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Atrial fibrillation substrate

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https://www.readbyqxmd.com/read/28228428/the-effect-of-aggressive-blood-pressure-control-on-the-recurrence-of-atrial-fibrillation-after-catheter-ablation-a-randomized-open-label-clinical-trial-substrate-modification-with-aggressive-blood-pressure-control-smac-af
#1
Ratika Parkash, George A Wells, John L Sapp, Jeffrey S Healey, Jean-Claude Tardif, Isabelle Greiss, Léna Rivard, Jean-Francois Roux, Lorne Gula, Isabelle Nault, Paul G Novak, David H Birnie, Andrew C Ha, Stephen B Wilton, Iqwal Mangat, Christopher J Gray, Martin J Gardner, Anthony S L Tang
Background -Radiofrequency catheter ablation for atrial fibrillation has become an important therapy for AF, however recurrence rates remain high. We proposed to determine whether aggressive blood pressure (BP) lowering prevents recurrent atrial fibrillation (AF) after catheter ablation in patients with AF and a high symptom burden. Methods -We randomly assigned 184 patients with AF and a BP greater than 130/80 mmHg to aggressive BP (target <120/80 mm Hg) or standard BP treatment (target <140/90 mmHg) prior to their scheduled AF catheter ablation...
February 22, 2017: Circulation
https://www.readbyqxmd.com/read/28226611/beat-to-beat-variability-of-p-wave-in-patients-suffering-from-atrial-fibrillation
#2
Federica Censi, Giovanni Calcagnini, Eugenio Mattei, Alessandro Ricci, Ivan Corazza, Elisa Reggiani, Giuseppe Boriani, Federica Censi, Giovanni Calcagnini, Eugenio Mattei, Alessandro Ricci, Ivan Corazza, Elisa Reggiani, Giuseppe Boriani, Elisa Reggiani, Giuseppe Boriani, Ivan Corazza, Alessandro Ricci, Federica Censi, Eugenio Mattei, Giovanni Calcagnini
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
https://www.readbyqxmd.com/read/28226544/kurtosis-as-a-statistical-approach-to-identify-the-pivot-point-of-the-rotor
#3
Shivaram P Arunachalam, Elizabeth M Annoni, Siva K Mulpuru, Paul A Friedman, Elena G Tolkacheva, Shivaram P Arunachalam, Elizabeth M Annoni, Siva K Mulpuru, Paul A Friedman, Elena G Tolkacheva, Elena G Tolkacheva, Paul A Friedman, Elizabeth M Annoni, Siva K Mulpuru, Shivaram P Arunachalam
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia that causes stroke affecting more than 2.3 million people in the US. Catheter ablation to terminate AF is successful for paroxysmal AF but suffers limitations with persistent AF patients as current mapping methods cannot identify AF active substrates outside of pulmonary vein region. In this work, we developed a novel Kurtosis based mapping technique that can accurately identify pivot points of the rotors that were induced in ex-vivo isolated rabbit heart...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28211132/comparison-of-left-atrial-voltage-between-sinus-rhythm-and-atrial-fibrillation-in-association-with-electrogram-wave-form
#4
Masaharu Masuda, Masashi Fujita, Osamu Iida, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Akihiro Sunaga, Takuya Tsujimura, Yasuhiro Matsuda, Takuya Ohashi, Masaaki Uematsu
BACKGROUND: The efficacy of low-voltage-guided ablation in addition to pulmonary vein (PV) isolation for atrial fibrillation (AF) has been reported with voltage mapping being performed during sinus rhythm (SR) or AF. The study aimed to compare the left atrial voltage between SR and AF in association with the electrogram wave form. METHODS: This prospective observational study included 30 consecutive patients with persistent AF. After completion of PV isolation, electrogram points were taken during both SR and AF at the identical locations evenly throughout the left atrium...
February 16, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28208135/abcb1-and-slco1b3-gene-polymorphisms-and-their-impact-on-digoxin-pharmacokinetics-in-atrial-fibrillation-patients-among-the-tunisian-population
#5
Nejia Tounsi, Imen Trabelsi, Emna Kerkeni, Mohamed Habib Grissa, Nizar Fredj, Adel Sekma, Malek Mzali, Ilhem Hellara, Kamel Monastiri, Wahiba Douki, Semir Nouira
BACKGROUND: Digoxin is a substrate of P-glycoprotein (P-gp) and organic anion transporting polypeptide transporters that are encoded by ABCB1 and SLCO1B3 genes. Genetic polymorphisms in both genes may explain inter-individual variability of serum digoxin concentration (SDC). This study evaluates the possible effect of the most common ABCB1 and SLCO1B3 polymorphisms on SDC after a single oral dose of digoxin in Tunisian atrial fibrillation (AF) patients. METHODS: ABCB1 and SLCO1B3 genotypes were analyzed in 102 patients with AF who received digoxin (0...
