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Electrophysiology, ablation

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https://www.readbyqxmd.com/read/28797676/electrogram-signature-of-specific-activation-patterns-analysis-of-atrial-tachycardias-at-high-density-endocardial-mapping
#1
Antonio Frontera, Masateru Takigawa, Ruairidh Martin, Nathaniel Thompson, Ghassen Cheniti, Gregoire Massouille, Josselin Duchateau, JeanYves Wielandts, Elvis Teijera, Takeshi Kitamura, Michael Wolf, Nora Al-Jefairi, Konstantinos Vlachos, Seigo Yamashita, Sana Amraoui, Arnaud Denis, Meleze Hocini, Hubert Cochet, Frederic Sacher, Pierre Jaïs, Michel Haïssaguerre, Nicolas Derval
BACKGROUND: The significance of fractionated electrograms (EGMs) is object of debate with multiple mechanisms described. OBJECTIVE: Using Rhythmia™, a high-density mapping system, we sought to investigate the relationship between specific electrophysiological phenomena and EGM characteristics at those sites. METHODS: 25 consecutive patients underwent High Density (HD) atrial mapping during Atrial Tachycardias (ATs). Bipolar EGMs were recorded with a 64-electrode basket catheter...
August 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28794085/idiopathic-ventricular-arrhythmias-originating-from-the-parietal-band-electrocardiographic-and-electrophysiological-characteristics-and-outcome-of-catheter-ablation
#2
Takumi Yamada, Naoki Yoshida, Taihei Itoh, Silvio H Litovsky, Harish Doppalapudi, H Thomas McElderry, G Neal Kay
BACKGROUNDS: The parietal band is one of the muscle bands in the right ventricle. This study investigated the electrocardiographic and electrophysiological characteristics and ablation outcome of idiopathic ventricular arrhythmias (VAs) originating from the parietal band. METHODS AND RESULTS: We studied 14 patients with idiopathic VA origins in the parietal band among 294 consecutive patients with VA origins in the right ventricle. The QRS morphologies of the parietal band VAs were characterized by a left bundle branch block and left inferior (n=12) or superior (n=2) axis pattern with the presence of a notch in the middle of the QRS in all cases, precordial transition at ≤lead V3 in 7 patients, and a slow QRS onset in 4 patients...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28791747/ecg-morphology-of-premature-ventricular-contractions-predicts-presence-of-myocardial-fibrotic-substrate-on-cardiac-magnetic-resonance-imaging-in-patients-undergoing-ablation
#3
Sabrina Oebel, Borislav Dinov, Arash Arya, Sebastian Hilbert, Philipp Sommer, Andreas Bollmann, Gerhard Hindricks, Ingo Paetsch, Cosima Jahnke
BACKGROUND: The most likely origin of PVCs may be deduced from surface ECG analysis while planning an electrophysiological study (EPS). Apart from purely benign forms of increased ventricular ectopy, myocardial substrate (e.g., regional fibrosis) may be present in certain cases, which will significantly impact the ablation approach. CMR imaging can reliably identify fibrotic target lesions and, hence, may assist in adequate patient selection and procedural planning. METHODS AND RESULTS: We analyzed 101 patients (59% male, mean age 57...
August 9, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28790104/first-in-man-analysis-of-the-relationship-between-electrical-rotors-from-noninvasive-panoramic-mapping-and-atrial-fibrosis-from-magnetic-resonance-imaging-in-patients-with-persistent-atrial-fibrillation
#4
Christian Sohns, Christine Lemes, Andreas Metzner, Thomas Fink, Mikhail Chmelevsky, Tilman Maurer, Margarita Budanova, Vladislav Solntsev, Walther H W Schulze, Wieland Staab, Shibu Mathew, Christian Heeger, Bruno Reißmann, Eugene Kholmovski, Dietmar Kivelitz, Feifan Ouyang, Karl-Heinz Kuck
BACKGROUND: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging can be used to evaluate characteristics of atrial fibrosis. The novel noninvasive epicardial and endocardial electrophysiology system (NEEES) allows for the identification of sources with rotor activity. This study describes a new technique to examine the relationship between rotors and LGE signal intensity in patients with persistent atrial fibrillation (PERS) scheduled for ablation. METHODS AND RESULTS: Ten consecutive patients underwent pulmonary vein isolation for persistent atrial fibrillation...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28780623/effect-of-a-photosensitization-reaction-performed-during-the-first-3%C3%A2-min-after-exposure-of-rat-myocardial-cells-to-talaporfin-sodium-in-vitro
#5
Marika Doi, Emiyu Ogawa, Tsunenori Arai
To better understand the mechanism of photodynamic cardiac ablation, we studied the effects of a photosensitization reaction (PR) performed during the first 3 min after rat myocardial cells were exposed to talaporfin sodium. A 3-mm-square microelectrode array with 64 electrodes was used to continuously measure the action potentials of the myocardial cells. A 30 μg/mL talaporfin sodium solution, a chlorine photosensitizer, was used, along with a 663-nm red diode laser (86 mW/cm(2) for up to 600 s). The first trough of the measured action potential waveform corresponding to Na(+) dynamics decreased exponentially with increasing PR duration...
