Incidence and clinical predictors of subsequent atrial fibrillation requiring additional ablation after cavotricuspid isthmus ablation for typical atrial flutter.

Objectives: We sought to investigate the incidence of atrial fibrillation after catheter ablation for typical atrial flutter and to determine the predictors for symptomatic atrial fibrillation that required a further additional dedicated ablation procedure.

Design: 127 patients underwent elective cavotricuspid isthmus ablation with the indication of symptomatic, typical atrial flutter. The occurrence of atrial flutter, atrial fibrillation, cerebrovascular events and the need for additional ablation procedures for symptomatic atrial fibrillation was assessed during long-term follow-up.

Effect of flecainide on the extension and localization of complex fractionated electrogram during atrial fibrillation.

Aims: Complex fractionated electrogram (CFE) ablation in addition to pulmonary vein isolation is an accepted strategy for the treatment of non-paroxysmal atrial fibrillation (AF). We sought to determine the effect of flecainide on the distribution and extension of CFE areas.

Methods: Twenty-three non-paroxysmal AF patients were enrolled in this prospective study.

Ablation effect indicated by impedance fall is correlated with contact force level during ablation for atrial fibrillation.

Introduction: Previous studies have validated the use of impedance fall as a measure of the effects of ablation. We investigated whether catheter-to-tissue contact force correlated with impedance fall during atrial fibrillation ablation.

Methods And Results: A total of 394 ablation points from 35 patients who underwent atrial fibrillation ablation were selected and analyzed in terms of the presence of stable catheter contact in non-ablated areas in the left atrium.

Long-term outcomes of adjunctive complex fractionated electrogram ablation to pulmonary vein isolation as treatment for non-paroxysmal atrial fibrillation.

Purpose: The adjunctive ablation of areas of complex fractionated electrogram (CFE) to pulmonary vein isolation (PVI) is an emerging strategy for patients with non-paroxysmal atrial fibrillation (AF). We studied the long-term outcomes of this approach.

Methods: Sixty-six patients (mean age 58 ± 9, 86.

N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation.

Aims: We investigated the relationship between arrhythmia burden, left atrial volume (LAV) and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) at baseline and after long-term follow-up of atrial fibrillation (AF) ablation.

Methods: We studied 38 patients (23 paroxysmal, 6 women, mean age 56 ± 11) scheduled for AF ablation. LAV was calculated on the basis of computed tomography images at baseline and long-term follow-up, and arrhythmia burden was graded from self-reported frequency and duration of AF episodes.

Ventricular arrhythmias originating from the aortomitral continuity: an uncommon variant of left ventricular outflow tract tachycardia.

Aims: Ventricular arrhythmias arising from the fibrous rings have been demonstrated, but knowledge about the aortomitral continuity (AMC) as a source of the arrhytmias is still limited. The objective is to describe the characteristics of ventricular arrhythmias originating from the AMC in patients without structural heart disease.

Methods And Results: Ten patients with ventricular tachycardia (VT) and/or premature ventricular contractions, who had been successfully treated by catheter ablation at the AMC beneath the aortic valve, were enrolled.

Remote magnetic versus manual catheters: evaluation of ablation effect in atrial fibrillation by myocardial marker levels.

Background: A remote magnetic navigation (MN) system is available for radiofrequency ablation of atrial fibrillation (AF), challenging the conventional manual ablation technique. The myocardial markers were measured to compare the effects of the two types of MN catheters with those of a manual-irrigated catheter in AF ablation.

Methods: AF patients underwent an ablation procedure using either a conventional manual-irrigated catheter (CIR, n = 65) or an MN system utilizing either an irrigated (RMI, n = 23) or non-irrigated catheter (RMN, n = 26).

[Magnetic navigation for ablation of cardiac arrhythmias].

Background: The first use of magnetic navigation for radiofrequency ablation of supraventricular tachycardias, was published in 2004. Subsequently, the method has been used for treatment of most types of tachyarrhythmias. This paper provides an overview of the method, with special emphasis on usefulness of a new remote-controlled magnetic navigation system.

