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Epicardial ablation

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https://www.readbyqxmd.com/read/28921386/midterm-outcomes-of-two-staged-hybrid-ablation-of-persistent-and-long-standing-persistent-atrial-fibrillation-using-the-versapolar-epicardial-surgical-device-and-subsequent-catheter-ablation
#1
Petr Budera, Pavel Osmancik, Dalibor Herman, Jana Zdarska, David Talavera, Anna Mala, Radka Prochazkova, Zbynek Straka
PURPOSE: Hybrid ablation of atrial fibrillation (AF) is a promising treatment strategy for patients with non-paroxysmal AF, although, data regarding mid-term outcomes are limited. METHODS: Patients with persistent or long-standing persistent AF were enrolled. Initially, a thoracoscopic, right-sided, epicardial ablation was performed, with a goal of creating a box lesion on the posterior wall of the left atrium; a novel versapolar radiofrequency (RF) catheter was used...
September 18, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28917555/incidence-and-significance-of-adhesions-encountered-during-epicardial-mapping-and-ablation-of-ventricular-tachycardia-in-patients-with-no-history-of-prior-cardiac-surgery-or-pericarditis
#2
Anthony Li, Eric Buch, Noel G Boyle, Kalyanam Shivkumar, Jason S Bradfield
BACKGROUND: Pericardial adhesions can prevent epicardial access and restrict catheter movement during mapping and ablation of ventricular tachycardia (VT) . The incidence of adhesions in patients without prior cardiac surgery or clinically evident pericarditis is not known. OBJECTIVE: To describe the incidence of pericardial adhesions in patients without prior cardiac surgery or pericarditis and explore their impact. METHODS: A retrospective search of our ablation database containing patients who underwent epicardial ablation for VT was undertaken...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28887362/resolving-bipolar-electrogram-voltages-during-atrial-fibrillation-using-omnipolar-mapping
#3
Shouvik K Haldar, Karl Magtibay, Andreu Porta-Sanchez, Stéphane Massé, Nicholas Mitsakakis, Patrick F H Lai, Mohammed Ali Azam, John Asta, Marjan Kusha, Paul Dorian, Andrew C T Ha, Vijay Chauhan, D Curtis Deno, Kumaraswamy Nanthakumar
BACKGROUND: Low-voltage-guided substrate modification is an emerging strategy in atrial fibrillation (AF) ablation. A major limitation to contemporary bipolar electrogram (EGM) analysis in AF is the resultant lower peak-to-peak voltage (Vpp) from variations in wavefront direction relative to electrode orientation and from fractionation and collision events. We aim to compare bipole Vpp with novel omnipolar peak-to-peak voltages (Vmax) in sinus rhythm (SR) and AF. METHODS AND RESULTS: A high-density fixed multielectrode plaque was placed on the epicardial surface of the left atrium in dogs...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28881765/mitral-isthmus-ablation-using-a-circular-mapping-catheter-positioned-in-the-left-atrial-appendage-as-a-reference-for-conduction-block
#4
Takahiko Nishiyama, Takehiro Kimura, Taishi Fujisawa, Kazuaki Nakajima, Akira Kunitomi, Shin Kashimura, Yoshinori Katsumata, Nobuhiro Nishiyama, Yoshiyasu Aizawa, Keiichi Fukuda, Seiji Takatsuki
BACKGROUND: For perimitral atrial flutter (PMFL) developing after catheter ablation of atrial fibrillation (AF), to create a complete conduction block at the mitral isthmus (MI) is mandatory to terminate it, however, it is still challenging. METHODS: This study consisted of 80 patients (74 male, 61 ± 8.1 years) undergoing MI ablation. After a circular mapping catheter was positioned at the neck of the left atrial appendage (LAA), the MI ablation was performed on the MI line just below the LAA neck targeting the earliest activation recording site of the LAA catheter during pacing from the coronary sinus (CS)...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28862969/three-dimensional-integrated-functional-structural-and-computational-mapping-to-define-the-structural-fingerprints-of-heart-specific-atrial-fibrillation-drivers-in-human-heart-ex-vivo
#5
Jichao Zhao, Brian J Hansen, Yufeng Wang, Thomas A Csepe, Lidiya V Sul, Alan Tang, Yiming Yuan, Ning Li, Anna Bratasz, Kimerly A Powell, Ahmet Kilic, Peter J Mohler, Paul M L Janssen, Raul Weiss, Orlando P Simonetti, John D Hummel, Vadim V Fedorov
BACKGROUND: Structural remodeling of human atria plays a key role in sustaining atrial fibrillation (AF), but insufficient quantitative analysis of human atrial structure impedes the treatment of AF. We aimed to develop a novel 3-dimensional (3D) structural and computational simulation analysis tool that could reveal the structural contributors to human reentrant AF drivers. METHODS AND RESULTS: High-resolution panoramic epicardial optical mapping of the coronary-perfused explanted intact human atria (63-year-old woman, chronic hypertension, heart weight 608 g) was conducted during sinus rhythm and sustained AF maintained by spatially stable reentrant AF drivers in the left and right atrium...
