[Dyspnea and palpitations in a 39-year-old male patient].

A 39-year-old male patient presented with dyspnea and palpitations. The electrocardiogram (ECG) showed a first degree atrioventricular (AV) block and frequent atrial extra systoles. Within the following 48 h the AV block gradually developed into a third degree intermittent complete AV block.

Long-term left atrial remodeling after ablation of persistent atrial fibrillation: 7-year follow-up by cardiovascular magnetic resonance imaging.

Purpose: Restoration of sinus rhythm in patients with persistent atrial fibrillation (ps. AF) induces reverse atrial remodeling and improvement of left ventricular function. We evaluated the effect of ablative treatment on cardiac remodeling after a long follow-up period of 7 years by cardiovascular magnetic resonance (CMR).

Updated Survey on Interventional Electrophysiology: 5-Year Follow-Up of Infrastructure, Procedures, and Training Positions in Germany.

Objectives: This study provides an update and comparison to a 2010 nationwide survey on cardiac electrophysiology (EP), types and numbers of interventional electrophysiological procedures, and training opportunities in 2015.

Background: In 2010, German cardiology centers performing interventional EP were identified and contacted to provide a survey on cardiac EP.

Methods: German cardiology centers performing interventional EP in 2015 were identified from quality reports and contacted to repeat the 2010 questionnaire.

[AV nodal reentrant tachycardia. Diagnosis and therapy].

The AV nodal reentrant tachycardia (AVNRT) is one of the most common arrhythmias encountered in clinical practice. It is characterized by a constant heart rate and an on/off phenomenon. The clinical symptoms may include palpitations, anxiety, polyuria, and dyspnea.

Three-dimensional rotational venography of the coronary sinus tree facilitates left ventricular lead implantation for CRT.

Background: Precise knowledge of the coronary sinus (CS) tree anatomy facilitates catheter-based intubation of the CS, target vein and lead selection and reduces the need for fluoroscopy, contrast medium and overall procedure time in cardiac resynchronization therapy (CRT). Three-dimensional rotational angiography (3DRA) provides a new means of multiangle imaging of the CS tree that can be applied preoperatively.

Purpose And Methods: Our study aims to investigate the feasibility of preoperative rotational CS venography and its implications for CRT device implantation procedures.

Fast atrial activity predicts recurrence of atrial fibrillation after pulmonary vein isolation: results from a prospective randomized study.

Background: Recurrence of atrial fibrillation (AF) after ablative treatment is common. We hypothesized that AF recurrence is heralded by fast ectopic atrial activity occurring after electrical reconnection of previously isolated pulmonary veins.

Methods: Patients with paroxysmal or persistent AF undergoing pulmonary vein isolation (PVI) were followed up by 24-h Holter monitoring every 3 months for the first year and every 6 months thereafter.

Second generation of cryoballoons can improve efficiency of cryoablation for atrial fibrillation.

Background: We investigated whether the new second generation of cryoballoons can improve the efficiency and safety of cryoablation for atrial fibrillation (AF) during ablation and in terms of outcome.

Methods: Data of AF patients consecutively treated with a single 28-mm cryoballoon were analyzed. Patients were divided into two groups: the G1 group was treated with the first-generation cryoballoons (ArcticFront) and G2 with the second generation (ArcticFront Advance).

Diagnosis and management of atrial fibrillation: an overview.

Atrial fibrillation (AF) has been defined as the new cardiovascular "epidemic". Its prevalence is rising in developed countries, and the associated social and economic costs are high. In the last few years, there has been an increasing interest in understanding the mechanisms of AF and its management.

Prolonged ablation on critical segments of pulmonary vein ostia in paroxysmal atrial fibrillation: a prospective randomized controlled study.

Introduction: Electrical reconnection of the pulmonary veins (PVs) plays a key role in the recurrence of atrial fibrillation (AF) after ablative treatment. This randomized controlled study tested the hypothesis that prolonged ablations, on areas that may be critical for left atrial (LA)-PV conduction, can significantly reduce the rate of acute PV reconnection and AF recurrence.

Methods: Patients with paroxysmal AF were randomly assigned to either a control or an add-on group.

Precordial electrode placement for optimal ECG monitoring: implications for ambulatory monitor devices and event recorders.

Introduction: Detection of QRS complexes, P-waves and atrial fibrillation f-waves in electrocardiographic (ECG) signals is critical for the correct diagnosis of arrhythmias. We aimed to find the best bipolar lead (BL) with the highest signal amplitude and shortest inter-electrode spacing.

Methods: ECG signals (120 seconds) were recorded in 36 patients with 16 precordial electrodes placed in a standardized pattern.

A survey of German centres performing invasive electrophysiology: structure, procedures, and training positions.

Aims: To provide a nationwide survey (and reference for the future) on cardiac electrophysiologists, types and numbers of invasive electrophysiological procedures, and training opportunities in 2010.

Methods And Results: German cardiology centres performing invasive electrophysiology were identified from quality reports and contacted to fill a questionnaire. A majority of 122 centres (65%) responded.

Combined use of three-dimensional rotational angiogram of left atrium and circular multi-electrode ablation catheter for pulmonary vein isolation.

Background: A novel circular pulmonary vein ablation catheter (PVAC) has been introduced for pulmonary vein isolation (PVI). Accurate delineation of left atrium-pulmonary vein (LA-PV) anatomy is important for this technique. The aim of this study was to test whether the 3-dimensional rotational angiography (3D RTA) of the left atrium can facilitate PVI using PVAC technique.

Oxygen Kinetics and Heart Rate Response during Early Recovery from Exercise in Patients with Heart Failure.