Characteristics and distribution of complex fractionated atrial electrograms in patients with paroxysmal and persistent atrial fibrillation.

Introduction: Substrate-based radiofrequency ablation for treatment of atrial fibrillation (AF) is still under development. The purpose of this study was to investigate the different characteristics and distribution of complex fractionated atrial electrograms (CFAE) in both atria in patients with paroxysmal and persistent AF.

Methods And Results: The NavX system was used to map the left and right atria and the coronary sinus in 20 AF patients (ten persistent).

Atrio-pulmonary vein conduction delay during pulmonary vein isolation for atrial fibrillation is related to vein anatomy, age, and focal activity.

Background: During pulmonary vein isolation for treatment of atrial fibrillation (AF), a significant delay in atrio-pulmonary vein (PV) conduction is often observed. We sought to investigate this conduction delay in various PV in individual patients.

Methods: We studied 385 AF patients (mean age: 54 +/- 11 years, 74 women) who underwent segmental PV isolation (PVI).

Spatial relationships between the pulmonary veins and sites of complex fractionated atrial electrograms during atrial fibrillation.

Background: Pulmonary vein (PV) isolation is used for the treatment of atrial fibrillation (AF). Complex fractionated atrial electrogram (CFAE) mapping has been introduced to guide AF ablation. However, the spatial relationship between PV and CFAE is not well defined.

[Catheter ablation of tachyarrhythmias in children and adolescents].

Background: Catheter ablation has been increasingly applied in children and adolescents with tachyarrhythmias. The aim of this article is to assess the results of ablation therapy of tachycardias in patients below 18 years of age at Haukeland University Hospital.

Material And Methods: 141 patients (70 boys and 71 girls, aged 5-17 (13.

Electroanatomical mapping and radiofrequency catheter ablation of atrial tachycardia originating from the donor heart after orthotopic heart transplantation in a child.

A 15-year-old boy who had been given an orthotopic heart transplant 12 years earlier underwent radiofrequency ablation after 14 months of tachycardia. At the time of the procedure, the patient presented moderate signs of heart failure and tachycardia-induced cardiomyopathy. During electroanatomical mapping we identified a focal atrial tachycardia with origin in the donor right atrium and bi-directional atrio-atrial conduction.

Treatment of atrial fibrillation by silencing electrical activity in the posterior inter-pulmonary-vein atrium.

Aims: The recurrence of atrial fibrillation (AF) after pulmonary vein (PV) isolation is still a challenge. We investigated a new approach to treating AF patients by silencing electrical activity in the posterior inter-pulmonary-vein atrium (PIA).

Methods And Results: Three ablation steps are required to obtain PIA electrical silence: electrical PV isolation, the creation of two lines of lesions between the two superior and inferior PVs and the abolition of residual electrical signals within the PIA.

Significance of late recurrence of atrial fibrillation during long-term follow-up after pulmonary vein isolation.

Background And Study Objective: Patients with paroxysmal or persistent atrial fibrillation (AF) can be treated by pulmonary vein (PV) isolation. Although the recurrence rate after the procedure is relatively high, the long-term outcomes after initially recurrence-free procedures remains unclear. We examined the rates of recurrence of AF after PV isolation.

Device treatment of atrial tachycardia--minor additional effect of repeating pacing sequences.

Purpose: Ramp and burst pacing as treatment for atrial tachycardia (AT), one known trigger mechanism of atrial fibrillation (AF) are available in permanent pacemakers to reduce the burden of AF. An analysis of the success rate of three consecutive antitachycardia pacing sequences is presented.

Method: The AT 500 (Medtronic) pacemaker was implanted in 36 patients (18 female, mean age 77+/-11 years) with pacemaker indication due to tachybrady arrhythmias (n=34), and other indications (n=2).

Reducing atrial tachycardia and atrial fibrillation episodes with a prevention and treatment device and tailored treatment.

