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Atrial fibrillation substrate

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https://www.readbyqxmd.com/read/29688325/anatomical-hotspots-of-fractionated-electrograms-in-the-left-and-right-atrium-do-they-exist
#1
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
https://www.readbyqxmd.com/read/29669504/atrial-fibrillation-in-autoimmune-rheumatic-diseases-from-the-pathogenesis-to-the-treatment
#2
Giuseppe Ciconte, Manuel Conti, Martina Evangelista, Carlo Pappone
BACKGROUND: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in the general population and is associated with an increased number of adverse outcomes. The onset and maintenance of this arrhythmia requires a trigger event and the presence of a predisposing substrate. Atrial fibrosis, a major characteristic of AF-related structural remodeling, represents a process closely related to inflammation as demonstrated by emerging evidence. Aim of this article is to review the evidence linking AF to systemic autoimmune diseases...
April 17, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29663449/mild-hypothermia-33%C3%A2-c-increases-the-inducibility-of-atrial-fibrillation-an-in-vivo-large-animal-model-study
#3
Martin Manninger, Alessio Alogna, David Zweiker, Birgit Zirngast, Stefan Reiter, Viktoria Herbst, Heinrich Maechler, Burkert M Pieske, Frank R Heinzel, Helmut Brussee, Heiner Post, Daniel Scherr
OBJECTIVE: Application of therapeutic mild hypothermia in patients after resuscitation, often accompanied by myocardial infarction, cardiogenic shock and systemic inflammation may impact on cardiac rhythm. We therefore tested susceptibility to atrial arrhythmias during hyperthermia (HT, 40.5°C), normothermia (NT, 38.0°C) and mild hypothermia (MH, 33.0°C). METHODS: Nine healthy, anesthetized closed-chest landrace pigs were instrumented with a quadripolar stimulation catheter in the high right atrium and a decapolar catheter in the coronary sinus...
April 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29659148/hydrogen-sulphide-increases-pulmonary-veins-and-atrial-arrhythmogenesis-with-activation-of-protein-kinase-c
#4
Chao-Shun Chan, Yung-Kuo Lin, Yu-Hsun Kao, Yao-Chang Chen, Shih-Ann Chen, Yi-Jen Chen
Hydrogen sulphide (H2 S), one of the most common toxic air pollutants, is an important aetiology of atrial fibrillation (AF). Pulmonary veins (PVs) and left atrium (LA) are the most important AF trigger and substrate. We investigated whether H2 S may modulate the arrhythmogenesis of PVs and atria. Conventional microelectrodes and whole-cell patch clamp were performed in rabbit PV, sinoatrial node (SAN) or atrial cardiomyocytes before and after the perfusion of NaHS with or without chelerythrine (a selective PKC inhibitor), rottlerin (a specific PKC δ inhibitor) or KB-R7943 (a NCX inhibitor)...
April 16, 2018: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/29623658/atrial-fibrillation-in-patients-with-heart-failure-current-state-and-future-directions
#5
REVIEW
Tuoyo O Mene-Afejuku, Persio D López, Adedoyin Akinlonu, Carissa Dumancas, Ferdinand Visco, Savi Mushiyev, Gerald Pekler
Heart failure affects nearly 26 million people worldwide. Patients with heart failure are frequently affected with atrial fibrillation, and the interrelation between these pathologies is complex. Atrial fibrillation shares the same risk factors as heart failure. Moreover, it is associated with a higher-risk baseline clinical status and higher mortality rates in patients with heart failure. The mechanisms by which atrial fibrillation occurs in a failing heart are incompletely understood, but animal studies suggest they differ from those that occur in a healthy heart...
