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Epicardial ablation

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https://www.readbyqxmd.com/read/27909499/hyperacute-and-chronic-changes-in-cerebral-magnetic-resonance-images-after-pvac-nmarq-and-epicardial-thoracoscopic-surgical-ablation-for-paroxysmal-atrial-fibrillation
#1
Conn Sugihara Mbbs, Neil Barlow Mbbs, Emma Owens Mbbs, David Sallomi Mb ChB, Neil Sulke Md
Threshold testing of cardiac rhythm devices is essential to monitoring the proper functioning of such devices (1). However, the currently method of applying multiple ECG leads to the patient is burdensome and time consuming (2). We are presenting a completely new way to perform cardiac rhythm device threshold testing using pulse oximetry. Twenty patients, with varying cardiac rhythm devices and pacing modes, were enrolled and had their atrial and ventricular thresholds tested. A comparison was made between simultaneous threshold determinations via the standard EGM based method and the new pulse oximetry based method...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27907904/a-new-cryoenergy-for-ventricular-tachycardia-ablation-a-proof-of-concept-study
#2
Benjamin Berte, Frédéric Sacher, Jean-Yves Wielandts, Saagar Mahida, Xavier Pillois, Rukshen Weerasooriya, Olivier Bernus, Pierre Jaïs
INTRODUCTION: Lack of transmural lesion formation during radiofrequency (RF) ablation for ventricular tachycardia (VT) is an important determinant of arrhythmia recurrence. The aim of this proof-of-concept study was to evaluate safety and efficacy of a new and more powerful cryoablation system for ventricular ablation. METHODS AND RESULTS: Five healthy female sheep (59 ± 6 kg) underwent a surgical sternotomy for epicardial and endocardial access [endocardial access via right atrial appendage and left ventricular (LV) apex]...
October 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27906707/hybrid-ablation-for-atrial-fibrillation-current-approaches-and-future-directions
#3
Gianluigi Bisleri, Benedict Glover
PURPOSE OF REVIEW: Catheter ablation of atrial fibrillation has rapidly evolved during the past decade: although the treatment of paroxysmal atrial fibrillation via a transcatheter approach has been consistently successful, persistent and long-standing atrial fibrillation still represents a major clinical challenge with less favorable outcomes to date. Because novel, minimally invasive surgical approaches have been developed for atrial fibrillation ablation, the aim of the present review is to analyze the current evidence surrounding the integration of surgical and transcatheter strategies in a hybrid fashion for the treatment of atrial fibrillation...
January 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27900527/should-all-patients-with-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy-undergo-epicardial-catheter-ablation
#4
Andreas Müssigbrodt, Elena Efimova, Helge Knopp, Livio Bertagnolli, Nikolaos Dagres, Sergio Richter, Daniela Husser, Andreas Bollmann, Gerhard Hindricks, Arash Arya
BACKGROUND: Epicardial radiofrequency catheter ablation is currently considered as the therapeutic option of choice in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and recurrent ventricular tachycardia (VT). We hypothesised that inducibility of VT may guide the ablation strategy and thereby affect long-term results. Additional epicardial ablation was only performed if VT were still inducible after thorough endocardial ablation. METHODS: The objective was to examine an inducibility-guided ablation approach by comparing the long-term results between endocardial and epi-endocardial radiofrequency catheter ablation of VT in a large cohort of patients with ARVD/C...
November 30, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27867071/evaluation-of-a-novel-high-resolution-mapping-system-for-catheter-ablation-of-ventricular-arrhythmias
#5
Karthik Viswanathan, Lilian Mantziari, Charles Butcher, Emily Hodkinson, Eric Lim, Habib Khan, Sandeep Panikker, Shouvik Haldar, Julian W E Jarman, David G Jones, Wajid Hussain, John P Foran, Vias Markides, Tom Wong
BACKGROUND: The mapping of ventricular arrhythmias in humans using a mini-basket 64-electrode catheter paired with a novel automatIc mapping system (Rhythmia(TM)) has not been evaluated. OBJECTIVE: To evaluate the safety and efficacy of mapping ventricular arrhythmias and clinical outcomes after ablation using this system. METHODS: Electroanatomic (EA) maps for ventricular arrhythmias were obtained during 20 consecutive procedures in 19 patients (ventricular tachycardia [VT] 12; ventricular ectopy [VE] 7)...
