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Surgical Cardiac Ablation

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https://www.readbyqxmd.com/read/29161368/management-of-cardiac-tamponade-in-catheter-ablation-of-atrial-fibrillation-single-centre-15%C3%A2-year-experience-on-5222-procedures
#1
Rikuta Hamaya, Shinsuke Miyazaki, Hiroshi Taniguchi, Shigeki Kusa, Hiroaki Nakamura, Hitoshi Hachiya, Takatsugu Kajiyama, Tomonori Watanabe, Miyako Igarashi, Kenzo Hirao, Yoshito Iesaka
Aims: Cardiac tamponade during atrial fibrillation (AF) ablation is infrequent but potentially fatal. This study aimed to retrospectively investigate the incidence, management, and outcomes of tamponade in large patient series. Methods and results: The study analysed 5222 AF ablation procedures in 3483 patients between 2002 and 2016 under a heparin-bridge anticoagulation protocol. Cardiac tamponade occurred in 51 procedures/patients, and the incidence was 0...
November 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29142816/unilateral-pulmonary-edema-in-a-patient-with-worsening-tricuspid-valve-regurgitation-a-secret-inside-pulmonary-veins
#2
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/29138937/effects-of-propofol-sedation-on-pacing-thresholds-results-from-an-observational-cohort-study
#3
Jakob Lüker, Arian Sultan, Tobias Plenge, Samuel Lee, Jan-Hendrik van den Bruck, Daniel Steven
BACKGROUND: Propofol is one of the most commonly used intravenous anaesthetic drugs for surgical procedures. The use of propofol for sedation is also common practice during endoscopic procedures, electrophysiology studies, and ablation procedures, as well as pacemaker and defibrillator implantation. It was found that propofol alters the electrophysiologic properties of the heart and its conduction system. The effects of propofol on pacing thresholds are unknown and could have implications for pacemaker (PM) and defibrillator (ICD) implantation procedures, as well as sedation and anaesthesia in PM and ICD patients in general...
November 14, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29132931/hybrid-surgical-versus-percutaneous-access-epicardial-ventricular-tachycardia-ablation
#4
Anthony Li, Justin Hayase, Duc Do, Eric Buch, Marmar Vaseghi, Olujimi A Ajijola, Carlos Macias, Yuliya Krokhaleva, Houman Khakpour, Noel G Boyle, Peyman Benharash, Reshma Biniwale, Kalyanam Shivkumar, Jason S Bradfield
BACKGROUND: There is limited experience of surgical epicardial access in the contemporary era of ventricular tachycardia ablation after prior cardiac surgery. OBJECTIVE: To describe our institutional experience with surgical epicardial access, the influence of surgical approach and compare outcomes to a propensity-matched percutaneous epicardial access control group. METHODS: A retrospective study of consecutive surgical epicardial VT ablation cases from a single center was performed...
November 10, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29131765/comprehensive-cross-sectional-imaging-of-the-pulmonary-veins
#5
Cameron Hassani, Farhood Saremi
The pulmonary veins carry oxygenated blood from the lungs to the heart, but their importance to the radiologist extends far beyond this seemingly straightforward function. The anatomy of the pulmonary veins is variable among patients, with several noteworthy variant and anomalous patterns, including supernumerary pulmonary veins, a common ostium, anomalous pulmonary venous return, and levoatriocardinal veins. Differences in pulmonary vein anatomy and the presence of variant or anomalous anatomy can be of critical importance, especially for preoperative planning of pulmonary and cardiac surgery...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29109075/atrioesophageal-fistula-clinical-presentation-procedural-characteristics-diagnostic-investigations-and-treatment-outcomes
#6
REVIEW
Hui-Chen Han, Francis J Ha, Prashanthan Sanders, Ryan Spencer, Andrew W Teh, David O'Donnell, Omar Farouque, Han S Lim
BACKGROUND: Percutaneous or surgical ablation are increasingly used worldwide in the management of atrial fibrillation. The development of atrioesophageal fistula (AEF) is among the most serious and lethal complications of atrial fibrillation ablation. We sought to characterize the clinical presentation, procedural characteristics, diagnostic investigations, and treatment outcomes of all reported cases of AEF. METHODS AND RESULTS: Electronic searches were conducted in PubMed and Embase for English scientific literature articles...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29049711/hybrid-treatment-combining-robotic-coronary-artery-bypass-grafting-and-percutaneous-catheter-radiofrequency-ablation
#7
Tatsuya Tarui, Norihiko Ishikawa, Ryuta Kiuchi, Go Watanabe
Isolated coronary artery bypass grafting associated with atrial fibrillation is routinely performed through a sternotomy, and cardiac arrest. Advancements in this surgical approach have led to better cosmesis, a quick postoperative recovery, with the same postoperative results. We report a case of a novel, less invasive hybrid treatment combining robot-assisted coronary artery bypass grafting and percutaneous radiofrequency catheter ablation.
