Remote magnetic navigation ablation via the right jugular vein approach in patient with interruption of the inferior vena cava and incessant left atrial flutter.

Remote magnetic navigation (RMN) can be safely and effectively utilized in patients with difficult cardiac arrhythmias and complex anatomy. Interruption of the inferior vena cava (IVC) is a rare congenital abnormality that results in the inability to use conventional femoral access in patients that require interventional procedures. The present case demonstrates the feasibility of left atrial flutter ablation using RMN via jugular approach in a patient with interruption of IVC.

Pulmonary Artery Denervation for Patients With Residual Pulmonary Hypertension After Pulmonary Endarterectomy.

Background: Pulmonary artery denervation (PADN) procedure has not been applied to patients with residual chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA).

Objectives: This study sought to assess the safety and efficacy of PADN using remote magnetic navigation in patients with residual CTEPH after PEA.

Methods: Fifty patients with residual CTEPH despite medical therapy at least 6 months after PEA, who had mean pulmonary artery pressure ≥25 mm Hg or pulmonary vascular resistance (PVR) > 400 dyn‧s‧cm based on right heart catheterization were randomized to treatment with PADN (PADN group; n = 25) using remote magnetic navigation for ablation or medical therapy with riociguat (MED group; n = 25).

Surgical treatment of atrial fibrillation: technique of thoracoscopic radiofrequency fragmentation of the left atrium.

Presented in the article is a detailed description of a modified technique of minimally invasive surgical treatment of patients with atrial fibrillation - thoracoscopic radiofrequency fragmentation of the left atrium. This modification differs from the prototype GALAXY procedure by a significant increase of the 'quantitative' rather than 'qualitative' parameter of surgical aggression in relation to the left atrium. This technique results in creation of multiple transmural continuous closed lines of lesion to the left atrium and, consequently, a reduced risk of inadequate surgical treatment for atrial fibrillation.

[Visualisation and Radiofrequency Ablation of Sympathetic Innervation Loci in the Left Atrium in Patients with Paroxysmal Atrial Fibrillation].

Introduction: A novel cardiac gamma camera utilizes the radiopharmaceutical Iodine-123-Meta-iodobenzylguanidine (123I-MIBG) to visualize cardiac sympathetic innervation. Physiological accumulation of 123I-mIBG provides an anatomical quantitative determination of the structures of the autonomic nervous system (ANS) with discrete uptake areas (DUA) of sympathetic activity located in the left atrium (LA) corresponding to the main ganglionic plexi (GP) clusters that could not previously be visualized.

Aim: to visualize the DUA of the heart in patients with paroxysmal atrial fibrillation (AF) and to assess the effect of radiofrequency ablation (RFA) on DUA in LA.

Long-term suppression of atrial fibrillation by botulinum toxin injection into epicardial fat pads in patients undergoing cardiac surgery: Three-year follow-up of a randomized study.

Background: Botulinum toxin (BTX) injections into epicardial fat pads in patients undergoing coronary artery bypass grafting (CABG) has resulted in suppression of atrial fibrillation (AF) during the early postoperative period through 1-year of follow-up in a pilot program.

Objective: The purpose of this study was to report 3-year AF patterns by the use of implantable cardiac monitors (ICMs).

Methods: Sixty patients with a history of paroxysmal AF and indications for CABG were randomized 1:1 to either BTX or placebo injections into 4 posterior epicardial fat pads.