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https://www.readbyqxmd.com/read/28733782/catheter-ablation-of-atrial-fibrillation-an-overview-for-clinicians
#1
REVIEW
Nebojša Mujović, Milan Marinković, Radoslaw Lenarczyk, Roland Tilz, Tatjana S Potpara
Catheter ablation (CA) of atrial fibrillation (AF) is currently one of the most commonly performed electrophysiology procedures. Ablation of paroxysmal AF is based on the elimination of triggers by pulmonary vein isolation (PVI), while different strategies for additional AF substrate modification on top of PVI have been proposed for ablation of persistent AF. Nowadays, various technologies for AF ablation are available. The radiofrequency point-by-point ablation navigated by electro-anatomical mapping system and cryo-balloon technology are comparable in terms of the efficacy and safety of the PVI procedure...
July 21, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28723807/can-patients-with-femoral-neck-fracture-benefit-from-preoperative-thromboprophylaxis-a-prospective-randomized-controlled-trial
#2
Qiangqiang Li, Bingyang Dai, Jiacheng Xu, Yao Yao, Kai Song, Haojun Zhang, Dongyang Chen, Qing Jiang
BACKGROUND: The effectiveness of preoperative thromboprophylaxis remains obscure in patients with femoral neck fracture. The purpose of the current study was to investigate whether these patients benefit from preoperative thromboprophylaxis. METHODS: In this prospective, randomized controlled trial, a total of 80 patients with femoral neck fracture were randomly assigned to receive either rivaroxaban or conservative treatment before surgery. For all patients, color Doppler ultrasound of both lower extremities was performed immediately after admission...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723304/the-quest-for-durable-lesions-in-catheter-ablation-of-atrial-fibrillation-technological-advances-in-radiofrequency-catheters-and-balloon-devices
#3
Tilman Maurer, Karl-Heinz Kuck
Atrial fibrillation is the most common cardiac arrhythmia and represents a growing clinical, social and economic challenge. Catheter ablation for symptomatic atrial fibrillation has evolved from an experimental procedure into a widespread therapy and offers a safe and effective treatment option. A prerequisite for durable PVI are transmural and contiguous circumferential lesions around the pulmonary veins. However, electrical reconnection of initially isolated pulmonary veins remains a primary concern and is a dominant factor for arrhythmia recurrence during long-term follow up...
July 19, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28718039/a%C3%A2-decade-of-atrial-fibrillation-ablation-shifts-in-patient-characteristics-and-procedural-outcomes
#4
C Teunissen, N Clappers, R J Hassink, J F van der Heijden, F H Wittkampf, P Loh
BACKGROUND: Over the past decade, radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has evolved into a frequently performed procedure. The aim of this study was to monitor changes in patient characteristics, procedural characteristics, outcomes and complications over the past 10 years. METHODS: All consecutive patients who underwent primary RFCA treatment of AF in the University Medical Center Utrecht from 2005-2015 were included. In all patients, the primary ablation strategy was pulmonary vein (PV) antrum isolation without additional substrate modification...
July 17, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28716896/poor-prognosis-indicated-by-venous-circulating-tumor-cell-clusters-in-early-stage-lung-cancers
#5
Vasudha Murlidhar, Rishindra M Reddy, Shamileh Fouladdel, Lili Zhao, Martin K Ishikawa, Svetlana Grabauskiene, Zhuo Zhang, Jules Lin, Andrew C Chang, Philip W Carrott, William R Lynch, Mark B Orringer, Chandan Kumar-Sinha, Nallasivam Palanisamy, David G Beer, Max S Wicha, Nithya Ramnath, Ebrahim Azizi, Sunitha Nagrath
Early detection of metastasis can be aided by circulating tumor cells (CTCs), which also show potential to predict early relapse. Due to the limited CTC numbers in peripheral blood in early stages, we investigated CTCs in pulmonary vein blood accessed during surgical resection of tumors. Pulmonary vein (PV) and peripheral vein (Pe) blood specimens from patients with lung cancer were drawn during the perioperative period and assessed for CTC burden using a microfluidic device. From 108 blood samples analyzed from 36 patients, PV had significantly higher number of CTCs compared to pre-operative Pe (p<0...