April 5, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29609877/impact-of-catheter-ablation-of-atrial-fibrillation-on-long-term-clinical-outcomes-in-patients-with-heart-failure
#6
Sadamitsu Ichijo, Shinsuke Miyazaki, Shigeki Kusa, Hiroaki Nakamura, Hitoshi Hachiya, Takatsugu Kajiyama, Yoshito Iesaka
BACKGROUND: Heart failure (HF) promotes atrial fibrillation (AF) and AF worsens HF. This study aimed to investigate the long-term clinical outcomes after AF ablation in patients with HF. METHODS AND RESULTS: A total of 106 consecutive HF patients, including 51 (48.1%) with a reduced left ventricular ejection fraction (LVEF) (HFrEF) and 55 (51.9%) with a preserved LVEF (HFpEF), underwent AF ablation. All patients underwent successful pulmonary vein antrum isolation, and substrate modification was added in 38 (35...
March 30, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29606886/influence-of-abcb1-and-cyp3a5-gene-polymorphisms-on-pharmacokinetics-of-apixaban-in-patients-with-atrial-fibrillation-and-acute-stroke
#7
Alexander Valerevich Kryukov, Dmitry Alekseevich Sychev, Denis Anatolevich Andreev, Kristina Anatolievna Ryzhikova, Elena Anatolievna Grishina, Anastasia Vladislavovna Ryabova, Mark Alekseevich Loskutnikov, Valeriy Valerevich Smirnov, Olga Dmitrievna Konova, Irina Andreevna Matsneva, Pavel Olegovich Bochkov
Introduction: Difficulties in non-vitamin K anticoagulant (NOAC) administration in acute stroke can be associated with changes in pharmacokinetic parameters of NOAC such as biotransformation, distribution, and excretion. Therefore, obtaining data on pharmacokinetics of NOAC and factors that affect it may help develop algorithms for personalized use of this drug class in patients with acute cardioembolic stroke. Patients and methods: Pharmacokinetics of apixaban in patients with acute stroke was studied earlier by Kryukov et al...
2018: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/29600791/arrhythmogenic-atrial-substrate-in-persistent-atrial-fibrillation-relationship-to-heart-failure
#8
EDITORIAL
Thomas Arentz, Björn Müller-Edenborn, Amir Jadidi
No abstract text is available yet for this article.
January 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29600790/biatrial-electrical-and-structural-atrial-changes-in-heart-failure-electroanatomic-mapping-in-persistent-atrial-fibrillation-in-humans
#9
Sandeep Prabhu, Aleksandr Voskoboinik, Alex J A McLellan, Kah Y Peck, Bhupesh Pathik, Chrishan J Nalliah, Geoff R Wong, Sonia M Azzopardi, Geoffrey Lee, Justin Mariani, Liang-Han Ling, Andrew J Taylor, Jonathan M Kalman, Peter M Kistler
OBJECTIVES: This study sought to characterize the biatrial substrate in heart failure (HF) and persistent atrial fibrillation (PeAF). BACKGROUND: Atrial fibrillation (AF) and HF frequently coexist; however, the contribution of HF to the biatrial substrate in PeAF is unclear. METHODS: Consecutive patients with PeAF and normal left ventricular (NLV) systolic function (left ventricular ejection fraction [LVEF] >55%) or idiopathic cardiomyopathy (LVEF ≤45%) undergoing AF ablation were enrolled...
January 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29600787/measure-what-can-be-measured-multimodal-examination-of-the-atrial-fibrillation-substrate
#10
EDITORIAL
Mark O'Neill, Steven E Williams
No abstract text is available yet for this article.
January 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29590384/atrial-remodelling-and-function-implications-for-atrial-fibrillation-surgery
#11
Stefano Benussi, Gijs E de Maat
The exact mechanism of atrial fibrillation (AF) is still incompletely understood. A number of alterations that impact focal electrical discharge, the atrial substrate and modulating factors contribute to its pathogenesis. Atrial remodelling (resulting in atrial cardiomyopathy) sets the stage for AF development. Once present, AF results in the loss of synchronized atrial contraction, which affects ventricular filling and atrial reservoir and conduit functions. Passive atrial function is particularly important in patients with left ventricular diastolic dysfunction...
