Non-invasive characterisation of macroreentrant atrial tachycardia types from a vectorcardiographic approach with the slow conduction region as a cornerstone.

Background And Objectives: Macroreentrant atrial tachyarrhythmias (MRATs) can be caused by different reentrant circuits. The treatment for each MRAT type may require ablation at different sites, either at the right or left atria. Unfortunately, the reentrant circuit that drives the arrhythmia cannot be ascertained previous to the electrophysiological intervention.

Precision and reproducibility of non-automatic measurement of the QRS complex in potential candidates for cardiac resynchronization therapy.

Background: Accurate measurement of QRS complex duration (QRSd) remains crucial for the selection of patients for cardiac resynchronization therapy (CRT). However, assessment of QRSd on conventional surface electrocardiograms (ECG), especially when performed without computer assistance, may be challenging due to the limited accuracy of the human eye to discriminate differences in the range of 10 ms at 25 mm/s. The value and reproducibility of visual assessment of QRSd at 25 mm/s on conventional ECGs was compared to those obtained using an electrophysiology recording system (EPRS) with simultaneous 12 lead traces at 100 mm/s, which was considered the gold standard.

Common atrial flutter catheter ablation without discontinuing oral anticoagulation.

To determine if performing catheter ablation under oral anticoagulation is associated with a higher risk of thromboembolic or bleeding complications. Patients with common atrial flutter that underwent catheter ablation of the cavo-tricuspid isthmus were consecutively included in the study. All patients were taking oral anticoagulants at least 3 weeks before the ablation.

What is behind radiofrequency delivery at the cavo-tricuspid isthmus?

Catheter-based ablation of isthmus-dependent common atrial flutter results in very high success rates and almost no complications. However, bidirectional conduction block through the isthmus may be challenging in a small percentage of patients regarding the use of high power and high temperature settings during radiofrequency delivery. Anatomical and physiological circumstances may be the reason for such difficulties to achieve bidirectional block at the cavo-tricuspid isthmus.

Non-Fluoroscopic Transseptal Catheterization During Electrophysiology Procedures using a Remote Magnetic Navigation System.

Transseptal punctures are commonly performed, and left atrial (LA) access is frequently lost during lengthy, complex electrophysiology (EP) procedures. We describe a new technique for non-fluoroscopic re-crossing the fossa ovalis using a new multielectrode transseptal sheath (TS) and a new remote magnetic catheter navigation system (RMNS) (CGCI System, Magnetecs) that uses 8 rapid external electromagnets for real-time navigation of a magnet-tipped electrode catheter across the initial transseptal puncture site in 5 patients undergoing left-sided ablation procedures. The three-dimensional (3D) position of a 8.

Remote magnetic navigation for accurate, real-time catheter positioning and ablation in cardiac electrophysiology procedures.

New remote navigation systems have been developed to improve current limitations of conventional manually guided catheter ablation in complex cardiac substrates such as left atrial flutter. This protocol describes all the clinical and invasive interventional steps performed during a human electrophysiological study and ablation to assess the accuracy, safety and real-time navigation of the Catheter Guidance, Control and Imaging (CGCI) system. Patients who underwent ablation of a right or left atrium flutter substrate were included.

[Basic mechanisms of the new antiarrhythmic drugs in atrial fibrillation].

Atrial fibrillation (AF) is the most common sustained arrhythmia seen in clinical practice. Despite of new technological breakthroughs and the understanding of the mechanisms underlying AF, based on animal models and ablation procedures in patients, the antiarrhythmic drugs remain the main therapeutic strategy to restore and maintain the sinus rhythm. New antiarrhythmic drugs are already available in the clinical practice and many others are under development.

Improved prognosis after using mild hypothermia to treat cardiorespiratory arrest due to a cardiac cause: comparison with a control group.

Introduction And Objectives: Patients who survive a cardiac arrest have a poor short-term prognosis in terms of mortality and neurological function. The use of mild hypothermia has been investigated in only a few randomized studies, but appears to be effective for treating these patients. The aim of this study was to investigate the effect of this treatment on survival and neurological outcomes.