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https://www.readbyqxmd.com/read/29147788/dissociated-pulmonary-vein-activity-after-cryoballoon-ablation-and-radiofrequency-ablation-for-atrial-fibrillation-a-propensity-score-matched-analysis
#1
Kenichi Tokutake, Michifumi Tokuda, Seiichiro Matsuo, Ryota Isogai, Kenichi Yokoyama, Mika Kato, Ryohsuke Narui, Shinichi Tanigawa, Seigo Yamashita, Satoru Miyanaga, Michihiro Yoshimura, Teiichi Yamane
Cryoballoons (CBs) have proven to be effective for achieving pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Dissociated PV activity (DPVA) after successful radiofrequency PVI is sometimes observed inside the PV and has been found to prove the achievement of electrical disconnection from the left atrium. However, little is known about the incidence or characteristics of DPVA after CB-PVI. The aim of this study was to compare the incidence and characteristics of DPVA in patients undergoing CB and radiofrequency (RF) ablation for AF...
November 17, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29147720/anticoagulation-in-atrial-fibrillation-current-evidence-and-guideline-recommendations
#2
J W Erath, S H Hohnloser
Atrial fibrillation (AF) is the most frequently encountered sustained arrhythmia with a prevalence of 0.5-10%, depending predominantly on age. The arrhythmia is associated with significant morbidity and mortality, mainly due to thromboembolic events including stroke and systemic embolisms. These complications can be effectively prevented with anticoagulation therapy either with vitamin K antagonists (VKA) or with non-vitamin K antagonists (NOAC). VKA therapy is effective in preventing strokes but these medications are difficult to use, are associated with significant bleeding risk, and have pharmacokinetic/dynamic properties that make their use cumbersome...
November 17, 2017: Herz
https://www.readbyqxmd.com/read/29146378/association-of-p-wave-duration-index-with-atrial-fibrillation-recurrence-after-cryoballoon-catheter-ablation
#3
Onur Kaypakli, Hasan Koca, Durmuş Yıldıray Şahin, Sefa Okar, Fadime Karataş, Mevlüt Koç
AIM: We aimed to investigate the relationship between the recurrence of AF and P wave duration index (PWDI) in patients with nonvalvular PAF. METHODS: We included 114 patients who underwent cryoballoon catheter ablation with the diagnosis of paroxysmal atrial fibrillation (PAF) (55 male, 59 female; mean age 55.5±10,9years). PWDI was calculated by dividing the Pwd by the PR interval in DII lead of 12‑lead ECG. Patients had regular follow-up visits with 12-lead ECG, medical history and clinical evaluation...
October 9, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29145517/which-patients-recur-as-atrial-tachycardia-rather-than-atrial-fibrillation-after-catheter-ablation-of-atrial-fibrillation
#4
Pil-Sung Yang, Young-Ah Park, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
INTRODUCTION: The ablation gaps have been known as the main mechanism of recurrence as atrial tachycardia (AT) rather than atrial fibrillation (AF) after AF catheter ablation. However, AF organization due to reduction of critical mass or focal trigger may also be the mechanism of AT recurrence. We sought to find out the main clinical factors of recurrence as AT rather than AF after AF ablation in the absence of antiarrhythmic drug effect. METHODS: We analyzed 521 patients (70...
2017: PloS One
https://www.readbyqxmd.com/read/29144514/catheter-ablation-of-atrial-fibrillation-in-elderly-population
#5
Josef Kautzner, Petr Peichl, Marek Sramko, Robert Cihak, Bashar Aldhoon, Dan Wichterle
Background: Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinical benefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volume center focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods: Consecutive patients who underwent catheter ablation for AF between January 2001 and December 2016 were analysed...
September 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29142816/unilateral-pulmonary-edema-in-a-patient-with-worsening-tricuspid-valve-regurgitation-a-secret-inside-pulmonary-veins
#6
Elvira Resciniti, Ilaria Caso, Iside Scarfò, Giuseppe Di Pasquale, Giovanni La Canna
We present the case of a 69-year-old patient who was referred to the Department of Echocardiography for surgical treatment of severe tricuspid valve regurgitation (TVR) with advanced congestive heart failure. In 2013 the patient underwent unsuccessful percutaneous ablation for permanent atrial fibrillation. In 2015, following numerous episodes of atrial fibrillation and congestive heart failure with left pleural effusion, the patient was admitted to another center. A transthoracic echocardiogram showed severe TVR and moderate precapillary pulmonary hypertension, confirmed at right cardiac catheterization...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29141843/stable-sr-electrophysiological-substrate-ablation-in-the-left-atrium-during-sinus-rhythm-for-the-treatment-of-nonparoxysmal-atrial-fibrillation-a-prospective-multicenter-randomized-clinical-trial
#7
Bing Yang, Chenyang Jiang, Yazhou Lin, Gang Yang, Huimin Chu, Heng Cai, Fengmin Lu, Xianzhang Zhan, Jian Xu, Xinhua Wang, Chi-Keong Ching, Balbir Singh, Young-Hoon Kim, Minglong Chen
BACKGROUND: Circumferential pulmonary vein isolation (CPVI) alone or combined with adjuvant substrate modifications is unsatisfactory for atrial fibrillation (AF) control in nonparoxysmal AF patients. Ablation targeting the fibrotic areas after CPVI (STABLE-SR [Electrophysiological Substrate Ablation in the Left Atrium During Sinus Rhythm]) is a newly evolved substrate modification strategy. METHODS AND RESULTS: In this multicenter, randomized clinical trial, 229 symptomatic nonparoxysmal AF patients were 1:1 randomized to STABLE-SR group (n=114) or conventional STEPWISE group (n=115)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29138144/successful-minimally-invasive-surgical-ablation-of-atrial-fibrillation-a-call-to-do-better
#8
EDITORIAL
Anson M Lee
No abstract text is available yet for this article.