August 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29016802/intra-atrial-re-entrant-tachycardia-in-congenital-heart-disease-types-and-relation-of-isthmus-to-atrial-voltage
#8
Ivo Roca-Luque, Nuria Rivas Gándara, Laura Dos Subirà, Jaume Francisco Pascual, Antònia Pijuan Domenech, Jordi Pérez-Rodon, M Teresa Subirana, Alba Santos Ortega, Berta Miranda, Ferran Rosés-Noguer, Ignacio Ferreira-Gonzalez, Jaume Casaldàliga Ferrer, David García-Dorado García, Angel Moya Mitjans
Background: Intra-atrial re-entrant tachycardia (IART) is a frequent and severe complication in patients with congenital heart disease (CHD). Cavotricuspid isthmus (CTI)-related IART is the most frequent mechanism. However, due to fibrosis and surgical scars, non-CTI-related IART is also frequent. Objective: The main objective of this study was to describe the types of IART and circuit locations and to define a cut-off value for unhealthy tissue in the atria. Methods and results: This observational study included all consecutive patients with CHD who underwent a first ablation procedure for IART from January 2009 to December 2015 (94 patients, 39...
August 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28969539/transseptal-access-to-the-left-atrium-tips-and-tricks-to-keep-it-safe-derived-from-single-operator-experience-and-review-of-the-literature
#9
Antonis S Manolis
BACKGROUND: Transseptal puncture (TSP) remains a demanding procedural step in accessing the left atrium with inherent risks and safety concerns, mostly related to cardiac tamponade. OBJECTIVE: Based on our own experience with 249 TSP procedures and in-depth literature review, we present our results and offer several tips and tricks that may render TSP successful and safe. METHODS: This prospective study comprised 249 consecutive patients (146 men), aged 41...
September 27, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28944183/transaortic-septal-myectomy-techniques-and-pitfalls
#10
REVIEW
Anthony Ralph-Edwards, Rachel D Vanderlaan, Pietro Bajona
Hypertrophic cardiomyopathy (HCM) is the most common congenital cardiac disease, affecting up to 1 in 200 individuals. When it causes left ventricular outflow tract (LVOT) obstruction, treatment is indicated to reduce symptoms and the risk of sudden cardiac death. Pharmacologic therapy is the first line treatment, however if it fails, surgical myectomy or percutaneous ablation of the hypertrophic myocardium are the standard therapies to eliminate subaortic obstruction. Both surgical myectomy and percutaneous ablation have been demonstrated as safe and effective treatments; however, myectomy is the gold standard with a significantly lower complication rate and more complete and longstanding reduction of LVOT obstruction...
July 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28941606/new-developments-in-hypertrophic-cardiomyopathy
#11
REVIEW
Robert M Cooper, Claire E Raphael, Max Liebregts, Nandan S Anavekar, Josef Veselka
Hypertrophic cardiomyopathy is the leading cause of sudden death in young individuals and an important cause of heart failure at any age. In this review we discuss advances in investigation and management of this heterogenous disease. Improved cardiac imaging has allowed us to detail many of the structural abnormalities whereas the use of new techniques, predominantly in cardiac magnetic resonance imaging, has given us a greater insight in to tissue architecture, mechanism of contractile abnormalities, and function...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28938531/premature-senescence-of-cardiac-fibroblasts-and-atrial-fibrosis-in-patients-with-atrial-fibrillation
#12
Jun Xie, Yuhan Chen, Chuanxian Hu, Quanhua Pan, Bingjian Wang, Xueling Li, Jin Geng, Biao Xu
Premature senescence is associated with atrial fibrosis and has an antifibrotic effect in mice. However, the role of senescence in atrial fibrillation (AF) remains unclear. Here, we investigated the association of premature senescence with fibrosis and also determined the role of senescence in the recurrence of AF after surgery ablation. Western blot, Sirius red staining, SA-β-gal staining and immunohistochemistry were performed to detect the degree of atrial fibrosis ,the expression of TGF-β and collagens, and also the senescence markers in 72 tissue specimens of left atrial appendage in this study...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28901158/hypertrophic-obstructive-cardiomyopathy-review-of-surgical-treatment
#13
Jonathan Price, Nicholas Clarke, Aslan Turer, Eduard Quintana, Carlos Mestres, Lynn Huffman, Matthias Peltz, Michael Wait, W Steves Ring, Michael Jessen, Pietro Bajona
Hypertrophic cardiomyopathy ranks among the most common congenital cardiac diseases, affecting up to 1 in 200 of the general population. When it causes left ventricular outflow tract obstruction, treatment is guided to reduce symptoms and the risk of sudden cardiac death. Pharmacologic therapy is the first-line treatment, but when it fails, surgical myectomy or percutaneous ablation of the hypertrophic myocardium are the standard therapies to eliminate subaortic obstruction. Both surgical myectomy and percutaneous ablation are proven safe and effective treatments; however, myectomy is the gold standard with a significantly lower complication rate and more complete and lasting reduction of left ventricular outflow tract obstruction...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28876642/outcome-of-liver-resection-for-carcinoid-neuroendocrine-metastases
#14
M D Polkinghorne, J E J Krige, E Jonas, U K Kotze, M M Bernon
BACKGROUND: Gastrointestinal carcinoid tumours, despite their low malignant potential, frequently metastasize to the liver. While liver resection improves survival and provides symptomatic relief, multifocal bilobar disease complicates surgical management. METHOD: All patients with carcinoid liver secondaries managed by resection from 1990-2015 were identified from a prospective departmental database. Demographic data, operative management, morbidity using the Accordion classification and mortality were analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28856513/emerging-pharmacologic-and-structural-therapies-for-hypertrophic-cardiomyopathy
#15
REVIEW
Daniel J Philipson, Eugene C DePasquale, Eric H Yang, Arnold S Baas
Hypertrophic cardiomyopathy is the most common inherited heart disease. Although it was first described over 50 years ago, there has been little in the way of novel disease-specific therapeutic development for these patients. Current treatment practice largely aims at symptomatic control using old drugs made for other diseases and does little to modify the disease course. Septal reduction by surgical myectomy or percutaneous alcohol septal ablation are well-established treatments for pharmacologic-refractory left ventricular outflow tract obstruction in hypertrophic cardiomyopathy patients...
