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"atrial fibrillation" and "catheter ablation" and selection

Martin Fiala, Veronika Bulková, Libor Škňouřil, Renáta Nevřalová, Ondřej Toman, Jaroslav Januška, Jindřich Špinar, Dan Wichterle
AIMS: Identifying patients who benefit from restored sinus rhythm (SR) would optimize the selection of candidates for ablation of long-standing persistent atrial fibrillation (LSPAF). This prospective study sought to identify the hitherto unknown factors associated with global functional improvement after successful radiofrequency catheter ablation of LSPAF. METHODS AND RESULTS: In 171 LSPAF patients (84% of the total consecutive 203 patients) who were examined in SR 12 months after ablation, the individual per cent change from baseline value in maximum oxygen consumption at exercise test (VO2 max), left ventricular ejection fraction (LVEF), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and five-dimensional descriptive system (EQ-5D) of quality-of-life questionnaire were classified in quartiles by 0 (worse) to 3 (best) grades...
October 5, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Tomofumi Nakamura, Kaoru Okishige, Toshiro Kanazawa, Mitsumi Yamashita, Naohiko Kawaguchi, Nobutaka Kato, Hideshi Aoyagi, Yasuteru Yamauchi, Tetsuo Sasano, Kenzo Hirao
AIMS: Pulmonary vein (PV) isolation (PVI) utilizing a cryoballoon (CB) has become one of the standard therapeutic options for atrial fibrillation (AF). However, it connotes a potential risk of cerebral ischaemic events (CIEs). This study aimed to clarify the prevalence of CIEs after PVI using second-generation CBs assessed by magnetic resonance imaging (MRI) of the brain. METHODS: This prospective observational study consisted of 160 patients that underwent PVI with second-generation CBs for drug-refractory AF...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Mayank Sardana, Adedotun A Ogunsua, Matthew Spring, Amir Shaikh, Owusu Asamoah, Glenn Stokken, Clifford Browning, Cynthia Ennis, J Kevin Donahue, Lawrence S Rosenthal, Kevin C Floyd, Gerard P Aurigemma, Nisha I Parikh, David D McManus
INTRODUCTION: Although catheter ablation (CA) for atrial fibrillation (AF) is commonly used to improve symptoms, AF recurrence is common and new tools are needed to better inform patient selection for CA. Left atrial function index (LAFI), an echocardiographic measure of atrial mechanical function, has shown promise as a noninvasive predictor of AF. We hypothesized that LAFI would relate to AF recurrence after CA. METHODS AND RESULTS: All AF patients undergoing index CA were enrolled in a prospective institutional AF Treatment Registry between 2011 and 2014...
August 28, 2016: Journal of Cardiovascular Electrophysiology
Ping Xia, Rupesh Kotecha, Naveen Sharma, Martin Andrews, Kevin L Stephans, Carlos Oberti, Sara Lin, Oussama Wazni, Patrick Tchou, Walid I Saliba, John Suh
PURPOSE:  To explore the feasibility of using stereotactic body radiotherapy (SBRT) to irradiate the antra of the four pulmonary veins while protecting nearby critical organs, such as the esophagus. MATERIALS AND METHODS:  Twenty patients who underwent radiofrequency catheter ablation for atrial fibrillation were selected. For each patient, the antra of the four pulmonary veins were identified as the target volumes on a pre-catheterization contrast or non-contrast CT scan...
2016: Curēus
Jonathan P Piccini, Laurent Fauchier
Many patients with atrial fibrillation have substantial symptoms despite ventricular rate control and require restoration of sinus rhythm to improve their quality of life. Acute restoration (ie, cardioversion) and maintenance of sinus rhythm in patients with atrial fibrillation are referred to as rhythm control. The decision to pursue rhythm control is based on symptoms, the type of atrial fibrillation (paroxysmal, persistent, or long-standing persistent), patient comorbidities, general health status, and anticoagulation status...
August 20, 2016: Lancet
Isabelle C Van Gelder, Michiel Rienstra, Harry J G M Crijns, Brian Olshansky
Control of the heart rate (rate control) is central to atrial fibrillation management, even for patients who ultimately require control of the rhythm. We review heart rate control in patients with atrial fibrillation, including the rationale for the intervention, patient selection, and the treatments available. The choice of rate control depends on the symptoms and clinical characteristics of the patient, but for all patients with atrial fibrillation, rate control is part of the management. Choice of drugs is patient-dependent...
