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Ablation fo atrial fibrillation

Luigi Di Biase, J David Burkhardt, Rodney Horton, Javier Sanchez, Prasant Mohanty, Sanghamitra Mohanty, Shane Bailey, G Joseph Gallinghouse, Andrea Natale, Subramaniam C Krishnan
INTRODUCTION: We investigated the feasibility to proactively stimulate subsequent closure of a patent foramen ovale (PFO) by injuring (mechanical trauma or radiofrequency [RF] energy) the opposing surfaces of the septum primum (SP) and septum secundum (SS). METHODS: 1. Mechanical Injury: The interatrial septum of patients who underwent multiple left atrial (LA) ablations over 6 years, where a PFO was used for LA access, were examined. Patients whose PFO was absent during a later procedure were identified...
January 31, 2019: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Kentaro Yoshida, Masako Baba, Yasutoshi Shinoda, Tomohiko Harunari, Yasuaki Tsumagari, Naoya Koda, Kosuke Hayashi, Takumi Yaguchi, Hiroaki Watabe, Hideyuki Hasebe, Kazutaka Aonuma, Noriyuki Takeyasu, Akihiko Nogami, Masaki Ieda
BACKGROUND: Ablation of the pulmonary venous carina is occasionally required for pulmonary vein isolation (PVI) despite its nonessential role in ipsilateral PVI from the anatomical (endocardial) viewpoint. Although the Bachmann bundle (BB) is a common and main interatrial band, local variations in small tongues of muscular fibers were frequently found in autopsy studies. OBJECTIVE: We sought to clarify the effect of the electrical conduction pattern from the right atrium (RA) to the left atrium (LA) during sinus rhythm on the necessity of performing right-sided pulmonary venous carina ablation to achieve PVI...
November 20, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
İsmail Erden, Emine Çakcak Erden, Ebru Golcuk, Tolga Aksu, Kıvanç Yalin, Tümer Erdem Güler, Kazım Serhan Özcan, Burak Turan
BACKGROUND: The aim of our study was to demonstrate the added value of routine transesophageal echocardiography (TEE) for correctly positioning the transseptal system in the fossa ovalis (FO), thus potentially preventing complications during fluoroscopy-guided transseptal puncture (TP), and for assessing the optimal puncture site within the FO according to the expected procedure type. METHODS: Ninety-one patients undergoing pulmonary vein isolation (PVI) procedures by cryoballoon technique for drug-resistant paroxysmal or persistent atrial fibrillation (AF) were prospectively included...
June 2016: Journal of Arrhythmia
Michael E Rich, Andrew Tseng, Hae W Lim, Paul J Wang, Wilber W Su
The cryoballoon catheter ablates atrial fibrillation (AF) triggers in the left atrium (LA) and pulmonary veins (PVs) via transseptal access. The typical transseptal puncture site is the fossa ovalis (FO) - the atrial septum's thinnest section. A potentially beneficial transseptal site, for the cryoballoon, is near the inferior limbus (IL). This study examines an alternative transseptal site near the IL, which may decrease the frequency of acute iatrogenic atrial septal defect (IASD). Also, the study evaluates the acute pulmonary vein isolation (PVI) success rate utilizing the IL location...
June 15, 2015: Journal of Visualized Experiments: JoVE
Gian-Battista Chierchia, Ruben Casado-Arroyo, Carlo de Asmundis, Moises Rodriguez-Manero, Andrea Sarkozy, Giulio Conte, Juan Sieira, Moises Levinstein, Giannis Baltogiannis, Giacomo di Giovanni, Ingrid Overeinder, Salvatore Ocello, Eligio Rosas, Francesco Isola, Pedro Brugada
BACKGROUND: Cryoballoon ablation (CBA) (Arctic Front, Medtronic, USA) has proven very effective in achieving pulmonary vein isolation (PVI). Different transseptal (TS) puncture sites might influence CBA procedure. The aim of the present study was to analyze the influence of different TS puncture sites (anterior, medial and posterior) on the acute and midterm outcomes of CBA in a series of patients undergoing PVI for drug resistant AF. METHODS AND RESULTS: A total 103 patients (78 males, mean age: 57 ± 13 years) formed the study group...
