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https://www.readbyqxmd.com/read/28664343/catheter-ablation-of-atypical-atrial-flutter-a-novel-3d-anatomic-mapping-approach-to-quickly-localize-and-terminate-atypical-atrial-flutter
#1
Sri Sundaram, William Choe, J Ryan Jordan, Nate Mullins, Charles Boorman, Eric J Kessler, Sunil Nath
PURPOSE: This study aims to describe a novel method of High Density Activation Sequence Mapping combined with Voltage Gradient Mapping Overlay (HD-VGM) to quickly localize and terminate atypical atrial flutter. METHODS: Twenty-one patients presenting with 26 different atypical atrial flutter circuits after a previous catheter or surgical AF ablation were studied. HD-VGM was performed with a commercially available impedance-based mapping system to locate and successfully ablate the critical isthmus of each tachycardia circuit...
June 29, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28659670/is-the-routine-use-of-impedance-analysis-for-the-diagnosis-of-gastro-esophageal-reflux-disease-more-expensive-than-conventional-ph-monitoring-cost-analysis-of-two-procedures
#2
Nurkan Törer, Özgür Aytaç
Conventional 24-h pH monitoring is the gold standard for the diagnosis of non-erosive, non-acidic gastro-esophageal reflux disease. Multichannel Intraluminal Impedance (MII) analysis markedly improves diagnostic accuracy of non-erosive, non-acidic gastro-esophageal reflux disease. However, MII catheters are more expensive than standard catheters. This study aimed to determine the rates of acid or non-acid reflux and by making a retrospective projection, to predict the costs of two algorithms. We retrospectively reviewed the medical data of 102 patients who presented to our hospital with suspected non-erosive GERD and underwent 24 h impedance/pH-monitoring...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28639728/prospective-use-of-ablation-index-targets-improves-clinical-outcomes-following-ablation-for-atrial-fibrillation
#3
Ahmed Hussein, Moloy Das, Vivek Chaturvedi, Issa Khalil Asfour, Niji Daryanani, Maureen Morgan, Christina Ronayne, Matthew Shaw, Richard Snowdon, Dhiraj Gupta
AIMS: Late recovery of ablated tissue leading to reconnection of pulmonary veins remains common following radiofrequency catheter ablation for AF. Ablation Index (AI), a novel ablation quality marker, incorporates contact force (CF), time and power in a weighted formula. We hypothesized that prospective use of our previously-published derived AI targets would result in better outcomes when compared to CF-guided ablation. METHODS: 89 consecutive drug-refractory AF patients (49% paroxysmal) underwent AI-guided ablation (AI-group)...
June 22, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28623986/double-prepuncture-as-a-valuable-adjunctive-technique-for-complex-endovenous-ablation
#4
Scarlett Hao, Samantha Cox, Thomas S Monahan, Rajabrata Sarkar
OBJECTIVE: The objective of this study was to characterize the technique and to report the results of double prepuncture used during complex radiofrequency ablation (RFA) in cases of treating multiple incompetent veins or encountering focal obstruction to catheter advancement. METHODS: A double prepuncture technique was applied in patients requiring endovascular ablation of multiple veins and patients with great saphenous vein cannulation failure. We treated 13 limbs in 12 patients during a 24-month period with RFA in which the double prepuncture technique was used...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28622178/labor-analgesia-onset-with-dural-puncture-epidural-versus-traditional-epidural-using-a-26-gauge-whitacre-needle-and-0-125-bupivacaine-bolus-a-randomized-clinical-trial
#5
Sylvia H Wilson, Bethany J Wolf, Kellie N Bingham, Quiana S Scotland, John M Fox, Erick M Woltz, Latha Hebbar
BACKGROUND: Lumbar epidurals (LEs) provide excellent analgesia. Combined spinal epidural and dural puncture epidural (DPE) are 2 techniques to expedite neuraxial analgesia onset. In DPE, dura is punctured but medication is not administered in the cerebrospinal fluid. Expedited analgesia onset has been demonstrated with DPE, using 0.25% bupivacaine; however, this concentration may impede an unassisted vaginal birth and is not currently used for induction and maintenance of labor analgesia...
