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Journal of Atrial Fibrillation

Mehrdad Ghahramani, Mohammed Ruzieh
Physicians have been mesmerized by a beating heart and its relationship to the peripheral pulse since the ancient times. Although William Harvey in 1628 was credited as the first to describe "fibrillation of the auricles," chaotic irregularity of the pulse was acknowledged by some as early as in the antiquity. In fact, a close examination of history may reveal a description of cardiac arrhythmias long before the era of modern medicine.
August 2018: Journal of Atrial Fibrillation
James A Reiffel
That clinically-documented atrial fibrillation (AF) in association with a variety of elevated clinical/laboratory risk markers is associated with an increased risk of stroke is well known -- regardless of whether the AF is paroxysmal, persistent, or permanent. Moreover, data is accumulating to suggest that the absolute rate of stroke should be expectedly higher with a greater burden of AF and greater degree of comorbid contributors. Relatedly, stroke prevention with chronic oral anticoagulation (OAC) is recommended for AF patients with appropriate risk markers by all major medical, cardiologic, and surgical guideline-writing organizations...
August 2018: Journal of Atrial Fibrillation
Tawseef Dar, Bharath Yarlagadda, Prasad Gunasekaran, Dhanunjaya Lakkireddy, Mark A Wiley
Ventricular free wall rupture (VFWR) is a rare entity and is mostly related to post myocardial infarction (MI) complications usually involving left ventricle. In traumatic chest injuries, the right ventricle (RV) is more commonly involved due to its anatomic and structural vulnerability, as in our case. Survival, although rare, has almost always been secondary to urgent surgical repair, which is the current standard of care for such cases. However, extremely tenuous hemodynamic parameters preclude urgent surgical interventions in most of these cases...
August 2018: Journal of Atrial Fibrillation
Mohit K Turagam, Venkat Vuddanda, Donita Atkins, Rakesh Venkata, Bhavya Yarlagadda, Himabindu Korra, Jaya Pitchika, Sudharani Bommana, Dhanujaya R Lakkireddy
Background: There is limited data regarding effect of prolonged radiation exposure during electrophysiological (EP) procedures on direct DNA damage. Comet test has shown to assess DNA damage following radiation exposure. Methods: We performed a single-center prospective observational study assessing direct DNA damage using the quantitative comet assay in patients undergoing cardiac resynchronization (CRT) and atrial fibrillation (AF) catheter ablation procedures...
August 2018: Journal of Atrial Fibrillation
Muhammad Balouch, Dong Juang, Bhradeev Sivasambu, Rizma J Bajwa, Tarek Zghaib, Jonathan Chrispin, Ronald D Berger, Hiroshi Ashikaga, Hugh Calkins, Joseph E Marine, David D Spragg
Background: Acute pulmonary vein (PV) reconnection predicts atrial fibrillation (AF) recurrence after ablation. Contact-force (CF) sensing catheters improve lesion delivery. We assessed the incidence, timing, location, and lesion characteristics of acute reconnection after PV isolation with CF sensing catheters. Methods: Patients undergoing radiofrequency ablation for AF from October 2016 to February 2017 were studied. Assessment for acute reconnection at 20 and 40 minute intervals was performed in each isolated PV...
August 2018: Journal of Atrial Fibrillation
Vincenzo Russo, Anna Rago, Vincenzo Tavoletta, Valter Bianchi, Cristina Carella, Giuseppe Ammirati, Aniello Viggiano, Stefano De Vivo, Antonio Rapacciuolo, Gerardo Nigro, Antonio D'Onofrio
Background: Remote Monitoring (RM) has been introduced for several years and nowadays most pacemakers are equipped with such a technology. RM can provide early detection of high atrial rate episodes (AHREs) onset and enable prompt medical intervention. However, there are still little data on the clinical reactions triggered by the AHRE detected by RM of pacemaker recipients and on their possible benefit on patients' outcome. Methods/Design: The RAPID study is a multicenter, prospective, non-interventional study designed to compare the time from onset to first physician's evaluation of AHRE episode with arrhythmic burden ≥5% (72 minutes) for pacemaker recipients without atrial fibrillation history, between patients followed with RM or conventionally with annual in-hospital visits...
August 2018: Journal of Atrial Fibrillation
Takuro Nishimura, Kaoru Okishige, Yasuteru Yamauchi, Hideshi Aoyagi, Naruhiko Ito, Yusuke Tsuchiya, Takatoshi Shigeta, Rena Nakamura, Mitsutoshi Asano, Mitsumi Yamashita, Tomofumi Nakamura, Hidetoshi Suzuki, Tsukasa Shimura, Manabu Kurabayashi, Takehiko Keida, Tetsuo Sasano, Kenzo Hirao
Background: Complete occlusion of the pulmonary veins (PVs) with the cryoballoon (CB) is considered to be the crucial factor for a successful PV isolation (PVI). We investigated whether a complete occlusion was indispensable for a successful CB based PVI of every PV. Methods and Results: Atrial fibrillation patients (n=123, 97; paroxysmal) undergoing a de novo PVI were enrolled. A total of 477 PVs were analyzed. The occlusion grade (OG) was scored as follows: OG3 (complete occlusion), OG2 (incomplete occlusion with slight leakage), OG1 (poor occlusion with massive leakage)...
