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Paroxysmal atrial fibrillation

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https://www.readbyqxmd.com/read/28635186/catheter-ablation-of-atrial-fibrillation-with-box-isolation-of-fibrotic-areas-lessons-on-fibrosis-distribution-and-extent-clinical-characteristics-and-their-impact-on-long-term-outcome
#1
Doreen Schreiber, Andreas Rieger, Fabian Moser, Hans Kottkamp
INTRODUCTION: The BIFA concept (box isolation of fibrotic areas) supplementing pulmonary vein isolation (PVI) was implemented in atrial fibrillation (AF) patients with fibrotic atrial cardiomyopathy (FACM) to improve catheter ablation outcomes. METHODS AND RESULTS: 92 patients with FACM underwent PVI+BIFA. We investigated patient characteristics (58 persistent/34 paroxysmal,68±8y,LA 44±7mm,CHA2 DS2 -VASc 2.6±1.3,FACM I:15.2%,II:53.3%,III:26.1%,IV:5.4%), periprocedural data concerning fibrosis extent/distribution and their impact on outcome...
June 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28633451/cha2ds2-vasc-score-and-blood-biomarkers-to-identify-patients-with-atrial-high-rate-episodes-and-paroxysmal-atrial-fibrillation-the-role-of-timp-4-regulation
#2
Salvatore Patanè, Francesco Patanè
No abstract text is available yet for this article.
June 19, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28631211/current-practice-of-dutch-cardiologists-in-detecting-and-diagnosing-atrial-fibrillation-results-of-an-online-case-vignette-study
#3
N Verbiest-van Gurp, P J M van Bladel, H A M van Kesteren, P M Erkens, H E J H Stoffers
INTRODUCTION: Detection of atrial fibrillation (AF) is important given the risk of complications, such as stroke and heart failure, and the need for preventive measures. Detection is complicated because AF can be silent or paroxysmal. Describing current practice may give clues to improve AF detection. The aim of this study was to describe how cardiologists currently detect AF. METHODS: Between December 2014 and May 2015, we sent Dutch cardiologists an online questionnaire...
June 19, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28631077/noninvasive-evaluation-of-reverse-atrial-remodeling-after-catheter-ablation-of-atrial-fibrillation-by-p-wave-dispersion
#4
Yuhi Fujimoto, Kenji Yodogawa, Kenta Takahashi, Ippei Tsuboi, Hiroshi Hayashi, Shunsuke Uetake, Yu-Ki Iwasaki, Meiso Hayashi, Yasushi Miyauchi, Wataru Shimizu
Atrial fibrillation (AF) itself creates structural and electrophysiological changes such as atrial enlargement, shortening of refractory period and decrease in conduction velocity, called "atrial remodeling", promoting its persistence. Although the remodeling process is considered to be reversible, it has not been elucidated in detail. The aim of this study was to assess the feasibility of P wave dispersion in the assessment of reverse atrial remodeling following catheter ablation of AF. Consecutive 126 patients (88 males, age 63...
June 19, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28630168/incidence-and-factors-associated-with-the-occurrence-of-pulmonary-vein-narrowing-after-cryoballoon-ablation
#5
Ryohsuke Narui, Michifumi Tokuda, Masato Matsushima, Ryota Isogai, Kenichi Tokutake, Kenichi Yokoyama, Mika Hioki, Keiichi Ito, Shin-Ichi Tanigawa, Seigo Yamashita, Keiichi Inada, Kenri Shibayama, Seiichiro Matsuo, Satoru Miyanaga, Kenichi Sugimoto, Michihiro Yoshimura, Teiichi Yamane
BACKGROUND: In contrast with traditional radiofrequency ablation, little is known about the influence of cryoballoon ablation on the morphology of pulmonary veins (PVs). We evaluated the influence of cryoballoon ablation on the PV dimension (PVD) and investigated the factors associated with a reduction of the PVD. METHODS AND RESULTS: Seventy-four patients who underwent cryoballoon ablation for paroxysmal atrial fibrillation were included in the present study. All subjects underwent contrast-enhanced computed tomography both before and at 3 months after the procedure...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28624117/a-case-of-pacemaker-malfunction-should-i-intervene
#6
Colin Yeo, David H Birnie, Girish M Nair
A 53year old lady was noted to have persistent bradycardia in the recovery unit shortly after a dual chamber permanent pacemaker (PPM) was implanted. The patient was asymptomatic. The pacemaker was implanted for symptomatic intermittent complete heart block. She had surgical closure of an atrial septal defect three decades earlier and a previous tricuspid valve replacement with concomitant biatrial cryomaze procedure for paroxysmal atrial fibrillation.
