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"atrial fibrillation" and "catheter ablation" and selection

Khola Tahir, Andy Kiser, Thomas Caranasos, J Paul Mounsey, Anil Gehi
WHO SHOULD UNDERGO HYBRID AF ABLATION?: Patients with symptomatic persistent or long-standing persistent atrial fibrillation refractory to pharmacological or routine catheter ablation can be considered for hybrid epicardial-endocardial AF ablation. Although it seems clear that patient selection should be important when considering hybrid AF ablation for optimal results, unfortunately, available data on the outcomes of hybrid epicardial-endocardial ablation is limited. Hybrid ablation is rarely compared to stand-alone catheter ablation, the surgical approach (access site, lesion set, ablation tool) is inconsistent, and the patient population studied is often suitable for a catheter ablation approach (paroxysmal AF, minimal structural heart disease)...
March 8, 2018: Current Treatment Options in Cardiovascular Medicine
Jackson J Liang, Melissa A Elafros, Michael T Mullen, Daniele Muser, Tatsuya Hayashi, Andres Enriquez, Rajeev K Pathak, Erica S Zado, Pasquale Santangeli, Jeffrey S Arkles, Robert D Schaller, Gregory E Supple, David S Frankel, Fermin C Garcia, Rajat Deo, David Lin, Michael P Riley, Saman Nazarian, Sanjay Dixit, Francis E Marchlinski, David J Callans
INTRODUCTION: Whether successful catheter ablation for atrial fibrillation (AF) reduces risk of cerebrovascular events (CVEs) remains controversial and whether oral anticoagulation therapy (OAT) can be safely discontinued in patients rendered free of AF recurrences remains unknown. We evaluated OAT use patterns and examined long-term rates of CVEs (stroke/TIA) and major bleeding episodes (MBEs) in patients with nonparoxysmal AF treated with catheter ablation. METHODS AND RESULTS: Four hundred patients with nonparoxysmal AF (200 persistent, 200 longstanding persistent; mean age 60...
March 7, 2018: Journal of Cardiovascular Electrophysiology
Yemei He, Baixue Zhang, Fang Zhu, Zheyu Hu, Jia Zhong, Wenhui Zhu
AIMS: Paroxysmal atrial fibrillation (PAF) commonly recurs after radiofrequency catheter ablation (RFCA). This study aimed to assess left atrial appendage (LAA) volume and function by transesophageal echocardiography (TEE) and to explore its value in predicting PAF recurrence after RFCA. METHODS: Eighty patients with PAF were recruited. The left atrial (LA) and LAA volume and function were measured by transthoracic echocardiography (TTE) and TEE before ablation...
March 6, 2018: Echocardiography
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
Christopher Piorkowski, Mads Kronborg, Jerome Hourdain, Judith Piorkowski, Bettina Kirstein, Sebastian Neudeck, Simon Wechselberger, Ellen Päßler, Anastasia Löwen, Ali El-Armouche, Julia Mayer, Stefan Ulbrich, Liying Pu, Utz Richter, Thomas Gaspar, Yan Huo
BACKGROUND: Until today, catheter interventional mapping and ablation of atrial fibrillation (AF) has been limited to the right and left atrial endocardium. We report feasibility, electrophysiological findings, and clinical outcome using a combined endo-/epicardial catheter approach for mapping and ablation of AF. METHODS AND RESULTS: Fifty-nine patients with permanence of pulmonary vein isolation and further symptomatic recurrences of paroxysmal AF, persistent AF, or atrial tachycardia underwent reablation using biatrial endo-/epicardial mapping and ablation...
February 2018: Circulation. Arrhythmia and Electrophysiology
Kevin G Graves, Victoria Jacobs, Heidi T May, Michael J Cutler, John D Day, T Jared Bunch
Atrial fibrillation (AF) is a commonly encountered arrhythmia, which is not yet fully understood. Catheter ablation has shown to be an effective strategy for rhythm management and several small or retrospective studies have shown that stroke rates are decreased in ablated AF patients compared to those medically managed. Several studies even show that ablation returns stroke risk to that of non-AF patients. Large scale, prospective trials will further illuminate this connection and provide mechanistic understanding of the role of the procedure versus the process of selection for the procedure and peri- and post-procedural therapy and management...
