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Paroxysmal atrial fibrillation

Ying-Chieh Liao, Jo-Nan Liao, Li-Wei Lo, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Tze-Fan Chao, Fa-Po Chung, Ta-Chuan Tuan, Abigail Louise D Te, Rohit Walia, Shinya Yamada, Chung-Hsing Lin, Chin-Yu Lin, Yao-Ting Chang, Suresh Allamsetty, Y U Wen-Chung, Jing-Long Huang, Tsu-Juey Wu, Shih-Ann Chen
INTRODUCTION: Although rare, some paroxysmal atrial fibrillations (AF) still progress despite radiofrequency (RF) ablation. In the study, we evaluated the long-term efficacy of RF ablation and the predictors of AF progression. METHODS: A total of 589 paroxysmal AF patients (404 men and 185 women; aged 54 ± 12 years) who received three-dimensional mapping and ablation were enrolled. Their clinical parameters and electrophysiological characteristics were collected...
October 25, 2016: Journal of Cardiovascular Electrophysiology
Jaroslav Meluzin, Zdenek Starek, Tomas Kulik, Jiri Jez, Frantisek Lehar, Josef Tomandl, Ladislav Dusek, Jiri Wolf, Pavel Leinveber, Miroslav Novak
BACKGROUND: Noninvasive diagnosis of exercise-induced elevation of left ventricular filling pressure is difficult and remains unsatisfactory. The aim of this study was to assess the accuracy of the ratio of early diastolic transmitral (E) to mitral annular (e') velocity and to determine new parameters or parameter combinations with the ability to predict exercise-induced left atrial pressure (LAP) elevation. METHODS AND RESULTS: Eighty patients with paroxysmal atrial fibrillation (AF) referred for catheter AF ablation underwent simultaneous exercise echocardiography and direct invasive LAP measurements, as well as a resting and postexercise biomarker analysis...
October 25, 2016: Echocardiography
Fabian Sanchis-Gomar, Carme Perez-Quilis, Giuseppe Lippi, Gianfranco Cervellin, Roman Leischik, Herbert Löllgen, Enrique Serrano-Ostáriz, Alejandro Lucia
Atrial fibrillation (AF) is the most common heart arrhythmia, the risk of which typically increases with age. This condition is commonly associated with major cardiovascular diseases and structural heart damage, while it is rarely observed in healthy young people. However, increasing evidence indicates that paroxysmal AF can also onset in young or middle-aged and otherwise healthy endurance athletes (e.g., cyclists, runners and cross-country skiers). Here we review the topic of AF associated with strenuous endurance exercise (SEE), for example cycling, running and cross-country skiing, especially at a competitive level, and we propose the definition of a new syndrome based on the accumulating data in the literature: SEE-related AF under the acronym of 'PAFIYAMA' ('paroxysmal AF in young and middle-aged athletes')...
October 19, 2016: International Journal of Cardiology
Jedrzej Kosiuk, Romina Milani, Laura Ueberham, Tobias Uhe, Clara Stegmann, Gerhard Hindricks, Andreas Bollmann
Remote ischemic preconditioning (RIPC) has been studied in models of different cardiovascular entities. Recently, a beneficial effect of RIPC on incidence of atrial fibrillation (AF) in postsurgical patients has been suggested. However, the potential impact of RIPC on electrophysiological- and thrombogenesis-related parameters in the setting of paroxysmal nonvalvular AF has not been investigated. The aim of the study is to answer the following questions: (1) Does RIPC have impact on inducibility of AF in patients with known paroxysmal AF? If yes, what are the direct electrophysiological mechanisms of this phenomenon, and could RIPC be implemented to reduce AF burden? (2) Does RIPC have the potential to minimize thrombogenic effects of simulated episodes of AF? If so, what are inhibited components of thrombogenesis and can this be used to reduce thromboembolic risk related to paroxysmal AF? The presented study is a 2-arm, randomized, placebo-controlled, double-blinded, single-center trial in a cohort of 146 patients with paroxysmal AF referred for AF ablation in sinus rhythm...
