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Electrophysiology, ablation

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https://www.readbyqxmd.com/read/29777556/electrophysiology-and-structural-interventions-in-adults-with-congenital-heart-disease-comparison-of-combined-versus-separate-procedures
#1
Ian Lindsay, Farnoosh Nik-Ahd, Jamil A Aboulhosn, Jeremy P Moore
BACKGROUND: Electrophysiologic (EP) and structural interventions in adult congenital heart disease (ACHD) are typically completed during separate hospital encounters. With planning/coordination, these cases can be combined. OBJECTIVES: We hypothesized that this integrated approach would yield patient and health system benefits. METHODS: Consecutive ACHD patients undergoing combined interventions were matched to controls with identical but separate procedures...
May 18, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29766449/value-of-an-old-school-approach-safety-and-long-term-success-of-radiofrequency-current-catheter-ablation-of-atrioventricular-nodal-reentrant-tachycardia-in-children-and-young-adolescents
#2
Henrike Siebels, Christian Sohns, Jan-Hendrik Nürnberg, Jürgen Siebels, Klaus Langes, Joachim Hebe
PURPOSE: Radiofrequency current energy (RFC) ablation is still considered as the gold standard for atrioventricular nodal reentrant tachycardia (AVNRT). Success-rates for AVNRT ablation vary irrespective of the ablation technology and strategy. This study aimed to access safety, efficacy, and long-term outcome of RFC catheter ablation for the treatment of AVNRT in children and adolescents aged < 19 years with special focus on modulation versus ablation of the AV nodal slow pathway (SP)...
May 15, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29759784/atrial-tachycardias-after-surgical-atrial-fibrillation-ablation-clinical-characteristics-electrophysiological-mechanisms-and-ablation-outcomes-from-a-large-multicenter-study
#3
Rakesh Gopinathannair, Philip L Mar, Muhammad Rizwan Afzal, Luigi Di Biase, Yixi Tu, Thanmay Lakkireddy, Jaimin R Trivedi, Mark S Slaughter, Andrea Natale, Dhanunjaya Lakkireddy
OBJECTIVES: The clinical characteristics, electrophysiological mechanisms, and ablation outcomes of post-surgical atrial fibrillation ablation (SAFA) atrial tachycardias (ATs) have not been studied in a large, multicenter cohort. BACKGROUND: ATs are often seen following SAFA. METHODS: Analysis was performed on 137 patients (age, 62 ± 10 years; 74% male) who underwent catheter ablation for symptomatic post-SAFA AT from 2004 to 2013 at 3 high-volume institutions in the United States...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759434/pulmonary-vein-re-isolation-as-a-routine-strategy-regardless-of-symptoms-the-pressure-randomized-controlled-trial
#4
Moloy Das, Gareth J Wynn, Yawer Saeed, Sean Gomes, Maureen Morgan, Christina Ronayne, Laura J Bonnett, Johan E P Waktare, Derick M Todd, Mark C S Hall, Richard L Snowdon, Simon Modi, Dhiraj Gupta
OBJECTIVES: The goal of this study was to determine whether a strategy of early re-isolation of pulmonary vein (PV) reconnection in all patients, regardless of symptoms, would reduce the recurrence of atrial fibrillation (AF) and improve quality of life. BACKGROUND: Lasting pulmonary vein isolation (PVI) remains elusive. PV reconnection is strongly linked to the recurrence of arrhythmia. METHODS: A total of 80 patients with paroxysmal AF were randomized 1:1 after contact force-guided PVI to receive either standard care or undergo a repeat electrophysiology study after 2 months regardless of symptoms (repeat study)...
June 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759426/development-of-nonpulmonary-vein-foci-increases-risk-of-atrial-fibrillation-recurrence-after-pulmonary-vein-isolation
#5
Rintaro Hojo, Seiji Fukamizu, Takeshi Kitamura, Yuya Aomyama, Mitsuhiro Nishizaki, Yoichi Kobayashi, Harumizu Sakurada, Masayasu Hiraoka
OBJECTIVES: The aim of this paper was to clarify the impact of nonpulmonary vein foci (NPVF) on atrial fibrillation (AF) recurrence after pulmonary vein (PV) isolation. BACKGROUND: NPVF are considered contributing factors for the recurrence of AF after PV isolation, but their exact role remains unclear. METHODS: We retrospectively reviewed 216 patients (paroxysmal AF, n = 172; persistent AF, n = 44) who underwent a second electrophysiological study 6 months after the original PV isolation...
