AF Ablation Update 2019

Most years I write an update on any big developments in AF ablation. This year’s version will be a short one. I have little new to report. But it’s worth reviewing some basic issues. We still do not know the cause of atrial fibrillation (AF). That makes it hard to fix with ablation. Knowledge Deficits: To explain why not knowing the cause of AF impairs our ability to ablate it, it’s useful to compare AF ablation to WPW ablation. Wolfe-Parkinson-White or WPW syndrome causes rapid heart rates because of an extra pathway from the top to the bottom (atria and ventricle) of the heart. You can cure WPW by ablating the extra pathway–often with one burn. The approach to AF is to use single burns (or cryo-balloon lesions) to electrically isolate the muscle bundles surrounding the pulmonary veins. Think of that one burn (used in WPW ablation) times 60-80 to form electrical fences around the pulmonary vein orifices. This is called pulmonary vein isolation or PVI. Studies show that it is the best technique for ablating AF.[1] It’s what we did in 2004 and it’s what we do now. The problem is that sometimes AF is triggered by cells in the pulmonary veins, and sometimes it is not. That means we could be doing 60-80 burns in the heart and not going after the right target. There is NO way to tell. The good news, though, is that the pulmonary veins are involved often. The other problem is that even when AF is being triggered by cells within the pulm...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs

Related Links:

Source: Journal of Toxicology and Environmental Health Part A - Category: Environmental Health Authors: Source Type: research
We describe the most highly recommended generic and disease-specific PRO tools in SCD and discuss the challenges of incorporating them in clinical practice. EXPERT OPINION: PRO measures are essential to incorporate into SCD clinical trials either as primary or secondary outcomes. The use of PRO measures in SCD facilitates a patient-centered approach, which is likely to lead to improved outcomes. Significant challenges remain in adapting PRO tools to routine clinical use and in developing countries. PMID: 33034214 [PubMed - as supplied by publisher]
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
Authors: Sabet Sarvestani F, Azarpira N Abstract Heart and cerebral infarctions, as two important ischemic diseases, lead to the death of tissues due to inadequate blood supply and high mortality worldwide. These statuses are started via blockage of vessels and depletion of oxygen and nutrients which affected these areas. After reperfusion and restoration of oxygen supply, more severe injury was mediated by multifaceted cascades of inflammation and oxidative stress. microRNAs (miRNAs) as the regulator of biological and pathological pathways can adjust these conditions by interaction with their targets. Also, miRNAs...
Source: Immunological Investigations - Category: Allergy & Immunology Tags: Immunol Invest Source Type: research
Source: European Journal of Sport Science - Category: Sports Medicine Authors: Source Type: research
Currently in fellowship doing bread/butter procedures (MBB, epidurals, PNB, few SCS/PNS trials, etc.) and just interviewed at a private practice spot where they do a lot of procedures that I will have not done any training in prior to graduating (e.g. IT pump, SI fusion, Vertiflex, Kypho, MILD, Discectomy, lots of SCS/PNS trials etc) and significant amount of "OR pain procedures" at a very busy practice seeing 30-40 pts/day - how many of you are commonly performing these procedures and are... private practice concern
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
CONCLUSIONS: Considering the low number of university students disclosing sexual assaults to health professionals or support services, the results of this survey suggest more work is needed to facilitate greater disclosures to health professionals enabling victims to access the services they need regardless of alcohol use. PMID: 33032303 [PubMed - in process]
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
Authors: Zhao N, Xiang Q, Liu Z, Zhao X, Cui Y Abstract INTRODUCTION: There remains an unmet need for better anticoagulants. The phase I clinical trial is of great significance in the development of anticoagulants, and the design is special. This system review aims to provide insights for the design of future phase I clinical trials of anticoagulants. AREAS COVERED: We searched the database PubMed and ClinicalTrail.gov website, to collate the phase I clinical trial of anticoagulants in healthy people. The study protocol, inclusion exclusion criteria, safety and pharmacodynamic indexes were reviewed. EXPERT ...
Source: Expert Review of Clinical Pharmacology - Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research
This study therefore investigated the impacts of RRCC on air pollution based on detailed household heating data obtained from intensive face-to-face interviews in Shandong province, China. The total contributions and specific contributions of coal, stoves, and coal-stove combinations to air pollution were simulated using the WRF-CAMx-PSAT model. The RRCC for heating had a considerable impact on air pollution, contributing 36.1, 9.1, and 16.1% of atmospheric SO2, NOx, and PM2.5 in winter, respectively. Different coal-stove combinations had different impacts on air pollution and mitigation efficiencies. The combination of bi...
Source: Chemosphere - Category: Chemistry Authors: Tags: Chemosphere Source Type: research
Acceptance of trauma can also help to reduce its damaging effects. → Support PsyBlog for just $5 per month. Enables access to articles marked (M) and removes ads. → Explore PsyBlog's ebooks, all written by Dr Jeremy Dean: Accept Yourself: How to feel a profound sense of warmth and self-compassion The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic Spark: 17 Steps That Will Boost Your Motivation For Anything Activate: How To Find Joy Again By Changing What You Do
Source: PsyBlog | Psychology Blog - Category: Psychiatry & Psychology Authors: Tags: Sleep subscribers-only Source Type: blogs
Publication date: Available online 9 October 2020Source: NeuropsychologiaAuthor(s): Erin L. Meier, Shannon M. Sheppard, Emily B. Goldberg, Catherine R. Head, Delaney M. Ubellacker, Alexandra Walker, Argye E. Hillis
Source: Neuropsychologia - Category: Neurology Source Type: research
More News: Alcoholism | Angioplasty | Arrhythmia | Atrial Fibrillation | Back Pain | Bleeding | Burns | Cardiology | Chronic Pain | Clinical Trials | Coronary Angioplasty | Depression | Education | Heart | Heart Failure | Medical Devices | Medical Ethics | Pain | Parkinson's Disease | Percutaneous Coronary Intervention | Sleep Disorders | Sleep Medicine | Sports Medicine | Stroke | Study | Weight Loss