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Surgical Cardiac Ablation

Yoshinari Enomoto, Go Hashimoto, Naohiko Sahara, Hikari Hashimoto, Hiroki Niikura, Keijiro Nakamura, Raisuke Iijima, Hidehiko Hara, Makoto Suzuki, Mahito Noro, Masao Moroi, Kaoru Sugi, Masato Nakamura
A 70-years-old male with a history of hypertension and drug resistant paroxysmal atrial fibrillation (AF) presented to our hospital for catheter ablation to his symptomatic AF. He had no prior surgical or percutaneous procedure to close or exclude the left atrial appendage (LAA). A transesophageal echocardiography (TEE) was performed to rule out intra-cardiac thrombus prior to the ablation procedure. Although the TEE imaging at multiple acquisition angles was obtained, the LAA could not be visualized and an absence of the LAA was suspected...
March 12, 2018: International Heart Journal
Grzegorz Suwalski, Robert Emery, Jakub Mróz, Kamil Kaczejko, Leszek Gryszko, Andrzej Cwetsch, Andrzej Skrobowski
OBJECTIVES: In patients undergoing cardiac surgical procedures, pulmonary vein isolation may be easily accomplished, and it is important to achieve bidirectional conduction block across created lesions. The primary aim of this study was to assess the risk of pulmonary vein stenosis (PVS) after multiple applications of epicardial bipolar radiofrequency energy. METHODS: Thirty-five consecutive patients who were referred for off-pump coronary revascularization with concomitant pulmonary vein isolation and left atrial appendage occlusion were prospectively included in the study...
March 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Taner Kasar, Pelin Ayyildiz, Gulhan Tunca Sahin, Erkut Ozturk, Selman Gokalp, Sertac Haydin, Alper Guzeltas, Yakup Ergul
BACKGROUND: We aimed to evaluate rhythm abnormalities in cases of congenitally corrected transposition of the great arteries (ccTGA) and associated treatment strategies. PATIENTS AND METHODS: This retrospective cohort study included 65 pediatric patients with ccTGA who were admitted to the clinic between 2009 and 2017. The patients were divided into two groups, and surgical data, Holter electrocardiographic (ECG) recordings, ECG recordings, electrophysiological data, and device implantation data on the two groups were compared...
February 24, 2018: Congenital Heart Disease
Habib Rehman Khan, Ines Kralj-Hans, Shouvik Haldar, Toufan Bahrami, Jonathan Clague, Anthony De Souza, Darrel Francis, Wajid Hussain, Julian Jarman, David Gareth Jones, Neeraj Mediratta, Raad Mohiaddin, Tushar Salukhe, Simon Jones, Joanne Lord, Caroline Murphy, Joanna Kelly, Vias Markides, Dhiraj Gupta, Tom Wong
BACKGROUND: Atrial fibrillation is the commonest arrhythmia which raises the risk of heart failure, thromboembolic stroke, morbidity and death. Pharmacological treatments of this condition are focused on heart rate control, rhythm control and reduction in risk of stroke. Selective ablation of cardiac tissues resulting in isolation of areas causing atrial fibrillation is another treatment strategy which can be delivered by two minimally invasive interventions: percutaneous catheter ablation and thoracoscopic surgical ablation...
February 20, 2018: Trials
Yuting P Chiang, Yuichi J Shimada, Jonathan Ginns, Shepard D Weiner, Hiroo Takayama
Hypertrophic cardiomyopathy (HCM) is the most commonly inherited cardiac disease-recent studies suggest a prevalence as high as 1 in 200. For symptomatic patients with obstructive HCM who are refractory to medical therapy, septal reduction is indicated. Septal myectomy (SM) is considered the gold standard septal reduction technique. However, due to a shortage of surgeons who are experienced in this technique, alcohol septal ablation (ASA) has overtaken SM as the most commonly performed procedure for obstructive HCM...
