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https://www.readbyqxmd.com/read/27909526/achieving-bidirectional-long-delays-in-pulmonary-vein-antral-lines-prior-to-bidirectional-block-in-patients-with-paroxysmal-atrial-fibrillation-the-bi-bi-technique-for-atrial-fibrillation-ablation
#1
Adel F Mina Md Facc Fhrs, Nicholas L Warnecke Pa-C
Background: Pulmonary Vein Antral isolation (PVAI) is currently the standard of care for both paroxysmal and persistent atrial fibrillation ablation. Reconnection to the pulmonary vein is the most common cause of recurrence of atrial fibrillation. Achieving the endpoint of bidirectional block (BDB) for cavotricuspid isthmus dependant flutter has improved our outcomes for atrial flutter ablation. With this we tried to achieve long delays in the pulmonary veins antral lines prior to complete isolation comparable to those delays found in patient with bidirectional block of atrial flutter lines...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27702849/time-matters-adenosine-testing-immediately-after-pulmonary-vein-isolation-does-not-substitute-a-waiting-period
#2
Cas Teunissen, Nick Clappers, Wil Kassenberg, Rutger J Hassink, Jeroen F van der Heijden, Peter Loh
AIMS: Adenosine testing can reveal dormant pulmonary vein (PV) conduction after PV antrum isolation (PVAI). However, the optimal timing for adenosine administration is unknown. We hypothesized that adenosine testing immediately after PVAI reliably reveals PV reconnection and thereby eliminates the need for an observation period. METHODS: Fifty patients underwent PVAI. Immediately after isolation of a PV pair, adenosine was administered. Both PV pairs were separately tested...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27478152/adenosine-guided-pulmonary-vein-antral-isolation-for-paroxysmal-atrial-fibrillation-a-randomized-study
#3
Michael Efremidis, Konstantinos P Letsas, Louiza Lioni, Konstantinos Vlachos, Stamatis Georgopoulos, Athanasios Saplaouras, Eleni Geladari, George Giannopoulos, Tong Liu, Spyridon Deftereos, Antonios Sideris
OBJECTIVES: The prognostic significance of adenosine-mediated pulmonary vein (PV) dormant conduction and whether such conduction should be eliminated still remain controversial. This randomized study aimed to investigate whether adenosine-guided ablation of the reconnection gaps improves the long-term outcomes of pulmonary vein antral isolation (PVAI) for paroxysmal atrial fibrillation (AF). METHODS AND RESULTS: Consecutive patients with paroxysmal AF were randomly assigned to undergo (n = 80, group 1) or not (n = 81, group 2) adenosine testing following PVAI...
August 1, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27163758/impact-of-rotor-ablation-in-nonparoxysmal-atrial-fibrillation-patients-results-from-the-randomized-oasis-trial
#4
Sanghamitra Mohanty, Carola Gianni, Prasant Mohanty, Philipp Halbfass, Tamara Metz, Chintan Trivedi, Thomas Deneke, Gery Tomassoni, Rong Bai, Amin Al-Ahmad, Shane Bailey, John David Burkhardt, G Joseph Gallinghouse, Rodney Horton, Patrick M Hranitzky, Javier E Sanchez, Luigi Di Biase, Andrea Natale
BACKGROUND: Nonrandomized studies have reported focal impulse and rotor modulation (FIRM)-guided ablation to be superior to pulmonary vein antrum isolation (PVAI) for persistent atrial fibrillation and long-standing persistent atrial fibrillation. OBJECTIVES: This study sought to compare efficacy of FIRM ablation with or without PVAI versus PVAI plus non-PV trigger ablation in randomized persistent atrial fibrillation and long-standing persistent atrial fibrillation patients...
