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Atrial fibrillation substrate

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https://www.readbyqxmd.com/read/29912236/-dual-atrioventricular-nodal-pathways-physiology-arrhythmic-findings-and-electrocardiographic-manifestations
#1
Marcello Costantini, Vincenzo Carbone, Lorenzo Costantini
The atrioventricular (AV) node is an anatomically well-defined structure, conveniently housed in the triangle of Koch. There are two distinct atrial impulse approaches to the AV node, one of which (in the anterior portion of triangle of Koch) has a faster conduction, while the other one (in the posterior portion) has a slower conduction. However, it is not said that such a conductive duality translates into any arrhythmic phenomena. Actually, these arrhythmias are due to an imbalance of the two pathways electrophysiological properties, which does not always exist...
April 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29908372/association-of-fibrotic-remodeling-and-cytokines-chemokines-content-in-epicardial-adipose-tissue-with-atrial-myocardial-fibrosis-in-patients-with-atrial-fibrillation
#2
Ichitaro Abe, Yasushi Teshima, Hidekazu Kondo, Haruka Kaku, Shintaro Kira, Yuki Ikebe, Shotaro Saito, Akira Fukui, Tetsuji Shinohara, Kunio Yufu, Mikiko Nakagawa, Naoki Hijiya, Masatsugu Moriyama, Tatsuo Shimada, Shinji Miyamoto, Naohiko Takahashi
BACKGROUND: Epicardial adipose tissue (EAT) is associated with atrial fibrillation (AF), but the underlying mechanisms remain to be fully elucidated. OBJECTIVE: Using human left atrial appendage (LAA) samples, we examined the interactive relationship between the EAT profile and atrial myocardial fibrosis through histological and biochemical analyses. METHODS: LAA samples were obtained from 59 consecutive AF patients during cardiovascular surgery...
June 13, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29904288/frequency-of-atrial-arrhythmias-after-atrial-flutter-ablation-and-the-effect-of-presenting-rhythm-on-the-day-of-ablation
#3
Anupama Vasudevan, Aneley Hundae, Darara Borodge, Peter A McCullough, Peter J Wells
Radiofrequency catheter ablation of the cavotricuspid isthmus is a proven therapy for typical atrial flutter (AFl); however, in some patients, new atrial arrhythmias (AA) may occur after AFl ablation. This study explored the difference in the occurrence of spontaneous AA after AFl ablation as a function of the patient's presenting rhythm on the day of the AFl ablation. A retrospective study of consecutive patients who underwent AFl ablation at Baylor University Medical Center at Dallas was performed. A total of 188 subjects were included; 50% (94) presented in AFl (Group AFl) on the day of the ablation procedure and 94 presented in sinus rhythm (SR; Group SR)...
July 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29902583/the-application-of-kinomic-array-analysis-to-screen-for-altered-kinases-in-atrial-fibrillation-remodeling
#4
Roelien A M Meijering, Marit Wiersma, Deli Zhang, Eva A H Lanters, Femke Hoogstra-Berends, Jetse Scholma, Sander Diks, XiaoYan Qi, Natasja M S de Groot, Stanley Nattel, Robert H Henning, Bianca J J M Brundel
BACKGROUND: Dysregulation of protein kinase-mediated signaling is an early event in many diseases, including the most common clinical cardiac arrhythmia, atrial fibrillation (AF). Kinomic profiling represents a promising technique to identify candidate kinases. OBJECTIVE: Here we employ kinomic profiling to identify kinases altered in AF remodeling using atrial tissue from a canine AF-model (atrial tachypacing). METHODS: Left atrial tissue obtained in a previous canine study was used for kinome array (containing 1024 kinase pseudo-substrates) analysis...
June 11, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29893827/prediction-of-electro-anatomical-substrate-using-apple-score-and-biomarkers
#5
Jelena Kornej, Petra Büttner, Philipp Sommer, Nikolaos Dagres, Borislav Dinov, Katja Schumacher, Andreas Bollmann, Gerhard Hindricks
Aims: Low voltage areas (LVAs) represent advanced remodelling processes in left atrium in patients with atrial fibrillation (AF) and are associated with higher rates of arrhythmia recurrences. However, the prediction of LVA based on clinical parameters is understudied. Recently, we introduced APPLE score to predict rhythm outcomes after catheter ablation. The aim of this study was to analyse (i) LVA prediction using APPLE score and (ii) differences in biomarker profiles according to APPLE score in AF patients...
