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https://www.readbyqxmd.com/read/29454549/technology-advances-to-improve-response-to-cardiac-resynchronization-therapy-what-clinicians-should-know
#1
Angelo Auricchio, Ward A Heggermont
Cardiac resynchronization therapy (CRT) is a well-established treatment for symptomatic heart failure patients with reduced left ventricular ejection fraction, prolonged QRS duration, and abnormal QRS morphology. The ultimate goals of modern CRT are to improve the proportion of patients responding to CRT and to maximize the response to CRT in patients who do respond. While the rate of CRT nonresponders has moderately but progressively decreased over the last 20 years, mostly in patients with left bundle branch block, in patients without left bundle branch block the response rate is almost unchanged...
February 14, 2018: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29453212/implant-of-a-left-atrial-appendage-occluder-device-watchman-and-leadless-pacing-system-micra-through-the-same-venous-access-in-a-single-sitting
#2
Sofian Johar, Nazar Luqman
A left atrial appendage occluder device (Watchman) and leadless pacemaker (Micra) was implanted from a single right femoral vein access in a 73-year-old female patient with persistent atrial fibrillation and symptomatic tachy-brady syndrome and unable to take oral anticoagulants. Standard methods of implantation were followed for both procedures. The Watchman device was implanted first followed by dilatation of the same venous access site in order to implant Micra transcatheter pacing system. The patient tolerated the procedures well and there were no complications...
February 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29428145/his-bundle-pacing-is-it-ready-for-prime-time
#3
REVIEW
Fatima M Ezzeddine, Gopi Dandamudi
Long-term right ventricular apical pacing has been associated with detrimental effects, including an increased risk for heart failure, atrial fibrillation, and death. Most of these adverse effects result from ventricular dyssynchrony related to perturbed ventricular depolarization. In addition, biventricular pacing has limited benefits in patients with non-left bundle branch block and severely reduced ejection fraction. Consequently, alternative pacing strategies that mimic natural physiology are desired. Recently, permanent His bundle pacing has emerged as a true physiologic form of ventricular pacing that has been shown to be safe and feasible in clinical practice...
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29425570/a-potential-relationship-between-gut-microbes-and-atrial-fibrillation-trimethylamine-n-oxide-a-gut-microbe-derived-metabolite-facilitates-the-progression-of-atrial-fibrillation
#4
Lilei Yu, Guannan Meng, Bing Huang, Xiaoya Zhou, Stavros Stavrakis, Menglong Wang, Xuefei Li, Liping Zhou, Yuhong Wang, Meng Wang, Zhenya Wang, Jielin Deng, Sunny S Po, Hong Jiang
BACKGROUND: Emerging evidence indicates gut microbes and their products could activate the autonomic nervous system (ANS), which plays important roles in the initiation and maintenance of atrial fibrillation (AF). Trimethylamine N-oxide (TMAO), a metabolite derived from gut microbes, is associated with cardiovascular diseases. The present study aimed to investigate the role of TMAO in the progression of AF. METHODS: In part 1: TMAO or saline was locally injected into 4 major atrial ganglionated plexi (GP) to clarify its effect on cardiac ANS and AF inducibility in normal canines...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29424572/atrial-arrhythmias-and-autonomic-dysfunction-in-rats-exposed-to-chronic-intermittent-hypoxia
#5
Sara L Bober, John Ciriello, Douglas L Jones
Obstructive sleep apnea (OSA), which involves chronic, intermittent hypoxia (CIH), is a major risk factor for developing atrial fibrillation (AF). Whether or not CIH alone alters cardiac mechanisms to support AF is unknown. This study investigated the effects of CIH on atrial electrophysiology and arrhythmia vulnerability, and evaluated the role of autonomics in CIH promotion of AF. Adult male Sprague-Dawley rats were exposed to 8h/day of CIH or normoxia for 7 days. Following exposure, rats were anesthetized for intracardiac electrophysiological studies...
