Background: Patients with atrial fibrillation (AF) usually experience a worsening of their AF burden over time. We aimed to investigate timing of pulmonary vein isolation (PVI) by cryoballoon (CB-2) after the first clinical diagnosis of AF on ablation-related outcomes.
Methods: A total of 132 consecutive patients with paroxysmal AF undergoing PVI by CB-2 were included in the study. The patients were retrospectively sorted into two groups to evaluate differences in AF recurrence risk associated with early ablation (n = 89), defined as within 365 days of first AF diagnosis, and late ablation (n = 365), defined as > 365 days after first AF diagnosis. AF-free survival during follow-up was compared between groups.
Results: Although mean procedure times were comparable between groups, mean fluoroscopy times were lower in the early ablation group. For the whole study group, median (interquartile range) time from AF diagnosis to first ablation was 4.0 (2.0-11.3) months [3.0 (1.0-4.0) vs 14.0 (12.0-22.5) months in the early and late ablation groups, respectively]. Median follow-up for the whole population was 12.0 (12.0-18.0) months, and after the blanking period, 14 (10.6%) patients had arrhythmia recurrence (2 in the early and 12 in the late ablation groups). In the univariable Cox regression analysis and propensity score adjusted penalized Cox regression analysis, there was a significant association between delay in ablation time and AF recurrence (unadjusted hazard ratio = 7.74, 95% CI 2.26-40.1, p < 0.001, adjusted hazard ratio = 7.50, 95% CI 2.23-38.6, p < 0.001).
Conclusion: Delays in treatment with CB-2 ablation may negatively affect AF-free survival rates among patients with paroxysmal AF.
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http://dx.doi.org/10.1007/s10840-022-01167-3 | DOI Listing |
J Am Soc Nephrol
January 2025
Department of Pharmacology, Tianjin Key Laboratory of Inflammatory Biology, Center for Cardiovascular Diseases, Haihe Laboratory of Cell Ecosystem, Key Laboratory of Immune Microenvironment and Disease (Ministry of Education), The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, Key Laboratory of Experimental Hematology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
Background: Notch signaling, a conserved mechanism of cell-to-cell communication, plays a crucial role in regulating cellular processes such as proliferation and differentiation in a context-dependent manner. However, the specific contribution of Notch signaling to the progression of polycystic kidney disease (PKD) remains unclear.
Methods: We investigated the changes in Notch signaling activity (Notch1-4) in the kidneys of autosomal dominant PKD (ADPKD) patients and two ADPKD mouse models (early and late onset).
Heart Rhythm
December 2024
University of Melbourne, Melbourne, Victoria, Australia; Royal Melbourne Hospital, Melbourne, Victoria, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Victoria, Australia. Electronic address:
Background: Early recurrence of atrial tachyarrhythmia (ERAT) is common following catheter ablation of atrial fibrillation (AF). The specific clinical and arrhythmia characteristics of ERAT influencing late recurrence risk in persistent AF is unclear. Additionally, the impact of different ablation strategies on the incidence and prognostic significance of ERAT remains unknown.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
December 2024
Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK.
Introduction: Atrial late gadolinium enhancement (Atrial-LGE) and electroanatomic voltage mapping (Atrial-EAVM) quantify the anatomical and functional extent of atrial cardiomyopathy. We aimed to explore the relationships between, and outcomes from, these modalities in patients with atrial fibrillation undergoing ablation.
Methods: Patients undergoing first-time ablation had disease severities quantified using both Atrial-LGE and Atrial-EAVM.
Pulsed Field Ablation (PFA) is a new ablation method being rapidly adopted for treatment of atrial fibrillation, which shows advantages in safety and efficiency over radiofrequency and cryo-ablation. In this study, we used an in vivo swine model (10 healthy and 5 with chronic myocardial infarct) for ventricular PFA, collecting intracardiac electrograms, electro-anatomical maps, native T1-weighted and late gadolinium enhancement MRI, gross pathology, and histology. We used 1000-1500 V pulses, with 1-16 pulse trains to vary PFA dose.
View Article and Find Full Text PDFJ Vet Cardiol
December 2024
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, 930 Campus Road, Ithaca, NY, 14853, USA. Electronic address:
A seven-year-old, male intact Newfoundland was referred for catheter ablation of supraventricular tachycardia. Activation mapping was performed using an electroanatomical mapping system to visualize the activation wavefront in a color-coded fashion on an anatomical shell. Atrial flutter with an early-meets-late signal (i.
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