October 9, 2013: International Journal of Cardiology
Ben Ren, Harriët W Mulder, Alexander Haak, Marijn van Stralen, Tamas Szili-Torok, Josien P W Pluim, Marcel L Geleijnse, Johan G Bosch
PURPOSE: The aim of this paper is to propose a transoesophageal echocardiography (TOE) image acquisition protocol which provides a systematic manner of acquiring a minimal number of overlapping 3D TOE datasets allowing the reconstruction of a wide 3D view of the left atrium (LA) with anatomical landmarks that are important for atrial fibrillation catheter ablation. METHODS: In eight cardiac surgical patients, 3D TOE datasets were acquired with a six-step protocol...
June 2013: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Geoffrey Lee, Harry Wu, Jonathan M Kalman, Don Esmore, Trevor Williams, Greg Snell, Peter M Kistler
INTRODUCTION: The cornerstone of catheter ablation for atrial fibrillation (AF) is pulmonary vein electrical isolation (PVI). Recurrent AF post-PVI is a major limitation of the procedure with PV reconnection present in most patients. Single (SLT) and double (DLT) lung transplant surgery involves a 'cut and sew' PV antral isolation analogous to a catheter-based approach providing an opportunity to assess the efficacy of durable PVI. METHODS AND RESULTS: A total of three hundred and twenty-seven consecutive lung transplant patients were compared with 201 control non-transplant thoracic surgery (THR) patients between 1998 and 2008...
November 2010: European Heart Journal
Jari M Tapanainen, Raija Jurkko, Fredrik Holmqvist, Daniela Husser, Ole Kongstad, Markku Mäkijärvi, Lauri Toivonen, Pyotr G Platonov
PURPOSE: We wanted to illustrate the right-to-left impulse propagation routes during sinus in patients with paroxysmal atrial fibrillation (PAF), as alterations in conduction patterns have been linked to the pathogenesis of PAF, and as no large patient materials have been published. METHODS: Patients underwent 3-D electroanatomical contact mapping prior to catheter ablation. The site of the earliest left atrial (LA) activation was determined. RESULTS: Three different interatrial routes were identified, either as solitary pathways (36/50 patients, 72%) or in their combinations (14/50)...
August 2009: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Hong Euy Lim, Hui-Nam Pak, Hung-Fat Tse, Chu-Pak Lau, Chun Hwang, Young-Hoon Kim
BACKGROUND: Percutaneous transcatheter ablation of atrial fibrillation (AF) in patients with interruption of inferior vena cava (IVC) has not been reported in the literature. OBJECTIVE: The purpose of this article was to demonstrate the safety and feasibility of the superior approach via the right internal jugular vein in performing catheter ablation of AF. METHODS: We performed AF ablation in 3 patients (mean age: 51.7 +/- 18.5 years, 2 paroxysmal AF and 1 persistent AF) with complete interruption of IVC...
February 2009: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Raija Jurkko, Ville Mäntynen, Jari M Tapanainen, Juha Montonen, Heikki Väänänen, Hannu Parikka, Lauri Toivonen
AIMS: Alteration in conduction from right to left atrium (LA) is linked to susceptibility to atrial fibrillation (AF). We examined whether different inter-atrial conduction pathways can be identified non-invasively by magnetocardiographic mapping (MCG). METHODS AND RESULTS: In 27 patients undergoing catheter ablation of paroxysmal AF, LA activation sequence was determined during sinus rhythm using invasive electroanatomic mapping. Before this, 99-channel magnetocardiography was recorded over anterior chest...
February 2009: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
David R Tomlinson, Nikant Sabharwal, Yaver Bashir, Timothy R Betts
BACKGROUND: Patients undergoing catheter ablation for atrial fibrillation (AF) frequently require redo procedures, but there are no data reporting interatrial septum thickness (IAS) and difficulty during repeat transseptal puncture (TSP). METHODS: Patients undergoing two separate AF ablation procedures had preprocedural fossa ovalis (FO) thickness measured using transesophageal echocardiography (TEE). "Difficult" TSP was defined by two observers as requiring excessive force, or conversion to TEE guidance...
December 2008: Pacing and Clinical Electrophysiology: PACE
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