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    21 results match your criteria Circulation: Arrhythmia and Electrophysiology [Journal]

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    Characterization of Gadolinium Contrast Enhancement of Radiofrequency Ablation Lesions in Predicting Edema and Chronic Lesion Size.
    Circ Arrhythm Electrophysiol 2017 Nov;10(11)
    From the Department of Bioengineering (E.G., J.S., N.A., D.J.D., R.M., R.R.), Cardiovascular Medicine (E.G., J.S., N.A., R.R.), UCAIR, Department of Radiology and Imaging Sciences (E.G.K.), Department of Medicine (S.T., N.H., R.R.), and Department of Surgery (D.J.D.), University of Utah, Salt Lake City.
    Background: Magnetic resonance imaging (MRI) has been used to acutely visualize radiofrequency ablation lesions, but its accuracy in predicting chronic lesion size is unknown. The main goal of this study was to characterize different areas of enhancement in late gadolinium enhancement MRI done immediately after ablation to predict acute edema and chronic lesion size.

    Methods And Results: In a canine model (n=10), ventricular radiofrequency lesions were created using ThermoCool SmartTouch (Biosense Webster) catheter. Read More

    Mitral-Aortic Flow Reversal in Cardiac Resynchronization Therapy: Coupling With Ejection and Impact of Variations in Atrioventricular Delay.
    Circ Arrhythm Electrophysiol 2017 May;10(5):e004927
    From the Cardiology Department, University Hospital Ramón y Cajal, Madrid, Spain (D.R.-M., J.L.M.M., J.M., C.F.-G., E.F., B.B., J.M.M., R.M.F., A.H.M., J.L.Z.); and University of Alcalá, Madrid, Spain (A.H.M., J.L.Z.).
    Background: Flow entering the left ventricle is reversed toward the outflow tract through rotating reversal flow around the mitral valve. This was thought to facilitate early ejection, but had not been proved to date. We hypothesized that perfect coupling between reversal and ejection flow would occur at optimal atrioventricular delay (AVD), contributing to its hemodynamic superiority, and evaluated its applicability for AVD optimization. Read More

    Postsynaptic α1-Adrenergic Vasoconstriction Is Impaired in Young Patients With Vasovagal Syncope and Is Corrected by Nitric Oxide Synthase Inhibition.
    Circ Arrhythm Electrophysiol 2016 Aug;9(8)
    From the Departments of Pediatrics (J.M.S., S.M., C.T., M.S.M.), Physiology (J.M.S., M.S., M.S.M.), New York Medical College, Valhalla, NY; The National Heart & Lung Institute, Imperial College, London, United Kingdom (R.S.); and Department of Medicine, Baystate Medical Center, Springfield & Tufts University School of Medicine, MA (P.V.).
    Background: Syncope is a sudden transient loss of consciousness and postural tone with spontaneous recovery; the most common form is vasovagal syncope (VVS). During VVS, gravitational pooling excessively reduces central blood volume and cardiac output. In VVS, as in hemorrhage, impaired adrenergic vasoconstriction and venoconstriction result in hypotension. Read More

    Effect of Left Atrial Ablation Process and Strategy on Microemboli Formation During Irrigated Radiofrequency Catheter Ablation in an In Vivo Model.
    Circ Arrhythm Electrophysiol 2016 Jan;9(1):e003226
    From the Translational Interventional Electrophysiology Laboratory (M.T., H.I.L., K.D.P., S.B.J., D.L.P.) and Department of Radiology (K.M.W.), Mayo Clinic/St. Marys Campus, Rochester, MN.
    Background: Formation of microemboli during catheter ablation has been suggested as a cause for asymptomatic cerebral emboli. However, it is unknown which part of the process and ablation setting/strategy is most strongly related to this occurrence.

