Pulmonary vein isolation is an established therapeutic procedure for symptomatic atrial fibrillation (AF). This approach involves ablation of atrial tissue just outside the pulmonary veins. However, patient outcomes are limited because of a high rate of arrhythmia recurrence. Ablation of electrically active tissue inside the pulmonary vein may improve procedural success, but is currently avoided because of the complication of postablation stenosis. An innovative device that can ablate inside pulmonary veins and prevent stenosis is a viable strategy to increase long-term efficacy. We have developed a prototypical balloon catheter device capable of nonthermal pulmonary vein ablation along with elution of an antifibrotic agent intended to eliminate arrhythmogenic substrate without the risk of stenosis and have demonstrated its functionality in 4 acute canine experiments. Further optimization of this device may provide an innovative means to simultaneously ablate and prevent pulmonary vein stenosis for improved AF treatment in humans.
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http://dx.doi.org/10.1016/j.trsl.2014.07.002 | DOI Listing |
Vasa
January 2025
Department of Vascular Surgery, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, Greece.
We investigated the safety and efficacy of rivaroxaban as routine thromboprophylaxis after endovenous thermal ablation (EVTA). Adhering to the PRISMA 2020 guidelines, we conducted a systematic review for studies published up to April 2024. Primary endpoints included endovenous heat-induced thrombosis (EHIT) class ≥ II, deep vein thrombosis (DVT), major and minor bleeding and the composite endpoint of major thromboembolic complications including any incidents of EHIT ≥ III, DVT or pulmonary embolism (PE).
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Radiology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK.
Subdermal contraceptive implants are now commonly used throughout the world. One of the rare complications of these implants is migration to the lungs due to misplacement of the implant during insertion, with only a limited number of cases documented. Here, we present a case where a subdermal contraceptive implant embolised in the subsegmental branch of the pulmonary artery within the anterobasal segment of the left lower lobe.
View Article and Find Full Text PDFBackground: The results of pulmonary vein isolation are limited by arrhythmia recurrence, which is most often due to a failure to effectuate a durable contiguous circumferential transmural lesion around the pulmonary vein (PV) ostia. We postulated that enhancing the index ablation line through use of multiple cryoballoon diameters would be superior to standard ablation with bonus freeze.
Methods: We enrolled 226 consecutive patients referred for cryoballoon-based PV isolation (PVI).
Cardiol Young
January 2025
Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität München, Europäisches Kinderherzzentrum München, Munich, Germany.
Objective: This study aimed to evaluate veno-venous collaterals between bidirectional cavopulmonary shunt and total cavopulmonary connection.
Methods: Patients who underwent staged total cavopulmonary connection between 1995 and 2022 were reviewed. Veno-venous collaterals between bidirectional cavopulmonary shunt and total cavopulmonary connection were depicted using angiograms.
Eur Heart J Case Rep
January 2025
Department of Cardiology, Changhai Hospital, Shanghai 200433, China.
Background: Several studies have demonstrated a notable increase in the incidence of atrial arrhythmias among individuals with atrial septal defect (ASD) occluder. Although the sequential dilation technique has been proposed as the mainstream technique for transseptal puncture with ASD occluder, it is associated with substantial risks and technical difficulties.
Case Summary: We report a patient who underwent catheter ablation for atrial fibrillation and had a large ASD occluder.
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