June 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29754436/unresolved-questions-associated-with-the-management-of-ventricular-pre-excitation-syndrome
#6
REVIEW
Béatrice Brembilla-Perrot, Nicolas Girerd, Jean-Marc Sellal
many recent recommendations concern the management of pre-excitation syndrome. In clinical practice, they are sometimes difficult to use. The purpose of the authors was to discuss the main problems associated with this management. This article is protected by copyright. All rights reserved Three problems are encountered: 1) the reality of the absence of symptoms or the interpretation of atypical symptoms, 2) the electrocardiographic diagnosis of pre-excitation syndrome that can be missed and 3) the exact electrophysiological protocol and its interpretation used for the evaluation of the prognosis Because of significant progress largely related to the development of curative treatment, it seems easy to propose ablation in many patients despite the related risks of invasive studies and to minimize the invasive risk by only performing ablation for patients with at-risk pathways...
May 13, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29753550/rescue-procedure-for-an-electrical-storm-using-robotic-non-invasive-cardiac-radio-ablation
#7
Raphaël Jumeau, Mahmut Ozsahin, Juerg Schwitter, Véronique Vallet, Frédéric Duclos, Michele Zeverino, Raphaël Moeckli, Etienne Pruvot, Jean Bourhis
Stereotactic body radiotherapy (SBRT) is an emerging non-invasive treatment in the management of ventricular tachycardia (VT). We report here an intensive care patient suffering from an electrical storm due to incessant VT, unresponsive to catheter ablation and anti-arrhythmic drugs, showing an immediate and durable response to electrophysiology-guided cardiac SBRT.
May 9, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29735555/genetic-activation-inactivation-and-deletion-reveal-a-limited-and-nuanced-role-for-somatostatin-containing-basal-forebrain-neurons-in-behavioral-state-control
#8
Christelle Anaclet, Roberto De Luca, Anne Venner, Olga Malyshevskaya, Michael Lazarus, Elda Arrigoni, Patrick M Fuller
Recent studies have identified an especially important role for basal forebrain GABAergic (BFVGAT ) neurons in the regulation of behavioral waking and fast cortical rhythms associated with cognition. However, BFVGAT neurons comprise several neurochemically and anatomically distinct sub-populations, including parvalbumin- and somatostatin-containing BFVGAT neurons (BFParv and BFSOM ), and it was recently reported that optogenetic activation of BFSOM neurons increases the probability of a wakefulness to non-rapid-eye movement (NREM) sleep transition when stimulated during the animal's rest period...
May 7, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29721116/ventricular-tachycardia-storm-originating-from-interventricular-septum-successfully-treated-with-surgical-cryoablation-with-electroanatomic-and-electrophysiological-mapping-before-dual-valve-replacement
#9
Iwanari Kawamura, Seiji Fukamizu, Satoshi Miyazawa, Rintaro Hojo, Fusahiko Ito, Masazumi Watanabe, Mitsuhiro Nishizaki, Harumizu Sakurada, Masayasu Hiraoka
A 58-year-old man with dilated cardiomyopathy was admitted with heart failure. He had a history of two catheter ablation procedures for ventricular tachycardia (VT) originating from the intraventricular septum (IVS). Before dual valve replacement (DVR), he suffered a VT storm. An electrophysiological study revealed an extended low-voltage area at the IVS with the exit of the induced VT at the anterior side. Radiofrequency application was performed at the VT exit as a landmark for surgical cryoablation (SA)...
