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Atrial fibrillation substrate

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https://www.readbyqxmd.com/read/29018165/catheter-ablation-of-the-superolateral-mitral-isthmus-line-a-novel-approach-to-reduce-the-need-for-epicardial-ablation
#1
Tilman Maurer, Andreas Metzner, S Yen Ho, Peter Wohlmuth, Bruno Reißmann, Christian Heeger, Christine Lemes, Kentaro Hayashi, Ardan M Saguner, Johannes Riedl, Christian Sohns, Shibu Mathew, Karl-Heinz Kuck, Erik Wissner, Feifan Ouyang
BACKGROUND: The mitral isthmus is a critical part of perimitral reentrant tachycardia, as well as an important substrate of persistent atrial fibrillation. Deployment of an endocardial mitral isthmus line (MIL) with the end point of bidirectional block may be challenging and often requires additional epicardial ablation within the coronary sinus. METHODS AND RESULTS: The study population comprised 114 patients with perimitral flutter who underwent de novo ablation of an MIL...
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29016756/the-electrocardiogram-as-a-predictor-of-successful-pharmacological-cardioversion-and-progression-of-atrial-fibrillation
#2
Stef Zeemering, Theo A R Lankveld, Pietro Bonizzi, Ione Limantoro, Sebastiaan C A M Bekkers, Harry J G M Crijns, Ulrich Schotten
Aims: Non-invasive characterization of atrial fibrillation (AF) substrate complexity based on the electrocardiogram (ECG) may improve outcome prediction in patients receiving rhythm control therapies for AF. Multiple parameters to assess AF complexity and predict treatment outcome have been suggested. A comparative study of the predictive performance of complexity parameters on response to therapy and progression of AF in a large patient population is needed to standardize non-invasive analysis of AF...
July 26, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29016724/triggered-intracellular-calcium-waves-in-dog-and-human-left-atrial-myocytes-from-normal-and-failing-hearts
#3
Gary L Aistrup, Rishi Arora, Søren Grubb, Shin Yoo, Benjamin Toren, Manvinder Kumar, Aaron Kunamalla, William Marszalec, Tej Motiwala, Shannon Tai, Sean Yamakawa, Satya Yerrabolu, Francisco J Alvarado, Hector H Valdivia, Jonathan M Cordeiro, Yohannes Shiferaw, J Andrew Wasserstrom
Aims: Abnormal intracellular Ca 2+ cycling contributes to triggered activity and arrhythmias in the heart. We investigated the properties and underlying mechanisms for systolic triggered Ca 2+ waves in left atria from normal and failing dog hearts. Methods and Results: Intracellular Ca 2+ cycling was studied using confocal microscopy during rapid pacing of atrial myocytes (36 °C) isolated from normal and failing canine hearts (ventricular tachypacing model). In normal atrial myocytes (NAMs), Ca 2+ waves developed during rapid pacing at rates ≥ 3...
August 29, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28964164/sensitivity-of-reentrant-driver-localization-to-electrophysiological-parameter-variability-in-image-based-computational-models-of-persistent-atrial-fibrillation-sustained-by-a-fibrotic-substrate
#4
Dongdong Deng, Michael J Murphy, Joe B Hakim, William H Franceschi, Sohail Zahid, Farhad Pashakhanloo, Natalia A Trayanova, Patrick M Boyle
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, causing morbidity and mortality in millions worldwide. The atria of patients with persistent AF (PsAF) are characterized by the presence of extensive and distributed atrial fibrosis, which facilitates the formation of persistent reentrant drivers (RDs, i.e., spiral waves), which promote fibrillatory activity. Targeted catheter ablation of RD-harboring tissues has shown promise as a clinical treatment for PsAF, but the outcomes remain sub-par...
