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Atrial fibrillation substrate

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https://www.readbyqxmd.com/read/28438722/propagation-of-meandering-rotors-surrounded-by-high-dominant-frequency-areas-in-persistent-atrial-fibrillation
#1
João Salinet, Fernando S Schlindwein, Peter Stafford, Tiago P Almeida, Xin Li, Frederique J Vanheusden, María S Guillem, G André Ng
BACKGROUND: identification of arrhythmogenic regions remains a challenge in persistent atrial fibrillation (persAF). Frequency and phase analysis allows identification of potential ablation targets. OBJECTIVE: This study aims to investigate the spatiotemporal association between dominant frequency (DF) and re-entrant phase activation areas. METHODS: Eight persAF patients undergoing first-time catheter ablation procedure were enrolled. A non-contact array catheter was deployed into the left atrium (LA) and 2048 AF electrograms (AEG) were acquired for 15 seconds following ventricular far-field cancellation...
April 21, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28436566/atrial-fibrillation-originating-from-superior-vena-cava-with-atrial-flutter-electrocardiogram-pattern
#2
Hung-Kai Huang, Shih-Lin Chang, Yenn-Jiang Lin, Li-Wei Lo, Yu-Feng Hu, Fa-Po Chung, Yen-Chang Huang, Chung-Hsing Lin, Chao-Shun Chan, Hung-Yu Chang, Chin-Yu Lin, Yao-Ting Chang, Ching-Hui Huang, Shih-Ann Chen
BACKGROUNDS: Substrate property is related to the genesis and maintenance of atrial fibrillation (AF). The aim of the study was to investigate the impact of substrate property on the electrocardiogram (ECG) in patients with AF originating from the superior vena cava (SVC). METHODS AND RESULTS: Seventy-six patients with AF originating from SVC underwent catheter ablation were included from 2004 to 2013. Of these patients, 16 had a presentation of atrial flutter (AFL)-pattern ECG during AF (group 1), and 60 patients did not (group 2)...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28434446/revisiting-pulmonary-vein-isolation-alone-for-persistent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#3
Aleksandr Voskoboinik, Jeremy T Moskovitch, Nadav Harel, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Early studies demonstrated relatively low success rates for pulmonary vein isolation (PVI) alone in patients with persistent atrial fibrillation (PeAF). However, the advent of new technologies and the observation that additional substrate ablation does not improve outcomes have created a new focus on PVI alone for treatment of PeAF. OBJECTIVE: The purpose of this study was to systematically review the recent medical literature to determine current medium-term outcomes when a PVI-only approach is used for PeAF...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28429499/atrial-fibrillation-patients-with-isolated-pulmonary-veins-is-sinus-rhythm-achievable
#4
Judit Szilágyi, Gregory M Marcus, Nitish Badhwar, Byron K Lee, Randall J Lee, Vasanth Vedantham, Zian H Tseng, Tomos Walters, Melvin Scheinman, Jeffrey Olgin, Edward P Gerstenfeld
BACKGROUND: The cornerstone of atrial fibrillation (AF) ablation is isolation of the pulmonary veins (PVs). Patients with recurrent AF undergoing repeat ablation usually have PV reconnection (PVr). The ablation strategy and outcome of patients undergoing repeat ablation who have persistent isolation of all PVs (PVi) at the time of repeat ablation is unknown. METHODS AND RESULTS: We studied consecutive patients with recurrent AF undergoing repeat ablation and compared patients with PVi to those with PVr...
April 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28387462/identification-and-electrophysiological-characterization-of-early-left-atrial-structural-remodeling-as-a-predictor-for-atrial-fibrillation-recurrence-after-pulmonary-vein-isolation
#5
Atsuhiko Yagishita, Dina Sparano, Ivan Cakulev, J Rod Gimbel, Timothy Phelan, Hossam Mustafa, Samer De Oliveira, Judith Mackall, Mauricio Arruda
BACKGROUND: Voltage-guided substrate ablation following pulmonary vein isolation (PVI) improves atrial fibrillation (AF) ablation outcomes. However, by setting upper voltage cutoff of 0.5 mV during sinus rhythm (SR) to guided substrate ablation using electroanatomic voltage mapping (EAVM), mildly affected low voltage area (maLVA) may be undetected. We sought to determine the optimal bipolar voltage cutoff to identify maLVA, its electrogram complexity, and the implication on ablation outcome...