July 19, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/26857909/randomized-study-of-persistent-atrial-fibrillation-ablation-ablate-in-sinus-rhythm-versus-ablate-complex-fractionated-atrial-electrograms-in-atrial-fibrillation
#5
Mohamed Bassiouny, Walid Saliba, Ayman Hussein, John Rickard, Mariam Diab, Wahaj Aman, Thomas Dresing, Thomas Callahan, Mandeep Bhargava, David O Martin, Mingyuan Shao, Bryan Baranowski, Khaldoun Tarakji, Patrick J Tchou, Ali Hakim, Mohamed Kanj, Bruce Lindsay, Oussama Wazni
BACKGROUND: Achieving long-term successful outcomes with ablation of persistent atrial fibrillation (AF) remains a clinical and procedural challenge. We aimed to assess 2 ablation strategies for persistent AF: pulmonary vein antral isolation (PVAI) in sinus rhythm after direct current cardioversion versus PVAI and ablation targeting complex-fractionated atrial electrograms while in AF. METHODS AND RESULTS: Between June 2009 and July 2013, patients with continuous persistent AF for ≥3 months were prospectively randomized to either direct current cardioversion before PVAI and posterior wall/septum ablation while in sinus rhythm (group 1), versus same ablation in group 1 in addition to complex-fractionated atrial electrogram ablation while in AF (group 2)...
February 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/26838694/five-year-efficacy-of-pulmonary-vein-antrum-isolation-as-a-primary-ablation-strategy-for-atrial-fibrillation-a-single-centre-cohort-study
#6
Cas Teunissen, Wil Kassenberg, Jeroen F van der Heijden, Rutger J Hassink, Vincent J H M van Driel, Nicolaas P A Zuithoff, Pieter A Doevendans, Peter Loh
AIMS: Pulmonary vein antrum isolation (PVAI) is the cornerstone of atrial fibrillation (AF) ablation. There is an ongoing discussion on whether and when to add substrate modification to PVAI. This study evaluates (1) long-term efficacy of PVAI as a primary ablation strategy in all patients independently from AF type and (2) predictors of arrhythmia recurrence. METHODS AND RESULTS: A total of 509 consecutive patients (mean age 57 years, 38.9% non-paroxysmal AF) with AF underwent PVAI...
September 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/26376379/prevalence-patterns-and-clinical-predictors-of-left-ventricular-late-gadolinium-enhancement-in-patients-undergoing-cardiac-magnetic-resonance-prior-to-pulmonary-vein-antral-isolation-for-atrial-fibrillation-a-cross-sectional-observational-study
#7
John W Nance, Irfan M Khurram, Saman Nazarian, Jane DeWire, Hugh Calkins, Stefan L Zimmerman
Cardiac magnetic resonance (CMR) imaging is increasingly used to evaluate patients with atrial fibrillation (AF) before pulmonary vein antral isolation (PVAI). The purpose of this study was to assess the incidence and pattern of left ventricular (LV) late gadolinium enhancement (LGE) in patients undergoing CMR before PVAI and compare the clinical and demographic differences of patients with and without LV LGE. Clinical and demographic data on 62 patients (mean age 61 ± 7.9, 69% male) undergoing CMR before PVAI for AF were collected...
September 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26346285/clinical-significance-of-early-recurrence-after-pulmonary-vein-antrum-isolation-in-paroxysmal-atrial-fibrillation-insight-into-the-mechanism
#8
Shinsuke Miyazaki, Hiroshi Taniguchi, Hiroaki Nakamura, Takamitsu Takagi, Jin Iwasawa, Hitoshi Hachiya, Yoshito Iesaka
BACKGROUND: Early recurrence of atrial fibrillation (ERAF) is common after pulmonary vein antrum isolation (PVAI); however, the definition, study population, and lesion set are not uniform in prior studies. We examined ERAF for paroxysmal AF while complying with the definition in the latest guidelines. METHODS AND RESULTS: We included 471 patients undergoing empirical PVAI for paroxysmal AF. ERAF was observed in 180 patients (38.2%) including 49, 16, and 115 within 3, 4-7 days, and 8-90 days, respectively, after the index procedure...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/26304713/importance-of-non-pulmonary-vein-triggers-ablation-to-achieve-long-term-freedom-from-paroxysmal-atrial-fibrillation-in-patients-with-low-ejection-fraction