August 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28842979/epicardial-ablation-utilising-remote-magnetic-navigation-in-a-patient-with-brugada-syndrome-and-inferior-early-repolarisation
#6
Paul Chun Yih Lim, Koonlawee Nademanee, Edward Chun Yi Lee, Wee Siong Teo
We report a case of epicardial ablation in a combined Brugada and inferior early repolarization syndrome patient with recurrent defibrillator therapy for spontaneous VF. Electroanatomic mapping and ablation were achieved with remote magnetic navigation. Highly fractionated electrograms were seen epicardially in the anterior RVOT and at the anterior-inferior right ventricle. Ablation of the RVOT region resulted in resolution Brugada pattern ECG. The inferior early repolarisation persisted despite ablation of the inferior right ventricular epicardium...
August 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28835839/percutaneous-catheter-ablation-of-epicardial-accessory-pathways
#7
Eduardo Back Sternick, Mariana Faustino, Frederico Soares Correa, Cristiano Pisani, Maurício Ibrahim Scanavacca
Radiofrequency (RF) catheter ablation is the treatment of choice in patients with accessory pathways (APs) and Wolff-Parkinson-White syndrome. Endocardial catheter ablation has limitations, including the inability to map and ablate intramural or subepicardial APs. Some of these difficulties can be overcome using an epicardial approach performed through the epicardial venous system or by percutaneous catheterisation of the pericardial space. When a suspected left inferior or infero-paraseptal AP is refractory to ablation or no early activation is found at the endocardium, a transvenous approach via the coronary sinus is warranted because such epicardial pathways can be in close proximity to the coronary venous system...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28833720/near-field-impedance-accurately-distinguishes-among-pericardial-intracavitary-and-anterior-mediastinal-position
#8
David A Burkland, Anand V Ganapathy, Mathews John, Brian D Greet, Mohammad Saeed, Abdi Rasekh, Mehdi Razavi
INTRODUCTION: Epicardial catheter ablation is increasingly used to treat arrhythmias with an epicardial component. Nevertheless, percutaneous epicardial access remains associated with a significant risk of major complications. Developing a technology capable of confirming proper placement within the pericardial space could decrease complication rates. The purpose of this study was to examine differences in bioimpedance among the pericardial space, anterior mediastinum, and right ventricle...
August 22, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28798020/unipolar-endocardial-voltage-mapping-in-the-right-ventricle-optimal-cutoff-values-correcting-for-computed-tomography-derived-epicardial-fat-thickness-and-their-clinical-value-for-substrate-delineation
#9
Jeroen Venlet, Sebastiaan R D Piers, Gijsbert F L Kapel, Marta de Riva, Philippe F G Pauli, Rob J van der Geest, Katja Zeppenfeld
BACKGROUND: Low endocardial unipolar voltage (UV) at sites with normal bipolar voltage (BV) may indicate epicardial scar. Currently applied UV cutoff values are based on studies that lacked epicardial fat information. This study aimed to define endocardial UV cutoff values using computed tomography-derived fat information and to analyze their clinical value for right ventricular substrate delineation. METHODS AND RESULTS: Thirty-three patients (50±14 years; 79% men) underwent combined endocardial-epicardial right ventricular electroanatomical mapping and ablation of right ventricular scar-related ventricular tachycardia with computed tomographic image integration, including computed tomography-derived fat thickness...
