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Electrophysiology, ablation

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https://www.readbyqxmd.com/read/28433223/risk-of-intraatrial-thrombi-after-thoracoscopic-ablation-in-absence-of-heparin-and-appendage-closure
#1
Petr Budera, Pavel Osmancik, Dalibor Herman, David Talavera, Robert Petr, Zbynek Straka
BACKGROUND: Catheter and surgical ablation of atrial fibrillation (AF) can be associated with a risk of thromboembolic events. The goal of this study was to assess optimal anticoagulation management during thoracoscopic ablation of AF. METHODS: Fifty-two patients with persistent or long-standing persistent AF underwent hybrid ablation consisting of thoracoscopic ablation followed by electrophysiologic (EP) evaluation and consecutive ablation if indicated. The thoracoscopic ablation was performed using three different anticoagulation protocols: (1) without periprocedural heparin and without occlusion of the left atrial appendage; (2) with periprocedural heparin but without left atrial appendage occlusion; and (3) with periprocedural heparin and left atrial appendage occlusion...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28431060/catheter-ablation-vs-antiarrhythmic-drug-therapy-in-patients-with-symptomatic-atrioventricular-nodal-re-entrant-tachycardia-a-randomized-controlled-trial
#2
Demosthenes G Katritsis, Theodoros Zografos, George D Katritsis, Eleftherios Giazitzoglou, Vasilios Vachliotis, George Paxinos, A John Camm, Mark E Josephson
Aims: To conduct a randomized trial in order to guide the optimum therapy of symptomatic atrioventricular nodal re-entrant tachycardia (AVNRT). Methods and Results: Patients with at least one symptomatic episode of tachycardia per month and an electrophysiologic diagnosis of AVNRT were randomly assigned to catheter ablation or chronic antiarrhythmic drug (AAD) therapy with bisoprolol (5 mg od) and/or diltiazem (120-300 mg od). All patients were properly educated to treat subsequent tachycardia episodes with autonomic manoeuvres or a 'pill in the pocket' approach...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28421394/waveform-integrity-in-atrial-fibrillation-the-forgotten-issue-of-cardiac-electrophysiology
#3
Miguel Martínez-Iniesta, Juan Ródenas, Raúl Alcaraz, José J Rieta
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice with an increasing prevalence of about 15% in the elderly. Despite other alternatives, catheter ablation is currently considered as the first-line therapy for the treatment of AF. This strategy relies on cardiac electrophysiology systems, which use intracardiac electrograms (EGM) as the basis to determine the cardiac structures contributing to sustain the arrhythmia. However, the noise-free acquisition of these recordings is impossible and they are often contaminated by different perturbations...
April 18, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28420481/safety-and-feasibility-of-subcutaneous-purse-string-suture-of-the-femoral-vein-after-electrophysiological-procedures-on-uninterrupted-oral-anticoagulation
#4
Marc Kottmaier, Felix Bourier, Tilko Reents, Alina Reiter, Marielouise Kornmayer, Verena Semmler, Martha Telishevska, Katharina Koch-Büttner, Michael Deiss, Stephanie Brooks, Christian Grebmer, Carsten Lennerz, Christoph Kolb, Gabriele Hessling, Isabel Deisenhofer
The aim of this study was to compare safety and feasibility of a subcutaneous purse-string suture (PSS) with manual compression (MC) to gain hemostasis in patients after multiple femoral venous punctures undergoing electrophysiological procedures on uninterrupted oral anticoagulation (OAK). A total of 784 patients who underwent catheter ablation for atrial fibrillation (n = 564) or (a)typical atrial flutter (n = 220) were assessed. Four hundred sixty-two patients received PSS (58.9%) and 322 patients (41...
