Evaluation of left atrial appendage function and thrombi in patients with atrial fibrillation: from transthoracic to real time 3D transesophageal echocardiography
AbstractThe detection of embolic sources in patients with atrial fibrillation (AF) is important to guide anticoagulant therapy. Two-dimensional transesophageal echocardiography (TEE) is the gold standard to study left atrial appendage (LAA) anatomy and morphology, despite some false-positive diagnosis. We hypothesized that real time 3D TEE (RT3DTEE) is superior to 2DTEE in detecting and/or excluding LAA thrombi. We studied 93 patients with non-valvular AF (60 males, age = 67.1 ± 14.2 years) referred for electric cardioversion with transthoracic, 2DTEE and RT3DTEE. Before cardioversion, TTE allowed a confident measurement of emptying velocity of LAA (LAAeV) only in 59/93 patients (63%). On the contrary a good quality TEE LAAeV was obtained in all patients with 49/93 (53%) dysfunctional LAA (LAAeV
Adding an ethanol infusion to the vein of Marshall during catheter ablation of persistent atrial fibrillation increases the chances of maintaining normal rhythm, a new study has shown.Medscape Medical News
Publication date: April 2020Source: IJC Heart &Vasculature, Volume 27Author(s): Hanne Ehrlinder, Nicola Orsini, Karin Modig, Claes Hofman-Bang, Håkan Wallén, Bruna Gigante
Condition: Heart Failure With Preserved Ejection Fraction Intervention: Procedure: RF ablation of AF using CARTO 3 and a Thermocool ST SF ablation catheter Sponsors: University of Rochester; Biosense Webster, Inc. Not yet recruiting
Condition: Atrial Fibrillation Interventions: Drug: Spironolactone 25mg; Drug: Placebo oral tablet Sponsors: National University Hospital, Singapore; University of Otago Recruiting
AbstractAimTo examine the rates of all ‐cause mortality and heart failure (HF) readmission in patients hospitalized with decompensated HF according to HF duration – new‐onset HF and worsening of chronic HF.Methods and resultsIn this nationwide observational cohort study, 17 176 patients were included at first hospital admission for HF in the period 2013–2015 using data from Danish nationwide registries. In total, 8860 (51.6%) patients were admitted with new‐onset HF and 8316 (48.4%) with worsening of chronic HF. Patients with worsening of chronic HF were charact erized by a greater como...
European Journal of Heart Failure, Volume 22, Issue 3, Page 389-390, March 2020.
AbstractIntroductionRadiation exposure during catheter ablation procedures is a significant hazard for both patients and operators. Atrial fibrillation (AF) ablation procedures have been historically associated with higher fluoroscopy usage than other electrophysiology procedures. Recent efforts have been made to reduce dependence on fluoroscopy during pulmonary vein isolation (PVI) ablation procedures using alternative techniques.MethodsWe performed a meta ‐analysis of studies comparing zero or low fluoroscopy (LF) vs conventional fluoroscopy (CF) approaches for AF ablation. Outcomes of interest included acute and 12‐...
Journal of Cardiovascular Electrophysiology, EarlyView.
AbstractPurposeAtrial fibrillation (AF) is the most common cardiac arrhythmia with a considerable impact on patients ’ quality of life (QoL).MethodsThis prospective, multicenter, observational study aimed to evaluate the effect of oral treatment with controlled-release (CR) flecainide on AF patients ’ QoL and treatment compliance during a 12-week period. A total of 70 sites enrolled consecutive patients with paroxysmal (PAF) or persistent AF (PerAF), treated with flecainide CR in the context of a rhythm control strategy. The effect on QoL was assessed by the Canadian Cardiovascular Society Se verity of Atrial F...
ConclusionIn ENSURE-AF, thromboembolic events were rare and absolute bleeding event rates were higher with concomitant APT. These findings may be relevant for AF-patients considered for dual therapy; even for a short treatment duration of 1 month.