February 17, 2017: Pharmacology
https://www.readbyqxmd.com/read/28205526/association-evidence-of-ccttt-repeat-polymorphism-in-the-inos-promoter-and-the-risk-of-atrial-fibrillation-in-taiwanese
#6
Lung-An Hsu, Yung-Hsin Yeh, Wei-Jan Chen, Chi-Tai Kuo, Feng-Chun Tsai, Yi-Hsin Chan, Chun-Li Wang, Chi-Jen Chang, Hsin-Yi Tsai
Inducible nitric oxide synthase (iNOS) plays an important role in the pathogenesis of atrial fibrillation (AF). The iNOS promoter has a CCTTT-repeat length polymorphism that can determine the level of gene transcription. This study enrolled 200 AF patients and 240 controls. The length of CCTTT-repeat polymorphism in the iNOS promoter region was examined by polymerase chain reactions, with the alleles with ≤11 repeats designated as S and alleles with ≥12 repeats designated as L alleles. AF patients carried significantly higher frequencies of the LL genotype than control subjects (40...
February 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28190945/mems-based-flexible-force-sensor-for-tri-axial-catheter-contact-force-measurement
#7
Hardik J Pandya, Jun Sheng, Jaydev P Desai
Atrial fibrillation (AFib) is a significant healthcare problem caused by the uneven and rapid discharge of electrical signals from pulmonary veins (PVs). The technique of radiofrequency (RF) ablation can block these abnormal electrical signals by ablating myocardial sleeves inside PVs. Catheter contact force measurement during RF ablation can reduce the rate of AFib recurrence, since it helps to determine effective contact of the catheter with the tissue, thereby resulting in effective power delivery for ablation...
February 2017: Journal of Microelectromechanical Systems
https://www.readbyqxmd.com/read/28185351/persistent-atrial-fibrillation-ablation-with-or-without-contact-force-sensing
#8
Ayman A Hussein, Amr F Barakat, Walid I Saliba, Khaldoun G Tarakji, Mohamed Bassiouny, Bryan Baranowski, Patrick Tchou, Mandeep Bhargava, Thomas Dresing, Thomas Callahan, Daniel Cantillon, Mohamed Kanj, Bruce D Lindsay, Oussama M Wazni
INTRODUCTION: Arrhythmia recurrences remain common after ablation of persistent atrial fibrillation (PersAF). Contact force sensing catheters have been introduced for objective assessment of contact during radiofrequency application and have been suggested to improve outcomes in ablation of paroxysmal AF, but little is known about their role in PersAF ablation. We aimed to compare the procedural profiles and outcomes of (PersAF) ablation with or without using contact force (CF) sensing catheters...
February 10, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28158495/jak-stat-signaling-and-the-atrial-fibrillation-promoting-fibrotic-substrate
#9
Yu Chen, Sirirat Surinkaew, Patrice Naud, Xiao-Yan Qi, Marc-Antoine Gillis, Yan-Fen Shi, Jean-Claude Tardif, Dobromir Dobrev, Stanley Nattel
No abstract text is available yet for this article.
February 2, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28154101/cardioembolic-stroke
#10
Hooman Kamel, Jeff S Healey
Cardiac embolism accounts for an increasing proportion of ischemic strokes and might multiply several-fold during the next decades. However, research points to several potential strategies to stem this expected rise in cardioembolic stroke. First, although one-third of strokes are of unclear cause, it is increasingly accepted that many of these cryptogenic strokes arise from a distant embolism rather than in situ cerebrovascular disease, leading to the recent formulation of embolic stroke of undetermined source as a distinct target for investigation...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28124622/intermittent-hypoxia-causes-nox2-dependent-remodeling-of-atrial-connexins
#11
Joanna Gemel, Zihan Su, Alex Gileles-Hillel, Abdelnaby Khalyfa, David Gozal, Eric C Beyer
BACKGROUND: Obstructive sleep apnea has been linked to the development of heart disease and arrhythmias, including atrial fibrillation. Since altered conduction through gap junction channels can contribute to the pathogenesis of such arrhythmias, we examined the abundance and distributions of the major cardiac gap junction proteins, connexin40 (Cx40) and connexin43 (Cx43) in mice treated with sleep fragmentation or intermittent hypoxia (IH) as animal models of the components of obstructive sleep apnea...
