[Fermeture de l'oreillette gauche - une alternative à l'anticoagulation permanente en cas de fibrillation auriculaire?].

Left Atrial Appendage Closure- An Alternative to Continuous Anticoagulation for Atrial Fibrillation? Approximately 25% of all ischemic insults are caused by cardiac emboli in atrial fibrillation. Therefore, in patients with atrial fibrillation, oral anticoagulation is initiated or transesophageal echocardiography is performed before electroconversion to exclude blood clots in the heart. This shows that virtually all cardiac thrombi (>90%) are localized in the atrial ear.

Correlation between conduction velocity and frequency analysis in patients with atrial fibrillation using high-density charge mapping.

Spectral analysis of atrial signals has been used to identify regions of interest in atrial fibrillation (AF). However, the relationship to the atrial substrate is unclear. In this study, we compare regions with dominant frequency (DF), simultaneously determined in the left atrium (LA) by a novel noncontact mapping system using unipolar charge density signals, to the zones of slow conduction (SZ) during AF.

Barlow disease: effect of mitral valve repair on ventricular arrhythmias in 82 patients in a retrospective long-term study.

Background: Patients (pt) with mitral valve prolapse (MVP) due to Barlow disase (BD) have an increased incidence of ventricular arrhythmias (VA; including ventricular tachycardias VT) and sudden cardiac death (SCD). Data on the effect of MV repair on VA are scarce.

Methods: Pre- and postoperative VA in severe mitral regurgitation (MR) with MVP due to BD undergoing surgical mitral valve repair were analyzed.

Paroxysmal and persistent atrial fibrillation ablation outcomes with the pulmonary vein ablation catheter GOLD duty-cycled phased radiofrequency ablation catheter: quality of life and 12-month efficacy results from the GOLD Atrial Fibrillation Registry.

Aims: The GOLD AF Registry has been designed to prospectively assess the population, indications, and outcomes using second-generation phased radiofrequency (RF) ablation (pulmonary vein ablation catheter GOLD) in a global examination of standard-of-care use for the treatment of paroxysmal and persistent atrial fibrillation (AF).

Methods And Results: GOLD AF (NCT02433613) is a prospective, observational, multi-centre registry designed to characterize efficacy and safety of phased RF ablation in patients with AF. The primary endpoint was freedom from AF recurrence at 12-month follow-up after a 90-day blanking period.

Image-guided ablation of scar-related ventricular tachycardia: towards a shorter and more predictable procedure.

Purpose: The aim of this study was to analyze the feasibility and reproducibility of using image integration software at a remote setting over the MUSIC network to perform image-guided VT ablation. Furthermore, we analyzed the efficacy of a focused workflow with electroanatomical mapping (EAM) limited to imaging-defined scar.

Methods: In a prospective two-centre study, consecutive patients undergoing image integration-guided VT ablation (magnetic resonance [DE-MRI] and/or multidetector computed tomography [MDCT]) were included.

High-resolution noncontact charge-density mapping of endocardial activation.

Background: Spatial resolution in cardiac activation maps based on voltage measurement is limited by far-field interference. Precise characterization of electrical sources would resolve this limitation; however, practical charge-based cardiac mapping has not been achieved.

Methods: A prototype algorithm, developed from first principles of electrostatic field theory, derives charge density (CD) as a spatial representation of the true sources of the cardiac field.

Leadless pacing using the transcatheter pacing system (Micra TPS) in the real world: initial Swiss experience from the Romandie region.

Aims: Leadless pacemakers are implanted in Switzerland since June 2015. Large worldwide registries have shown high implant success, low complication rates, and good electrical parameters up to 12 months' follow-up. However, data are scarce outside the investigational setting.

[The Old-Age Heart].

The Old-Age Heart Abstract. Knowledge of cardiovascular changes in old age and their therapeutic options is important. Old age can lead to hypertrophy of the left ventricle, diastolic dysfunction, heart valve changes and pulmonary hypertension.

Long-term follow-up after left atrial appendage occlusion with comparison of transesophageal echocardiography versus computed tomography to guide medical therapy and data about postclosure cardioversion.

Aims: The use of left atrial appendage (LAA) occluders in atrial fibrillation is increasing. There are few data on the comparison between transesophageal echocardiography (TEE) and computed tomography (MDCT) assessing peridevice flow and outcome of electrical cardioversion (ECV) in these patients.

Methods And Results: Single-center prospective registry from 2009 to 2015 including all LAA occluders to analyze success and complications during implantation and follow-up.

Safety and efficacy of the nMARQ catheter for paroxysmal and persistent atrial fibrillation.

Aims: Circular irrigated radiofrequency ablation using the nMARQ catheter has recently been introduced for the treatment of atrial fibrillation (AF). The aim of this study is to report the safety and efficacy of catheter ablation using this technology in patients with paroxysmal and persistent AF.

Methods And Results: The data of a prospective registry describing the experience of a single operator using this technology on 327 consecutive patients were analysed.