January 24, 2018: Current Treatment Options in Cardiovascular Medicine
Luisa Ciuffo, Susumu Tao, Esra Gucuk Ipek, Tarek Zghaib, Muhammad Balouch, Joao A C Lima, Saman Nazarian, David D Spragg, Joseph E Marine, Ronald D Berger, Hugh Calkins, Hiroshi Ashikaga
OBJECTIVES: The purpose of this study was to evaluate the usefulness of intra-atrial dyssynchrony as a marker of underlying left atrial (LA) remodeling to predict recurrence after the first atrial fibrillation (AF) ablation. BACKGROUND: Catheter ablation for AF remains far from curative with relatively high recurrence rates. One of the causes of recurrence is poor patient selection out of a diverse patient population with different degrees of LA remodeling. METHODS: We included 208 patients with a history of AF (59...
January 12, 2018: JACC. Cardiovascular Imaging
Yun-Qiu Jiang, Ying Tian, Li-Jun Zeng, Shu-Nan He, Zhi-Tao Zheng, Liang Shi, Yan-Jiang Wang, Yu-Xing Wang, Xian-Dong Yin, Xiao-Qing Liu, Xin-Chun Yang, Xing-Peng Liu
INTRODUCTION: Hybrid ablation, an emerging therapy that combines surgical intervention and catheter ablation, has become a viable option for the treatment of persistent atrial fibrillation. In this analysis, we aimed to evaluate the safety and efficacy of hybrid ablation, as well as compare the outcomes of one-step and staged approaches. METHODS: We conducted a search in major online databases and selected the studies that met the inclusion criteria. The primary endpoint was defined as no episode of atrial fibrillation or atrial tachycardia lasting longer than 30 seconds without administration of antiarrhythmic drugs...
2018: PloS One
Qi Kang, XiaoLong Li, Mengyun Yang, Taniya Fernando, Zheng Wan
OBJECTIVE: To observe the change of the inflammatory factor Galectin-3 in patients with coronary heart disease, and the correlation between Galectin-3 and the severity of the disease. To observe changes of Galectin-3 in patients with atrial fibrillation (AF) before and after radiofrequency ablation, and the changes of Galectin-3 before and after an interim treatment with a high dose of atorvastatin on patients with acute myocardial infarction(AMI). METHODS: Patients with coronary heart disease and atrial fibrillation having normal heart function were selected, among them, the patients with AMI were given a short term treatment of 80mg atorvastatin before PCI, and patients with atrial fibrillation underwent radiofrequency catheter ablation...
December 27, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
Lucaz Gadenz, Javad Hashemi, Mohammad Hassan Shariat, Lorne Gula, Damian P Redfearn
Introduction: Experimental data strongly supports a role for high-frequency sources in the perpetuation of atrial fibrillation, it follows that identification of areas exhibiting spectra containing high dominant frequencies (DF) may represent perpetuating sources and targeted elimination might terminate AF. The aim of this review is to present and critically appraise the literature on DF studied in association with AF ablation. Methods And Results: A systematic review was done including the PubMed (MEDLINE), Cochrane Central Register of Controlled Trials (Central), Scientific Electronic Library Online (SciELO), and HighWire Press databases...
April 2017: Journal of Atrial Fibrillation
Hideharu Okamatsu, Ken Okumura
Pulmonary vein (PV) antrum isolation (PVAI) is effective in treating paroxysmal atrial fibrillation (AF) but is less so for persistent AF. A recent randomized study on the ablation strategies for persistent AF demonstrated that 2 common atrial substrate modifications, creation of linear lesions in the left atrium and ablation of complex fractionated electrogram sites, in addition to PVAI did not improve the outcome compared with stand-alone PVAI, suggesting the necessity of a more individualized, selective approach to persistent AF...
December 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
Jonathan P Piccini, Paulus Kirchhof
No abstract text is available yet for this article.
February 7, 2018: European Heart Journal
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
Alan Bulava, Jiri Hanis, Ladislav Dusek
BACKGROUND: Prevalence of atrial fibrillation (AF) increases with age. Radiofrequency catheter ablation (RFCA) is an established treatment option superior to antiarrhythmics (AAs). In this study, we investigated safety and efficacy of RFCA of AF in octogenarians. METHODS: From our database, we extracted procedural and follow-up data for patients ≥ 80 years with symptomatic AF undergoing RFCA and compared this population to RFCA patients ≤ 50 years. All patients underwent pulmonary vein isolation (PVI) supplemented by linear lesions in PVI-nonresponders...
