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https://www.readbyqxmd.com/read/28070060/the-brugada-syndrome%C3%A3-from-gene-to-therapy
#1
Antonio Curcio, Giuseppe Santarpia, Ciro Indolfi
It is almost a quarter of century that a pioneering work of 2 researchers named Brugada brought the entire scientific community to understanding the molecular, clinical, and electrophysiological aspects of a distinctive syndrome. It affects mainly young adults with syncope and/or sudden cardiac death caused by polymorphic ventricular tachycardia or ventricular fibrillation in the absence of any sign of cardiac degeneration or alteration. Although the involvement of the epicardial layer of the right ventricular outflow tract, and the requirement of pharmacologic challenge for unveiling concealed forms, have been fully characterized, many areas of uncertainties remain to be elucidated, such as the unpredictable usefulness of programmed ventricular stimulation, the role of radiofrequency catheter ablation for reducing ST-segment elevation, and the value of risk stratification in patients diagnosed with upper displacement of right precordial leads...
January 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28068706/atrioesophageal-fistula-after-minimally-invasive-video-assisted-epicardial-ablation-reported-by-kik
#2
Piotr Suwalski
No abstract text is available yet for this article.
January 9, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28066659/percutaneous-epicardial-ablation-of-incessant-atrial-tachycardia-originating-from-the-left-atrial-appendage
#3
Ji-Eun Ban, Tae Young Park, Sang-Weon Park
A 38-year-old woman presented with antiarrhythmic drug-refractory atrial tachycardia (AT). Holter recording demonstrated incessant episodes of AT followed by a long sinus pause. Electrophysiologic study revealed that the earliest endocardial activation was observed at the neck of the left atrial appendage (LAA). After unsuccessful endocardial ablation, epicardial access via a percutaneous subxiphoid approach demonstrated that the earliest epicardial atrial activation was observed on the opposite site to the endocardial LAA neck suggestive of ligament of Marshall (LOM) muscle sleeve as regarding the epicardial sharp potentials under guidance of a circular mapping catheter...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065832/a-novel-method-to-enhance-phenotype-epicardial-functional-substrates-and-ventricular-tachyarrhythmias-in-brugada-syndrome
#4
Fa-Po Chung, Sunu Budhi Raharjo, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Chin-Yu Lin, Yao-Ting Chang, Yuan Hung, Abigail Te, Shinya Yamada, Hiroshi Tasaka, Shih-Ann Chen, Chin-Tien Wang
BACKGROUND: Fever is associated with the manifestation of Brugada phenotype and ventricular tachycardia/fibrillation (VT/VF) in patients with Brugada syndrome (BrS). The thermal effect on the pathogenesis of functional substrates in BrS remains unknown. OBJECTIVE: The study aimed to elucidate the thermal effect on BrS phenotype, VT/VF, and electrophysiological characteristics of epicardial functional substrates in BrS. METHODS: We consecutively studied 15 patients with BrS receiving radiofrequency catheter ablation (RFCA) for drug-refractory ventricular tachyarrhythmias...
January 5, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28054738/radiofrequency-catheter-ablation-targeting-the-vein-of-marshall-in-difficult-mitral-isthmus-ablation-or-pulmonary-vein-isolation
#5
Ji Hyun Lee, Gi-Byoung Nam, Minsu Kim, You Mi Hwang, Jongmin Hwang, Jun Kim, Kee-Joon Choi, You-Ho Kim
INTRODUCTION: The ligament of Marshall may hinder the creation of mitral isthmus (MI) block or pulmonary vein (PV) isolation (PVI) in radiofrequency (RF) catheter ablation of atrial fibrillation (AF). We aimed to assess the benefit of RF ablation targeting the vein of Marshall (VOM) in failed cases of MI block or PVI. METHODS AND RESULTS: We reviewed the medical records of patients who underwent RF ablation targeting the VOM after failed MI ablation or left PVI using the conventional method, which included circumferential point-by-point ablation around the PV antrum and carina, or endocardial MI and epicardial distal coronary sinus (CS) ablation for MI block...
