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Epicardial ablation

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https://www.readbyqxmd.com/read/29346633/intraoperative-epicardial-focal-pulmonary-venous-electrocardiography-in-patients-with-atrial-fibrillation
#1
Grzegorz Suwalski, Robert Emery, Jakub Mróz, Kamil Kaczejko, Leszek Gryszko, Andrzej Cwetsch, Andrzej Skrobowski
OBJECTIVES: In patients referred to off-pump coronary artery bypass grafting, pulmonary vein isolation (PVI) may be used for those with persistent atrial fibrillation (AF), an alternative to the Maze procedure. However, the success rate of PVI in persistent AF is limited. The study assesses the prognostic value of focal epicardial electrocardiography of the pulmonary veins (PVs) for surgical ablation results. METHODS: We mapped 140 PV in 35 cases undergoing off-pump coronary artery bypass grafting...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29327638/hybrid-and-surgical-procedures-for-the-treatment-of-persistent-and-longstanding-persistent-atrial-fibrillation
#2
Jose M Sanchez, Ghannam Al-Dosari, Sherman Chu, Ramin Beygui, Tobias Deuse, Nitish Badhwar, Randall J Lee
Atrial fibrillation (AF) is the most common cardiac arrhythmia. The incidence of AF increases with age and is associated with increased stroke, heart failure and mortality. Persistent and long standing persistent AF is difficult to treat and often refractory to medical therapy and catheter ablation. Areas covered: This article reviews the historical development of the surgical Cox-MAZE procedure and current hybrid and minimally invasive surgical approaches for the treatment of persistent and long standing persistent AF...
January 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29326836/minimally-invasive-epicardial-surgical-ablation-alone-versus-hybrid-ablation-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#3
Charles M Pearman, Shi S Poon, Laura J Bonnett, Shouvik Haldar, Tom Wong, Neeraj Mediratta, Dhiraj Gupta
Maintaining sinus rhythm in patients with non-paroxysmal AF is an elusive goal. Some suggest that hybrid ablation, combining minimally invasive epicardial surgical ablation with endocardial catheter ablation, may be more effective than either modality alone. However, randomised trials are lacking. We investigated whether hybrid ablation is more effective than epicardial ablation alone at preventing recurrent AF by performing a systematic review and meta-analysis. The review was prospectively registered with PROSPERO (CRD42016043389)...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326833/ganglionated-plexi-ablation-physiology-and-clinical-applications
#4
Stavros Stavrakis, Sunny Po
Ganglionated plexi (GP), consisting of conglomerations of autonomic ganglia on the epicardial surface of the heart, have been shown to play a significant role in different arrhythmias, including atrial fibrillation. GP ablation has become an adjunctive procedure in the treatment of atrial fibrillation, while it has been used successfully in preliminary studies in vasovagal syncope. This review will present the current data on the physiology and clinical applications of GP ablation in the treatment of atrial fibrillation and other diseases...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29325036/evaluation-of-left-atrial-linear-ablation-using-contiguous-and-optimized-radiofrequency-lesions-the-aline-study
#5
Michael Wolf, Milad El Haddad, Joël Fedida, Philippe Taghji, Katarina Van Beeumen, Teresa Strisciuglio, Jan De Pooter, Caroline Lepièce, Yves Vandekerckhove, René Tavernier, Mattias Duytschaever, Sébastien Knecht
Aims: Achieving block across linear lesions is challenging. We prospectively evaluated radiofrequency (RF) linear ablation at the roof and mitral isthmus (MI) using point-by-point contiguous and optimized RF lesions. Methods and results: Forty-one consecutive patients with symptomatic persistent AF underwent stepwise contact force (CF)-guided catheter ablation during ongoing AF. A single linear set of RF lesions was delivered at the roof and posterior MI according to the 'Atrial LINEar' (ALINE) criteria, i...