June 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598912/cardiac-output-measurements-based-on-the-pulse-wave-transit-time-and-thoracic-impedance-exhibit-limited-agreement-with-thermodilution-method-during-orthotopic-liver-transplantation
#6
Aurora Magliocca, Emanuele Rezoagli, Thomas Anthony Anderson, Sara Maria Burns, Fumito Ichinose, Hovig Vatche Chitilian
BACKGROUND: Orthotopic liver transplantation (OLT) is characterized by significant intraoperative hemodynamic variability. Accurate and real-time cardiac output (CO) monitoring aids clinical decision making during OLT. The purpose of this study is to compare accuracy, precision, and trending ability of CO estimation obtained noninvasively using pulse wave transit time (estimated continuous cardiac output [esCCO; Nihon Kohden, Tokyo, Japan]) or thoracic bioimpedance (ICON; Osypka Medical GmbH, Berlin, Germany) to thermodilution cardiac output (TDCO) measured with a pulmonary artery catheter...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28582283/reservoir-pressure-analysis-of-aortic-blood-pressure-an-in-vivo-study-at-five-locations-in-humans
#7
Om Narayan, Kim H Parker, Justin E Davies, Alun D Hughes, Ian T Meredith, James D Cameron
INTRODUCTION: The development and propagation of the aortic blood pressure wave remains poorly understood, despite its clear relevance to major organ blood flow and potential association with cardiovascular outcomes. The reservoir pressure model provides a unified description of the dual conduit and reservoir functions of the aorta. Reservoir waveform analysis resolves the aortic pressure waveform into an excess (wave related) and reservoir (compliance related) pressure. The applicability of this model to the pressure waveform as it propagates along the aorta has not been investigated in humans...
June 2, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28572979/complex-effects-of-high-flow-nasal-cannula-therapy-on-hemodynamics-in-the-pediatric-patient-after-cardiac-surgery
#8
EDITORIAL
Yu Inata, Muneyuki Takeuchi
BACKGROUND: The high-flow nasal cannula (HFNC) system has been widely used for children in various clinical settings. However, the physiological and clinical impact of HFNC therapy on the pediatric patient with respiratory distress after cardiac surgery has not been thoroughly investigated. MAIN BODY OF THE ABSTRACT: It seems logical to use HFNC as a primary therapy for post-extubation respiratory failure after congenital heart surgery, in which low cardiac output syndrome and upper airway obstruction are commonly encountered; the HFNC therapy alleviates the work of breathing and large negative swings of intrathoracic pressure, which in turn helps to decrease the systemic ventricular afterload...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28569739/endoscopic-guided-measurement-of-mucosal-admittance-can-discriminate-gastroesophageal-reflux-disease-from-functional-heartburn
#9
Tomoaki Matsumura, Hideaki Ishigami, Mai Fujie, Takashi Taida, Shingo Kasamatsu, Kenichiro Okimoto, Keiko Saito, Daisuke Maruoka, Tomoo Nakagawa, Takeshi Suzuki, Tatsuro Katsuno, Makoto Arai
OBJECTIVES: A novel catheter that can measure mucosal admittance (MA), the inverse of impedance, was developed recently. In this pilot study, we aimed to clarify the usefulness of measuring MA for diagnosing gastroesophageal reflux disease (GERD). METHODS: We conducted two prospective studies. In the first study, esophageal MA was evaluated in 120 participants (24 with erosive esophagitis, 82 with heartburn but non-erosive esophagitis, and 14 healthy volunteers) and compared with the endoscopic findings...
