General Anesthesia Improves Efficiency of High-Power Short-Duration Catheter Ablation for Atrial Fibrillation: Comparison with Mild Conscious Sedation.

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia globally. High-power, short-duration radiofrequency (RF) catheter ablation (CA) for AF has recently emerged, reducing ablation times and enhancing patient tolerability with comparable efficacy and safety. While the benefits of general anesthesia (GA) for standard-power, standard-duration CA are well-established, data comparing GA to mild conscious sedation (MCS) for high-power, short-duration CA are limited.

Galectin-3, Inflammation, and the Risk of Atrial High-Rate Episodes in Patients with Dual Chamber Pacemakers.

Atrial high-rate episodes (AHREs) are atrial tachyarrhythmias that are exclusively detected by cardiac implantable electronic devices (CIEDs) with an atrial lead. The objective of this study was to investigate the incidence and predictive factors for AHREs, and to evaluate the ability of inflammation biomarkers to predict the occurrence of AHREs. 102 patients undergoing CIED procedure who received a dual chamber pacemaker were included.

Particularities of Catheter Ablation in Women with Atrial Fibrillation and Associated Ischemic Heart Disease.

Background: Atrial fibrillation is more common in men, but in the presence of ischemic heart disease, this arrhythmia is more frequent in women. However, like in coronary heart disease, women with atrial fibrillation are suboptimally treated.

Methods: To identify particularities of ablation, in women with atrial fibrillation and ischemic heart disease.

Atrial Fibrillation Ablation in a Patient with Cor Triatriatum Sinister and Left Common Pulmonary Vein: Impact of Left Atrium Anatomy on Ablation Approach.

Atrial fibrillation is the most common presentation in adult patients with cor triatriatum sinister. The key to successful and safe catheter ablation in these patients is an accurate exploration and thorough understanding of the left atrial anatomy, both before and during the procedure. Catheter manipulation is highly dependable on left atrial anatomy, including the interatrial septum, insertion of pulmonary veins and cor triatriatum membrane.

Value of Left Atrial Appendage Function Measured by Transesophageal Echocardiography for Prediction of Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation.

Atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA) remains a challenging issue. This study aims to explore the left atrial appendage function by transesophageal echocardiography (TEE) and assess its value in predicting AF recurrence following RFCA in paroxysmal AF patients. Eighty-one patients with paroxysmal AF that underwent RFCA were recruited.

Formula to estimate left atrial volume using antero-posterior diameter in patients with catheter ablation of atrial fibrillation.

In patients undergoing atrial fibrillation (AF) ablation, an enlarged left atrium (LA) is a predictor of procedural failure as well as AF recurrence on long term. The most used method to assess LA size is echocardiography-measured diameter, but the most accurate remains computed tomography (CT).The aim of our study was to determine whether there is an association between left atrial diameters measured in echocardiography and the left atrial volume determined by CT in patients who underwent AF ablation.

The role of intracardiac echocardiography in reducing radiation exposure during atrial fibrillation ablation.

Aims: Intracardiac echocardiography (ICE) is a relatively young technique used during complex electrophysiology proce-dures, such as atrial fibrillation (AF) ablation. The aim of this study was to assess whether the use of ICE modifies the radia-tion exposure at the beginning of the learning curve in AF ablation.

Materials And Methods: In this retrospective study, 52 patients, in which catheter ablation for paroxysmal or persistent AF was performed, were included.

Atrial high-rate episodes: a comprehensive review.

Cardiac electronic implantable devices (CIEDs) have the ability to monitor, store and interpret complex arrhythmias, which has generated a new arrhythmic entity: atrial high-rate episodes (AHRE). AHRE are atrial tachyarrhythmias, detected only by CIEDs. They are widely considered a precursor to atrial fibrillation (AF) but can also be represented by other kinds of supraventricular arrhythmias such as atrial flutter or atrial tachycardia.

Assessment of subclinical diabetic cardiomyopathy by speckle-tracking imaging.

Background: Diastolic dysfunction is traditionally believed to be the first subclinical manifestation of diabetic cardiomyopathy (DCM), leading to systolic dysfunction and then overt heart failure. However, in the last few years, several studies suggested that systolic subclinical dysfunction measured by speckle-tracking echocardiography (STE) may appear ahead of diastolic dysfunction. In this review, the main endpoint is to show whether subclinical myocardial systolic dysfunction appears ahead of diastolic dysfunction and the implication this may have on the evolution and management of DCM.

Catheter ablation of a latent accessory pathway under continuous infusion of adenosine: A case report.

Rationale: In absence of conduction over the accessory pathway (AP) during the electrophysiological study, mapping and ablation is impossible. Various techniques can be used to activate absent conduction. In this presentation we describe the first case of latent AP ablation performed under continuous infusion of adenosine.

The Impact of Pulmonary Vein Anatomy on the Outcomes of Catheter Ablation for Atrial Fibrillation.

Prior studies have identified a number of predictors for Atrial fibrillation (AF) ablation success, including comorbidities, the type of AF, and left atrial (LA) size. Ectopic foci in the initiation of paroxysmal AF are frequently found in pulmonary veins. Our aim was to assess how pulmonary vein anatomy influences the recurrence of atrial fibrillation after radiofrequency catheter ablation.

Tachycardia-induced cardiomyopathy in a patient with left-sided accessory pathway and left bundle branch block: A case report.

