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https://www.readbyqxmd.com/read/29054201/electrocardiographic-features-various-atrial-site-pacing
#1
REVIEW
Asit Das
Atrial pacing is done for either symptomatic sinus node dysfunction (SND) or for maintenance of atrio-ventricular synchrony in a dual chamber pacemaker. Conventionally, atrial lead is placed in the right atrial appendage. Atrial conduction disorder in patients with permanent pacing results in higher incidence of atrial fibrillation. Atrial septal pacing has emerged as a solution to this problem. So, it is extremely important to understand the different features of paced P wave from various atrial pacing sites...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29045344/atrial-fibrillation-and-cardiac-resynchronization-therapy
#2
Maurizio Gasparini, Paola Galimberti
PURPOSE OF REVIEW: Atrial fibrillation and heart failure are commonly encountered in current clinical practice. This review aims to revisit the complex interaction of these two common situations and the best treatment whenever both occurs, especially focusing on heart failure patients undergoing cardiac resynchronization therapy (CRT). RECENT FINDINGS: It has been recently confirmed that in patients undergoing cardiac resynchronization therapy, 100% biventricular pacing percentage should be pursued...
October 17, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29031455/does-permanent-atrial-fibrillation-modify-response-to-cardiac-resynchronization-therapy-in-heart-failure-patients
#3
Ana Abreu, Mário Oliveira, Pedro Silva Cunha, Helena Santa Clara, Guilherme Portugal, Inês Gonçalves Rodrigues, Vanessa Santos, Luis Morais, Mafalda Selas, Rui Soares, Luísa Branco, Rui Ferreira, Miguel Mota Carmo
INTRODUCTION: The benefits of cardiac resynchronization therapy (CRT) documented in heart failure (HF) may be influenced by atrial fibrillation (AF). We aimed to compare CRT response in patients in AF and in sinus rhythm (SR). METHODS: We prospectively studied 101 HF patients treated by CRT. Rates of clinical, echocardiographic and functional response, baseline NYHA class and variation, left ventricular ejection fraction, volumes and mass, atrial volumes, cardiopulmonary exercise test (CPET) duration (CPET dur), peak oxygen consumption (VO2max) and ventilatory efficiency (VE/VCO2 slope) were compared between AF and SR patients, before and at three and six months after implantation of a CRT device...
October 12, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29030379/right-ventricular-pacing-increases-risk-of-appropriate-implantable-cardioverter-defibrillator-shocks-asymmetrically-an-analysis-of-the-altitude-database
#4
Edmond M Cronin, Paul Jones, Milan C Seth, Niraj Varma
BACKGROUND: Right ventricular pacing (RVP) increases risk of atrial fibrillation in patients with implantable cardioverter-defibrillators (ICDs), but ventricular proarrhythmia is less clear. We analyzed a large remote monitoring database to assess this question. METHODS AND RESULTS: Patients with single- or dual-chamber ICDs, engaged in remote monitoring for at least 6 months and with unchanged tachycardia programming, were included. %RVP was derived for each weekly transmission...
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29018164/termination-of-vernakalant-resistant-atrial-fibrillation-by-inhibition-of-small-conductance-ca-2-activated-k-channels-in-pigs
#5
Jonas Goldin Diness, Lasse Skibsbye, Rafel Simó-Vicens, Joana Larupa Santos, Pia Lundegaard, Carlotta Citerni, Daniel Rafael Peter Sauter, Sofia Hammami Bomholtz, Jesper Hastrup Svendsen, Søren-Peter Olesen, Ulrik S Sørensen, Thomas Jespersen, Morten Grunnet, Bo Hjorth Bentzen
BACKGROUND: Evidence has emerged that small-conductance Ca(2+)-activated K(+) (SK) channels constitute a new target for treatment of atrial fibrillation (AF). SK channels are predominantly expressed in the atria as compared with the ventricles. Various marketed antiarrhythmic drugs are limited by ventricular adverse effects and efficacy loss as AF progresses. METHODS AND RESULTS: A total of 43 pigs were used for the studies. AF reversion in conscious long-term tachypaced pigs: Pigs were subjected to atrial tachypacing (7 Hz) until they developed sustained AF that could not be reverted by vernakalant 4 mg/kg (18...
