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impedance catheter

Roger A Winkle, Ryan Moskovitz, R Hardwin Mead, Gregory Engel, Melissa H Kong, William Fleming, Jonathan Salcedo, Rob A Patrawala, John H Tranter, Isaac Shai
PURPOSE: The optimal radiofrequency (RF) power and lesion duration using contact force (CF) sensing catheters for atrial fibrillation (AF) ablation are unknown. We evaluate 50 W RF power for very short durations using CF sensing catheters during AF ablation. METHODS: We evaluated 51 patients with paroxysmal (n = 20) or persistent (n = 31) AF undergoing initial RF ablation. RESULTS: A total of 3961 50 W RF lesions were given (average 77...
February 19, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Ahmed AlTurki, Riccardo Proietti
Recurrence of atrial fibrillation after pulmonary vein isolation is mainly due to pulmonary vein reconnection. Contact force sensing catheters that allow operators to assess and optimize the degree of contact as well as remote magnetic navigation which facilitates intracardiac catheter steering and improves catheter stability are two technological advances designed to improve catheter ablation outcomes by enhancing the ablation lesion. Lesion dimension can be assessed indirectly via electrogram signal attenuation and impedance drop...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
Stefano Grossi, Francesco Grassi, Lorenzo Galleani, Francesca Bianchi, Maria Rosa Conte
RATIONALE: Pulmonary vein isolation (PVI) is the method of choice for the treatment of drug-resistant atrial fibrillation (AF). However, arrhythmia recurrences are frequently due to suboptimal lesions formation and pulmonary vein reconnection. Contact force (CF)- and remote magnetic navigation (RMN)-guided catheters are both capable of improving contact and energy transfer to the tissue, possibly improving PVI outcome. OBJECTIVE: The objective of our study was to compare CF- and RMN-guided PVI in patients with paroxysmal AF in terms of surrogate parameters of the dimension and quality of the lesions...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
Tomoaki Matsumura, Makoto Arai, Hideaki Ishigami, Mai Fujie, Kentaro Ishikawa, Naoki Akizue, Takashi Taida, Yuki Ohta, Shinsaku Hamanaka, Kenichiro Okimoto, Keiko Saito, Daisuke Maruoka, Tomoo Nakagawa, Naoya Kato
BACKGROUND: Impaired esophageal mucosal integrity plays a role in causing symptoms of gastroesophageal reflux disease (GERD). Recently, the assessment of esophageal baseline impedance (BI) using the multichannel intraluminal impedance-pH (MII-pH) test was suggested as a surrogate technique for the study of esophageal mucosal integrity and was reported to be useful in distinguishing GERD from non-GERD. However, measuring BI requires a 24-h testing period, is complicated, and causes considerable patient discomfort...
February 1, 2018: Digestion
Alberto Pagnamenta, Frédéric Lador, Andrea Azzola, Maurice Beghetti
Since 1998 pulmonary hypertension has been clinically classified into five well-defined, distinct categories. A definitive diagnosis of pulmonary hypertension requires the invasive confirmation of an elevated mean pulmonary artery pressure of 25 mm Hg or above during a right heart catheterization. From a hemodynamic point of view, pulmonary hypertension is classified into precapillary and postcapillary pulmonary hypertension on the basis of a pulmonary artery wedge pressure threshold value of 15 mm Hg. Pulmonary vascular resistance is better characterized by multi-point pressure/flow measurements than by single-point determination...
January 9, 2018: Respiration; International Review of Thoracic Diseases
A Ruiz-Vargas, R Mohd Rosli, A Ivorra, J W Arkwright
BACKGROUND: Intraluminal electrical impedance is a well-known diagnostic tool used to study bolus movement in the human esophagus. However, it is use in the human colon it is hindered by the fact that the content cannot be controlled and may include liquid, gas, solid, or a mixture of these at any one time. This article investigates the use of complex impedance spectroscopy to study different luminal content (liquid and gas). METHODS: An excised section of guinea pig proximal colon was placed in an organ bath with Krebs solution at 37°C and a custom built bioimpedance catheter was placed in the lumen...
January 8, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Jack T Seki, Tian Q Wang, Paul M Yip, Tony Mazzulli, Mark D Minden
Background Dysfunctional central venous catheter prohibits the administration of potential life-saving chemotherapy and the delivery of essential supportive care needs to patients. Sodium bicarbonate injection has been shown to impede against fibrin clot formation and prolong prothrombin time and thrombin clotting time. Sodium bicarbonate injection has been tried as a second-line agent with good results in a small number of patients (internal data not published) when alteplase failed. We assessed whether the pre-filled sodium bicarbonate injection in 5 mL syringes would not only preserve sterility and retain its pH and concentration but also amount to the potential cost savings for future use when stored in a refrigerated environment...