January 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29317972/high-density-mapping-in-ventricular-tachycardia-ablation-a-pentaray%C3%A2-study
#6
Petra Maagh, Arnd Christoph, Henning Dopp, Markus Sebastian Mueller, Gunnar Plehn, Axel Meissner
Background: High-density mapping of ventricular tachycardia (VT) with PentaRay® (Biosense-Webster) provides high resolution with discrimination of local abnormal electrograms and slow conducting channels. We evaluate the feasibility of PentaRay® to characterize the anatomical substrate and assume an influence of the outcome despite limitations. Methods: Over a 24-month period, 26 endocardial and four epicardial maps were obtained of 26 VT patients (18 ischemic cardiomyopathy (ICM, 69...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29296575/ablation-of-epicardial-ventricular-tachycardia-in-a-chagasic-patient-with-situs-inversus-totalis-a-case-report
#7
Lucas Hollanda Oliveira, Enia Coutinho, Marly Uellendahl, Guilherme Melo Ferreira, Fabrizio Raimundi, Cristiano Dietrich, Carlos Volponi, Christian Moreno Luize, Claudio Cirenza, Angelo de Paola
No abstract text is available yet for this article.
December 2017: HeartRhythm Case Reports
https://www.readbyqxmd.com/read/29286395/benefits-of-cardiac-resynchronization-therapy-in-an-asynchronous-heart-failure-model-induced-by-left-bundle-branch-ablation-and-rapid-pacing
#8
Jingfeng Wang, Zhenning Nie, Haiyan Chen, Xianhong Shu, Zhaohua Yang, Ruiming Yao, Yangang Su, Junbo Ge
It is now well recognized that heart failure (HF) patients with left bundle branch block (LBBB) derive substantial clinical benefits from cardiac resynchronization therapy (CRT), and LBBB has become one of the important predictors for CRT response. The conventional tachypacing-induced HF model has several major limitations, including absence of stable LBBB and rapid reversal of left ventricular (LV) dysfunction after cessation of pacing. Hence, it is essential to establish an optimal model of chronic HF with isolated LBBB for studying CRT benefits...
December 11, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29280039/left-ventricular-outflow-tract-arrhythmias-with-divergent-qrs-morphology-mapping-of-different-exits-and-ablation-strategy
#9
Christopher Reithmann, Michael Fiek
BACKGROUND: Ventricular arrhythmias (VAs) from the left ventricular outflow tract (LVOT) can have multiple exits exhibiting divergent ECG features. METHODS: In a series of 131 patients with VAs with LVOT origin, 10 patients presented with divergent QRS morphologies. Multisite endo- and epicardial mapping of different exit sites was performed. RESULTS: The earliest ventricular activity of 23 LVOT VAs in 10 patients was detected in the endocardium of the LV in 7 patients, the aortic sinuses of Valsalva (SoV) in 3 patients, the distal coronary sinus in 6 patients, the anterior interventricular vein in 3 patients, and the posterior right ventricular outflow tract (RVOT) in 4 patients...
December 27, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29250293/hypothetical-anatomy-of-brugada-phenomenon-long-qt-sine-long-qt-syndrome-implicating-morphologically-undefined-specific-brugada-s-myocells
#10
REVIEW
Petras Stirbys
The Brugada syndrome (BrS) is associated with increased risk of ventricular arrhythmias and sudden cardiac death. It generates genetically mediated arrhythmias posing a true pathophysiological challenge. In search of the similarities between BrS and long QT syndrome some novel insights are suggested. In patients with BrS the duration of QT interval is usually normal. Some investigators have found prolonged QT interval in the syndrome's natural course or the duration of QT segment have been extended by provocative tests unmasking BrS...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29242236/near-field-ultrasound-imaging-during-radiofrequency-catheter-ablation-tissue-thickness-and-epicardial-wall-visualization-and-assessment-of-radiofrequency-ablation-lesion-formation-and-depth
#11
David E Haines, Matthew Wright, Erik Harks, Szabolcs Deladi, Steven Fokkenrood, Rob Brink, Harm Belt, Alexander F Kolen, Nenad Mihajlovic, Fei Zuo, Darrell Rankin, William Stoffregen, Debra Cockayne, Joseph Cefalu
BACKGROUND: Safe and successful radiofrequency catheter ablation depends on creation of transmural lesions without collateral injury to contiguous structures. Near-field ultrasound (NFUS) imaging through transducers in the tip of an ablation catheter may provide important information about catheter contact, wall thickness, and ablation lesion formation. METHODS AND RESULTS: NFUS imaging was performed using a specially designed open-irrigated radiofrequency ablation catheter incorporating 4 ultrasound transducers...