October 24, 2016: Clinical Cardiology
R-C Zhao, W Han, J Han, J Yu, J Guo, J-L Fu, Z Li, R-Z Zhao
OBJECTIVE: To study the efficacy and safety of radiofrequency catheter ablation (RFCA) in patients with different forms of atrial fibrillation. PATIENTS AND METHODS: By retrospective analysis, we summarize 720 cases, where patients diagnosed with atrial fibrillation in our hospital were treated with RFCA from February 2010 to October 2014. Among the cases, 425 were diagnosed with paroxysmal atrial fibrillation and 295 with non-paroxysmal atrial fibrillation (including persistent atrial fibrillation and permanent atrial fibrillation)...
October 2016: European Review for Medical and Pharmacological Sciences
Asit Das, Suvro Banerjee, S C Mandal
BACKGROUND: Pacing in the Bachmann's bundle (BB) area (upper atrial septum) appears superior to right atrial appendage or free wall stimulation for the prevention of paroxysmal atrial fibrillation in patients with atrial conduction delay. However, insertion of active fixation lead in the upper atrial septal position is difficult and time consuming with conventional stylet, inhibiting application of this pacing method in routine practice. METHODS: The technique of positioning the atrial lead in BB with hand-made stylet is presented with emphasis on electrocardiographic P-wave pattern and fluoroscopic landmarks...
September 2016: Indian Heart Journal
C Narasimhan, Jagmohan Singh Verma, A G Ravi Kishore, Balbir Singh, Sameer Dani, Kamaldeep Chawala, Azizul Haque, Aftab Khan, Mohan Nair, Amit Vora, V Rajasekhar, Joy M Thomas, Anoop Gupta, Ajay Naik, V S Prakash, Lisa Naditch, P Gabriel Steg
BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia with high risk for many cardiovascular (CV) complications. Adherence to recommended management guidelines is important to avoid complications. In India, there is little knowledge on how AF is managed in real world. METHODS: This is a cross-sectional study of patients in India enrolled in RealiseAF survey between February 2010 and March 2010 with a diagnosis of AF within the last 12 months...
September 2016: Indian Heart Journal
Stefan Georg Spitzer, László Károlyi, Carola Rämmler, Frank Scharfe, Thomas Weinmann, Mirko Zieschank, Anke Langbein
INTRODUCTION: A patient-tailored ablation approach focused on the elimination of both pulmonary vein triggers as well as substrate drivers may result in favourable outcomes with recurrent persistent AF patients. OBJECTIVE: We evaluated the long-term outcomes of rotor ablation combined with conventional pulmonary vein isolation (PVI) in patients with recurrent non-paroxysmal AF. METHODS: 58 consecutive patients underwent FIRM-guided rotor ablation followed by conventional PVI for the treatment of recurrent non-paroxysmal AF...
October 21, 2016: Journal of Cardiovascular Electrophysiology
Mu Qin, Xu Liu, Shao-Hui Wu, Xiao-Dong Zhang
Several clinically relevant outcomes post atrial substrate modification in patients with atrial fibrillation (AF) have not been systematically analyzed among published studies on adjunctive cardiac ganglionated plexi (GP) or complex fractionated atrial electograms (CFAE) ablation vs. pulmonary vein isolation (PVI) alone. Out of 176 reports identified, the present meta-analysis included 14 randomized and non-randomized controlled trials (1613 patients) meeting inclusion criteria. Addition of GP ablation to PVI significantly increased freedom from atrial tachyarrhythmia in short- (OR: 1...
