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Nerve ablation

Naoko Yamaguchi, Kentaro Yamakawa, Pradeep S Rajendran, Tatsuo Takamiya, Marmar Vaseghi
BACKGROUND: Neuraxial modulation with cardiac sympathetic denervation (CSD) can potentially reduce burden of ventricular tachy-arryhthmias (VT). Despite catheter ablation and CSD, however, VT can recur in patients with cardiomyopathy and the role of vagal nerve stimulation (VNS) in this setting is unclear. OBJECTIVE: The purpose of this study was to evaluate electrophysiological effects of VNS after CSD in normal and infarcted hearts. METHODS: In 10 normal and 6 infarcted pigs, electrophysiological and hemodynamic parameters were evaluated before and during intermittent VNS pre-CSD (bilateral stellectomy and T2-T4 thoracic ganglia removal) as well as post-CSD...
March 9, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Michael Gold, Anneke Andriessen, Alexandros Bader, Red Alinsod, Elizabeth Shane French, Nathan Guerette, Yegor Kolodchenko, Michael Krychman, Susan Murrmann, Julene Samuels
INTRODUCTION: The use of energy-based devices for the treatment of vaginal laxity, orgasmic dysfunction, and stress incontinence, such as minimally ablative fractional laser and radiofrequency, is gaining momentum. This review aims to answer clinical questions on the application of energy-based devices for feminine genital rejuvenation. METHODS: The target group includes physicians involved in esthetic medicine and feminine genital rejuvenation. A literature review was conducted on technologies in use for feminine rejuvenation to explore their safety, efficacy, tolerability, patient satisfaction, and clinical usability...
March 10, 2018: Journal of Cosmetic Dermatology
Aleksandr Voskoboinik, Paul B Sparks, Joseph B Morton, Geoffrey Lee, Stephen A Joseph, Joshua J Hawson, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Despite technological advances, studies continue to report high complication rates for atrial fibrillation (AF) ablation. We sought to review complication rates for AF ablation at a high-volume centre over a 14-year period and identify predictors of complications. METHODS: We reviewed prospectively collected data from 2750 consecutive AF ablation procedures at our institution using radiofrequency energy (RF) between January 2004 and May 2017. All cases were performed under general anaesthetic with transoesophageal echocardiography (TEE), 3D-mapping and an irrigated ablation catheter...
February 3, 2018: Heart, Lung & Circulation
Samer Bassilios Habre, James Bradford Depew, Robert D Wallace, Petros Konofaos
Neuroma pain can be severe, persistent, and treatment-resistant. Forehead and scalp anesthesia is troublesome for patients. Following an iatrogenic ablative injury to the right supraorbital nerve, with subsequent painful neuroma formation, a human cadaveric nerve allograft (AxoGen, Alachua, FL) was used to restore sensation of the right forehead and treat pain. At 1-year follow-up, the patient was pain-free, and protective sensation to the right forehead was recovered with comparable static and dynamic 2-point discrimination between the injured (20 mm, 12 mm respectively) and the normal side (15 mm, 10 mm respectively)...
March 8, 2018: Journal of Craniofacial Surgery
Christopher T Banek, Madeline M Gauthier, Daniel C Baumann, Dusty Van Helden, Ninitha Asirvatham-Jeyaraj, Angela Panoskaltsis-Mortari, Gregory D Fink, John W Osborn
Recent preclinical studies show renal denervation (RDNx) may be an effective treatment for hypertension; however, the mechanism remains unknown. We have recently reported total RDNx (TRDNx) and afferent-selective RDNx (ARDNx) similarly attenuated the development of deoxycorticosterone acetate (DOCA)-salt hypertension. Whereas TRDNx abolished renal inflammation, ARDNx had a minimal effect despite an identical anti-hypertensive effect. Although this study established that ARDNx attenuates the development of DOCA-salt hypertension, it is unknown whether this mechanism remains operative once hypertension is established...
March 7, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
S Ploteau, B Merlot, H Roman, M Canis, P Collinet, X Fritel
Minimal and mild endometriosis (stage 1 and 2 AFSR) can lead to chronic pelvic pain and infertility but can also exist in asymptomatic patients. The prevalence of asymptomatic patients with minimal and mild endometriosis is not clear but typical endometriosis lesions are found in about 5 to 10% of asymptomatic women and more than 50% of painful and/or infertile women. Laparoscopic treatment of minimal and mild endometriotic lesions is justified in case of pelvic pain because their destruction decrease significatively the pain compared with diagnostic laparoscopy alone...
March 3, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Kivanc Yalin, Amr Abdin, Evgeny Lyan, Noureddin Sawan, Spyridon Liosis, Christian Elsner, Alexander Jobs, Ben Brüggemann, Jelena Koester, Ingo Eitel, Charlotte Eitel, Roland Richard Tilz
BACKGROUND: The second-generation cryoballoon (CB) is increasingly used for treatment of persistent atrial fibrillation (AF). Data regarding the clinical outcome and mechanism of arrhythmia recurrence following persistent AF ablation using CB is sparse. In this study, we aimed to assess the efficacy of CB and mechanisms of atrial tachyarrhythmia (ATA) recurrence in patients with persistent AF. METHODS AND RESULTS: A total of 133 patients (66 ± 10 years, 60% male) with symptomatic persistent AF, who were scheduled for PVI using the second-generation CB were enrolled...