November 17, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27862994/colchicine-increases-ventricular-vulnerability-in-an-experimental-whole-heart-model
#6
Gerrit Frommeyer, Julius Krawczyk, Dirk G Dechering, Simon Kochhäuser, Patrick Leitz, Michael Fehr, Lars Eckardt
The traditional gout medication colchicine has been reported to effectively prevent atrial fibrillation recurrence after atrial fibrillation ablation or cardiac surgery in a few clinical trials. Severe adverse events have not yet been reported. The aim of the present study was to assess possible direct electrophysiological effects in an experimental whole-heart model. Ten rabbit hearts were isolated and Langendorff-perfused. Thereafter, colchicine was administered in 2 concentrations (1μM and 3μM). Eight endo- and epicardial monophasic action potentials and a 12-lead ECG showed a stable QT interval and action potential duration during colchicine infusion...
November 11, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27855290/transcatheter-leadless-cardiac-pacing-the-new-alternative-solution
#7
Antoine Da Costa, Amandine Axiotis, Cécile Romeyer-Bouchard, Loucif Abdellaoui, Zahi Afif, Jean Baptiste Guichard, Antoine Gerbay, Karl Isaaz
INTRODUCTION: A lack of information about the feasibility and safety of leadless pacemaker (LPMs) exists in a fragile population of patients with limited venous anatomy access or conventional pacemaker (PM) contraindication. Accordingly, the goal of this prospective observational study was to report our experience with this new leadless technology in a subset of patients with contraindication or limited venous access. METHODS AND RESULTS: Between May 2015 and July 2016, 14 patients were consecutively included...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27780243/local-electrical-dyssynchrony-during-atrial-fibrillation-theoretical-considerations-and-initial-catheter-ablation-results
#8
Pawel Kuklik, Benjamin Schäffer, Boris A Hoffmann, Anand N Ganesan, Doreen Schreiber, Julia M Moser, Ruken Ö Akbulak, Arian Sultan, Daniel Steven, Bart Maesen, Ulrich Schotten, Christian Meyer, Stephan Willems
BACKGROUND: Electrogram-based identification of the regions maintaining persistent Atrial Fibrillation (AF) is a subject of ongoing debate. Here, we explore the concept of local electrical dyssynchrony to identify AF drivers. METHODS AND RESULTS: Local electrical dyssynchrony was calculated using mean phase coherence. High-density epicardial mapping along with mathematical model were used to explore the link between local dyssynchrony and properties of wave conduction...
2016: PloS One
https://www.readbyqxmd.com/read/27763695/use-of-new-imaging-carto%C3%A2-segmentation-module-software-to-facilitate-ablation-of-ventricular-arrhythmias
#9
Oholi Tovia-Brodie, Bernard Belhassen, Aharon Glick, Haim Shmilovich, Galit Aviram, Raphael Rosso, Yoav Michowitz
INTRODUCTION: A new imaging software (CARTO® Segmentation Module, Biosense Webster) allows preprocedural 3-D reconstruction of all heart chambers based on cardiac CT. We describe our initial experience with the new module during ablation of ventricular arrhythmias. METHODS AND RESULTS: Eighteen consecutive patients with idiopathic ventricular arrhythmias or ischemic ventricular tachycardia (VT) were studied. In the latter group, a combined endocardial and epicardial ablation was performed...
October 20, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27751294/electrical-storm-in-dilated-cardiomyopathy-treated-using-epicardial-radiofrequency-ablation-as-a-first-line-therapy
#10
Massimiliano Faustino, Tullio Agricola, Borejda Xyheri, Enrico Di Girolamo, Luigi Leonzio, Carmine Pizzi
We report a patient with non-ischemic dilated cardiomyopathy and low left ventricular systolic function (28%) presenting with an electrical storm originated in epicardial scar and ablated by radiofrequency. This case report suggests that a strategy of epicardial catheter ablation is reasonable for the patient presenting with electrical storm related to structural disease with a low left ventricular ejection fraction.