August 20, 2016: Lancet
Ping Yang, Lijin Pu, Liuqing Yang, Fang Li, Zhiling Luo, Tao Guo, Baotong Hua, Shumin Li
BACKGROUND The aim of this study was to evaluate the value of the implantable loop recorder (ILR) in diagnosing atrial fibrillation (AF) and assessing the postoperative efficacy of radiofrequency catheter ablation (RFCA). MATERIAL AND METHODS A total of 32 patients who successfully underwent RFCA were selected. These patients discontinued antiarrhythmic medication with no AF recurrence for more than 3 months after RFCA, and underwent ILR placement by a conventional method. The clinical manifestations and information on arrhythmias recorded by the ILR were followed up to assess the efficacy of AF RFCA...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Henry Huang, Dawood Darbar
INTRODUCTION: Over the last decade, tremendous progress has been made in defining the genetic architecture of atrial fibrillation (AF). This has in part been driven by poor understanding of the pathophysiology of AF, limitations of current therapies and failure to target therapies to the underlying mechanisms. AREAS COVERED: Genetic approaches to AF have identified mutations encoding cardiac ion channels, and signaling proteins linked with AF and genome-wide association studies have uncovered common genetic variants modulating AF risk...
October 2016: Expert Review of Cardiovascular Therapy
Vicente Zarzoso, Decebal G Latcu, Antonio R Hidalgo-Muñoz, Marianna Meo, Olivier Meste, Irina Popescu, Nadir Saoudi
BACKGROUND: Catheter ablation (CA) of persistent atrial fibrillation (AF) is challenging, and reported results are capable of improvement. A better patient selection for the procedure could enhance its success rate while avoiding the risks associated with ablation, especially for patients with low odds of favorable outcome. CA outcome can be predicted non-invasively by atrial fibrillatory wave (f-wave) amplitude, but previous works focused mostly on manual measures in single electrocardiogram (ECG) leads only...
July 8, 2016: Archives of Cardiovascular Diseases
Maojing Wang, Shanglang Cai, Libo Sun, Qing Zhao, Wenjing Feng
BACKGROUND: Amiodarone is an antiarrhythmic drug that is frequently used to control atrial fibrillation (AF). Many patients with AF are afraid of the risk of ablation and take amiodar-one, some patients develop amiodarone-induced thyrotoxicosis (AIT). The purpose of the study was to investigate the safety and efficacy of early radiofrequency catheter ablation in patients with paroxysmal AF complicated with AIT. METHODS: From the 146 consecutive patients with paroxysmal AF who had been treated with amiodarone and underwent 3-dimensional mapping system guided circumferential pulmonary vein isolation (PVI) at our center from January 2013 to June 2014, 20 had developed AIT...
2016: Cardiology Journal
Jonathan W Waks, Peter Zimetbaum
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and affects over 33 million people worldwide. AF is associated with stroke and systemic thromboembolism, unpleasant symptoms and reduced quality of life, heart failure, and increased mortality, and treatment of AF and its complications are associated with significant cost. Antiarrhythmic drugs (AADs) can suppress AF, allowing long-term maintenance of sinus rhythm, and have the potential to relieve symptoms and reverse or prevent adverse effects associated with AF...
June 2, 2016: Journal of Cardiovascular Pharmacology and Therapeutics
Raúl Alcaraz, Fernando Hornero, José J Rieta
Atrial fibrillation (AF) is the most common arrhythmia in routine clinical practice. Despite many years of research, its mechanisms still are not well understood, thus reducing the effectiveness of AF treatments. Nowadays, pulmonary vein isolation by catheter ablation is the treatment of choice for AF resistant either to pharmacological or electrical cardioversion. However, given that long-term recurrences are common, an appropriate patient selection before the procedure is of paramount relevance in the improvement of AF catheter ablation outcome...
May 24, 2016: Annals of Biomedical Engineering
Jens Cosedis Nielsen, Jens Christian Gerdes
No abstract text is available yet for this article.
August 2016: European Heart Journal
Seung-Young Roh, Dong-Hyeok Kim, Jinhee Ahn, Kwang No Lee, Dae In Lee, Jaemin Shim, Jong-Il Choi, Sang-Weon Park, Young-Hoon Kim
INTRODUCTION: Atrial fibrillation (AF) is a common manifestation in cases of hypertrophic cardiomyopathy (HCM). Catheter ablation (CA) for AF in patients with asymmetric septal HCM (SeHCM) is selectively effective and often needs a repeat procedure. Apical HCM (ApHCM) has a better prognosis than SeHCM. However, the outcome of CA for AF in patients with ApHCM is unclear. METHODS AND RESULTS: Eighteen patients with ApHCM (ApHCM group) and 13 SeHCM patients (SeHCM group) underwent CA for AF...
