Background: Cryoballoon ablation (CBA) for pulmonary vein isolation (PVI) is an established modality for the treatment of atrial fibrillation (AF). We report feasibility of left atrial (LA) substrate modification in addition to PVI both using the cryoballoon.
Methods: LA substrates and CBA-induced scar were assessed at baseline and 3 months after ablation using late gadolinium enhancement magnetic resonance imaging (LGE-MRI). Common periprocedural data including postablation LGE-MRI for evaluation of esophageal thermal injury, and CBA-associated complications were collected. Freedom from AF recurrence at 12 months was assessed using Holter and 30-day rhythm monitors.
Results: In 26 patients (64 ± 11 years, 69% male; 27% persistent AF, CHADSVASC score: 2.3 ± 1.5; left ventricular ejection fraction: 56 ± 10%, oral anticoagulation with warfarin/direct oral anticoagulants: n = 11/15), referred for first-time AF ablation, CBA of the pulmonary veins and extrapulmonary LA substrates was performed (median: 12 [interquartile range {IQR}: 7-14] freezes over 1675 seconds [IQR: 1168-2160]). On LGE-MRI, significant postablation cryoballoon-induced LA scar (median: 19.4% [IQR: 13.4-24.7] in comparison to baseline preablation LA-LGE (median: 10.6% [IQR 3.1-13.1]; P = .01) was found. Freedom from AF recurrence at 12 months was 74.5% with median time-to-recurrence of 242 days (IQR: 172-298). In 15 of 26 (58%) patients, esophageal enhancement on the postablation MRI was present with full recovery after 3 months. No major periprocedural complications were observed.
Conclusion: LA substrate modification in addition to PVI using LGE-MRI-guided CBA is feasible but still experimental. The efficacy and safety have to be investigated in a prospective randomized trial.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/jce.14551 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Maternal obesity alters histone modifications mediated by the interaction between Ezh2 and Ampk, impairing neural differentiation in the developing embryonic brain cortex.
J Biol Chem
January 2025
Department of Biochemistry, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, UAE; Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, UAE; ASPIRE Precision Medicine Research Institute Abu Dhabi (PMRI-AD), United Arab Emirates University, Al Ain, UAE. Electronic address:
Neurodevelopmental disorders have complex origins that manifest early during embryonic growth and are associated with intricate gene regulation dynamics. A perturbed metabolic environment such as hyperglycemia or dyslipidemia, particularly due to maternal obesity, poses a threat to the optimal development of the embryonic central nervous system. Accumulating evidence suggests that these metabolic irregularities during pregnancy may alter neurogenesis pathways, thereby predisposing the developing fetus to neurodevelopmental disorders.
View Article and Find Full Text PDFIdentification and Characterization of a New Thermophilic κ-Carrageenan Sulfatase.
J Agric Food Chem
January 2025
Faculty of Chemistry, Biotechnology, and Food Science, NMBU Norwegian University of Life Sciences, P.O. Box 5003, 1432 Aas, Norway.
Carrageenans are sulfated polysaccharides found in the cell wall of certain red seaweeds. They are widely used in the food industry for their gelling and stabilizing properties. In nature, carrageenans undergo enzymatic modification and degradation by marine organisms.
View Article and Find Full Text PDFPurpose: Understanding the molecular mechanisms of adaptive regulation in the tumor microenvironment is crucial for precision therapy in hepatocellular carcinoma (HCC). We hypothesized that cargo proteins carried by extracellular vesicles (EVs) released in a hypoxic microenvironment might promote HCC progression by remodeling tumor-associated macrophages (TAMs).
Methods: EV protein analysis by label-free proteomics mass spectrometry of HCC cell lines of different tumor grades was performed.
Genesis and regulation of C-terminal cyclic imides from protein damage.
Proc Natl Acad Sci U S A
January 2025
Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA 02138.
C-Terminal cyclic imides are posttranslational modifications that can arise from spontaneous intramolecular cleavage of asparagine or glutamine residues resulting in a form of irreversible protein damage. These protein damage events are recognized and removed by the E3 ligase substrate adapter cereblon (CRBN), indicating that these aging-related modifications may require cellular quality control mechanisms to prevent deleterious effects. However, the factors that determine protein or peptide susceptibility to C-terminal cyclic imide formation or their effect on protein stability have not been explored in detail.
View Article and Find Full Text PDFHighly Thermal-Conductive Cubic Boron Arsenide: Single-Crystal Growth, Properties, and Future Thin-Film Epitaxy.
J Phys Chem Lett
January 2025
College of Electronic and Optical Engineering & College of Flexible Electronics (Future Technology), State Key Laboratory of Organic Electronics and Information Displays, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu 210023, P.R. China.
Heat dissipation has become a critical challenge in modern electronics, driving the need for a revolution in thermal management strategies beyond traditional packaging materials, thermal interface materials, and heat sinks. Cubic boron arsenide (c-BAs) offers a promising solution, thanks to its combination of high thermal conductivity and high ambipolar mobility, making it highly suitable for applications in both electronic devices and thermal management. However, challenges remain, particularly in the large-scale synthesis of a high-quality material and the tuning of its physical properties.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!