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Arrhythmia ablation

Hielko Miljoen, Joris Ector, Christophe Garweg, Johan Saenen, Wim Huybrechts, Andrea Sarkozy, Rik Willems, Hein Heidbuchel
AIMS: Prolonged participation in exercise results in structural and electrical cardiac remodelling. The development of an athlete's heart is recognized as a risk factor for atrial arrhythmias. This study aims to evaluate the impact of athlete heart remodelling on the presentation of atrioventricular nodal re-entrant tachycardia (AVNRT). METHODS AND RESULTS: A retrospective analysis of an ablation database selecting all patients with an electrophysiologically confirmed diagnosis of AVNRT...
February 14, 2019: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Fanhao Ye, Wenbing Jiang, Yi Wang, Wei Lin, Hao Chen, Binglin Pan
RATIONALE: Amiodarone, a broad-spectrum antiarrhythmic drug, is widely used for the clinical treatment of tachyarrhythmias because of its safety and efficacy. PATIENT CONCERNS: A 30-year-old woman presented with known paroxysmal atrial tachycardia and severe preeclampsia. Two days before admission, she had given birth to twins. She described her symptoms as a sudden palpitation at 10:20 accompanied by chest tightness and shortness of breath. DIAGNOSIS: Cardiac arrhythmia and acute left heart failure...
February 2019: Medicine (Baltimore)
Megan Schmidt, Mark A Benscoter, Paul Anthony Iaizzo
OBJECTIVE: The ability to monitor catheter contact force (CF) plays a major role in assessing radiofrequency ablation, impacting lesion size and arrhythmia recurrence, and dictating ablation duration and/or overall patient safety. Our study sought to determine the relative CFs required to elicit reproducible monophasic action potential (MAP) recordings. METHODS: The study utilized 4 swine in which: 1) median sternotomies were performed and MAPs were collected from 7 ventricular locations on the epicardial surface of each heart, and 2) a subset of endocardial signals was recorded from a reanimated heart...
February 14, 2019: IEEE Transactions on Bio-medical Engineering
Andreu Porta-Sánchez, Andrew C T Ha, Xuesong Wang, Fahad Almehmadi, Peter C Austin, Hadas D Fischer, Atif Al-Qubbany, Diego Chemello, Vijay Chauhan, Eugene Downar, Douglas S Lee, Kumaraswamy Nanthakumar
BACKGROUND: Catheter ablation of ventricular tachycardia (VT) can reduce the burden of ventricular arrhythmia (VA) but its effect on health care utilization and costs after such therapy is poorly known. We sought to compare the rates of cardiovascular (CV)-related hospitalizations, survival, and health care costs in patients with recurrent VT treated either with VT ablation or with medical therapy. METHODS: One-hundred implantable cardioverter-defibrillator patients with structural heart disease who underwent VT ablation were included...
February 2019: Canadian Journal of Cardiology
Wenjuan Liu, Gang Wang, Cuicui Zhang, Wenwen Ding, Wanwen Cheng, Yizhi Luo, Chaoliang Wei, Jie Liu
BACKGROUND: KChIP2 (K+ channel interacting protein) is the auxiliary subunit of the fast transient outward K+ current (Ito,f ) in heart, and insufficient KChIP2 expression induces Ito,f downregulation and arrhythmogenesis in cardiac hypertrophy. Studies have shown muscle-specific mitsugumin 53 (MG53) has promiscuity of function in the context of normal and diseased heart. This study investigates the possible roles of cardiac MG53 in regulation of KChIP2 expression and Ito,f, and the arrhythmogenic potential in hypertrophy...
February 14, 2019: Circulation
Konstantinos N Aronis, Rheeda Ali, Natalia A Trayanova
Atrial fibrillation is the most common arrhythmia in humans and is associated with high morbidity, mortality and health-related expenses. Computational approaches have been increasingly utilized in atrial electrophysiology. In this review we summarize the recent advancements in atrial fibrillation modeling at the organ scale. Multi-scale atrial models now incorporate high level detail of atrial anatomy, tissue ultrastructure and fibrosis distribution. We provide the state-of-the art methodologies in developing personalized atrial fibrillation models with realistic geometry and tissue properties...