April 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29566135/european-heart-rhythm-association-ehra-position-paper-on-arrhythmia-management-and-device-therapies-in-endocrine-disorders-endorsed-by-asia-pacific-heart-rhythm-society-aphrs-and-latin-american-heart-rhythm-society-lahrs
#12
Bulent Gorenek, Giuseppe Boriani, Gheorge-Andrei Dan, Laurent Fauchier, Guilherme Fenelon, He Huang, Gulmira Kudaiberdieva, Gregory Y H Lip, Rajiv Mahajan, Tatjana Potpara, Juan David Ramirez, Marc A Vos, Francisco Marin
Endocrine disorders are associated with various tachyarrhythmias, including atrial fibrillation (AF), ventricular tachycardia (VT), ventricular fibrillation (VF), and bradyarrhythmias. Along with underlying arrhythmia substrate, electrolyte disturbances, glucose, and hormone levels, accompanying endocrine disorders contribute to development of arrhythmia. Arrhythmias may be life-threatening, facilitate cardiogenic shock development and increase mortality. The knowledge on the incidence of tachy- and bradyarrhythmias, clinical and prognostic significance as well as their management is limited; it is represented in observational studies and mostly in case reports on management of challenging cases...
March 16, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29563374/early-recurrence-after-longstanding-persistent-atrial-fibrillation-ablation
#13
Kei Takayama, Hitoshi Hachiya, Yoshito Iesaka, Kenzo Hirao, Mitsuaki Isobe
Early recurrence (ER) of atrial fibrillation (AF) is common after ablation of longstanding persistent AF. However, optimal timing for repeat ablation has yet to be established.Two-hundred-four patients (mean age 62 ± 9 years) with longstanding persistent AF underwent catheter ablation including pulmonary vein (PV) isolation and substrate modification. ER defined as AF recurrence within 60 days, occurred in 115 patients (56.4%) 9 ± 1 days after the procedure. Analysis showed optimal blanking period to be 15 days...
March 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29541763/associations-of-obstructive-sleep-apnea-with-atrial-fibrillation-and-continuous-positive-airway-pressure-treatment-a-review
#14
Dominik Linz, R Doug McEvoy, Martin R Cowie, Virend K Somers, Stanley Nattel, Patrick Lévy, Jonathan M Kalman, Prashanthan Sanders
Importance: Obstructive sleep apnea (OSA) is the most common clinically significant breathing abnormality during sleep. It is highly prevalent among patients with atrial fibrillation (AF), and it promotes arrhythmogenesis and impairs treatment efficacy. Observations: The prevalence of OSA ranges from 3% to 49% in population-based studies and from 21% to 74% in patients with AF. Diagnosis and treatment of OSA in patients with AF requires a close interdisciplinary collaboration between electrophysiologists, cardiologists, and sleep specialists...
March 14, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29541165/east-meets-west-the-influence-of-racial-ethnic-and-cultural-risk-factors-on-cardiac-surgical-risk-model-performance
#15
Sarah Soo-Hoo, Samantha Nemeth, Onur Baser, Michael Argenziano, Paul Kurlansky
Objective: To explore the impact of racial and ethnic diversity on the performance of cardiac surgical risk models, the Chinese SinoSCORE was compared with the Society of Thoracic Surgeons (STS) risk model in a diverse American population. Methods: The SinoSCORE risk model was applied to 13 969 consecutive coronary artery bypass surgery patients from twelve American institutions. SinoSCORE risk factors were entered into a logistic regression to create a 'derived' SinoSCORE whose performance was compared with that of the STS risk model...