September 2017: Chaos
https://www.readbyqxmd.com/read/28962160/effect-of-eicosapentaenoic-acid-and-pitavastatin-on-electrophysiology-and-anticoagulant-gene-expression-in-mice-with-rapid-atrial-pacing
#5
Maoqing Tong, Jiewen Wang, Yunxin Ji, Xiaomin Chen, Jieru Wang, Shuangshuang Wang, Liemin Ruan, Hanbin Cui, Ying Zhou, Qingyu Zhang, Eiichi Watanabe
Atrial remodeling is considered to be any persistent change in atrial structure or function, and is responsible for the development and perpetuation of atrial fibrillation (AF). Oxidative stress and intracellular pH regulation may also be linked to AF; however it remains unclear whether eicosapentaenoic acid (EPA) or statins have beneficial therapeutic effects. The aim of the present study was to investigate the effects of EPA and pitavastatin on the electrophysiology of and gene expressions in mice with rapidly-paced atria...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28946993/beat-to-beat-p-wave-morphology-as-a-predictor-of-paroxysmal-atrial-fibrillation
#6
Dimitrios Filos, Ioanna Chouvarda, Dimitris Tachmatzidis, Vassilios Vassilikos, Nicos Maglaveras
BACKGROUND AND OBJECTIVES: Atrial Fibrillation (AF) is the most common cardiac arrhythmia. The initiation and the perpetuation of AF is linked with phenomena of atrial remodeling, referring to the modification of the electrical and structural characteristics of the atrium. P-wave morphology analysis can reveal information regarding the propagation of the electrical activity on the atrial substrate. The purpose of this study is to investigate patterns on the P-wave morphology that may occur in patients with Paroxysmal AF (PAF) and which can be the basis for distinguishing between PAF and healthy subjects...
November 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28943552/aortic-aneurysm-associated-disseminated-intravascular-coagulation-dic-that-responded-well-to-a-switch-from-warfarin-to-rivaroxaban
#7
Yasuko Kadohira, Shinya Yamada, Erika Matsuura, Tomoe Hayashi, Eriko Morishita, Shinji Nakao, Hidesaku Asakura
We describe a case in which uncontrolled chronic disseminated intravascular coagulation (DIC) caused by an aortic aneurysm that was exacerbated by chemotherapy for lung cancer, showed dramatic improvement when warfarin, which was being administered for atrial fibrillation, was replaced by rivaroxaban, a direct oral anticoagulant (DOAC). The present case is interesting because a DOAC was effective in treating DIC due to an aortic aneurysm, whereas warfarin, another oral anticoagulant, was ineffective. In controlling DIC, it is important to inhibit activated coagulation factors such as thrombin and activated factor X, rather than the coagulation factors, which act as substrates...
September 25, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28939092/spanish-catheter-ablation-registry-16th-official-report-of-the-spanish-society-of-cardiology-working-group-on-electrophysiology-and-arrhythmias-2016
#8
Adolfo Fontenla, Javier García-Fernández, José Luis Ibáñez
INTRODUCTION AND OBJECTIVES: This report describes the findings of the 2016 Spanish Catheter Ablation Registry. METHODS: Data were retrospectively collected by means of a standardized questionnaire completed by each of the participating centers. RESULTS: Data were collected from 83 centers. A total of 13 482 ablation procedures were performed (the highest historically reported in this registry), with a mean of 162.4 ± 116 and a median of 136 procedures per center...
September 19, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28925871/biomarkers-associated-with-atrial-fibrosis-and-remodeling
#9
Polychronis Dilaveris, Christos-Konstantinos Antoniou, Panagiota Manolakou, Eleftherios Tsiamis, Konstantinos Gatzoulis, Dimitris Tousoulis
Atrial fibrillation is the most common rhythm disturbance encountered in clinical practice. Although often considered as solely arrhythmic in nature, current evidence has established that atrial myopathy constitutes both the substrate and the outcome of atrial fibrillation, thus initiating a vicious, self-perpetuating cycle. This myopathy is triggered by stress-induced (including pressure/volume overload, inflammation, oxidative stress) responses of atrial tissue, which in the long term become maladaptive, and combines elements of both structural, especially fibrosis, and electrical remodeling, with contemporary approaches yielding potentially useful biomarkers of these processes...
September 18, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28919580/concomitant-obesity-and-metabolic-syndrome-add-to-the-atrial-arrhythmogenic-phenotype-in-male-hypertensive-rats
#10
Mathias Hohl, Dennis H Lau, Andreas Müller, Adrian D Elliott, Benedikt Linz, Rajiv Mahajan, Jeroen M L Hendriks, Michael Böhm, Ulrich Schotten, Prashanthan Sanders, Dominik Linz
BACKGROUND: Besides hypertension, obesity and the metabolic syndrome have recently emerged as risk factors for atrial fibrillation. This study sought to delineate the development of an arrhythmogenic substrate for atrial fibrillation in hypertension with and without concomitant obesity and metabolic syndrome. METHODS AND RESULTS: We compared obese spontaneously hypertensive rats (SHR-obese, n=7-10) with lean hypertensive controls (SHR-lean, n=7-10) and normotensive rats (n=7-10)...