Background: Pacemaker treatment of known trigger mechanisms for atrial tachyarrhythmias (AT) and atrial fibrillation (AF) has shown reduction in the incidence of AF. A new arrhythmia management device, which included storage of AT/AF (for tailoring treatment) and three prevention algorithms and one for treatment, was examined in order to identify the influence on arrhythmia episodes over a 12-month follow-up (FU) period.

Methods: Twenty-three consecutive patients with known tachybradyarrhythmias were examined.

A clinical study of patients with and without recurrence of paroxysmal atrial fibrillation after pulmonary vein isolation.

Patients with paroxysmal atrial fibrillation (PAF) can be treated by pulmonary vein (PV) isolation. However, the recurrence rate after this procedure is relatively high. We sought to evaluate the quality of life (QOL) of patients with PAF recurrence after PV isolation and to analyze factors related to recurrences.

Proportionality of rate response to metabolic workload provided by a rate adaptive pacemaker with automatic rate profile optimization.

Objective: The rate response of a pacemaker (PM) was compared with the sinus rate in patients during repeated exercise tests, at different settings of the rate response parameters.

Methods And Results: In patients with paroxysmal sick sinus syndrome (n=3) or atrioventricular block (n=8), a rate responsive PM was implanted. The activity-dependent pacing rate is represented by the sensor indicated rate (SIR).

Reverse remodelling of systolic left ventricular contraction pattern by long term cardiac resynchronisation therapy: colour Doppler shows resynchronisation.

Objective: To quantify long term effects of cardiac resynchronisation therapy (CRT) by biventricular pacing in patients with heart failure (HF).

Methods: Regional changes in left ventricular (LV) contraction patterns effected by CRT in 19 patients with HF (12 with ischaemia; mean (SD) age 66 (9) years) with bundle branch block were examined by colour Doppler tissue velocity imaging (c-TVI). Time differences during main systolic tissue velocity peak (SYS) were compared in the basal and mid LV interventricular septum and in the corresponding LV free wall segments.

Color Doppler tissue velocity imaging demonstrates significant asynchronous regional left ventricular contraction and relaxation in patients with bundle branch block and heart failure compared with control subjects.

Bundle branch block in patients with severe heart failure (HF) may result in asynchronous regional left ventricular (LV) contraction. Colour Doppler tissue velocity imaging (c-TVI) allows tissue velocity profiles to be measured with a resolution of 10 ms. Normal subjects (n = 30) showed a synchronous regional longitudinal LV pattern of movement, and HF patients with bundle branch block (n = 30) showed asynchronous contraction and relaxation patterns which were quantified by c-TVI as ranging from -22 to 19 ms.

Feasibility of color doppler tissue velocity imaging for assessment of regional timing of left ventricular longitudinal movement.

OBJECTIVE--The feasibility of color Doppler tissue velocity imaging (c-TVI) with a high time resolution of 10 ms for simultaneous measurement of the temporal characteristics of regional left ventricular (LV) tissue velocities at different LV sites was examined. Methods and results--In 20 subjects with structurally normal hearts, inter- and intraobserver agreement and the beat-to-beat variation were tested in c-TVI profiles from basal and mid-LV segments of the interventricular septum (IS) and of the lateral free wall (LFW). For peak tissue velocities a mean error of less than 1 cm/s was demonstrated.

Color Doppler tissue velocity imaging can disclose systolic left ventricular asynchrony independent of the QRS morphology in patients with severe heart failure.

Unlabelled: A QRS width greater than 120 ms is assumed to be a marker of inter- and intraventricular asynchrony in severe heart failure (HF) patients. Color Doppler tissue velocity imaging (c-TVI) with a time resolution of 10 ms was used to study regional left ventricular (LV) longitudinal systolic contraction pattern in HF patients with left and right bundle branch block (LBBB and RBBB) and in patients with normal QRS width. We studied 12 women and 23 men with severe HF, with a mean age of 66 +/- 11 years in New York Heart Association functional Class 2.