March 16, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28408649/external-arrhythmia-ablation-using-photon-beams-ablation-of-the-atrioventricular-junction-in-an-intact-animal-model
#5
H Immo Lehmann, Amanda J Deisher, Mitsuru Takami, Jon J Kruse, Limin Song, Sarah E Anderson, Jack T Cusma, Kay D Parker, Susan B Johnson, Samuel J Asirvatham, Robert C Miller, Michael G Herman, Douglas L Packer
BACKGROUND: This study sought to investigate external photon beam radiation for catheter-free ablation of the atrioventricular junction in intact pigs. METHODS AND RESULTS: Ten pigs were randomized to either sham irradiation or irradiation of the atrioventricular junction (55, 50, 40, and 25 Gy). Animals underwent baseline electrophysiological evaluation, cardiac gated multi-row computed tomographic imaging for beam delivery planning, and intensity-modulated radiation therapy...
April 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28407062/voltage-gradient-mapping-and-electrophysiologically-guided-cryoablation-in-children-with-avnrt
#6
Fabrizio Drago, Irma Battipaglia, Mario Salvatore Russo, Romolo Remoli, Vincenzo Pazzano, Gino Grifoni, Greta Allegretti, Massimo Stefano Silvetti
Aims: Recently, voltage gradient mapping of Koch's triangle to find low-voltage connections, or 'voltage bridges', corresponding to the anatomic position of the slow pathway, has been introduced as a method to ablate atrioventricular nodal reentry tachycardia (AVNRT) in children. Thus, we aimed to assess the effectiveness of voltage mapping of Koch's triangle, combined with the search for the slow potential signal in 'low-voltage bridges', to guide cryoablation of AVNRT in children. Methods and results: From June 2015 to May 2016, 35 consecutive paediatric patients (mean age 12...
April 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28403080/characteristics-of-diurnal-ventricular-premature-complex-variation-in-right-ventricular-outflow-tract-arrhythmias-after-catheter-ablation
#7
Shih-Jie Jhuo, Li-Wei Lo, Shih-Lin Chang, Yenn-Jiang Lin, Fa-Po Chung, Yu-Feng Hu, Tze-Fan Chao, Ta-Chuan Tuan, Jo-Nan Liao, Chin-Yu Lin, Yao-Ting Chang, Chung-Hsing Lin, Rohit Walia, Abigail Louise D Te, Shinya Yamada, Sunu Budhi Raharjo, Wei-Hua Tang, Kun-Tai Lee, Wen-Ter Lai, Shih-Ann Chen
Diurnal variations in ventricular tachyarrhythmias (VAs) have been demonstrated in idiopathic arrhythmogenic heart disease. The electrophysiological characteristics of diurnal variations in idiopathic right ventricular outflow tract (RVOT) VA have not previously been elucidated. Sixty-two consecutive patients undergoing catheter ablation for idiopathic RVOT VA (mean age: 42.8 ± 12.3 years, 35 females) were enrolled. The diurnal variation type (group 1, n = 36) was defined as those patients who had most ventricular premature contractions (VPCs) during the night hours by preprocedure Holter recordings...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28402404/long-term-outcome-of-surgical-cryoablation-for-refractory-ventricular-tachycardia-in-patients-with-non-ischemic-cardiomyopathy
#8
Jackson J Liang, Brian P Betensky, Daniele Muser, Erica S Zado, Elad Anter, Nimesh D Desai, David J Callans, Rajat Deo, David S Frankel, Mathew D Hutchinson, David Lin, Michael P Riley, Robert D Schaller, Gregory E Supple, Pasquale Santangeli, Michael A Acker, Joseph E Bavaria, Wilson Y Szeto, Prashanth Vallabhajosyula, Francis E Marchlinski, Sanjay Dixit
Aims: Limited data exist on the long-term outcome of patients (pts) with non-ischemic cardiomyopathy (NICM) and ventricular tachycardia (VT) refractory to conventional therapies undergoing surgical ablation (SA). We aimed to investigate the long-term survival and VT recurrence in NICM pts with VT refractory to radiofrequency catheter ablation (RFCA) who underwent SA. Methods and results: Consecutive pts with NICM and VT refractory to RFCA who underwent SA were included...
