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https://www.readbyqxmd.com/read/28441850/-clinical-application-of-one-stage-operation-of-epicardial-permanent-pacemaker-implantation-and-cardiac-surgery
#1
C L Ren, S L Jiang, C S Xiao, R Wang, C Q Gao
Objective: To summarize the results and clinical application experience of one-stage operation of epicardial permanent pacemaker implantation and cardiac surgery. Methods: From November 2014 to July 2016, 15 patients (9 males and 6 females) with ages ranging from 50 to 73 (63.5±6.2) years requiring cardiac surgery with bradycardia underwent one-stage operation of epicardial permanent pacemaker implantation and cardiac surgery. All operations were performed under general anesthesia with chest median incision approach...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28441232/atriobronchial-fistula-complicated-by-septic-cerebral-air-emboli-after-pulmonary-vein-ablation
#2
David Velghe, Thomas Apers, Stefanie Devriendt, Ivo Deblier, Bart Hendriks, Rogier Nieuwendijk, Peter Rogiers
OBJECTIVE: To describe a case of an infected atriobronchial fistula as a late complication after pulmonary vein ablation, leading to septic air emboli and requiring urgent cardiac surgery. DATA SOURCES: Clinical observation. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. PubMed was searched for relevant literature. DATA SYNTHESIS: Given its high success and low complication rate, pulmonary vein isolation is expected to be increasingly performed worldwide...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28439618/-radiofrequency-current-or-cryoballoon-for-ablation-of-atrial-fibrillation-hot-or-cold
#3
B Reissmann, K-H Kuck, A Metzner
Atrial fibrillation (AF) is the most common form of cardiac arrhythmia. The aim of therapy in symptomatic patients is the establishment of a stable sinus rhythm (SR). Catheter ablation with isolation of the pulmonary veins is the essential component of all forms of ablation therapy and provides the most effective treatment option. The most frequently used technologies for pulmonary vein isolation (PVI) are radiofrequency current (RFC)-based and cryoballoon (CB)-guided ablation. Irrespective of the simplification of PVI, CB ablation is characterized by a short learning curve and short procedural times and demonstrated non-inferiority with respect to safety and efficacy when directly compared to RFC ablation for the treatment of patients with paroxysmal AF; however, the clinical outcome in patients with persistent AF is often insufficient when performing pulmonary vein isolation (PVI) alone for stabilization of SR...
April 24, 2017: Herz
https://www.readbyqxmd.com/read/28434446/revisiting-pulmonary-vein-isolation-alone-for-persistent-atrial-fibrillation-a-systematic-review-and-meta-analysis
#4
Aleksandr Voskoboinik, Jeremy T Moskovitch, Nadav Harel, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Early studies demonstrated relatively low success rates for pulmonary vein isolation (PVI) alone in patients with persistent atrial fibrillation (PeAF). However, the advent of new technologies and the observation that additional substrate ablation does not improve outcomes have created a new focus on PVI alone for treatment of PeAF. OBJECTIVE: The purpose of this study was to systematically review the recent medical literature to determine current medium-term outcomes when a PVI-only approach is used for PeAF...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28433554/catheter-ablation-to-prevent-sudden-cardiac-death
#5
Josef Kautzner, Petr Peichl
Since ventricular arrhythmias are a common cause of sudden cardiac death (SCD), treatment for ventricular arrhythmias is the target area of interest in research field. Among different means to prevent ventricular arrhythmias, catheter ablation (CA) has emerged as an effective therapeutic method. CA can decrease the likelihood of SCD in the following arrhythmia categories: 1) idiopathic ventricular fibrillation (VF) that is usually triggered by premature ventricular beats originating in the Purkinje fibres; 2) VF in subjects with structural heart disease, especially after myocardial infarction, that is triggered by premature ventricular beats from surviving Purkinje fibres; 3) Brugada syndrome in which modification of an epicardial substrate in the right ventricular outflow tract might be the most promising strategy; 4) recurrent monomorphic ventricular tachycardias in the setting of structural heart disease; 5) ventricular preexcitation in which CA appears to be a method of choice in high risk patients, regardless of the presence or absence of symptoms...