    Methods And Results: A total of 27 pigs were used. Read More

    Long-Term Suppression of Atrial Fibrillation by Botulinum Toxin Injection Into Epicardial Fat Pads in Patients Undergoing Cardiac Surgery: One-Year Follow-Up of a Randomized Pilot Study.
    Circ Arrhythm Electrophysiol 2015 Dec 20;8(6):1334-41. Epub 2015 Oct 20.
    From the State Research Institute of Circulation Pathology, Novosibirsk, Russia (E.P., A.R., A.S., S.B., D.S., A.B.-P., S.Z., V.V.L., A.K.); Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences, Tomsk, Russia (B.K., V.S.); Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City (S.S.P.); and University of Rochester School of Medicine & Dentistry and the Arrhythmia Institute, The Valley Health System, New York, NY and Ridgewood, NJ (J.S.S.).
    Background: Animal models suggest that the neurotransmitter inhibitor, botulinum toxin, when injected into the epicardial fat pads can suppress atrial fibrillation inducibility. The aim of this prospective randomized double-blind study was to compare the efficacy and safety of botulinum toxin injection into epicardial fat pads for preventing atrial tachyarrhythmias.

    Methods And Results: Patients with history of paroxysmal atrial fibrillation and indication for coronary artery bypass graft surgery were randomized to botulinum toxin (Xeomin, Merz, Germany; 50 U/1 mL at each fat pad; n=30) or placebo (0. Read More

    Transcaval puncture for access to the pulmonary venous atrium after the extracardiac total cavopulmonary connection operation.
    Circ Arrhythm Electrophysiol 2015 Aug 23;8(4):824-8. Epub 2015 Jun 23.
    From the Division of Pediatric Cardiology, UCLA Medical Center (J.P.M., B.H., K.M.S.), Ahmanson-UCLA Adult Congenital Heart Disease Center, Division of Cardiology (J.P.M., K.M.S.), and Section of Cardiovascular Imaging, Department of Radiology (D.Z.B.), University of California at Los Angeles.
    Background: Patients with surgically palliated total cavopulmonary connection are at risk for recurrent atrial arrhythmia requiring catheter ablation. Transcatheter procedures for those with extracardiac conduits (extracardiac-total cavopulmonary connection) are perhaps the most challenging because of exclusion of the venous circulation from the arrhythmia substrate. Puncture through the inferior vena cava to the pulmonary venous atrium may be an effective route for access in these patients. Read More

    Spatial and time-course thermodynamics during pulmonary vein isolation using the second-generation cryoballoon in a canine in vivo model.
    Circ Arrhythm Electrophysiol 2015 Feb 22;8(1):186-92. Epub 2014 Dec 22.
    From the Mayo Clinic/St. Marys Campus, Rochester, MN.
    Background: Thermodynamics in the left atrium-pulmonary vein (PV) junction, phrenic nerve, and esophagus during PV isolation (PVI) using the second-generation cryoballoon are not known.

    Methods And Results: Twenty dogs underwent PVI using second-generation cryoballoon. Ablations were performed for ≤2 deliveries based on PVI without a bonus freeze. Read More

    Ictal asystole and ictal syncope: insights into clinical management.
    Circ Arrhythm Electrophysiol 2015 Feb 12;8(1):159-64. Epub 2014 Nov 12.
    From the Autonomic Dysfunction Center (M.B., W.D.D., S.R.R.), Departments of Medicine (M.B., D.D., S.R.R.), Pharmacology (D.D., S.R.R.), Neurology (A.A., B.A.-K.), and Biostatistics (D.P., W.D.D.), Vanderbilt University School of Medicine, Nashville, TN; Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada (S.R.R.).
    Background: Ictal asystole is a rare, serious, and often treatable cause of syncope. There are currently limited data to guide management. Characterization of ictal syncope predictors may aid in the selection of high-risk patients for treatments such as pacemakers. Read More

    Progression of atrial fibrillation after a failed initial ablation procedure in patients with paroxysmal atrial fibrillation: a randomized comparison of drug therapy versus reablation.
    Circ Arrhythm Electrophysiol 2013 Aug 7;6(4):754-60. Epub 2013 Jun 7.
    State Research Institute of Circulation Pathology, Novosibirsk, Russia.
    Background: The aim of this prospective randomized study was to assess whether an early reablation was superior to antiarrhythmic drug (AAD) therapy in patients with previous failed pulmonary vein isolation.