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27747025/atrial-fibrillation-review-of-current-treatment-strategies
#11
Joshua Xu, Jessica G Y Luc, Kevin Phan
Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in modern clinical practice, with an estimated prevalence of 1.5-2%. The prevalence of AF is expected to double in the next decades, progressing with age and increasingly becoming a global medical challenge. The first-line treatment for AF is often medical treatment with either rate control or anti-arrhythmic agents for rhythm control, in addition to anti-coagulants such as warfarin for stroke prevention in patient at risk. Catheter ablation has emerged as an alternative for AF treatment, which involves myocardial tissue lesions to disrupt the underlying triggers and substrates for AF...
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27738073/safety-long-term-outcomes-and-predictors-of-recurrence-after-first-line-combined-endoepicardial-ventricular-tachycardia-substrate-ablation-in-arrhythmogenic-cardiomyopathy-impact-of-arrhythmic-substrate-distribution-pattern-a-prospective-multicentre-study
#12
Antonio Berruezo, Juan Acosta, Juan Fernández-Armenta, Alonso Pedrote, Alberto Barrera, Eduardo Arana-Rueda, Andrés Ignacio Bodegas, Ignasi Anguera, Luis Tercedor, Diego Penela, David Andreu, Rosario Jesus Perea, Susana Prat-González, Lluis Mont
BACKGROUND: First-line endoepicardial ventricular tachycardia (VT) ablation has been proposed for patients with arrhythmogenic cardiomyopathy (AC). This study reports procedural safety, outcomes, and predictors of recurrence. METHODS AND RESULTS: Forty-one consecutive patients [12 with left ventricle (LV) involvement, 7 left-dominant] underwent first-line endoepicardial VT substrate ablation. Standard bipolar and unipolar thresholds were used to define low-voltage areas (LVA)...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27733496/outside-in-subepicardial-dissection-during-percutaneous-epicardial-ventricular-tachycardia-ablation
#13
Guo Jincun, Zhou Faguang, Huang Weibin, Wang Yan, Dong Kang, Roderick Tung
No abstract text is available yet for this article.
October 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27733494/long-term-outcome-after-catheter-ablation-of-ventricular-tachycardia-in-patients-with-nonischemic-dilated-cardiomyopathy
#14
Daniele Muser, Pasquale Santangeli, Simon A Castro, Rajeev K Pathak, Jackson J Liang, Tatsuya Hayashi, Silvia Magnani, Fermin C Garcia, Mathew D Hutchinson, Gregory G Supple, David S Frankel, Michael P Riley, David Lin, Robert D Schaller, Sanjay Dixit, Erica S Zado, David J Callans, Francis E Marchlinski
BACKGROUND: Catheter ablation (CA) of ventricular tachycardia (VT) in patients with nonischemic dilated cardiomyopathy can be challenging because of the complexity of underlying substrates. We sought to determine the long-term outcomes of endocardial and adjuvant epicardial CA in nonischemic dilated cardiomyopathy. METHODS AND RESULTS: We examined 282 consecutive patients (aged 59±15 years, 80% males) with nonischemic dilated cardiomyopathy who underwent CA. Ablation was guided by activation/entrainment mapping for tolerated VT and pacemapping/targeting of abnormal electrograms for unmappable VT...
October 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27729345/challenging-radiofrequency-catheter-ablation-of-idiopathic-ventricular-arrhythmias-originating-from-the-left-ventricular-summit-near-the-left-main-coronary-artery
#15
Takumi Yamada, Harish Doppalapudi, Silvio H Litovsky, H Thomas McElderry, G Neal Kay
BACKGROUND: Radiofrequency catheter ablation (RFCA) of idiopathic ventricular arrhythmias (VAs) originating from the basal portion of the left ventricular (LV) summit, which is divided from the apical LV (A-LV) summit by the great cardiac vein (GCV), is challenging. This study investigated the efficacy of RFCA and electrocardiographic and electrophysiological characteristics of these VAs. METHODS AND RESULTS: Forty-five consecutive patients with symptomatic idiopathic LV summit VAs were studied...