Clinical Long-Term Response to Cardiac Resynchronization Therapy Is Independent of Persisting Echocardiographic Markers of Dyssynchrony.

Background: The aim of the study was to prove the concept that correction of established parameters of dyssynchrony is a requirement for favorable long-term outcome in patients with cardiac resynchronization therapy (CRT), whereas patients with persisting dyssynchrony should have a less favorable response.

Methods: After CRT implantation and optimization of dyssynchrony parameters, we evaluated whether correction or persistence of dyssynchrony predicted long-term outcome. Primary endpoint was a combination of cardiac mortality/heart transplantation and hospitalization due to worsening heart failure, and secondary endpoint was NYHA class.

Investigation into causes of abnormal cerebral MRI findings following PVAC duty-cycled, phased RF ablation of atrial fibrillation.

Introduction: Left atrial catheter ablation of the pulmonary veins (PVs) is an established option for patients with atrial fibrillation (AF). Asymptomatic cerebral emboli (ACE) detected by diffusion weighted MRI (DW-MRI) following AF ablation has been reported at varying rates. This variability may be linked to procedural variables and demographic risk factors.

Electrical activation in the coronary sinus branches as a guide to cardiac resynchronisation therapy: rationale for a coordinate system.

Background: For successful cardiac resynchronisation therapy (CRT) a spatial and electrical separation of right and left ventricular electrodes is essential. The spatial distribution of electrical delays within the coronary sinus (CS) tributaries has not yet been identified.

Objective: Electrical delays within the CS are described during sinus rhythm (SR) and right ventricular pacing (RVP).

Initial results of linear duty-cycled radiofrequency for atypical flutter and atrial tachycardia.

Background: Duty-cycled radiofrequency (DCRF) is increasingly used for ablation of atrial fibrillation (AF). Many patients also have atrial flutter (AFL). Recently, a linear multielectrode has been shown to create linear block at the cavotricuspid isthmus and in the left atrium (LA).

Duty-cycled unipolar/bipolar versus conventional radiofrequency ablation in paroxysmal and persistent atrial fibrillation.

Background: Duty-cycled (DC) radiofrequency ablation (RFA) for atrial fibrillation (AF) has been introduced, however, data on large patient series and comparison to conventional RFA are scarce.

Methods: Between 2006 and 2008 DC RFA was performed in 209 consecutive patients (143 (68%) paroxysmal and 66 (32%) persistent AF). As controls served 211 patients, 155 (73%) with paroxysmal and 56 (27%) with persistent AF (p=0.

Interaction of vitamin K antagonists with heparin affect monitoring by activated clotting times.

Background: Unfractionated heparin is recommended during atrial fibrillation (AF) ablation to achieve activated clotting time (ACT) above 250-300 s to prevent clot. Many patients on therapeutic international normalised ratio (INR) undergo AF ablation procedures; however, it is unknown whether they require less heparin to achieve similar ACT levels.

Methods: During AF ablation, the ACT was measured before and 10 min after administration of i.

Linear ablation with duty-cycled radiofrequency energy at the cavotricuspid isthmus.

Background: Multielectrode catheters using duty-cycled radiofrequency (RF) have been developed to treat atrial fibrillation (AF). Many of these patients also have atrial flutter. Therefore, a linear multielectrode has been developed using the same RF energy.

Ablation of persistent atrial fibrillation using multielectrode catheters and duty-cycled radiofrequency energy.

Objectives: The purpose of this study was to assess the efficacy and safety of a novel, multielectrode, duty-cycled radiofrequency ablation (RFA) system for long-standing persistent atrial fibrillation (AF).

Background: RFA for persistent AF remains a lengthy and challenging procedure.

Methods: In 5 European centers, 50 patients with long-standing persistent AF underwent RFA.

Effects of AV delay programming on ventricular resynchronisation: role of radionuclide ventriculography.

Purpose: Optimal atrioventricular delay (AVD) setting for cardiac resynchronisation therapy, i.e. biventricular pacing in patients with heart failure, remains a formidable challenge.

Automatic impedance monitoring and patient alert feature in implantable cardioverter defibrillators: being alert for the unexpected!

Recent advances in implantable cardioverter defibrillator (ICD) technology have enabled implementation of an automatic monitoring feature in ICDs that provides daily measurements of several technical parameters such as battery status, pacing, and high-voltage impedance. The system alerts the patient with an audible alarm to contact the physician in case the measured parameters are not within normal limits. Early detection of intermittent and potentially serious complications justifies routine use of this feature.

Rate-dependent AV delay optimization in cardiac resynchronization therapy.

Background: During cardiac resynchronization therapy (CRT), cardiac performance is dependent on an optimized atrioventricular delay (AVD). However, the optimal AVD at different heart rates has not been defined yet during CRT.

Method: The effects of an increase in heart rate by pacing or physical exercise on optimal AVD were studied in 36 patients with biventricular pacemakers/defibrillators.