April 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28369767/multiple-targets-for-flecainide-action-implications-for-cardiac-arrhythmogenesis
#6
REVIEW
Samantha C Salvage, Karthik H Chandrasekharan, Kamalan Jeevaratnam, Angela F Dulhunty, Andrew J Thompson, Antony P Jackson, Christopher L-H Huang
Flecainide suppresses cardiac tachyarrhythmias including paroxysmal atrial fibrillation, supraventricular tachycardia, arrhythmic long QT syndromes (LQTS), as well as the Ca(2+) -mediated, catecholaminergic polymorphic ventricular, tachycardia (CPVT). However, flecainide can also exert pro-arrhythmic effects most notably following myocardial infarction and when used to diagnose Brugada Syndrome (BrS). These divergent actions result from its physiological and pharmacological actions at multiple, interacting, levels of cellular organisation...
April 3, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28343787/relationship-between-rotors-and-complex-fractionated-electrograms-in-atrial-fibrillation-using-a-novel-computational-analysis
#7
Pedro Adragão, Pedro Carmo, Diogo Cavaco, João Carmo, António Ferreira, Francisco Moscoso Costa, Maria Salomé Carvalho, João Mesquita, Rita Quaresma, Francisco Belo Morgado, Miguel Mendes
INTRODUCTION: Rotors and complex fractionated atrial electrograms (CFAEs) have been suggested as possible therapeutic targets in ablation of atrial fibrillation (AF). The aim of this study was to assess the relationship between rotors and CFAEs in patients with AF. METHODS: We studied 18 patients with AF (mean age 69±8 years, 33% female) who underwent rotor ablation and pulmonary vein isolation. Endocardial mapping was performed with a basket catheter to identify the presence, number and location of rotors and CFAEs...
April 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28340160/safety-of-fluoroscopy-guided-transseptal-approach-for-ablation-of-left-sided-arrhythmias
#8
Zviad Matoshvili, Hamid Bastani, Tara Bourke, Frieder Braunschweig, Nikola Drca, Kristjan Gudmundsson, Per Insulander, Anette Jemtrén, Göran Kennebäck, Ott Saluveer, Jonas Schwieler, Jari Tapanainen, Christer Wredlert, Mats Jensen-Urstad
Aims: The transseptal approach is used for left atrial access during the ablation of atrial fibrillation (AF) and other left-sided arrhythmia substrates. Transseptal puncture (TP) is commonly performed with fluoroscopic guidance, contrast injection, and pressure monitoring. In many centres, additional techniques [intracardiac echocardiography (ICE), transoesophageal echocardiography (TEE), radiofrequency needle] are used to facilitate TP but its use adds costs. In this retrospective study, we studied the safety and complication rate when TP was routinely done with fluoroscopic guidance, contrast injection, and pressure monitoring using ICE or TEE only in selected cases...
March 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339601/characterization-and-consistency-of-interactions-of-triggers-and-substrate-at-the-onset-of-paroxysmal-atrial-fibrillation
#9
David G Jones, Vias Markides, Anthony W C Chow, Richard J Schilling, Prapa Kanagaratnam, Tom Wong, D Wyn Davies, Nicholas S Peters
Aims: Initiating mechanisms of atrial fibrillation (AF) remain poorly understood, involving complex interaction between triggers and the atrial substrate. This study sought to classify the transitional phenomena, hypothesizing that there is consistency within and between patients in trigger-substrate interaction during transition to AF. Methods and results: Non-contact left atrial (LA) mapping was performed in 17 patients undergoing ablation for paroxysmal AF. All had spontaneous ectopy...
