Hybrid venous recanalization and cardiac implantable electronic device lead revision procedures: A single-center retrospective analysis of 38 patients.

Purpose: The purpose of this study was to describe the safety and efficacy of hybrid recanalization procedures in a series of patients with obstructed central veins requiring cardiac implantable electronic device (CIED) revision.

Methods: Between 2008 and 2016, 38 consecutive patients (24 M; age 60.5 ± 16.

Long-Term Evaluation of Biotronik Linox and Linox(smart) Implantable Cardioverter Defibrillator Leads.

Introduction: Expert consensus holds that post-market, systematic surveillance of ICD leads is essential to ensure confirmation of adequate lead performance. GALAXY (NCT00836589) and CELESTIAL (NCT00810264) are ongoing multicenter, prospective, non-randomized registries conducted to confirm the long-term safety and reliability of Biotronik leads.

Methods And Results: ICD and CRT-D patients are followed for Linox and Linox(smart) ICD lead performance and safety for 5 years post-implant.

Ampere Hour as a Predictor of Cardiac Resynchronization Defibrillator Pulse Generator Battery Longevity: A Multicenter Study.

Background: Cardiac resynchronization defibrillator (CRT-D) devices improve survival for New York Heart Association classes II-IV systolic heart failure patients with QRS > 120 ms and left ventricular ejection fraction < 35%. A limitation of 100% CRT pacing is excess battery depletion and pulse generator (PG) replacement compared to VVI or dual-chamber systems. Ampere hour (Ah) measures PG battery capacity and may predict CRT-D device longevity.

Value of Cardiac Magnetic Resonance Imaging in Patients With Failed Ablation Procedures for Ventricular Tachycardia.

Background: Ventricular tachycardia (VT) in patients with cardiomyopathy originates in scar tissue. Intramural or epicardial scar may result in ineffective ablation if mapping and ablation are limited to the endocardium. The purpose of this study was to investigate whether preprocedural magnetic resonance imaging (MRI) is beneficial in patients with failed endocardial VT ablations in determining an appropriate ablation strategy.

Percutaneous Extraction of Embolized Intracardiac Inferior Vena Cava Filter Struts Using Fused Intracardiac Ultrasound and Electroanatomic Mapping.

This report describes the percutaneous extraction of embolized intracardiac inferior vena cava (IVC) filter struts using fluoroscopy and fused intracardiac echocardiography and three-dimensional electroanatomic mapping. Six patients with indwelling IVC filters placed at outside institutions 5 months to 14 years previously presented with cross-sectional imaging of the chest demonstrating fractured IVC filter struts embolized to the myocardial free wall (four patients) or interventricular septum (two patients). All embolized filter struts were successfully retrieved, and open heart surgery was avoided.

Occult obstructive sleep apnea and clinical outcomes of radiofrequency catheter ablation in patients with atrial fibrillation.

Background: Recurrent atrial fibrillation (AF) after successful cardioversion can be predicted by obstructive sleep apnea (OSA) diagnosed by polysomnography. However, it is not known whether the validated STOP-BANG questionnaire can predict AF recurrence after radiofrequency ablation (RFA). Our objective is to determine the prevalence of unrecognized OSA in patients with AF and its relation to freedom from AF after RFA.

Recurrence of PVCs in patients with PVC-induced cardiomyopathy.

Background: The natural history of premature ventricular complex (PVC)-induced cardiomyopathy is incompletely understood.

Objective: The purpose of this study was to assess long term follow-up data in patients who underwent successful PVC ablation for PVC-induced cardiomyopathy.

Methods: The subjects of this study were 60 patients (17 women; mean age 52.

Effect of ablation of frequent premature ventricular complexes on left ventricular function in patients with nonischemic cardiomyopathy.

Background: Frequent idiopathic premature ventricular complexes (PVCs) can result in PVC-induced cardiomyopathy. Frequent PVCs can also aggravate ischemic cardiomyopathy.

