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Atrial fibrillation substrate

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https://www.readbyqxmd.com/read/29446840/uncontrolled-blood-pressure-affects-atrial-remodeling-and-adverse-clinical-outcome-in-paroxysmal-atrial-fibrillation
#1
Masashi Kamioka, Naoko Hijioka, Yoshiyuki Matsumoto, Minoru Nodera, Takashi Kaneshiro, Hitoshi Suzuki, Yasuchika Takeishi
BACKGROUND: To investigate the impact of uncontrolled blood pressure (BP) on left atrial (LA) remodeling and clinical outcome after pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (AF). METHODS: One hundred and one symptomatic paroxysmal AF patients (85 males, 62.2±8.4 year-old) who underwent successful PVI were classified as follows: group 1 (n = 46), no hypertension (HTN); group 2 (n = 36), HTN with controlled BP; and group 3 (n = 19), HTN with uncontrolled BP...
February 15, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29439000/endo-epicardial-catheter-ablation-of-atrial-fibrillation-feasibility-outcome-and-insights-into-arrhythmia-mechanisms
#2
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
https://www.readbyqxmd.com/read/29431632/long-term-clinical-comparison-of-procedural-end-points-after-pulmonary-vein-isolation-in-paroxysmal-atrial-fibrillation-elimination-of-nonpulmonary-vein-triggers-versus-noninducibility
#3
Kwang-No Lee, Seung-Young Roh, Yong-Soo Baek, Hee-Soon Park, Jinhee Ahn, Dong-Hyeok Kim, Dae In Lee, Jaemin Shim, Jong-Il Choi, Sang-Weon Park, Young-Hoon Kim
BACKGROUND: Pulmonary vein isolation (PVI) is effective for maintenance of sinus rhythm in 50% to 75% of patients with paroxysmal atrial fibrillation, and it is not uncommon for patients to require additional ablation after PVI. We prospectively evaluated the relative effectiveness of 2 post-PVI ablation strategies in paroxysmal atrial fibrillation. METHODS AND RESULTS: A total of 500 patients (mean age, 55.7±11.0 years; 74.6% male) were randomly assigned to undergo ablation by 2 different strategies after PVI: (1) elimination of non-PV triggers (group A, n=250) or (2) stepwise substrate modification including complex fractionated atrial electrogram or linear ablation until noninducibility of atrial tachyarrhythmia was achieved (group B, n=250)...
February 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29428663/shengmai-san-derived-herbal-prevents-the-development-of-a-vulnerable-substrate-for-atrial-fibrillation-in-a-rat-model-of-ischemic-heart-failure
#4
Jin Ma, Shiyu Ma, Chunxia Yin, Huanlin Wu
OBJECTIVE: The study aimed to investigate whether a Shengmai San-derived herbal, Fumai granule (FM), which had a preventive effect on atrial fibrillation (AF) in myocardial infarction (MI)-induced heart failure (HF) rat and to determine the underlying mechanisms. DESIGN AND METHODS: MI was induced by a ligation of the left anterior descending coronary artery. One week after MI surgery, FM was gavaged for 4 weeks. AF inducibility was detected by transesophageal programmed electrical stimulation technology...
February 8, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29402528/influence-of-chronic-volume-overload-induced-atrial-remodeling-on-electrophysiological-responses-to-cholinergic-receptor-stimulation-in-the-isolated-rat-atria
#5
Xin Cao, Megumi Aimoto, Marie Fukumoto, Yoshinobu Nagasawa, Hikaru Tanaka, Akira Takahara
Whereas molecular mechanisms of atrial fibrillation (AF) have been widely investigated, there is limited information regarding interrelation between chronic volume overload and parasympathetic nervous system in the pathophysiology of AF. In this study, we investigated the influence of abdominal aorto-venocaval shunt (AVS)-induced atrial remodeling on electrophysiological responses to cholinergic receptor stimulation in the isolated rat atria. Interstitial fibrosis, cardiomyocyte hypertrophy and atrial enlargement, known as structural arrhythmogenic substrates for AF, took place after one month of AVS operation...