#9
MULTICENTER STUDY
Yonghui Zhao, Luigi Di Biase, Chintan Trivedi, Sanghamitra Mohanty, Rong Bai, Prasant Mohanty, Carola Gianni, Pasquale Santangeli, Rodney Horton, Javier Sanchez, G Joseph Gallinghouse, Jason Zagrodzky, Richard Hongo, Salwa Beheiry, Dhanunjaya Lakkireddy, Madhu Reddy, Patrick Hranitzky, Amin Al-Ahmad, Claude Elayi, J David Burkhardt, Andrea Natale
BACKGROUND: Whether ablation of non-pulmonary vein (PV) triggers after pulmonary vein antrum isolation (PVAI) improves the long-term procedure outcome in patients with paroxysmal atrial fibrillation (PAF) and left ventricular systolic dysfunction is unknown. OBJECTIVE: We sought to evaluate whether a more extensive ablation procedure improves outcomes at follow-up. METHODS: Consecutive patients with PAF refractory to antiarrhythmic drugs presenting for PVAI were prospectively studied...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/26277862/proven-isolation-of-the-pulmonary-vein-antrum-with-or-without-left-atrial-posterior-wall-isolation-in-patients-with-persistent-atrial-fibrillation
#10
Rong Bai, Luigi Di Biase, Prasant Mohanty, Chintan Trivedi, Antonio Dello Russo, Sakis Themistoclakis, Michela Casella, Pietro Santarelli, Gaetano Fassini, Pasquale Santangeli, Sanghamitra Mohanty, Antonio Rossillo, Gemma Pelargonio, Rodney Horton, Javier Sanchez, Joseph Gallinghouse, J David Burkhardt, Chang-Sheng Ma, Claudio Tondo, Andrea Natale
BACKGROUND: It is unclear whether isolation of the left atrial posterior wall (LAPW) offers additional benefits over pulmonary vein antrum isolation (PVAI) alone in patients with persistent atrial fibrillation (AF). OBJECTIVE: We sought to determine the impact of PVAI and LAPW isolation (PVAI+LAPW) versus PVAI alone on the outcome of ablation of persistent AF. METHODS: During the first procedure, PVAI was performed in 20 patients (group 1), whereas in 32 patients (group 2), PVAI was extended to the left atrial (LA) septum and coronary sinus (CS), and isolation of the LAPW was targeted (ePVAI+LAPW)...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/26187447/early-recurrence-of-atrial-arrhythmias-following-pulmonary-vein-antral-isolation-timing-and-frequency-of-early-recurrences-predicts-long-term-ablation-success
#11
Jackson J Liang, Melissa A Elafros, William W Chik, Pasquale Santangeli, Erica S Zado, David S Frankel, Gregory E Supple, Robert D Schaller, David Lin, Mathew D Hutchinson, Michael P Riley, David J Callans, Francis E Marchlinski, Sanjay Dixit
BACKGROUND: Early recurrence of atrial arrhythmia (ERAA) is common after atrial fibrillation (AF) ablation and is associated with long-term recurrence. However, the association between timing or frequency of ERAA and long-term ablation success remains unclear. OBJECTIVE: We aimed to examine whether timing or frequency of ERAA after pulmonary vein antral isolation (PVAI) affects long-term ablation success. METHODS: Three hundred AF patients (100 paroxysmal, 100 persistent, 100 long-standing persistent; mean age 59...
December 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/25957039/prospective-randomized-comparison-between-a-fixed-2c3l-approach-vs-stepwise-approach-for-catheter-ablation-of-persistent-atrial-fibrillation
#12
RANDOMIZED CONTROLLED TRIAL
Jian-Zeng Dong, Cai-Hua Sang, Rong-Hui Yu, De-Yong Long, Ri-Bo Tang, Chen-Xi Jiang, Man Ning, Nian Liu, Xing-Peng Liu, Xin Du, Hung-Fat Tse, Chang-Sheng Ma
AIMS: This prospective clinical trial was designed to evaluate the efficacy of an ablation strategy, namely '2C3L', in the treatment of persistent atrial fibrillation (AF); and to compare its efficacy with that of the 'stepwise' approach, which has been acknowledged as a promising ablation technique for persistent AF. METHODS AND RESULTS: The '2C3L' technique is a fixed ablation approach consisting of bilateral circumferential pulmonary vein antrum isolation (PVAI) and three linear ablation lesion sets across the mitral isthmus, left atrial roof, and cavo-tricuspid isthmus...