April 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28401870/response-of-narrow-qrs-tachycardia-to-premature-atrial-extra-what-is-the-mechanism
#9
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Bharatraj Banavalikar, Sreevilasam Pushpangadhan Abhilash, Anees Thajudeen, Ajitkumar Valaparambil
A 60-year-old woman was referred for radiofrequency catheter ablation of narrow QRS tachycardia that was terminated with intravenous adenosine. Twelve-lead ECG showed no baseline preexcitation. Echocardiogram was essentially normal. The electrophysiological study showed a normal AH interval of 114 ms and HV interval of 48 ms during sinus rhythm. Anterograde study demonstrated no dual AV nodal physiology. Atrial pacing protocols easily and reproducibly induced narrow QRS tachycardia (Fig. 1A & 1B). Premature atrial extra (PAE) stimuli were delivered during the tachycardia (Fig...
November 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/28387462/identification-and-electrophysiological-characterization-of-early-left-atrial-structural-remodeling-as-a-predictor-for-atrial-fibrillation-recurrence-after-pulmonary-vein-isolation
#10
Atsuhiko Yagishita, Dina Sparano, Ivan Cakulev, J Rod Gimbel, Timothy Phelan, Hossam Mustafa, Samer De Oliveira, Judith Mackall, Mauricio Arruda
BACKGROUND: Voltage-guided substrate ablation following pulmonary vein isolation (PVI) improves atrial fibrillation (AF) ablation outcomes. However, by setting upper voltage cutoff of 0.5 mV during sinus rhythm (SR) to guided substrate ablation using electroanatomic voltage mapping (EAVM), mildly affected low voltage area (maLVA) may be undetected. We sought to determine the optimal bipolar voltage cutoff to identify maLVA, its electrogram complexity, and the implication on ablation outcome...
April 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28357564/the-use-of-nonhuman-primate-models-to-understand-processes-in-parkinson-s-disease
#11
REVIEW
Javier Blesa, Inés Trigo-Damas, Natalia López-González Del Rey, José A Obeso
Research with animal models has led to critical health advances that have saved or improved the lives of millions of human beings. Specifically, nonhuman primate's genetic and anatomo-physiological similarities to humans are especially important for understanding processes like Parkinson's disease, which only occur in humans. Unambiguously, the unique contribution made by nonhuman primate research to our understanding of Parkinson's disease is widely recognized. For example, monkeys with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) parkinsonisms are responsive to dopamine replacement therapies, mimicking what is seen in PD patients...
March 29, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28340110/peri-mitral-atrial-flutter-personalized-ablation-strategy-based-on-arrhythmogenic-substrate
#12
Jinbo Yu, Kai Chen, Bing Yang, Fengxiang Zhang, Weizhu Ju, Hongwu Chen, Gang Yang, Mingfang Li, Benqi Wang, Kai Gu, Feifan Ouyang, Siew Yen Ho, Sunny Po, Minglong Chen
Aims: The aim of this study is to characterize the arrhythmogenic substrate for peri-mitral atrial flutter (PMAFL), thereby determining a personalized ablation strategy to treat PMAFL. Methods and results: Thirty-six consecutive PMAFL patients (mean age: 63.8 ± 11.3, 23 males) underwent detailed three-dimensional electroanatomic mapping in left atrium (LA). The LA was divided into septal-anterior wall (SAW), posterior inferior wall (PIW), and mitral isthmus (MI) region, respectively...