June 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29891251/exercise-and-atrial-fibrillation-prevention-or-causation
#6
Adrian D Elliott, Dominik Linz, Christian V Verdicchio, Prashanthan Sanders
Regular exercise contributes to improved cardiovascular health and reduced cardiovascular mortality. Previous studies have shown that regular physical activity and high cardiorespiratory fitness both contribute to a reduction in incident atrial fibrillation (AF). However, the risk of AF appears to be paradoxically increased by participation in endurance exercise. Although the mechanisms are not well understood, exercise-induced changes in autonomic tone alongside the development of an arrhythmogenic atrial substrate, appear to contribute to an excess of AF amongst athletes, despite an overall reduction in cardiovascular disease incidence...
May 8, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29859827/the-influence-of-the-electrodes-spacing-of-a-mapping-catheter-on-the-atrial-voltage-substrate-map
#7
Hitoshi Mori, Ritsushi Kato, Yoshifumi Ikeda, Koji Goto, Sayaka Tanaka, So Asano, Yuichiro Shiki, Takahiko Nagase, Mai Tahara, Shiro Iwanaga, Toshihiro Muramatsu, Kazuo Matsumoto
BACKGROUND: Detailed substrate mapping is important for catheter ablation. However, the influence of the electrode spacing of the mapping catheter on the substrate map has not been well clarified. The aim of this study was to investigate the influence of the electrode spacing of the mapping catheter on the voltage of the substrate map. METHODS: Protocol 1: We recorded the local atrial potentials of the left atrium (LA) using the ablation catheter during sinus rhythm in six atrial fibrillation (AF) patients...
May 30, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29798792/medical-and-interventional-outcomes-in-pediatric-lone-atrial-fibrillation
#8
Matthew L Furst, Elizabeth V Saarel, Ayman A Hussein, Oussama M Wazni, Patrick Tchou, Mohamed Kanj, Walid I Saliba, Peter F Aziz
OBJECTIVES: The goal of this study was to describe the clinical characteristics of pediatric patients with lone atrial fibrillation (LAF) and their treatment outcomes. The authors focused on patients who underwent ablation and compared the recurrence after ablation of supraventricular tachycardia substrates as presumed triggers versus pulmonary vein isolation (PVI). BACKGROUND: LAF in pediatrics is rare, and outcomes remain poorly defined. Current guidelines on ablation are based on a few small studies, and we present outcomes from the largest cohort of patients after ablation...
May 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29777140/different-responses-of-left-atrium-and-left-atrial-appendage-to-radiofrequency-catheter-ablation-of-atrial-fibrillation-a-follow-up-mri-study
#9
Yun Gi Kim, Jaemin Shim, Suk-Kyu Oh, Hee-Soon Park, Kwang-No Lee, Sung Ho Hwang, Jong-Il Choi, Young-Hoon Kim
Atrial fibrillation (AF) is known to cause adverse remodeling of left atrium (LA). Radiofrequency catheter ablation (RFCA) of AF is associated with decrease in LA volume. However, the impact of RFCA on left atrial appendage (LAA) volume and hemodynamic function is not fully understood. We analyzed 123 patients who underwent cardiac magnetic resonance imaging (MRI) evaluation before and after RFCA in Korea University Anam Hospital. LA and LAA volume were measured before and after RFCA based on cardiac MRI. Baseline LA volume was 99...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29759784/atrial-tachycardias-after-surgical-atrial-fibrillation-ablation-clinical-characteristics-electrophysiological-mechanisms-and-ablation-outcomes-from-a-large-multicenter-study
#10
Rakesh Gopinathannair, Philip L Mar, Muhammad Rizwan Afzal, Luigi Di Biase, Yixi Tu, Thanmay Lakkireddy, Jaimin R Trivedi, Mark S Slaughter, Andrea Natale, Dhanunjaya Lakkireddy
OBJECTIVES: The clinical characteristics, electrophysiological mechanisms, and ablation outcomes of post-surgical atrial fibrillation ablation (SAFA) atrial tachycardias (ATs) have not been studied in a large, multicenter cohort. BACKGROUND: ATs are often seen following SAFA. METHODS: Analysis was performed on 137 patients (age, 62 ± 10 years; 74% male) who underwent catheter ablation for symptomatic post-SAFA AT from 2004 to 2013 at 3 high-volume institutions in the United States...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759774/assessment-of-left-atrial-fibrosis-by-late-gadolinium-enhancement-magnetic-resonance-imaging-methodology-and-clinical-implications
#11
REVIEW
Johannes Siebermair, Eugene G Kholmovski, Nassir Marrouche
Recently, studies using late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) to identify structural changes of atrial tissue have contributed significantly to understanding the pathophysiology and progression of atrial fibrillation (AF). Moreover, imaging of atrial fibrosis using MRI has evolved to be a tool to improve clinical outcome of AF ablation procedures by allowing a patient-specific individualized management approach. LGE-MRI has been shown to predict AF ablation outcome based on pre-procedural imaging to define the extent of atrial fibrosis...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759705/can-we-identify-the-extra-pulmonary-vein-substrate-in-paroxysmal-atrial-fibrillation-using-incremental-atrial-pacing
#12
EDITORIAL
Amir S Jadidi, Zoraida Moreno-Weidmann, Thomas Arentz
No abstract text is available yet for this article.
