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ablation,stent,atrial fibrilation,

Dirk Prochnau, Ralf Surber, Matthias Hoyme, Sylvia Otto, Anna Selle, Tudor C Poerner
Atrial fibrillation (AF) is a frequent reason for emergency department visits. According to current guidelines either rate- or rhythm-control are acceptable therapeutic options in such situations. In this report, we present the complicated clinical course of a patient with AF and a rapid ventricular response. Because of paroxysmal AF, the patient was on chronic oral anticoagulation therapy with warfarin. Pharmacological treatment was ineffective to control ventricular rate, and immediate synchronized electrical cardioversion was performed...
September 13, 2016: CJEM
Nikos Papageorgiou, Alexandros Briasoulis, George Lazaros, Massimo Imazio, Dimitris Tousoulis
AIMS: Colchicine has been suggested to be beneficial in preventing recurrent pericarditis. The goal of this study was to review all randomized controlled trials that assess the use of colchicine for the prevention and treatment of cardiac diseases. METHODS: We performed a meta-analysis of the effects of colchicine on pericarditis, post-pericardiotomy syndrome and post-procedural atrial fibrillation recurrence, in-stent restenosis, gastrointestinal adverse effects and treatment discontinuation rates...
August 31, 2016: Cardiovascular Therapeutics
Hawa Edriss, Tatiana Denega, Victor Test, Kenneth Nugent
Radiofrequency catheter ablation has become a widely used intervention in the treatment of atrial fibrillation. Pulmonary vein stenosis (PVS) is one of the most serious complications associated with this procedure; the degree of stenosis ranges from mild (<50%) to complete venous occlusion. The natural history of PVS and the risk of progression of existing PVS are uncertain. Symptomatic and/or severe PVS is a serious medical problem and can be easily misdiagnosed since it is an uncommon and relatively new medical problem, often has low clinical suspicion among clinicians, and has a non-specific presentation that mimics other more common respiratory or cardiac diseases...
August 2016: Respiratory Medicine
Silanath Terpenning, Loren H Ketai, Shawn D Teague, Stacy M Rissing
BACKGROUND: Atrial fibrillation (AF) may be the cause or sequela of left atrial abnormalities and variants. PURPOSE: To determine the prevalence of left atrial (LA) abnormalities in AF patients compared to normal sinus rhythm (NSR) patients. MATERIAL AND METHODS: We retrospectively reviewed 281 cardiac CT examinations from 2010 to 2012, excluding patients with prior pulmonary vein ablation, known coronary artery disease, prior coronary stent placement, or coronary artery bypass grafts...
June 2016: Acta Radiologica Open
Claire McCune, Peter McKavanagh, Ian B A Menown
INTRODUCTION: Multiple significant, potentially practice changing clinical trials in cardiology have been conducted and subsequently presented throughout the past year. METHODS: In this paper, the authors have reviewed and contextualized significant cardiovascular clinical trials presented at major international conferences of 2015 including American College of Cardiology, European Association for Percutaneous Cardiovascular Interventions, American Diabetes Association, European Society of Cardiology, Transcatheter Cardiovascular Therapeutics, Heart Rhythm Congress, and the American Heart Association Scientific Sessions...
June 8, 2016: Cardiology and Therapy
Jonathan Rosenberg, Westby G Fisher, Mayra Guerrero, Steve Smart, Justin Levisay, Ted Feldman, Michael Salinger
Pulmonary vein stenosis (PVS) is an uncommon but serious complication following radiofrequency ablation for atrial fibrillation. Occurrence of this complication has risen with increased rates of ablation procedures, with >50,000 AF ablation procedures performed per year, and can occur within weeks to months post procedure. Currently, the main therapies for PVS include percutaneous interventions with balloon angioplasty and stenting, but these treatments are complicated by a high rate of restenosis. The optimal treatment for recurrent pulmonary vein in-stent restenosis has not been determined...
May 2016: Journal of Invasive Cardiology
Hans-Christoph Diener, James Aisenberg, Jack Ansell, Dan Atar, Günter Breithardt, John Eikelboom, Michael D Ezekowitz, Christopher B Granger, Jonathan L Halperin, Stefan H Hohnloser, Elaine M Hylek, Paulus Kirchhof, Deirdre A Lane, Freek W A Verheugt, Roland Veltkamp, Gregory Y H Lip
Patients with atrial fibrillation (AF) have a high risk of stroke and mortality, which can be considerably reduced by oral anticoagulants (OAC). Recently, four non-vitamin-K oral anticoagulants (NOACs) were compared with warfarin in large randomized trials for the prevention of stroke and systemic embolism. Today's clinician is faced with the difficult task of selecting a suitable OAC for a patient with a particular clinical profile or a particular pattern of risk factors and concomitant diseases. We reviewed analyses of subgroups of patients from trials of vitamin K antagonists vs...
