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Journal of Cardiovascular Electrophysiology

Zak Loring, Brett D Atwater, Xiaojuan Xia, Jimmy Axelsson, Igor Klem, Robin Nijveldt, Erik B Schelbert, Jean-Philippe Couderc, David G Strauss, Martin Ugander, Björn Wieslander
INTRODUCTION: We evaluated the association between a novel ECG marker of late, rightward electrocardiographic forces (termed the lead one ratio [LOR]) and left ventricular ejection fraction (LVEF), myocardial scar, and clinical outcomes in patients with left bundle branch block (LBBB). METHODS AND RESULTS: LOR was calculated in LBBB patients from a derivation cohort (n=240) and receiver operator characteristic curves identified optimal threshold values for predicting myocardial scar and LVEF <35%...
February 10, 2019: Journal of Cardiovascular Electrophysiology
Shinsuke Miyazaki, Kanae Hasegawa, Kenichi Kaseno, Hiroshi Tada
A 56-year-old man without any structural heart disease underwent a second ablation procedure for a recurrent atrial tachycardia (AT). He had undergone cryoballoon pulmonary vein isolation, left atrial roof, and mitral isthmus linear ablation of atrial fibrillation 2 years prior. This article is protected by copyright. All rights reserved.
February 8, 2019: Journal of Cardiovascular Electrophysiology
Takumi Yamada, Krittapoom Akrawinthawong, Paul B Tabereaux
A 71-year-old man with an idiopathic ventricular tachycardia (VT) refractory to amiodarone and beta blocker and syncope, underwent radiofrequency catheter ablation (RFCA) of the VT at another hospital. RFCA within the middle cardiac vein completely suppressed the VT, but the VT recurred on an isoproterenol infusion. This article is protected by copyright. All rights reserved.
February 8, 2019: Journal of Cardiovascular Electrophysiology
Raja Selvara, Pramod Pawar, Devender Sharma, Anandaraja Subramanian
A young boy with mild preexcitation had recurrent tachycardia. We present the electrograms during atrial programmed stimulation and discuss the findings. This article is protected by copyright. All rights reserved.
February 6, 2019: Journal of Cardiovascular Electrophysiology
Rod Passman
Shared decision making surrounding anticoagulation is among the most challenging aspects of atrial fibrillation (AF) management. Few scenarios, however, are more complicated than when these discussions take place following implementation of a rhythm control strategy where symptoms have abated and repetitive and prolonged rhythm monitoring consistently demonstrates sinus rhythm. This article is protected by copyright. All rights reserved.
February 6, 2019: Journal of Cardiovascular Electrophysiology
Prasanth Ganesan, Anthony Salmin, Elizabeth M Cherry, David T Huang, Arkady M Pertsov, Behnaz Ghoraani
INTRODUCTION: Targeting repeating-pattern atrial fibrillation (AF) sources (reentry or focal drivers) can help in patient-specific ablation therapy for AF; however, the development of reliable and accurate tools for locating such sources remains a major challenge. We describe an iterative catheter navigation (ICAN) algorithm to locate AF drivers using a conventional circular Lasso catheter. METHODS AND RESULTS: At each step, the algorithm analyzes 10 bipolar electrograms recoded at a given catheter location and the history of previous catheter movements to determine if the source is inside the catheter loop...
February 6, 2019: Journal of Cardiovascular Electrophysiology
Guillaume Laborie, Zeynab Jebberi, Céline Marra, Agustín Bortone
A 67-year old man was referred to our institution for catheter ablation of symptomatic left atrial tachycardia (LAT) occurring 12 months after pulmonary vein isolation (PVI) in the setting of paroxysmal atrial fibrillation (AF). The procedure was carried out under general anesthesia. A 6F decapolar catheter was inserted at first within the coronary sinus (CS) through the right femoral vein. This article is protected by copyright. All rights reserved.