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759616/spatial-relationships-of-complex-fractionated-atrial-electrograms-and-continuous-electrical-activity-to-focal-electrical-sources-implications-for-substrate-ablation-in-human-atrial-fibrillation
#13
Simon Kochhäuser, Atul Verma, Rupin Dalvi, Adrian Suszko, Pouria Alipour, Prashanthan Sanders, Jean Champagne, Laurent Macle, Girish M Nair, Hugh Calkins, David J Wilber, Vijay S Chauhan
OBJECTIVES: This study sought to evaluate the spatial relationships of focal electrical sources (FSs) to complex fractionated atrial electrograms (CFAE) and continuous electrical activity (CEA). BACKGROUND: Fractionated atrial electrograms have been associated with atrial fibrillation (AF) drivers in computational studies and represent ablation targets in the management of persistent AF. METHODS: We included a subset of 66 patients (age: 63 [56, 67] years, 69% persistent AF) with electroanatomic data from the SELECT AF (Selective complex fractionated atrial electrograms targeting for atrial fibrillation) randomized control trial that compared the efficacy of CFAE with CEA ablation in AF patients undergoing pulmonary vein antral ablation...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759532/therapeutic-approaches-to-atrial-fibrillation-ablation-targeting-atrial-fibrosis
#14
REVIEW
Hans Kottkamp, Doreen Schreiber, Fabian Moser, Andreas Rieger
Atrial fibrosis is the fundamental histopathologic finding in atrial fibrillation (AF) patients and an important predictor of ablation failure beyond pulmonary vein isolation. There is wide variation in the extent and localization of left atrial fibrosis in patients with paroxysmal and nonparoxysmal AF. Box isolation of fibrotic areas is an effective rhythm control concept in patients with paroxysmal AF despite durable pulmonary vein isolation, and this strategy has recently been implemented successfully in initial AF ablation procedures in addition to pulmonary vein isolation for patients with nonparoxysmal AF...
July 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759428/atrial-fibrillation-and-pulmonary-venous-electrical-conduction-recovery-after-full-surgical-resection-and-anastomosis-of-the-pulmonary-veins-insights-from-follow-up-and-ablation-procedures-in-lung-transplant-recipients
#15
Ayman A Hussein, Tanmay S Panchabhai, Marie M Budev, Khaldoun Tarakji, Amr F Barakat, Walid Saliba, Bruce Lindsay, Oussama M Wazni
OBJECTIVES: The authors report their experience with atrial fibrillation (AF) rates and ablation findings in lung transplant recipients. BACKGROUND: Pulmonary venous (PV) conduction recovery accounts for most failed atrial fibrillation (AF) catheter ablation procedures. Lung transplantation involves full surgical resection and replacement of the recipient's PVs with donor's PVs, which may represent the ultimate PV ablation. METHODS: They followed 755 consecutive lung transplant recipients categorized based on transplant status (unilateral vs...