February 9, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29419690/association-between-paced-qrs-duration-and-atrial-fibrillation-after-permanent-pacemaker-implantation-a-retrospective-observational-cohort-study
#6
FuWei Xing, JingZhou Jiang, XiaoLiang Hu, Chong Feng, JianGui He, YuGang Dong, YueDong Ma, AnLi Tang
Right ventricular pacing often results in prolonged QRS duration (QRSd) as the result of right ventricular stimulation, and atrial fibrillation (AF) may result. The association of pacing-induced prolonged QRSd and AF in patients with permanent pacemakers is unknown.We selected 180 consecutive patients who underwent pacemaker implantation for complete/advanced atrioventricular block. All of the patients were paced from the right ventricular septum. Electrocardiography recordings were obtained at the beginning and the end of pacemaker implantation...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29378480/irbesartan-prevents-sodium-channel-remodeling-in-a-canine-model-of-atrial-fibrillation
#7
Xuewen Wang, Guangping Li
INTRODUCTION: Activation of the renin-angiotensin system (RAS) plays an important role in atrial electrical remodeling (AER). The purpose of the present study was to evaluate the effects of irbesartan on cardiac sodium current (INa) in a canine model of atrial fibrillation. MATERIALS AND METHODS: Eighteen dogs were randomized into sham, pacing or pacing+irbesartan groups ( n = 6 in each group). The dogs in the pacing and irbesartan group were paced at 500 bpm for two weeks...
January 2018: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/29378361/assessment-of-thrombotic-risk-in-atrial-fibrillation-with-ultrasound-molecular-imaging-of-p-selectin
#8
Yuanwen Jing, Yinlan Hu, Hairui Li, Junfen Wang, Xiaoyun Si, Hao Zheng, Jian Liu, Wangjun Liao, Yulin Liao, Jianping Bin
Molecular imaging of inflammatory mediators in atria may contribute to thrombotic risk assessment of atrial fibrillation (AF). We investigated the feasibility of ultrasound molecular imaging (UMI) targeted to P-selectin to assess thrombotic risk in AF. Rat AF models were established with rapid atrial pacing. Microbubbles targeted to P-selectin were injected into the rats, followed by left atrial (LA) UMI examination. Furthermore, P-selectin, platelets (PLTs), fibrin and tissue factor (TF) of LA were detected by histopathology and scanning electron microscopy...
February 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29367535/management-of-arrhythmias-in-heart-failure
#9
REVIEW
Daniele Masarone, Giuseppe Limongelli, Marta Rubino, Fabio Valente, Rossella Vastarella, Ernesto Ammendola, Rita Gravino, Marina Verrengia, Gemma Salerno, Giuseppe Pacileo
Heart failure patients are predisposed to develop arrhythmias. Supraventricular arrhythmias can exacerbate the heart failure symptoms by decreasing the effective cardiac output and their control require pharmacological, electrical, or catheter-based intervention. In the setting of atrial flutter or atrial fibrillation, anticoagulation becomes paramount to prevent systemic or cerebral embolism. Patients with heart failure are also prone to develop ventricular arrhythmias that can present a challenge to the managing clinician...
February 28, 2017: Journal of Cardiovascular Development and Disease
https://www.readbyqxmd.com/read/29346633/intraoperative-epicardial-focal-pulmonary-venous-electrocardiography-in-patients-with-atrial-fibrillation
#10
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/29340587/subclinical-device-detected-atrial-fibrillation-and-stroke-risk-a-systematic-review-and-meta-analysis
#11
Rajiv Mahajan, Tharani Perera, Adrian D Elliott, Darragh J Twomey, Sharath Kumar, Dian A Munwar, Kashif B Khokhar, Anand Thiyagarajah, Melissa E Middeldorp, Chrishan J Nalliah, Jeroen M L Hendriks, Jonathan M Kalman, Dennis H Lau, Prashanthan Sanders
Aims: To determine stroke risk in subclinical atrial fibrillation (AF) and temporal association between subclinical AF and stroke. Methods and results: Pubmed/Embase was searched for studies reporting stroke in subclinical AF in patients with cardiac implantable electronic devices (CIEDs). After exclusions, 11 studies were analysed. Of these seven studies reported prevalence of subclinical AF, two studies reported association between subclinical and clinical AF, seven studies reported stroke risk in subclinical AF, and five studies reported temporal relationship between subclinical AF and stroke...
