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Electrophysiology, ablation

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https://www.readbyqxmd.com/read/28548234/catheter-ablation-of-atrial-flutter-a-survey-focusing-on-post-ablation-oral-anticoagulation-management-and-ecg-monitoring
#1
Philipp Attanasio, Tabea Budde, Philipp Lacour, Abdul Shokor Parwani, Burkert Pieske, Florian Blaschke, Wilhelm Haverkamp, Leif-Hendrik Boldt, Martin Huemer
BACKGROUND: A considerable amount of patients with typical atrial flutter develops atrial fibrillation after CTI ablation. No uniform recommendations are available to guide anticoagulation regimes or ECG monitoring strategies after this procedure. METHODS: We conducted a web-based survey in electrophysiology (EP) centers in Germany, Switzerland and Austria. Responses were received from 47 centers. The survey was designed to investigate variations in management of the following: Ablation strategy, oral anticoagulation (OAC) management and ECG monitoring after successful cavotricuspid isthmus (CTI) ablation...
May 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28543389/coexistence-of-a-permanent-form-of-a-junctional-reciprocating-tachycardia-and-coronary-sinus-aneurysm-a-case-report
#2
Yuki Shimizu, Osamu Inaba, Masahiko Goya, Kenzo Hirao
A 58-year-old man with a long R-P' narrow QRS tachycardia underwent an electrophysiological study. The tachycardia was diagnosed as permanent form of junctional reciprocating tachycardia (PJRT), and the earliest atrial activation site during tachycardia was coronary sinus (CS) ostium. Radiofrequency ablation at the site was initially not successful because the tip impedance and temperature were unstable. After changing of the ablation catheter to that with contact force sensor, the accessory pathway was immediately ablated and the PJRT was no longer induced...
May 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28537000/advances-in-clinical-cardiology-2016-a-summary-of-the-key-clinical-trials
#3
REVIEW
Alastair Gray, Conor McQuillan, Ian B A Menown
INTRODUCTION: The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016. METHODS: The authors reviewed clinical trials presented at major cardiology conferences during 2016 including the American College of Cardiology (ACC), European Association for Percutaneous Cardiovascular Interventions (EuroPCR), European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA)...
May 23, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28515113/force-sensing-catheters-during-pediatric-radiofrequency-ablation-the-federation-study
#4
Aarti S Dalal, Hoang H Nguyen, Tammy Bowman, George F Van Hare, Jennifer N Avari Silva
BACKGROUND: Based on data from studies of atrial fibrillation ablations, optimal parameters for the TactiCath (TC; St. Jude Medical, Inc) force-sensing ablation catheter are a contact force of 20 g and a force-time integral of 400 g·s for the creation of transmural lesions. We aimed to evaluate TC in pediatric and congenital heart disease patients undergoing ablation. METHODS AND RESULTS: Comprehensive chart and case reviews were performed from June 2015 to March 2016...
May 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28507740/mark-josephson-pioneer-educator-and-mentor-to-a-generation-of-cardiac-electrophysiologists
#5
William G Stevenson
In January 2017 we lost a giant in cardiac electrophysiology, whose work and teachings touched all of us working in the field. Mark Josephson's early work, building on the work of Hein Wellens in using programmed stimulation and catheter mapping to understand scar-related ventricular tachycardias, led the way to surgical and then catheter ablation as a viable therapy for that arrhythmia. His seminal observations are many and catalogued in 'The Josephson School' a wonderful book with 59 Chapters and extensive commentary devoted to his research...
April 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28507032/%C3%AE-2-nicotinic-acetylcholine-receptors-influence-hippocampus-dependent-learning-and-memory-in-adolescent-mice
#6
Shahrdad Lotfipour, Celina Mojica, Sakura Nakauchi, Marcela Lipovsek, Sarah Silverstein, Jesse Cushman, James Tirtorahardjo, Andrew Poulos, Ana Belén Elgoyhen, Katumi Sumikawa, Michael S Fanselow, Jim Boulter
The absence of α2* nicotinic acetylcholine receptors (nAChRs) in oriens lacunosum moleculare (OLM) GABAergic interneurons ablate the facilitation of nicotine-induced hippocampal CA1 long-term potentiation and impair memory. The current study delineated whether genetic mutations of α2* nAChRs (Chrna2(L9'S/L9'S) and Chrna2(KO)) influence hippocampus-dependent learning and memory and CA1 synaptic plasticity. We substituted a serine for a leucine (L9'S) in the α2 subunit (encoded by the Chrna2 gene) to make a hypersensitive nAChR...
June 2017: Learning & Memory
https://www.readbyqxmd.com/read/28500479/-catheter-ablation-of-persistent-atrial-fibrillation-where-do-we-go
#7
C Lemeš, K-H Kuck, S Mathew
Despite the very promising initial results of clinical studies, catheter ablation of persistent atrial fibrillation (AF) remains a challenge in modern electrophysiology. On the basis of the hypothesized pathophysiological mechanisms, a variety of ablation strategies have been developed over the course of time. The current ablation strategies range from pulmonary vein isolation (PVI) alone as first-line therapy, through ablation of multiple linear lesions, ablation of complex fractionated atrial electrograms (CFAE), rotor ablation, isolation of fibrotic and scar tissue up to isolation of the left atrial appendage (LAA); however, it is unclear even to the present day whether these complex and time-consuming strategies actually improve the success rate of ablation therapy...
