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atrial fibrillation heart failure ablation

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https://www.readbyqxmd.com/read/29222043/catheter-ablation-of-atrial-fibrillation-in-patients-with-heart-failure-and-preserved-ejection-fraction
#1
Eric Black-Maier, Xinru Ren, Benjamin A Steinberg, Cynthia L Green, Adam S Barnett, Normita Sta Rosa, Sana M Al-Khatib, Brett D Atwater, James P Daubert, Camille Frazier-Mills, Augustus O Grant, Donald D Hegland, Kevin P Jackson, Larry R Jackson, Jason I Koontz, Robert K Lewis, Albert Y Sun, Kevin L Thomas, Tristam D Bahnson, Jonathan P Piccini
BACKGROUND: Few studies have examined outcomes of catheter ablation for atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF). OBJECTIVE: Compare outcomes of AF ablation in patients with HFpEF versus HF with reduced ejection fraction (HFrEF). METHODS: We performed a retrospective study of 230 patients with HF who underwent AF ablation, including 97 (42.2%) with HFrEF and 133 (57.8%) with HFpEF. Outcomes included adverse events, symptoms (Mayo AF Symptom Inventory [MAFSI]), New York Heart Association (NYHA) functional class, and freedom from recurrent atrial arrhythmia at 12-months...
December 5, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29218612/transoesophageal-echocardiography-prior-to-catheter-ablation-could-be-avoided-in-atrial-fibrillation-patients-with-a-low-risk-of-stroke-and-without-filling-defects-in-the-late-phase-mdct-scan-a-retrospective-analysis-of-783-patients
#2
Zhengqin Zhai, Min Tang, Shu Zhang, Pihua Fang, Yuhe Jia, Tianjie Feng, Jiande Wang
OBJECTIVES: To test whether multidetector computed tomography (MDCT) could completely replace transoesophageal echocardiography (TEE) to detect left atrial appendage (LAA) thrombi in atrial fibrillation (AF) patients using a large sample size. METHODS: 783 patients with AF who underwent MDCT and TEE before catheter ablation were retrospectively included. Demographic data were obtained. Two radiologists blinded to clinical data made the imaging diagnosis. RESULTS: Most of the patients (96...
December 7, 2017: European Radiology
https://www.readbyqxmd.com/read/29211301/outcome-in-patients-with-left-common-pulmonary-vein-after-cryoablation-with-second-generation-cryoballoon
#3
Thomas Beiert, Pia C Lodde, Lutz P T Linneborn, Jessica Werner, Lisa Prinz, Florian Stöckigt, Markus Linhart, Lars Lickfett, Georg Nickenig, Jan W Schrickel, René P Andrié
BACKGROUND: Pulmonary vein isolation (PVI) has become a widely accepted therapy in patients suffering from symptomatic atrial fibrillation (AF). HYPOTHESIS: AF-free survival differs in patients with left common pulmonary vein (LCPV) after PVI with second generation cryoballoon. METHODS: We included patients scheduled for first PVI for paroxysmal or persistent AF. Symptomatic and/or documented arrhythmia episodes (> 30 s) were defined as AF recurrence, excluding a three month blanking period...
December 6, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29192223/predictors-of-atrial-fibrillation-recurrence-after-catheter-ablation-data-from-the-german-ablation-registry
#4
A Sultan, J Lüker, D Andresen, K H Kuck, E Hoffmann, J Brachmann, M Hochadel, S Willems, L Eckardt, T Lewalter, J Senges, D Steven
Catheter ablation (CA) for atrial fibrillation (AF) has emerged as a widespread first or second line treatment option. However, up to 45% of patients (pts) show recurrence of AF within 12 month after CA. We present prospective multicenter registry data comparing characteristics of pts with and without recurrence of AF within the first year after CA. This study comprises all pts with complete follow-up one year after CA (1-y-FU; n = 3679). During 1y-FU in 1687 (45.9%) pts recurrence of AF occurred. The multivariate analysis revealed female sex and AF type prior to the procedure as predictors for AF recurrence...
November 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29180458/clinical-outcomes-after-ablation-of-the-av-junction-in-patients-with-atrial-fibrillation-impact-of-cardiac-resynchronization-therapy
#5
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/29173598/mechanisms-clinical-significance-and-prevention-of-cognitive-impairment-in-patients-with-atrial-fibrillation
#6
REVIEW
Lena Rivard, Paul Khairy
Atrial fibrillation (AF) and dementia are major health issues, with growing evidence suggesting a consistent association between AF and all forms of dementia. Although dementia and AF share several risk factors, the association appears to be independent of a history of clinical stroke and other comorbidities such as hypertension, heart failure, and diabetes. Proposed mechanisms linking AF to cognitive decline include altered hemodynamics resulting in cerebral hypoperfusion, inflammation, genetic factors, and silent cerebral ischemia due to subclinical microemboli...