September 2017: Journal of Geriatric Cardiology: JGC
Zsuzsanna Kis, Anna Me Noten, Mihran Martirosyan, Astrid A Hendriks, Rohit Bhagwandien, Tamas Szili-Torok
BACKGROUND: Atrial fibrillation (AF) is the most frequent arrhythmia, and its prevalence is increasing with aging. We aimed to compare the long-term outcome data of patients < 65 years vs. ≥ 65 years who underwent catheter ablation (CA) for drug-refractory AF. METHODS: Consecutive patients with primary pulmonary vein isolation performed between March 2001 and December 2011, and those who completed a five-year of follow-up were divided into two groups: patients aged < 65 years into group 1, and patients aged ≥ 65 into group 2...
September 2017: Journal of Geriatric Cardiology: JGC
Alexis Hermida, Maciej Kubala, Sarah Traullé, Otilia Buiciuc, Serge Quenum, Jean-Sylvain Hermida
INTRODUCTION: Assess the prevalence and predictors of Left Atrial Tachycardia (LAT) after cryoballoon ablation of pulmonary veins. METHODS AND RESULTS: Patients who underwent catheter ablation of pulmonary veins with a second-generation cryoballoon for symptomatic paroxysmal (151/270, 56%) or persistent (119/270, 44%) atrial fibrillation were entered in a single-centre prospective registry. Patients who experienced post-cryoballoon LAT (pcryo-LAT) were selected on the basis of 12-lead ECG characteristics...
October 11, 2017: Journal of Cardiovascular Electrophysiology
Tilman Maurer, Andreas Metzner, S Yen Ho, Peter Wohlmuth, Bruno Reißmann, Christian Heeger, Christine Lemes, Kentaro Hayashi, Ardan M Saguner, Johannes Riedl, Christian Sohns, Shibu Mathew, Karl-Heinz Kuck, Erik Wissner, Feifan Ouyang
BACKGROUND: The mitral isthmus is a critical part of perimitral reentrant tachycardia, as well as an important substrate of persistent atrial fibrillation. Deployment of an endocardial mitral isthmus line (MIL) with the end point of bidirectional block may be challenging and often requires additional epicardial ablation within the coronary sinus. METHODS AND RESULTS: The study population comprised 114 patients with perimitral flutter who underwent de novo ablation of an MIL...
October 2017: Circulation. Arrhythmia and Electrophysiology
João Mesquita, António Miguel Ferreira, Diogo Cavaco, Francisco Moscoso Costa, Pedro Carmo, Hugo Marques, Francisco Morgado, Miguel Mendes, Pedro Adragão
Aims: Several predictors of relapse after catheter ablation of atrial fibrillation (AF) have been established, but assessing each patient's individual risk remains challenging. Our aim was to develop and validate a score to estimate the risk of AF recurrence after the first radiofrequency pulmonary vein isolation (PVI) procedure. Methods and results: Independent predictors of AF relapse were identified retrospectively in a two-centre registry of 1934 patients who underwent a first PVI procedure...
August 18, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Kamil Adalet
The prevalence of atrial fibrillation increases dramatically with advancing age. Elderly adults with atrial fibrillation-even those with high bleeding risk- benefit from anticoagulation. The risk of ischemic stroke or systemic embolism was significantly lower with new direct oral anticoagulants (DOACs) than warfarin as was the risk of major bleeding and intracranial bleeding. Antiplatelet therapy should have a limited role for stroke prevention in elderly adults. Left atrial appendix occlusion may be a suitable alternative for those with contraindications to oral anticoagulants...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Maddalena Valinoti, Claudio Fabbri, Dario Turco, Roberto Mantovan, Antonio Pasini, Cristiana Corsi
BACKGROUND: Radiofrequency ablation (RFA) is an important and promising therapy for atrial fibrillation (AF) patients. Optimization of patient selection and the availability of an accurate anatomical guide could improve RFA success rate. In this study we propose a unified, fully automated approach to build a 3D patient-specific left atrium (LA) model including pulmonary veins (PVs) in order to provide an accurate anatomical guide during RFA and without PVs in order to characterize LA volumetry and support patient selection for AF ablation...
January 2018: Magnetic Resonance Imaging
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