April 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28431249/macrophages-facilitate-electrical-conduction-in-the-heart
#6
Maarten Hulsmans, Sebastian Clauss, Ling Xiao, Aaron D Aguirre, Kevin R King, Alan Hanley, William J Hucker, Eike M Wülfers, Gunnar Seemann, Gabriel Courties, Yoshiko Iwamoto, Yuan Sun, Andrej J Savol, Hendrik B Sager, Kory J Lavine, Gregory A Fishbein, Diane E Capen, Nicolas Da Silva, Lucile Miquerol, Hiroko Wakimoto, Christine E Seidman, Jonathan G Seidman, Ruslan I Sadreyev, Kamila Naxerova, Richard N Mitchell, Dennis Brown, Peter Libby, Ralph Weissleder, Filip K Swirski, Peter Kohl, Claudio Vinegoni, David J Milan, Patrick T Ellinor, Matthias Nahrendorf
Organ-specific functions of tissue-resident macrophages in the steady-state heart are unknown. Here, we show that cardiac macrophages facilitate electrical conduction through the distal atrioventricular node, where conducting cells densely intersperse with elongated macrophages expressing connexin 43. When coupled to spontaneously beating cardiomyocytes via connexin-43-containing gap junctions, cardiac macrophages have a negative resting membrane potential and depolarize in synchrony with cardiomyocytes. Conversely, macrophages render the resting membrane potential of cardiomyocytes more positive and, according to computational modeling, accelerate their repolarization...
April 20, 2017: Cell
https://www.readbyqxmd.com/read/28431070/emerging-molecular-therapies-targeting-myocardial-infarction-related-arrhythmias
#7
Helen E Driessen, Toon A B van Veen, Gerard J J Boink
Cardiac disease is the leading cause of death in the developed world. Ventricular arrhythmias associated with myocardial ischaemia and/or infarction are a major contributor to cardiovascular mortality, and require improved prevention and treatment. Drugs, devices, and radiofrequency catheter ablation have made important inroads, but have significant limitations ranging from incomplete success to undesired toxicities and major side effects. These limitations derive from the nature of the intervention. Drugs are frequently ineffective, target the entire heart, and often do not deal with the specific arrhythmia trigger or substrate...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28431066/limited-left-atrial-surgical-ablation-effectively-treats-atrial-fibrillation-but-decreases-left-atrial-function
#8
Marieke G Compier, Laurens F Tops, Jerry Braun, Katja Zeppenfeld, Robert J Klautz, Martin J Schalij, Serge A Trines
Aims: Limited left atrial (LA) surgical ablation with bipolar radiofrequency is considered to be an effective procedure for treatment of atrial fibrillation (AF). We studied whether limited LA surgical ablation concomitant to cardiac surgery is able to maintain LA function. Methods and Results: Thirty-six consecutive patients (age 66 ± 12 years, 53% male, 78% persistent AF) scheduled for valve surgery and/or coronary revascularization and concomitant LA surgical ablation were included...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28431061/high-prevalence-of-arrhythmic-and-myocardial-complications-in-patients-with-cardiac-glycogenosis-due-to-prkag2-mutations
#9
Julien Thevenon, Gabriel Laurent, Flavie Ader, Pascal Laforêt, Didier Klug, Anju Duva Pentiah, Laurent Gouya, Claude Alain Maurage, Salem Kacet, Jean-Christophe Eicher, Juliette Albuisson, Michel Desnos, Eric Bieth, Denis Duboc, Laurent Martin, Patricia Réant, François Picard, Claire Bonithon-Kopp, Elodie Gautier, Christine Binquet, Christel Thauvin-Robinet, Laurence Faivre, Patrice Bouvagnet, Philippe Charron, Pascale Richard
Aims: Mutations in PRKAG2, the gene encoding for the γ2 subunit of 5'-AMP-activated protein kinase (AMPK), are responsible for an autosomal dominant glycogenosis with a cardiac presentation, associating hypertrophic cardiomyopathy (HCM), ventricular pre-excitation (VPE), and progressive heart block. The aim of this study was to perform a retrospective time-to-event study of the clinical manifestations associated with PRKAG2 mutations. Methods and Results: A cohort of 34 patients from 9 families was recruited between 2001 and 2010...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28431051/safety-long-term-outcomes-and-predictors-of-recurrence-after-first-line-combined-endoepicardial-ventricular-tachycardia-substrate-ablation-in-arrhythmogenic-cardiomyopathy-impact-of-arrhythmic-substrate-distribution-pattern-a-prospective-multicentre-study
