Four typical pulmonary venous pressure curves displaying the level of occlusion during atrial fibrillation ablation by cryoballoon.

Background: Cryoballoon ablation is safe and effective for pulmonary vein isolation in patients with symptomatic drug-refractory paroxysmal atrial fibrillation. To monitor adhesion between the balloon and the pulmonary vein, an alternative technique to pulmonary venography is to analyze changes in the pressure curve.

Methods: We have described the adhesion level characterized by four types of pressure waveforms.

Recurrences of Atrial Fibrillation Despite Durable Pulmonary Vein Isolation: The PARTY-PVI Study.

Background: Recurrences of atrial fibrillation (AF) after pulmonary vein isolation (PVI) are mainly due to pulmonary vein reconnection. However, a growing number of patients have AF recurrences despite durable PVI. The optimal ablative strategy for these patients is unknown.

Ventricular fibrillation in acute myocardial infarction: 20-year trends in the FAST-MI study.

Aims: Sudden cardiac arrest remains a major complication of acute myocardial infarction (AMI) and is frequently related to ventricular fibrillation (VF). Incidence and impact of VF among patients hospitalized for AMI were evaluated.

Methods And Results: Data from the FAST-MI programme consisting of 5 French nationwide prospective cohort studies between 1995 and 2015 were analysed, totally including 14 423 patients with AMI (66 ± 14 years, 72% males, 59% ST-elevation myocardial infarction).

Preventing atrial fibrillation by combined right isthmus ablation and cryoballoon pulmonary vein isolation in patients with typical atrial flutter: PAF-CRIOBLAF study.

Background: Although less common, typical atrial flutter shares similar pathophysiological roots with atrial fibrillation. Following successful cavo-tricuspid isthmus ablation using radiofrequency, many patients, however, develop atrial fibrillation in the mid-to-long-term. This study sought to assess whether pulmonary vein isolation conducted at the same time as cavo-tricuspid isthmus ablation would significantly modify the atrial fibrillation burden upon follow-up in patients suffering from typical atrial flutter.

Exclusion of Intra-Atrial Thrombus Diagnosis Using D-Dimer Assay Before Catheter Ablation of Atrial Fibrillation.

Objectives: This study hypothesized that the association of D-dimer blood level and several clinical items in a new risk score could predict the absence of atrial thrombus.

Background: Symptomatic and drug resistant atrial fibrillation (AF) can be treated by catheter ablation. The procedure-related risk of thromboembolism is limited by the pre-operative use of transesophageal echocardiography (TEE) to detect atrial thrombi.

The second generation cryoballoon has improved durable isolation of left but not right pulmonary veins: new insights from a multicentre study.

Aims: Pulmonary vein isolation (PVI) using second-generation cryoballoon (CB2) is associated with improved outcomes compared with first generation (CB1). We aimed at investigating the characteristics of left and right PV reconnections after CB1 and CB2 ablations in patients with clinical recurrences requiring redo ablation.

Methods And Results: From 2010 to 2016, 776 patients underwent 28-mm cryoballoon PVI for symptomatic paroxysmal atrial fibrillation (AF) in 3 centres, 279 with CB1 and 497 with CB2.

Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation.

Background: Compared with the first-generation Arctic Front cryoballoon (ARC-CB), the new Arctic Front Advance cryoballoon (ARC-Adv-CB) increases the efficient CB-tissue contact surface during freezing, which may increase the incidence of phrenic nerve (PN) palsy (PNP).

Objective: To evaluate the safety and efficacy of paroxysmal atrial fibrillation (AF) ablation with the ARC-Adv-CB as well as the merits of a predictor of PNP.

Methods: AF ablation was performed by using a "single 28-mm big CB" approach.

[Atrial fibrillation: who should be anticoagulated?].

The growing incidence of Atrial Fibrillation (AF) induces an increasing morbimortality, particularly thromboembolism (TE). Vitamin K Antagonists (VKA) reduce of 62 % the stroke rate in case of AF and are more efficient with INR between 2 and 3 than aspirin or the association aspirin-VKA with INR<2. The only place for clopidogrel could be its association with aspirin if VKA are contra-indicated.

[Managing bradycardia in adults].

Bradycardia represents a common cause of requirement for specialist advice and it looks sometimes difficult to evaluate its pathological criteria and its medical management. The authors remind the physiological mechanisms and their aetiologies, cardiac or not. Many complementary exams can be employed but a rigorous strategy is necessary, based on the use of electrocardiogram, Holter ECG, implantable loop recorder, stress test, cardiac echography, tilt testing, electrophysiological study.