January 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28032928/integrity-of-the-ganglionated-plexi-is-essential-to-parasympathetic-innervation-of-the-atrioventricular-node-by-the-right-vagus-nervez
#6
Olivier Xhaet, Luc DE Roy, Mariana Floria, Olivier Deceuninck, Dominique Blommaert, Fabien Dormal, Elisabeth Ballant, Mark LA Meir
INTRODUCTION: Radiofrequency isolation of pulmonary vein can be accompanied by transient sinus bradycardia or atrioventricular nodal (AVN) block, suggesting an influence on vagal cardiac innervation. However, the importance of the atrial fat pads in relation with the vagal innervation of AVN in humans remains largely unknown. This article is protected by copyright. All rights reserved The aim of this study was to evaluate the role of ganglionated plexi (GP) in the innervation of the AVN by the right vagus nerve...
December 29, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28031213/relationship-between-distance-and-change-in-surface-ecg-morphology-during-pacemapping-as-a-guide-to-ablation-of-ventricular-arrhythmias-implications-for-the-spatial-resolution-of-pacemapping
#7
Anthony Li, Joseph Samuel Davis, Jeremiah Wierwille, Keith Herold, Dennis Morgan, Elijah Behr, Stephen Shorofsky, Magdi Saba
BACKGROUND: Pacemapping is used to localize the exit site of ventricular arrhythmia. Although the relationship between distance and change in QRS morphology is its basis, this relationship has not been systematically quantified. METHODS AND RESULTS: Patients (n=68) undergoing ventricular arrhythmia ablation between March 2012 and July 2013 were recruited. Pacemapping was targeted to areas of voltage >0.5 mV. Linear mixed-effects models were constructed of distance against morphology difference measured by the root mean square error sum across all 12 ECG leads (E12)...
January 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28024555/innovative-approaches-to-arrhythmic-storm-the-growing-role-of-interventional-procedures
#8
REVIEW
Lena Rivard, Jason Andrade
Arrhythmic or electrical storm (AES) is a clinical condition characterized by 3 or more sustained ventricular arrhythmia episodes leading to appropriate device therapy in a 24-hour period and is associated with very high mortality. The clinical presentation is dramatic, and the management remains challenging. Although pharmacologic treatment and sedation are still part of the initial treatment, newer approaches that include ablation (endocardial, epicardial, or alternative procedures), sympathetic blockade (pharmacologic or by interventional sympathetic denervation), and mechanical hemodynamic support are used increasingly in this setting...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28017936/catheter-ablation-reduces-ventricular-tachycardia-burden-in-patients-with-arrhythmogenic-right-ventricular-cardiomyopathy-insights-from-a-north-western-french-multicentre-registry
#9
Zouheir Souissi, Stéphane Boulé, Jean-Sylvain Hermida, Alexandre Doucy, Philippe Mabo, Dominique Pavin, Frédéric Anselme, Nathanaël Auquier, Sandro Ninni, Augustin Coisne, François Brigadeau, Valérie Deken-Delannoy, Didier Klug, Dominique Lacroix
AIMS: Studies assessing radiofrequency ablation (RFA) of ventricular tachycardia (VT) in arrhythmogenic right ventricular cardiomyopathy (ARVC) report VT recurrences, but have not evaluated the impact of RFA on relevant clinical events during follow-up. We aimed to investigate relevant RFA outcomes in a multicentric registry. METHODS AND RESULTS: This study included 49 patients with ARVC (46 with definite diagnosis, 3 with borderline diagnosis according to revised Task Force Criteria) who underwent 92 RFA procedures (83 endocardial, 9 combined endo-epicardial) between 1999-2015...