March 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28335032/allele-specific-ablation-rescues-electrophysiological-abnormalities-in-a-human-ips-cell-model-of-long-qt-syndrome-with-a-calm2-mutation
#13
Yuta Yamamoto, Takeru Makiyama, Takeshi Harita, Kenichi Sasaki, Yimin Wuriyanghai, Mamoru Hayano, Suguru Nishiuchi, Hirohiko Kohjitani, Sayako Hirose, Jiarong Chen, Fumika Yokoi, Taisuke Ishikawa, Seiko Ohno, Kazuhisa Chonabayashi, Hideki Motomura, Yoshinori Yoshida, Minoru Horie, Naomasa Makita, Takeshi Kimura
Background: Calmodulin is a ubiquitous Ca 2+ sensor molecule encoded by three distinct calmodulin genes, CALM1-3 . Recently, mutations in CALM1-3 have been reported to be associated with severe early-onset long-QT syndrome (LQTS). However, the underlying mechanism through which heterozygous calmodulin mutations lead to severe LQTS remains unknown, particularly in human cardiomyocytes. Objectives: We aimed to establish an LQTS disease model associated with a CALM2 mutation (LQT15) using human induced pluripotent stem cells (hiPSCs) and to assess mutant allele-specific ablation by genome editing for the treatment of LQT15...
March 1, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28328585/mechanical-support-with-impella-during-malignant-arrhythmia-ablation-a-case-report-on-the-growing-trend-in-the-electrophysiology-laboratory
#14
Adam C Adler, Ramesh Kodavatiganti
Congenitally corrected transposition of the great arteries is a rare form of congenital heart disease in which the persistence of the right ventricle as the systemic ventricle leads to heart failure, tricuspid valve insufficiency, and arrhythmia. Supraventricular arrhythmias are especially common in these patients. We discuss the anesthetic management of a 33-year-old patient with congenitally corrected transposition of the great arteries who required a ventricular assist device to maintain cardiac output during ablation of supraventricular tachyarrythmia...
March 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28324925/non-invasive-imaging-of-ventricular-activation-during-pacing-and-arrhythmia-methods-and-validation
#15
Long Yu, Steven Pogwizd, Bin He
Cardiovascular disease continued to be a leading killer world widely. Each year, about 400,000 cases of sudden cardiac arrest are reported in the U.S. alone. Clinically, radio-frequency ablative procedure has become widely applied in the treatment of ventricular arrhythmia. Non-invasive approaches have been demonstrated to be able to provide important information on the arrhythmogenesis and potentially assist in the clinical practice. In this work, we develop and validate a novel temporal sparse based imaging method, Cardiac Electrical Sparse Imaging (CESI)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28320941/potent-neuroprotection-after-stroke-afforded-by-a-double-knot-spider-venom-peptide-that-inhibits-acid-sensing-ion-channel-1a
#16
Irène R Chassagnon, Claudia A McCarthy, Yanni K-Y Chin, Sandy S Pineda, Angelo Keramidas, Mehdi Mobli, Vi Pham, T Michael De Silva, Joseph W Lynch, Robert E Widdop, Lachlan D Rash, Glenn F King
Stroke is the second-leading cause of death worldwide, yet there are no drugs available to protect the brain from stroke-induced neuronal injury. Acid-sensing ion channel 1a (ASIC1a) is the primary acid sensor in mammalian brain and a key mediator of acidosis-induced neuronal damage following cerebral ischemia. Genetic ablation and selective pharmacologic inhibition of ASIC1a reduces neuronal death following ischemic stroke in rodents. Here, we demonstrate that Hi1a, a disulfide-rich spider venom peptide, is highly neuroprotective in a focal model of ischemic stroke...
April 4, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28320262/intracardiac-electrophysiological-conduction-parameters-in-adult-dogs
#17
Alicja Cepiel, Agnieszka Noszczyk-Nowak, Robert Pasławski, Adrian Janiszewski, Urszula Pasławska
BACKGROUND: Invasive electrophysiology study (EPS) is one of the most important adjunct tests for the evaluation of arrhythmias in human medicine. Moreover, it is a vital procedure conducted prior to, and after, radiofrequency ablation. However, EPS is neither well known, nor widely used in veterinary medicine. OBJECTIVE: To define the values for intracardiac conduction parameters determined during invasive EPS in dogs. ANIMALS AND METHODS: The study included 16 admitted dogs of various breeds, sex and ages and 6 control Beagles...