January 1, 2017: Journal of Oncology Pharmacy Practice
Rikuta Hamaya, Shinsuke Miyazaki, Takatsugu Kajiyama, Tomonori Watanabe, Shigeki Kusa, Hiroaki Nakamura, Hitoshi Hachiya, Yoshito Iesaka
BACKGROUND: Clinical utility of irrigation-tip ablation catheters for cavo-tricuspid isthmus (CTI) ablation is established. Recently, new-generation enhanced-cooling irrigation-tip catheters were introduced into clinical use. This study compared the performance of different types of novel irrigation-tip catheters in CTI ablation. METHODS: One hundred patients undergoing CTI ablation with novel irrigated-tip catheters were included. Ablation was performed with a power output of 30-35W using either 4-mm flexible tip catheters [FlexAbility (FAs) St...
November 24, 2017: Journal of Cardiology
R Mohd Rosli, R E Leibbrandt, L Wiklendt, M Costa, D A Wattchow, N J Spencer, S J Brookes, T I Omari, P G Dinning
BACKGROUND: High-resolution impedance manometry is a technique that is well established in esophageal motility studies for relating motor patterns to bolus flow. The use of this technique in the colon has not been established. METHODS: In isolated segments of rabbit proximal colon, we recorded motor patterns and the movement of liquid or gas boluses with a high-resolution impedance manometry catheter. These detected movements were compared to video recorded changes in gut diameter...
December 13, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Rukiye Vardar, Muharrem Keskin
Ambulatory esophageal pH monitoring is an essential method in patients exhibiting signs of non-erosive reflux disease (NERD) to make an objective diagnosis. Intra-esophageal pH monitoring is important in patients who are non-responsive to medications and in those with extraesophageal symptoms, particularly in NERD, before surgical interventions. With the help of the wireless capsule pH monitoring, measurements can be made under more physiological conditions as well as longer recordings can be performed because the investigation can be better tolerated by patients...
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Gerard Amorós-Figueras, Esther Jorge, Concepción Alonso-Martin, Daniel Traver, Maria Ballesta, Ramon Bragós, Javier Rosell-Ferrer, Juan Cinca
BACKGROUND: Measurement of myocardial electrical impedance can allow recognition of infarct scar and is theoretically not influenced by changes in cardiac activation sequence, but this is not known. OBJECTIVES: The objectives of this study were to evaluate the ability of endocardial electrical impedance measurements to recognize areas of infarct scar and to assess the stability of the impedance data under changes in cardiac activation sequence. METHODS: One-month-old myocardial infarction confirmed by cardiac magnetic resonance imaging was induced in 5 pigs submitted to coronary artery catheter balloon occlusion...
December 27, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Nikolaos Fragakis, Lydia Krexi, Panagiota Kyriakou, Melani Sotiriadou, Charalambos Lazaridis, Athanasios Karamanolis, Panagiotis Dalampyras, Stelios Tsakiroglou, Vassilios Skeberis, Dimitrios Tsalikakis, Vassilios Vassilikos
BACKGROUND: Radiofrequency (RF) ablation of the slow pathway (SP) in atrioventricular nodal reentry tachycardia (AVNRT) is occasionally complicated with atrioventricular block (AVB) often predicted by junctional beats (JB) with loss of ventriculo-atrial (VA) conduction. METHODS: We analyzed retrospectively 153 patients undergoing ablation of SP for typical AVNRT. Patients were divided into two age groups: 127 ≤ 70 years and 26 > 70 years. We analyzed the interval between the atrial electrogram in the His-bundle position and the distal ablation catheter [A(H)-A(RFd)] and between the distal ablation catheter and the proximal coronary sinus catheter [A(RFd)-A(CS)] before RF applications with and without JB...
January 2018: Pacing and Clinical Electrophysiology: PACE
Felix Bourier, Bernhard Schwarz, Amir Brkic, Lara Wolff, Verena Semmler, Marc Kottmaier, Elena Risse, Marta Telishevska, Stephanie Brooks, Sarah Lengauer, Marielouise Kornmayer, Katharina Koch-Büttner, Florian Berger, Gabriele Hessling, Isabel Deisenhofer, Tilko Reents
INTRODUCTION: For radiofrequency (RF) ablation, the EP Shuttle® (Stockert GmbH, Freiburg, Germany), Ampere® (St. Jude Medical, St. Paul, MN, USA), and SmartAblate® (Biosense Webster, Diamond Bar, CA, USA) generator models are most frequently used in clinical practice. The aim of this study was to assess the correlation between selected and delivered RF power for different generators. METHODS AND RESULTS: In an experimental setup, ablation catheters were connected to the EP Shuttle® , Ampere® , and SmartAblate® generators...
February 2018: Journal of Cardiovascular Electrophysiology
Sofy H Weisenberg, Stephanie C TerMaath, Charlotte N Barbier, Judith C Hill, James A Killeffer
OBJECTIVE Cerebrospinal fluid (CSF) shunts are the primary treatment for patients suffering from hydrocephalus. While proven effective in symptom relief, these shunt systems are plagued by high failure rates and often require repeated revision surgeries to replace malfunctioning components. One of the leading causes of CSF shunt failure is obstruction of the ventricular catheter by aggregations of cells, proteins, blood clots, or fronds of choroid plexus that occlude the catheter's small inlet holes or even the full internal catheter lumen...
