The effect of antiarrhythmic medication management on atrial fibrillation ablation outcomes.

Background: Patients commonly present for atrial fibrillation (AF) ablation while taking antiarrhythmic (AA) medications. It is unknown if AA use at the time of ablation affects procedural outcome. This study compares the AF ablation outcomes of patients who underwent ablation while on AA medications to those who were not on AA medications.

Complications arising from catheter ablation of atrial fibrillation: temporal trends and predictors.

Background: The reported complication rate of catheter ablation of atrial fibrillation (AF) varies.

Objective: Our goal was to assess temporal trends and the effect of both institutional and individual operators' experience on the incidence of complications.

Methods: All patients undergoing AF ablation at Johns Hopkins Hospital between February 2001 and December 2010 were prospectively enrolled in a database.

Conventional pulmonary vein isolation compared with the "box isolation" method: a randomized clinical trial.

Purpose: Esophageal injury is a potential complication with radiofrequency ablation in the posterior wall of the left atrium (LA). The "box isolation" method isolates the posterior LA wall including the pulmonary veins without ablation on the posterior LA wall. This study compares the acute and long-term efficacy of the box isolation method with conventional circumferential pulmonary vein isolation (PVI) for catheter ablation of AF.

Demographic profile of patients undergoing catheter ablation of atrial fibrillation.

Background: Catheter ablation is a widely accepted treatment for drug refractory atrial fibrillation (AF). The purpose of our study was to examine secular trends in the demographic profile of patients undergoing AF ablation.

Methods And Results: Data for 792 patients who underwent catheter ablation for AF at Johns Hopkins Hospital between years 2001 and 2009 were systematically reviewed.

Chronic kidney disease and mortality in implantable cardioverter-defibrillator recipients.

Incidence of sudden cardiac death (SCD) in end-stage renal disease (ESRD) remains high. Limited data is available about whether implantable cardioverter-defibrillators (ICDs) can prevent arrhythmic death in patients with chronic kidney disease (CKD). The purpose of this retrospective study was to determine the impact of CKD on all-cause and sudden cardiac death in ICD recipients.

Transoesophageal echocardiography predictors of periprocedural cerebrovascular accident in patients undergoing catheter ablation of atrial fibrillation.

Aims: To assess the utility of transoesophageal echocardiography (TEE) parameters such as spontaneous echo contrast (SEC), left atrial (LA) appendage velocities, and aortic plaque in predicting periprocedural cerebrovascular accidents (CVAs) in patients undergoing catheter ablation of atrial fibrillation (AF).

Methods And Results: Five hundred and seventy-nine consecutive patients underwent catheter ablation of AF with pre-procedural TEE, 94% of whom also received pre-procedural warfarin and enoxaparin bridging. Of the 579 patients, 10 patients (cases) who developed periprocedural CVA (1.

A prospective study evaluating the role of obesity and obstructive sleep apnea for outcomes after catheter ablation of atrial fibrillation.

Background: Obesity and obstructive sleep apnea (OSA) have a strong association with atrial fibrillation (AF). The purpose of this study was to prospectively determine the effects of obesity, assessed by the body mass index (BMI) and OSA on the efficacy of catheter ablation of AF.

Methods: The patient population consisted of 109 patients (mean age: 60 +/- 10 years, 79% male, 67% paroxysmal, mean BMI 28 +/- 5 kg/m(2)) who underwent catheter ablation of AF.

Outcomes in patients requiring cardioversion following catheter ablation of atrial fibrillation.

Introduction: Early recurrence of atrial tachyarrhythmias is commonly noted after catheter ablation of atrial fibrillation (AF). The long-term outcomes of patients who require cardioversion for persistent AF after AF ablation is not known. This study reports the outcomes of patients who underwent cardioversion for persistent AF or atrial flutter following an AF ablation procedure.

Incidence and predictors of periprocedural cerebrovascular accident in patients undergoing catheter ablation of atrial fibrillation.

Background: Cerebrovascular accident (CVA) is a serious complication of catheter ablation of atrial fibrillation (AF). The incidence and clinical predictors of periprocedural CVA in patients undergoing AF ablation are not fully understood.

Methods: This study included 721 cases (age 57 +/- 11 years; 23% female; 345 persistent AF) in 579 consecutive patients referred for AF ablation.

Association of transseptal punctures with isolated migraine aura in patients undergoing catheter ablation of cardiac arrhythmias.

Background: Transseptal catheterization (TSC) is performed during catheter ablation involving the lefthand side of the heart. TSC causes a transient iatrogenic atrial septal defect that can predispose patients to migraine episodes. However, isolated migraine aura episodes in patients undergoing TSC have not been described.

Does left atrial volume and pulmonary venous anatomy predict the outcome of catheter ablation of atrial fibrillation?

Introduction: Preprocedural factors may be helpful in selecting patients with atrial fibrillation (AF) for treatment with catheter ablation and in making an assumption regarding their prognosis. The aims of this study were to investigate whether left atrial (LA) volume and pulmonary venous (PV) anatomy, evaluated by computed tomography (CT) prior to ablation, will predict AF recurrence following catheter ablation.

