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https://www.readbyqxmd.com/read/28100967/anesthetic-management-in-radiofrequency-catheter-ablation-of-ventricular-tachycardia
#1
REVIEW
Yi Deng, Payam S Naeini, Mehdi Razavi, Charles D Collard, Daniel A Tolpin, James M Anton
Radiofrequency catheter ablation is increasingly being used to treat patients who have ventricular tachycardia, and anesthesiologists frequently manage their perioperative care. This narrative review is intended to familiarize anesthesiologists with preprocedural, intraprocedural, and postprocedural implications of this ablation. Ventricular tachycardia typically arises from structural heart disease, most often from scar tissue after myocardial infarction. Many patients thus affected will benefit from radiofrequency catheter ablation in the electrophysiology laboratory to ablate the foci of arrhythmogenesis...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28091832/utility-and-safety-of-the-safesept%C3%A2-transseptal-guidewire-for-electrophysiology-studies-with-catheter-ablation-in-pediatric-and-congenital-heart-disease
#2
Joseph J Knadler, Jeffrey B Anderson, Ahmad S Chaouki, Richard J Czosek, Chad Connor, Timothy K Knilans, David S Spar
PURPOSE: The atrial transseptal procedure is used in catheter ablation of left-sided arrhythmias. Studies in adult patients have shown the SafeSept™ transseptal guidewire (SSTG) to be effective in atrial transseptal procedures. We analyzed our 5-year experience with SSTG use in pediatric and congenital heart disease patients undergoing catheter ablation. METHODS: This is a single-center retrospective analysis of patients undergoing catheter ablation from 2009 to 2014...
January 14, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28073882/the-role-of-superior-vena-cava-in-catheter-ablation-of-long-standing-persistent-atrial-fibrillation
#3
Kai Xu, Yuanlong Wang, Shaohui Wu, Li Zhou, Liang Zhao, Weifeng Jiang, Xiaodong Zhang, Xu Liu
AIMS: The superior vena cava (SVC) has been established as an important source of atrial fibrillation (AF). The role of SVC in long-standing persistent AF and the efficacy of empiric electrical isolation of the SVC are still unclear. The purpose of this study was to judge the role of SVC in catheter ablation of long-standing persistent AF. METHODS AND RESULTS: A total of 102 consecutive patients with long-standing persistent AF were enrolled. All patients underwent circumferential pulmonary vein isolation, complex fractionated atrial electrograms ablation, and linear ablation during the index procedure...
January 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28069837/high-sensitive-cardiac-troponin-t-as-a-novel-predictor-for-recurrence-of-atrial-fibrillation-after-radiofrequency-catheter-ablation
#4
Koki Nakanishi, Shota Fukuda, Hajime Yamashita, Toshifumi Hasegawa, Michihiko Kosaka, Naoya Shirai, Kenei Shimada, Junichi Yoshikawa, Atsushi Tanaka
AIMS: We aimed to determine whether elevated serum high-sensitive cardiac troponin T (hs-TnT) levels predict atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). METHODS AND RESULTS: We included 125 consecutive patients with AF (paroxysmal, n = 79; persistent, n = 46) who underwent first-time PVI. Serum hs-TnT, high-sensitive C-reactive protein (hs-CRP), atrial natriuretic peptide, and plasma B-type natriuretic peptide levels were measured in venous samples collected before PVI...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28065539/atlas-based-mosaicing-of-left-atrial-3-d-transesophageal-echocardiography-images
#5
Harriët W Mulder, Marijn van Stralen, Ben Ren, Alexander Haak, Max A Viergever, Johan G Bosch, Josien P W Pluim
Transesophageal echocardiography (TEE) is a promising imaging modality used to guide cardiac interventions, such as catheter ablation for the treatment of cardiac arrhythmias. These procedures rely on good visualization of the left atrium and pulmonary veins. To visualize these structures in a single volume, the acquisition, registration and fusion of multiple TEE views of the left atrium are required. We introduce atlas-based mosaicing as a method for the registration of images that are acquired according to a standardized protocol...