June 8, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28622606/dementia-correlates-with-anticoagulation-underuse-in-older-patients-with-atrial-fibrillation
#7
Giovanni Viscogliosi, Evaristo Ettorre, Iulia Maria Chiriac
OBJECTIVES: Stroke prevention in older atrial fibrillation (AF) patients remains a challenge. This study aimed to investigate whether a dementia diagnosis is an independent correlate of lower prescription rate of oral anticoagulant treatment (OAT) in a sample of older AF patients. METHODS: Cross-sectional retrospective study. Consecutive older community-dwelling AF patients referred for a comprehensive geriatric assessment, were considered. Evaluation of physical, social and mental health, and administration of the Cumulative Illness Rating Scale (CIRS) and Barthel Index were performed...
June 8, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28614214/a-rare-case-of-multiple-thrombi-in-a-giant-left-atrium
#8
Alfredo Intorcia, Marco A Perrone, Riccardo Morgagni, Domenico Sergi, Massimo Marchei, Mauro Borzi, Francesco Romeo
: Giant left atrium is frequently associated with rheumatic mitral valve disease. The incidence of left atrial thrombus among patients with mitral stenosis and atrial fibrillation varies from 7 to 38%. Anticoagulation therapy achieves a high rate of resolution of left atrial appendage (LAA) and left atrial cavity thrombi, but in selected patients surgical therapy must be considered. An 81-year-old woman presented to our emergency department with repeated episodes of transient ischemic attack. She had a history of carotid artery stenosis, chronic lymphocytic leukemia, rheumatic heart disease, and paroxysmal atrial fibrillation...
June 12, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28612230/right-atrial-diameter-and-outcome-of-catheter-ablation-of-atrial-fibrillation
#9
Song -Nan Wen, Nian Liu, Rong Bai, Ri-Bo Tang, Rong-Hui Yu, De-Yong Long, Cai-Hua Sang, Chen-Xi Jiang, Song-Nan Li, Jia-Hui Wu, Yan-Fei Ruan, Rong Hu, Xin Du, Xiao-Hui Liu, Jian-Zeng Dong, Chang-Sheng Ma
PURPOSE: While AF is considered more like a left atrial (LA) disease, to what extent the right atrium contributes to the pathogenesis and ablation outcome of AF remains unclear. This study aimed to identify if right atrial diameter (RAD) could predict arrhythmia recurrence after catheter ablation of atrial fibrillation (AF). METHODS: Four hundred and seventy patients with drug-resistant AF [paroxysmal AF (PAF) 196; non-PAF 274] who underwent primary catheter ablation were enrolled...
June 13, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28611206/pulmonary-vein-isolation-alone-versus-additional-linear-ablation-in-patients-with-persistent-atrial-fibrillation-converted-to-paroxysmal-type-with-antiarrhythmic-drug-therapy-a-multicenter-prospective-randomized-study
#10
Hee Tae Yu, Jaemin Shim, Junbeom Park, In-Soo Kim, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Young-Hoon Kim, Hui-Nam Pak
BACKGROUND: Atrial fibrillation (AF) type can vary depending on condition and timing, and some patients who initially present with persistent AF may be changed to paroxysmal AF after antiarrhythmic drug medication and cardioversion. We investigated whether circumferential pulmonary vein isolation (CPVI) alone is an effective rhythm control strategy in patients with persistent AF to paroxysmal AF. METHODS AND RESULTS: We enrolled 113 patients with persistent AF to paroxysmal AF (male 75%, 60...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28610723/pathophysiology-of-paroxysmal-and-persistent-atrial-fibrillation-rotors-foci-and-fibrosis
#11
REVIEW
Dennis H Lau, Dominik Linz, Ulrich Schotten, Rajiv Mahajan, Prashanthan Sanders, Jonathan M Kalman
Recent advances in our understanding of the mechanisms underlying atrial fibrillation (AF) have further underscored the complex pathophysiological basis of the arrhythmia. It has become apparent that the current clinical classification of AF does not reflect the severity of the underlying atrial disease. Atrial fibrosis has been identified as the key structural change in different substrates that are responsible for the perpetuation of AF. Three-dimensional electroanatomical mapping and late gadolinium-enhanced magnetic resonance imaging are novel modalities that can be used to facilitate identification and quantitation of atrial fibrosis for improved delineation of the AF substrate...