August 5, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28770255/massive-accumulation-of-myofibroblasts-in%C3%A2-the-critical-isthmus-is-associated-with%C3%A2-ventricular-tachycardia-inducibility-in%C3%A2-post-infarct-swine-heart
#6
Tarvinder S Dhanjal, Nicolas Lellouche, Christopher J von Ruhland, Guillaume Abehsira, David H Edwards, Jean-Luc Dubois-Randé, Konstantinos Moschonas, Emmanuel Teiger, Alan J Williams, Christopher H George
OBJECTIVES: In this study the authors determined the extent of cellular infiltration and dispersion, and regional vascularization in electrophysiologically (EP) defined zones in post-myocardial infarction (MI) swine ventricle. BACKGROUND: The critical isthmus (CI) in post-MI re-entrant ventricular tachycardia (VT) is a target for catheter ablation. In vitro evidence suggests that myofibroblasts (MFB) within the scar border zone (BZ) may increase the susceptibility to slow conduction and VT, but whether this occurs in vivo remains unproven...
July 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28767385/left-anterior-descending-coronary-artery-dissection-during-ventricular-tachycardia-ablation-case-report
#7
Kordic Kresimir, Manola Sime, Zeljkovic Ivan, Benko Ivica, Pavlovic Nikola
Fascicular left ventricular tachycardia (VT) is the second most frequent idiopathic left VT in the setting of a structurally normal heart. Catheter ablation is curative in most patients with low complication rates. We report a case of ostial left anterior descending coronary artery (LAD) occlusion during fascicular ventricular tachycardia ablation. Dissection was the most likely cause of LAD obstruction. To the authors' best knowledge, this is the first case reporting selective LAD dissection during electrophysiology study with no left main coronary artery (LMCA) affection...
July 26, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28766834/transseptal-puncture-using-surgical-electrocautery-in-children-and-adults-with-and-without-complex-congenital-heart-disease
#8
Srinath T Gowda, Athar M Qureshi, Daniel Turner, Nitin Madan, Justin Weigand, Richard Lorber, Harinder R Singh
BACKGROUND: Atrial transseptal puncture (TSP) for cardiac catheterization procedures remain challenging in children and adults with complex congenital heart disease (CHD). OBJECTIVES: We sought to evaluate our experience using radiofrequency (RF) current via surgical electrocautery needle for TSP to facilitate diagnostic and interventional procedures. METHODS: Retrospective chart review of all patients (pts) who underwent TSP using RF energy (10-25 W) via surgical electrocautery from three centers from January 2011 to January 2017 were evaluated...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28765754/radiofrequency-catheter-ablation-is-effective-for-atrial-fibrillation-patients-with-hypertrophic-cardiomyopathy-by-decreasing-left-atrial-pressure
#9
Hiroki Ikenaga, Yukiko Nakano, Noboru Oda, Kazuyoshi Suenari, Akinori Sairaku, Takehito Tokuyama, Hiroshi Kawazoe, Hiroya Matsumura, Shunsuke Tomomori, Yasuki Kihara
BACKGROUND: Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) refractory to medical therapy remains controversial in patients with hypertrophic cardiomyopathy (HCM); the acute effects on the direct left atrial (LA) pressure are not completely understood. METHODS: We consecutively studied patients with HCM (n=15) and without HCM (NHCM, n=106) who underwent extensive encircling pulmonary vein isolation for drug-refractory AF. We compared clinical parameters, echocardiographic parameters, electrophysiological parameters, LA pressures using hemodynamic catheterization and recurrence rate in both groups...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28758758/-thoracoscopic-epicardial-ablation-of-atrial-fibrillation-using-the-cobra-fusion-system-as-the-first-part-of-hybrid-ablation
#10
P Budera, P Osmančík, D Talavera, R Fojt, A Kraupnerová, J Žďárská, T Vaněk, Z Straka