July 17, 2017: Cancer Research
https://www.readbyqxmd.com/read/28715071/the-influence-of-ablation-power-reduction-associated-with-esophagus-location-on-pulmonary-veins-isolation-results-in-patients-with-paroxysmal-atrial-fibrillation-six-month-follow-up
#6
Piotr Buchta, Krzysztof Myrda, Michał Skrzypek, Adam Wojtaszczyk, Barbara Budzyn, Mariusz Gąsior
BACKGROUND: Catheter ablation of atrial fibrillation (AF) could be associated with a thermal esophageal (EO) injury. To avoid this complication intraluminal esophageal temperature monitoring and ablation power reduction at the areas with excessive heating could be used. However, the reduced energy could limit the ablation lesion depth, without creation of consist transmural scar and influence on long-term ablation results. AIM: The primary goal was to evaluate the homogeneity of forced ablation power reduction due to excessive EO heating in different parts of left atrium...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28706589/catheter-ablation-of-atrial-fibrillation-facilitated-by-preprocedural-three-dimensional-transesophageal-echocardiography-long-term-outcome
#7
Klaus Kettering, Felix Gramley, Stephan von Bardeleben
AIM: To evaluate the long-term outcome of catheter ablation of atrial fibrillation (AF) facilitated by preprocedural three-dimensional (3-D) transesophageal echocardiography. METHODS: In 50 patients, 3D transesophageal echocardiography (3D TEE) was performed immediately prior to an ablation procedure (paroxysmal AF: 30 patients, persistent AF: 20 patients). The images were available throughout the ablation procedure. Two different ablation strategies were used. In most of the patients with paroxysmal AF, the cryoablation technique was used (Arctic Front Balloon, CryoCath Technologies/Medtronic; group A2)...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28701305/redox-and-activation-of-protein-kinase-a-dysregulates-calcium-homeostasis-in-pulmonary-vein-cardiomyocytes-of-chronic-kidney-disease
#8
Shih-Yu Huang, Yao-Chang Chen, Yu-Hsun Kao, Ming-Hsiung Hsieh, Yung-Kuo Lin, Shih-Ann Chen, Yi-Jen Chen
BACKGROUND: Chronic kidney disease (CKD) increases the occurrence of atrial fibrillation and pulmonary vein (PV) arrhythmogenesis. Calcium dysregulation and reactive oxygen species (ROS) enhance PV arrhythmogenic activity. The purposes of this study were to investigate whether CKD modulates PV electrical activity through dysregulation of calcium homeostasis and ROS. METHODS AND RESULTS: Biochemical and electrocardiographic studies were conducted in rabbits with and without CKD (induced by 150 mg/kg per day neomycin sulfate and 500 mg/kg per day cefazolin)...
July 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28690298/comparison-of-empiric-isolation-and-conventional-isolation-of-superior-vena-cava-in-addition-to-pulmonary-vein-isolation-on-the-outcome-of-paroxysmal-atrial-fibrillation-ablation
#9
Jin-Yi Li, Jing-Bo Jiang, Guo-Qiang Zhong, Hong-Hong Ke, Yan He
Radiofrequency catheter ablation (RFCA) in the treatment of AF is currently based on pulmonary vein isolation (PVI). Some studies have investigated the efficacy of empiric SVC isolation (SVCI) in addition to conventional PVI in order to improve success rates and reduce recurrence rates. However, the results of the studies have given conflicting data.We performed a meta-analysis to evaluate the efficacy and safety of the empiric SVCI compared with conventional SVCI for paroxysmal atrial fibrillation (PAF) ablation...
July 10, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28688719/how-safe-are-noacs-compared-with-phenprocoumon-after-pulmonary-vein-isolation-with-the-cryoballoon-technique-using-purse-string-suture-closure
#10
Ersan Akkaya, Alexander Berkowitsch, Sergej Zaltsberg, Nikolas Deubner, Harald Greiss, Andreas Hain, Christian W Hamm, Johannes Sperzel, Malte Kuniss, Thomas Neumann
INTRODUCTION: The aim of this observational study was to compare the postprocedural incidence of bleeding and thromboembolic complications associated with novel oral anticoagulants (NOACs) with that of interrupted and continuous phenprocoumon after pulmonary vein isolation (PVI) using a purse-string suture (PSS) closure of the puncture site. METHODS AND RESULTS: Consecutive patients who had undergone PVI via cryoballoon ablation were divided into the following groups: (1) interrupted phenprocoumon with heparin bridging (n=101), (2) continuous phenprocoumon targeting an internationally normalized ratio>2 (n=70), and (3) NOACs without bridging that were restarted 2-4h after the procedure (n=185)...
