Repeat ablation of atrial fibrillation using electrogram dispersion to identify additional areas of mechanistic significance.

Background: Electrogram dispersion identifies putative atrial fibrillation (AF) drivers in first time ablation procedures, with high acute termination rates and long-term outcomes akin to extensive ablation approaches. Its use in a population that had undergone repeat ablation is unknown, particularly where the pulmonary veins are already isolated.

Objective: This purpose of this study was to assess electrogram dispersion mapping during repeat ablation procedures for persistent AF.

Achieving bi-directional conduction block during catheter ablation is not enough to prevent recurrence of cavo-tricuspid isthmus dependant atrial flutter: Role of subclinical conduction.

Background: Achieving bi-directional conduction block, as assessed by differential pacing and change in activation along tricuspid annulus (TA), across the cavo-tricuspid isthmus (CTI), is considered a satisfactory end point during catheter ablation of atrial flutter (AFL).

Aim: To assess role of subclinical conduction by observing polarity reversal of local bipolar signals from RS to QR pattern lateral to the line of ablation, in predicting recurrence of CTI dependant AFL after ablation in patients with bidirectional conduction block.

Method And Results: Of 683 patients undergoing ablation of CTI dependent AFL, 73 (10.

Safety and Long-Term Success of Persistent Atrial Fibrillation Ablation Using THERMOCOOL SMARTTOUCH® Catheter: Real-World Experience.

Background: To investigate the real-world clinical experience of persistent atrial fibrillation (persAF) ablation using the THERMOCOOL SMARTTOUCH® catheter with contact force (CF)-sensing ability in a prospective, multicenter registry.

Methods: Patients with persAF (excluding long-standing persAF) undergoing ablation were enrolled. Primary adverse events (AEs), 12-month success, quality of life (QoL), and correlation of success with CF were assessed.

Safety and long-term effectiveness of paroxysmal atrial fibrillation ablation with a contact force-sensing catheter: real-world experience from a prospective, multicentre observational cohort registry.

Aims: Real-time contact force (CF)-sensing radiofrequency ablation catheter for treatment of paroxysmal atrial fibrillation (PAF) allows optimization of electrode-tissue contact, which correlates with long-term success. This prospective, multicentre observational registry assessed the real-world clinical effectiveness of a CF-sensing catheter for ablation of drug-refractory PAF.

Methods And Results: Patients were followed-up at 3, 6, and 12 months after ablation.

Outcomes in Patients With Congenital Heart Disease Receiving the Subcutaneous Implantable-Cardioverter Defibrillator: Results From a Pooled Analysis From the IDE Study and the EFFORTLESS S-ICD Registry.

Objectives: This study was conceived to determine the safety and efficacy of the subcutaneous implantable cardioverter-defibrillator (S-ICD) in patients with congenital heart disease (CHD).

Background: The S-ICD is a treatment option for patients with CHD in which a transvenous device is contraindicated due to anatomic considerations. However, efficacy in this group has not been determined.

Importance of superior vena cava isolation in successful ablation of persistent atrial fibrillation in patient with partial anomalous pulmonary vein.

Ectopic foci arising from pulmonary veins (PVs) are the predominant sources for the initiation and maintenance of atrial fibrillation (AF) in a vast majority of cases. However, ectopic foci also exist in the non-PV areas like superior vena cava (SVC) in 10-20% of the cases. We report the significance of SVC isolation in a patient with persistent AF and anomalous pulmonary venous connection of the right superior pulmonary vein into the SVC.

Laser Doppler assessment of dermal circulatory changes in people with coronary artery disease.

Background: Dermal microcirculation provides an easily accessible vasculature bed which can be used to assess endothelial mediated vasodilatation. We studied and compared microcirculatory changes in response to acetylcholine iontophoresis (ACh), local heating of the skin and reactive hyperaemia in patients with coronary artery disease (CAD).

Methods And Results: Forty eight patients with CAD were studied and compared with 25 age and sex matched control subjects.

The Role of Asymmetric Dimethylarginine (ADMA) in Endothelial Dysfunction and Cardiovascular Disease.

Endothelium plays a crucial role in the maintenance of vascular tone and structure. Endothelial dysfunction is known to precede overt coronary artery disease. A number of cardiovascular risk factors, as well as metabolic diseases and systemic or local inflammation cause endothelial dysfunction.

Carotid intima-media thickness as a surrogate marker of cardiovascular disease in diabetes.

Background: Diabetes mellitus is associated with a high risk of cardiovascular disease. Carotid intima-media thickness (CIMT) is increasingly used as a surrogate marker for atherosclerosis. Its use relies on its ability to predict future clinical cardiovascular end points.

Comparative reproducibility of dermal microvascular blood flow changes in response to acetylcholine iontophoresis, hyperthermia and reactive hyperaemia.

Laser Doppler fluxmetry (LDF) can non-invasively measure skin microvascular changes in response to acetylcholine (ACh), local heating of the skin and reactive hyperaemia following arterial occlusion. Various studies have used microvascular changes in response to these stimuli, especially ACh iontophoresis and local heating, as a surrogate marker of endothelial function. There are few data in the literature regarding the comparative reproducibility of microvascular perfusion changes induced by the three stimuli.

A study of endothelial function and circulating asymmetric dimethylarginine levels in people with Type 1 diabetes without macrovascular disease or microalbuminuria.

Background: Asymmetric dimethylarginine (ADMA) is a competitive inhibitor of endothelial nitric oxide synthase (eNOS) that is associated with endothelial dysfunction, and is a risk marker for cardiovascular disease, a significant problem in Type 1 diabetes. The aim of the present study was to measure circulating ADMA, and define its association with endothelial dysfunction and endothelial markers in people with Type 1 diabetes with low likelihood of macrovascular disease.

Methods: Sixty-one young people with Type 1 diabetes without macrovascular disease or nephropathy and 62 healthy volunteers underwent brachial artery flow-mediated dilatation (FMD) and assay of plasma ADMA and adhesion molecules.

Predicting the development of macrovascular disease in people with type 1 diabetes: A 9-year follow-up study.

The aim of the article was to use prospectively collected data on people with type 1 diabetes to assess which routinely collected clinical measures predict the development of macrovascular disease in people with type 1 diabetes. Data have been collected in a structured format at an annual review since 1985. For this study, all people with type 1 diabetes in the database in both 1992 and 2001 were ascertained.