January 31, 2019: International Journal of Cardiology
Charles M Pearman, James Redfern, Emmanuel A Williams, Richard L Snowdon, Paul Modi, Mark C S Hall, Simon Modi, Johan E P Waktare, Saagar Mahida, Derick M Todd, Neeraj Mediratta, Dhiraj Gupta
Aims: Video-assisted thoracoscopic surgery (VATS) ablation has been advocated as a treatment option for non-paroxysmal atrial fibrillation (AF) in recent guidelines. Real-life data on its safety and efficacy during a centre's early experience are sparse. Methods and results: Thirty patients (28 persistent/longstanding persistent AF) underwent standalone VATS ablation for AF by an experienced thoracoscopic surgeon, with the first 20 cases proctored by external surgeons...
February 6, 2019: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Mindy Vroomen, Jules R Olsthoorn, Bart Maesen, Vladimir L'Espoir, Mark La Meir, Marco Das, Jos G Maessen, Harry J G M Crijns, Sander Verheule, Laurent Pison
OBJECTIVES: Epicardial adipose tissue volume (EAT-V) has been linked to atrial fibrillation (AF) recurrences after catheter ablation. We retrospectively studied the association between atrial EAT-V and outcome after hybrid AF ablation (epicardial surgical and endocardial catheter ablation). METHODS: On preoperative cardiac computed tomography angiography scans, the left atrium and right atrium were manually delineated using the open source ImageJ. With custom-made automated software, the number of pixels in the regions of interest on each slice was calculated...
February 11, 2019: European Journal of Cardio-thoracic Surgery
Victor Garcia-Bustos, Rafael Sebastian, Maite Izquierdo, César Rios-Navarro, Vicente Bodí, Francisco Javier Chorro, Amparo Ruiz-Sauri
Purkinje cells (PCs) are more resistant to ischemia than myocardial cells, and are suspected to participate in ventricular arrhythmias following myocardial infarction (MI). Histological studies afford little evidence on the behavior and adaptation of PCs in the different stages of MI, especially in the chronic stage, and no quantitative data have been reported to date beyond subjective qualitative depictions. The present study uses a porcine model to present the first quantitative analysis of the distal cardiac conduction system and the first reported change in the spatial distribution of PCs in three representative stages of MI: an acute model both with and without reperfusion; a subacute model one week after reperfusion; and a chronic model one month after reperfusion...
2019: PloS One
Amita Singh, Keigo Kawaji, Neha Goyal, Noreen T Nazir, Andrew Beaser, Virginia O'Keefe-Baker, Karima Addetia, Roderick Tung, Peng Hu, Victor Mor-Avi, Amit R Patel
Implantable cardioverter defibrillators (ICDs) have been a relative contraindication to cardiovascular magnetic resonance imaging. Although cardiovascular magnetic resonance provides valuable information regarding scar in patients with ventricular arrhythmias or cardiomyopathy, ICDs in these patients frequently cause artifacts hindering accurate interpretation of both cine and late gadolinium enhancement (LGE) images. We sought to quantify the frequency and severity of artifact on LGE images and assess whether a modified wideband LGE protocol could improve the diagnostic yield of scar identification in agreement with invasive electroanatomic mapping (EAM)...
January 31, 2019: American Journal of Cardiology
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
Andreas A Giannopoulos, Aju P Pazhenkottil
No abstract text is available yet for this article.
February 4, 2019: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Manuel Castellá, Dipak Kotecha, Charlotte van Laar, Lisette Wintgens, Yakir Castillo, Johannes Kelder, David Aragon, María Nuñez, Elena Sandoval, Aina Casellas, Lluís Mont, Wim Jan van Boven, Lucas V A Boersma, Bart P van Putte
Aims: Our objectives were to compare effectiveness and long-term prognosis after epicardial thoracoscopic atrial fibrillation (AF) ablation vs. endocardial catheter ablation, in patients with prior failed catheter ablation or high risk of failure. Methods and results: Patients were randomized to thoracoscopic or catheter ablation, consisting of pulmonary vein isolation with optional additional lines (2007-2010). Patients were reassessed in 2016/2017, and those without documented AF recurrence underwent 7-day ambulatory electrocardiography...