December 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/25346442/evaluation-of-diaphragmatic-electromyograms-in-radiofrequency-ablation-of-atrial-fibrillation-prospective-study-comparing-different-monitoring-techniques
#13
COMPARATIVE STUDY
Shinsuke Miyazaki, Noboru Ichihara, Hiroshi Taniguchi, Hitoshi Hachiya, Hiroaki Nakamura, Eisuke Usui, Yoshihisa Kanaji, Takamitsu Takagi, Jin Iwasawa, Akio Kuroi, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: The utility of compound motor action potential (CMAP) monitoring for anticipating phrenic nerve injury (PNI) during cryoballoon ablation has been reported. We sought to compare two different CMAP recording techniques and evaluated the feasibility during pulmonary vein antrum isolation (PVAI) and superior vena cava isolation (SVCI) using radiofrequency energy. METHODS AND RESULTS: Forty-two patients undergoing paroxysmal atrial fibrillation ablation were prospectively enrolled...
March 2015: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/24793457/epicardial-adipose-tissue-based-defragmentation-approach-to-persistent-atrial-fibrillation-its-impact-on-complex-fractionated-electrograms-and-ablation-outcome
#14
Shiro Nakahara, Yuichi Hori, Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi, Kan Takayanagi, Koichi Nagashima, Kazumasa Sonoda, Rikitake Kogawa, Naoko Sasaki, Ichiro Watanabe, Yasuo Okumura
BACKGROUND: Increased epicardial adipose tissue (EAT) volume is associated with atrial fibrillation (AF). However, the efficacy of EAT-based left atrial (LA) ablation for persistent AF (PsAF) is unclear. OBJECTIVE: The purpose of this study was to assess whether EAT-based LA ablation is effective for PsAF. METHODS: In 60 PsAF patients (group I), 3-dimensional reconstructed computed tomography images depicting EAT were merged with NavX-based dominant-frequency (DF) and complex fractionated electrogram (CFE) maps obtained during AF...
August 2014: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/24724831/catheter-ablation-of-atrial-fibrillation-in-patients-with-mechanical-mitral-valve-long-term-outcome-of-single-procedure-of-pulmonary-vein-antrum-isolation-with-or-without-nonpulmonary-vein-trigger-ablation
#15
MULTICENTER STUDY
Rong Bai, Luigi di Biase, Prasant Mohanty, Pasquale Santangeli, Sanghamitra Mohanty, Agnes Pump, Claude S Elayi, Yeruva Madhu Reddy, Giovanni B Forleo, Richard Hongo, Salwa Beheiry, Antonio Dello Russo, Michela Casella, Gemma Pelargonio, Pietro Santarelli, Rodney Horton, Javier Sanchez, Joseph Gallinghouse, J David Burkhardt, Changsheng Ma, Dhanunjaya Lakkireddy, Claudio Tondo, Andrea Natale
INTRODUCTION: It is unclear whether extended pulmonary vein antrum isolation (PVAI) plus nonpulmonary vein (non-PV) trigger elimination prevents more arrhythmia recurrence than PVAI alone in patients with mechanical mitral valve (MMV) undergoing AF ablation. This study compared the efficacy and long-term outcome of 2 ablation strategies--PVAI alone versus extended PVAI plus non-PV trigger elimination--for the treatment of AF in patients with MMV. METHODS AND RESULTS: One hundred and nine consecutive AF patients with MMV were divided into 2 groups: standard PVAI was performed in group 1 (N = 45); in group 2 (N = 64) PVAI was extended to the LA posterior wall, LA septum, and CS; and all non-PV triggers were eliminated...
August 2014: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/24672673/-electrical-exclusion-of-a-critical-myocardial-mass-by-extended-pulmonary-vein-antrum-isolation-for-persistent-atrial-fibrillation-treatment
#16
Sergey E Mamchur, Irina N Mamchur, Egor A Khomenko, Nikita S Bokhan, Diana A Scherbinina
UNLABELLED: The aim of the study was to compare the efficacy of pulmonary vein antrum isolation (PVAI), extended PVAI and ganglionic plexi (GP) ablation in persistent AF. METHODS: One hundred and twenty patients 56.2 ± 8.8 years old were randomized into three groups: GP ablation (n = 37), PVAI (n = 42), and extended PVAI (n = 41). The following parameters were studied: sinus rhythm restoration, vagal reactions, fluoroscopy time, procedure duration, lesion surface area...
