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Surgical Cardiac Ablation

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https://www.readbyqxmd.com/read/28187972/late-results-of-the-cox-maze-iv-procedure-in-patients-undergoing-coronary-artery-bypass-grafting
#1
Matthew R Schill, Farah N Musharbash, Vivek Hansalia, Jason W Greenberg, Spencer J Melby, Hersh S Maniar, Laurie A Sinn, Richard B Schuessler, Marc R Moon, Ralph J Damiano
OBJECTIVE: Most patients with atrial fibrillation (AF) undergoing cardiac surgery do not receive concomitant ablation. This study reviewed outcomes of patients with AF undergoing Cox-maze IV (CMIV) procedure with radiofrequency and cryoablation and coronary artery bypass grafting (CABG) at our institution. METHODS: Between the introduction of radiofrequency ablation in 2002 and 2015, 135 patients underwent left- or biatrial CMIV with CABG. Patients undergoing other cardiac procedures, except mitral valve repair, or who had emergent, reoperative, or off-pump procedures were excluded...
January 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28167089/alternative-approaches-for-ablation-of-resistant-ventricular-tachycardia
#2
REVIEW
Carola Gianni, Sanghamitra Mohanty, Chintan Trivedi, Luigi Di Biase, Amin Al-Ahmad, Andrea Natale, J David Burkhardt
Ventricular tachycardia (VT) ablation is usually performed with an ablation catheter that delivers unipolar radiofrequency (RF) energy to eliminate the re-entry circuit responsible for VT. However, there are some instances when unipolar RF ablation fails, notably in VTs with a deep intramural origin, or cases in which epicardial access is not attainable due to prior cardiac surgery. To overcome these limitations, several alternative approaches have been used in clinical practice, including alcohol ablation or coil embolization, simultaneous unipolar or bipolar RF ablation, surgical ablation, or noninvasive ablation with stereotactic radiosurgery...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28118160/we-know-what-the-cardiac-surgeon-did-during-last-hybrid-arrhythmia-procedure
#3
Narendra Kumar, Laurent Pison, Sandro Gelsomino, Ismail Aksoy, Mark La Meir, Jos Maessen
Superior vena cava (SVC) is an important source of origin of atrial fibrillation (AF) triggers other than a pulmonary vein. Because of the proximity of SVC-aorta ganglionic plexi to the SVC and the extension of myocardium in the SVC from the right atrium, SVC frequently becomes an important source of ectopic beats initiating AF. The potential complications of SVC isolation may include sinus node injury. Sinus node isolation was observed in a patient who had undergone previous surgical isolation of SVC for AF, while attempting to ablate endocardially, near the superior part of interatrial septum for an atrial tachycardia...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28095388/the-use-of-mitraclip-for-symptomatic-patients-with-hypertrophic-obstructive-cardiomyopathy
#4
Felix Thomas, Florian Rader, Robert J Siegel
OBJECTIVES: Current nonpharmacological therapies for symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM), including septal myectomy and alcohol septal ablation (ASA), carry significant risks for serious cardiac conduction abnormalities. We present a review of the currently available published data regarding the novel use of the relatively low-risk MitraClip® system in the treatment of symptomatic patients. METHODS: Data were collected from 4 separate studies on the use of the MitraClip on 15 symptomatic HOCM patients with systolic anterior motion (SAM) of the mitral valve apparatus...
January 18, 2017: Cardiology
https://www.readbyqxmd.com/read/28077188/point-catheter-ablation-of-macro-re-entrant-ventricular-tachycardia-in-a-patient-after-surgical-repair-for-double-outlet-right-ventricle
#5
Gaku Izumi, Hisashi Yokoshiki, Atsuhito Takeda
Catheter ablation of ventricular tachycardia is often difficult in patients after surgery for CHD. In patients with a ventricular septal defect patch, it is necessary to decide which ventricular side is appropriate for catheter ablation. In this article, we report a case of successful point catheter ablation of re-entrant ventricular tachycardia. Identification of the ventricular septal defect patch using intra-cardiac echocardiography was useful.