November 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28835834/supraventricular-arrhythmias-in-patients-with-adult-congenital-heart-disease
#16
Carina Blomström Lundqvist, Tatjana S Potpara, Helena Malmborg
An increasing number of patients with congenital heart disease survive to adulthood; such prolonged survival is related to a rapid evolution of successful surgical repairs and modern diagnostic techniques. Despite these improvements, corrective atrial incisions performed at surgery still lead to subsequent myocardial scarring harbouring a potential substrate for macro-reentrant atrial tachycardia. Macroreentrant atrial tachycardias are the most common (75 %) type of supraventricular tachycardia (SVT) in patients with adult congenital heart disease (ACHD)...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28833764/ganglionated-plexi-as-neuromodulation-targets-for-atrial-fibrillation
#17
Eue-Keun Choi, Ye Zhao, Thomas H Everett, Peng-Sheng Chen
The autonomic nervous system plays an important role in the genesis of atrial fibrillation and is one of the candidate targets for atrial fibrillation therapy. This review focuses on the role of the autonomic nervous system in atrial fibrillation development and discusses the results of the ganglionated plexi catheter and surgical ablation in preclinical and clinical studies. The heart is innervated by the extrinsic and intrinsic autonomic nervous systems. The intrinsic autonomic nervous system consists of multiple ganglionated plexi and axons, which innervate the neighboring atrial myocardium and control their electrophysiological properties...
August 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28802656/rethinking-papillary-muscle-resection-for-refractory-ventricular-tachycardia-in-the-lvad-era-a-case-report
#18
Zachary J Il'Giovine, Adam D DeVore, Chetan B Patel, Jason Koontz, Jacob Schroder
We report the case of a 57-year-old man with a history of ischemic cardiomyopathy who presented to the hospital with recurrent episodes of ventricular tachycardia refractory to antiarrhythmic medications. Mapping identified a deep premature ventricular contraction focus in the anterolateral papillary muscle, an area that has been previously identified as difficult to treat with radiofrequency catheter ablation. The hospital course was complicated by cardiogenic shock and VT-storm, and the patient ultimately underwent surgical resection of the anterolateral papillary muscle with left ventricular assist device placement as a successful bridge to cardiac transplantation...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28775383/high-resolution-3-dimensional-imaging-of-the-human-cardiac-conduction-system-from-microanatomy-to-mathematical-modeling
#19
Robert S Stephenson, Andrew Atkinson, Petros Kottas, Filip Perde, Fatemeh Jafarzadeh, Mike Bateman, Paul A Iaizzo, Jichao Zhao, Henggui Zhang, Robert H Anderson, Jonathan C Jarvis, Halina Dobrzynski
Cardiac arrhythmias and conduction disturbances are accompanied by structural remodelling of the specialised cardiomyocytes known collectively as the cardiac conduction system. Here, using contrast enhanced micro-computed tomography, we present, in attitudinally appropriate fashion, the first 3-dimensional representations of the cardiac conduction system within the intact human heart. We show that cardiomyocyte orientation can be extracted from these datasets at spatial resolutions approaching the single cell...
August 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28774344/late-outcome-of-surgical-radiofrequency-ablation-for-persistent-valvular-atrial-fibrillation-in-china-a-single-center-study
#20
Hailong Cao, Yunxing Xue, Qing Zhou, Minggang Yu, Chenbin Tang, Dongjin Wang
BACKGROUND: Atrial fibrillation (AF) adversely affects surgical outcomes of cardiac valve surgery. Surgical ablation is an effective way to treat valvular AF. The aim of this study was to evaluate the late outcome of surgical radiofrequency ablation and explore the risk factors of AF recurrence in Chinese patients undergoing cardiac valve surgery. METHODS: Three hundred ninety six consecutive patients with persistent valvular AF were enrolled in this study. They underwent concomitant modified Maze IV and were completed follow-ups...
August 3, 2017: Journal of Cardiothoracic Surgery
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