March 2014: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/24597730/the-impact-of-catheter-ablation-in-the-interpulmonary-isthmus-on-atrial-fibrillation-ablation-outcomes-a-randomized-study
#17
RANDOMIZED CONTROLLED TRIAL
Konstantinos P Letsas, Michael Efremidis, Konstantinos Vlachos, Dimitrios Karlis, Louiza Lioni, Dimitrios Asvestas, Kosmas Valkanas, Constantinos C Mihas, Antonios Sideris
INTRODUCTION: Previous studies have underscored the importance of the interpulmonary isthmus in the initiation and maintenance of atrial fibrillation (AF). The efficacy of additional radiofrequency energy delivery in the interpulmonary isthmus following pulmonary vein antral isolation (PVAI) was investigated. METHODS AND RESULTS: A total of 76 patients (49 males, mean age 56.8 ± 10.3) with drug-resistant paroxysmal (n = 64) and short-lasting persistent AF (n = 12) underwent PVAI...
July 2014: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/24373867/long-term-outcome-and-preprocedural-predictors-of-atrial-tachyarrhythmia-recurrence-following-pulmonary-vein-antrum-isolation-based-catheter-ablation-in-patients-with-non-paroxysmal-atrial-fibrillation
#18
Koichiro Ejima, Kotaro Arai, Tsuyoshi Suzuki, Ken Kato, Kentaro Yoshida, Toshiaki Nuki, Futoshi Suzuki, Shoko Uematsu, Keiko Fukushima, Hiromi Hoshi, Tetsuyuki Manaka, Kyomi Ashihara, Morio Shoda, Nobuhisa Hagiwara
BACKGROUND: Although various empiric adjunctive ablation techniques are widely performed with pulmonary vein antrum isolation (PVAI) to enhance the procedural efficacy of catheter ablation in non-paroxysmal atrial fibrillation (NPAF) patients, they are not required in all NPAF patients. METHODS AND RESULTS: Eighty consecutive NPAF patients refractory to antiarrhythmic drugs underwent a PVAI-based ablation. Structural heart disease was present in 40% of patients and systolic dysfunction in 21%...
July 2014: Journal of Cardiology
https://www.readbyqxmd.com/read/24370218/-clinical-characteristics-and-long-term-outcome-of-non-pulmonary-vein-foci-ablation-in-patients-with-paroxysmal-atrial-fibrillation
#19
Hong-wu Chen, Ming-long Chen, Bing Yang, Wei-zhu Ju, Feng-xiang Zhang, Kai Gu, Ming-fang Li, Ke-jiang Gao
OBJECTIVE: To evaluate the clinical characteristics and long-term results of non-pulmonary veins (PV) trigger ablation in patients with paroxysmal atrial fibrillation (AF). METHODS: Eighty-six patients [48 men, mean age (52.3 ± 10.2) years] were included in the study. Circumferential pulmonary vein antrum isolation guided by a 3-D mapping system was performed. Aggressive high right atrium programmed stimulation and burst pacing were made before and after isoproterenol infusion...
November 2013: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/24317918/impact-of-pulmonary-vein-antrum-isolation-on-left-atrial-size-and-function-in-patients-with-atrial-fibrillation
#20
Irene E Hof, Evert-Jan Vonken, Birgitta K Velthuis, Fred H Wittkampf, Jeroen F van der Heijden, Kars G Neven, Wil Kassenberg, Mathias Meine, Maarten J Cramer, Richard N Hauer, Peter Loh
PURPOSE: The success of PVAI in eliminating AF has been proven; however, its impact on the LA remains uncertain. This study aimed to determine the impact of pulmonary vein antrum isolation (PVAI) on left atrial (LA) size and function in patients with atrial fibrillation (AF). METHODS: Consecutive patients with AF were included (n = 206). Magnetic resonance imaging (MRI) was performed before and after PVAI in all patients. A subgroup (n = 52) underwent delayed enhancement MRI...
April 2014: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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