2016: PloS One
Sergio E Masnaghetti, Simona Sarzi Braga, Raffaella Vaninetti, Paola Baiardi, Roberto F E Pedretti
BACKGROUND AND AIMS: Hospitalized patients after acute cardiovascular events have poorer prognosis if glucose regulation is diagnosed as abnormal. We compared the short and long-term outcome of patients with newly diagnosed altered fasting glycemia (AFG) to that of known diabetic patients and patients with normal glucose regulation (NGR) after admission to cardiac rehabilitation. METHODS: We retrospectively analyzed 2490 consecutive patients. Three groups were identified: known diabetes mellitus (n = 540, 22%), fasting glycemia above 110 mg/dl (AFG, n = 269, 11%), and fasting glycemia 110 mg/dl or less (NGR, n = 1681, 67%)...
October 15, 2016: Journal of Cardiovascular Medicine
Mi-Na Kim, Donghyuk Cho, Jae-Min Shim, Jong Il Choi, Seong-Mi Park, Young-Hoon Kim, Wan-Joo Shim
OBJECTIVE: Hypertension (HT) is the important risk factor for atrial fibrillation (AF). Hemodynamic overload by increased blood pressure causes atrial wall stretch and atrial dysfunction. Left atrial (LA) dysfunction has been regarded as the most important risk factor for AF recurrence after radiofrequency catheter ablation (RFCA). But there are controversies regarding the role of hypertension as a risk factor of AF recurrence after RFCA. The aim of this study was to assess whether the hypertension is an independent risk factor for AF recurrence after RFCA...
September 2016: Journal of Hypertension
Kazuomi Kario, Satoshi Hoshide
OBJECTIVE: It has been long believed that there is a close association between hypertension and atrial fibrillation (AF). However, there have been few studies on the impact of antihypertensive medication in hypertensives with AF. To investigate whether the timing of the antihypertensive drug administration influences blood pressure (BP) level and biomarkers to hypertensives with AF. DESIGN AND METHOD: The present study was a multicentered, prospective, randomized, open-labelled clinical trial to investigate the difference in the effect of telmisartan/amlodipine combination tablets on BP levels and BP variability using ambulatory BP monitoring (ABPM) and home BP between the morning administration and the bedtime administration in hypertensives with paroxysmal AF...
September 2016: Journal of Hypertension
Kaylin T Nguyen, Rachel A Gladstone, Jonathan W Dukes, Babak Nazer, Eric Vittinghoff, Nitish Badhwar, Vasanth Vedantham, Edward P Gerstenfeld, Byron K Lee, Randall J Lee, Zian H Tseng, Jeffrey E Olgin, Melvin M Scheinman, Gregory M Marcus
INTRODUCTION: Atrial refractoriness may be an important determinant of atrial fibrillation (AF) risk, but its measurement is not clinically accessible. Because the QT interval predicts incident AF and the atrium and ventricle share repolarizing ion currents, we investigated the association between an individual's QT interval and atrial effective refractory period (AERP). METHODS: In paroxysmal AF patients presenting for catheter ablation, the QT interval was measured from the surface 12-lead ECG...
October 18, 2016: Pacing and Clinical Electrophysiology: PACE
P Gal, T J Buist, J J J Smit, A Adiyaman, A R Ramdat Misier, P P H M Delnoy, A Elvan
INTRODUCTION: Pulmonary vein (PV) reconnection is frequently the cause of recurrence of atrial fibrillation (AF) after ablation. The second-generation gold multi-electrode ablation (Gold-MEA) catheter has a new design possibly resulting in improved lesion formation compared with its predecessor. We aimed to determine the association between effective radiofrequency applications with the Gold-MEA catheter and outcome after AF ablation. METHODS: 50 consecutive patients with paroxysmal AF underwent Gold-MEA (PVAC GOLD(TM), Medtronic Inc...