June 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28687670/stand-alone-pulmonary-vein-isolation-versus-pulmonary-vein-isolation-with-additional-substrate-modification-as-index-ablation-procedures-in-patients-with-persistent-and-long-standing-persistent-atrial-fibrillation-the-randomized-alster-lost-af-trial-ablation
#11
Thomas Fink, Michael Schlüter, Christian-Hendrik Heeger, Christine Lemes, Tilman Maurer, Bruno Reissmann, Johannes Riedl, Laura Rottner, Francesco Santoro, Boris Schmidt, Peter Wohlmuth, Shibu Mathew, Christian Sohns, Feifan Ouyang, Andreas Metzner, Karl-Heinz Kuck
BACKGROUND: Pulmonary vein isolation (PVI) for persistent atrial fibrillation is associated with limited success rates and often requires multiple procedures to maintain stable sinus rhythm. In the prospective and randomized Alster-Lost-AF trial (Ablation at St. Georg Hospital for Long-Standing Persistent Atrial Fibrillation), we sought to assess, in patients with symptomatic persistent or long-standing persistent atrial fibrillation, the outcomes of initial ablative strategies comprising either stand-alone PVI (PVI-only approach) or a stepwise approach of PVI followed by complex fractionated atrial electrogram ablation and linear ablation (Substrate-modification approach)...
July 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28685200/role-of-the-burden-of-premature-atrial-contractions-during-the-blanking-period-following-second-generation-cryoballoon-ablation-in-predicting-late-recurrences-of-atrial-arrhythmias
#12
Hugo-Enrique Coutiño, Juan-Pablo Abugattas, Moisés Levinstein, Giacomo Mugnai, Darragh Moran, Valentina De Regibus, Erwin Ströker, Ken Takarada, Rajin Choudhury, Luis Marroquín, Francesca Salghetti, Ian-Emiray Lusoc, Saverio Iacopino, Juan Sieira, Carlo de Asmundis, Pedro Brugada, Gian-Battista Chierchia
PURPOSE: Recent data suggests that high burden of premature atrial complexes after pulmonary vein isolation predicts recurrences of atrial arrhythmias. The present study sought to assess the role of premature atrial complexes burden in predicting atrial arrhythmias recurrences in patients with atrial fibrillation (AF) who have undergone second-generation cryoballoon ablation (CB-Adv). METHODS: Consecutive patients with drug-resistant paroxysmal atrial fibrillation who underwent pulmonary vein isolation using CB-Adv technology as the index procedure were retrospectively included...
July 6, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28683753/two-stage-correction-of-type-iv-total-anomalous-pulmonary-venous-connection
#13
Hunbo Shim, Ji-Hyuk Yang, Tae-Gook Jun
BACKGROUND: The small size of the pulmonary veins in infants increases the risk of pulmonary vein obstruction (PVO) after surgical repair of type IV total anomalous pulmonary venous connection (TAPVC). Here, we described the outcomes of our strategy, which delayed total correction after initial partial correction. METHODS: We reviewed the data of patients who underwent total correction for type IV TAPVC. In total, 11 out of 103 patients with TAPVC had type IV TAPVC with biventricular physiology...
July 6, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28678147/efficacy-of-second-generation-cryoballoon-ablation-in-paroxysmal-and-persistent-atrial-fibrillation-patients
#14
Antonio Curnis, Francesca Salghetti, Manuel Cerini, Francesca Vassanelli, Lorenza Inama, Clara Villa, Daniele Giacopelli, Abdallah Raweh, Luca Bontempi
AIMS: In this study, we aimed to compare the efficacy of single pulmonary vein isolation with the second-generation cryoballoon (CB-Adv) and predictors of atrial fibrillation recurrences in patients with paroxysmal (PAF) and persistent atrial fibrillation (PersAF). METHODS: Consecutive PAF and PersAF patients undergoing CB-Adv for the first time were enrolled. Patients were followed with in-clinic visits including Holter ECG. Atrial arrhythmic episodes symptomatic or documented lasting more than 30 s were considered as recurrences...