February 4, 2016: European Heart Journal
Chien-Ming Lo, Hung-I Lu, Yen-Yu Chen, Jen-Ping Chang
BACKGROUND: Radiofrequency catheter ablation for paroxysmal atrial fibrillation is well established but not drawback free. Pulmonary vein stenosis is one of the complications and usually treated with stenting with the disadvantages of high re-stenosis rate and anticoagulant dependence. CASE PRESENTATION: Herein, we present the case of a 47 year-old lady, who suffered from fever and hemoptysis due to right inferior pulmonary vein occlusion after radiofrequency catheter ablation for paroxysmal atrial fibrillation...
2016: Journal of Cardiothoracic Surgery
Howard A Fink, Laura S Hemmy, Roderick MacDonald, Maureen H Carlyle, Carin M Olson, Maurice W Dysken, J Riley McCarten, Robert L Kane, Santiago A Garcia, Indulis R Rutks, Jeannine Ouellette, Timothy J Wilt
BACKGROUND: Risks for intermediate- and long-term cognitive impairment after cardiovascular procedures in older adults are poorly understood. PURPOSE: To summarize evidence about cognitive outcomes in adults aged 65 years or older at least 3 months after coronary or carotid revascularization, cardiac valve procedures, or ablation for atrial fibrillation. DATA SOURCES: MEDLINE, Cochrane, and Scopus databases from 1990 to January 2015; ClinicalTrials...
July 21, 2015: Annals of Internal Medicine
Juan Carlos Rama-Merchan, Ignacio Cruz-González, Javier Martín-Moreiras, Francisco Javier García-Fernández, Pedro L Sánchez
Pulmonary vein (PV) stenosis (PVS) is a known complication of PV isolation procedures for AF (atrial fibrillation). PV angioplasty and stenting have been used as an effective therapy for PVS, yet high rates of restenosis are common. Experience with intravascular ultrasound (IVUS) in evaluating the PVS morphological characteristics and appropriate stent deployment is very limited. Furthermore, the use of IVUS could minimise the risk of restenosis. We describe the case of a patient with sub-occlusion of the left superior PV and total occlusion of the left inferior PV following catheter ablation for AF treated by stenting with IVUS guidance...
September 2015: Heart, Lung & Circulation
Julie Kalabalik, Gail B Rattinger, Jesse Sullivan, Malgorzata Slugocki, Antonia Carbone, Anastasia Rivkin
Atrial fibrillation is a commonly encountered arrhythmia associated with increased risk for thromboembolic events. Anticoagulation is necessary to decrease the risk of ischemic stroke. Traditionally, warfarin has been the only oral pharmacotherapeutic option for long-term anticoagulation in patients with nonvalvular atrial fibrillation (NVAF). Recently, non-vitamin K antagonist oral anticoagulants (NOAC), including dabigatran, rivaroxaban, apixaban, and edoxaban, have become available as alternatives for warfarin in the prevention of stroke in patients with NVAF...
June 2015: Drugs
Torben Bjerregaard Larsen, Tatjana Potpara, Nikolaos Dagres, Alessandro Proclemer, Elena Sciarrafia, Carina Blomström-Lundqvist
The purpose of this European Heart Rhythm Association Survey was to assess the clinical practice in relation to the use of oral anticoagulation therapy for patients with atrial fibrillation (AF) in Europe. Of special interest were patients undergoing percutaneous coronary intervention (PCI), cardioversion procedures, catheter ablation, surgery, and those suffering from anticoagulation-related bleeding. Of 38 responding centres, non-vitamin K antagonist oral anticoagulants (NOACs) were used for stroke prophylaxis and were preferred (33...
May 2015: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Xin Pan, Cheng Wang, Youjun Zhang, Weihua Wu, Weiyi Fang
OBJECTIVE: To evaluate the feasibility, safety, and effectiveness of pulmonary vein stenting in patients with severe pulmonary vein stenosis (PVS) after catheter ablation of atrial fibrillation (AF). METHODS: This retrospective analysis included 5 PVS patients (3 males, (54.1 ± 11.2) years old) confirmed by computed tomography angiography after catheter ablation of AF in Shanghai Chest Hospital from April 2010 to April 2013. After selective pulmonary vein angiography, stents were implanted in the pulmonary vein...