Background. The purpose of this study was to assess the post-exercise O(2) uptake and heart rate response in patients with heart failure (HF) in comparison to healthy individuals. Methods and Results.

Predictive value of left atrial volume measured by non-invasive cardiac imaging in the treatment of paroxysmal atrial fibrillation.

Purpose: We investigate the role of left atrial volume (LAV) as a predictor of outcome following pulmonary vein isolation (PVI) in patients with exclusive paroxysmal atrial fibrillation (AF).

Methods: PVI was performed in 213 patients (80 females, aged 60 ± 10 years) with paroxysmal AF using either the pulmonary vein ablation catheter (PVAC, n = 78) or conventional single-tip ablation (n = 135). LAV was assessed by multi-detector computed tomography (n = 39) or cardiac magnetic resonance imaging (n = 174) prior to ablation.

Characteristic changes of volume and three-dimensional structure of the left atrium in different forms of atrial fibrillation: predictive value after ablative treatment.

Introduction: Atrial fibrillation (AF) is associated with electroanatomical remodelling of the left atrium (LA), especially with LA dilatation. However, little is known about the changes of the three-dimensional structure of the LA, regarding the type of atrial fibrillation and their prognostic value after an ablative treatment.

Methods: One hundred fifteen patients (72 males, 59 ± 11 years) with an indication for AF ablation were prospectively included.

Frequency analysis of atrial fibrillation surface and intracardiac electrograms during pulmonary vein isolation.

Aims: Frequency analysis of atrial electrograms from patients diagnosed with persistent atrial fibrillation (AF) appears to be crucial in its clinical diagnosis. This work explores the fibrillatory frequency properties of both surface and intracardiac electrograms before and after pulmonary vein isolation (PVI) using three time-frequency techniques.

Methods And Results: Surface electrocardiograms (ECGs) of 21 patients diagnosed with persistent AF undergoing PVI were recorded.

Cardiovascular magnetic resonance imaging for accurate sizing of the left atrium: predictability of pulmonary vein isolation success in patients with atrial fibrillation.

Purpose: To prospectively determine the most reproducible approach for left-atrial size assessment using cardiovascular magnetic resonance (CMR) imaging in patients with atrial fibrillation and its value for prediction of pulmonary vein isolation (PVI) treatment success.

Materials And Methods: Eighty patients underwent CMR imaging prior to PVI; the CMR examination included standard cine sequences, a multislice cine sequence in 4-chamber orientation with full left-atrial coverage, and a contrast-enhanced MR angiography of the left atrium. Left-atrial size was determined as: diameter, area, volume segmented from angiography, and diastolic/systolic volumes from cine imaging (Simpson's rule).

Intraprocedural imaging of left atrium and pulmonary veins: a comparison study between rotational angiography and cardiac computed tomography.

Background: Atrial fibrillation (AF) ablation is facilitated by anatomical visualization of the left atrium (LA) and the pulmonary veins (PVs). The purpose of this study was to compare accuracy, radiation exposure, and costs between three-dimensional atriography (3D-ATG) and cardiac computed tomography (CCT).

Methods: Seventy patients with an indication for AF ablation were included.

Serial monitoring of reverse left-atrial remodeling after pulmonary vein isolation in patients with atrial fibrillation: a magnetic resonance imaging study.

Purpose: To prospectively determine the impact of sinus rhythm restoration on left-atrial (LA) volumes and function assessed by cardiac magnetic resonance (CMR) imaging within the first year after pulmonary vein isolation (PVI).

Methods: Forty-one patients (28 men; age: 57 ± 10 years) with paroxysmal or non-paroxysmal atrial fibrillation were studied serially using CMR at baseline and at 1-, 3-, 6- and 12-month intervals following PVI. LA diastolic and systolic volumes were determined by cine imaging with full gapless LA coverage applying Simpson's rule.

A novel cryoballoon technique for mapping and isolating pulmonary veins: a feasibility and efficacy study.

Introduction: The study was designed to evaluate the feasibility and efficacy of a simplified cryoballoon technique in which a microcircular catheter was introduced into the central lumen of a cryoballoon catheter for the purpose of recording pulmonary vein (PV) potentials during ablation procedures and without interchanging catheters.

Methods And Results: A total of 23 consecutive patients with paroxysmal atrial fibrillation (AF) were enrolled. A single transseptal puncture was made and a cryoballoon catheter was inserted into the left atrium.

Magnetic resonance imaging versus computed tomography for characterization of pulmonary vein morphology before radiofrequency catheter ablation of atrial fibrillation.

The accurate assessment of pulmonary vein (PV) anatomy is important in planning radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). The aim of the present study was to perform a head-to-head comparison of magnetic resonance imaging (MRI) and multislice computed tomography (CT) for the evaluation of PV morphology before RFCA of AF. Contrast-enhanced MRI (on a 1.

Optimal fluoroscopic projections for angiographic imaging of the pulmonary vein ostia: lessons learned from the intraprocedural reconstruction of the left atrium and pulmonary veins.

Aims: Electrical isolation of the pulmonary veins (PVs) is the cornerstone of the ablative treatment of atrial fibrillation. Selective angiography of the PVs in standard fluoroscopic projections is often used for intraprocedural identification of PVs and their ostia. Variable spatial orientation and significant variability of PV anatomy are important limitations of this imaging approach.

Reconstructing and registering three-dimensional rotational angiogram of left atrium during ablation of atrial fibrillation.

Background: Three-dimensional (3D) image of left atrium (LA) can greatly facilitate ablation of atrial fibrillation (AF). Reconstructing method using computed tomography (CT) has certain limitations. The 3D image of LA can be intraprocedurally reconstructed by a rotational angiography technique.