Methods And Results: We included 146 patients (mean age 57 +/- 11 years, 83% male) with symptomatic AF (55% paroxysmal, 18% persistent, 27% long-standing persistent).

Predictive value of obstructive sleep apnoea assessed by the Berlin Questionnaire for outcomes after the catheter ablation of atrial fibrillation.

Aims: Obstructive sleep apnoea (OSA) is a risk factor for atrial fibrillation (AF) recurrence after catheter ablation. The purpose of this study is to determine whether OSA assessed by the simple tool, the Berlin Questionnaire (BQ), is useful in predicting the efficacy of catheter ablation of AF.

Methods And Results: The patient population consisted of 210 consecutive patients [mean age 58 +/- 10 years, 167 (80%) male, 119 (57%) paroxysmal] who underwent catheter ablation of AF and completed the BQ.

Incidence and outcomes of protamine reactions in patients undergoing catheter ablation of atrial fibrillation.

Background: Aggressive anticoagulation with heparin to maintain an activated clotting time (ACT) >300 s is required during catheter ablation of atrial fibrillation (AF) to reduce the risk of systemic thromboembolism. The purpose of this study is to describe the incidence and outcome of protamine reactions and analyze the risk factors in patients undergoing catheter ablation of AF.

Methods: The patient population included 242 consecutive patients (193 men, age 57.

Correlation of left atrial diameter by echocardiography and left atrial volume by computed tomography.

Introduction: For patients undergoing catheter ablation of atrial fibrillation (AF), left atrial size is a predictor of recurrence of AF during follow-up. For this reason, major clinical trials have used a left atrial diameter (LAD) of more than 5.0 or 5.

Validation of a simplified method to determine left atrial volume by computed tomography in patients with atrial fibrillation.

The success of catheter ablation of atrial fibrillation (AF) is highly dependent on a preprocedural assessment of the size and shape of the left atrium. The most precise method to determine left atrial (LA) volume using computed tomography requires manually tracing the LA area of each cross-sectional image. This is a labor-intensive and time-consuming technique.

Incidence and predictors of left atrial thrombus prior to catheter ablation of atrial fibrillation.

Background: Transesophageal echocardiography (TEE) is commonly used prior to catheter ablation of atrial fibrillation (AF) in order to exclude left atrial (LA) thrombus. However, the incidence and predictors of LA thrombus detected with TEE have not been systematically examined in this setting.

Methods: This study included 732 cases (mean age 57 +/- 11 years; 23% female; 353 persistent AF) in 585 consecutive patients referred for catheter ablation of AF.

Amino acid supplementation differentially modulates STAT1 and STAT3 activation in the myocardium exposed to ischemia/reperfusion injury.

We have previously demonstrated that the transcription factor STAT1 plays a critical role in promoting apoptotic cell death, whereas the related STAT3 family member may antagonize STAT1 and protect cardiac myocytes from ischemia/reperfusion (I/R) injury. More recently we demonstrated that long-term nutritional supplementation with mixed amino acids (AAs) can enhance myocyte survival by preserving mitochondrial functional capacity during I/R injury. We therefore investigated whether short-term nutritional supplementation with the same AA mixture has any effects on STAT1 or STAT3 activation in the Langendorff perfused rat heart exposed to I/R injury.

Oral administration of amino acidic supplements improves protein and energy profiles in skeletal muscle of aged rats: elongation of functional performance and acceleration of mitochondrial recovery in adenosine triphosphate after exhaustive exertion.

Sarcopenia is an inevitable age-related degenerative process chiefly characterized by decreased synthesis of muscle proteins and impaired mitochondrial function, leading to progressive loss of muscle mass. Here, we sought to probe whether long-term administration of oral amino acids (AAs) can increase protein and adenosine triphosphate (ATP) content in the gastrocnemius muscle of aged rats, enhancing functional performance. To this end, 6- and 24-month-old male Fisher 344 rats were divided into 3 groups: group A (6-month-old rats) and group B (24-month-old rats) were used as adult and senescent control group, respectively, while group C (24-month-old rats) was used as senescent treated group and underwent 1-month oral treatment with a mixture of mainly essential AAs.

Complications of catheter ablation for atrial fibrillation: incidence and predictors.

Introduction: Pulmonary vein (PV) isolation by catheter ablation is an increasingly used strategy to treat atrial fibrillation (AF). Complication rates from AF ablation reported in different case series vary widely. We conducted a retrospective analysis of 641 consecutive ablation procedures to assess complication rates, temporal trends, and clinical predictors of adverse outcomes.

Recurrent acute profound thrombocytopenia related to readministration of eptifibatide.

We describe the case of an 86-year-old woman who presented with unstable angina. She was given heparin and eptifibatide, and she underwent percutaneous coronary intervention (PCI). Shortly thereafter, she developed acute profound thrombocytopenia (6,000 platelets/mm3), which resolved after the discontinuation of heparin and eptifibatide.