May 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28607614/pulmonary-vein-potential-mapping-in-atrial-fibrillation-with-high-density-and-standard-spiral-lasso-catheters-a-comparative-study
#12
Axel Meissner, Petra Maagh, Arnd Christoph, Ahmet Oernek, Gunnar Plehn
BACKGROUND: The dominant single-shot procedure for Pulmonary Vein Isolation (PVI) is the Cryoballoon Ablation (CBA) technique using a spiral catheter (Achieve™, AC) for mapping and monitoring purposes. We hypothesized that Basket Catheters, such as the High Density Mesh Mapper (HDMM), with its high-density mapping properties, could detect Pulmonary Vein Potentials (PVPs) that the octapolar AC would not be able to identify. METHODS: Twenty-four patients (average age 61...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28607613/complex-fractionated-atrial-electrograms-high-dominant-frequency-regions-and-left-atrial-voltages-during-sinus-rhythm-and-atrial-fibrillation
#13
Naoko Sasaki, Ichiro Watanabe, Yasuo Okumura, Koichi Nagashima, Rikitake Kogawa, Kazumasa Sonoda, Kazuki Iso, Keiko Takahashi, Masaru Arai, Ryuta Watanabe, Sayaka Kurokawa, Kimie Ohkubo, Toshiko Nakai, Atsushi Hirayama, Mizuki Nikaido
BACKGROUND: Ablation targeting complex fractionated atrial electrograms (CFAEs) or high dominant frequency (DF) sites is generally effective for persistent atrial fibrillation (AF). CFAEs and/or high DF sites may exist in low-voltage regions, which theoretically represent abnormal substrates. However, whether CFAEs or high DF sites reflect low voltage substrates during sinus rhythm (SR) is unknown. METHODS: Sixteen patients with AF (8 with paroxysmal AF; 8, persistent AF) underwent high-density mapping of the left atrium (LA) with a 3-dimensional electroanatomic mapping system before ablation...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28605524/prevalence-and-predictors-of-low-voltage-zones-in-the-left-atrium-in-patients-with-atrial-fibrillation
#14
Yan Huo, Thomas Gaspar, Matthias Pohl, Judith Sitzy, Utz Richter, Sebastian Neudeck, Julia Mayer, Mads Brix Kronborg, Christopher Piorkowski
Aims: To describe the extent and distribution of low voltage zones (LVZ) in a large cohort of patients undergoing ablation for paroxysmal and persistent atrial fibrillation (AF), and to explore baseline predictors of LVZ in these patients. Methods and results: Consecutive patients who underwent a bipolar voltage map guided AF ablation, were enrolled. Voltage maps were conducted for each patient using 3-dimensional electroanatomical mapping system and LVZ were defined as areas of bipolar voltage < 0...
June 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28603589/empirical-anticoagulation-for-patients-in-sinus-rhythm-at-high-risk-of-ischaemic-stroke-a-review-of-current-literature
#15
REVIEW
Irma Battipaglia, James O'Neill, Andrew J Hogarth, Muzahir H Tayebjee
Ischaemic stroke is one of the commonest causes of morbidity and mortality worldwide and around a fifth of events can be attributed to a cardioembolic source. This is typically due to atrial fibrillation (AF), the most common sustained cardiac arrhythmia. However, AF can, at times, be difficult to detect due to a relative lack of symptoms and the fact that it can be paroxysmal in nature. Studies have shown that diagnosis of AF improves as the length of cardiac monitoring increases. However, prolonged cardiac monitoring is not a cost-effective way of diagnosing AF...