February 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29709577/endocardial-ablation-of-ventricular-ectopic-beats-arising-from-the-basal-infero-septal-process-of-the-left-ventricle
#10
Anthony Li, Zia Zuberi, Jason S Bradfield, John K Zarif, David E Ward, Robert H Anderson, Kalyanam Shivkumar, Magdi M Saba
BACKGROUND: Idiopathic VE shows predilection to sites within the left ventricular base such as the outflow tract/aortic sinuses, LV summit and adjacent to the aorto-mitral continuity. We characterize VE arising from the inferior septum of the LV base that were successfully managed by LV endocardial ablation from the infero-septal recess of the LV. OBJECTIVES: To determine the incidence, electrocardiographic, electrophysiological findings and anatomical features associated with ventricular ectopy (VE) arising from the basal infero-septal process of the left ventricle (ISP-LV) ablated using an LV endocardial approach via the infero-septal recess of the left ventricle...
April 27, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29700862/the-quantitative-assessment-of-epicardial-fat-distribution-on-human-hearts-implications-for-epicardial-electrophysiology
#11
Alexander R Mattson, Mario J Soto, Paul A Iaizzo
INTRODUCTION: Epicardial electrophysiological procedures rely on dependable interfacing with the myocardial tissue. For example, epicardial pacing systems must generate sustainable chronic pacing capture, while epicardial ablations must effectively deliver energy to the target hyper-excitable myocytes. The human heart has a significant adipose layer which may impede epicardial procedures. The objective of this study was to quantitatively assess the relative location of epicardial adipose on the human heart, in order to define locations where epicardial therapies might be performed successfully...
April 26, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29688325/anatomical-hotspots-of-fractionated-electrograms-in-the-left-and-right-atrium-do-they-exist
#12
Roeliene Starreveld, Lisette J M E van der Does, Natasja M S de Groot
Aims: Targeting of complex fractionated electrograms (CFEs) in the atria is not yet beneficial in treating drug-refractory atrial fibrillation (AF). In order to gain insight into potential anatomical hotspots of fractionated electrograms, a structured literature search was performed. Methods and results: PubMed was searched for studies describing fractionation during human atrial electrophysiological measurements (n = 565), of which 36 articles described the pre-ablation distribution of fractionated electrograms for the left atrium and/or right atrium in at least four regions...
April 20, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29685719/groin-haemostasis-with-a-purse-string-suture-for-patients-following-catheter-ablation-procedures-gitar-study
#13
Nicholas Jackson, Michael McGee, Waheed Ahmed, Allan Davies, Jim Leitch, Mark Mills, Matthew Cambourn, Saad Ezad, Andrew Boyle, John Attia, Kumaraswamy Nanthakumar, Malcolm Barlow
BACKGROUND: The most frequent complications from percutaneous electrophysiology procedures relate to vascular access. We sought to perform the first randomised controlled trial for femoral venous haemostasis utilising a simple and novel purse string suture (PSS) technique. METHODS: We randomised 200 consecutive patients who were referred for electrophysiology procedures at two different hospitals to either 10minutes of manual pressure or a PSS over the femoral vein and determined the incidence of vascular access site complications...
March 20, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29678783/safety-and-efficacy-of-stereotactic-radioablation-targeting-pulmonary-vein-tissues-in-an-experimental-model
#14
Paul C Zei, Doug Wong, Edward Gardner, Thomas Fogarty, Patrick Maguire
BACKGROUND: Stereotactic radioablation (SR), a commonly used therapy to treat malignancies, has been utilized to treat refractory ventricular tachycardia, but the feasibility of treating atrial fibrillation (AF) with SR is unknown. OBJECTIVE: We evaluated the safety and efficacy of SR targeting pulmonary vein (PV) antral tissues as potential therapy for AF. METHODS: Seventeen adult canines and two adult swine underwent surgical fiducial marker placement, 3D anatomic rendering CT angiogram of the left atrium (LA), and creation of a treatment plan targeting the right superior pulmonary veins (RSPVs)...
April 17, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29675625/multidetector-ct-of-iatrogenic-and-self-inflicted-vascular-lesions-and-infections-at-the-groin
#15
REVIEW
Massimo Tonolini, Anna Maria Ierardi, Gianpaolo Carrafiello, Domenico Laganà
The number and complexity of endovascular procedures performed via either arterial or venous access are steadily increasing. Albeit associated with higher morbidity compared to the radial approach, the traditional common femoral artery remains the preferred access site in a variety of cardiac, aortic, oncologic and peripheral vascular procedures. Both transarterial and venous cannulation (for electrophysiology, intravenous laser ablation and central catheterisation) at the groin may result in potentially severe vascular access site complications (VASC)...
