Self-sustained waves of electrophysiological activity can cause arrhythmia in the heart. These reentrant excitations have been associated with spiral waves circulating around either an anatomically defined weakly conducting region or a functionally determined core. Recently, an ablation procedure has been clinically introduced that stops atrial fibrillation of the heart by destroying the electrical activity at the spiral core. This is puzzling because the tissue at the anatomically defined spiral core would already be weakly conducting, and a further decrease should not improve the situation. In the case of a functionally determined core, an ablation procedure should even further stabilize the rotating wave. The efficacy of the procedure thus needs explanation. Here, we show theoretically that fundamentally in any excitable medium a region with a propagation velocity faster than its surrounding can act as a nucleation center for reentry and can anchor an induced spiral wave. Our findings demonstrate a mechanistic underpinning for the recently developed ablation procedure. Our theoretical results are based on a very general and widely used two-component model of an excitable medium. Moreover, the important control parameters used to realize conditions for the discovered phenomena are applicable to quite different multicomponent models.
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http://dx.doi.org/10.1073/pnas.1611475114 | DOI Listing |
Front Surg
January 2025
Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
We report a case of a patient with dilated cardiomyopathy who experienced recurrent ventricular tachycardia (VT) and multiple defibrillations following CRT-D implantation. Due to worsening cardiac function, the patient required surgical implantation of a left ventricular assist device (LVAD) as a bridge to heart transplantation. During the procedure, we used the Ensite three-dimensional mapping system to perform activation and substrate mapping of the VT targets, followed by endocardial and epicardial cryoballoon ablation of clinical VT.
View Article and Find Full Text PDFJ Biomed Opt
January 2025
Columbia University, Department of Electrical Engineering, New York, United States.
Significance: Radiofrequency ablation to treat atrial fibrillation (AF) involves isolating the pulmonary vein from the left atria to prevent AF from occurring. However, creating ablation lesions within the pulmonary veins can cause adverse complications.
Aim: We propose automated classification algorithms to classify optical coherence tomography (OCT) volumes of human venoatrial junctions.
World J Gastroenterol
January 2025
Department of Gastroenterology, University Hospital of Larisa, Larisa 41100, Greece.
Liver cancer, and in particular hepatocellular carcinoma (HCC) is a disease of rising prevalence and incidence. To date, definitive treatment options include either surgical excision or ablation of the affected area. With increasing research on several pathways that could be involved in the progression of HCC, new elements within these pathways emerge as potential targets for novel therapies.
View Article and Find Full Text PDFJ Cardiol Cases
January 2025
Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Unlabelled: Septal reduction therapy is an effective treatment for hypertrophic obstructive cardiomyopathy (HOCM). Alcohol septal ablation (ASA) is indicated for HOCM patients who are ineligible for surgical myectomy, but several tips exist for the management of high-risk patients with ASA. Here, we present a case of successful ASA in a HOCM patient with multiple comorbidities, including severe obesity, drug-refractory bronchial asthma, poorly controlled diabetes, and steroid-induced immunosuppression.
View Article and Find Full Text PDFQuant Imaging Med Surg
January 2025
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background: Data on overall survival (OS) and progression-free survival (PFS) after microwave ablation (MWA) for intrahepatic cholangiocarcinoma (ICC) are scarce. We conducted a systematic review of the safety and efficacy of MWA for ICC.
Methods: The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies reporting the outcomes of MWA for ICC.
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