January 10, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29336990/failure-of-intracardiac-pacing-after-fatal-propafenone-overdose-a-case-report
#12
Ivan Zeljković, Nikola Bulj, Matea Kolačević, Vedran Čabrilo, Diana Delić Brkljačić, Šime Manola
BACKGROUND: Propafenone is a sodium-channel blocker, class IC antiarrhythmic drug, frequently used to manage supraventricular dysrhythmias, especially atrial fibrillation. We report a self mono-intoxication with propafenone. CASE REPORT: A 68-year-old woman presented with a decreased level of consciousness, hypotension, and electrocardiogram showing QRS widening with atrial asystole and extreme bradycardia < 20 beats/min. After initial stabilization with transcutaneous pacing, laboratory findings detected normal electrolyte ranges and metabolic acidosis, and her medical history revealed availability of propafenone due to paroxysmal atrial fibrillation and depressive syndrome, which led to the suspicion of intoxication...
January 11, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29250289/mechanistic-insights-into-durable-pulmonary-vein-isolation-achieved-by-second-generation-cryoballoon-ablation
#13
Yasuo Okumura, Ichiro Watanabe, Kazuki Iso, Keiko Takahashi, Koichi Nagashima, Kazumasa Sonoda, Hiroaki Mano, Naoko Yamaguchi, Rikitake Kogawa, Ryuta Watanabe, Masaru Arai, Kimie Ohkubo, Sayaka Kurokawa, Toshiko Nakai, Atsushi Hirayama
Background: The mechanism explaining the efficacy of cryoballoon ablation (CBA) for atrial fibrillation has not been clarified. Methods and Results: We compared lesion characteristics between patients in whom pulmonary vein isolation (PVI) was performed by CBA (n=56) and those by contact force (CF)-based RF ablation (n=56). We evaluated the 3-dimensional PV morphology before and after cryoballoon inflation. After PVI, a 3D left atrial voltage map was created. Pacing (10 mA and 2 ms) was performed within the low voltage area from the ablation line, and electrically unexcitable ablated tissue was identified...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29224646/association-of-insurance-type-with-receipt-of-oral-anticoagulation-in-insured-patients-with-atrial-fibrillation-a-report-from-the-american-college-of-cardiology-ncdr-pinnacle-registry
#14
MULTICENTER STUDY
Celina M Yong, Yuyin Liu, Patricia Apruzzese, Gheorghe Doros, Christopher P Cannon, Thomas M Maddox, Anil Gehi, Jonathan C Hsu, Steven A Lubitz, Salim Virani, Mintu P Turakhia
BACKGROUND: It is poorly understood whether insurance type may be a major contributor to the underuse of oral anticoagulation (OAC) among patients with atrial fibrillation (AF), particularly for novel oral anticoagulants (NOACs). METHODS: We performed a retrospective cohort registry study of patients with insurance, AF, CHA2DS2-VASc ≥2, and at least one outpatient encounter recorded in the ACC NCDR's PINNACLE Registry between January 1, 2011 and December 31, 2014...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29221440/effect-of-flecainide-on-atrial-fibrillatory-rate-in-a-large-animal-model-with-induced-atrial-fibrillation
#15
Eva Z Hesselkilde, Helena Carstensen, Maria M Haugaard, Jonas Carlson, Steen Pehrson, Thomas Jespersen, Rikke Buhl, Pyotr G Platonov
BACKGROUND: Atrial fibrillatory cycle length has been considered one of the indices of atrial electrical remodelling during atrial fibrillation (AF), which can be assessed from surface ECG by computer-assisted calculation of atrial fibrillatory rate (AFR). Horses have been suggested as a bona fide model for AF studies since horses too, develop lone AF, however data on AF characteristics in horses are extremely sparse and non-invasive characterization of AF complexity using surface ECG processing has not been reported...