May 12, 2017: Herz
https://www.readbyqxmd.com/read/28500178/electrical-substrate-elimination-in-135-consecutive-patients-with-brugada-syndrome
#8
Carlo Pappone, Josep Brugada, Gabriele Vicedomini, Giuseppe Ciconte, Francesco Manguso, Massimo Saviano, Raffaele Vitale, Amarild Cuko, Luigi Giannelli, Zarko Calovic, Manuel Conti, Paolo Pozzi, Andrea Natalizia, Simonetta Crisà, Valeria Borrelli, Ramon Brugada, Georgia Sarquella-Brugada, Marco Guazzi, Alessandro Frigiola, Lorenzo Menicanti, Vincenzo Santinelli
BACKGROUND: There is emerging evidence that localization and elimination of abnormal electric activity in the epicardial right ventricular outflow tract may be beneficial in patients with Brugada syndrome. METHODS AND RESULTS: A total of 135 symptomatic Brugada syndrome patients having implantable cardiac defibrillator were enrolled: 63 (group 1) having documented ventricular tachycardia (VT)/ventricular fibrillation (VF) and Brugada syndrome-related symptoms, and 72 (group 2) having inducible VT/VF without ECG documentation at the time of symptoms...
May 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28500177/efficacy-of-an-anatomical-approach-in-radiofrequency-catheter-ablation-of-idiopathic-ventricular-arrhythmias-originating-from-the-left-ventricular-outflow-tract
#9
Takumi Yamada, Naoki Yoshida, Harish Doppalapudi, Silvio H Litovsky, H Thomas McElderry, G Neal Kay
BACKGROUND: When anatomic obstacles preclude radiofrequency catheter ablation of idiopathic ventricular arrhythmias (VAs) originating from the left ventricular outflow tract (LVOT), an alternative approach from the anatomically opposite side (endocardial versus epicardial or above versus below the aortic valve) may be considered (anatomic ablation). The purpose of this study was to investigate the efficacy of an anatomic ablation in idiopathic LVOT VAs. METHODS AND RESULTS: We studied 229 consecutive patients with idiopathic LVOT VAs...
May 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28496076/-early-results-of-complex-fractionated-atrial-electrogram-mapping-guided-atrial-fibrillation-surgery
#10
Kazuaki Fukahara, Mari Sakai, Shigeki Yokoyama, Toshio Doi, Naoki Yoshimura
OBJECTIVE: Although the Cox-maze operation is the standard surgical procedure for permanent atrial fibrillation(AF), conversion to sinus rhythm is limited by patient characteristics, including the duration of AF, atrial size, and voltage of fibrillation waves. A surgical strategy based on structural alteration of the electrical substrates of AF is required to achieve better outcomes of AF surgery. Complex fractionated atrial electrogram (CFAE) plays an important role in the electrical substrate of AF...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28485510/longstanding-persistent-accelerated-idioatrial-rhythm-benign-sinus-node-like-rhythm-or-insidious-rhythm
#11
Hailei Liu, Chao Zhu, Bing Yang, Weizhu Ju, Hongwu Chen, Fengxiang Zhang, Kai Gu, Mingfang Li, Pipin Kojodjojo, Minglong Chen
INTRODUCTION: Detailed description of longstanding persistent accelerated idioatrial rhythm (AIAR) is lacking. This observational study investigated the clinical manifestations, electrophysiological characteristics, diagnosis, treatment and prognosis of this unusual arrhythmia. METHODS AND RESULTS: Fifteen patients (11 males; average age 25.9±15.7 years) suspected with longstanding persistent AIAR were enrolled in our study. All patients had ECG, 24-hour Holter monitoring, isoproterenol provocation test, echocardiogram, and exercise treadmill test...
May 9, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28484842/conventional-mapping-and-ablation-of-focal-ventricular-tachycardias-in-the-healthy-heart
#12
REVIEW
Sonia Busch, Johannes Brachmann, Ahmed Saleh, Mathias Forkmann
Ventricular tachycardias (VT) in the healthy heart, also known as idiopathic VTs, often have a focal origin. Triggered activity due to delayed after-depolarization is the most likely mechanism of focal VTs. Localization of the site of origin of focal VTs is based on activation mapping with or without combination with pace mapping. The characteristic anatomic site of origin of idiopathic VTs is the right and left outflow tract. Other sites include the tricuspid and mitral annulus, the papillary muscles, and Purkinje fibers...