December 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28012204/thorax-percutaneous-approach-for-epicardial-ventricular-ablation-in-a-patient-with-electrical-storm
#10
Gaetano Barbato, Valeria Carinci, Sergio Fortiparri, Piercamillo Pavesi, Francesco Pergolini, Giuseppe DI Pasquale
Subxiphoid puncture is considered the standard approach for epicardial ablation of ventricular arrhythmia but in some cases this access is impracticable due to the patient's anatomy. We describe the case of a patient with electrical storm and abnormal subdiaframmatic anatomy that precluded the usual subxiphoid approach. In this patient the pericardial space was gained through a direct thorax puncture at the fifth intercostals space close to the mammary line. The tools and technique utilized in this case were similar to what is usually used for traditional subxiphoid puncture...
December 24, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28011827/localization-of-premature-ventricular-contractions-from-the-papillary-muscles-using-the-standard-12-lead-electrocardiogram-a-feasibility-study-using-a-novel-cardiac-isochrone-positioning-system
#11
Peter M van Dam, Noel G Boyle, Michael M Laks, Roderick Tung
AIMS: The precise localization of the site of origin of a premature ventricular contraction (PVC) prior to ablation can facilitate the planning and execution of the electrophysiological procedure. In clinical practice, the targeted ablation site is estimated from the standard 12-lead ECG. The accuracy of this qualitative estimation has limitations, particularly in the localization of PVCs originating from the papillary muscles. Clinical available electrocardiographic imaging (ECGi) techniques that incorporate patient-specific anatomy may improve the localization of these PVCs, but require body surface maps with greater specificity for the epicardium...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28011703/optogenetic-termination-of-ventricular-arrhythmias-in-the-whole-heart-towards-biological-cardiac-rhythm-management
#12
Emile C A Nyns, Annemarie Kip, Cindy I Bart, Jaap J Plomp, Katja Zeppenfeld, Martin J Schalij, Antoine A F de Vries, Daniël A Pijnappels
AIMS: Current treatments of ventricular arrhythmias rely on modulation of cardiac electrical function through drugs, ablation or electroshocks, which are all non-biological and rather unspecific, irreversible or traumatizing interventions. Optogenetics, however, is a novel, biological technique allowing electrical modulation in a specific, reversible and trauma-free manner using light-gated ion channels. The aim of our study was to investigate optogenetic termination of ventricular arrhythmias in the whole heart...
December 23, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27979714/epicardial-substrate-ablation-for-brugada-syndrome
#13
Koonlawee Nademanee, Meleze Hocini, Michel Haïssaguerre
No abstract text is available yet for this article.
December 12, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27968777/noninvasive-epicardial-and-endocardial-electrocardiographic-imaging-of-scar-related-ventricular-tachycardia
#14
Linwei Wang, Omar A Gharbia, B Milan Horáček, John L Sapp
BACKGROUND: The majority of life-threatening ventricular tachycardias (VTs) are sustained by heterogeneous scar substrates with narrow strands of surviving tissue. An effective treatment for scar-related VT is to modify the underlying scar substrate by catheter ablation. If activation sequence and entrainment mapping can be performed during sustained VT, the exit and isthmus of the circuit can often be identified. However, with invasive catheter mapping, only monomorphic VT that is hemodynamically stable can be mapped in this manner...
November 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27943352/electrode-contact-force-controlled-bipolar-radiofrequency-ablation-different-effects-on-lesion-size-between-dual-and-single-bath-preparations
#15
Masaomi Chinushi, Osamu Saitoh, Junya Watanabe, Ayari Sugai, Katsuya Suzuki, Yukio Hosaka, Hiroshi Furushima
BACKGROUND: During bipolar (BIP) radiofrequency (RF) ablation using 2 catheters in humans, each catheter is placed in separate cardiac chambers or spaces. We developed a contact force-controlled experimental preparation, and compared measurements made with 2 catheters placed in a single bath (SB), versus each catheter placed in separate baths, in order to assess the preparation-dependent differences in the results of BIP-RF ablation. METHODS: In the SB experiments, a porcine heart was placed in the center of the bath, while in the dual bath (DB) experiments, it was placed between 2 half baths communicating through windows...