July 3, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28675511/electrophysiological-relation-between-the-superior-vena-cava-and-right-superior-pulmonary-vein-in-patients-with-paroxysmal-atrial-fibrillation
#15
Kentaro Yoshida, Ai Hattori, Hidekazu Tsuneoka, Yasuaki Tsumagari, Yoshiaki Yui, Akira Kimata, Yoko Ito, Mari Ebine, Yoshiko Uehara, Naoya Koda, Masako Misaki, Daisuke Abe, Noriyuki Takeyasu, Kazutaka Aonuma, Akihiko Nogami
INTRODUCTION: The superior vena cava (SVC) is a main source of non-pulmonary vein (PV) ectopies initiating atrial fibrillation (AF). Empiric SVC isolation may improve rhythm outcomes after catheter ablation of AF. Because the SVC passes immediately adjacent to the right superior PV (RSPV), an electrophysiological relation could be present between the two structures. The present study aimed to estimate the interrelation between the SVC and RSPV by evaluating arrhythmogenic activities observed during catheter ablation of AF...
July 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28655535/adenosine-testing-after-atrial-fibrillation-ablation-systematic-review-and-meta-analysis
#16
Nelson Wang, Steven Phan, Aran Kanagaratnam, Narendra Kumar, Kevin Phan
BACKGROUND: Adenosine can be used to reveal dormant pulmonary vein (PV) conduction after pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF). We performed a systematic review and meta-analysis to assess the impact of adenosine administration in patients undergoing PVI for AF. METHODS: Meta-analysis of 22 studies was performed to assess the rates of freedom from AF in 1) patients with dormant PV conduction versus patients without dormant PV conduction, and 2) patients given routine adenosine post PVI versus patients not given adenosine...
June 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28652028/cryoablation-for-atrial-fibrillation-in-2017-what-have-we-learned
#17
REVIEW
Padmanabhan Shakkottai, Raymond W Sy, Mark A McGuire
Catheter ablation has become a standard technique for the treatment of atrial fibrillation. Pulmonary vein isolation (PVI) is the most important component of catheter ablation of atrial fibrillation. Radiofrequency (RF) ablation and balloon cryoablation can be used to achieve PVI. This review examines the biophysics and clinical efficacy of balloon cryoablation and discusses the potential advantages and disadvantages compared to RF ablation.
May 26, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28651348/an-e-e-ratio-on-echocardiography-predicts-the-existence-of-left-atrial-low-voltage-areas-and-poor-outcomes-after-catheter-ablation-for-atrial-fibrillation
#18
Masaharu Masuda, Masashi Fujita, Osamu Iida, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Akihiro Sunaga, Takuya Tsujimura, Yasuhiro Matsuda, Takuya Ohashi, Masaaki Uematsu
Aims: An elevated left atrial pressure has been reported to play an important role in the development of atrial remodelling in atrial fibrillation (AF) patients. The study aimed at elucidating the association between the diastolic early transmitral flow velocity/mitral annular velocity (E/e', a non-invasive surrogate of left atrial pressure) and left atrial low-voltage-area existence, and the prognostic impact of the E/e' on procedural outcomes in patients undergoing AF ablation. Methods and results: Total of 215 consecutive patients were divided into 3 groups based on the estimated left atrial pressure: normal (E/e' < 8...
June 22, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28649087/acute-hemodynamic-and-tissue-effects-of-cryoballoon-ablation-on-pulmonary-vessels-the-ivus-cryo-study
#19
Jakub Baran, Paweł Lewandowski, Krzysztof Smarż, Agnieszka Sikorska, Beata Zaborska, Piotr Kułakowski
BACKGROUND: Cryoballoon-based pulmonary vein isolation (CB-PVI) has been widely used for the treatment of atrial fibrillation. Although generally safe and effective, the procedure may be associated with pulmonary vein (PV) stenosis and bronchial or esophageal injury. The mechanisms leading to these complications have not been studied in detail. Our aim was to examine acute effects of cryoballoon on the pulmonary vessel and right heart pressures as well as PV wall morphology. METHODS AND RESULTS: In 8 patients (5 men, mean age 55±14 years) undergoing CB-PVI, pressure in each PV was measured by catheter located inside the PV directly before and after CB-PVI...
June 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28644155/transvenous-before-surgical-hybrid-procedure
#20
Joseph J Tiano, Robert Drennan, John Novella, Rafael Squiteri, Malcolm Robinson, Albert DiMeo, Lindsey Scierka, Paul LeLorier
BACKGROUND: Historically, persistent atrial fibrillation (PeAF) and long standing persistent atrial fibrillation (LSPeAF) have demonstrated limited clinical success despite hybrid approaches. OBJECTIVE: We describe our experience with the endocardial-before-epicardial approach defined by a comprehensive endovascular approach preceding and guiding the epicardial approach which includes an extensive posterior wall ablation. METHODS: 40 patients were followed over a 12 month period...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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