December 8, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29220422/atrioventricular-node-ablation-and-his-bundle-pacing
#16
Pugazhendhi Vijayaraman, Faiz A Subzposh, Angela Naperkowski
Aims: Atrioventricular node ablation (AVNA) and right ventricular pacing (RVP) are effective therapies for patients with atrial fibrillation (AF) and rapid ventricular rates. His bundle pacing (HBP) is a physiologic alternative to RVP. The aim of our study is to assess the feasibility and safety of HBP in patients undergoing AVNA and its effect on left ventricular (LV) function. Methods and results: Permanent HBP is the preferred form of ventricular pacing at our institute...
December 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29189109/monocentric-experience-of-leadless-pacing-with-focus-on-challenging-cases-for-conventional-pacemaker
#17
Christophe Garweg, Joris Ector, Gabor Voros, Adèle Greyling, Bert Vandenberk, Stefaan Foulon, Rik Willems
AIM: Leadless cardiac pacemaker has been developed to reduce complications related to cardiac pacing and is considered as an alternative to conventional pacemaker although safety and efficacy data in clinical practice are limited. The purpose of this study was to investigate the safety and efficacy profile of Micra Transcatheter Pacing System (TPS) used in daily clinical activity with a focus on challenging cases for conventional pacing. METHODS: A total of 66 patients (46 men, 79...
November 30, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29186415/atrioventricular-dromotropathy-evidence-for-a-distinctive-entity-in-heart-failure-with-prolonged-pr-interval
#18
Floor C W M Salden, Valentina Kutyifa, Martin Stockburger, Frits W Prinzen, Kevin Vernooy
Heart failure (HF) is often accompanied by atrioventricular (AV) conduction disturbance, represented by prolongation of the PR interval on the electrocardiogram. Studies suggest that PR prolongation exists in at least 10% of HF patients, and it seems more prevalent in the presence of prolonged QRS duration. A prolonged PR interval may result in elevated left ventricular (LV) end-diastolic pressure, diastolic mitral regurgitation, and reduced LV pump function. This seems especially the case in patients with heart disease, in whom it is associated with an increased risk for atrial fibrillation, advanced AV heart block, HF, and death...
November 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29180458/clinical-outcomes-after-ablation-of-the-av-junction-in-patients-with-atrial-fibrillation-impact-of-cardiac-resynchronization-therapy
#19
Suneet Mittal, Dan L Musat, Michael H Hoskins, Julie B Prillinger, Gregory J Roberts, Yelena Nabutovsky, Faisal M Merchant
BACKGROUND: Patients with atrial fibrillation (AF) often undergo AV junction ablation (AVJA) and pacemaker implantation. Right ventricular (RV) pacing contributes to increased risk of heart failure (HF), which may be mitigated by biventricular pacing. We sought to determine the impact of AVJA concurrent with RV versus biventricular pacemaker implantation on AF and HF hospitalizations. METHODS AND RESULTS: The MarketScan Commercial and Medicare Supplemental claims database was used to select 18- to 100-year-old patients with AF with pacemaker implantation...
November 27, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29174249/low-interatrial-septal-pacing-a-simple-method
#20
Asit Das, Dhiman Kahali, Shibananda Dutta
BACKGROUND: Sinus node disease is associated with widespread structural and electrophysiological changes in the atria in addition to abnormalities at the sinus node. The atrial conduction disorder in patients with atrial pacing results in higher incidence of atrial fibrillation. Studies have shown that low interatrial septal pacing is superior to right atrial appendage pacing in preventing persistent or permanent atrial fibrillation in these patients. However, implantation of active fixation lead in low interatrial septal position is difficult and time consuming with conventional stylet, inhibiting application of this method in routine practice...
November 2017: Indian Heart Journal
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