February 28, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Hsin-Pin Lin, Idil Oksuz, John Svaren, Rajeshwar Awatramani
Recent studies have elucidated the crucial role for microRNAs in peripheral nerve myelination by ablating components of the microRNA synthesis machinery. Few studies have focused on the role of individual microRNAs. To fill this gap, we focused this study on miR-138, which was shown to be drastically reduced in Dicer1 and Dgcr8 knockout mice with hypomyelinating phenotypes and to potentially target the negative regulators of Schwann cell differentiation. Here, we show that of two miR-138 encoding loci, mir-138-1 is the predominant locus transcribed in Schwann cells...
February 28, 2018: Scientific Reports
Jinjun Chen, Lingyong Li, Shao-Rui Chen, Hong Chen, Jing-Dun Xie, Rita E Sirrieh, David M MacLean, Yuhao Zhang, Meng-Hua Zhou, Vasanthi Jayaraman, Hui-Lin Pan
α2δ-1, commonly known as a voltage-activated Ca2+ channel subunit, is a binding site of gabapentinoids used to treat neuropathic pain and epilepsy. However, it is unclear how α2δ-1 contributes to neuropathic pain and gabapentinoid actions. Here, we show that Cacna2d1 overexpression potentiates presynaptic and postsynaptic NMDAR activity of spinal dorsal horn neurons to cause pain hypersensitivity. Conversely, Cacna2d1 knockdown or ablation normalizes synaptic NMDAR activity increased by nerve injury. α2δ-1 forms a heteromeric complex with NMDARs in rodent and human spinal cords...
February 27, 2018: Cell Reports
Angela C Hirbe, Jack Jennings, Nael Saad, Joseph D Giardina, Yu Tao, Jingqin Luo, Shellie Berry, Jacqui Toeniskoetter, Brian A Van Tine
LESSONS LEARNED: Ablation therapy appears to be a reasonably safe and effective approach to obtain a significant treatment-free interval for a subset of patients with limited sites of metastatic disease for which systemic control can be obtained with six cycles of chemotherapy. BACKGROUND: Metastatic sarcoma often becomes resistant to treatment by chemotherapy. There is sometimes prolonged stable disease from active chemotherapy that provides a window of opportunity for an intervention to prolong disease-free survival...
February 27, 2018: Oncologist
Wilber Su, G Joseph Orme, Robert Hoyt, James Baker, Steven Compton, Christopher Fellows, John Harding, J Thomas Svinarich, Marcin Kowalski, Bryan Piedad, David Kenigsberg, John Seger, Zeshan K Ahmad, Paul Wang
BACKGROUND: Pulmonary vein isolation (PVI) via catheter ablation is an approved therapy for patients with drug-refractory and symptomatic atrial fibrillation (AF). Furthermore, cryoballoon is now considered to be as effective as focal radiofrequency catheter ablation. This study examines the second-generation cryoballoon performance in a US multicenter review of real-world practices. METHODS: By retrospective chart collections, the long-term efficacy and safety of the cryoballoon procedure were assessed in 15 US centers...
February 24, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
George D Bittner, Dale R Sengelaub, Cameron L Ghergherehchi
Current Neuroscience dogma holds that transections or ablations of a segment of peripheral nerves produce: (1) Immediate loss of axonal continuity, sensory signaling, and motor control; (2) Wallerian rapid (1-3 days) degeneration of severed distal axons, muscle atrophy, and poor behavioral recovery after many months (if ever, after ablations) by slowly-regenerating (1 mm/d), proximal-stump outgrowths that must specifically reinnervate denervated targets; (3) Poor acceptance of microsutured nerve allografts, even if tissue-matched and immune-suppressed...
January 2018: Neural Regeneration Research
Sanjeet S Grewal, Krzysztof R Gorny, Christopher P Favazza, Robert E Watson, Timothy J Kaufmann, Jamie J Van Gompel
BACKGROUND AND IMPORTANCE: Laser interstitial thermal therapy (LiTT) has increasingly been used as a treatment option for medically refractory epilepsy, tumors, and radiation necrosis. The use of LiTT requires intraoperative magnetic resonance (MR) thermography. This can become an issue in patients with other implanted therapeutic devices such as pacemakers and vagal nerve stimulators due to concerns regarding increases in the specific absorption rate (SAR). This is a technical case report demonstrating a successfully and safely performed LiTT in a 1...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Atsushi Sakaoka, Hisako Terao, Shintaro Nakamura, Hitomi Hagiwara, Toshihito Furukawa, Kiyoshi Matsumura, Kenichi Sakakura
BACKGROUND: Ablation lesion depth caused by radiofrequency-based renal denervation (RDN) was limited to <4 mm in previous animal studies, suggesting that radiofrequency-RDN cannot ablate a substantial percentage of renal sympathetic nerves. We aimed to define the true lesion depth achieved with radiofrequency-RDN using a fine sectioning method and to investigate biophysical parameters that could predict lesion depth. METHODS AND RESULTS: Radiofrequency was delivered to 87 sites in 14 renal arteries from 9 farm pigs at various ablation settings: 2, 4, 6, and 9 W for 60 seconds and 6 W for 120 seconds...