January 16, 2018: Journal of Pharmacological Sciences
https://www.readbyqxmd.com/read/29398686/combined-analysis-of-human-and-experimental-murine-samples-identified-novel-circulating-micrornas-as-biomarkers-for-atrial-fibrillation
#6
Yu Natsume, Kasumi Oaku, Kentaro Takahashi, Wakana Nakamura, Ai Oono, Satomi Hamada, Masahiro Yamazoe, Kensuke Ihara, Takeshi Sasaki, Masahiko Goya, Kenzo Hirao, Tetsushi Furukawa, Tetsuo Sasano
BACKGROUND: Recent experimental studies have demonstrated that several microRNAs (miRNAs) expressed in atrial tissue promote a substrate of atrial fibrillation (AF). However, because it has not been fully elucidated whether these experimental data contribute to identifying circulating miRNAs as biomarkers for AF, we used a combined analysis of human serum and murine atrial samples with the aim of identifying these biomarkers for predicting AF.Methods and Results:Comprehensive analyses were performed to screen 733 miRNAs in serum from 10 AF patients and 5 controls, and 672 miRNAs in atrial tissue from 6 inducible atrial tachycardia model mice and 3 controls...
February 5, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29380561/doxycycline-attenuates-chronic-intermittent-hypoxia-induced-atrial-fibrosis-in-rats
#7
Weiding Wang, Kai Zhang, Xiongfeng Li, Zuowang Ma, Yue Zhang, Meng Yuan, Ya Suo, Xue Liang, Gary Tse, Christos A Goudis, Tong Liu, Guangping Li
INTRODUCTION: Atrial structural remodeling in the form of fibrosis contributes to the arrhythmic substrate in atrial fibrillation (AF). The aim of this study was to investigate the effects of doxycycline on chronic intermittent hypoxia (CIH)-induced atrial fibrosis and the pathophysiological mechanisms underlying such changes. METHODS: A total of 30 Sprague-Dawley rats were randomized into three groups: Control group, CIH group, CIH with doxycycline treatment (CIH-D) group...
January 29, 2018: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/29358197/impact-of-renal-denervation-on-atrial-arrhythmogenic-substrate-in-ischemic-model-of-heart-failure
#8
Shinya Yamada, Man-Cai Fong, Ya-Wen Hsiao, Shih-Lin Chang, Yung-Nan Tsai, Li-Wei Lo, Tze-Fan Chao, Yenn-Jiang Lin, Yu-Feng Hu, Fa-Po Chung, Jo-Nan Liao, Yao-Ting Chang, Hsing-Yuan Li, Satoshi Higa, Shih-Ann Chen
BACKGROUND: Myocardial infarction increases the risk of heart failure (HF) and atrial fibrillation. Renal denervation (RDN) might suppress the development of atrial remodeling. This study aimed to elucidate the molecular mechanism of RDN in the suppression of atrial fibrillation in a HF model after myocardial infarction. METHODS AND RESULTS: HF rabbits were created 4 weeks after coronary ligation. Rabbits were classified into 3 groups: normal control (n=10), HF (n=10), and HF-RDN (n=6)...
January 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29338326/diabetes-mellitus-and-atrial-remodelling-in-patients-with-paroxysmal-atrial-fibrillation-role-of-electroanatomical-mapping-and-catheter-ablation
#9
Domenico Grieco, Zefferino Palamà, Alessio Borrelli, Ermenegildo De Ruvo, Luigi Sciarra, Antonio Scarà, Emilia Goanta, Vito Calabrese, Paolo Pozzilli, Germano Di Sciascio, Leonardo Calò
Complex fractionated atrial electrograms (CFAEs) are related to atrial fibrosis, but their ablation has not yet shown superiority. The aim of the study was to compare, in terms of clinical outcome, two strategies of paroxysmal atrial fibrillation (AF) ablation in patients with type 1 diabetes mellitus (DM): pulmonary vein isolation (PVI) vs. PVI + CFAEs. Compared to an historical population of patient with paroxysmal AF and without DM, a higher percentage of patients with DM showed more than 25% of atrial area interested by CFAEs (study population, 58% vs historical group, 15%; p < 0...