May 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28600457/paroxysmal-atrial-fibrillation-in-a-patient-on-hemodialysis
#16
Charmaine E Lok
No abstract text is available yet for this article.
June 9, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28599946/a-58-year-old-man-with-fatigue-weight%C3%A2-loss-and-diffuse-miliary-pulmonary%C3%A2-opacities
#17
Udit Chaddha, Rebekah English, Jessica Daniels, Rajat Walia, Atul C Mehta, Tanmay S Panchabhai
A 58-year-old man presented with a 6-month history of profound fatigue and a weight loss of 35 to 40 pounds. He reported occasional night sweats and mildly painful knees and elbows without swelling or redness. He denied respiratory symptoms, rashes, or fevers. He had no respiratory symptoms. The patient's history was significant for rheumatoid arthritis (with arthralgias and joint involvement), paroxysmal atrial fibrillation, and hypothyroidism. His medications included digoxin and metoprolol. He had been taking methotrexate and low-dose prednisone (5 mg) for approximately 10 years but discontinued taking these medications 2 years prior to current presentation...
June 2017: Chest
https://www.readbyqxmd.com/read/28596994/recurrent-post-ablation-paroxysmal-atrial-fibrillation-shares-substrates-with-persistent-atrial-fibrillation-an-11-center-study
#18
Junaid A B Zaman, Tina Baykaner, Paul Clopton, Vijay Swarup, Robert C Kowal, James P Daubert, John D Day, John Hummel, Amir A Schricker, David E Krummen, Moussa Mansour, Gery F Tomassoni, Kevin R Wheelan, Mohan Vishwanathan, Shirley Park, Paul J Wang, Sanjiv M Narayan, John M Miller
INTRODUCTION: The role of atrial fibrillation (AF) substrates is unclear in patients with paroxysmal AF (PAF) that recurs after pulmonary vein isolation (PVI). We hypothesized that patients with recurrent post-ablation (redo) PAF despite PVI have electrical substrates marked by rotors and focal sources, and structural substrates that resemble persistent AF more than patients with (de novo) PAF at first ablation. METHODS: In 175 patients at 11 centers, we compared AF substrates in both atria using 64 pole-basket catheters and phase mapping, and indices of anatomical remodeling between patients with de novo or redo PAF and first ablation for persistent AF...
April 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28590042/changes-in-arrhythmogenic-properties-and-five-year-prognosis-after-carbon-ion-radiotherapy-in-patients-with-mediastinum-cancer
#19
Mari Amino, Koichiro Yoshioka, Makiyoshi Shima, Tohru Okada, Mio Nakajima, Yoshiya Furusawa, Shigetaka Kanda, Sadaki Inokuchi, Teruhisa Tanabe, Yuji Ikari, Tadashi Kamada
INTRODUCTION: Carbon-ion irradiation of rabbit hearts has improved left ventricular conduction abnormalities through upregulation of gap junctions. However, to date, there has been no investigation on the effect of carbon-ion irradiation on electrophysiological properties in human. We investigated this effect in patients with mediastinum extra-cardiac cancer treated with carbon-ion radiotherapy that included irradiating the heart. METHODS AND RESULTS: In April-December 2009, eight patients were prospectively enrolled (including two male, aged 72...
June 7, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28584202/feasibility-of-atrial-autocapture%C3%A2-to-detect-atrial-evoked-response-experience-from-102-patients-implanted-with-dual-chamber-pacemakers
#20
Hai-Long Si, Qin Qin, Bing-Rang Zhao, Gang Chen, Ya-Ru Lu, Lu Kou, Jing-Yu Yang, Wen-Hua Lin, Zi-Wen Ren
BACKGROUND: Atrial AutoCapture™ (ACap™) was a new technological development that confirmed atrial capture by analyzing evoked response (ER) with a new method - paced depolarization integral ER detection - and optimized energy output to changes in the stimulation threshold. The purpose of this study was to evaluate the clinical performance of ACap™ function. METHODS: This was a prospective, observational, nonrandomized two-center study. Between November 2008 and August 2014, 102 patients were enrolled from two different institutions...
June 20, 2017: Chinese Medical Journal
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