December 10, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27943299/a-non-fluoroscopic-technique-for-coronary-arteries-three-dimensional-mapping-during-epicardial-ventricular-tachycardia-ablation
#16
Vittorio Calzolari, Gaetano Barbato, Martino Crosato, Luca DE Mattia, Alessandro Daniotti, Stefano Indiani, Paolo Antonio Maria Squasi, Zoran Olivari
When performing epicardial ablation of ventricular tachycardia (VT) caution must be taken not to damage the coronary arteries. We report a case in which a new, non-fluoroscopic technique for incorporating an accurate, real-time reconstruction of the main coronary vessels into a three-dimensional electro-anatomic map was used for epicardial VT ablation. This article is protected by copyright. All rights reserved.
December 10, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27943113/significance-and-clinical-characteristics-of-atrial-fibrillation-post-epicardial-access
#17
Alan Sugrue, Ammar M Killu, David O Hodge, Christopher J McLeod, Thomas M Munger, Siva K Mulpuru, Douglas L Packer, Suraj Kapa, Samuel J Asirvatham, Paul A Friedman
INTRODUCTION: Epicardial access (EpiAcc) has become an important adjunct for ventricular tachycardia (VT) or premature ventricular complex (PVC) ablation. We hypothesized that post-procedural pericarditis may lead to an increased risk of atrial fibrillation (AF), and therefore assessed the incidence and clinical impact of post-procedural AF in patients undergoing EpiAcc. METHODS: We reviewed the records of all patients who underwent EpiAcc as part of an ablation procedure between January 1, 2004 and July 31, 2014 at Mayo Clinic Rochester...
December 9, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27939893/use-of-flecainide-in-combination-antiarrhythmic-therapy-in-patients-with-arrhythmogenic-right-ventricular-cardiomyopathy
#18
Simon Ermakov, Edward P Gerstenfeld, Yana Svetlichnaya, Melvin M Scheinman
BACKGROUND: Antiarrhythmic therapy is commonly used for suppression of arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) in conjunction with implantable cardioverter-defibrillators and catheter ablation. The efficacy of combination flecainide and sotalol/metoprolol therapy for patients refractory to single agents and/or catheter ablation has not been well established. OBJECTIVE: The purpose of this study was to describe our experience with the addition of flecainide in combination with sotalol/metoprolol for treatment of arrhythmias in patients with ARVC...
December 9, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27932238/gender-differences-in-patients-with-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy-clinical-manifestations-electrophysiological-properties-substrate-characteristics-and-prognosis-of-radiofrequency-catheter-ablation
#19
Chin-Yu Lin, Fa-Po Chung, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Yao-Ting Chang, Yun-Yu Chen, Rohit Walia, Abigail Louise D Te, Shinya Yamada, Shih-Ann Chen
BACKGROUND: Gender differences in the penetrance and clinical expression of genetic mutations have been reported in patients with arrhythmogenic right ventricular (RV) dysplasia/cardiomyopathy (ARVD/C). Our study aimed at clarifying the impact of gender on ventricular substrates and clinical outcomes after radiofrequency catheter ablation (RFCA). METHODS: Patients with ARVD/C underwent RFCA for drug-refractory ventricular arrhythmias (VAs) were consecutively enrolled...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27930603/strategies-to-improve-the-efficacy-of-epicardial-linear-ablation-on-the-beating-heart
#20
Yoshiyuki Watanabe, Matthew R Schill, Toshinobu Kazui, Spencer J Melby, Richard B Schuessler, Ralph J Damiano
OBJECTIVE: Creating transmural linear lesions on the beating heart is an important component of minimally invasive surgical ablation for atrial fibrillation. Animal studies have shown poor efficacy for surface bipolar radiofrequency ablation (RFA). Clinicians have developed strategies including multiple device applications and vena caval occlusion (VCO) to improve ablation efficacy. These techniques were evaluated in an acute porcine model. METHODS: In the first experiment, an RFA device was used to perform two 40-second epicardial ablations on the right atrium of six pigs...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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