January 25, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28337705/the-effects-of-polyunsaturated-fatty-acids-and-antioxidant-vitamins-on-atrial-oxidative-stress-nitrotyrosine-residues-and-connexins-following-extracorporeal-circulation-in-patients-undergoing-cardiac-surgery
#10
Felipe Petersen, Ramón Rodrigo, Manfred Richter, Sawa Kostin
Cardiac surgery with extracorporeal circulation is characterized by different degrees of myocardial ischemia/reperfusion, which is often associated with postoperative atrial fibrillation (POAF). We have previously shown that a novel preventive therapy based on the reinforcement of the antioxidant system using omega-3 fatty acids plus antioxidant vitamin supplementation applied to patients undergoing cardiac surgery reduces POAF occurrence. We hypothesized that oxidative stress and nitrosative stress are involved in the development of an arrhythmogenic substrate by their effect on connexins (Cx40, Cx43 and Cx45) abundance and distribution pattern...
March 23, 2017: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/28321025/one-year-success-rate-of-pulmonary-vein-isolation-using-a-novel-irrigated-multipolar-mapping-and-ablation-catheter-with-reduced-power-settings
#11
Dong-In Shin, Jan-Erik Guelker, Christian Blockhaus, Jan Schmidt, Muhammed Kurt, Lukas Clasen, Patrick Mueller, Lars Bansemir, Christoph Brinkmeyer, Alexander Bufe, Malte Kelm, Hisaki Makimoto
The use of a novel irrigated multipolar ablation and mapping catheter for pulmonary vein isolation in patients with atrial fibrillation (AF) has demonstrated reasonable acute success rates and short procedure times, however, long-term outcome data are limited. The aim of this study was to analyze the long-term efficacy of this novel ablation system utilizing a reduced power setting for safety purposes.A total of 89 patients with paroxysmal (63 of 89 patients; 71%) or persistent AF underwent PVI with a reduced power setting of maximum 20 Watts (W) unipolar radiofrequency energy and 30 seconds in duration...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28316148/ablation-of-complex-fractionated-electrograms-with-or-without-additional-linear-lesions-for-persistent-atrial-fibrillation-the-adline-trial
#12
Sonia Ammar-Busch, Felix Bourier, Tilko Reents, Verena Semmler, Marta Telishevska, Susanne Kathan, Monika Hofmann, Gabriele Hessling, Isabel Deisenhofer
BACKGROUND: For persistent atrial fibrillation (AF) ablation, different strategies including complex fractionated atrial electrograms (CFAE) ablation and linear lesions (LL) have been used in addition to pulmonary vein isolation (PVI). However, it is still a matter of debate if extended substrate modification improves long-term outcome. The aim of this study was to determine the benefit of LL in addition to PVI and CFAE ablation regarding freedom from arrhythmia recurrence in patients with persistent AF...
March 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28291708/transvenous-electrical-cardioversion-of-atrial-fibrillation-in-two-dogs
#13
S W Jung, D K Newhard, K Harrelson
Atrial fibrillation is characterized by uncoordinated electrical activation of the atria that leads to the loss of atrial mechanical function and atrial fibrosis as a substrate promoting maintenance of rhythm abnormality. Transvenous electrical cardioversion has not been previously reported in the dog. The authors demonstrate the use of this technique for successful cardioversion of atrial fibrillation in two dogs with dilated cardiomyopathy.
March 10, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/28290788/-the-myocardial-sleeves-of-the-pulmonary-veins-potential-implications-for-atrial-fibrillation
#14
Y V Egorov, L V Rozenshtrauh
Pulmonary veins (PVs) are thought to play an important role in the initiation of atrial fibrillation. However, systematic microelectrode studies from different regions of the left atria and PV myocardium remain limited. METHODS AND RESULTS: A 2-microelectrode technique was used to characterize electrophysiological properties of rat left atrial and PV myocardium, at baseline and during electrical stimulation. PV myocardium was characterized by prolonged action potential duration (APD) (74+/-2 ms in the PV mouth vs...
February 2017: Kardiologiia
https://www.readbyqxmd.com/read/28290548/atrial-structure-function-and-arrhythmogenesis-in-aged-and-frail-mice
#15
Hailey J Jansen, Motahareh Moghtadaei, Martin Mackasey, Sara A Rafferty, Oleg Bogachev, John L Sapp, Susan E Howlett, Robert A Rose
Atrial fibrillation (AF) is prevalent in aging populations; however not all individuals age at the same rate. Instead, individuals of the same chronological age can vary in health status from fit to frail. Our objective was to determine the impacts of age and frailty on atrial function and arrhythmogenesis in mice using a frailty index (FI). Aged mice were more frail and demonstrated longer lasting AF compared to young mice. Consistent with this, aged mice showed longer P wave duration and PR intervals; however, both parameters showed substantial variability suggesting differences in health status among mice of similar chronological age...