August 2018: Journal of Atrial Fibrillation
Enes E Gul, Usama Boles, Sohaib Haseeb, Wilma Hopman, Kevin A Michael, Chris Simpson, Hoshiar Abdollah, Adrian Baranchuk, Damian Redfearn, Benedict Glover
Background: Catheter ablation is a cornerstone treatment strategy in atrial fibrillation (AF). Left atrial (LA) size is one of the contributors in development of AF recurrences. The impact of contact-forced (CF) guided catheter ablation on the success rate of persistent AF patients with severe enlarged LA has not been investigated yet. Methods: Sixty-six patients with diagnosis of longstanding persistent AF undergoing catheter ablation were enrolled. All patients underwent a standard transthoracic echocardiography according to the guidelines...
August 2018: Journal of Atrial Fibrillation
Donald S Rubenstein, Hang Yin, Sana A Azami
Background: Rotational circuits that occur between bipolar electrodes exhibit double potentials (DPs). It had been previously surmised that rotors could not be electrically tracked directly. Purpose: Our purpose was twofold; first, to show that the use of compass mapping, one can regionally identify rotational activity; and second, to show that by combining simultaneous compass map recordings, standard narrow-adjacent bipolar, and unipolar recordings, that specific signature recording patterns emerge that allow one to identify the accurate time, location, and path of a rotational mechanism...
August 2018: Journal of Atrial Fibrillation
Brent Klinkhammer, Mevan Wijetunga, Yassar Almanaseer
We present a particularly rare case and the first ever report of a ventricular self-extraction in a 98-year old female. Our patient had a past medical history significant for severe Alzheimer's dementia, paroxysmal atrial fibrillation, and sick sinus syndrome who was admitted in clinically stable condition following the unwitnessed self-extraction the ventricular lead of her dual chamber pacemaker. This case highlights the potential risks and other clinical challenges of pacemaker and ICD placement in elderly patients and in patients with cognitive impairment...
August 2018: Journal of Atrial Fibrillation
Stephane Arques
Atrial fibrillation is the most common cardiac rhythm disorder observed in clinical practice. It carries high morbidity and mortality rates, primarily related to heart failure, stroke and death. Validation of noninvasive markers in the diagnosis of heart failure with preserved ejection fraction and risk stratification is relevant in this clinical setting. The spectral tissue Dopplerderived E/e' ratio is a simple and reproducible index, which has been validated in noninvasive assessment of left ventricular diastolic pressures, regardless of rhythm...
August 2018: Journal of Atrial Fibrillation
Younghoon Kwon, Sneha Gadi, Neil R Shah, Christopher Stout, Jacob N Blackwell, Yeilim Cho, Ryan J Koene, Nishaki Mehta, Sula Mazimba, Andrew E Darby, John D Ferguson, Kenneth C Bilchick
Background: Self-reported poor sleep quality has been suggested in patients with AF. Slow wave sleep (SWS) is considered the most restorative sleep stage and represents an important objective measure of sleep quality. The aim of this study was to compare quantity of SWS between patients with and without AF. Methods and Results: We included patients with and without a documented history of AF by reviewing clinically indicated polysomnography data from a single sleep center...
August 2018: Journal of Atrial Fibrillation
Robert A Pickett, Kimberly Owens, Penny Landis, Rahmani Sara, Hae W Lim
Introduction: Parameters used to gauge the effectiveness of a cryoballoon lesion have been described that monitor the ablation at the time of balloon-to-pulmonary vein (PV) occlusion, during the cryoablation freeze, and at the thaw phase of the cryoablation. This study examines the balloon-to-PV occlusion step and monitors the completeness of occlusion using capnography to measure end-tidal CO2 (ETCO2). Specifically, the main objective was to determine if ETCO2 measurements can be used to quantify the amount of balloon-to-PV occlusion and to determine if acute ETCO2 parameters could predict long-term freedom from atrial fibrillation (AF)...
June 2018: Journal of Atrial Fibrillation
Barry Burstein, Rodrigo Barbosa, Maude Peretz- Larochelle, Michelle Samuel, Vidal Essebag, Martin L Bernier
A 43-year-old man presented after ventricular fibrillation cardiac arrest with evidence of pre-excited atrial fibrillation. Electrophysiology study with guideline-directed testing demonstrated a low risk accessory pathway effective refractory period, which became high-risk with isoproterenol infusion. This case represents a challenging scenario wherein a high-risk pathway may be misclassified using the currently indicated methods of risk stratification.