June 1, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28550489/impedance-ph-monitoring-for-diagnosis-of-reflux-disease-new-perspectives
#10
REVIEW
Marzio Frazzoni, Nicola de Bortoli, Leonardo Frazzoni, Salvatore Tolone, Vincenzo Savarino, Edoardo Savarino
Heartburn is the most specific symptom of gastroesophageal reflux disease (GERD). In clinical practice, heartburn relief by a proton pump inhibitor (PPI) trial does suffice to confirm GERD. However, an objective diagnosis of GERD is required before anti-reflux endoscopic or surgical interventions, independently from PPI response. Thus, since normal findings at upper endoscopy are detected in the majority of patients with heartburn, reflux monitoring is often required. When traditional catheter-based or wireless pH tests are used, reflux episodes are conventionally identified by pH drops below 4...
August 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28543389/coexistence-of-a-permanent-form-of-a-junctional-reciprocating-tachycardia-and-coronary-sinus-aneurysm-a-case-report
#11
Yuki Shimizu, Osamu Inaba, Masahiko Goya, Kenzo Hirao
A 58-year-old man with a long R-P' narrow QRS tachycardia underwent an electrophysiological study. The tachycardia was diagnosed as permanent form of junctional reciprocating tachycardia (PJRT), and the earliest atrial activation site during tachycardia was coronary sinus (CS) ostium. Radiofrequency ablation at the site was initially not successful because the tip impedance and temperature were unstable. After changing of the ablation catheter to that with contact force sensor, the accessory pathway was immediately ablated and the PJRT was no longer induced...
May 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28543374/ultrasound-phantom-using-sodium-alginate-as-a-gelling-agent
#12
Minoru Aoyagi, Tomomi Hiraguri
For medical workers, ultrasound phantoms for human soft tissue are used not only for accuracy management of ultrasound diagnosis but also to aid ultrasound-guided needle and blind catheter insertion training without risk to real patients. For the phantoms, ultrasound characteristics and a texture are required to mimic the human soft tissue. The proposed phantom was composed of sodium alginate, calcium sulfate dihydrate, trisodium phosphate 12-hydrate, glycerol, and water. The propagation speed, attenuation coefficient, acoustic impedance, and texture of the proposed phantom were almost the same as those of human soft tissue...
May 23, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28526271/an-in-vitro-urinary-catheterization-model-that-approximates-clinical-conditions-for-evaluation-of-innovations-to-prevent-catheter-associated-urinary-tract-infections
#13
R Y R Chua, K Lim, S S J Leong, P A Tambyah, B Ho
BACKGROUND: Catheter associated urinary tract infections (CAUTI) account for about 25% of nosocomial infections globally and often result in increased morbidity and healthcare costs. An added concern is the presence of microbial biofilms which are major reservoirs of bacteria, especially antibiotic resistant bacteria, in catheters. Since the practice of the closed drainage system, innovations to combat CAUTI have not produced significant improvements in clinical outcomes. The lack of a robust laboratory platform to test new CAUTI preventive strategies may impede development of novel technologies...
May 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28526091/a-pre-therapeutic-coating-for-medical-devices-that-prevents-the-attachment-of-candida-albicans
#14
Diego Vargas-Blanco, Aung Lynn, Jonah Rosch, Rony Noreldin, Anthony Salerni, Christopher Lambert, Reeta P Rao
BACKGROUND: Hospital acquired fungal infections are defined as "never events"-medical errors that should never have happened. Systemic Candida albicans infections results in 30-50% mortality rates. Typically, adhesion to abiotic medical devices and implants initiates such infections. Efficient adhesion initiates formation of aggressive biofilms that are difficult to treat. Therefore, inhibitors of adhesion are important for drug development and likely to have a broad spectrum efficacy against many fungal pathogens...