December 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29233092/heart-rate-variability-after-radiofrequency-ablation-of-epicardial-ganglionated-plexuses-on-the-ovine-left-atrium
#12
Vilius Kviesulaitis, Aras Puodziukynas, Dainius Haroldas Pauza, Vytautas Zabiela, Tomas Kazakevicius, Raimundas Vaitkevicius, Evaldas Diržinauskas, Vytenis Semaška, Antanas Strazdas, Ruta Unikaite, Kristina Rysevaite, Neringa Pauziene, Remigijus Zaliunas
BACKGROUND: Ganglionated plexuses (GP) are terminal parts of cardiac autonomous nervous system (ANS). Radiofrequency ablation (RFA) for atrial fibrillation (AF) possibly affects GP. Changes in heart rate variability (HRV) after RFA can reflect ANS modulation. METHODS: Epicardial RFA of GP on the left atrium (LA) was performed under the general anesthesia in 15 mature Romanov sheep. HRV was used to assess the alterations in autonomic regulation of the heart. A 24 - hour ECG monitoring was performed before the ablation, 2 days after it and at each of the 12 following months...
December 12, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29223305/usefulness-of-ultra-high-resolution-mapping-for-detecting-epicardial-atrial-activation-during-mitral-isthmus-ablation
#13
Hiroki Kitajima, Yuji Nishikawa, Keitaro Senoo, Masahiro Esato
We describe a patient with perimitral atrial flutter (PMF) following the atrial fibrillation ablation and the linear ablation at the mitral isthmus (MI). From both the activation and the voltage maps using ultra-high resolution mapping, we detected the epicardial connection through the coronary sinus (CS) within the entire reentrant circuit. Point ablation within the CS, not additional linear MI ablation from the endocardium terminates PMF, with a bidirectional block across the low voltage area at the MI.
November 21, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29221283/effectiveness-and-safety-of-simultaneous-hybrid-thoracoscopic-endocardial-catheter-ablation-of-atrial-fibrillation-in-obese-and-non-obese-patients
#14
Kevin Phan, Laurent Pison, Nelson Wang, Aran Kanagaratnam, Tristan D Yan, Bart Maesen, Jos G Maessen, Harry J Crijns, Mark La Meir
Background: We evaluated the safety and effectiveness of the hybrid thoracoscopic endocardial epicardial ablation technique for the treatment of atrial fibrillation (AF) in obese versus non-obese patients. Methods: Between January 2010 and January 2015, a cohort of 61 patients were retrospectively identified to undergo ablation of AF as a stand-alone procedure using a thoracoscopic, hybrid epicardial-endocardial technique. All patients underwent continuous 7-day Holter monitoring at 3, 6 months, 1 year and yearly thereafter...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29156015/european-prospective-multicentre-study-of-hybrid-thoracoscopic-and-transcatheter-ablation-of-persistent-atrial-fibrillation-the-historic-af-trial
#15
Claudio Muneretto, Gianluigi Bisleri, Fabrizio Rosati, Ralf Krakor, Laura Giroletti, Lorenzo Di Bacco, Alberto Repossini, Massimo Moltrasio, Antonio Curnis, Claudio Tondo, Gianluca Polvani
OBJECTIVES: The HISTORIC-AF trial is a prospective, multicentre, single-arm study designed to evaluate the outcomes of a staged endoscopic and transcatheter ablation in patients with stand-alone, persistent or long-standing persistent atrial fibrillation (AF). METHODS: From 2012 to 2015, 100 consecutive patients were enrolled and underwent thoracoscopic left atrial epicardial isolation ('box lesion') followed by transcatheter ablation in case of AF recurrency. The safety end point was the composite outcome of freedom from major adverse events at 30-days, while efficacy end points were: (i) primary: freedom from AF and stable sinus rhythm following isolated thoracospic ablation >60% and (ii) secondary: freedom from AF and stable sinus rhythm >80% following hybrid ablation (as per HRS criteria)...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29145303/epicardial-radiofrequency-catheter-ablation-of-brugada-syndrome-with-electrical-storm-during-ventricular-fibrillation-a-case-report