December 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29168622/mitral-valve-pressure-gradient-after-percutaneous-mitral-valve-repair-every-beat-counts
#7
Daniel Lavall, Bruno Scheller, Christian Werner, Axel Buob, Felix Mahfoud
A patient presented with symptoms of decompensated heart failure 2 months after percutaneous mitral valve (MV) repair. Echocardiography demonstrated impaired left ventricular function with elevated MV pressure gradients and pulmonary pressures during rapid atrial fibrillation. Heart rate control was achieved by implantation of a biventricular pacemaker with subsequent His-bundle ablation because atrial fibrillation was refractory to medical treatment. During biventricular pacing at different rates (50-110 b...
November 23, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29151496/cost-effectiveness-analysis-of-cardiovascular-disease-treatment-in-japan
#8
Satoshi Kodera, Arihiro Kiyosue, Jiro Ando, Hiroshi Akazawa, Hiroyuki Morita, Masafumi Watanabe, Issei Komuro
The quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER) are important concepts in cost-effectiveness analysis, which is becoming increasingly important in Japan. QALY is used to estimate quality of life (QOL) and life years, and can be used to compare the efficacies of cancer and cardiovascular treatments. ICER is defined as the difference in cost between treatments divided by the difference in their effects, with a smaller ICER indicating better cost-effectiveness. Here, we present a review of cost-effectiveness analyses in Japan as well other countries...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29142816/unilateral-pulmonary-edema-in-a-patient-with-worsening-tricuspid-valve-regurgitation-a-secret-inside-pulmonary-veins
#9
Elvira Resciniti, Ilaria Caso, Iside Scarfò, Giuseppe Di Pasquale, Giovanni La Canna
We present the case of a 69-year-old patient who was referred to the Department of Echocardiography for surgical treatment of severe tricuspid valve regurgitation (TVR) with advanced congestive heart failure. In 2013 the patient underwent unsuccessful percutaneous ablation for permanent atrial fibrillation. In 2015, following numerous episodes of atrial fibrillation and congestive heart failure with left pleural effusion, the patient was admitted to another center. A transthoracic echocardiogram showed severe TVR and moderate precapillary pulmonary hypertension, confirmed at right cardiac catheterization...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#10
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29131434/five-year-impact-of-catheter-ablation-for-atrial-fibrillation-in-patients-with-a-prior-history-of-stroke
#11
T Jared Bunch, Heidi T May, Tami L Bair, Brian G Crandall, Michael J Cutler, John D Day, Victoria Jacobs, Charles Mallender, Jeffrey S Osborn, J Peter Weiss
BACKGROUND: Catheter ablation of atrial fibrillation(AF) is an established therapeutic rhythm approach. Patients with a prior history of a stroke(CVA) represent a unique high-risk population for recurrent thromboembolic events. The role of antiarrhythmic treatment on the natural history of stroke recurrence in these patients is not fully understood. METHODS: Three patient groups with a prior CVA and 5 years of follow-up were matched 1:3:3 by propensity score(±0...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29111210/interaction-of-adverse-disease-related-pathways-in-hypertrophic-cardiomyopathy
#12
Ethan J Rowin, Martin S Maron, Raymond H Chan, Anais Hausvater, Wendy Wang, Hassan Rastegar, Barry J Maron
Hypertrophic cardiomyopathy (HC) has been characterized as a generally progressive genetic heart disease, creating an ominous perspective for patients and managing cardiologists. We explored the HC disease burden and interaction of adverse clinical pathways to clarify patient expectations over long time periods in the contemporary therapeutic era. We studied 1,000 consecutive HC patients (52 ± 17 years) at Tufts Medical Center, followed 9.3 ± 8 years from diagnosis, employing a novel disease pathway model: 46% experienced a benign course free of adverse pathways, but 42% of patients progressed along 1 major pathway, most commonly refractory heart failure to New York Heart Association class III or IV requiring surgical myectomy (or alcohol ablation) or heart transplant; repetitive or permanent atrial fibrillation; and least commonly arrhythmic sudden death events...