January 12, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28045674/play-the-map-ablation-of-a-macro-reentrant-atrial-tachycardia-in-a-patient-after-senning-repair-for-transposition-of-the-great-arteries
#6
Emre Yalcinkaya, Firat Duru, Matthias Greutmann, Thomas Wolber
A 50-year-old male patient who had undergone Senning repair for transposition of the great arteries at the age of 7 years was referred to our electrophysiology lab with recurrent supraventricular tachycardias. Fast anatomical mapping of the systemic venous atrium was performed with the CARTO electroanatomical mapping system. Propagation mapping with animated dynamic maps facilitates the understanding of the underlying mechanism and provides visualization of reentrant circuits of tachycardias in cardiac chambers with native barriers and surgical scars...
2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28019045/autonomic-modulation-for-the-treatment-of-ventricular-arrhythmias-therapeutic-use-of-percutaneous-stellate-ganglion-blocks
#7
Marat Fudim, Richard Boortz-Marx, Chetan B Patel, Albert Y Sun, Jonathan P Piccini
Ventricular tachycardia (VT), ventricular fibrillation (VF) and electrical storm are commonly encountered emergency conditions in cardiac and surgical intensive care units. In most cases, recurrent ventricular arrhythmias or electrical storm are associated with a heightened sympathetic tone. These arrhythmias can be difficult to treat and may be refractory to beta-blockade, antiarrhythmic therapy, sedation, and mechanical hemodynamic support. While monomorphic ventricular tachycardia and PVC-triggered polymorphic ventricular tachycardia may sometimes be amenable to successful ablation, some patients may be too critically ill to make such an approach feasible...
December 26, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28007240/the-society-of-thoracic-surgeons-2017-clinical-practice-guidelines-for-the-surgical-treatment-of-atrial-fibrillation
#8
Vinay Badhwar, J Scott Rankin, Ralph J Damiano, A Marc Gillinov, Faisal G Bakaeen, James R Edgerton, Jonathan M Philpott, Patrick M McCarthy, Steven F Bolling, Harold G Roberts, Vinod H Thourani, Rakesh M Suri, Richard J Shemin, Scott Firestone, Niv Ad
Surgical ablation for atrial fibrillation (AF) can be performed without additional risk of operative mortality or major morbidity, and is recommended at the time of concomitant mitral operations to restore sinus rhythm. (Class I, Level A) Surgical ablation for AF can be performed without additional operative risk of mortality or major morbidity, and is recommended at the time of concomitant isolated aortic valve replacement, isolated coronary artery bypass graft surgery, and aortic valve replacement plus coronary artery bypass graft operations to restore sinus rhythm...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27938886/the-society-of-thoracic-surgeons-mitral-valve-repair-replacement-plus-coronary-artery-bypass-grafting-composite-score-a-report-of-the-society-of-thoracic-surgeons-quality-measurement-task-force
#9
J Scott Rankin, Vinay Badhwar, Xia He, Jeffrey P Jacobs, James S Gammie, Anthony P Furnary, Frank L Fazzalari, Jane Han, Sean M O'Brien, David M Shahian
BACKGROUND: The Society of Thoracic Surgeons (STS) Quality Measurement Task Force has developed a composite performance measure for mitral repair/replacement (MVRR) with concomitant coronary artery bypass grafting (CABG). METHODS: Data were acquired from the STS Adult Cardiac Surgery Database for 26,463 patients undergoing MVRR + CABG operations between July 1, 2011, and June 30, 2014. Established STS risk models were applied, along with modifications enabling the inclusion of patients with concomitant closures of atrial septal defects and patent foramen ovale, surgical ablation for atrial fibrillation, and tricuspid valve repair (TVR)...
December 6, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27919928/impact-of-surgical-ablation-of-atrial-fibrillation-on-the-progression-of-tricuspid-regurgitation-and-right-sided-heart-remodeling-after-mitral-valve-surgery-a-propensity-score-matching-analysis
#10
Jiangang Wang, Jie Han, Yan Li, Qing Ye, Fei Meng, Tiange Luo, Baiyu Tian, Haibo Zhang, Yixin Jia, Wen Zeng, Chunlei Xu, Wei Han, Yuqing Jiao, Xu Meng
BACKGROUND: This study assessed the role of surgical ablation for atrial fibrillation (AF) in decreasing tricuspid regurgitation (TR) and right-sided heart remodeling in patients after mitral valve procedure. METHODS AND RESULTS: Between 1994 and 2014, 1568 consecutive patients with AF undergoing mitral valve procedure were identified. In 26.0% (n=408), surgical ablation of AF was used. Propensity-score matching (PSM) was performed on the basis of 41 known perioperative risk variables...