October 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27685438/atrioesophageal-fistula-after-minimally-invasive-video-assisted-epicardial-ablation-for-lone-atrial-fibrillation
#16
Charles Kik, Richard van Valen, Mostafa M Mokhles, Jos A Bekkers, Ad J J C Bogers
Minimally invasive video-assisted epicardial beating heart ablation for lone atrial fibrillation claims to be safe and effective. We, however, report on three patients with an atrioesophageal fistula after this procedure. The exact pathogenesis of this complication is unknown. All patients presented around 6 weeks after surgery with either fever or neurological deficits. Diagnosis can be made by computed tomography scan. We advocate an aggressive surgical approach with closure of the atrial defect on cardiopulmonary bypass and closure and reinforcement of the esophagus with an intercostal muscle flap in a single-stage surgery...
September 29, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27663412/challenges-and-outcomes-of-posterior-wall-isolation-for-ablation-of-atrial-fibrillation
#17
Prabhat Kumar, Ayotunde M Bamimore, Jennifer D Schwartz, Eugene H Chung, Anil K Gehi, Andy C Kiser, James P Hummel, J Paul Mounsey
BACKGROUND: The left atrial posterior wall (PW) often contains sites required for maintenance of atrial fibrillation (AF). Electrical isolation of the PW is an important feature of all open surgeries for AF. This study assessed the ability of current ablation techniques to achieve PW isolation (PWI) and its effect on recurrent AF. METHODS AND RESULTS: Fifty-seven consecutive patients with persistent or high-burden paroxysmal AF underwent catheter ablation, which was performed using an endocardial-only (30) or a hybrid endocardial-epicardial procedure (27)...
2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27646458/combined-right-ventricular-outflow-tract-epicardial-and-endocardial-late-potential-ablation-for-treatment-of-brugada-storm-a-case-report-and-review-of-the-literature
#18
Sandeep A Saha, Kousik Krishnan, Christopher Madias, Richard G Trohman
A 34-year-old man with Brugada syndrome (BrS) presented with electrical storm, manifested as multiple appropriate shocks from his implantable cardioverter-defibrillator over a period of 7 hours. He had not tolerated prior treatment with quinidine, and had self-discontinued cilostazol citing persistent palpitations. After stabilization with intravenous isoproterenol, an electrophysiology study was performed but no spontaneous or induced ventricular ectopic beats were identified. A three-dimensional (3D) endocardial electro-anatomic map of the right ventricular outflow tract (RVOT), pulmonic valve, and pulmonary artery, as well as a 3D epicardial map of the RVOT, were created...
September 19, 2016: Cardiology and Therapy
https://www.readbyqxmd.com/read/27625170/prevalence-and-electrocardiographic-and-electrophysiological-characteristics-of-idiopathic-ventricular-arrhythmias-originating-from-intramural-foci-in-the-left-ventricular-outflow-tract
#19
Takumi Yamada, Harish Doppalapudi, William R Maddox, H Thomas McElderry, Vance J Plumb, G Neal Kay
BACKGROUNDS: Idiopathic ventricular arrhythmias (VAs) originating from the left ventricular outflow tract (LVOT) sometimes require catheter ablation from both the endocardial and epicardial sides for their elimination, suggesting the presence of intramural VA foci. This study investigated the prevalence and electrocardiographic and electrophysiological characteristics of these idiopathic intramural LVOT VAs when compared with the idiopathic endocardial and epicardial LVOT VAs. METHODS AND RESULTS: We studied 82 consecutive VAs with origins in the aortomitral continuity (n=30), LV summit (n=34), and intramural site (n=18)...
September 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27617087/arrhythmogenic-cardiomyopathy-electrical-and-structural-phenotypes
#20
Deniz Akdis, Corinna Brunckhorst, Firat Duru, Ardan M Saguner
This overview gives an update on the molecular mechanisms, clinical manifestations, diagnosis and therapy of arrhythmogenic cardiomyopathy (ACM). ACM is mostly hereditary and associated with mutations in genes encoding proteins of the intercalated disc. Three subtypes have been proposed: the classical right-dominant subtype generally referred to as ARVC/D, biventricular forms with early biventricular involvement and left-dominant subtypes with predominant LV involvement. Typical symptoms include palpitations, arrhythmic (pre)syncope and sudden cardiac arrest due to ventricular arrhythmias, which typically occur in athletes...
August 2016: Arrhythmia & Electrophysiology Review
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