June 2018: Journal of Atrial Fibrillation
Uma N Srivatsa, Guibo Xing, Ezra Amsterdam, Nipavan Chiamvimonvat, Nayereh Pezeshkian, Dali Fan, Richard H White
Background: Catheter ablation (ABL) for non-valvular (NV) atrial fibrillation (AF) improves rhythm control. Our aim was to compare re-hospitalization for heart failure (HF), acute coronary syndrome (ACS), or recurrent AF among patients with NVAF who underwent ABL versus controls. Methods: From the Office of Statewide Planning and Development (OSHPD) database, we identified all patients who had at least one hospitalization for AF between 2005-2013. Patients who subsequently underwent ABL were compared to controls (up to fivematched controls by age, sex and duration of AF between diagnosis and time of ABL)...
June 2018: Journal of Atrial Fibrillation
Nitish Badhwar, Ghannam Al-Dosari, Jonathan Dukes, Randall J Lee
Two patients with long-standing atrial fibrillation (AF) refractory to medical management and with prior pulmonary vein isolation underwent a new hybrid epicardial/endocardial subxyphoid approach for AF ablation and left atrial appendage (LAA) ligation. Pulmonary vein and LA posterior wall isolation, as well as LAA exclusion were achieved in both patients. There were no procedural complications. Both patients remain in sinus rhythm. Both patients are off antiarrhythmic medications.
June 2018: Journal of Atrial Fibrillation
Enes Elvin Gul, Mohammad Melhem, Sohaib Haseeb, Rifat Al Harach, Osama Al Amudi
Ventricular arrhythmias are life-threatening and can serve as a precursor to sudden death. They are a common presentation in patients with severely reduced left ventricular (LV) function. The use of an implantable cardioverter defibrillator (ICD) is seen as an acceptable therapy against malignant ventricular arrhythmias. In patients with LV heart failure, a left ventricular assist device (LVAD) can provide pulsatile flow to mimic the cardiac systolic and diastolic function. We report a case of a 38-year-old male with a LVAD who presented to the emergency department due to syncope and frequent ICD discharges...
June 2018: Journal of Atrial Fibrillation
Tetsuma Kawaji, Satoshi Shizuta, Shintaro Yamagami, Takanori Aizawa, Akihiro Komasa, Takashi Yoshizawa, Masashi Kato, Takafumi Yokomatsu, Shinji Miki, Koh Ono, Takeshi Kimura
Background: Radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF) is still challenging even in RFCA-era for AF. The aim of this study was to assess the clinical utility of nifekalant, a pure potassium channel blocker,during RFCA for persistent AF. Methods and results: We retrospectively enrolled 157 consecutive persistentAF patientsundergoing first RFCA procedure withcomplex fractionated atrial electrogram (CFAE)ablation after pulmonary veins isolation and compared outcomes between patientswith (NFK group: N=79) and without (No-NFK group: N=78)additional CFAE ablation using intravenous nifekalant (0...
June 2018: Journal of Atrial Fibrillation
Jonathan Marquardt, Kira Marquardt, Christian Scheckenbach, Wenzhong Zhang, Fabian Stimpfle, Martin Duckheim, Carole Maleck, Peter Seizer, Meinrad Gawaz, Jürgen Schreieck, Michael Gramlich
Purpose: During invasive electrophysiological studies (EPS), atrial fibrillation (AF) can be induced in patients without a history of AF. However, the prognostic value is not well evaluated in this population. Our aim was to investigate whether AF inducibility in those patients is associated with future clinical episodes of AF; whether non-inducibility is predictive of freedom from new-onset AF and finally, to examine clinical factors associated with inducibility. Methods: Medical records from patients undergoing EPS between the years 2011 and 2014 were analysed retrospectively with 62 patients matching our inclusion criteria...
June 2018: Journal of Atrial Fibrillation
Osmar Antonio Centurión, Karina Elizabeth Scavenius, Laura B García, Luis Miño, Judith Torales, Orlando Sequeira
The development of atrial fibrillation (AF) during the course of the evolution of heart failure (HF) worsens the clinical outcomes and the prognosis accounting for an enormous economic burden on healthcare. AF is considered to be an independent predictor of morbidity and mortality increasing the risk of death and hospitalization in 76% in HF patients. Despite the good clinical results obtained with conventional pharmacological agents and different new drugs, the optimal medical treatment can fail in the intention to improve symptoms and quality of life of HF patients with severe left ventricular dysfunction and AF with uncontrolled ventricular rate...
June 2018: Journal of Atrial Fibrillation
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