December 5, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27909513/assessment-of-sinoatrial-node-function-in-patients-with-persistent-and-long-standing-persistent-forms-of-atrial-fibrillation-after-maze-iii-procedure-combined-with-mitral-valve-operation
#11
Kulikov Aleksei A, Bokeria Leo A
RESEARCH OBJECTIVE: Assessment of sinoatrial node function after Maze III procedure combined with a mitral valve operation. METHODS: 100 patients were included in the research with persistent and long-standing persistent forms of atrial fibrillation (AF) and need of operative treatment concerning valve disease. The following preoperative preparation methods were executed to all patients: Electrocardiogram in 12 standard assignments;Two-dimensional echocardiographic with assessment of systolic and diastolic functions of the left ventricle, size of the left atrium and grade of valve disease;Transesophageal echocardiography for exclusion of blood clots in the left atrium and left atrial appendage;Coronary angiography for exclusion of coronary heart disease;Computer tomography for examination of cardiac chambers and anatomic characteristics of pulmonary veins...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909499/hyperacute-and-chronic-changes-in-cerebral-magnetic-resonance-images-after-pvac-nmarq-and-epicardial-thoracoscopic-surgical-ablation-for-paroxysmal-atrial-fibrillation
#12
Conn Sugihara Mbbs, Neil Barlow Mbbs, Emma Owens Mbbs, David Sallomi Mb ChB, Neil Sulke Md
Threshold testing of cardiac rhythm devices is essential to monitoring the proper functioning of such devices (1). However, the currently method of applying multiple ECG leads to the patient is burdensome and time consuming (2). We are presenting a completely new way to perform cardiac rhythm device threshold testing using pulse oximetry. Twenty patients, with varying cardiac rhythm devices and pacing modes, were enrolled and had their atrial and ventricular thresholds tested. A comparison was made between simultaneous threshold determinations via the standard EGM based method and the new pulse oximetry based method...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27871122/efficacy-and-safety-of-ablation-for-people-with-non-paroxysmal-atrial-fibrillation
#13
REVIEW
Jonathan Nyong, Guy Amit, Alma J Adler, Onikepe O Owolabi, Pablo Perel, David Prieto-Merino, Pier Lambiase, Juan Pablo Casas, Carlos A Morillo
BACKGROUND: The optimal rhythm management strategy for people with non-paroxysmal (persistent or long-standing persistent) atrial fibrilation is currently not well defined. Antiarrhythmic drugs have been the mainstay of therapy. But recently, in people who have not responded to antiarrhythmic drugs, the use of ablation (catheter and surgical) has emerged as an alternative to maintain sinus rhythm to avoid long-term atrial fibrillation complications. However, evidence from randomised trials about the efficacy and safety of ablation in non-paroxysmal atrial fibrillation is limited...
22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27864594/morphologic-classification-of-the-right-auricule-on-256-slice-computed-tomography
#14
Cai-Ying Li, Bu-Lang Gao, Tong Pan, Cheng Xiang, Xiao-Wei Liu, Hai-Qing Yang, Lan-Ying Yi, Qi-Bin Liao
PURPOSE: To investigate the shape of right auricule on 256-slice computed tomography (CT). MATERIALS AND METHODS: Five hundred people (250 men, age range 16-84 years) who had cardiac multidetector CT angiography were recruited in this study. All patients had normal sinus rhythm with normal blood pressure (<140/90 mmHg for systolic/diastolic pressure). The morphology of the right auricule was studied and compared after reconstruction of the raw images. RESULTS: All patients successfully had cardiac CT angiography (100%), and the right auricule morphology was divided into five types and nine subtypes, including Type I of triangular shape (Ia and Ib), Type II of M shape (IIa and IIb), Type III of L shape (IIIa and IIIb), Type IV of reverse L shape (IVa and IVb), and Type V of balanced shape...