March 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28284503/renal-denervation-regulates-the-atrial-arrhythmogenic-substrates-through-reverse-structural-remodeling-in-heart-failure-rabbit-model
#16
Shinya Yamada, Li-Wei Lo, Yu-Hui Chou, Wei-Lun Lin, Shih-Lin Chang, Yenn-Jiang Lin, Shih-Ann Chen
BACKGROUND: Heart failure (HF) causes atrial remodeling and increases the incidence of atrial fibrillation (AF). Renal denervation (RDN) has been shown to decrease the development of AF. This study aimed to identify the effects of RDN on the atrial arrhythmogenic substrates in HF. METHODS: Rabbits were classified into four groups: control (n=9), RDN (n=10), HF (n=6) and HF-RDN (n=9). Surgical and chemical RDN was approached through bilateral retroperitoneal flank incisions in RDN and HF-RDN...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28282592/development-of-an-automaton-model-of-rotational-activity-driving-atrial-fibrillation
#17
E J Ciaccio, A B Biviano, E Y Wan, N S Peters, H Garan
BACKGROUND: Atrial fibrillation (AF) is difficult to treat effectively, owing to uncertainty in where to best ablate to eliminate arrhythmogenic substrate. A model providing insight into the electrical activation events would be useful to guide catheter ablation strategy. Method A two-dimensional, 576×576 node automaton was developed to simulate atrial electrical activity. The substrate field was altered by the presence of differing refractory period at varying locations. Fibrosis was added in the form of short, randomly positioned lines of conduction block...
March 2, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28274566/postoperative-atrial-fibrillation-the-role-of-the-inflammatory-response
#18
Yosuke Ishii, Richard B Schuessler, Sydney L Gaynor, Kiyomi Hames, Ralph J Damiano
OBJECTIVE: Abnormal atrial conduction has been shown to be a substrate for postoperative atrial fibrillation (POAF). This study aimed to determine the relationship between the location of the atrial reentry responsible for POAF, and degree of atrial inflammation. METHODS: Normal mongrel dogs (n = 18) were divided into 3 groups: anesthesia alone (anesthesia), lateral right atriotomy (atriotomy), and lateral right atriotomy with anti-inflammatory therapy (steroid)...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28271726/molecular-mechanisms-of-atrial-fibrosis-implications-for-the-clinic
#19
REVIEW
Shivshankar Thanigaimani, Dennis H Lau, Thomas Agbaedeng, Adrian D Elliott, Rajiv Mahajan, Prashanthan Sanders
Recent research has unravelled an increasing list of cardiac conditions and risk factors that may be responsible for the abnormal underlying atrial substrate that predisposes to atrial fibrillation (AF). Atrial fibrosis has been demonstrated as the pivotal structural abnormality underpinning conduction disturbances that promote AF in different disease models. Despite the advancement in our discoveries of the molecular mechanisms involved in the profibrotic milieu, targeted therapeutics against atrial fibrosis remain lacking...
April 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28268440/beat-to-beat-variability-of-p-wave-in-patients-suffering-from-atrial-fibrillation
#20
Federica Censi, Giovanni Calcagnini, Eugenio Mattei, Alessandro Ricci, Ivan Corazza, Elisa Reggiani, Giuseppe Boriani
The aim of this paper was to analyze the P-wave variability over time in patients suffering from Atrial Fibrillation (AF). Behind some time-domain and morphological features of the P-wave template, two novel indexes of P-wave variability have been estimated: one based on the cross-correlation coefficients among the P-waves (Correlation Index, CI), and one associated to variation of P-waves amplitude (Amplitude Index, AI). These indexes were estimated in two experimental models: patients suffering from persistent AF respect to control subjects and patients developing post-operative AF (POAF) after coronary artery bypass grafting respect to patients without POAF...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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