INTRODUCTION: Treatment of persistent and long-standing persistent atrial fibrillation is not successfully managed by methods of catheter ablation or pharmacotherapy. Hybrid ablation (i.e. combination of minimally invasive surgical ablation, followed by electrophysiological assessment and subsequent endocardial catheter ablation to complete the entire intended procedure) presents an ever more used and very promising treatment method. METHOD: Patients underwent thoracoscopic ablation of pulmonary veins and posterior wall of the left atrium (the box-lesion) with use of the COBRA Fusion catheter; thoracoscopic occlusion of the left atrial appendage using the AtriClip system was also done in later patients...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28751003/follow-up-of-children-or-teenagers-with-paroxysmal-supraventricular-tachycardia-but-without-pre-excitation-syndrome
#11
Béatrice Brembilla-Perrot, Arnaud Olivier, Thibaut Villemin, Vladimir Manenti, Julie Vincent, Anne Moulin-Zinsch, Jean-Paul Lethor, Anne Tisserant, François Marçon, Sellal Jean Marc
BACKGROUND: Paroxysmal supraventricular tachycardia (SVT) is considered benign in children if the electrocardiogram in sinus rhythm is normal, but causes anxiety in parents, children and doctors. AIMS: To report on the clinical and electrophysiological data from children with SVT, their follow-up and management. METHODS: Overall, 188 children/teenagers (mean age 15±2.8 years) with a normal electrocardiogram in sinus rhythm were studied for SVT, and followed for 2...
July 24, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28735009/serotonergic-network-in-the-subesophageal-zone-modulates-the-motor-pattern-for-food-intake-in-drosophila
#12
Andreas Schoofs, Sebastian Hückesfeld, Michael J Pankratz
The functional organization of central motor circuits underlying feeding behaviors is not well understood. We have combined electrophysiological and genetic approaches to investigate the regulatory networks upstream of the motor program underlying food intake in the Drosophila larval central nervous system. We discovered that the serotonergic network of the CNS is able to set the motor rhythm frequency of pharyngeal pumping. Pharmacological experiments verified that modulation of the feeding motor pattern is based on the release of serotonin...
July 19, 2017: Journal of Insect Physiology
https://www.readbyqxmd.com/read/28733782/catheter-ablation-of-atrial-fibrillation-an-overview-for-clinicians
#13
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/28732009/effects-of-local-cardiac-denervation-on-cardiac-innervation-and-ventricular-arrhythmia-after-chronic-myocardial-infarction
#14
Xudong Liu, Lin Sun, Jugang Chen, Yingying Jin, Qing Liu, Zhongnan Xia, Liang Wang, Jingjie Li
BACKGROUND: Modulation of the autonomic nervous system (ANS) has already been demonstrated to display antiarrhythmic effects in patients and animals with MI. In this study, we investigated whether local cardiac denervation has any beneficial effects on ventricular electrical stability and cardiac function in the chronic phase of MI. METHODS: Twenty-one anesthetized dogs were randomly assigned into the sham-operated, MI and MI-ablation groups, respectively. Four weeks after local cardiac denervation, LSG stimulation was used to induce VPCs and VAs...
2017: PloS One
https://www.readbyqxmd.com/read/28730651/a-comparison-of-the-electrophysiologic-and-electroanatomic-characteristics-between-the-right-and-left-atrium-in-persistent-atrial-fibrillation-is-the-right-atrium-a-window-into-the-left
#15
Sandeep Prabhu, Aleksandr Voskoboinik, Alex Ja McLellan, Kah Y Peck, Bupesh Pathik, Chrishan J Nalliah, Geoff R Wong, Sonia M Azzopardi, Geoffrey Lee, Justin Mariani, Liang-Han Ling, Andrew J Taylor, Jonathan M Kalman, Peter M Kistler
INTRODUCTION: The right atrium (RA) is readily accessible; however, it is unclear whether changes in the RA are representative of the LA. We performed detailed bi-atrial electroanatomic mapping to determine the electrophysiological relationship between the atria. METHODS AND RESULTS: Consecutive patients with persistent AF underwent bi-atrial electroanatomical mapping with a contact force catheter acquiring points with a CF > 10 g prior to ablation. Points were analyzed for tissue voltage, complex electrograms, low voltage (< 0...