    Methods And Results: Patients with paroxysmal atrial fibrillation (AF) eligible for AAD therapy or reablation after a previously failed initial pulmonary vein isolation procedure were eligible for this study and were followed up for 3 years to assess rhythm by means of an implanted cardiac monitor. After the blanking period postablation, 154 patients had symptomatic AF recurrences and were randomized to AAD (n=77) or repulmonary vein isolation (n=77). Read More

    Effects of iatrogenic myocardial injury on coronary microvascular function in patients undergoing radiofrequency catheter ablation of atrial fibrillation.
    Circ Arrhythm Electrophysiol 2013 Apr 9;6(2):318-26. Epub 2013 Mar 9.
    Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
    Background: Iatrogenic myocardial injury by radiofrequency catheter ablation (RFCA) releases proinflammatory substances from damaged myocardium, and these may contribute to endothelial dysfunction in systemic vascular structure. The aim of this study is to evaluate the effect of nonischemic myocardial damage on coronary microvascular function in patients undergoing atrial fibrillation (AF) ablation.

    Methods And Results: We included 49 patients who underwent AF ablation (paroxysmal AF=25, persistent AF=24) and 34 controls. Read More

    Microembolism and catheter ablation I: a comparison of irrigated radiofrequency and multielectrode-phased radiofrequency catheter ablation of pulmonary vein ostia.
    Circ Arrhythm Electrophysiol 2013 Feb 7;6(1):16-22. Epub 2013 Feb 7.
    Department of Cardiovascular Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI 48073, USA.
    Background: Cerebral diffusion-weighted MRI lesions have been observed after catheter ablation of atrial fibrillation. We hypothesized that conditions predisposing to microembolization could be identified using a porcine model of pulmonary vein ablation and an extracorporeal circulation loop.

    Methods And Results: Ablations of the pulmonary veins were performed in 18 swine with echo monitoring. Read More

    Percutaneous hemodynamic support with Impella 2.5 during scar-related ventricular tachycardia ablation (PERMIT 1).
    Circ Arrhythm Electrophysiol 2013 Feb 19;6(1):151-9. Epub 2012 Dec 19.
    Helmsley Electrophysiology Center, Mount Sinai School of Medicine, New York, NY 10029, USA.
    Background: Percutaneous left ventricular assist devices (pLVADs) are increasingly being used to facilitate ablation of unstable ventricular tachycardia (VT), but the safety profile and hemodynamic benefits of these devices have not been described in a systematic, prospective manner.

    Methods And Results: Twenty patients with scar VT underwent ablation with a pLVAD. Neuromonitoring using cerebral oximetry was performed to evaluate a cerebral desaturation threshold to guide the duration of activation/entrainment mapping. Read More

    Local coronary flow is associated with an unsuccessful complete block line at the mitral isthmus in patients with atrial fibrillation.
    Circ Arrhythm Electrophysiol 2011 Dec 9;4(6):838-43. Epub 2011 Oct 9.
    Cardiovascular Division, Shiroyama Hospital, Hibikino, Osaka, Japan.
    Background: The addition of a mitral isthmus (MI) block line after pulmonary vein isolation could lead to a favorable outcome of catheter ablation in patients with atrial fibrillation (AF). However, it is sometimes tough to create a complete MI block line, and the cooling effect because of the local coronary flow may prevent the creation of a successful MI block line.