January 5, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28054100/total-absence-of-pulmonary-vein-potentials-in-a-patient-with-paroxysmal-atrial-fibrillation-was-it-really-isolated
#6
Kenichi Yokoyama, Seigo Yamashita, Kenichi Tokutake, Ryohsuke Narui, Mika Kato, Shinichi Tanigawa, Michifumi Tokuda, Keiichi Inada, Seiichiro Matsuo, Kenri Shibayama, Satoru Miyanaga, Michihiro Yoshimura, Teiichi Yamane
We herein present a case (72 years, male) with total absence of pulmonary veins (PVs) potentials at the beginning of the first procedure for paroxysmal atrial fibrillation (AF), demonstrating dormant conduction between the left atrium and all PVs revealed by adenosine triphosphate provocation with relation to the incidence of AF. He was free from atrial arrhythmias during 1 year follow-up after complete PV isolation with the elimination of multiple transient dormant conductions by circular mapping catheter guide ablation...
January 4, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28040290/obstructive-sleep-and-atrial-fibrillation-pathophysiological-mechanisms-and-therapeutic-implications
#7
REVIEW
Christos A Goudis, Dimitrios G Ketikoglou
Atrial fibrillation (AF) is the commonest arrhythmia in clinical practice and is associated with increased cardiovascular morbidity and mortality. Obstructive sleep apnea (OSA), a common breathing disorder, is an independent risk factor for AF. Several pathophysiological mechanisms, including apnea-induced hypoxia, intrathoracic pressure shifts, sympathovagal imbalance, atrial remodeling, oxidative stress, inflammation and neurohumoral activation have been implicated in the occurrence of AF in OSA patients...
December 22, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28039281/association-of-rate-dependent-conduction-block-between-eccentric-coronary-sinus-to-left-atrial-connections-with-inducible-atrial-fibrillation-and-flutter
#8
Dong Huang, Joseph E Marine, Jing-Bo Li, Tarek Zghaib, Esra Gucuk Ipek, Sunil Sinha, David D Spragg, Hiroshi Ashikaga, Ronald D Berger, Hugh Calkins, Saman Nazarian
BACKGROUND: We sought to describe the prevalence and variability of coronary sinus (CS) and left atrial (LA) myocardium connections, their susceptibility to rate-dependent conduction block, and association with atrial fibrillation (AF) and flutter induction. METHODS AND RESULTS: The study cohort included 30 consecutive AF patients (age 63.3±10.5 years, 63% male). Multipolar catheters were positioned in the CS, high right atrium (HRA), and LA parallel to and near the CS...
January 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28018976/identifying-the-third-dimension-in-2d-fluoroscopy-to-create-3d-cardiac-maps
#9
Jasbir Sra, David Krum, Indrajit Choudhuri, Barry Belanger, Mark Palma, Donald Brodnick, Daniel B Rowe
Three-dimensional cardiac mapping is important for optimal visualization of the heart during cardiac ablation for the treatment of certain arrhythmias. However, many hospitals and clinics worldwide cannot afford the high cost of the current mapping systems. We set out to determine if, using predefined algorithms, comparable 3D cardiac maps could be created by a new device that relies on data generated from single-plane fluoroscopy and patient recording and monitoring systems, without the need for costly equipment, infrastructure changes, or specialized catheters...
December 22, 2016: JCI Insight
https://www.readbyqxmd.com/read/28017937/catheter-ablation-of-atrial-fibrillation-in-very-young-adults-a-5-year-follow-up-study
#10
Ardan M Saguner, Tilman Maurer, Erik Wissner, Francesco Santoro, Christine Lemes, Shibu Mathew, Christian Sohns, Christian H Heeger, Bruno Reißmann, Johannes Riedl, Thomas Fink, Kentaro Hayashi, Peter Wohlmuth, Karl-Heinz Kuck, Feifan Ouyang, Andreas Metzner
AIMS: Catheter ablation is an established therapy for symptomatic atrial fibrillation (AF). However, outcome data on catheter ablation for AF in young adults is scarce. METHODS AND RESULTS: From 2005-2014, 85 consecutive young adults (mean age 31 ± 4 years; 69% men) with symptomatic paroxysmal AF (PAF, n = 52) and persistent (Pers) AF (n = 33) underwent pulmonary vein isolation (PVI) [±ablation of complex fractionated atrial electrograms/linear lesions in PVI non-responders] at our centre...