Objective: The purpose of this study was to investigate the impact of frequent PVCs on nonischemic cardiomyopathy.

Mortality and cerebrovascular events after radiofrequency catheter ablation of atrial fibrillation.

Background: Atrial fibrillation (AF) is associated with a significant increase in the risk of stroke and mortality. It is unclear whether maintaining sinus rhythm (SR) after radiofrequency ablation (RFA) is associated with an improvement in stroke risk and survival.

Objective: The purpose of this study was to determine whether SR after RFA of AF is associated with an improvement in the risk of cerebrovascular events (CVEs) and mortality during an extended 10-year follow-up.

Predictors of outcome after catheter ablation of premature ventricular complexes.

Background: The purpose of this study was to assess how well acute procedural outcomes predict the clinical outcome of catheter ablation of premature ventricular complexes (PVCs).

Methods: A consecutive series of 50 patients (28 women, age: 51 ± 13 years) with frequent PVCs was referred for PVC ablation. Acute failure was defined as inability to eliminate the predominant PVC or recurrence of the predominant PVC within 12 hours.

Characteristics of intramural scar in patients with nonischemic cardiomyopathy and relation to intramural ventricular arrhythmias.

Background: Ventricular arrhythmias have been described to originate from intramural locations. Intramural scar can be assessed by delayed-enhanced MRI, but MRIs cannot be performed on every patient. The objective of this study was to assess the value of voltage mapping to detect MRI-defined intramural scar and to correlate the scar with ventricular arrhythmias.

Reasons for failed ablation for idiopathic right ventricular outflow tract-like ventricular arrhythmias.

Background: The right ventricular outflow tract (RVOT) is the most common site of origin of ventricular arrhythmias (VAs) in patients with idiopathic VAs. A left bundle branch block, inferior axis morphology arrhythmia is the hallmark of RVOT arrhythmias. VAs from other sites of origin can mimic RVOT VAs, and ablation in the RVOT typically fails for these VAs.

The optimal range of international normalized ratio for radiofrequency catheter ablation of atrial fibrillation during therapeutic anticoagulation with warfarin.

Background: Uninterrupted anticoagulation with warfarin during radiofrequency catheter ablation (RFA) of atrial fibrillation is associated with a lower risk of periprocedural complications than when warfarin is temporarily discontinued. However, the optimal international normalized ratio (INR) levels during RFA have not been defined.

Methods And Results: In this retrospective analysis, RFA was performed in 1133 consecutive patients (mean age, 61±10 years) with paroxysmal (550) or persistent atrial fibrillation (583).

Endocardial ablation of postinfarction ventricular tachycardia with nonendocardial exit sites.

Background: Most infarct-related ventricular tachycardias (VTs) have an exit site that can be targeted by endocardial ablation. However, some VT reentry circuits have an exit site that is intramural or epicardial. Even these circuits may have an endocardial component that can be endocardially ablated.

Characteristics of atrial tachycardia due to small vs large reentrant circuits after ablation of persistent atrial fibrillation.

Background: While macroreentrant atrial tachycardias (ATs) have been reasonably well described, little is known about small reentrant circuits.

Objective: To compare characteristics of large and small reentrant circuits after ablation of persistent atrial fibrillation.

Methods: Seventy-seven patients (age 61±10 years; left atrium 46±6 mm; ejection fraction 0.

Dabigatran vs warfarin for radiofrequency catheter ablation of atrial fibrillation.

Background: It is not clear whether dabigatran is as safe and effective as uninterrupted anticoagulation with warfarin during radiofrequency catheter ablation (RFA) of atrial fibrillation (AF).

Objective: To compare the safety and efficacy of dabigatran by using a novel administration protocol and uninterrupted anticoagulation with warfarin for periprocedural anticoagulation in patients undergoing RFA of AF.

Methods: In this case-control analysis, 763 consecutive patients (mean age 61±10 years) underwent RFA of AF using dabigatran (N = 191) or uninterrupted warfarin (N = 572) for periprocedural anticoagulation.