#16
Shufen Jiang, Xiaomeng Yin, Chang Dong, Yunlong Xia, Jinqiu Liu
RATIONALE: Brugada syndrome (BrS) is characterized by ST segment elevation at the J point ≥2 mm in the right precordial electrocardiogram (ECG) leads, in the absence of structural heart disease, electrolyte disturbances, or ischemia. It is a well-described cause of sudden death in young patients, especially in the age of between 30 and 40 years old. Here, we reported an unusual case of electrical storm (ES) of ventricular fibrillation (VF) caused by BrS with complete right bundle-branch block (CRBBB) in a 75-year-old male patient...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136152/concomitant-thoracoscopic-surgery-for-solitary-pulmonary-nodule-and-atrial-fibrillation
#17
Rongxin Lu, Ju Mei, Dongfang Zhao, Zhaolei Jiang, Haibo Xiao, Mingsong Wang, Nan Ma
OBJECTIVES: The incidence of both solitary pulmonary nodules (SPN) and non-valvular atrial fibrillation (NVAF) has increased over the past decade. We performed concomitant video-assisted thoracoscopic surgery with modified epicardial radiofrequency ablation procedure for NVAF and SPN resection. METHODS: Sixteen patients (7 men, mean age 62.6 ± 11.2 years) with SPN and NVAF underwent this procedure. Of these patients, 10 had paroxysmal atrial fibrillation and 6 persistent atrial fibrillation...
November 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29133381/endocardial-unipolar-voltage-maps-to-identify-epicardial-circuits-during-ventricular-tachycardia-ablation-in-chagasic-cardiomyopathy-when-the-pot-of-gold-may-not-be-at-the-other-end-of-the-rainbow
#18
EDITORIAL
André Zimerman, Juan F Viles-Gonzalez, André d'Avila
No abstract text is available yet for this article.
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29133379/ventricular-tachycardia-in-the-setting-of-chagasic-cardiomyopathy-use-of-voltage-mapping-to-characterize-endoepicardial-nonischemic-scar-distribution
#19
Richard Soto-Becerra, Victor Bazan, William Bautista, Federico Malavassi, Jhancarlo Altamar, Juan David Ramirez, Arlen Everth, David J Callans, Francis E Marchlinski, Diego Rodríguez, Fermin C García, Luis C Sáenz
BACKGROUND: Chagasic cardiomyopathy (CC) is the most frequent nonischemic substrate causing left ventricular (LV) tachycardia in Latin America. Systematic characterization of the LV epicardial/endocardial scar distribution and density in CC has not been performed. Additionally, the usefulness of unipolar endocardial electroanatomic mapping to identify epicardial scar has not been assessed in this setting. METHODS AND RESULTS: Nineteen patients with CC undergoing detailed epicardial and endocardial LV tachycardia mapping and ablation were included...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29132931/hybrid-surgical-versus-percutaneous-access-epicardial-ventricular-tachycardia-ablation
#20
Anthony Li, Justin Hayase, Duc Do, Eric Buch, Marmar Vaseghi, Olujimi A Ajijola, Carlos Macias, Yuliya Krokhaleva, Houman Khakpour, Noel G Boyle, Peyman Benharash, Reshma Biniwale, Kalyanam Shivkumar, Jason S Bradfield
BACKGROUND: There is limited experience of surgical epicardial access in the contemporary era of ventricular tachycardia ablation after prior cardiac surgery. OBJECTIVE: To describe our institutional experience with surgical epicardial access, the influence of surgical approach and compare outcomes to a propensity-matched percutaneous epicardial access control group. METHODS: A retrospective study of consecutive surgical epicardial VT ablation cases from a single center was performed...
November 10, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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