June 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29733479/levosimendan-differentially-modulates-electrophysiological-activities-of-sinoatrial-nodes-pulmonary-veins-and-the-left-and-right-atria
#16
Yung-Kuo Lin, Yao-Chang Chen, Yi-Ann Chen, Jen-Hung Huang, Shih-Ann Chen, Yi-Jen Chen
INTRODUCTION: Calcium overload increases the risk of atrial fibrillation (AF). Levosimendan, a calcium sensitizer, increases myofilament contractility. Clinical reports suggested that levosimendan might increase AF occurrence, but the electrophysiological effects of levosimendan on AF substrates and triggers (pulmonary veins, PVs) are not clear. METHODS AND RESULTS: Conventional microelectrodes were used to record action potentials (APs) in isolated rabbit PVs, sinoatrial nodes (SANs), the left atrium (LA), and right atrium (RA) before and after application of different concentrations of levosimendan with or without milrinone (a phosphodiesterase [PDE] III inhibitor), and glibenclamide (an ATP-sensitive potassium channel [KATP ] inhibitor)...
May 7, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29725307/comparing-reentrant-drivers-predicted-by-image-based-computational-modeling-and-mapped-by-electrocardiographic-imaging-in-persistent-atrial-fibrillation
#17
Patrick M Boyle, Joe B Hakim, Sohail Zahid, William H Franceschi, Michael J Murphy, Edward J Vigmond, Rémi Dubois, Michel Haïssaguerre, Mélèze Hocini, Pierre Jaïs, Natalia A Trayanova, Hubert Cochet
Electrocardiographic mapping (ECGI) detects reentrant drivers (RDs) that perpetuate arrhythmia in persistent AF (PsAF). Patient-specific computational models derived from late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) identify all latent sites in the fibrotic substrate that could potentially sustain RDs, not just those manifested during mapped AF. The objective of this study was to compare RDs from simulations and ECGI (RDsim /RDECGI ) and analyze implications for ablation. We considered 12 PsAF patients who underwent RDECGI ablation...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29716710/catheter-ablation-for-electrical-storm-in-brugada-syndrome-results-of-substrate-based-ablation
#18
Abhijeet Shelke, Ajit Tachil, Daljeet Saggu, Masilamani Lawrance Jesuraj, Sachin Yalagudri, Calambur Narasimhan
BACKGROUND: Brugada syndrome (BrS) is known to cause malignant ventricular arrhythmia (VA) and sudden cardiac death (SCD). Patients with implantable cardioverter defibrillator (ICD) may experience recurrent shocks from ICD. Recent reports indicate that radiofrequency ablation (RFA) in BrS is feasible, and effective. Catheter ablation of premature ventricular complexes (PVCs) triggering VA and substrate modification of right ventricular outflow tract (RVOT) has been described. METHODS AND RESULTS: Five patients (4 males, age-23 to 32 years) with BrS and electrical storm (ES) despite being on isoprenaline infusion and cilostazol (phosphodiestrase-3 inhibitor) underwent 3 dimensional electroanatomic mapping and RFA...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29706494/is-there-a-role-for-genes-in-exercise-induced-atrial-cardiomyopathy
#19
REVIEW
Diane Fatkin, Charles D Cox, Inken G Huttner, Boris Martinac
In endurance athletes, prolonged high intensity exercise participation can have deleterious effects on the myocardium with subsequent structural and electrical remodelling. In a subset of athletes, there is a predilection for atrial involvement and the risk of atrial fibrillation (AF) is increased. The mechanisms underpinning exercise-induced atrial cardiomyopathy have yet to be fully elucidated and the contribution of an individual's genetic makeup is unknown. Some athletes may have rare genetic variants that are sufficient to cause AF irrespective of exercise exposure...
April 9, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29688325/anatomical-hotspots-of-fractionated-electrograms-in-the-left-and-right-atrium-do-they-exist
#20
Roeliene Starreveld, Lisette J M E van der Does, Natasja M S de Groot
Aims: Targeting of complex fractionated electrograms (CFEs) in the atria is not yet beneficial in treating drug-refractory atrial fibrillation (AF). In order to gain insight into potential anatomical hotspots of fractionated electrograms, a structured literature search was performed. Methods and results: PubMed was searched for studies describing fractionation during human atrial electrophysiological measurements (n = 565), of which 36 articles described the pre-ablation distribution of fractionated electrograms for the left atrium and/or right atrium in at least four regions...
April 20, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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