional and 3D-echocardiography to predict AF recurrence. METHODS AND RESULTS: Consecutive patients undergoing AF ablation by means of pulmonary vein isolation were included in a prospective registry. Echocardiograms were obtained prior to the ablation procedure, and analyzed offline in a standardized manner, including 3D-left atrial (LA) volumetry and determination of LA function and sphericity...
March 16, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28287031/comparison-of-diverse-platelet-activation-markers-as-indicators-for-left-atrial-thrombus-in-atrial-fibrillation
#8
Daniel Tarnowski, David M Poitz, Lina Plichta, Felix M Heidrich, Stephan Wiedemann, Tobias Ruf, Johannes Mierke, Tobias Löhn, Stefanie Jellinghaus, Ruth H Strasser, Karim Ibrahim, Christian Pfluecke
Atrial fibrillation (AF) is well known for being a major risk factor of thromboembolic stroke. We could recently demonstrate an association of monocyte-platelet aggregates (MPAs) with the degree of thrombogenicity in patients with AF. This study investigated platelet activation markers, as potential biomarkers for the presence of left atrial (LA) thrombus in patients with AF. One hundred and eight patients with symptomatic AF underwent transesophageal echocardiography (TEE) before scheduled cardioversion or pulmonary vein isolation...
March 13, 2017: Platelets
https://www.readbyqxmd.com/read/28285383/adenosine-administration-during-hybrid-atrial-fibrillation-ablation-to-test-dormant-pulmonary-vein-conduction
#9
Mindy Vroomen, Mark La Meir, Jos G Maessen, Harry J Crijns, Laurent Pison
BACKGROUND: Adenosine administration after initial pulmonary vein isolation (PVI) reveals dormant conduction and predicts atrial fibrillation (AF) recurrence. Elimination of dormant conduction when present may increase a long-term success rate of AF ablation procedures. There are no studies till date using adenosine to reveal acute reconduction of pulmonary veins (PVs) after epicardial PVI during a hybrid AF ablation procedure. METHODS: We included 24 patients (21 male, 55 ± 9 years) undergoing hybrid ablation for symptomatic paroxysmal (n = 12) and persistent (n = 12) AF, using an epicardial bipolar radiofrequency clamp to perform PVI...
March 11, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28285382/impact-of-deep-sedation-on-the-electrophysiological-behavior-of-pulmonary-vein-and-non-pv-firing-during-catheter-ablation-for-atrial-fibrillation
#10
Ryohsuke Narui, Seiichiro Matsuo, Ryota Isogai, Kenichi Tokutake, Kenichi Yokoyama, Mika Kato, Keiichi Ito, Shin-Ichi Tanigawa, Seigo Yamashita, Michifumi Tokuda, Keiichi Inada, Kenri Shibayama, Satoru Miyanaga, Kenichi Sugimoto, Michihiro Yoshimura, Teiichi Yamane
PURPOSE: Catheter ablation for atrial fibrillation is performed with and without deep sedation, which could affect the arrhythmogenic activity during the procedure. We investigated the impact of sedation on electrophysiological properties in patients with AF who underwent catheter ablation. METHODS: This study consisted of 255 consecutive patients with atrial fibrillation (229 males, persistent: 105 patients) who underwent a single-catheter ablation procedure. The patients were divided into the following two groups according to the depth of sedation during the procedure: group M (mild sedation with flunitrazepam in 138 patients) and group D (deep sedation with propofol in 117 patients)...
March 11, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28283860/long-term-outcome-after-second-generation-cryoballoon-ablation-for-paroxysmal-atrial-fibrillation-a-3-years-follow-up
#11
Ken Takarada, Ingrid Overeinder, Carlo de Asmundis, Erwin Stroker, Giacomo Mugnai, Valentina de Regibus, Darragh Moran, Hugo Coutino-Moreno, Juan-Pablo Abugattas, Rajin Choudhury, Diego Ruggiero, Gaetano Paparella, Saverio Iacopino, Pedro Brugada, Gian-Battista Chierchia
BACKGROUND: The second-generation cryoballoon (cryoballoon Advance; CB-A) offers excellent outcomes on the mid-term follow-up. To the best of our knowledge, little is known regarding the long-term outcome after CB-A ablation for paroxysmal atrial fibrillation (AF). OBJECTIVE: The aim of the study was to evaluate the freedom from recurrence of AF during a 3-year follow-up period, among consecutive patients having undergone pulmonary vein isolation (PVI) with the CB-A for paroxysmal AF (PAF)...