August 2017: Circulation. Arrhythmia and 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
#10
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/28771538/a-novel-noninvasive-surface-ecg-analysis-using-interlead-qrs-dispersion-in-arrhythmogenic-right-ventricular-cardiomyopathy
#11
Wan-Hsin Hsieh, Chin-Yu Lin, Abigail Louise D Te, Men-Tzung Lo, Cheng-I Wu, Fa-Po Chung, Yi-Chung Chang, Shih-Lin Chang, Chen Lin, Li-Wei Lo, Yu-Feng Hu, Jo-Nan Liao, Yun-Yu Chen, Shih-Jie Jhuo, Sunu Budhi Raharjo, Yenn-Jiang Lin, Shih-Ann Chen
BACKGROUND: This study investigated the feasibility of using the precordial surface ECG lead interlead QRS dispersion (IQRSD) in the identification of abnormal ventricular substrate in arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS: Seventy-one consecutive patients were enrolled and reclassified into 4 groups: definite ARVC with epicardial ablation (Group 1), ARVC with ventricular tachycardia (VT, Group 2), idiopathic right ventricular outflow tract VT without ARVC (Group 3), and controls without VT (Group 4)...
2017: PloS One
https://www.readbyqxmd.com/read/28765757/vagal-response-in-cryoballoon-ablation-of-atrial-fibrillation-and-autonomic-nervous-system-utility-of-epicardial-adipose-tissue-location
#12
Satoshi Yanagisawa, Yasuya Inden, Yoshiaki Mizutani, Aya Fujii, Yosuke Kamikubo, Yasunori Kanzaki, Monami Ando, Junya Funabiki, Yosuke Murase, Masaki Takenaka, Noriaki Otake, Tetsuyoshi Hattori, Rei Shibata, Toyoaki Murohara
BACKGROUND: Mechanism and effects of vagal response (VR) during cryoballoon ablation procedure on the cardiac autonomic nervous system (ANS) are unclear. The present study aimed to evaluate the relationship between VR during cryoballoon catheter ablation for atrial fibrillation and ANS modulation by evaluating epicardial adipose tissue (EAT) locations and heart rate variability (HRV) analysis. METHODS: Forty-one patients with paroxysmal atrial fibrillation (11 with VR during the procedure and 30 without VR) who underwent second-generation cryoballoon ablation were included...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765746/controlled-atrial-fibrillation-after-pulmonary-vein-stenting
#13
Young-Ah Park, Jiwon Seo, Hui-Nam Pak
When there is no pulmonary vein reconnection after catheter ablation for atrial fibrillation, patients can experience recurrence of atrial fibrillation without clear evidence of non-pulmonary vein foci. We describe a patient with significant pulmonary vein stenosis and recurrent atrial fibrillation after four ablation procedures. After successful pulmonary vein stenting, the symptoms were resolved, and sinus rhythm was maintained for 2 years without treatment with antiarrhythmic medication. We believe pulmonary vein stenting potentially controlled atrial fibrillation by providing pulmonary vein pressure relief or by compressing the epicardial triggers occurring at the pulmonary vein ostium...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28765086/spectrum-of-atrial-arrhythmias-using-the-ligament-of-marshall-in-patients-with-atrial-fibrillation
#14
Aman Chugh, Hitinder S Gurm, Kavita Krishnasamy, Mohammed Saeed, Watchara Lohawijarn, Kyle Hornsby, Ryan Cunnane, Hamid Ghanbari, Rakesh Latchamsetty, Thomas Crawford, Krit Jongnarangsin, Frank Bogun, Hakan Oral, Fred Morady
BACKGROUND: The role of the ligament of Marshall (LOM) in patients with atrial fibrillation (AF) has not been well defined. OBJECTIVE: The purpose of this study was to describe the role of the LOM in patients with AF and related arrhythmias. METHODS: Fifty-six patients (mean age 63 ± 11 years; persistent AF in 48 [86%]; ejection fraction 0.49 ± 0.13; left atrial diameter 4.7 ± 0.6 cm) with LOM-mediated arrhythmias were included. RESULTS: A LOM-pulmonary vein (PV) connection was present in 18 patients (32%) and was eliminated with radiofrequency (RF) ablation at the left lateral ridge or crux (n = 12), at the mitral annulus (n = 3), or with alcohol/ethanol (EtOH) ablation of the vein of Marshall (VOM; n = 3)...