November 10, 2017: Journal of Neurosurgery
E L Storlid, T Hausken, G A Lied, O H Gilja, J G Hatlebakk
BACKGROUND: Gastric accommodation to a meal may be important in the pathogenesis of upper gastrointestinal disorders, but has been difficult to investigate in a minimally invasive fashion. METHODS: We studied gastric and lower esophageal physiology during food intake, combining transabdominal ultrasound, multichannel high-resolution impedance-manometry (HRIM) and a symptom questionnaire. A HRIM catheter was distally positioned at incisura angularis and 300 mL saline with 75 g glucose was ingested...
November 9, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
M W P de Wolf, T van der Beek, A E Hamaekers, M Theunissen, D Enk
BACKGROUND: Ventilation through small-diameter tubes typically precludes use of a cuff as this will impede the necessary passive outflow of gas alongside the tube's outer surface. Ventrain assists expiration and enables oxygenation and normoventilation through small-bore cannulas or catheters, particularly in obstructed airways. A small-bore ventilation catheter (SBVC; 40 cm long, 2.2 mm inner diameter) with a separate pressure monitoring lumen and a cuff was developed. Efficacy of oxygenation and ventilation with Ventrain through this catheter was investigated in sealed and open airways in a porcine cross-over study...
November 8, 2017: Acta Anaesthesiologica Scandinavica
Hisaki Makimoto, Andreas Metzner, Roland Richard Tilz, Tina Lin, Christian-H Heeger, Andreas Rillig, Shibu Mathew, Christine Lemeš, Erik Wissner, Karl-Heinz Kuck, Feifan Ouyang
INTRODUCTION: Higher contact force (CF) theoretically increases the risk of blood charring, diminishing lesion formation. We aimed to investigate the relationship between CF, impedance change, and char formation during pulmonary vein isolation (PVI). METHODS: CF was assessed during PVI in 65 patients. Radiofrequency ablation (RFA) with power-controlled mode was applied in the point-by-point manner. The RFA were divided into five groups: group A (CF < 10 g), group B (10 g ≤ CF < 20 g), group C (20 g ≤ CF < 30 g), group D (30 g ≤ CF < 40 g), and group E (CF ≥ 40 g)...
February 2018: Journal of Cardiovascular Electrophysiology
Yeoungjee Cho, Neil C Boudville, Suetonia Palmer, Josephine Chow, Carmel M Hawley, Matthew D Jose, Rob Macginley, Louis Huang, Jo-Anne Moodie, Thu Nguyen, Laura Robison, Jeffrey Wong, David W Johnson
BACKGROUND: Evidence of effective interventions to prevent peritoneal dialysis (PD) catheter malfunction before first use is presently insufficient to guide clinical care. Regular flushing of the PD catheter (e.g. before PD commencement) has been adopted by some practitioners in the belief that it will prevent catheter obstruction and/or malfunction. The aim of this study was to characterize and evaluate PD catheter flushing practices across Australian and New Zealand PD units. METHODS: An on-line survey was distributed to all 62 PD units in Australia (12 August 2016; n = 51) and New Zealand (2 February 2017; n = 11), with questions relating to PD catheter flushing practices, audit, and outcomes...
November 2, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Junjing Su, Charlotte Manisty, Kim H Parker, Ulf Simonsen, Jens Erik Nielsen-Kudsk, Soren Mellemkjaer, Susan Connolly, P Boon Lim, Zachary I Whinnett, Iqbal S Malik, Geoffrey Watson, Justin E Davies, Simon Gibbs, Alun D Hughes, Luke Howard
BACKGROUND: In contrast to systemic hypertension, the significance of arterial waves in pulmonary hypertension (PH) is not well understood. We hypothesized that arterial wave energy and wave reflection are augmented in PH and that wave behavior differs between patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). METHODS AND RESULTS: Right heart catheterization was performed using a pressure and Doppler flow sensor-tipped catheter to obtain simultaneous pressure and flow velocity measurements in the pulmonary artery...
October 31, 2017: Journal of the American Heart Association
G J Brink, W Y Lei, T I Omari, M M J Singendonk, J S Hung, T T Liu, C H Yi, C L Chen
BACKGROUND: Abdominal compression has been implemented as a provocative maneuver in high-resolution impedance manometry (HRIM) to "challenge" normal esophageal physiology with the aim of revealing abnormal motor patterns which may explain symptoms. In this study, we measured the effects of abdominal compression on esophageal functioning utilizing novel pressure-impedance parameters and attempted to identify differences between healthy controls and globus patients. METHODS: Twenty-two healthy volunteers (aged 23-32 years, 41% female) and 22 globus patients (aged 23-72 years, 68% female) were evaluated with HRIM using a 3...
October 24, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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