October 17, 2016: Netherlands Heart Journal
Ning Ma, Xiao-Yan Wu, Chang-Sheng Ma, Nian Liu, Rong Bai, Xin Du, Yan-Fei Ruan, Jian-Zeng Dong
Catheter ablation has been recommended as a treatment option for paroxysmal atrial fibrillation (PAF) patients complicated with type 2 diabetes mellitus (T2DM). PAF patients with T2DM have a higher recurrence rate after catheter ablation. Prolongation of corrected QT (QTc) interval has been linked to poor outcomes in T2DM patients. Whether the abnormal QTc interval is associated with the ablation outcome in the PAF patients with T2DM remains unknown. In this study, 134 PAF patients with T2DM undergoing primary catheter ablation were retrospectively enrolled...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Jeremiah Wasserlauf, Bradley P Knight, Zhi Li, Adin-Cristian Andrei, Rishi Arora, Alexandru B Chicos, Jeffrey J Goldberger, Susan S Kim, Albert C Lin, Nishant Verma, Martha M Bohn, Rod S Passman
BACKGROUND: Cryoballoon ablation (CBA) for paroxysmal atrial fibrillation (pAF) can be performed under general anesthesia (GA) or moderate sedation (MS). Our objective was to compare the effectiveness, safety, procedure duration, and time spent in the electrophysiology (EP) laboratory for CBA performed under GA and MS. METHODS: . Patients undergoing a first CBA for pAF were identified. Patients received either GA administered by an anesthesiologist or MS with midazolam and fentanyl administered by EP laboratory staff...
October 17, 2016: Pacing and Clinical Electrophysiology: PACE
Sergio Conti, Massimo Moltrasio, Claudio Tondo, Gaetano Fassini
Cryoballoon ablation is a widely diffuse technology to perform paroxysmal atrial fibrillation ablation. The new generation cryoballoon catheters have been redesigned in order to improve the cooling capability. During cryoballoon ablation it is not unusual to observe the formation of a contrast dye ice-cap on top of the balloon itself. The automated balloon deflation before dissolution of the ice cap may increase the risk of embolization of large ice-mixed-contrast crystals in the systemic circulation. In the case hereby reported, we describe an uneventful embolization of this contrast dye ice cap in the systemic circulation...
October 17, 2016: Pacing and Clinical Electrophysiology: PACE
Akira Fujiki, Masao Sakabe
Objective Detecting paroxysmal atrial fibrillation in patients with ischemic stroke presenting in sinus rhythm is difficult because such episodes are often short, and they are also frequently asymptomatic. It is possible that the ventricular repolarization dynamics may reflect atrial vulnerability and cardioembolic stroke. Hence, we compared the QT-RR relation between cardioembolic stroke and atherosclerotic stroke during sinus rhythm. Methods The subjects comprised 62 consecutive ischemic stroke patients including 31 with cardioembolic strokes (71...
2016: Internal Medicine
Sharan Prakash Sharma, Rajbir S Sangha, Khagendra Dahal, Parasuram Krishnamoorthy
BACKGROUND: It is not clear whether additional empiric superior vena cava isolation (SVCI) to pulmonary vein isolation (PVI) results in low recurrences of atrial fibrillation. We aimed to perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) that evaluated role of empiric SVCI in atrial fibrillation ablation. METHODS: We searched PubMed, EMBASE, Cochrane, Scopus, and relevant references for RCTs (inception April 15, 2016 without language restrictions) and performed meta-analysis using random effects model...
October 14, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Melanie A Gunawardene, Boris A Hoffmann, Benjamin Schaeffer, Da-Un Chung, Julia Moser, Ruken Oezge Akbulak, Mario Jularic, Christian Eickholt, Jana Nuehrich, Christian Meyer, Stephan Willems
INTRODUCTION: Comparative data of early recurrence rates of atrial fibrillation (ERAF) following second-generation cryoballoon (CB-G2) and radiofrequency current (RFC) ablation for pulmonary vein isolation (PVI) in paroxysmal AF (PAF) are rare. We randomized PAF patients into either PVI with CB-G2 (group 1) or PVI with a combined RFC-approach applying contact force (CF) with the endpoint of unexcitability (group 2) to investigate ERAF. METHODS: In group 1 (n = 30), CB-G2-PVI was performed...
October 14, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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