April 19, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29669504/atrial-fibrillation-in-autoimmune-rheumatic-diseases-from-the-pathogenesis-to-the-treatment
#16
Giuseppe Ciconte, Manuel Conti, Martina Evangelista, Carlo Pappone
BACKGROUND: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in the general population and is associated with an increased number of adverse outcomes. The onset and maintenance of this arrhythmia requires a trigger event and the presence of a predisposing substrate. Atrial fibrosis, a major characteristic of AF-related structural remodeling, represents a process closely related to inflammation as demonstrated by emerging evidence. Aim of this article is to review the evidence linking AF to systemic autoimmune diseases...
April 17, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29667208/the-use-of-cardiac-ct-alone-to-exclude-left-atrial-thrombus-before-atrial-fibrillation-ablation-efficiency-safety-and-cost-analysis
#17
Wassim Mosleh, Ali Sheikh, Zaid Said, Mohamed A Abdel-Aal, Siri Gadde, Tanvi Shah, Michael F Wilson, Hiroko Beck, Chee Kim, Umesh C Sharma
BACKGROUND: Atrial fibrillation (AF) is a growing financial burden on the healthcare system. Cardiac computed tomographic angiography (CCTA) is needed for pulmonary vein mapping before AF ablation (AFA). CCTA has shown to be an alternative to transesophageal echocardiogram (TEE) to rule-out left atrial appendage thrombus (LAAT) pre-AFA. We aim to examine the safety, cost-effectiveness, and time-efficiency of utilizing CCTA alone to rule out LAAT before AFA. METHODS: We prospectively screened patients with paroxysmal AF undergoing cryoablation...
April 17, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29660447/the-usefulness-of-ventricular-pacing-during-atrial-fibrillation-ablation-in-a-persistent-left-superior-vena-cava-a-case-report
#18
Sen Matsumoto, Yasuharu Matsunaga-Lee, Nobutaka Masunaga, Yuzuru Takano
A 69-year-old woman with palpitations was referred to our hospital for a second session of atrial fibrillation (AF) catheter ablation. She had a history of AF ablation including pulmonary vein (PV) isolation and persistent left superior vena cava (PLSVC) isolation. Electrophysiologic studies showed the veno-atrial connections that had recovered. After PV isolation was performed, AF was induced by atrial premature contraction (APC) from the PLSVC, and AF storm occurred. During PLSVC isolation, AF was not induced by APC from the PLSVC...
April 13, 2018: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29658207/ablation-induced-change-in-the-course-of-fascicular-tachycardia
#19
Avishag Laish-Farkash, Avi Sabbag, Michael Glikson, Aharon Glick, Vladimir Khalameizer, Amos Katz, Yoav Michowitz
BACKGROUND: Multiform fascicular tachycardia (FT) was recently described as a ventricular tachycardia (VT) that has a reentrant mechanism using multiple fascicular branches and produces alternate fascicular VT forms. Ablating the respective fascicle may cause a change in the reentrant circuit resulting in a change in morphology. Ablation of the septal fascicle is crucial for successful treatment. OBJECTIVES: To describe four cases of FT in which ablation induced a change in QRS morphologies and aggravated clinical course...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29656325/dosing-of-the-second-generation-cryoballoon-using-acute-time-to-pulmonary-vein-isolation-as-an-indicator-of-durable-ablation-in-a-canine-model
#20
Wilber Su, Nicolas Coulombe, Nicole Kirchhof, Erin Grassl, Dan Wittenberger
BACKGROUND: Rigid time-based dosing protocol(s) currently used in the clinic for cryoballoon ablation of atrial fibrillation may be inadequate to guide the circumferential and transmural cryothermal energy transfer across the pulmonary vein (PV) and may result in injury to collateral tissues or electrical gaps between the PV and left atrium (LA). OBJECTIVE: A physiologic endpoint (e.g., acute time-to-PV isolation a.k.a. time-to-effect; TTE) may be effective in the determination of a transmural lesion formation and may allow for individualized ablation dosing across each PV...
April 14, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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