    Methods And Results: This study enrolled 81 AF patients in whom the creation of an MI block line was attempted in those with persistent or pacing-inducible AF after pulmonary vein isolation. Read More

    Use of an implantable monitor to detect arrhythmia recurrences and select patients for early repeat catheter ablation for atrial fibrillation: a pilot study.
    Circ Arrhythm Electrophysiol 2011 Dec 19;4(6):823-31. Epub 2011 Sep 19.
    State Research Institute of Circulation Pathology, Novosibirsk, Russia.
    Background: Catheter ablation of atrial fibrillation (AF) has proved effective in curing highly symptomatic patients with paroxysmal AF. The aim of this prospective, randomized study was to identify the optimal treatment of patients with AF recurrences after the first ablation.

    Methods And Results: Two hundred eighty-six patients with paroxysmal AF underwent ablation (circumferential pulmonary vein isolation with linear lesions) and were monitored with an implantable cardiac monitor (Reveal XT, Medtronic). Read More

    Utility of the ventricular fibrillation waveform to predict a return of spontaneous circulation and distinguish acute from post myocardial infarction or normal Swine in ventricular fibrillation cardiac arrest.
    Circ Arrhythm Electrophysiol 2011 Jun 14;4(3):337-43. Epub 2011 Apr 14.
    Sarver Heart Center, University of Arizona College of Medicine, Tucson, 85724-5037, USA.
    Background: In cardiac arrest, the ventricular fibrillation (VF) waveform, particularly amplitude spectral area (AMSA) and slope, predicts the return of spontaneous circulation (ROSC), but it is unknown whether the predictive utility differs in an acute myocardial infarction (MI), prior MI, or normal myocardium and if the waveform can distinguish the underlying myocardial state. We hypothesized that in a swine model of VF cardiac arrest, AMSA and slope predict ROSC after a shock independent of substrate and distinguish an acute from nonacute MI state.

    Methods And Results: MI was induced by occlusion of the left anterior descending artery. Read More

    Atrial coronary arteries in areas involved in atrial fibrillation catheter ablation.
    Circ Arrhythm Electrophysiol 2010 Dec 18;3(6):600-5. Epub 2010 Sep 18.
    Heart Institute do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
    Background: The proximity to vascular structures is a limiting factor during radiofrequency ablation. However, little or no attention has been given to the atrial arterial circulation during the development of atrial fibrillation (AF) catheter ablation techniques.

    Methods And Results: We examined the atrial arterial circulation in areas involved in AF ablation in 24 heart specimens by colored resin injection and careful dissection. Read More

    Preshock cardiopulmonary resuscitation worsens outcome from circulatory phase ventricular fibrillation with acute coronary artery obstruction in swine.
    Circ Arrhythm Electrophysiol 2009 Apr 18;2(2):179-84. Epub 2009 Feb 18.
    Sarver Heart Center, Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona 85724-5037, USA.
    Background: Some clinical studies have suggested that chest compressions before defibrillation improve survival in cardiac arrest because of prolonged ventricular fibrillation (VF; ie, within the circulatory phase). Animal data have also supported this conclusion, and we have previously demonstrated that preshock chest compressions increase the VF median frequency and improve the likelihood of a return of spontaneous circulation in normal swine. We hypothesized that chest compressions before defibrillation in a swine model of acute myocardial ischemia would also increase VF median frequency and improve resuscitation outcome. Read More

    Burst stimulation improves hemodynamics during resuscitation after prolonged ventricular fibrillation.
    Circ Arrhythm Electrophysiol 2009 Feb;2(1):57-62
    University of Alabama at Birmingham, Birmingham, AL, USA.
    Background: Although return of spontaneous circulation (ROSC) is frequently achieved during resuscitation for sudden cardiac arrest, systolic blood pressure can then decrease, requiring additional myocardial support. Previous studies have shown that a series of 1-ms electrical pulses delivered through the defibrillation patches during ventricular fibrillation (VF) can stimulate the autonomic nervous system to increase myocardial function following defibrillation. We hypothesized that a similar series of electrical pulses could increase myocardial function and blood pressure during the early post-resuscitation period. Read More

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