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29016724/triggered-intracellular-calcium-waves-in-dog-and-human-left-atrial-myocytes-from-normal-and-failing-hearts
#6
Gary L Aistrup, Rishi Arora, Søren Grubb, Shin Yoo, Benjamin Toren, Manvinder Kumar, Aaron Kunamalla, William Marszalec, Tej Motiwala, Shannon Tai, Sean Yamakawa, Satya Yerrabolu, Francisco J Alvarado, Hector H Valdivia, Jonathan M Cordeiro, Yohannes Shiferaw, J Andrew Wasserstrom
Aims: Abnormal intracellular Ca 2+ cycling contributes to triggered activity and arrhythmias in the heart. We investigated the properties and underlying mechanisms for systolic triggered Ca 2+ waves in left atria from normal and failing dog hearts. Methods and Results: Intracellular Ca 2+ cycling was studied using confocal microscopy during rapid pacing of atrial myocytes (36 °C) isolated from normal and failing canine hearts (ventricular tachypacing model). In normal atrial myocytes (NAMs), Ca 2+ waves developed during rapid pacing at rates ≥ 3...
August 29, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28966986/intra-atrial-conduction-delay-revealed-by-multisite-incremental-atrial-pacing-is-an-independent-marker-of-remodeling-in-human-atrial-fibrillation
#7
Steven E Williams, Nick W F Linton, James Harrison, Henry Chubb, John Whitaker, Jaswinder Gill, Christopher A Rinaldi, Reza Razavi, Steven Niederer, Matthew Wright, Mark O'Neill
OBJECTIVES: This study sought to characterize direction-dependent and coupling interval-dependent changes in left atrial conduction and electrogram morphology in uniformly classified patients with paroxysmal atrial fibrillation (AF) and normal bipolar voltage mapping. BACKGROUND: Although AF classifications are based on arrhythmia duration, the clinical course, and treatment response vary between patients within these groups. Electrophysiological mechanisms responsible for this variability are incompletely described...
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28964122/a-computational-framework-for-testing-arrhythmia-marker-sensitivities-to-model-parameters-in-functionally-calibrated-populations-of-atrial-cells
#8
Márcia R Vagos, Hermenegild Arevalo, Bernardo Lino de Oliveira, Joakim Sundnes, Mary M Maleckar
Models of cardiac cell electrophysiology are complex non-linear systems which can be used to gain insight into mechanisms of cardiac dynamics in both healthy and pathological conditions. However, the complexity of cardiac models can make mechanistic insight difficult. Moreover, these are typically fitted to averaged experimental data which do not incorporate the variability in observations. Recently, building populations of models to incorporate inter- and intra-subject variability in simulations has been combined with sensitivity analysis (SA) to uncover novel ionic mechanisms and potentially clarify arrhythmogenic behaviors...
September 2017: Chaos
https://www.readbyqxmd.com/read/28964116/revealing-kinetics-and-state-dependent-binding-properties-of-ikur-targeting-drugs-that-maximize-atrial-fibrillation-selectivity
#9
Nicholas Ellinwood, Dobromir Dobrev, Stefano Morotti, Eleonora Grandi
The KV1.5 potassium channel, which underlies the ultra-rapid delayed-rectifier current (IKur) and is predominantly expressed in atria vs. ventricles, has emerged as a promising target to treat atrial fibrillation (AF). However, while numerous KV1.5-selective compounds have been screened, characterized, and tested in various animal models of AF, evidence of antiarrhythmic efficacy in humans is still lacking. Moreover, current guidelines for pre-clinical assessment of candidate drugs heavily rely on steady-state concentration-response curves or IC50 values, which can overlook adverse cardiotoxic effects...
September 2017: Chaos
https://www.readbyqxmd.com/read/28964113/memory-effects-transient-growth-and-wave-breakup-in-a-model-of-paced-atrium
#10
Alejandro Garzón, Roman O Grigoriev
The mechanisms underlying cardiac fibrillation have been investigated for over a century, but we are still finding surprising results that change our view of this phenomenon. The present study focuses on the transition from normal rhythm to spiral wave chaos associated with a gradual increase in the pacing rate. While some of our findings are consistent with existing experimental, numerical, and theoretical studies of this problem, one result appears to contradict the accepted picture. Specifically we show that, in a two-dimensional model of paced homogeneous atrial tissue, transition from discordant alternans to conduction block, wave breakup, reentry, and spiral wave chaos is associated with the transient growth of finite amplitude disturbances rather than a conventional instability...