September 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28919427/age-dependent-atrial-arrhythmic-phenotype-secondary-to-mitochondrial-dysfunction-in-pgc-1%C3%AE-deficient-murine-hearts
#11
Haseeb Valli, Shiraz Ahmad, Karan R Chadda, Ali B A K Al-Hadithi, Andrew A Grace, Kamalan Jeevaratnam, Christopher L-H Huang
INTRODUCTION: Ageing and several age-related chronic conditions including obesity, insulin resistance and hypertension are associated with mitochondrial dysfunction and represent independent risk factors for atrial fibrillation (AF). MATERIALS AND METHODS: Atrial arrhythmogenesis was investigated in Langendorff-perfused young (3-4 month) and aged (>12 month), wild type (WT) and peroxisome proliferator activated receptor-γ coactivator-1β deficient (Pgc-1β(-/-)) murine hearts modeling age-dependent chronic mitochondrial dysfunction during regular pacing and programmed electrical stimulation (PES)...
October 2017: Mechanisms of Ageing and Development
https://www.readbyqxmd.com/read/28919314/24-hour-alberta-stroke-program-early-ct-score-assessment-in-post-stroke-spasticity-development-in-patients-with-a-first-documented-anterior-circulation-ischemic-stroke
#12
Ondrej Volny, Maria Justanova, Petra Cimflova, Linda Kasickova, Ivana Svobodova, Jan Muzik, Martin Bares
BACKGROUND: Neuroanatomic substrates responsible for development of post-stroke spasticity are still poorly understood. The study is focused on identification of brain regions within the territory of the middle cerebral artery associated with spasticity development. METHODS: This is a single-center prospective cohort study of first documented anterior circulation ischemic strokes with a neurologic deficit lasting >7 days (from March 2014 to September 2016, all patients are involved in a registry)...
September 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28912205/epicardial-breakthrough-waves-during-sinus-rhythm-depiction-of-the-arrhythmogenic-substrate
#13
Elisabeth M J P Mouws, Eva A H Lanters, Christophe P Teuwen, Lisette J M E van der Does, Charles Kik, Paul Knops, Jos A Bekkers, Ad J J C Bogers, Natasja M S de Groot
BACKGROUND: Epicardial breakthrough waves (EBW) during atrial fibrillation are important elements of the arrhythmogenic substrate and result from endo-epicardial asynchrony, which also occurs to some degree during sinus rhythm (SR). We examined the incidence and characteristics of EBW during SR and its possible value in the detection of the arrhythmogenic substrate associated with atrial fibrillation. METHODS AND RESULTS: Intraoperative epicardial mapping (interelectrode distances 2 mm) of the right atrium, Bachmann's bundle, the left atrioventricular groove, and the pulmonary vein area was performed during SR in 381 patients (289 male, 67±10 years) with ischemic or valvular heart disease...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28904308/aging-modulates-the-substrate-and-triggers-remodeling-in-atrial-fibrillation
#14
Yung-Kuo Lin, Yi-Ann Chen, Ting-I Lee, Yao-Chang Chen, Shih-Ann Chen, Yi-Jen Chen
Aging plays a critical role in the genesis of atrial fibrillation (AF) and also increases the risks of cardiac dysfunction and stroke in AF patients. AF is caused by increased AF triggering from abnormalities of the thoracic vein and/or modulated substrate (atrial) with enhancement of AF maintenance. Clinical and laboratory evidence indicates that aging is significant in the creation of atrial electrical and structural remodeling that leads to increased susceptibility to AF occurrence. Aging is commonly associated with cardiovascular comorbidities, oxidative stress, calcium dysregulation, atrial myopathy with apoptosis, and fibrosis, which all contribute to the genesis of AF...
September 14, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28887365/omnipolar-mapping-a-method-to-improve-the-fidelity-of-voltage-mapping-to-guide-substrate-based-atrial-fibrillation-ablation
#15
EDITORIAL
Jackson J Liang, Cory M Tschabrunn, Francis E Marchlinski
No abstract text is available yet for this article.