#10
Antonio Berruezo, Juan Acosta, Juan Fernández-Armenta, Alonso Pedrote, Alberto Barrera, Eduardo Arana-Rueda, Andrés Ignacio Bodegas, Ignasi Anguera, Luis Tercedor, Diego Penela, David Andreu, Rosario Jesus Perea, Susana Prat-González, Lluis Mont
Background: First-line endoepicardial ventricular tachycardia (VT) ablation has been proposed for patients with arrhythmogenic cardiomyopathy (AC). This study reports procedural safety, outcomes, and predictors of recurrence. Methods and Results: Forty-one consecutive patients [12 with left ventricle (LV) involvement, 7 left-dominant] underwent first-line endoepicardial VT substrate ablation. Standard bipolar and unipolar thresholds were used to define low-voltage areas (LVA)...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28431009/artefact-free-late-gadolinium-enhancement-imaging-in-patients-with-implanted-cardiac-devices-using-a-modified-broadband-sequence-current-strategies-and-results-from-a-real-world-patient-cohort
#11
Sebastian Hilbert, Alexander Weber, Kay Nehrke, Peter Börnert, Bernhard Schnackenburg, Sabrina Oebel, Ricardo Spampinato, Cathleen Rogge, Sergio Richter, Gerhard Hindricks, Ingo Paetsch, Cosima Jahnke
Aims: Cardiac magnetic resonance (CMR) imaging in patients with implanted cardiac devices is often limited by device-related imaging artefacts. Limitations can potentially be overcome by employing a broadband late gadolinium enhancement (LGE)-CMR imaging technique. The purpose of this study was to investigate the relationship between implanted cardiac devices and the optimal frequency offset on broadband LGE-CMR imaging to increase the artefact-free visibility of myocardial segments. Methods and results: A phantom study was performed to characterize magnetic field disturbances related to 15 different cardiac devices...
April 18, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28429512/tailored-approach-for-management-of-ventricular-tachycardia-in-cardiac-sarcoidosis
#12
Sachin Yalagudri, Ngwe Zin Thu, Soumen Devidutta, Daljeet Saggu, Ajit Thachil, Sridevi Chennapragada, Calambur Narasimhan
INTRODUCTION: Treating ventricular tachycardia (VT) in patients with cardiac sarcoidosis (CS) is challenging as patients present in different phase of the disease (inflammatory, scar or sometimes both). A customized approach to treatment is required for better outcomes. We describe our experience in the management of VT in CS based on the phase of the disease. METHODS AND RESULTS: Patients were considered to have myocardial inflammation if there was an increased myocardial (18) Fluoro Deoxy Glucose (FDG) uptake in PET-CT scan of the chest (n=14)...
April 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28424545/efficacy-and-safety-of-alcohol-septal-ablation-in-patients-over-65-years-old-with-obstructive-hypertrophic-cardiomyopathy
#13
Laila Cheddadi, Olivier Lairez, Thibault Lhermusier, Francisco Campelo-Parada, Michel Galinier, Didier Carrié, Nicolas Boudou
BACKGROUND: The performance of alcohol septal ablation (ASA) in elderly symptomatic patients with drug-refractory obstructive hypertrophic cardiomyopathy is still to be confirmed. The objective of this study was to compare the efficacy and safety of ASA in patients under and over 65 years old. METHODS AND RESULTS: Fifty-one consecutive patients with obstructive hypertrophic cardio-myopathy who underwent ASA were retrospectively included and reviewed for in-hospital major acute cardiac events and follow-up...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28424445/management-of-tachyarrhythmia-during-pregnancy
#14
Emily Ann Enderlin, Khaldia Taufiq Khaled, Luke Oke, Mohammed Madmani, Hakan Paydak
Maternal tachyarrhythmia is a common complication during pregnancy due to hormonal changes that enhance pre-existing arrhythmias or induce new arrhythmias in the presence of congenital heart defects in pregnant females. Presence of tachyarrhythmia during pregnancy poses risk to the mother and fetus, calling for proper treatment with medications. Use of antiarrhythmic drugs in cases of maternal tachyarrhythmia must give due consideration of potential teratogenic side effects. Utilization of antiarrhythmic drugs during pregnancy has been well studied; some result in minimal fetal harm or none at all...