September 2017: Chaos
https://www.readbyqxmd.com/read/28962160/effect-of-eicosapentaenoic-acid-and-pitavastatin-on-electrophysiology-and-anticoagulant-gene-expression-in-mice-with-rapid-atrial-pacing
#11
Maoqing Tong, Jiewen Wang, Yunxin Ji, Xiaomin Chen, Jieru Wang, Shuangshuang Wang, Liemin Ruan, Hanbin Cui, Ying Zhou, Qingyu Zhang, Eiichi Watanabe
Atrial remodeling is considered to be any persistent change in atrial structure or function, and is responsible for the development and perpetuation of atrial fibrillation (AF). Oxidative stress and intracellular pH regulation may also be linked to AF; however it remains unclear whether eicosapentaenoic acid (EPA) or statins have beneficial therapeutic effects. The aim of the present study was to investigate the effects of EPA and pitavastatin on the electrophysiology of and gene expressions in mice with rapidly-paced atria...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28960529/pro-arrhythmic-atrial-phenotypes-in-incrementally-paced-murine-pgc1%C3%AE-hearts-effects-of-age
#12
Haseeb Valli, Shiraz Ahmad, James A Fraser, Kamalan Jeevaratnam, Christopher L-H Huang
Atrial arrhythmias, most commonly manifesting as atrial fibrillation (AF), represent a major clinical problem. AF incidences increase with both age and conditions associated with energetic dysfunction. Atrial arrhythmic phenotypes were compared in young (12-16 week) and aged (>52 week), WT and peroxisome proliferator receptor gamma co-activator 1β-deficient (Pgc-1β(-/-) ), Langendorff-perfused hearts, previously used to model mitochondrial energetic disorder. Electrophysiological explorations were performed using simultaneous whole-heart electrocardiogram and intracellular atrial action potential (AP) recordings...
September 27, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28955382/atrial-fibrillation-in-heart-failure-a-therapeutic-challenge-of-our-times
#13
REVIEW
Syeda Atiqa Batul, Rakesh Gopinathannair
Atrial fibrillation (AF) and heart failure (HF) are growing cardiovascular disease epidemics worldwide. There has been an exponential increase in the prevalence of AF and HF correlating with an increased burden of cardiac risk factors and improved survival rates in patients with structural heart disease. AF is associated with adverse prognostic outcomes in HF and is most evident in mild-to-moderate left ventricular (LV) dysfunction where the loss of "atrial kick" translates into poorer quality of life and increased mortality...
September 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28940496/left-phrenic-nerve-injury-during-electrical-isolation-of-left-sided-pulmonary-veins-with-the-second-generation-cryoballoon
#14
Kaoru Okishige, Hideshi Aoyagi, Takurou Nishimura, Takatoshi Shigeta, Takehiko Keida, Yasuteru Yamauchi, Tetsuo Sasano, Kenzo Hirao
BACKGROUND: Phrenic nerve (PN) palsy (PNP) is the most frequent complication of cryoballoon ablation (CBA) of atrial fibrillation (AF). The major complication of this technique seems to be right-sided PN injury (PNI) following ablation of the right pulmonary veins (PVs). We sought to assess the incidence and prognosis of left-sided PNI during CBA. METHODS: CBA was performed in 448 patients with AF. During the ablation of the left-sided PVs, the PN was paced from the left subclavian vein with a pacing output just exceeding the threshold by 10∼20%...
September 21, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28919427/age-dependent-atrial-arrhythmic-phenotype-secondary-to-mitochondrial-dysfunction-in-pgc-1%C3%AE-deficient-murine-hearts
#15
Haseeb Valli, Shiraz Ahmad, Karan R Chadda, Ali B A K Al-Hadithi, Andrew A Grace, Kamalan Jeevaratnam, Christopher L-H Huang
INTRODUCTION: Ageing and several age-related chronic conditions including obesity, insulin resistance and hypertension are associated with mitochondrial dysfunction and represent independent risk factors for atrial fibrillation (AF). MATERIALS AND METHODS: Atrial arrhythmogenesis was investigated in Langendorff-perfused young (3-4 month) and aged (>12 month), wild type (WT) and peroxisome proliferator activated receptor-γ coactivator-1β deficient (Pgc-1β(-/-)) murine hearts modeling age-dependent chronic mitochondrial dysfunction during regular pacing and programmed electrical stimulation (PES)...