March 10, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28283739/persistent-tachycardia-within-isolated-pulmonary-veins-during-atrial-fibrillation-ablation
#12
Kenichiro Yamagata, Atsushi Doi, Hiro Kawata, Hisaki Makimoto, Teruki Yokoyama, Yuko Inoue, Hideo Okamura, Takashi Noda, Wataru Shimizu, Naohiko Aihara, Takayuki Maki, Shiro Kamakura, Kengo Kusano, Kazuhiro Satomi
During circumferential pulmonary vein (PV) isolation for ongoing atrial fibrillation (AF), distinguishing passive conduction to the pulmonary vein (PV) from rapid PV arrhythmia in the isolated PV is difficult. Hence, the purpose of this study is to investigate both the feasibility of distinguishing the PV tachycardia after circumferential PV isolation and the electrophysiological characteristics of these tachycardia. Among 178 consecutive patients who underwent circumferential PV isolation during ongoing AF, fibrillatory PV converted to a regular cycle length PV tachycardia independent of the atrial rhythm (=independent PV tachycardia) in 13 PVs among 12 (7%) patients...
March 10, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28281739/cerebral-micro-embolization-during-pulmonary-vein-isolation-relation-to-post-ablation-silent-cerebral-ischemia
#13
Edina Nagy-Baló, Mihran Martirosyan, Gábor Sándorfi, Orsolya Hajas, Levente Lánczi, Ervin Berényi, Lilla Ladányi, Alexandra Kiss, István Édes, Zoltán Csanádi
BACKGROUND: High incidences of silent cerebral ischemia (SCI) have been revealed by diffusion-weighted magnetic resonance imaging (DW MRI) after pulmonary vein isolation (PVI) for atrial fibrillation. A high number of mostly gaseous micro-embolic signals (MESs) was detected by transcranial Doppler (TCD) during PVI. In this investigation the possible relationship between MESs detected intraoperatively by TCD and new SCI on DW MRI post-ablation is reported. METHODS: 27 consecutive atrial fibrillation patients (6 female, age median: 64 interquartile range: 13...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28271292/prevalence-of-right-atrial-non-pulmonary-vein-triggers-in-atrial-fibrillation-patients-treated-with-thyroid-hormone-replacement-therapy
#14
Ki-Hun Kim, Sanghamitra Mohanty, Prasant Mohanty, Chintan Trivedi, Eli Hamilton Morris, Pasquale Santangeli, Rong Bai, Amin Al-Ahmad, John David Burkhardt, Joseph G Gallinghouse, Rodney Horton, Javier E Sanchez, Shane Bailey, Patrick M Hranitzky, Jason Zagrodzky, Soo G Kim, Luigi Di Biase, Andrea Natale
BACKGROUND: Thyroid hormone (TH) is known to enhance arrhythmogenicity, and high-normal thyroid function is related with an increased recurrence of atrial fibrillation (AF) after catheter ablation. However, the impact of thyroid hormone replacement (THR) on AF ablation is not well known. METHODS: This study evaluated 1163 consecutive paroxysmal AF patients [160 (14%) on THR and 1003 (86%) without THR] undergoing their first catheter ablation. A total of 146 patients on THR and 146 controls were generated by propensity matching, based on calculated risk factor scores, using a logistic model (age, sex, body mass index, and left atrium size)...
March 7, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28268379/kurtosis-as-a-statistical-approach-to-identify-the-pivot-point-of-the-rotor
#15
Shivaram P Arunachalam, Elizabeth M Annoni, Siva K Mulpuru, Paul A Friedman, Elena G Tolkacheva
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia that causes stroke affecting more than 2.3 million people in the US. Catheter ablation to terminate AF is successful for paroxysmal AF but suffers limitations with persistent AF patients as current mapping methods cannot identify AF active substrates outside of pulmonary vein region. In this work, we developed a novel Kurtosis based mapping technique that can accurately identify pivot points of the rotors that were induced in ex-vivo isolated rabbit heart...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28266773/long-term-outcomes-of-cancer-related-isolated-distal-deep-vein-thrombosis-the-optimev-study
#16
Jean-Philippe Galanaud, Marie-Antoinette Sevestre, Gilles Pernod, Céline Genty, Sébastien Richelet, Susan R Kahn, Carine Boulon, Hugo Terrisse, Isabelle Quéré, Jean-Luc Bosson
BACKGROUND: Isolated distal deep vein thrombosis (iDDVT) (infra-popliteal DVT without pulmonary embolism [PE]) is a frequent event and, in the absence of cancer, is usually considered to be a minor form of venous thromboembolism (VTE). However, the clinical significance of cancer-related iDDVT is unknown. METHODS: Using data from the observational, prospective multicentre OPTIMEV cohort, we compared, at 3 years, the incidences of death, VTE recurrence and major bleeding in patients with cancer-related iDDVT with cancer patients with isolated proximal DVT (matched 1:1 on age and sex) and with patients with iDDVT without cancer (matched 1:2 on age and sex)...