January 30, 2019: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Victor Waldmann, Mikael Laredo, Sylvia Abadir, Blandine Mondésert, Paul Khairy
A convergence of epidemiological and clinical features has prompted a precipitous rise in the prevalence of atrial fibrillation (AF) in the expanding population of adults with congenital heart disease. Herein, we synthesize the current state of knowledge on epidemiological features, associated morbidities, and pathophysiological insights regarding AF in adults with congenital heart disease. Management issues are examined including surgical, pharmacological, and catheter-based therapies. Throughout, knowledge gaps and avenues for future research are identified...
January 26, 2019: International Journal of Cardiology
Roger A Winkle, William Fleming, R Hardwin Mead, Gregory Engel, Melissa H Kong, Jonathan Salcedo, Rob A Patrawala, Luis Castro, Vincent Gaudiani
PURPOSE: To compare findings in patients undergoing atrial fibrillation(AF) and/or atrial flutter(AFl) ablation after failed cut and sew (CS) vs. non-cut and sew (NCS) surgical maze. METHODS: We compared 10 patients with prior CS to 25 with prior NCS maze undergoing catheter ablation after failed maze. RESULTS: Patient demographics: Age 68.3 ± 8.7 CS vs. 68.2 ± 9.2 NCS(P = 0.977), male 70% CS vs. 72% NCS(P = 1.000), LA size 5...
January 31, 2019: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Bianca Olivia Cojan-Minzat, Paul-Mihai Boarescu, Gabriel Cismaru, Radu Rosu, Carmen Cionca, Dana Pop, Dumitru Zdrenghea, Lucia Agoston-Coldea
RTIONALE: Left ventricular noncompaction (LVNC) is a genetic cardiomyopathy characterized by the presence of a thin compacted layer of myocardium and a spongy subendocardial layer with trabeculations and recesses. LVNC associated Wolf-Parkinson-White syndrome is very rare. PATIENT CONCERNS: A 32-year-old male presented with short episodes of palpitations and a syncope 6 months before his hospitalization. DIAGNOSIS: His ECG revealed the presence of a right posterior accessory pathway...
February 2019: Medicine (Baltimore)
G V Ryabykina, Z O Shokhzodaeva, O V Sapelnikov, M I Makeev, E Sh Kozhemyakina, E V Shchedrina, V E Volkov, R S Akchurin
AIM: To evaluate the diagnostic utility of long-term remote monitoring of ECG compared with 24 hour Holter monitoring for the detection of cardiac arrhythmias and conduction disturbance in patients with atrial fibrillation (AF) after catheter radiofrequency ablation (RFA; isolation) of the pulmonary veins. MATERIALS AND METHODS: The study included 62 patients aged 58.5±11.1 years, with paroxysmal or persistent AF, after catheter RFA (pulmonary veins isolation)...
December 30, 2018: Terapevticheskiĭ Arkhiv
Jesús E Dos Reis, Paul Soullié, Alberto Battaglia, Gregory Petitmangin, Philip Hoyland, Laurent Josseaume, Christian de Chillou, Freddy Odille, Jacques Felblinger
Electrocardiogram (ECG) acquisition is required during catheter treatment of cardiac arrhythmias. The remote magnetic navigation technology allows the catheter to be moved automatically inside the heart chambers using large external magnets. Each change of position of the catheter requires fast motion of the magnets, therefore magnetic fluxes are created through the ECG cables, causing large distortions of the ECG signals. In this study a novel ECG sensor is proposed for reducing such distortions. The sensor uses short cables to connect the electrodes to the amplification and optical conversion circuit, using a technology similar to that used for magnetic resonance imaging...
January 30, 2019: Annals of Biomedical Engineering
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
Claudia A J van der Heijden, Mindy Vroomen, Justin G Luermans, Rein Vos, Harry J G M Crijns, Sandro Gelsomino, Mark La Meir, Laurent Pison, Bart Maesen
As the mechanisms underlying persistent atrial fibrillation (AF) are still incompletely understood, a 'gold standard' strategy for ablation is lacking. The results of catheter ablation, independent of the ablation strategy applied, are disappointing. Hybrid ablation, combining a thoracoscopic epicardial and transvenous endocardial approach, has shown more favourable outcomes. To date, studies comparing both techniques are lacking. Therefore, we conducted a systematic review and meta-analysis of hybrid versus catheter ablation in patients with persistent or longstanding persistent AF...
January 28, 2019: European Journal of Cardio-thoracic Surgery
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