March 21, 2017: Veterinary Quarterly
https://www.readbyqxmd.com/read/28285382/impact-of-deep-sedation-on-the-electrophysiological-behavior-of-pulmonary-vein-and-non-pv-firing-during-catheter-ablation-for-atrial-fibrillation
#18
Ryohsuke Narui, Seiichiro Matsuo, Ryota Isogai, Kenichi Tokutake, Kenichi Yokoyama, Mika Kato, Keiichi Ito, Shin-Ichi Tanigawa, Seigo Yamashita, Michifumi Tokuda, Keiichi Inada, Kenri Shibayama, Satoru Miyanaga, Kenichi Sugimoto, Michihiro Yoshimura, Teiichi Yamane
PURPOSE: Catheter ablation for atrial fibrillation is performed with and without deep sedation, which could affect the arrhythmogenic activity during the procedure. We investigated the impact of sedation on electrophysiological properties in patients with AF who underwent catheter ablation. METHODS: This study consisted of 255 consecutive patients with atrial fibrillation (229 males, persistent: 105 patients) who underwent a single-catheter ablation procedure. The patients were divided into the following two groups according to the depth of sedation during the procedure: group M (mild sedation with flunitrazepam in 138 patients) and group D (deep sedation with propofol in 117 patients)...
March 11, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28283739/persistent-tachycardia-within-isolated-pulmonary-veins-during-atrial-fibrillation-ablation
#19
Kenichiro Yamagata, Atsushi Doi, Hiro Kawata, Hisaki Makimoto, Teruki Yokoyama, Yuko Inoue, Hideo Okamura, Takashi Noda, Wataru Shimizu, Naohiko Aihara, Takayuki Maki, Shiro Kamakura, Kengo Kusano, Kazuhiro Satomi
During circumferential pulmonary vein (PV) isolation for ongoing atrial fibrillation (AF), distinguishing passive conduction to the pulmonary vein (PV) from rapid PV arrhythmia in the isolated PV is difficult. Hence, the purpose of this study is to investigate both the feasibility of distinguishing the PV tachycardia after circumferential PV isolation and the electrophysiological characteristics of these tachycardia. Among 178 consecutive patients who underwent circumferential PV isolation during ongoing AF, fibrillatory PV converted to a regular cycle length PV tachycardia independent of the atrial rhythm (=independent PV tachycardia) in 13 PVs among 12 (7%) patients...
March 10, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28275856/-window-sliding-analysis-combined-with-high-density-and-rapid-electroanatomical-mapping-its-efficacy-and-the-outcome-of-catheter-ablation-of-atrial-tachycardia
#20
Kosuke Nakasuka, Koji Miyamoto, Takashi Noda, Tsukasa Kamakura, Mitsuru Wada, Ikutaro Nakajima, Kohei Ishibashi, Yuko Inoue, Hideo Okamura, Satoshi Nagase, Takeshi Aiba, Shiro Kamakura, Wataru Shimizu, Teruo Noguchi, Toshihisa Anzai, Satoshi Yasuda, Nobuyuki Ohte, Kengo Kusano
Atrial tachycardia (AT) is a clinically challenging arrhythmia that can occur based on atrial substrates. Nowadays, a rapid construction of three-dimensional electroanatomical maps, which has an analysis function for complex arrhythmias, named 'Window Sliding' (WS) is available. However, little data has revealed the efficacy of this mapping strategy. The aim of this study was to investigate the efficacy of the WS analysis for AT treatments. All patients underwent electrophysiological studies during ATs and the characteristics of the ATs were analyzed using rapid high-density mapping followed by the WS analysis...
March 8, 2017: Heart and Vessels
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