Differences in the structural characteristics and distribution of epicardial adipose tissue between left and right atrial fibrillation

AbstractAimsRight atrial (RA) fibrillation (RAF) was previously characterized by initiation from RA ectopies, presence of a right-to-left dominant frequency gradient during atrial fibrillation (AF), and augmentation of the gradient by adenosine triphosphate infusion. We investigated structural characteristics of the bi-atria and epicardial adipose tissue (EAT) volume in patients with RAF.Methods and resultsBy using multidetector computed tomography, RA, left atrial (LA), right and LA appendage (RAA and LAA, respectively) volumes, pulmonary vein (PV) sizes, and EAT volumes were compared between the RAF group (n = 8) and LA fibrillation (LAF) group (n = 32). Compared with the LAF group, the LA volume was smaller (median 81.3 [95% CI, 74.2–88.5] vs. 64.5 [54.8–74.2] mL/m2;P  = 0.04), the LAA volume was smaller (10.1 [9.0 –11.3] vs. 6.5 [4.5–8.5] mL/m2;P  = 0.008), and the RAA volume was larger (10.8 [9.1 –12.4] vs. 14.1 [11.6–16.6] mL/m2;P  = 0.044) in the RAF group. The RA volume was not significantly different between the groups (73.6 [66.8 –80.3] vs. 68.1 [57.1–79.1] mL/m2;P  = 0.47). The RAF group had smaller PVs (1.44 [1.33 –1.55] vs. 1.12 [0.94–1.30] cm2/m2 for the left inferior PV;P  = 0.01). Both the LA-EAT and RA-EAT volumes were smaller in the RAF group than the LAF group (4.2 [2.8 –5.6] vs. 9.1 [7.8–1...
Source: Europace - Category: Cardiology Source Type: research

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AbstractAimThe aim of the study was to investigate the role of anatomical characteristics of the pulmonary veins (PVs) determining cooling kinetics during second ‐generation cryoballoon ablation (CbA).Methods and Resultswe enrolled all consecutive patients who underwent CbA for symptomatic atrial fibrillation in our center from January 2019 to March 2019. All patients had complete computed tomography scans of the heart before the ablation. Anatomical characteristics were tested for prediction of a nadir temperature (NT)  ≤ −48°C. Significant differences were noted among PV max diameter (20.8&th...
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
AbstractMitral valve (MV) surgery is the second most performed valve operation in Europe. MV pathology is associated with atrial fibrillation, and, therefore, frequently combined with rhythm surgery and left atrial appendage exclusion (LAAE). Currently, no guidelines exist regarding the follow up after LAAE postoperative. Postoperative imaging with computed tomography (CT), in the absence of complaints, will inherently reveal unsuspected cardiac and noncardiac findings with potential clinical significance. However, poststernotomy alterations are nonspecific and often overlap with normal postoperative changes and could, the...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
In this study, we evaluated the correlation between LAA morphology and cardiac function by transthoracic echocardiography in patients with sinus rhythm.Methods and ResultsWe studied 55 patients (36 men, 70  ± 11 years) who underwent cardiac computed tomography and transthoracic echocardiography. The following 4 different morphologies were used to categorize LAA by computed tomography: chicken wing (CW), windsock, cactus, and cauliflower. These morphologies were also classified into CW and non-CW (nonCW) types. There were no significant differences in the left ventricular ejection fraction (63% vs ...
Source: Journal of Echocardiography - Category: Cardiology Source Type: research
AbstractAim of the studyThe aim of the study was to investigate the role of anatomical characteristics of the pulmonary veins (PV) determining cooling kinetics during second generation cryoballoon ablation (CbA).Methods and resultswe enrolled all consecutive patients who underwent CbA for symptomatic atrial fibrillation in our center from January 2019 to March 2019. All patients had complete computed tomography scans of the heart prior to the ablation. Anatomical characteristics were tested for prediction of a nadir temperature (NT) ≤‐48°C. Significant differences were noted among PV max diameter (20.8±2.8 ...
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
AbstractBackgroundPatients with atrial fibrillation (AF) and dementia experience reduced quality of life and increased mortality. Technetium 99m ECD brain perfusion single-photon emission computed tomography (99mTc-ECD brain perfusion SPECT) is a beneficial modality for diagnosing dementia and identifying high-risk patients with mild cognitive impairment. The aim of this study was to evaluate the prognostic value of brain perfusion using99mTc-ECD SPECT in patients with AF and dementia.MethodsOf a total of 405 consecutive patients diagnosed with AF as cardiac outpatients with dementia using the Mini-Mental State Examination...
Source: EJNMMI Research - Category: Radiology Source Type: research
AbstractBackgroundLarge pulmonary veins (PVs) have the risk of excessive cooling when the cryoballoon is moved into them, whereas smaller PVs may not be isolated because of insufficient balloon ‐tissue contact. We previously reported that the effective nadir balloon temperature (NBT) was
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: ELECTROPHYSIOLOGY Source Type: research
This study assessed correlations between near-infrared spectroscopy (NIRS) changes induced by a vascular occlusion test (VOT) and EAT volume measured by cardiac computed tomography (CCT) in patients with suspected coronary artery disease. We also assessed correlations between body mass index (BMI) and EAT volume in the same population. In addition, these correlations were compared in patients treated with statin therapy and in those without statin therapy. A NIRS probe was set on the right thenar eminence, and brachial artery blood flow was blocked for 3 min before being released. A negative correlation was found between o...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
We report a novel imaging system that offers real‐time 3‐D navigation of the cryoballoon within atrial anatomy that may circumvent these issues.Methods and resultsA novel overlay guidance system(OGS) (Siemens Healthcare, Forchheim, Germany) registers already ‐acquired segmented atrial cardiac tomography (CT) with fluoroscopy, enabling real‐time visualization of the cryoballoon within tomographic left atrial imaging during PVI. Phantom experiments in a patient‐specific 3D printed left atrium showed feasibility for confirming PV apposition and leaks . We applied OGS prospectively to 68 PVs during PVI in 17 patients...
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: ELECTROPHYSIOLOGY Source Type: research
Conclusions: Our findings do not support VKA use as an independent risk factor for higher ICAC degree in patients with ICH. We could not confirm the concerns about VKA use and intracranial carotid vascular calcification. We suggest further research in other cohorts with VKA users such as patients with ischemic stroke and atrial fibrillation.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Authors: Kimpton M, Siegal DM Abstract A 77-year-old man with atrial fibrillation and a CHA2DS2Vasc score of 6 for hypertension, age, diabetes, and previous stroke is brought to the emergency department with decreased level of consciousness. He is anticoagulated with rivaroxaban (a direct oral factor Xa inhibitor [FXaI]) and received his last dose about 4 hours before presentation. Urgent computed tomography of the head shows intracerebral hemorrhage. Because of his previous stroke, the patient's family is concerned about treating the bleed with pharmacological agents that may increase the risk of stroke. What are ...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
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