January 1, 2018: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/29274758/efficacy-and-safety-outcomes-of-direct-oral-anticoagulants-and-amiodarone-in-patients-with-atrial-fibrillation
#10
Florentino Lupercio, Jorge Romero, Bradley Peltzer, Carola Maraboto, David Briceno, Pedro Villablanca, Kevin Ferrick, Jay N Gross, Soo Kim, John Fisher, Luigi Di Biase, Andrew Krumerman
BACKGROUND: Direct oral anticoagulants (DOACs) and amiodarone are widely used in the treatment of non-valvular atrial fibrillation. The DOACs are P-glycoprotein (P-gp) and cytochrome p-450 (CYP3A4) substrates. DOAC levels may be increased by the concomitant use of potent dual P-gp/CYP3A4 inhibitors such as amiodarone, which can potentially translate into adverse clinical outcomes. We aimed to assess the efficacy and safety of drug-drug interaction by the concomitant use of DOACs and amiodarone...
December 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29250240/towards-a-mechanistic-understanding-and-treatment-of-a-progressive-disease-atrial-fibrillation
#11
REVIEW
Felix Yang, Joseph Tiano, Suneet Mittal, Mintu Turakhia, Israel Jacobowitz, Yisachar Greenberg
Atrial fibrosis appears to be a key factor in the genesis and/or perpetuation of atrial fibrillation (AF). The pathological distribution of atrial fibrosis is geographically consistent with the attachments between the posterior left atrium and the pericardium along the reflections where wall stiffness is increased and structural changes are found. While there is a wide range of complex etiological factors and electrophysiological mechanisms in AF, there is evidence for a common pathophysiological pathway that could account for deliberate substrate formation and progression of AF...
October 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250226/scar-homogenization-in-af-ablation-evolution-and-practice
#12
REVIEW
Minglong Chen
Laboratory studies, histology studies, image studies and the clinical studies all prove the positive correlation between atrial fibrillation and atrial fibrosis from different perspectives. Atrial fibrosis, by separating myocardial cell coupling, diminishing conduction velocity and promoting anisotropic conduction, produce the substrate to sustain atrial fibrillation (AF). These fibrotic areas can be translated into signal abnormalities (low voltage and complex electrgram), and be depicted by electroanatomic high density map...
June 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29244075/the-athlete-s-heart-is-a-proarrhythmic-heart-and-what-that-means-for-clinical-decision-making
#13
Hein Heidbuchel
Recurring questions when dealing with arrhythmias in athletes are about the cause of the arrhythmia and, more importantly, about the eligibility of the athlete to continue sports activities. In essence, the relation between sports and arrhythmias can be understood along three lines: sports as arrhythmia trigger on top of an underlying problem, sports as arrhythmic substrate promotor, or sports as substrate inducer. Often, there is no sharp divider line between these entities. The athlete's heart, a heart that adapts so magically to cope with the demands of exercise, harbours many structural and functional changes that by themselves predispose to arrhythmia development, at the atrial, nodal and ventricular levels...
December 13, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29229215/atrial-fibrillation-neurogenic-or-myogenic
#14
REVIEW
Alina Scridon, Răzvan Constantin Şerban, Philippe Chevalier
A 55-year-old hypertensive patient presents atrial fibrillation after vasovagal syncope. Non-invasive cardiac workup is normal. Without antiarrhythmic therapy, the patient has no recurrence for the next 3years, then presents with a stroke. Echocardiography eventually reveals left atrial dilation. This sequence of events illustrates the well-known links between age, arterial hypertension, atrial fibrillation, atrial neuromyopathy and stroke. A frequently neglected common denominator in this equation is impaired sympathovagal balance...