May 19, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28487616/age-related-impairment-of-esophagogastric-junction-relaxation-and-bolus-flow-time
#15
Charles Cock, Laura K Besanko, Carly M Burgstad, Alison Thompson, Stamatiki Kritas, Richard Heddle, Robert Jl Fraser, Taher I Omari
AIM: To investigate the functional effects of abnormal esophagogastric (EGJ) measurements in asymptomatic healthy volunteers over eighty years of age. METHODS: Data from 30 young controls (11 M, mean age 37 ± 11 years) and 15 aged subjects (9 M, 85 ± 4 years) were compared for novel metrics of EGJ-function: EGJ-contractile integral (EGJ-CI), "total" EGJ-CI and bolus flow time (BFT). Data were acquired using a 3.2 mm, 25 pressure (1 cm spacing) and 12 impedance segment (2 cm) solid-state catheter (Unisensor and MMS Solar GI system) across the EGJ...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28451774/relationship-between-left-atrium-catheter-contact-force-and-pacing-threshold
#16
Teresa Barrio-López, Mercedes Ortiz, Eduardo Castellanos, Carla Lázaro, Jefferson Salas, Sergio Madero, Jesús Almendral
PURPOSE: The purpose of this study is to analyze the relationship between contact force (CF) and pacing threshold in left atrium (LA). METHODS: Six to ten LA sites were studied in 28 consecutive patients with atrial fibrillation undergoing pulmonary vein isolation. Median CF, bipolar and unipolar electrogram voltage, impedance, and bipolar and unipolar thresholds for consistent constant capture and for consistent intermittent capture were measured at each site. RESULTS: Pacing threshold measurements were performed at 188 LA sites...
April 27, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28437259/utility-of-esophageal-mucosal-impedance-as-a-diagnostic-test-for-esophageal-disease
#17
Dhyanesh A Patel, Michael F Vaezi
PURPOSE OF REVIEW: The aim of this review is to summarize the use of direct mucosal impedance (MI) for the evaluation and management of esophageal diseases. RECENT FINDINGS: Esophageal multichannel intraluminal impedance with pH (MII-pH) monitoring has been considered the most sensitive test for gastroesophageal reflux disease (GERD), but recent studies have failed to establish impedance parameters that reliably predict treatment response to medical and surgical GERD therapies...
July 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28426462/high-resolution-esophageal-manometry-interpretation-in-clinical-practice
#18
Rena Yadlapati
PURPOSE OF REVIEW: Esophageal high-resolution manometry (HRM) is the current state-of-the-art diagnostic tool to evaluate esophageal motility patterns and, as such, is widely adopted in clinical practice. This article will review the interpretation of esophageal HRM in clinical practice. RECENT FINDINGS: HRM uses a high-resolution catheter to transmit intraluminal pressure data that are subsequently converted into dynamic esophageal pressure topography (EPT) plots...
July 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28425145/prevalence-of-gastroesophageal-reflux-in-cats-during-anesthesia-and-effect-of-omeprazole-on-gastric-ph
#19
R S Garcia, P C Belafsky, A Della Maggiore, J M Osborn, B H Pypendop, T Pierce, V J Walker, A Fulton, S L Marks
BACKGROUND: Gastroesophageal reflux (GER) is poorly characterized in anesthetized cats, but can cause aspiration pneumonia, esophagitis, and esophageal stricture formation. OBJECTIVE: To determine whether pre-anesthetic orally administered omeprazole increases gastric and esophageal pH and increases serum gastrin concentrations in anesthetized cats, and to determine the prevalence of GER using combined multichannel impedance and pH monitoring. ANIMALS: Twenty-seven healthy cats undergoing elective dental procedures...
May 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28419605/radiofrequency-catheter-ablation-of-atrial-fibrillation-electrical-modification-suggesting-transmurality-is-faster-achieved-with-remote-magnetic-catheter-in-comparison-with-contact-force-use
#20
Sok-Sithikun Bun, Anis Ayari, Decebal Gabriel Latcu, Abdelkarim Errahmouni, Nadir Saoudi
BACKGROUND: Remote magnetic navigation (RMN) and contact force (CF) sensing catheters are available technologies for radiofrequency (RF) catheter ablation of atrial fibrillation (AF). Our purpose was to compare time to electrogram (EGM) modification suggesting transmural lesions between RMN and CF-guided AF ablation. METHODS AND RESULTS: A total of 1,008 RF applications were analyzed in 21 patients undergoing RMN (n = 11) or CF-guided ablation (n = 10) for paroxysmal AF...
April 17, 2017: Journal of Cardiovascular Electrophysiology
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