October 2017: Mechanisms of Ageing and Development
https://www.readbyqxmd.com/read/28917011/prevalence-predictors-and-prognostic-implications-of-pr-interval-prolongation-in-patients-with-heart-failure
#16
Theodora Nikolaidou, Pierpaolo Pellicori, Jufen Zhang, Syed Kazmi, Kevin M Goode, John G Cleland, Andrew L Clark
AIMS: To determine the prevalence, incidence, predictors, and prognostic implications of PR interval prolongation in patients referred with suspected heart failure. METHODS AND RESULTS: Consecutive patients referred with suspected heart failure were prospectively enrolled. After excluding patients with implantable cardiac devices and atrial fibrillation, 1420 patients with heart failure and reduced ejection fraction (HeFREF) [age: median 71 (interquartile range IQR 63-78) years; men: 71%; NT-ProBNP: 1319 (583-3378) ng/L], 1094 with heart failure and normal ejection fraction (HeFNEF) [age: 76 (70-82) years; men: 47%; NT-ProBNP: 547 (321-1171) ng/L], and 1150 without heart failure [age: 68 (60-75) years; men: 51%; NT-ProBNP: 86 (46-140) ng/L] were included...
September 15, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28893549/continuous-optimization-of-cardiac-resynchronization-therapy-reduces-atrial-fibrillation-in-heart-failure-patients-results-of-the-adaptive-cardiac-resynchronization-therapy-trial
#17
David Birnie, Harrison Hudnall, Bernd Lemke, Kazutaka Aonuma, Kathy Lai-Fun Lee, Maurizio Gasparini, John Gorcsan, Jeffrey Cerkvenik, David O Martin
BACKGROUND: Data from randomized trials have suggested a modest or no effect of conventional cardiac resynchronization therapy (convCRT) on the incidence of atrial fibrillation (AF). AdaptivCRT (aCRT, Medtronic, Mounds View, MN) is a recently described algorithm for synchronized left ventricular (LV) pacing and continuous optimization of cardiac resynchronization therapy (CRT). OBJECTIVE: We compared the long-term effects of aCRT with convCRT pacing on the incidence of AF...
September 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28890081/factors-associated-with-postoperative-atrial-fibrillation-and-other-adverse-events-after-cardiac-surgery
#18
Emmanuel Akintoye, Frank Sellke, Roberto Marchioli, Luigi Tavazzi, Dariush Mozaffarian
OBJECTIVE: The study objective was to evaluate the impact of various surgical characteristics and practices on the risk of postoperative atrial fibrillation and other adverse outcomes after cardiac surgery. METHODS: By using the prospectively collected data of patients who underwent cardiac surgery in 28 centers across the United States, Italy, and Argentina, the details of surgery characteristics were collected for each patient and the outcomes, including postoperative atrial fibrillation, major adverse cardiovascular events, and mortality...
August 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28881765/mitral-isthmus-ablation-using-a-circular-mapping-catheter-positioned-in-the-left-atrial-appendage-as-a-reference-for-conduction-block
#19
Takahiko Nishiyama, Takehiro Kimura, Taishi Fujisawa, Kazuaki Nakajima, Akira Kunitomi, Shin Kashimura, Yoshinori Katsumata, Nobuhiro Nishiyama, Yoshiyasu Aizawa, Keiichi Fukuda, Seiji Takatsuki
BACKGROUND: For perimitral atrial flutter (PMFL) developing after catheter ablation of atrial fibrillation (AF), to create a complete conduction block at the mitral isthmus (MI) is mandatory to terminate it, however, it is still challenging. METHODS: This study consisted of 80 patients (74 male, 61 ± 8.1 years) undergoing MI ablation. After a circular mapping catheter was positioned at the neck of the left atrial appendage (LAA), the MI ablation was performed on the MI line just below the LAA neck targeting the earliest activation recording site of the LAA catheter during pacing from the coronary sinus (CS)...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28877652/angiotensin-1-7-attenuates-atrial-tachycardia-induced-sympathetic-nerve-remodeling
#20
Wenfeng Shangguan, Wen Shi, Guangping Li, Yuanyuan Wang, Jian Li, Xuewen Wang
INTRODUCTION: The effect of Angiotensin-(1-7) (Ang-(1-7)) on atrial autonomic remodeling is still unknown. We hypothesized that Ang-(1-7) could inhibit sympathetic nerve remodeling in a canine model of chronic atrial tachycardia. MATERIALS AND METHODS: Eighteen dogs were randomly assigned to sham group, pacing group and Ang-(1-7) group. Rapid atrial pacing was maintained for 14 days in the pacing and Ang-(1-7) groups. Ang-(1-7) was administered intravenously in the Ang-(1-7) group...
July 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
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