Rationale: Tachycardia-induced cardiomyopathy (TIC) is defined as systolic and/or diastolic dysfunction of the left ventricle resulting from prolonged elevated heart rates, completely reversible upon control of the arrhythmia. Atrioventricular reentrant tachycardia (AVRT) is one of the most frequent causes of TIC. In its incessant form, it is unlikely to be controlled by pharmacological treatment, catheter ablation being the principal therapeutic option.

Intracardiac echocardiography for transseptal puncture. A guide for cardiac electrophysiologists.

The key to a successful catheterization of the left heart chambers is the safe transseptal puncture. Intracardiac echocardiography (ICE) is an attractive tool used in cardiac catheterization and electrophysiology labs to provide detailed images thatcan facilitate transseptal puncture. ICE permits a direct visualization of the endocardium and precisely locates the needle and the sheath against the interatrial septum.

Recommendations for the use of electrophysiological study: Update 2018.

The field of cardiac electrophysiology has greatly developed during the past decades. Consequently, the use of electrophysiological studies (EPSs) in clinical practice has also significantly augmented, with a progressively increasing number of certified electrophysiology centers and specialists. Since Zipes et al published the Guidelines for Clinical Intracardiac Electrophysiology and Catheter Ablation Procedures in 1995, no official document summarizing current EPS indications has been published.

Variation of the PR interval for confirming ventricular pre-excitation on a 12-lead ECG.

We present the case of a 14-year-old female patient with recurrent episodes of paroxysmal supraventricular tachycardia (PSVT). Her ECG showed a PR interval of 160 ms in lead II, and a delta wave pattern in leads V2 and V3, with a normal QRS interval of 100 ms. We analyzed the three criteria for confirmation of minimal pre-excitation: (i) absence of a Q wave in V6; (ii) presence of an R wave in V1 and (iii) absence of an R wave in avR.

Intracardiac echocardiography to guide catheter ablation of an accessory pathway in Ebstein's anomaly. A case report.

We present the case of a 17-year-old girl with Ebstein anomaly and repeated episodes of reentrant tachycardia due to a right posterior accessory pathway. Catheter ablation was performed using intracardiac echocardiography. A ViewFlex Xtra probe was inserted and showed an anormal tricuspid valve with elongated anterior leaflet and low insertion of the septal leaflet towards the apex.

Intracardiac ultrasound to detect aneurysm in arrhythmogenic right ventricular dysplasia/cardiomyopathy.

Arrhythmogenic right ventricular dysplasia/cardiomyopathy is a genetic disorder characterized by fibrofattty replacement of the right ventricular myocardium. In the revised 2010 Task Force Criteria, a major criteria for ARVD/C is the presence of RV aneurysm by 2D echo. Our report demonstrates that intracardiac ultrasound can detect RV aneurysms and also focal absence of trabeculations which brings additional value to the diagnosis of ARVD/C.

Direct ICE imaging from inside the left atrial appendage during ablation of persistent atrial fibrillation.

We present the case of a 59-year-old patient with persistent atrial fibrillation, referred for atrial fibrillation ablation. The procedure was performed with the help of NAVX 3D mapping system (Saint Jude Medical) and iLAB Ultra ICE Plus ultrasound imaging catheter (Boston Scientific). The catheter permits cross-sectional images perpendicular to catheter's long axis.

Ablation of a left-sided accessory pathway with near-zero fluoroscopy in a 9-year-old boy.

Catheter ablation of cardiac arrhythmias in pediatric population is associated with the risk of ionizing radiation on the child. Due to a greater radiation sensitivity in children and a longer life expectancy newer techniques try to reduce the radiation exposure. A new technique for zero-fluoroscopy catheter ablation is described in a 9-year-old boy who had a left-sided concealed accessory pathway.

Intravascular pulmonary venous ultrasound imaging for catheter ablation of atrial fibrillation.

Atrial fibrillation is the most common cardiac arrhythmia. The development of electroanatomical mapping is an increase demand for advanced intracardiac imaging techniques of the left atrium and pulmonary veins. IVUS can demonstrate quantitative changes like lumen and wall thickness as well as qualitative changes of the pulmonary wall.

Catheter ablation of ventricular tachycardia related to a septo-apical left ventricular aneurysm.

A 60-year-old male patient with previous myocardial infarction (30 years ago) presented to our cardiology department for sustained monomorphic ventricular tachycardia. The patient presented multiple episodes of tachycardia treated by his internal cardiac defibrillator. Radiofrequency ablation was proposed as curative treatment.

Insights into the mechanism of idiopathic left ventricular tachycardia: a case report and literature review.

Left ventricular posterior fascicular tachycardia (LVPFT) is an idiopathic form of VT characterized by right bundle branch block morphology and left axis deviation. The mechanism of LPFVT is thought to be localized reentry close to the posterior fascicle. We present the case of a 24-year-old medical student who was admitted to the emergency department complaining of palpitations.

Distance between the Left Atrial Appendage and Mitral Annulus Evaluated by CARTO 3 Integrated Computed Tomography Imaging.

Objective: To measure distances between pulmonary veins (PV) and mitral annulus (MA) using angiographic computed tomography (CT) and to compare them with the left atrial appendage-MA (LAA-MA) line.

Materials And Methods: Data from 46 catheter ablation procedures for atrial fibrillation involving 36 males, mean age 53 years, range 27-78 years, were analyzed. Three types of mitral isthmus lines were measured using angiographic CT images integrated in the CARTO 3 system (Biosense Webster): the distance between the right superior PV and MA (RSPV-MA), the right inferior PV and MA (RIPV-MA), and the left inferior PV and MA (LIPV-MA).