Convergent procedure for long-standing persistent atrial fibrillation in heart failure with reduced ejection fraction.

Background: Catheter ablation for atrial fibrillation in patients with heart failure with reduced ejection fraction is associated with a significant reduction in morbimortality. The convergent procedure is a valid ablation option for the treatment of long-standing persistent atrial fibrillation.

Aim: To describe the outcomes of patients with heart failure with reduced ejection fraction and long-standing persistent atrial fibrillation who underwent the convergent procedure.

Single-catheter simplified stepwise approach to persistent atrial fibrillation ablation: A feasibility study.

Background: The strategy for atrial fibrillation ablation in persistent atrial fibrillation remains controversial. A single-catheter approach was recently validated for pulmonary vein isolation.

Aim: To evaluate the feasibility of this approach to performing persistent atrial fibrillation ablation, including pulmonary vein isolation and atrial lines, if needed.

Definition of success criteria for ablation of typical right atrial flutter with a single-catheter approach: A pilot study.

Background: The success rate of cavotricuspid isthmus ablation to treat right common flutter is high (up to 95%), but needs bidirectional block confirmation, requiring two or three catheters.

Aim: To describe a new pacing technique using a single catheter to ablate and confirm cavotricuspid isthmus block with differential PR interval measurements.

Methods: We included 61 patients from five centres, who were referred for cavotricuspid isthmus ablation.

Cardiac device implantation in Fabry disease: A retrospective monocentric study.

The incidence and predictive factors of arrhythmias and/or conduction abnormalities (ACAs) requiring cardiac device (CD) implantation are poorly characterized in Fabry disease (FD). The aim of our retrospective study was to determine the prevalence, incidence, and factors associated with ACA requiring CD implantation in a monocentric cohort of patients with confirmed FD who were followed up in a department of internal medicine and reference center for FD.Forty-nine patients (20M, 29F) were included.

Transfemoral implantation of an Edwards SAPIEN valve in a tricuspid bioprosthesis without fluoroscopic landmarks.

Aims: We describe the first report of an Edwards SAPIEN valve implanted in a tricuspid bioprosthesis from the femoral vein. We highlight the feasibility of this previously avoided approach and the techniques involved.

Methods And Results: A 61-year-old woman with multiple valve replacements for rheumatic heart disease presented with NHYA IV dyspnoea secondary to a severely stenosed tricuspid bioprosthesis.

[New energy sources for ablative methods].

Radiofrequency current is the reference energy source for endocavitary ablation of arrhythmias. It is particularly well adapted for the ablation of focal arrhythmogenic substrates such as accessory pathways or foyers of automatism. Technological advances have made the lesions larger but the extension of the indications of percutaneous ablation to more complex substrates such as atrial fibrillation have justified the evaluation of alternative energies.

Basal asynchrony and resynchronization with biventricular pacing predict long-term improvement of LV function in heart failure patients.

Biventricular pacing (BiV) is emerging for patients with dilated cardiomyopathy (DCM) and asynchrony. We measured basal asynchrony and early resynchronization by radionuclide angioscintigraphy (RNA) in order to predict long-term evolution of ventricular function after BiV. Thirty-four patients (NYHA Class III-IV,65.

[Arrhythmic cardiomyopathy].

Arrhythmic cardiomyopathy (ACM) is a clinical entity which can be reproduced in experimental models and which corresponds to all myocardial changes induced by chronic tachycardia. It may affect the atria and/or ventricles and, in this case, occur with all types of arrhythmia. Arrhythmia complicating a cardiomyopathy is the differential diagnosis of ventricular ACM.

Biventricular pacing in severe heart failure patients reverses electromechanical dyssynchronization from apex to base.

Biventricular (BV) pacing is an emerging treatment for patients with severe dilated cardiomyopathy and ventricular asynchrony. Radionuclide angioscintigraphy has shown that BV can reduce activation delays between left (LV) and right ventricles (RV), but alterations of electromechanical asynchrony between the LV base and apex have not been previously described. Radionuclide angioscintigraphy with Tc99m red cell labeling was performed in 21 patients, 64 +/- 17 years of age, in NYHA functional Class III or IV, and with a mean QRS duration of 180 +/- 15 ms.

[Validation of the measurement of cardiac output by acoustic quantification in patients with severe congestive heart failure].

The technique of acoustic quantification (AQ), because of its automatic detection of the contours, enables left ventricular volumes to be calculated in real time using the technique of disk summation. The objective of the study was to evaluate the reliability of cardiac output (CO) measurements obtained with AQ based on left ventricle volumes in patients with severe congestive heart failure. Seventeen patients, mean age 68 +/- 11 years, NYHA stage IV, in sinus rhythm and without significant valve regurgitation were enrolled prospectively.