A randomized comparison of pulmonary vein isolation with versus without concomitant renal artery denervation in patients with refractory symptomatic atrial fibrillation and resistant hypertension.

Objectives: The aim of this prospective randomized study was to assess the impact of renal artery denervation in patients with a history of refractory atrial fibrillation (AF) and drug-resistant hypertension who were referred for pulmonary vein isolation (PVI).

Background: Hypertension is the most common cardiovascular condition responsible for the development and maintenance of AF. Treating drug-resistant hypertension with renal denervation has been reported to control blood pressure, but any effect on AF is unknown.

Ganglionated plexi ablation directed by high-frequency stimulation and complex fractionated atrial electrograms for paroxysmal atrial fibrillation.

Background: The effectiveness of ganglionated plexi (GP) ablation in patients with atrial fibrillation (AF) is ambiguous. Some researchers had already suggested that additional identification of complex fractionated atrial electrograms (CFAE) around the areas with a positive reaction to high-frequency stimulation (HFS) might improve the accuracy of GP's boundaries location, then enhancing the success rate of ablation. The purpose of this study was to assess the safety and efficacy of GP ablation directed by HFS and CFAE in patients with paroxysmal AF (PAF).

Use of an implantable monitor to detect arrhythmia recurrences and select patients for early repeat catheter ablation for atrial fibrillation: a pilot study.

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).

Ablation of paroxysmal and persistent atrial fibrillation: 1-year follow-up through continuous subcutaneous monitoring.

Background: The aim of this prospective observational study was to identify responders to ablation through continuous subcutaneous monitoring for 1 year after ablation in patients with paroxysmal atrial fibrillation (PAF) or persistent AF (PersAF).

Method: Patients with symptomatic drug refractory AF were enrolled. Real-time three-dimensional (3D) left atrium maps were reconstructed by using a nonfluoroscopic navigation system (CARTO, Biosense-Webster Inc.

Percutaneous epicardial ablation of ventricular tachycardia after failure of endocardial approach in the pediatric population with arrhythmogenic right ventricular dysplasia.

Background: Despite the high efficacy of catheter ablation of ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular dysplasia (ARVD), in some patients, conventional endocardial ablation is ineffective. These failures could be explained by the presence of epicardial arrhythmogenic substrate. In these cases, a percutaneous epicardial ablation may be required.

Left atrial ablation at the anatomic areas of ganglionated plexi for paroxysmal atrial fibrillation.

Background: Modification of left atrial ganglionated plexi (GP) is a promising technique for the treatment of paroxysmal atrial fibrillation (AF) but its therapeutic efficacy is not established. This study aimed at evaluating the effectiveness of anatomic GP modification by means of an implantable arrhythmia monitoring device.

Methods: In 56 patients with paroxysmal AF, radiofrequency ablation at anatomic sites, where the main clusters of GP have been identified in the left atrium, was performed.

Ganglionated plexi ablation for longstanding persistent atrial fibrillation.

Aims: To study the potential efficacy of ganglionated plexi (GP) ablation in the setting of longstanding persistent atrial fibrillation (AF).

Methods And Results: Anatomic ablation at the areas of GP in the left atrium was performed in 89 patients with symptomatic, drug-refractory, persistent AF (71 men, 56 +/- 7 years of age). In 29 patients, a second procedure by means of circumferential pulmonary vein (PV) isolation was performed, and 5 of them were subjected to a third circumferential ablation.

Selective ganglionated plexi ablation for paroxysmal atrial fibrillation.

Background: Selective ganglionated plexi (GP) ablation guided by high-frequency stimulation has been proposed for the treatment of paroxysmal atrial fibrillation (AF), but the efficacy of the method is not established.

Objective: This study sought to compare selective ablation of GP identified by high-frequency stimulation with extensive regional ablation targeting the anatomic areas of GP in patients with paroxysmal AF.

Methods: Eighty patients with paroxysmal AF (age 53 +/- 9 years) were randomized to undergo selective GP ablation or regional left atrial ablation at the anatomic sites of GP.

Successful epicardial catheter ablation of micro-reentrant ventricular tachycardia in a 14-year-old child.

The article describes successful epicardial catheter ablation of ventricular tachycardia using the transpericardial approach in a 14-year-old adolescent. Conventional mapping of endocardial surface revealed criteria consistent with subpericardial localization of arrythmogenic substrate. Epicardial mapping using a transpericardial approach enabled localization and successful elimination of the ventricular tachycardia on the lateral wall of the right ventricle.

Catheter ablation of left atrial ganglionated plexi for atrial fibrillation.

Radiofrequency ablation of pulmonary vein ostia does not provide complete and long-term elimination of atrial fibrillation. Combining this procedure with local radiofrequency application on sites with strong vagal reflexes results in partial parasympathetic denervation and increases the antiarrhythmic effect. A novel catheter-ablation technique to modify ganglionated plexi in the left atrium was assessed in 58 patients (mean age, 52.