February 15, 2018: General Thoracic and Cardiovascular Surgery
Carlos A Mestres, Thomas Bartel, Antonio Sorgente, Silvana Müller, Christiane Gruner, Joseph Dearani, Eduard Quintana
Hypertrophic cardiomyopathy is the most common genetic cardiovascular disorder and is associated with symptoms of heart failure and increased risk of sudden cardiac death. The most common condition is obstruction of the left ventricular outflow tract. Surgical septal myectomy and alcohol septal ablation are the 2 accepted modes of septal reduction therapy and are indicated when there are advanced symptoms and a peak left ventricular outflow gradient ≥50 mmHg. Advantages of alcohol septal ablation are limited groin approach, reduction of obstruction of the left ventricular outflow tract and functional improvement, but there are higher chances for intracardiac device implantation and residual obstruction...
February 9, 2018: European Journal of Cardio-thoracic Surgery
W Hampton Gray, Fernando Fleischman, Mark J Cunningham, Anthony W Kim, Craig J Baker, Vaughn A Starnes, P Michael McFadden
Left atrial-esophageal fistula (AEF) following endovascular radiofrequency (RF) ablation for cardiac arrhythmias is a life threatening complication. Immediate surgical repair offers the best chance for survival. The optimal surgical technique is unknown. We describe our recommended surgical approach.
February 1, 2018: Annals of Thoracic Surgery
Sahin Iscan, Bortecin Eygi, Yuksel Besir, Ismail Yurekli, Habib Cakir, Levent Yilik, Orhan Gokalp, Ali Gurbuz
Atrial fibrillation (AF) is a cardiac dysrhythmia commonly seen in clinical practice especially after cardiac surgery. It is associated with increased morbidity and mortality for the patients. The pathogenesis of AF is not exactly understood yet, but there is growing data about the relationship between AF and inflammation. Cardiac surgery itself is a big source for inflammation. It causes major surgical trauma, ischemia/reperfusion injury, hypothermia, low arterial pressure, and the equipment of cardiopulmonary bypass makes a large foreign surface thus it activates inflammatory response...
January 31, 2018: Current Pharmaceutical Design
Xinxin Wang, Chunguo Wang, Minhua Ye, Jiang Lin, Jiang Jin, Quanteng Hu, Chengchu Zhu, Baofu Chen
INTRODUCTION: Surgical ablation is a generally established treatment for patients with atrial fibrillation undergoing concomitant cardiac surgery. Left atrial (LA) lesion set for ablation is a simplified procedure suggested to reduce the surgery time and morbidity after procedure. The present meta-analysis aims to explore the outcomes of left atrial lesion set versus no ablative treatment in patients with AF undergoing cardiac surgery. METHODS: A literature research was performed in six database from their inception to July 2017, identifying all relevant randomized controlled trials (RCTs) comparing left atrial lesion set versus no ablative treatment in AF patient undergoing cardiac surgery...
2018: PloS One
Paulina Batóg, Fanni Rencz, Márta Péntek, László Gulácsi, Krzysztof J Filipiak, Valentina Prevolnik Rupel, Judit Simon, Valentin Brodszky, Petra Baji, Jakub Závada, Guenka Petrova, Alexandru Rotar, Dominik Golicki
BACKGROUND: The measurement of health-related quality of life (HRQOL) by validated generic instruments, such as EQ-5D, becomes an increasingly important tool for the assessment of health care in a wide range of different diagnoses. AIM: To systematically review EQ-5D literature generated in cardiovascular diseases in eight selected Central and Eastern Europe (CEE) countries. METHODS: A structured literature search was conducted in MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, the Cochrane Library and the EuroQol website up to November 2016...
January 19, 2018: Kardiologia Polska
Catherine Peterson, Clay Elswick, Vicki Diaz, R Shane Tubbs, Marc Moisi
Air embolism developing from an atrial-esophageal fistula that was created as a complication from an atrial ablation procedure is a rare, yet usually fatal diagnosis. Neurologic manifestations such as meningitis, altered mental status, seizures, strokes, transient ischemic attacks (TIAs), psychiatric changes, and coma can ensue. Imaging of the brain might reveal infarcts, cerebral edema, as well as signs of pneumocephalus. This case describes a 42-year-old male with recent cardiac ablation procedure at an outside hospital for refractory atrial fibrillation (A-fib) who presented with altered mental status, dyspnea and diaphoresis...