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28424090/targeted-endomyocardial-biopsy-guided-by-real-time-cardiovascular-magnetic-resonance
#15
Christina Unterberg-Buchwald, Christian Oliver Ritter, Verena Reupke, Robin Niklas Wilke, Christine Stadelmann, Michael Steinmetz, Andreas Schuster, Gerd Hasenfuß, Joachim Lotz, Martin Uecker
BACKGROUND: Endomyocardial biopsies (EMB) are an important diagnostic tool for myocarditis and other infiltrative cardiac diseases. Routinely, biopsies are obtained under fluoroscopic guidance with a substantial radiation burden. Despite procedural success, there is a large sampling error caused by missing the affected myocardium. Therefore, multiple (>6) biopsies are taken in the clinical setting. In cardiovascular magnetic resonance (CMR), late gadolinium enhancement (LGE) depicts areas of affected myocardium in myocarditis or in other infiltrative cardiomyopathies...
April 19, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28422337/in-vivo-validation-of-a-novel-algorithm-for-automatic-premature-ventricular-contractions-recognition
#16
Jedrzej Kosiuk, Guilherme Portugal, Sebastian Hilbert, Silke John, Mario Oliveira, Gerhard Hindricks, Andreas Bollmann
INTRODUCTION: Template-matching algorithms are routinely used in the catheter ablation of patients with premature ventricular contractions (PVCs). However, systematic analysis of the accuracy and spatial resolution of such systems is lacking. Therefore, the aim of this evaluation was to perform a systematic in-vivo validation of performance of a novel automated template-matching algorithm. METHODS AND RESULTS: In a porcine model, paced beats simulating PVCs from different origins were investigated...
April 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28421621/presence-of-ganglia-and-telocytes-in-proximity-to-myocardial-sleeve-tissue-in-the-porcine-pulmonary-veins-wall
#17
T Vandecasteele, P Cornillie, K Vandevelde, A Logothetidou, L Couck, G van Loon, W Van den Broeck
Ganglia and telocytes were identified inside the porcine pulmonary veins wall near myocardial sleeve tissue at the atriopulmonary junction. These structures are reported to play a role in the initiation of pulses from outside the heart, which potentially can cause cardiac conduction disorders such as atrial fibrillation. In-depth knowledge on the fine structure of the pulmonary vein wall is a pre-requisite to better understand the underlying pathophysiology of atrial fibrillation and the origin and conduction of ectopic pulses...
April 19, 2017: Anatomia, Histologia, Embryologia
https://www.readbyqxmd.com/read/28421394/waveform-integrity-in-atrial-fibrillation-the-forgotten-issue-of-cardiac-electrophysiology
#18
Miguel Martínez-Iniesta, Juan Ródenas, Raúl Alcaraz, José J Rieta
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice with an increasing prevalence of about 15% in the elderly. Despite other alternatives, catheter ablation is currently considered as the first-line therapy for the treatment of AF. This strategy relies on cardiac electrophysiology systems, which use intracardiac electrograms (EGM) as the basis to determine the cardiac structures contributing to sustain the arrhythmia. However, the noise-free acquisition of these recordings is impossible and they are often contaminated by different perturbations...
April 18, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28419224/avoiding-oesophageal-injury-during-cardiac-ablation-insights-gained-from-mediastinal-anatomy
#19
Devan Marar, Venkatraman Muthusamy, Subramaniam C Krishnan
Aims: This study investigates the lateral displacement of the oesophagus at the level of the left atrium (LA) in 11 cadavers. Methods and results: The study was conducted using human cadavers. An endotracheal stylet probe was inserted into the eosphagus. The pericardium overlying the posterior LA was fixed in place. The lateral movement of the oesophagus from side to side was recorded. The initial study method had the stylet probe extending to the gastroesophageal (GE) junction...
April 16, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28410102/scanned-three-dimensional-intracardiac-arfi-and-swei-for-imaging-radiofrequency-ablation-lesions
#20
Peter Hollender, Lily Kuo, Virginia Chen, Stephanie Eyerly, Patrick Wolf, Gregg Trahey
Radiofrequency ablation (RFA) is used to locally disrupt electrical propagation in myocardium and treat arrhythmias, and direct visualization of ablation lesions by acoustic radiation force methods may benefit RFA procedures. This work compares four imaging modalities, B-Mode, ARFI, STL-SWEI and MTL-SWEI, in their ability to resolve RFA lesions in four ex vivo experiments. Ablation lesions are shown to be marked by at least a local halving of ARFI displacements and doubling of shear wave speeds. In a controlled ablation of ex vivo porcine and canine cardiac tissue, STL-SWEI and ARFI are shown to have similar CNR, better than MTL-SWEI and B-Mode...
April 7, 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
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