March 7, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28260190/general-anesthesia-improves-contact-force-and-reduces-gap-formation-in-pulmonary-vein-isolation-a-comparison-with-conscious-sedation
#17
Akio Chikata, Takeshi Kato, Takanori Yaegashi, Satoru Sakagami, Chieko Kato, Takahiro Saeki, Keiichi Kawai, Shin-Ichiro Takashima, Hisayoshi Murai, Soichiro Usui, Hiroshi Furusho, Shuichi Kaneko, Masayuki Takamura
Compared to conscious sedation (CS), the use of general anesthesia (GA) in pulmonary vein isolation (PVI) is associated with a lower recurrence rate of atrial fibrillation (AF). GA may improve catheter stability and mapping system accuracy compared to CS, but its influence on contact force (CF) parameters during ipsilateral PVI has not previously been investigated. The study population comprised 176 consecutive patients (107 in GA group and 69 in CS group) with AF who underwent their first PVI procedure. We retrospectively assessed CF parameters, force-time integral (FTI), FTI/wall thickness during anatomical ipsilateral PVI and long-term outcome after ablation...
March 4, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28259694/techniques-for-provocation-localization-and-ablation-of-nonpulmonary-vein-triggers-for-atrial-fibrillation
#18
Pasquale Santangeli, Francis E Marchlinski
The endpoint of current catheter-based ablation approaches for the treatment of atrial fibrillation (AF) is the elimination of all the possible triggers with the least amount of ablation necessary. Once all the triggers have been eliminated, the incremental value of any additional lesion sets remains to be proven. Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation approaches for eliminating AF triggers. However, up to 11% of patients demonstrate reproducible sustained AF initiation from non-PV foci...
March 1, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28258848/conduction-recovery-following-catheter-ablation-in-patients-with-recurrent-atrial-fibrillation-and-heart-failure
#19
Matteo Anselmino, Mario Matta, T Jared Bunch, Martin Fiala, Marco Scaglione, Georg Nölker, Pierre Qian, Thomas Neumann, Federico Ferraris, Fiorenzo Gaita
BACKGROUND: Atrial fibrillation (AF) catheter ablation is increasingly proposed for patients suffering from AF and concomitant heart failure (HF). However, the optimal ablation strategy remains controversial. We performed this study to assess the prevalence of pulmonary vein (PV) or linear lesion reconnection in HF patients undergoing repeated procedures. METHODS AND RESULTS: At seven high-volume centres, 165 patients with HF underwent a repeat procedure after a first AF ablation including PV isolation alone (47 patients, group A) or PV isolation plus left atrial lines (118 patients, group B)...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28256178/adjunctive-ablation-strategies-improve-the-efficacy-of-pulmonary-vein-isolation-in-non-paroxysmal-atrial-fibrillation-a-systematic-review-and-meta-analysis
#20
REVIEW
Muhammad R Afzal, Anweshan Samanta, Jawaria Chatta, Brihh Ansari, Sam Atherton, Syed Sabzwari, Mohit Turagam, Dhanunjaya Lakkireddy, Mahmoud Houmsse
BACKGROUND: Pulmonary vein (PV) isolation (PVI) has suboptimal outcomes in patients with non-paroxysmal atrial fibrillation (AF). Adjunctive strategies employed to ablate non-PV triggers have shown favorable outcomes. AIMS: To delineate the incremental benefit of adjunctive ablation in patients with non-paroxysmal AF through a meta-analysis. METHODS AND RESULTS: Database searches through August 2016 identified five non-randomized and seven randomized controlled trials (enrolling 1694 patients)...
March 2017: Expert Review of Cardiovascular Therapy
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