December 8, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29208256/combined-cryoballoon-and-radiofrequency-ablation-versus-radiofrequency-ablation-alone-for-long-standing-persistent-atrial-fibrillation
#15
COMPARATIVE STUDY
Tümer Erdem Guler, Tolga Aksu, Kivanc Yalin, Sukriye Ebru Golcuk, Ferit Onur Mutluer, Serdar Bozyel
BACKGROUND: To achieve sinus rhythm, ablation of long-standing persistent atrial fibrillation (LSPAF) usually requires substrate modification in addition to pulmonary vein isolation (PVI). In the present article, we aimed to compare clinical and substrate modification effects of 2 distinct PVI strategies during stepwise ablation in patients with LSPAF: (1) Combined approach: cryoballoon (CB) for PVI and radiofrequency (RF) ablation for substrate modification and (2) RF-only approach: RF ablation for both PVI and substrate modification...
December 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29187667/strategy-and-outcome-of-catheter-ablation-for-persistent-atrial-fibrillation%C3%A3-impact-of-progress-in-the-mapping-and-ablation-technologies
#16
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...
November 30, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29177475/individually-tailored-vs-standardized-substrate-modification-during-radiofrequency-catheter-ablation-for-atrial-fibrillation-a-randomized-study
#17
Simon Kircher, Arash Arya, David Altmann, Sascha Rolf, Andreas Bollmann, Philipp Sommer, Nikolaos Dagres, Sergio Richter, Ole-A Breithardt, Borislav Dinov, Daniela Husser, Charlotte Eitel, Thomas Gaspar, Christopher Piorkowski, Gerhard Hindricks
Aims: This randomized single-centre study sought to compare the efficacy and safety of pulmonary vein isolation (PVI) plus voltage-guided ablation vs. PVI with or without linear ablation depending on the type of atrial fibrillation (AF). Methods and results: Overall, 124 ablation-naive patients with paroxysmal or persistent AF were randomized to PVI with (persistent AF) or without (paroxysmal AF) additional linear ablation (control group) vs. PVI plus ablation of low-voltage areas (LVAs) irrespective of AF type...
November 21, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29174247/atrial-electrical-abnormality-in-patients-with-brugada-syndrome-assessed-by-signal-averaged-electrocardiography
#18
Yasutsugu Nagamoto, Yuto Fujii, Yuichi Morita, Yusuke Ueda, Yasuko Miyake, Kenichi Yamane, Mai Fujiwara, Shinji Mito, Yuichiro Watari, Hiromichi Tamekiyo, Tomokazu Okimoto, Yuji Muraoka, Yasuhiko Hayashi
BACKGROUND: Ventricular fibrillation and atrial fibrillation are well-known arrhythmias in patients with Brugada syndrome. This study evaluated the characteristics of the atrial arrhythmogenic substrate using the signal-averaged electrogram (SAECG) in patients with Brugada syndrome. METHODS: SAECGs were performed during normal sinus rhythm in 23 normal volunteers (control group), 21 patients with paroxysmal atrial fibrillation (PAF; PAF group), and 21 with Brugada syndrome (Brugada group)...
November 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29141846/atrial-substrate-modification-for-atrial-fibrillation-striving-to-get-smarter
#19
EDITORIAL
Prabhat Kumar, J Paul Mounsey
No abstract text is available yet for this article.
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29141843/stable-sr-electrophysiological-substrate-ablation-in-the-left-atrium-during-sinus-rhythm-for-the-treatment-of-nonparoxysmal-atrial-fibrillation-a-prospective-multicenter-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Bing Yang, Chenyang Jiang, Yazhou Lin, Gang Yang, Huimin Chu, Heng Cai, Fengmin Lu, Xianzhang Zhan, Jian Xu, Xinhua Wang, Chi-Keong Ching, Balbir Singh, Young-Hoon Kim, Minglong Chen
BACKGROUND: Circumferential pulmonary vein isolation (CPVI) alone or combined with adjuvant substrate modifications is unsatisfactory for atrial fibrillation (AF) control in nonparoxysmal AF patients. Ablation targeting the fibrotic areas after CPVI (STABLE-SR [Electrophysiological Substrate Ablation in the Left Atrium During Sinus Rhythm]) is a newly evolved substrate modification strategy. METHODS AND RESULTS: In this multicenter, randomized clinical trial, 229 symptomatic nonparoxysmal AF patients were 1:1 randomized to STABLE-SR group (n=114) or conventional STEPWISE group (n=115)...
November 2017: Circulation. Arrhythmia and Electrophysiology
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