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28887362/resolving-bipolar-electrogram-voltages-during-atrial-fibrillation-using-omnipolar-mapping
#16
Shouvik K Haldar, Karl Magtibay, Andreu Porta-Sanchez, Stéphane Massé, Nicholas Mitsakakis, Patrick F H Lai, Mohammed Ali Azam, John Asta, Marjan Kusha, Paul Dorian, Andrew C T Ha, Vijay Chauhan, D Curtis Deno, Kumaraswamy Nanthakumar
BACKGROUND: Low-voltage-guided substrate modification is an emerging strategy in atrial fibrillation (AF) ablation. A major limitation to contemporary bipolar electrogram (EGM) analysis in AF is the resultant lower peak-to-peak voltage (Vpp) from variations in wavefront direction relative to electrode orientation and from fractionation and collision events. We aim to compare bipole Vpp with novel omnipolar peak-to-peak voltages (Vmax) in sinus rhythm (SR) and AF. METHODS AND RESULTS: A high-density fixed multielectrode plaque was placed on the epicardial surface of the left atrium in dogs...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28862969/three-dimensional-integrated-functional-structural-and-computational-mapping-to-define-the-structural-fingerprints-of-heart-specific-atrial-fibrillation-drivers-in-human-heart-ex-vivo
#17
Jichao Zhao, Brian J Hansen, Yufeng Wang, Thomas A Csepe, Lidiya V Sul, Alan Tang, Yiming Yuan, Ning Li, Anna Bratasz, Kimerly A Powell, Ahmet Kilic, Peter J Mohler, Paul M L Janssen, Raul Weiss, Orlando P Simonetti, John D Hummel, Vadim V Fedorov
BACKGROUND: Structural remodeling of human atria plays a key role in sustaining atrial fibrillation (AF), but insufficient quantitative analysis of human atrial structure impedes the treatment of AF. We aimed to develop a novel 3-dimensional (3D) structural and computational simulation analysis tool that could reveal the structural contributors to human reentrant AF drivers. METHODS AND RESULTS: High-resolution panoramic epicardial optical mapping of the coronary-perfused explanted intact human atria (63-year-old woman, chronic hypertension, heart weight 608 g) was conducted during sinus rhythm and sustained AF maintained by spatially stable reentrant AF drivers in the left and right atrium...
August 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28856145/ablation-of-long-standing-persistent-atrial-fibrillation
#18
REVIEW
Behram P Mody, Anoshia Raza, Jason Jacobson, Sei Iwai, Daniel Frenkel, Rhadames Rojas, Wilbert S Aronow
Atrial fibrillation (AF) is the most commonly encountered arrhythmia in the clinical setting affecting nearly 6 million people in United States and the numbers are only expected to rise as the population continues to age. Broadly it is classified into paroxysmal, persistent and longstanding persistent AF. Electrical, structural and autonomic remodeling are some of the diverse pathophysiological mechanisms that contribute to the persistence of AF. Our review article emphasizes particularly on long standing persistent atrial fibrillation (LSPAF) aspect of the disease which poses a great challenge for electrophysiologists...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28821328/atrioventricular-block-masked-by-posteroseptal-bypass-tract-located-in-coronary-sinus-aneurysm
#19
Michael C Y Nam, Matthew Wilkins, Alana Harris, Naresh Dayananda
Atrial fibrillation with concurrent ventricular preexcitation identifies a high-risk arrhythmic substrate and usually results in catheter ablation of the atrioventricular bypass tract. Electrocardiography can only approximate the anatomical location of an accessory pathway. Here we report a case where a bypass tract was localised to a coronary sinus aneurysm and antegrade atrioventricular conduction masked underlying atrioventricular nodal block.
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28813234/cardiac-mr-strain-a-noninvasive-biomarker-of-fibrofatty-remodeling-of-the-left-atrial-myocardium
#20
Adrian T Huber, Jérôme Lamy, Amer Rahhal, Morgane Evin, Fabrice Atassi, Carine Defrance, Guillaume Lebreton, Karine Clément, Myriam Berthet, Richard Isnard, Pascal Leprince, Philippe Cluzel, Stéphane N Hatem, Nadjia Kachenoura, Alban Redheuil
Purpose To determine whether left atrial (LA) strain quantification with cardiac magnetic resonance (MR) imaging feature tracking is associated with the severity of LA fibrofatty myocardial remodeling at histologic analysis. Materials and Methods This prospective case-control study was approved by the institutional review board. LA strain was evaluated with cardiac MR feature tracking between January 2014 and March 2015 in 13 consecutive patients (mean age, 61 years ± 19; nine male) with mitral regurgitation in the 24 hours before mitral valve surgery and 13 age- and sex-matched healthy control subjects...
August 16, 2017: Radiology
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