2018: Heart Asia
https://www.readbyqxmd.com/read/29537666/a-novel-ablation-approach-in-atrial-fibrillation-patients-undergoing-fibrotic-based-substrate-modification-targeting-the-bachmann-s-bundle
#16
Fabian Moser, Andreas Rieger, Christian Pönisch, Hans Kottkamp
INTRODUCTION: Box isolation of fibrotic areas (BIFA) is a promising ablation approach for atrial fibrillation (AF) patients. However, complete isolation of fibrotic anteroseptal left atrial area, where Bachmann's bundle is blending into the left atrial myocardium, is very specific and complex. METHODS AND RESULTS: In 34 AF patients with anteroseptal fibrosis, circumferential BIFA was performed in addition to pulmonary vein isolation. In 8/34 patients, complete isolation of the fibrotic area was achieved with BIFA alone...
March 14, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29535268/atrial-cardiopathy-and-the-risk-of-ischemic-stroke-in-the-chs-cardiovascular-health-study
#17
Hooman Kamel, Traci M Bartz, Mitchell S V Elkind, Peter M Okin, Evan L Thacker, Kristen K Patton, Phyllis K Stein, Christopher R deFilippi, Rebecca F Gottesman, Susan R Heckbert, Richard A Kronmal, Elsayed Z Soliman, W T Longstreth
BACKGROUND AND PURPOSE: Emerging evidence suggests that an underlying atrial cardiopathy may result in thromboembolism before atrial fibrillation (AF) develops. We examined the association between various markers of atrial cardiopathy and the risk of ischemic stroke. METHODS: The CHS (Cardiovascular Health Study) prospectively enrolled community-dwelling adults ≥65 years of age. For this study, we excluded participants diagnosed with stroke or AF before baseline...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29535140/elevated-circulating-fibrocytes-is-a-marker-of-left-atrial-fibrosis-and-recurrence-of-persistent-atrial-fibrillation
#18
Yang Liu, Xiao-Hui Niu, Xiaomeng Yin, Yue-Jian Liu, Chao Han, Jie Yang, Xin Huang, Xiaohong Yu, Lianjun Gao, Yan-Zong Yang, Yun-Long Xia, Hui-Hua Li
BACKGROUND: In atrial fibrillation (AF), a more extensively fibrotic left atrium (LA) provides a substrate for arrhythmias and increases risk of relapse following ablation. Fibrocytes are bone marrow-derived circulating mesenchymal progenitors that have been identified in the atrium of patients with AF who have valvular diseases. The present study investigates the associations between circulating fibrocytes and LA fibrosis or the prevalence of recurrence after ablation in patients with persistent AF...
March 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29534678/cryoballoon-ablation-for-paroxysmal-atrial-fibrillation-in-a-case-of-persistent-left-superior-vena-cava
#19
Shiwei Huang, Binglin Pan, He Zou, Wei Lin
BACKGROUND: Atrial fibrillation (AF) usually originates from pulmonary veins (PVs) but can also be caused by pulmonary veins outside, such as the coronary sinus (CS), the superior vena cava (SVC), and the ligament of Marshall. CASE PRESENTATION: A 69-year-old male with a history of palpitations for 10 years was referred to our institute because of its recurrence for half a day. A dynamic electrocardiogram revealed sinus rhythm (SR) and paroxysmal AF. Echocardiography demonstrated normal cardiac structure, and physical examination results were unremarkable...
March 13, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29523465/low-rates-of-major-complications-for-radiofrequency-ablation-of-atrial-fibrillation-maintained-over-14-years-a-single-centre-experience-of-2750-consecutive-cases
#20
Aleksandr Voskoboinik, Paul B Sparks, Joseph B Morton, Geoffrey Lee, Stephen A Joseph, Joshua J Hawson, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Despite technological advances, studies continue to report high complication rates for atrial fibrillation (AF) ablation. We sought to review complication rates for AF ablation at a high-volume centre over a 14-year period and identify predictors of complications. METHODS: We reviewed prospectively collected data from 2750 consecutive AF ablation procedures at our institution using radiofrequency energy (RF) between January 2004 and May 2017. All cases were performed under general anaesthetic with transoesophageal echocardiography (TEE), 3D-mapping and an irrigated ablation catheter...
February 3, 2018: Heart, Lung & Circulation
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