January 17, 2017: BMC Cell Biology
https://www.readbyqxmd.com/read/28123766/low-incidence-of-left-atrial-delayed-enhancement-with-mri-in-patients-with-af-a-single-centre-experience
#12
John P Bois, James Glockner, Phillip M Young, Thomas A Foley, Seth Sheldon, Darrell B Newman, Grace Lin, Douglas L Packer, Peter A Brady
BACKGROUND: Atrial fibrillation (AF) is the most common sustained atrial arrhythmia. One potential target for ablation is left atrial (LA) scar (LAS) regions that may be the substrate for re-entry within the atria, thereby sustaining AF. Identification of LAS through LA delayed gadolinium enhancement (LADE) with MRI has been proposed. OBJECTIVES: We sought to evaluate LADE in patients referred for catheter ablation of AF. METHODS: Prospective analysis was conducted of consecutive patients who underwent pulmonary vein antrum isolation (PVAI) ablation for AF at a single institution...
2017: Open Heart
https://www.readbyqxmd.com/read/28122804/second-generation-cryoballoon-ablation-for-atrial-fibrillation-in-young-adults-midterm-outcome-in-patients-under-40-years-of-age
#13
Darragh Moran, Valentina De Regibus, Carlo de Asmundis, Ken Takarada, Giacomo Mugnai, Erwin Ströker, Arash Aryana, Saverio Iacopino, Diego Ruggiero, Hugo Enrique Coutiño-Moreno, Rajin Choudhury, Juan-Pablo Abugattas, Ebru Hacioglu, Gaetano Paparella, Pedro Brugada, Gian-Battista Chierchia
AIMS: Pulmonary vein isolation (PVI) has been demonstrated more effective in young patients, in which the substrate for atrial fibrillation (AF) is probably more confined to pulmonary vein potentials. The present study sought to focus on the midterm outcomes in patients under 40 years having undergone PVI with the Cryoballoon Advance because of drug resistant AF. METHODS AND RESULTS: Between June 2012 and December 2015, 57 patients having undergone Cryoballoon ablation (CB-A) below 40 years of age for AF in our centre were retrospectively analysed and considered for our analysis...
January 25, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28115807/functional-remodeling-of-both-atria-is-associated-with-occurrence-of-stroke-in-patients-with-paroxysmal-and-persistent-atrial-fibrillation
#14
Hsuan-Ming Tsao, Wei-Chih Hu, Ping-Huang Tsai, Chao-Lin Lee, Hsueh-Han Wang, Shih-Lin Chang, Tze-Fan Chao, Shih-Ann Chen
BACKGROUND: It is critical to recognize high risk patients who are prone to develop stroke in the management of atrial fibrillation (AF). The purpose of this study was to identify the determinants of AF related stroke by assessing the anatomical and functional remodeling of cardiac chambers. METHODS: We compared the cardiac structure and function of 28 consecutive patients with paroxysmal and persistent AF-related stroke with 69 patients with AF and 21 controls without stroke using contrast-enhanced 64-slice multi-detector computed tomography during sinus rhythm...
January 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28108547/characterising-the-difference-in-electrophysiological-substrate-and-outcomes-between-heart-failure-and-non-heart-failure-patients-with-persistent-atrial-fibrillation
#15
Shouvik K Haldar, David G Jones, Habib Khan, Sandeep Panikker, Julian W E Jarman, Charlie Butcher, Eric Lim, Gareth Wynn, Dhiraj Gupta, Wajid Hussain, Vias Markides, Tom Wong
AIMS: Characterizing the differences in substrate and clinical outcome between heart failure (HF) and non-heart failure (non-HF) patients undergoing persistent atrial fibrillation (AF) ablation. METHODS AND RESULTS: Using complex fractionated electrograms (CFE) as a surrogate marker of substrate complexity, we compared the bi-atrial substrate in patients with persistent AF with and without HF, at baseline and after ablation, to determine its impact on clinical outcome...