July 29, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28760469/delayed-electroanatomic-mapping-after-surgical-ablation-for-persistent-atrial-fibrillation
#15
Alan Bulava, Ales Mokracek, Vojtech Kurfirst
BACKGROUND: Long-term efficacy of catheter-based treatment of persistent atrial fibrillation is unsatisfactory. Minimally invasive surgical ablation techniques have been developed recently but their true efficacy has never been systematically tested. METHODS: Seventy patients (median age 63.5 years) with persistent atrial fibrillation underwent epicardial thoracoscopic radiofrequency pulmonary vein (PV) isolation, linear ablation, Marshal ligament disruption, and exclusion of the left atrial appendage...
July 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28758758/-thoracoscopic-epicardial-ablation-of-atrial-fibrillation-using-the-cobra-fusion-system-as-the-first-part-of-hybrid-ablation
#16
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/28752278/predictors-and-therapy-of-cardiomyopathy-caused-by-frequent-ventricular-ectopy
#17
REVIEW
Ghaith Sharaf Dabbagh, Frank Bogun
PURPOSE OF REVIEW: The aim of this review is to describe predictors and therapeutic principles for PVC-induced cardiomyopathy. RECENT FINDINGS: PVC-induced cardiomyopathy is a treatable condition resulting in a reversible form of cardiomyopathy. PVC-induced cardiomyopathy has only recently been recognized as an entity that causes a reversible form of cardiomyopathy. The mechanism of development of PVC-induced cardiomyopathy has not yet been elucidated, although dyssynchrony appears to play a major role...
September 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28744991/utility-of-high-density-multielectrode-mapping-during-ablation-of-scar-related-ventricular-tachycardia
#18
Óscar Cano, Diego Plaza, Assumpció Saurí, Joaquín Osca, Pau Alonso, Ana Andrés, María-José Sancho-Tello, Luis Martínez-Dolz
INTRODUCTION: Multielectrode mapping catheters (MEMC) allow the performance of high resolution and density maps but the utility of these catheters in ventricular tachycardia (VT) ablation procedures has not been yet widely described. We sought to evaluate the utility of a MEMC during scar-related VT ablation procedures. METHODS: 85 consecutive scar-related VT ablation procedures were performed in 81 patients. In the first 26 procedures, a standard 3.5 mm tip linear catheter was employed for endocardial/epicardial mapping (control group)...
July 26, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28744873/epicardial-ablation-of-tachyarrhythmia-in-children-experience-at-two-academic-centers
#19
Shailendra Upadhyay, Edward P Walsh, Frank Cecchin, John K Triedman, Juan Villafane, J Philip Saul
BACKGROUND: Experience with percutaneous epicardial ablation of tachyarrhythmia in pediatrics is limited. This case series addresses the feasibility, safety and complications of the procedure in children. METHODS: A total of 9 patients underwent 10 epicardial ablation procedures from 2002 to 2013 at two academic centers. Activation mapping was performed in all cases, and electro-anatomic map was utilized in 9 of the 10 procedures. Patients had undergone 1-3 failed endocardial catheter ablations in addition to medical management, and all had symptoms, a high-risk accessory pathway (AP), aborted cardiac arrest with Wolff-Parkinson-White syndrome (WPW) or ventricular dysfunction...
July 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28736712/successful-ablation-for-non-pulmonary-multi-foci-atrial-fibrillation-tachycardia-in-a-patient-with-coronary-sinus-ostial-atresia-by-transseptal-puncture-and-epicardial-approach
#20
Yukihiro Inamura, Junichi Nitta, Akira Sato, Masahiko Goya, Mitsuaki Isobe, Kenzo Hirao
No abstract text is available yet for this article.
May 2017: HeartRhythm Case Reports
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