May 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28476679/focal-atrial-tachycardias-from-the-para-hisian-region-strategies-for-mapping-and-catheter-ablation
#13
Jian-du Yang, Qi Sun, Xiao-Gang Guo, Gong-Bu Zhou, Xu Liu, Bin Luo, Hui-Qiang Wei, Jackson J Liang, Shu Zhang, Jian Ma
BACKGROUND: Focal atrial tachycardias (ATs) from the para-Hisian region can be successfully ablated from the right atrial septum (RAS), non-coronary cusp (NCC), and right middle septum (RMS). The optimal mapping and ablation strategy for ATs from these sites remains unclear. OBJECTIVE: We aimed to investigate the electrophysiologic characteristics and optimal ablation sites of para-Hisian ATs from the RAS, RMS, and NCC. METHODS: A total of 362 patients with ATs undergoing radiofrequency catheter ablation of ATs were included...
May 2, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28470984/application-of-the-2015-acc-aha-hrs-guidelines-for-risk-stratification-for-sudden-death-in-adult-patients-with-asymptomatic-pre-excitation
#14
Manoj N Obeyesekere, George J Klein
The management of the asymptomatic pre-excited patient largely hinges on risk stratification and individual patient considerations and choice. A high threshold to treat patients may lead to a small overall risk of death while a low threshold clearly leads to increased invasive testing and ablation with associated cost and procedural risk. A firm recommendation to uniformly assess all by electrophysiology study or, alternatively, reassure all is inappropriate and unjustified by data as reflected in the recent guideline recommendations...
May 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28461795/prolonged-sinus-pauses-upon-termination-of-paroxysmal-atrial-fibrillation-abnormal-right-atrial-electrophysiologic-and-electroanatomic-findings
#15
Zhengyu Bao, Hongwu Chen, Bing Yang, Michael Shehata, Weizhu Ju, Fengxiang Zhang, Gang Yang, Kai Gu, Mingfang Li, Kejiang Cao, Xunzhang Wang, Minglong Chen
The efficacy of pulmonary vein antral isolation for patients with prolonged sinus pauses (PSP) on termination of atrial fibrillation has been reported. We studied the right atrial (RA) electrophysiologic and electroanatomic characteristics in such patients. Forty patients underwent electroanatomic mapping of the RA: 13 had PSP (group A), 13 had no PSP (group B), and 14 had paroxysmal supraventricular tachycardia (control group C). Group A had longer P-wave durations in lead II than did groups B and C (115.5 ± 15...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28457240/arrhythmias-following-the-mustard-and-senning-operations-for-dextro-transposition-of-the-great-arteries-clinical-aspects-and-catheter-ablation
#16
REVIEW
Sherrie Joy Baysa, Melissa Olen, Ronald J Kanter
The atrial switch operations, the Mustard and Senning procedures, performed for dextro-transposition of the great arteries, have largely been supplanted by the arterial switch operation. As such, affected patients will only exist for approximately 30 more years. The main arrhythmias in these patients include sinoatrial node dysfunction, intraatrial reentry tachycardia, and sudden death. Device therapy for these patients is well-established, and catheter ablation for atrial tachycardias is highly efficacious...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457239/ebstein-anomaly
#17
REVIEW
Elizabeth D Sherwin, Dominic J Abrams
Ebstein anomaly is a rare form of congenital heart disease with a uniquely high prevalence of arrhythmias. The most prevalent arrhythmia mechanisms are intrinsic to the underlying embryologic defects and may manifest at any stage. Current electrophysiological and surgical strategies are well equipped to address these arrhythmia mechanisms, yet despite available technology and a robust understanding of the mechanisms, these cases remain challenging. Surgical techniques that render arrhythmia substrates unreachable mandate comprehensive presurgical electrophysiological assessment and potential ablation...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28449531/ablation-of-atrial-fibrillation-single-shot-techniques-poised-to-dominate-rhythm-control-strategies-the-future-is-here
#18
EDITORIAL
Antonis S Manolis
Over the recent years, the advent of single-shot techniques, such as circular catheter and cryoballoon ablation, has ushered in a new era in the catheter ablation approach and rhythm control strategies of patients with atrial fibrillation (AF). These techniques make it easier to navigate the heart and have the potential to decrease the threshold for, expand the access to, and increase patient and physician acceptance of rhythm-control therapies, that may lead to reduction of the AF disease burden and its socioeconomic impact...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28441822/-clinical-features-and-outcomes-of-radiofrequency-catheter-ablation-of-atrial-flutter-in-children
#19
H Jiang, X M Li, Y Zhang, H J Liu, M T Li, H Y Ge
Objective: To explore the clinical features of atrial flutter (AFL) and evaluate the efficacy of radiofrequency catheter ablation (RFCA) for AFL in children. Method: Data were collected and analyzed on 50 consecutive pediatric AFL patients (male 37/female 13) who underwent electrophysiology study and RFCA from February 2009 to November 2016 in a case observational study. The average age was (6.2±3.5) years and body weight was (23.7±13.5) kg. Heart structure was normal in 26 patients. Twenty-four patients had congenital heart disease (CHD) and among them 22 patients underwent repaired surgery before...
April 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28441820/-brief-interpretation-of-the-pediatric-and-congenital-electrophysiology-society-paces-and-the-heart-rhythm-society-hrs-expert-consensus-statement-on-the-use-of-catheter-ablation-in-children-and-patients-with-congenital-heart-disease
#20
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