December 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28012210/elimination-of-ventricular-arrhythmia-in-catecholaminergic-polymorphic-ventricular-tachycardia-by-targeting-catecholamine-sensitive-area-a-dominant-subordinate-relationship-between-origin-sites-of-bidirectional-ventricular-premature-contractions
#11
Yasuhiro Shirai, Masahiko Goya, Seiko Ohno, Minoru Horie, Shozaburo Doi, Mitsuaki Isobe, Kenzo Hirao
We report on a patient diagnosed with CPVT who underwent catheter ablation of VPCs induced by epinephrine. VPCs were classified roughly into 3 types. Type 1 and Type 2 VPCs (RBBB configuration and inferior axis) were eliminated by radio frequency applications at the left aortic sinus of Valsalva and the anterolateral papillary muscle (APM), respectively. Although no spontaneous VPCs were seen after the elimination of Type 1 and 2 VPCs, pacing resulting in capture at the APM induced type 3 VPC (RBBB configuration and superior axis) reproducibly...
December 24, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28011842/modelling-methodology-of-atrial-fibrosis-affects-rotor-dynamics-and-electrograms
#12
Caroline H Roney, Jason D Bayer, Sohail Zahid, Marianna Meo, Patrick M J Boyle, Natalia A Trayanova, Michel Haïssaguerre, Rémi Dubois, Hubert Cochet, Edward J Vigmond
AIMS: Catheter ablation is an effective technique for terminating atrial arrhythmia. However, given a high atrial fibrillation (AF) recurrence rate, optimal ablation strategies have yet to be defined. Computer modelling can be a powerful aid but modelling of fibrosis, a major factor associated with AF, is an open question. Several groups have proposed methodologies based on imaging data, but no comparison to determine which methodology best corroborates clinically observed reentrant behaviour has been performed...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28011841/towards-personalized-computational-modelling-of-the-fibrotic-substrate-for-atrial-arrhythmia
#13
Patrick M Boyle, Sohail Zahid, Natalia A Trayanova
: Atrial arrhythmias involving a fibrotic substrate are an important cause of morbidity and mortality. In many cases, effective treatment of such rhythm disorders is severely hindered by a lack of mechanistic understanding relating features of fibrotic remodelling to dynamics of re-entrant arrhythmia. With the advent of clinical imaging modalities capable of resolving the unique fibrosis spatial pattern present in the atria of each individual patient, a promising new research trajectory has emerged in which personalized computational models are used to analyse mechanistic underpinnings of arrhythmia dynamics based on the distribution of fibrotic tissue...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27989681/12-year-follow-up-of-catheter-ablation-for-atrial-fibrillation-a-prospective-multi-center-randomized-study
#14
Emanuele Bertaglia, Gaetano Senatore, Laura De Michieli, Antonio De Simone, Claudia Amellone, Sonia Ferretto, Vincenzo La Rocca, Marco Giuggia, Domenico Corrado, Franco Zoppo, Giuseppe Stabile
BACKGROUND: Randomized and controlled study have reported the effect of catheter ablation (CA) for atrial fibrillation (AF) over a follow-up of 12-24 months. OBJECTIVE: We report on the effect of CA plus antiarrhythmic drugs in comparison with antiarrhythmic drugs alone on the maintenance of sinus rhythm over a 12-year follow-up. METHODS: We extended the follow-up of the 137 patients who were enrolled in the Catheter Ablation for the Cure of Atrial Fibrillation Study between 01(st) February 2002 and 30(th) June 2003 and randomized to antiarrhythmic drugs (control group) or antiarrhythmic drugs plus CA (ablation group)...
December 15, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27986642/anatomic-characteristics-of-the-mitral-isthmus-region-the-left-atrial-appendage-isthmus-as-a-possible-ablation-target
#15
Mateusz K Hołda, Mateusz Koziej, Jakub Hołda, Kamil Tyrak, Katarzyna Piątek, Filip Bolechała, Wiesława Klimek-Piotrowska
The mitral isthmus is a part of the postero-inferior area of the lateral left atrial wall located between the mitral annulus and the left inferior pulmonary vein ostium. Linear ablation lesions are created within the mitral isthmus for the invasive treatment of left atrial arrhythmias. However, the anatomy of this region is not fully understood. The aim of this study has been to provide a detailed morphometric description of the mitral isthmus region and to propose another possible isthmus within the investigated heart area that may serve as a potential new ablation target...
