Evaluation of a simple technique aiming at optimizing point-by-point isolation of the left pulmonary veins: a randomized study

AbstractAimsWe sought to evaluate the efficacy and the safety of a simple technique for stabilizing the ablation catheter during anterior pulmonary vein (PV) encirclement in patients ablated for paroxysmal atrial fibrillation. This consisted of bending the ablation catheter in the left atrium, creating a loop that was cautiously advanced together with the long sheath at the ostium and then within the left superior PV. The curve was then progressively released to reach a stable contact with the anterior part of the left PVs.Methods and resultsEighty consecutive patients (age 64  ± 11 years, left atrial diameter 43 ± 8 mm) undergoing ‘CLOSE’-guided PV isolation were prospectively randomized into two groups depending on whether the loop technique was used or not. When using the loop technique, the encirclement of the left PVs was shorter [20 min (interqua rtile range, IQR 17–24) vs. 26 min (IQR 18–33),P 
Source: Europace - Category: Cardiology Source Type: research

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Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
AliveCor is close to our hearts. Literally. David Albert, the co-founder of the company, started experimenting with handheld, wireless ECG devices in the late 90s. Approximately 10 years later we tried out their FDA-cleared, medical grade gadget. It was a truly inspiring moment. Needless to say, we’ve been keeping track of their journey ever since. In our eyes Kardia is the textbook example of technology shaping health care, empowering and supporting not only e-patients, but medical professionals as well. So, let’s take a look at their newest creation, the KardiaMobile6L! Why did the chicken cross the ro...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Health Sensors & Trackers cardiology ecg fda Healthcare heart technology Source Type: blogs
Publication date: Available online 10 December 2019Source: Journal of Clinical NeuroscienceAuthor(s): Junya Aoki, Kentaro Suzuki, Satoshi Suda, Seiji Okubo, Masahiro Mishina, Kazumi KimuraAbstractBackgroundSince acute fluid-attenuated inversion recovery vascular hyperintensity (FVH) is indicative of disordered blood flow, FVH is considered a marker of acute major arterial occlusion. Conversely, the role of the absence of FVH (negative-FVH) remains unknown.MethodsConsecutive stroke patients were studied via magnetic resonance angiography, within 24 h of onset and major arterial occlusion. All patients were examined usi...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Premature atrial complexes (PACs) meet increased attention as a potential intermediary between sinus rhythm and atrial fibrillation (AF). Patients with even high numbers of PACs do not fulfill current guidelines for oral anticoagulation treatment though an associated stroke risk is suspected. Objective: We aimed to determine whether a high number of PACs or runs of AF less than 30 seconds in 2-day continuous electrocardiogram (ECG) recording was associated with risk of recurrent ischemic stroke/transient ischemic attack (TIA) or death in a large cohort of patients with acute ischemic stroke or TIA and no prior AF.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
AbstractAim: to develop an algorithm for optimization of rate ‐adaptive pacing settings in heart failure patients with preserved ejection fraction (HFpEF) and permanent cardiac pacing.Methods: This is a prospective randomized controlled study. 54 patients with HFpEF, permanent atrial fibrillation (AF) and VVIR pacing were randomized to an intervention group with optimization of rate ‐adaptation parameters by using cardiopulmonary exercise testing (CPET) and pacemaker stress‐echocardiography (PASE) and to a control group with conventional programming. CPET, 6‐minute walk test (6‐mwt), echocardiography (echo), Duke...
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research
In this study, we examined the safety of WATCHMAN implantation followed by 6 months of anti-thrombotic therapy in patients with a history of ICH.MethodsThis is a retrospective analysis of 63 patients with a history of ICH prior to WATCHMAN implantation (Group I) and 95 patients without a history of ICH who underwent WATCHMAN placement (Group II). The primary outcome was death, stroke, or major bleeding within 6  months of WATCHMAN placement.ResultsThe average CHA2DS2-VASc of Group I was 4.9  ± 1.7 vs 4.7 ± 1.4 for Group II (p = 0.34). The most common type of...
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
Guidelines do not address preoperative atrial fibrillation when considering adding tricuspid annuloplasty to mitral surgery. Our purpose was to determine the occurrence of late tricuspid regurgitation in patients with less than moderate tricuspid regurgitation undergoing degenerative mitral regurgitation surgery, and the importance of atrial fibrillation and tricuspid annular dilation.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
AbstractPatients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) should be triaged to an endovascular-capable hospital by the emergency medical service (EMS). We designed a prehospital LVO prediction scale based on EMS assessments. In the derivation cohort, 1157 patients transferred to our hospital by the EMS because of suspected stroke within 24 h of onset were retrospectively examined. Factors associated with AIS due to LVO were identified based on the EMS assessment, and a prehospital scale identifying LVO was developed. The accuracy of this scale was validated in 502 consecutive patients who were t...
Source: Translational Stroke Research - Category: Neurology Source Type: research
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Source: Journal of Emergency Nursing: JEN - Category: Nursing Authors: Tags: Practice Improvement Source Type: research
We thank Wang et al. for their comments and for bringing forward the challenges in managing care of patients with pulmonary hypertension (PH) and stroke. We acknowledge multiple possible mechanisms of stroke in patients with PH, and we highlighted them in our work, including paradoxical emboli and atrial fibrillation [1]. However, polycythemia (increased red cells) or other myeloproliferative disorders are considered to be a cause and not a consequence of PH [2,3]. In mice models, Sala et al. have showed that chronic hypoxia could lead to both PH and polycythemia [4].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Letter to the Editor Source Type: research
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