January 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28104074/substrate-ablation-without-pulmonary-vein-isolation-a-reasonable-proposition-for-atrial-fibrillation-ablation
#16
EDITORIAL
John Hummel
No abstract text is available yet for this article.
January 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28104073/af-ablation-guided-by-spatiotemporal-electrogram-dispersion%C3%A2-without-pulmonary-vein-isolation-a-wholly-patient-tailored-approach
#17
Julien Seitz, Clément Bars, Guillaume Théodore, Sylvain Beurtheret, Nicolas Lellouche, Michel Bremondy, Ange Ferracci, Jacques Faure, Guillaume Penaranda, Masatoshi Yamazaki, Uma Mahesh R Avula, Laurence Curel, Sabrina Siame, Omer Berenfeld, André Pisapia, Jérôme Kalifa
BACKGROUND: The use of intracardiac electrograms to guide atrial fibrillation (AF) ablation has yielded conflicting results. OBJECTIVES: The authors evaluated the usefulness of spatiotemporal dispersion, a visually recognizable electric footprint of AF drivers, for the ablation of all forms of AF. METHODS: The authors prospectively enrolled 105 patients admitted for AF ablation. AF was sequentially mapped in both atria with a 20-pole PentaRay catheter...
January 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28062142/aldosterone-pathway-blockade-to-prevent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#18
J Neefs, N W E van den Berg, J Limpens, W R Berger, S M Boekholdt, P Sanders, J R de Groot
BACKGROUND: Despite advances in therapeutic interventions AF remains a progressive and symptomatic disease. Therefore, novel therapeutic interventions targeting the underlying arrhythmogenic substrate for AF is needed. Atrial fibrosis is an important component of the arrhythmogenic substrate of AF and may be initiated by aldosterone binding to the mineralocorticoid receptor. We hypothesized that aldosterone pathway blockade with mineralocorticoid receptor antagonists (MRA) reduces atrial fibrosis, and thus AF...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28057773/inverse-remodelling-of-k2p3-1-k-channel-expression-and-action-potential-duration-in-left-ventricular-dysfunction-and-atrial-fibrillation-implications-for-patient-specific-antiarrhythmic-drug-therapy
#19
Constanze Schmidt, Felix Wiedmann, Xiao-Bo Zhou, Jordi Heijman, Niels Voigt, Antonius Ratte, Siegfried Lang, Stefan M Kallenberger, Chiara Campana, Alexander Weymann, Raffaele De Simone, Gabor Szabo, Arjang Ruhparwar, Klaus Kallenbach, Matthias Karck, Joachim R Ehrlich, István Baczkó, Martin Borggrefe, Ursula Ravens, Dobromir Dobrev, Hugo A Katus, Dierk Thomas
AIMS: Atrial fibrillation (AF) prevalence increases with advanced stages of left ventricular (LV) dysfunction. Remote proarrhythmic effects of ventricular dysfunction on atrial electrophysiology remain incompletely understood. We hypothesized that repolarizing K2P3.1 K(+ )channels, previously implicated in AF pathophysiology, may contribute to shaping the atrial action potential (AP), forming a specific electrical substrate with LV dysfunction that might represent a target for personalized antiarrhythmic therapy...
January 4, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28054729/comparison-of-the-efficacy-of-empiric-thoracic-vein-isolation-for-the-treatment-of-paroxysmal-and-persistent-atrial-fibrillation-in-patients-without-structural-heart-disease
#20
Koichiro Ejima, Ryuta Henmi, Yuji Iwanami, Daigo Yagishita, Morio Shoda, Nobuhisa Hagiwara
INTRODUCTION: The guidelines suggest that an adjuvant substrate modification in addition to pulmonary vein isolation (PVI) may be needed for persistent atrial fibrillation (PerAF) assuming that catheter ablation is less successful for PerAF than paroxysmal AF (PAF). To revisit the above assumption, we compared the outcome of the same catheter ablation strategy between PAF and PerAF. METHODS AND RESULTS: Two-hundred and thirty-three consecutive patients (mean age 60±10 years, 53 PerAF and 8 long-lasting PerAF) without structural heart disease underwent catheter ablation of AF by the same strategy using an empiric thoracic vein isolation (a wide circumferential PVI plus empiric superior vena cava isolation) as a major part of the strategy without any adjuvant substrate modification...
January 5, 2017: Journal of Cardiovascular Electrophysiology
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