February 2018: Circulation. Cardiovascular Interventions
Victoria Jacobs, Heidi T May, Brian G Crandall, Becca Ballantyne, Ben Chisum, Dave Johnson, Kevin G Graves, Michael Cutler, John D Day, Charles Mallender, Jeffrey S Osborn, J Peter Weiss, Thomas Jared Bunch
BACKGROUND: Vagus nerve injury during catheter ablation for atrial fibrillation (AF) can significantly impact quality of life and result in lingering gastrointestinal symptoms. This study was designed to define risk factors of vagal nerve injury, symptom prevalence and temporal resolution. METHODS: A total of 100 patients undergoing radiofrequency catheter ablation (RFCA) were enrolled and consented to participate in the study. Patients completed a 22 item questionnaire that included questions specific to vagus nerve injury symptomatology during their baseline visit and at 1 and 3 months post-RFCA...
February 13, 2018: Pacing and Clinical Electrophysiology: PACE
Dominik Linz, Mathias Hohl, Adrian D Elliott, Dennis H Lau, Felix Mahfoud, Murray D Esler, Prashanthan Sanders, Michael Böhm
Renal afferent and efferent sympathetic nerves are involved in the regulation of blood pressure and have a pathophysiological role in hypertension. Additionally, several conditions that frequently coexist with hypertension, such as heart failure, obstructive sleep apnea, atrial fibrillation, renal dysfunction, and metabolic syndrome, demonstrate enhanced sympathetic activity. Renal denervation (RDN) is an approach to reduce renal and whole body sympathetic activation. Experimental models indicate that RDN has the potential to lower blood pressure and prevent cardio-renal remodeling in chronic diseases associated with enhanced sympathetic activation...
February 10, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Michael T B Nguyen, Vishakha Thakrar, Clara C Chan
OBJECTIVE: To describe indications and outcomes of patients fitted with the EyePrintPRO therapeutic scleral lens. METHODS: A database search of patients fitted with the EyePrintPRO from 2014 to 2016. Fourteen eyes of 10 patients were reviewed retrospectively. Patient demographics, medical and ocular history, indications for fitting, duration of wear, symptoms, and best-corrected visual acuity (BCVA) were analyzed. RESULTS: Mean age at lens fitting was 49 years (range, 21-67 years)...
February 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Jeffrey S Fischgrund, A Rhyne, J Franke, R Sasso, S Kitchel, H Bae, C Yeung, E Truumees, M Schaufele, P Yuan, P Vajkoczy, M DePalma, D G Anderson, L Thibodeau, B Meyer
PURPOSE: To evaluate the safety and efficacy of radiofrequency (RF) ablation of the basivertebral nerve (BVN) for the treatment of chronic low back pain (CLBP) in a Food and Drug Administration approved Investigational Device Exemption trial. The BVN has been shown to innervate endplate nociceptors which are thought to be a source of CLBP. METHODS: A total of 225 patients diagnosed with CLBP were randomized to either a sham (78 patients) or treatment (147 patients) intervention...
February 8, 2018: European Spine Journal
N Facciolongo, A Di Stefano, V Pietrini, C Galeone, F Bellanova, F Menzella, N Scichilone, R Piro, G L Bajocchi, B Balbi, L Agostini, P P Salsi, D Formisano, M Lusuardi
BACKGROUND: Bronchial thermoplasty (BT) is a non-pharmacological intervention for severe asthma whose mechanism of action is not completely explained by a reduction of airway smooth muscle (ASM). In this study we analyzed the effect of BT on nerve fibers and inflammatory components in the bronchial mucosa at 1 year. METHODS: Endobronchial biopsies were obtained from 12 subjects (mean age 47 ± 11.3 years, 50% male) with severe asthma. Biopsies were performed at baseline (T0) and after 1 (T1), 2 (T2) and 12 (T12) months post-BT, and studied with immunocytochemistry and microscopy methods...
February 8, 2018: BMC Pulmonary Medicine
Mehdi Hichor, Venkat Krishnan Sundaram, Stéphanie A Eid, Ronza Abdel-Rassoul, Patrice X Petit, Didier Borderie, Jean Bastin, Assaad A Eid, Marin Manuel, Julien Grenier, Charbel Massaad
Reactive oxygen species (ROS) modify proteins and lipids leading to deleterious outcomes. Thus, maintaining their homeostatic levels is vital. This study highlights the endogenous role of LXRs (LXRα and β) in the regulation of oxidative stress in peripheral nerves. We report that the genetic ablation of both LXR isoforms in mice (LXRdKO) provokes significant locomotor defects correlated with enhanced anion superoxide production, lipid oxidization and protein carbonylation in the sciatic nerves despite the activation of Nrf2-dependant antioxidant response...
February 6, 2018: Scientific Reports
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