Reasons for recurrent ventricular tachycardia after catheter ablation of post-infarction ventricular tachycardia.

Objectives: The purpose of this study was to assess the determinants of ventricular tachycardia (VT) recurrence in patients who underwent VT ablation for post-infarction VT.

Background: The factors that predict recurrence of VT after catheter ablation in patients with prior infarctions are not well described.

Methods: Catheter ablation was performed in 98 consecutive patients (88 males [90%]; mean age 67 ± 10 years; ejection fraction 27 ± 13%) with post-infarction VT.

Effect of radiation therapy on permanent pacemaker and implantable cardioverter-defibrillator function.

Background: Radiation therapy's (RT's) effects on cardiac implantable electronic devices (CIEDs) such as implantable cardioverter-defibrillators (ICDs) and pacemakers (PMs) are not well established, leading to device removal or relocation in preparation for RT.

Objective: To determine the effect of scattered RT on CIED performance.

Methods: We analyzed 69 patients--50 (72%) with PMs and 19 (28%) with ICDs--receiving RT at the University of Michigan.

Recovery from left ventricular dysfunction after ablation of frequent premature ventricular complexes.

Background: Patients with frequent premature ventricular complexes (PVCs) and PVC-induced cardiomyopathy usually have recovery of left ventricular (LV) dysfunction postablation. The time course of recovery of LV function has not been described.

Objective: To describe the time course and predictors of recovery from LV dysfunction after effective ablation of PVCs in patients with PVC-induced cardiomyopathy.

Meta-analysis of safety and efficacy of uninterrupted warfarin compared to heparin-based bridging therapy during implantation of cardiac rhythm devices.

Optimal management of perioperative anticoagulation in patients undergoing pacemaker or implantable cardioverter-defibrillator implantation is not yet established. We performed a meta-analysis of the published literature to assess the safety and efficacy of perioperative heparin-based bridging therapy versus uninterrupted warfarin therapy in patients undergoing pacemaker or implantable cardioverter-defibrillator implantation. We performed a systematic review of MEDLINE (1950 to 2012), EMBASE (1988 to 2012), Cochrane Controlled Trials Register (fourth quarter 2011), and reports presented at scientific meetings (1994 to 2011).

Patient-centered management of atrial fibrillation: applying evidence-based care to the individual patient.

Atrial fibrillation is the most common arrhythmia encountered in clinical practice, and it is one of the most common cardiac conditions requiring hospitalization of a patient. Several national organizations have developed guidelines for the management of atrial fibrillation. These guidelines were updated in 2011 to incorporate new advances in antiarrhythmic drug therapy and anticoagulant therapy, as well as progress in the field of catheter ablation.

Impact of QRS duration of frequent premature ventricular complexes on the development of cardiomyopathy.

Background: Patients with frequent premature ventricular complexes (PVCs) are at risk of developing reversible PVC-induced cardiomyopathy (rPVC-CMP). Not all determinants of rPVC-CMP are known.

Objective: To assess the impact of the QRS duration of PVCs on the development of rPVC-CMP.

Intramural idiopathic ventricular arrhythmias originating in the intraventricular septum: mapping and ablation.

Background: Intramural septal idiopathic ventricular arrhythmias have not been described systematically.

Methods And Results: In a consecutive group of 93 patients with idiopathic ventricular arrhythmias referred for ablation, the site of origin of ventricular arrhythmias was assessed by activation mapping and pace-mapping. In 7 of 93 patients (8%), an intramural focus in the interventricular septum was identified.

The impact of age on the atrial substrate: insights from patients with a low scar burden undergoing catheter ablation of persistent atrial fibrillation.

Background: Advancing age is a strong risk factor for the development of atrial fibrillation (AF). However, its impact on the left atrial (LA) substrate in patients is not well defined.

Methods: Forty-seven patients underwent catheter ablation of persistent AF.