February 6, 2019: Journal of Cardiovascular Electrophysiology
Jakub Sroubek, Markus Rottmann, Michael Barkagan, Eran Leshem, Ayelet Shapira-Daniels, Erez Brem, Cesar Fuentes-Ortega, Jamie Malinaric, Shubhayu Basu, Meir Bar-Tal, Elad Anter
INTRODUCTION: Multielectrode mapping catheters improve the ability to map within heterogeneous scar. A novel OctarayTM catheter with 8 spines and 48 electrodes may further improve the speed and resolution of atrial mapping. The aims of this study were to (1) establish the Octaray's baseline mapping performance and electrogram characteristics in healthy atria and to (2) determine its utility for identifying gaps in a swine model of atrial ablation lines. METHODS AND RESULTS: The right atria of 8 healthy swine were mapped with Octaray and Pentaray catheters (Biosense-Webster) before and after creation of ablation lines with intentional gaps...
February 5, 2019: Journal of Cardiovascular Electrophysiology
Varunsiri Atti, Mohit K Turagam, Jalaj Garg, Dhanunjaya Lakkireddy
BACKGROUND: Currently, there is limited data regarding the impact of adjunctive renal sympathetic denervation (RSDN) with pulmonary vein isolation (PVI) in hypertensive patients with atrial fibrillation (AF). METHODS: A comprehensive literature search for studies comparing RSDN+PVI vs. PVI - alone for AF and history of hypertension until January 1st, 2019 was performed. The results were expressed as risk ratio (RR) for the categorical variables and mean difference (MD) for the continuous variables with 95% confidence intervals (CIs)...
February 5, 2019: Journal of Cardiovascular Electrophysiology
Rupa Bala, Mathew D Hutchinson
No abstract text is available yet for this article.
February 4, 2019: Journal of Cardiovascular Electrophysiology
Iwanari Kawamura, Seiji Fukamizu, Marina Arai, Dai Inagaki, Tomonori Miyabe, Satoshi Miyazawa, Takeshi Kitamura, Rintaro Hojo, Mitsuhiro Nishizaki, Harumizu Sakurada, Masayasu Hiraoka
INTRODUCTION: While characteristic waveforms of 12-lead electrocardiograms have been reported to predict the epicardial origin of ventricular tachycardia (VT), it has not been fully examined whether ventricular intracardiac electrograms (VEGMs) recorded from the implantable cardioverter defibrillator (ICD) via telemetry can determine the origin of VT or not. The aim of this study was to investigate the VEGM characteristics of VT originating from the epicardia. METHOD AND RESULTS: Intracardiac VEGMs of the induced VTs, with detected sites of origin during the VT study, were recorded in 15 (23 VTs) of the 46 patients...
February 1, 2019: Journal of Cardiovascular Electrophysiology
Erica S Zado, Monica Pammer, Tara Parham, David Lin, David S Frankel, Sanjay Dixit, Francis E Marchlinski
INTRODUCTION: After atrial fibrillation (AF) ablation, oral anticoagulation (OAC) is recommended if stroke risk as assessed by CHA2 DS2 -VASc score is high. However, patients without AF are often reluctant to take daily OAC. We describe outcome using as needed non-vitamin K antagonist (N)OACs guided by pulse monitoring to detect AF following successful ablation. METHODS AND RESULTS: We identified 99 patients (84% male, age 64±8 years), CHA2 DS2 -VASc score ≥1 in men and ≥2 in women (median 2, range 1-6), capable of pulse assessment twice daily and no AF on extended monitoring after AF ablation...
February 1, 2019: Journal of Cardiovascular Electrophysiology
Chin-Yu Lin, Fa-Po Chung, Ling Kuo, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Ting-Yung Chang, Shinya Yamada, Abigail Louise D Te, Ting-Chun Huang, Shih-Ann Chen
BACKGROUND: The reason for recurrence of ventricular arrhythmia (VA) after catheter ablation in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is not clear. METHODS: In this study, 91 ARVC patients (age, 47±13 years; 47 men) who underwent catheter ablation for drug-refractory ventricular arrhythmia (VA) were enrolled. The patients were categorized into single or multiple procedures (n=28). The baseline characteristics and electrophysiological features of the patients were examined to elucidate the reason of the VA recurrences...