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#9
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29136152/concomitant-thoracoscopic-surgery-for-solitary-pulmonary-nodule-and-atrial-fibrillation
#10
Rongxin Lu, Ju Mei, Dongfang Zhao, Zhaolei Jiang, Haibo Xiao, Mingsong Wang, Nan Ma
OBJECTIVES: The incidence of both solitary pulmonary nodules (SPN) and non-valvular atrial fibrillation (NVAF) has increased over the past decade. We performed concomitant video-assisted thoracoscopic surgery with modified epicardial radiofrequency ablation procedure for NVAF and SPN resection. METHODS: Sixteen patients (7 men, mean age 62.6 ± 11.2 years) with SPN and NVAF underwent this procedure. Of these patients, 10 had paroxysmal atrial fibrillation and 6 persistent atrial fibrillation...
November 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29135523/targeting-nonpulmonary-vein-triggers-during-atrial-fibrillation-ablation-is-the-game-worth-the-candle
#11
Ahmed AlTurki, Howard J Marshall, Riccardo Proietti
PURPOSE OF REVIEW: Triggers for atrial fibrillation are found outside the pulmonary veins in 12-20% of cases. The role of addressing these triggers during catheter ablations has not been well defined. Therefore, the aim of this review is to summarize the effect of ablation of nonpulmonary vein triggers in addition to pulmonary vein isolation across the spectrum of atrial fibrillation in patients receiving catheter ablation. RECENT FINDINGS: In paroxysmal atrial fibrillation, an inducible nonpulmonary vein trigger is an independent predictor of recurrence...
November 10, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29134434/fluoroscopy-free-af-ablation-using-transesophageal-echocardiography-and-electroanatomical-mapping-technology
#12
Benjamin O'Brien, Damian C Balmforth, Ross J Hunter, Richard J Schilling
PURPOSE: Guidelines recommend that radiation exposure during AF catheter ablation procedures should be 'as low as reasonably achievable' (ALARA), particularly since many patients may have multiple procedures. Consequently, avoiding radiation exposure altogether must, if safe to do so, be the ultimate goal. The primary objective was to determine the feasibility and efficacy of fluoroscopy-free AF ablation compared to the fluoroscopy-assisted procedure. METHODS: Patients underwent AF ablation using commercially available technology with no routine pre-procedural imaging...
November 14, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29133380/atrial-substrate-and-triggers-of-paroxysmal-atrial-fibrillation-in-patients-with-obstructive-sleep-apnea
#13
Elad Anter, Luigi Di Biase, Fernando M Contreras-Valdes, Carola Gianni, Sanghamitra Mohanty, Cory M Tschabrunn, Juan F Viles-Gonzalez, Eran Leshem, Alfred E Buxton, Guy Kulbak, Rim N Halaby, Peter J Zimetbaum, Jonathan W Waks, Robert J Thomas, Andrea Natale, Mark E Josephson
BACKGROUND: Obstructive sleep apnea (OSA) is associated with atrial remodeling, atrial fibrillation (AF), and increased incidence of arrhythmia recurrence after pulmonary vein (PV) isolation. We aimed to characterize the atrial substrate, including AF triggers in patients with paroxysmal AF and OSA. METHODS AND RESULTS: In 86 patients with paroxysmal AF (43 with ≥moderate OSA [apnea-hypopnea index ≥15] and 43 without OSA [apnea-hypopnea index <5]), right atrial and left atrial voltage distribution, conduction velocities, and electrogram characteristics were analyzed during atrial pacing...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29133182/a-novel-method-for-localization-and-ablation-of-conduction-gaps-after-wide-antral-circumferential-ablation-of-pulmonary-veins
#14
Raoul Bacquelin, Raphaël P Martins, Nathalie Behar, Vincent Galand, Baptiste Polin, Jonathan Lacaze, Frédéric Sebag, Christophe Leclercq, Jean-Claude Daubert, Philippe Mabo, Dominique Pavin
BACKGROUND: Atrial fibrillation ablation is often performed by achieving pulmonary vein isolation using the "wide antral circumferential ablation" (WACA) technique, but many pulmonary veins remain connected because of conduction gaps in the ablation line. AIM: To analyse the efficacy of a novel technique based on pacing manoeuvres to detect gaps in an initial WACA lesion. METHODS: Patients referred for radiofrequency atrial fibrillation ablation were enrolled prospectively...