December 13, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/27979373/electrophysiological-abnormalities-in-patients-with-paroxysmal-atrial-fibrillation-in-the-absence-of-overt-structural-heart-disease
#16
José David Arroja, Haran Burri, Chan Il Park, Philippe Giraudet, Marc Zimmermann
PURPOSE: The aim of the present study was to define the atrial electrical substrate in patients with paroxysmal atrial fibrillation (AF) occurring in the absence of overt structural heart disease and to assess if electrophysiological parameters could predict AF recurrence after radiofrequency ablation in this population. METHODS AND RESULTS: 45 consecutive patients (39 male, age 59 ± 10 years) with paroxysmal AF and without overt structural heart disease, referred for radiofrequency catheter ablation, were prospectively enrolled...
September 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/27957250/mechanisms-and-clinical-significance-of-early-recurrences-of-atrial-arrhythmias-after-catheter-ablation-for-atrial-fibrillation
#17
REVIEW
Jackson J Liang, Sanjay Dixit, Pasquale Santangeli
Early recurrence of atrial arrhythmias (ERAA) after ablation is common and strongly predicts late recurrences and ablation failure. However, since arrhythmia may eventually resolve in up to half of patients with ERAA, guidelines do not recommend immediate reintervention for ERAA episodes occurring during a 3-mo post-ablation blanking period. Certain clinical demographic, electrophysiologic, procedural, and ERAA-related characteristics may predict a higher likelihood of long-term ablation failure. In this review, we aim to discuss potential mechanisms of ERAA, and to summarize the clinical significance, prognostic implications, and treatment options for ERAA...
November 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/27939893/use-of-flecainide-in-combination-antiarrhythmic-therapy-in-patients-with-arrhythmogenic-right-ventricular-cardiomyopathy
#18
Simon Ermakov, Edward P Gerstenfeld, Yana Svetlichnaya, Melvin M Scheinman
BACKGROUND: Antiarrhythmic therapy is commonly used for suppression of arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) in conjunction with implantable cardioverter-defibrillators and catheter ablation. The efficacy of combination flecainide and sotalol/metoprolol therapy for patients refractory to single agents and/or catheter ablation has not been well established. OBJECTIVE: The purpose of this study was to describe our experience with the addition of flecainide in combination with sotalol/metoprolol for treatment of arrhythmias in patients with ARVC...
December 9, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27938453/role-of-low-kilovoltage-electrocardiographic-gated-multidetector-ct-in-electrophysiological-procedures-in-the-paediatric-age-group
#19
Sameh N K Khalil, Ahmed S Ibrahim
Treatment of arrhythmias by catheter ablation targeting the anatomical foci of arrhythmias by radiofrequency has evolved dramatically in recent years. A road map for the relevant heart structures is an important asset for the success of the procedure and should be obtained before the intervention. This can be achieved by intra-cardiac echocardiography, conventional angiographic methods, multidetector CT, or MRI. The electrophysiological technique comprises a diagnostic procedure and an interventional - therapeutic - procedure...
December 12, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27932238/gender-differences-in-patients-with-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy-clinical-manifestations-electrophysiological-properties-substrate-characteristics-and-prognosis-of-radiofrequency-catheter-ablation
#20
Chin-Yu Lin, Fa-Po Chung, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Yao-Ting Chang, Yun-Yu Chen, Rohit Walia, Abigail Louise D Te, Shinya Yamada, Shih-Ann Chen
BACKGROUND: Gender differences in the penetrance and clinical expression of genetic mutations have been reported in patients with arrhythmogenic right ventricular (RV) dysplasia/cardiomyopathy (ARVD/C). Our study aimed at clarifying the impact of gender on ventricular substrates and clinical outcomes after radiofrequency catheter ablation (RFCA). METHODS: Patients with ARVD/C underwent RFCA for drug-refractory ventricular arrhythmias (VAs) were consecutively enrolled...
January 15, 2017: International Journal of Cardiology
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