November 18, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27855290/transcatheter-leadless-cardiac-pacing-the-new-alternative-solution
#15
Antoine Da Costa, Amandine Axiotis, Cécile Romeyer-Bouchard, Loucif Abdellaoui, Zahi Afif, Jean Baptiste Guichard, Antoine Gerbay, Karl Isaaz
INTRODUCTION: A lack of information about the feasibility and safety of leadless pacemaker (LPMs) exists in a fragile population of patients with limited venous anatomy access or conventional pacemaker (PM) contraindication. Accordingly, the goal of this prospective observational study was to report our experience with this new leadless technology in a subset of patients with contraindication or limited venous access. METHODS AND RESULTS: Between May 2015 and July 2016, 14 patients were consecutively included...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27832334/-implantable-loop-recorder-in-atrial-fibrillation-and-after-catheter-ablation
#16
K Fikenzer, N Dagres, G Hindricks
BACKGROUND: Implantable loop recorders (ILR) are an established diagnostic method for detection of cardiac arrhythmias including atrial fibrillation. OBJECTIVE: The aim of this work is to provide an overview of available data and indications of ILR in atrial fibrillation, especially after catheter ablation, in order to illustrate practice-oriented recommendations. MATERIALS AND METHODS: We conducted a selective PubMed literature search. RESULTS AND DISCUSSION: ILR can record asymptomatic/rare atrial fibrillation episodes and prevent thromboembolic events by allowing timely initiation of oral anticoagulation...
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27807090/surgical-ablation-of-atrial-fibrillation-a-protocol-for-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#17
Graham R McClure, Emilie P Belley-Cote, Rohit K Singal, Iqbal H Jaffer, Nazari Dvirnik, Kevin R An, Gabriel Fortin, Jessica Spence, Richard P Whitlock
INTRODUCTION: Atrial fibrillation (AF) affects 10% of patients undergoing cardiac surgery and is an independent risk factor for all-cause mortality, ischaemic stroke and heart failure. Surgical AF ablation has been shown to significantly improve maintenance of sinus rhythm, however, small to medium size trials conducted to date lack the power required to assess patient-important outcomes such as mortality, stroke, heart failure and health-related quality of life. Moreover, a recent randomised trial (RCT) suggested harm by surgical AF ablation with an almost threefold increase in the requirement for permanent pacemaker postablation...
November 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27803496/left-atrial-to-esophageal-fistula-a-case-report-and-literature-review
#18
REVIEW
Muhammad Yasir Khan, Waqas Javed Siddiqui, Praneet S Iyer, Ahmed Dirweesh, Nigahus Karabulut
BACKGROUND Left atrial to esophageal fistula (LAEF) is a rare fatal complication of radiofrequency ablation (RFA) for atrial fibrillation and is associated with high mortality. Clinical features can be nonspecific and include fever, dysphagia, upper gastrointestinal (GI) bleeding, sepsis, and embolic stroke a after recent history of RFA for atrial fibrillation. CASE REPORT  A 57-year-old Caucasian male was brought to the emergency department (ED) by his family because of an altered mental status. He had undergone a radiofrequency ablation for paroxysmal atrial fibrillation three weeks earlier...
November 2, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27776530/sequential-hybrid-cryomaze-ablation-versus-surgical-cryomaze-alone-for-the-treatment-of-atrial-fibrillation-surhyb-study-protocol-for-a-randomized-controlled-trial
#19
Martin Eisenberger, Alan Bulava, Josef Kautzner, Petr Neuzil, Ales Mokracek, Jiri Hanis, Ladislav Dusek
BACKGROUND: Atrial fibrillation is common in patients with structural heart disease who are undergoing cardiac surgery. Surgical CryoMaze has been shown to be an effective treatment in several trials, but success rates have varied considerably, between 47-95 %. The sequential hybrid approach, combining surgical CryoMaze followed by radiofrequency catheter ablation, can achieve high freedom from atrial arrhythmias, even when rigorous methods to detect arrhythmias after the procedure are used...
October 24, 2016: Trials
https://www.readbyqxmd.com/read/27747025/atrial-fibrillation-review-of-current-treatment-strategies
#20
REVIEW
Joshua Xu, Jessica G Y Luc, Kevin Phan
Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in modern clinical practice, with an estimated prevalence of 1.5-2%. The prevalence of AF is expected to double in the next decades, progressing with age and increasingly becoming a global medical challenge. The first-line treatment for AF is often medical treatment with either rate control or anti-arrhythmic agents for rhythm control, in addition to anti-coagulants such as warfarin for stroke prevention in patient at risk. Catheter ablation has emerged as an alternative for AF treatment, which involves myocardial tissue lesions to disrupt the underlying triggers and substrates for AF...
September 2016: Journal of Thoracic Disease
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