November 15, 2017: Curēus
Jose M Sanchez, Ghannam Al-Dosari, Sherman Chu, Ramin Beygui, Tobias Deuse, Nitish Badhwar, Randall J Lee
Atrial fibrillation (AF) is the most common cardiac arrhythmia. The incidence of AF increases with age and is associated with increased stroke, heart failure and mortality. Persistent and long standing persistent AF is difficult to treat and often refractory to medical therapy and catheter ablation. Areas covered: This article reviews the historical development of the surgical Cox-MAZE procedure and current hybrid and minimally invasive surgical approaches for the treatment of persistent and long standing persistent AF...
February 2018: Expert Review of Cardiovascular Therapy
Marwan M Refaat, Jad Ballout, Moussa Mansour
With improved surgical techniques and medical management for patients with congenital heart diseases, more patients are living longer and well into adulthood. This improved survival comes with a price of increased morbidity, mainly secondary to increased risk of tachyarrhythmias. One of the major arrhythmias commonly encountered in this subset of cardiac patients is AF. Similar to the general population, the risk of AF increases with advancing age, and is mainly secondary to the abnormal anatomy, abnormal pressure and volume parameters in the hearts of these patients and to the increased scarring and inflammation seen in the left atrium following multiple surgical procedures...
December 2017: Arrhythmia & Electrophysiology Review
Christopher Elia, James Brazdzionis, Vartan Tashjian
INTRODUCTION: Chiari malformation type I (CM) commonly present with symptoms such as tussive headaches, paresthesias and in severe cases, corticobulbar dysfunction.3 However, patients may present with atypical symptoms lending to the complexity in this patient population. We present a case of a CM patient presenting with atypical cardiac symptoms and arrhythmias, all of which resolved after surgical decompression. CASE DESCRIPTION: A 31-year-old female presented with atypical chest pain, palpitations, tachycardia, headaches, and dizziness for 2 years...
December 27, 2017: World Neurosurgery
Min-Juan Zheng, Jian Yang, Guang-Bin He, Xiao-Dong Zhou, Li-Wen Liu
Surgical resection is the conventional therapeutic action for patients with an obstructive cardiac tumor. However, for patients in poor clinical condition, cardiac surgery can be risky. We report on the successful percutaneous radiofrequency (RF) ablation treatment of a right ventricular giant myxoma in a 70-year-old female with right ventricular outflow tract (RVOT) and pulmonary artery stenosis, who was unable to tolerate surgery. The treatment was effective in relieving RVOT stenosis and improving symptoms...
December 16, 2017: Annals of Thoracic Surgery
Ivo K Genev, Lindsey A Tompkins, Manorama M Khare, Farhad Farokhi
Introduction: Atrial fibrillation is the most common cardiac arrhythmia in the United States. It has been associated with a reduction in patient quality of life and more serious complications such as stroke and heart failure. The aim of this study was to compare the efficacy of commonly performed invasive procedures in keeping patients in normal sinus rhythm. Methods and Results: A retrospective chart review was performed on all patients who underwent primary radiofrequency catheter ablation, the complete Cox-maze, or the hybrid maze at OSF Saint Anthony Medical Center between January 2010 and December 2013 (n=140)...
February 2017: Journal of Atrial Fibrillation
Graham R McClure, Emilie P Belley-Cote, Iqbal H Jaffer, Nazari Dvirnik, Kevin R An, Gabriel Fortin, Jessica Spence, Jeff Healey, Rohit K Singal, Richard P Whitlock
Aims: The aim of this review was to assess the effect of concomitant surgical atrial fibrillation (AF) ablation on postoperative freedom from AF and patient-important outcomes. Methods and results: We searched Cochrane CENTRAL, MEDLINE, and EMBASE databases from inception to May 2016 for randomized controlled trials (RCTs) evaluating surgical AF ablation using any lesion set vs. no surgical AF ablation in adults with AF undergoing cardiac surgery. We performed screening, risk-of-bias evaluation, and data collection independently and in duplicate...
November 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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
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
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
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