November 10, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29131765/comprehensive-cross-sectional-imaging-of-the-pulmonary-veins
#15
Cameron Hassani, Farhood Saremi
The pulmonary veins carry oxygenated blood from the lungs to the heart, but their importance to the radiologist extends far beyond this seemingly straightforward function. The anatomy of the pulmonary veins is variable among patients, with several noteworthy variant and anomalous patterns, including supernumerary pulmonary veins, a common ostium, anomalous pulmonary venous return, and levoatriocardinal veins. Differences in pulmonary vein anatomy and the presence of variant or anomalous anatomy can be of critical importance, especially for preoperative planning of pulmonary and cardiac surgery...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29131442/increased-rates-of-atrial-fibrillation-recurrence-following-pulmonary-vein-isolation-in-overweight-and-obese-patients
#16
Bhradeev Sivasambu, Muhammad A Balouch, Tarek Zghaib, Rizma J Bajwa, Jonathan Chrispin, Ronald D Berger, Hiroshi Ashikaga, Saman Nazarian, Joseph E Marine, Hugh Calkins, David D Spragg
INTRODUCTION: Catheter ablation is common for patients with symptomatic, drug-refractory atrial fibrillation (AF). Obesity is a known risk factor for incident AF. The impact of obesity on AF ablation outcomes is incompletely understood. We sought to determine the impact of elevated body mass index (BMI) on pulmonary vein isolation (PVI) procedural outcomes and associated complications. METHODS AND RESULTS: We evaluated patients undergoing PVI from 2001 to 2015, dividing them into four groups: normal weight (BMI ≥ 18...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29131434/five-year-impact-of-catheter-ablation-for-atrial-fibrillation-in-patients-with-a-prior-history-of-stroke
#17
T Jared Bunch, Heidi T May, Tami L Bair, Brian G Crandall, Michael J Cutler, John D Day, Victoria Jacobs, Charles Mallender, Jeffrey S Osborn, J Peter Weiss
BACKGROUND: Catheter ablation of atrial fibrillation(AF) is an established therapeutic rhythm approach. Patients with a prior history of a stroke(CVA) represent a unique high-risk population for recurrent thromboembolic events. The role of antiarrhythmic treatment on the natural history of stroke recurrence in these patients is not fully understood. METHODS: Three patient groups with a prior CVA and 5 years of follow-up were matched 1:3:3 by propensity score(±0...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29129259/comparison-of-prevalence-and-management-of-left-atrial-appendage-thrombi-under-old-and-new-anticoagulants-prior-to-left-atrial-catheter-ablation
#18
Antoine Da Costa, Clarisse Delolme, Jean Baptiste Guichard, Antoine Gerbay, Romain Pierrard, Cécile Romeyer-Bouchard, Karl Isaaz
BACKGROUND: The prevalence and management of left atrial appendage (LAA) thrombi associated with new anticoagulants remain to be elucidated, especially prior to atrial fibrillation (AFib) ablation. This study sought to (1) compare the prevalence of LAA thrombi and/or severe LAA contrast under vitamin K antagonist (VKA) agents and novel oral anticoagulants (NOACs), (2) evaluate the rate of LAA thrombus resolution after anticoagulation modification, and (3) determine the predictive factors of LAA thrombi and severe LAA contrast in patients prior to LA AFib ablation...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29127542/left-atrial-function-after-epicardial-pulmonary-vein-isolation-in-patients-with-atrial-fibrillation
#19
Louise Bagge, Per Blomström, Lena Jidéus, Stefan Lönnerholm, Carina Blomström-Lundqvist
PURPOSE: Epicardial pulmonary vein isolation has become an increasingly used therapy for medically resistant atrial fibrillation. The purpose of the present study was therefore to evaluate if epicardial pulmonary vein isolation combined with ganglionated plexi ablation affects the size and mechanical function of the left atrium, and whether the effects are dependent on the extensiveness of the ablation applications. METHODS: A total of 42 patients underwent an echocardiographic examination prior to and 6 months after a minimal invasive epicardial pulmonary vein isolation procedure for the assessment of the effects on left atrial size and function...
November 10, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29126896/the-continuous-challenge-of-af-ablation-from-foci-to-rotational-activity
#20
REVIEW
Sanjiv M Narayan, Mohan N Vishwanathan, Christopher A B Kowalewski, Tina Baykaner, Miguel Rodrigo, Junaid A B Zaman, Paul J Wang
Pulmonary vein isolation (PVI) is central to ablation approaches for atrial fibrillation (AF), yet many patients still have arrhythmia recurrence after one or more procedures despite the latest technology for PVI. Ablation of rotational or focal sources for AF, which lie outside the pulmonary veins in many patients, is a practical approach that has been shown to improve success by many groups. Localized sources lie in atrial regions shown mechanistically to sustain AF in optical mapping and clinical studies of human AF, as well as computational and animal studies...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
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