September 20, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29045344/atrial-fibrillation-and-cardiac-resynchronization-therapy
#13
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
#14
Ana Abreu, Mário Oliveira, Pedro Silva Cunha, Helena Santa Clara, Guilherme Portugal, Inês Gonçalves Rodrigues, Vanessa Santos, Luís 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 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29029984/sleep-sleep-apnea-and-atrial-fibrillation-questions-and-answers
#15
REVIEW
Younghoon Kwon, Ryan J Koene, Alan D Johnson, Gen-Min Lin, John D Ferguson
Sleep apnea (SA) is a common sleep disorder increasingly recognized as a risk for cardiovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. An increasing number of investigations in recent years have linked SA to AF. In this review, we aim to provide a critical overview of the existing evidence in a question and answer format by addressing the following: What is the prevalent association between the two conditions (separating nocturnally detected AF episodes from AF as a prevalent condition)? Is SA a risk factor for incident AF? Is SA a risk factor for recurrence of AF following cardioversion/catheter-based ablation? What is the association between SA and AF in patients with heart failure? Are there signature electrocardiographic markers of AF found in patients with SA? Are there electrophysiology-based studies supporting the link between SA and AF? What other sleep characteristics (beyond SA) are found in patients with AF? What is the impact of SA treatment on AF? What is the effect of AF treatment on sleep? Finally, we address unsolved questions and suggest future directions to enhance our understanding of the AF-SA relationship...
September 4, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29025686/-usefulness-of-spectral-tissue-doppler-e-e-ratio-in-the-management-of-patients-with-atrial-fibrillation
#16
S Arques, E Roux
Atrial fibrillation is the most common cardiac rhythm disorder encountered in daily clinical practice. It carries high morbidity and mortality rates, mainly related to sudden death, heart failure and stroke. Validation of noninvasive markers in the diagnosis of heart failure with preserved ejection fraction and risk stratification is therefore attractive in this clinical setting. The spectral tissue Doppler-derived E/e' ratio is a simple and user-friendly index which has been validated in the assessment of left ventricular diastolic pressures, regardless of rhythm...
November 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29016832/contemporary-stroke-prevention-strategies-in-11%C3%A2-096-european-patients-with-atrial-fibrillation-a-report-from-the-eurobservational-research-programme-on-atrial-fibrillation-eorp-af-long-term-general-registry
#17
Giuseppe Boriani, Marco Proietti, Cécile Laroche, Laurent Fauchier, Francisco Marin, Michael Nabauer, Tatjana Potpara, Gheorghe-Andrei Dan, Zbigniew Kalarus, Igor Diemberger, Luigi Tavazzi, Aldo P Maggioni, Gregory Y H Lip
Aims: Contemporary data regarding atrial fibrillation (AF) management and current use of oral anticoagulants (OACs) for stroke prevention are needed. Methods and results: The EURObservational Research Programme on AF (EORP-AF) Long-Term General Registry analysed consecutive AF patients presenting to cardiologists in 250 centres from 27 European countries. From 2013 to 2016, 11 096 patients were enrolled (40.7% female; mean age 69 ± 11 years). At discharge, OACs were used in 9379 patients (84...
September 14, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29016766/temporal-pattern-episode-duration-based-classification-of-atrial-fibrillation-as-paroxysmal-vs-persistent-is-it-time-to-develop-a-more-integrated-prognostic-score-to-optimize-management
#18
Matthew Hammond-Haley, Rui Providência, Pier D Lambiase
Atrial fibrillation (AF) is a clinically heterogeneous arrhythmia that is currently classified according to the variety of temporal rhythm based manifestations observed clinically, including 'first detected episode', 'paroxysmal', 'persistent', or 'permanent' AF. Despite being widely adopted by the most recent consensus guidelines, the utility of this classification system to stratify patients into distinct and clinically useful groups that have different outcomes including mortality, morbidity, specific cardiovascular outcomes, and quality of life (QoL), remains questionable...
July 11, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28955382/atrial-fibrillation-in-heart-failure-a-therapeutic-challenge-of-our-times
#19
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/28916640/clinical-profile-and-consequences-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#20
Ethan J Rowin, Anais Hausvater, Mark S Link, Patrick Abt, William Gionfriddo, Wendy Wang, Hassan Rastegar, N A Mark Estes, Martin S Maron, Barry J Maron
Background -Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. Methods -Records were accessed of 1558 consecutive patients followed at the Tufts Medical Center Hypertrophic Cardiomyopathy Institute for 4.8 ± 3.4 years, from 2004 to 2014. Results -Of the 1558 HCM patients, 304 (20%) had episodes of AF, of which 226 (74%) were confined to symptomatic paroxysmal AF (PAF; average 5 ± 5; range 1 to > 20), while 78 (26%) developed permanent AF, preceded by 7 ± 6 PAF episodes...
September 15, 2017: Circulation
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