July 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28727191/anterior-pericardial-access-to-facilitate-electrophysiology-study-and-catheter-ablation-of-ventricular-arrhythmias-a-single-tertiary-center-experience
#16
Ali R Keramati, Deeptankar DeMazumder, Satish Misra, Jonathan Chrispin, Fabrizio R Assis, Chava Raghuram, Swati Dey, Hugh Calkins, Harikrishna Tandri
INTRODUCTION: Epicardial ablation is becoming an important part of management in patients with ventricular tachycardia (VT). Posterior epicardial access via the Sosa or Needle-in-Needle (NIN) approach for epicardial VT ablation is considered to be the method of choice for most electrophysiologists. Anterior epicardial access as an alternative technique has recently been proposed, but there is limited data about its safety, efficacy and the rate of immediate complications. In this study, we report our experience with anterior epicardial access between 2009 and 2016...
July 20, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28726656/anxiety-levels-in-patients-with-paroxy-smal-supraventricular-tachycardia-in-relation-with-the-patient-demographics-type-of-supraventricular-tachycardia-and-their-personality-type
#17
G Papiashvili, N Tabagari-Bregvadze, J Brugada
The aim of the study was to evaluate the incidence of different personality types and state and trait anxiety levels in patients with paroxysmal supraventricular tachycardia and their association with patients age, gender and the mechanism of the paroxysmal SVT. 62 patients with documented paroxysmal supraventricular tachycardia who underwent endocardial eletrophysiological study and catheter ablation of the paroxysmal SVT were included in the study. The patients were asked to fill out the Myers-Brigss Type Indicator and State-Trait Anxiety Inventory questionnaires and the results were analyzed and correlated with the arrhythmia mechanism determined during electrophysiological study and catheter ablation procedure, and the patients' demographics (age and gender)...
June 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28722339/structured-pain-management-reduces-patient-discomfort-after-catheter-ablation-and-rhythm-device-surgery
#18
M Dörschner, A Bollmann, B Dinov, S Richter, M Döring, A Arya, A Müssigbrodt, S Kircher, N Dagres, P Sommer, G Hindricks, K Bode
BACKGROUND: The goal was to test the effectiveness of a structured pain management programme after invasive electrophysiological interventions in cardiology including ablation of atrial fibrillation (AF) or ventricular tachycardia (VT) and implantation, or explantation, of pacemakers or implantable cardioverter defibrillators. METHODS: This was a prospective study with a pre-/post-design where a post-intervention group (116 consecutive patients) was compared to a pre-intervention group (102 consecutive patients) after implementation of a structured pain-management programme using the numeric rating scale (NRS 0-10) and classified as moderate-to-severe if NRS > 3...
July 18, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28719150/can-principles-of-the-surface-potential-be-combined-with-knowledge-of-natural-products-to-reduce-atrial-rhythm-disturbances
#19
EDITORIAL
H Ni, K Narsingani, H Zhang, W R Giles
Long lasting or chronic electrophysiological abnormalities in human atria are significant contributors to morbidity during healthy aging. Although both paroxysmal (brief) and chronic atrial fibrillation (AF) were considered to be benign; the notable association between maintained AF and stroke has resulted in AF now being a target for surgical intervention (ablation) and/or drug therapy. An interesting, forward looking paper from the Elinder Group(1) in this issue of Acta Physiologica reveals novel pharmacological agents and principles that could be the basis for more effective antiarrhythmic therapies for AF...
July 18, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28708765/distinct-behavioral-responses-evoked-by-selective-optogenetic-stimulation-of-the-major-trpv1-and-mrgd-subsets-of-c-fibers
#20
Hélène Beaudry, Ihab Daou, Ariel R Ase, Alfredo Ribeiro-da-Silva, Philippe Séguéla
Primary C-fiber nociceptors are broadly divided into peptidergic and non-peptidergic afferents. TRPV1 is a thermosensitive cation channel mainly localized in peptidergic nociceptors whereas MrgD is a sensory G protein-coupled receptor expressed in most non-peptidergic nociceptive afferents. TRPV1 and MrgD fibers have been reported to be primarily involved in thermal and mechanical nociception, respectively. Yet, their functional assessment in somatosensory transmission relied on ablation strategies that do not account for compensatory mechanisms...
July 12, 2017: Pain
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