January 30, 2019: Journal of Cardiovascular Electrophysiology
Takumi Yamada
A 67-year-old woman with a history of persistent atrial fibrillation and status post pulmonary vein (PV) isolation and Box ablation isolating the left atrial posterior wall (LAPW), underwent electrophysiological testing of an atypical atrial flutter (AFL) This article is protected by copyright. All rights reserved.
January 30, 2019: Journal of Cardiovascular Electrophysiology
Hussam Ali, Pierpaolo Lupo, Guido De Ambroggi, Riccardo Cappato
A 29-year-old male patient was referred to our center for malfunctioning (lead failure) of his implantable cardioverter defibrillator (ICD). He was known to be affected by a familial channelopathy, and one decade ago he underwent implantation of a transvenous, single chamber, ICD for secondary prevention. On admission, his basal 12-lead ECG showed sinus rhythm with remarkable repolarization abnormalities (Figure 1A). What is the likely underlying channelopathy in this patient? This article is protected by copyright...
January 30, 2019: Journal of Cardiovascular Electrophysiology
Adolfo Fontenla, María López-Gil, Daniel Rodríguez Muñoz, David Díez de Las Heras, Fernando Arribas
A 45 year-old man with non-ischaemic cardiomyopathy and a single-chamber ICD (with a lead implanted in the right ventricular apex, RVA) for primary prevention was referred for urgent ablation due to multiple shocks (up to 40) secondary to sustained and incessant regular tachycardias despite amiodarone infusion and deep sedation. A previous cardiac magnetic resonance revealed a severely dilated left ventricle, with a left ventricular ejection fraction of 15% and absence of gadolinium late enhancement.
January 28, 2019: Journal of Cardiovascular Electrophysiology
Adaya Weissler-Snir, Waseem Hindieh, Danna A Spears, Arnon Adler, Harry Rakowski, Raymond H Chan
OBJECTIVES: To examine the relationship between late gadolinium enhancement (LGE) extent and Non-sustained ventricular tachycardia (NSVT) characteristics in patients with hypertrophic cardiomyopathy (HCM). BACKGROUND: NSVT has been shown to be independently associated with sudden death (SD) in HCM. Previous studies have found LGE on cardiac magnetic resonance (CMR) to be independently associated with NSVT. METHODS: Seventy-three patients who had 14-day Holter monitoring for either risk stratification for SD (n=62) or evaluation of atrial fibrillation (n=11) a CMR study were included...
January 24, 2019: Journal of Cardiovascular Electrophysiology
Deepak Padmanabhan, Niyada Naksuk, Ammar K Killu, Suraj Kapa, Chance Witt, Alan Sugrue, Christopher V Desimon, Malini Madhavan, J R de Groot, Barry O'Brien, Tadhg Rabbette, Kenneth Coffey, Samuel J Asirvatham
BACKGROUND: Endocardial radiofrequency ablation of epicardial ganglionic plexus (GP) for atrial fibrillation (AF) is complicated by myocardial damage. OBJECTIVES: We hypothesized that an epicardial approach with a novel nitinol catheter system capable of causing irreversible electroporation (IRE) with direct current (DC) could selectively and permanently destroy GP without collateral myocardial injury. METHODS: Acute studies and medium-term terminal studies (mean survival, 1137 days) were performed with seven dogs...
January 24, 2019: Journal of Cardiovascular Electrophysiology
Shaojie Chen, Marcio G Kiuchi, Yuehui Yin, Shaowen Liu, Alexandra Schratter, Willem-Jan Acou, Christian Meyer, Helmut Pürerfellner, K R Julian Chun, Boris Schmidt
INTRODUCTION: Disturbance of sympathetic and vagal nervous system participates in the pathogenesis of hypertension and atrial fibrillation (AF). Renal denervation (RDN) can modulate autonomic nervous activity and reduce blood pressure (BP) in hypertensive patients. We aimed to evaluate the effect of RDN combined with pulmonary vein isolation (PVI) in patients with AF and hypertension. METHODS AND RESULTS: Clinical trials including randomized data comparing PVI plus RDN versus PVI alone were enrolled...
January 24, 2019: Journal of Cardiovascular Electrophysiology
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