July 2016: Journal of Cardiovascular Electrophysiology
I C Van Gelder, A H Hobbelt, E G Marcos, U Schotten, R Cappato, T Lewalter, J Schwieler, M Rienstra, G Boriani
Atrial fibrillation (AF) is not benign. Cardiovascular diseases and risk factors differ importantly amongst patients. Careful phenotyping with the aim to start tailored therapy may improve outcome and quality of life. Furthermore, structural remodelling plays an important role in initiation and progression of AF. Therapies that interfere in the remodelling processes are promising because they may modify the atrial substrate. However, success is still limited probably due to variations in the underlying substrate in individual patients...
May 2016: Journal of Internal Medicine
Rakesh Latchamsetty, Fred Morady
Strategies and technology related to catheter ablation for atrial fibrillation (AF) continue to advance since its inception nearly 20 years ago. Broader selections of patients are now offered ablation with a similar level of procedural outcome and safety standards. It is hoped that improved understanding of the pathophysiologic processes of the initiation and maintenance of AF will refine target selection during ablation and improve long-term procedural efficacy, particularly in patients with persistent and long-standing persistent AF...
April 2016: Heart Failure Clinics
Tatjana S Potpara, Vera Jokic, Nikolaos Dagres, Francisco Marin, Milica S Prostran, Carina Blomstrom-Lundqvist, Gregory Y H Lip
The kidney has numerous complex interactions with the heart, including shared risk factors (e.g., hypertension, dyslipidemia, etc.) and mutual amplification of morbidity and mortality. Both cardiovascular diseases and chronic kidney disease (CKD) may cause various alterations in cardiovascular system, metabolic homeostasis and autonomic nervous system that may facilitate the occurrence of cardiac arrhythmias. Also, pre-existent or incident cardiac arrhythmias such as atrial fibrillation (AF) may accelerate the progression of CKD...
2016: Current Medicinal Chemistry
Lennart J de Vries, Tamas Szili-Torok
In a select atrial fibrillation population, catheter ablation is considered first-line therapy. Prevention of early reconnection of the isolated pulmonary veins is an important goal for a successful treatment. Here, adequate catheter-tissue contact is crucial. One of the most promising new advances, therefore, is contact force (CF) sensing technology. The aim of this review is to provide an overview of innovations regarding catheter ablation of atrial fibrillation with a special focus on CF optimization. Both experimental and human studies show how CF sensing catheters lead to a reduction of fluoroscopy time, increased procedural safety and a better clinical outcome...
March 2016: Future Cardiology
Edward J Davies, Ben Clayton, Ian Lines, Guy A Haywood
BACKGROUND: The mechanisms by which persistent atrial fibrillation (PsAF) develops are incompletely understood. Consequently, the optimal strategy for the ablative management of PsAF remains debated. Current methods are often time consuming, complex and non-reproducible. We assessed the Tip-Versatile Ablation Catheter (T-VAC) technique, a rapidly delivered, empirical technique based on the box-set concept using duty-cycled linear catheter ablation technology. METHODS: Forty-four procedures in 40 patients undergoing PsAF ablation with the novel technique were prospectively entered onto a database: 27 de novo...
July 2016: Heart, Lung & Circulation
Gang Yang, Bing Yang, Youquan Wei, Fengxiang Zhang, Weizhu Ju, Hongwu Chen, Mingfang Li, Kai Gu, Yazhou Lin, Benqi Wang, Kejiang Cao, Pipin Kojodjojo, Minglong Chen
BACKGROUND: The high incidence of postprocedural atrial tachycardia reduces the absolute arrhythmia-free success rate of extensive ablation strategies to treat nonparoxysmal atrial fibrillation (NPAF). We hypothesized that a strategy of targeting low-voltage zones and sites with abnormal electrograms during sinus rhythm (SR-AEs) in the left atrium after circumferential pulmonary vein isolation and cavotricuspid isthmus ablation in patients with NPAF is superior. METHODS AND RESULTS: A total of 86 consecutive patients with NPAF were enrolled in study group...
February 2016: Circulation. Arrhythmia and Electrophysiology
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