October 2014: Zhonghua Xin Xue Guan Bing za Zhi
Lorne J Gula, Allan C Skanes
No abstract text is available yet for this article.
February 2015: Journal of Cardiovascular Electrophysiology
Christopher W Bailey, Robert J Tallaksen
We present a case of pericardioesophageal fistula formation in a 40 year old male who 23 days after undergoing a repeat ablation procedure for atrial fibrillation developed chest pressure, chills and diaphoresis. After initial labs and tests that demonstrated no evidence for acute myocardial ischemia, the patient underwent CT angiography of the chest. The study revealed pneumopericardium and a pericardial effusion. Suspicion was raised of perforation of the posterior left atrial myocardial wall with injury to adjacent esophagus...
October 2014: Journal of Radiology Case Reports
Adolfo Ferrero Guadagnoli, Alejandro E Contreras, Carlos R Leonardi, Miguel A Ballarino, Leonardo Atea, Alejandro R Peirone
Isolation of the pulmonary veins by applying radiofrequency is an effective treatment for atrial fibrillation. One of the potential complications with higher clinical compromise utilizing this invasive technique is the occurrence of stenosis of one or more pulmonary veins. This complication can be treated by angioplasty with or without stent implantation, with an adequate clinical improvement, but with a high rate of restenosis.
2014: Medicina
Andrew H McNeice, Neil M McAleavey, Ian B A Menown
Multiple, potentially practice-changing cardiology trials have been presented or published over the past year. In this paper, we summarize and place in clinical context, new data regarding management of acute coronary syndrome and ST-elevation myocardial infarction (copeptin assessment, otamixaban, cangrelor, prasugrel, sodium nitrite, inclacumab, ranolazine, preventive coronary intervention of non-culprit lesions, immediate thrombolytic therapy versus transfer for primary intervention), new coronary intervention data (thrombectomy, radial access, pressure wire fractional flow reserve, antiplatelet therapy duration and gene-guidance, permanent and biodegradable polymers, coronary bifurcation and strategies), and coronary artery bypass data (off pump vs...
August 2014: Advances in Therapy
Sanghamitra Mohanty, Pasquale Santangeli, Prasant Mohanty, Luigi Di Biase, Chintan Trivedi, Rong Bai, Rodney Horton, J David Burkhardt, Javier E Sanchez, Jason Zagrodzky, Shane Bailey, Joseph G Gallinghouse, Patrick M Hranitzky, Albert Y Sun, Richard Hongo, Salwa Beheiry, Andrea Natale
INTRODUCTION: Atrioesophageal fistula (AEF) is a rare but devastating complication of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). Surgical repair and esophageal stents are available treatment options for AEF. We report outcomes of these 2 management strategies. METHODS: Nine patients with AEF post-RFCA for AF were included in this study. AEF was diagnosed based on symptoms and chest CT imaging. Of the 9 patients, 5 received stents and 4 underwent surgical repair of fistula...
June 2014: Journal of Cardiovascular Electrophysiology
Namdar Manouchehri, Simon R Turner, Evan Lockwood, Laurence D Sterns, Eric Lr Bédard
A 69-year-old man underwent left atrial radiofrequency ablation for atrial fibrillation. After 10 minutes, the procedure was terminated due to pericardial tamponade secondary to perforation during mapping. Pericardiocentesis resolved the tamponade. Ablation was completed one week later, and the patient was discharged. Two days later, he presented with odynophagia. Computed tomography demonstrated small bilateral pleural effusions. He was judged to be stable and was discharged again, but returned 2 days later with chest pain...
November 2014: Asian Cardiovascular & Thoracic Annals
Salvatore Rosanio, Abdul M Keylani, Darrin C D'Agostino, Craig M DeLaughter, Antonio Vitarelli
This systematic review aims to provide an update on pharmacology, efficacy and safety of the newer oral direct thrombin and factor Xa inhibitors, which have emerged for the first time in ~60 years as cogent alternatives to warfarin for stroke prophylaxis in non-valvular atrial fibrillation. We also discuss on four of the most common clinical scenarios with several unsolved questions and areas of uncertainty that may play a role in physicians' reluctance to prescribe the newer oral anticoagulants such as 1) patients with renal failure; 2) the elderly; 3) patients presenting with atrial fibrillation and acute coronary syndromes and/or undergoing coronary stenting; and 4) patients planning to receive AF ablation with the use of pulmonary vein isolation...
July 1, 2014: International Journal of Cardiology
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