Combined use of electro-anatomic mapping system and intracardiac echocardiography to achieve zero-fluoroscopy catheter ablation for treatment of paroxysmal atrial fibrillation: a single centre experience

AbstractFluoroscopy is the principal imaging method for catheter ablation (CA) of atrial fibrillation (AF). However, radiation exposure carries potential health risk to patients and operators alike. Our aim was to study safety and efficacy of zero-fluoroscopy CA of paroxysmal AF with a combined use of electroanatomic mapping system (EAM) and intracardiac echocardiography (ICE). In addition, impact of ICE/EAM automatic integration system and contact force (CF) sensing technology on procedural times were assessed. We included 144 consecutive patients (69% males, age 60  ± 10 years, BMI 29 ± 4,6) referred for CA of symptomatic paroxysmal AF. All procedures were performed only with EAM system and ICE. No fluoroscopy was used. The acute procedural success of complete pulmonary vein isolation was achieved in all patients (100%) and adverse events were detec ted in eight patients (5.6%). In 53 (37%) patients the use of ICE/EAM automatic integration system shortened procedural times compared to those performed without it (148 ± 35 vs. 187 ± 44 min, p 
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

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Publication date: Available online 10 October 2020Source: IJC Heart &VasculatureAuthor(s): Dominik Linz, Jeroen Hendriks
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
Authors: Tsujioka S, Nozoe M, Kawano Y, Suematsu N, Kubota T Abstract A 70-year-old woman with situs inversus totalis underwent catheter ablation for atrial fibrillation and atrial flutter. Although her morphologic left atrium (LA) was enlarged, we performed cryoballoon ablation and liner radiofrequency ablation of the cava-tricuspid isthmus without mapping atrial arrhythmias. However, a different form of atrial tachycardia (AT) recurred. We performed catheter ablation a second time using a three-dimensional electroanatomic mapping system. AT was not terminated by the liner ablation at the roof of morphologic LA an...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Kirchhof and colleagues et al. (N Engl J Med. 2020;383(14):1305-1316 PMID: 32865375) randomized patients with early atrial fibrillation (AF) to rhythm control or usual care. The first primary outcome was a composite of cardiovascular death, stroke, or hospitalization with heart failure heart failure or coronary syndrome. The second primary outcome was the number of nights spent in the hospital. The trial was stopped for efficacy after a median of 5.1 years of follow-up of 2789 patients. A first-primary-outcome event occurred in 249 patients with rhythm control (3.9/100 person-years) and in 316 patients with usual care (5.0...
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
AbstractPurpose of reviewCatheter ablation has emerged as the most effective long-term rhythm controlling strategy in patients with symptomatic atrial fibrillation (AF). Over the last few years, the role of ablation has shifted from a last-resort strategy toward a first-line approach in AF management. The purpose of this review is to highlight the rationale behind an early ablation strategy and to summarize recent data regarding its effectiveness.Recent findingsPulmonary vein isolation (PVI), the cornerstone of catheter ablation of AF, is superior to antiarrhythmic drugs (AADs) in preventing recurrence of AF. PVI is most e...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
AbstractPurpose of reviewAtrial fibrillation is the commonest sustained arrhythmia in rheumatic heart disease and is associated with significant morbidity and mortality. In this review, we discuss its epidemiology, natural course and management with special emphasis on recent developments in understanding and treatment of atrial fibrillation in rheumatic heart disease.Recent findingsUse of direct oral anticoagulants appears promising, especially in developing countries where regular coagulation monitoring is a challenge. Also, restoration and maintenance of sinus rhythm in rheumatic atrial fibrillation appear feasible and ...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
AbstractPurpose of reviewDevice-based therapy utilizing cardiac contractility modulation (CCM ™) was approved by the FDA in March 2019 for patients with moderately to severely symptomatic heart failure with reduced ejection fraction between 25 and 45% on optimal guideline-directed medical therapy in normal sinus rhythm and not a candidate for cardiac resynchronization therapy. This review explores the mechanism of action behind CCM, the most recent clinical trials, and the expansion of therapy to additional patient populations.Recent findingsThe most recent trial on CCM explored a two-lead system, which was as equall...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
Condition:   Paroxysmal Atrial Fibrillation Intervention:   Device: Treatment with IntellaNav StablePoint Ablation Catheter Sponsor:   Boston Scientific Corporation Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Atrial Fibrillation Interventions:   Drug: HSY244;   Other: Placebo Sponsor:   Novartis Pharmaceuticals Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Atrial fibrillation (AF) is a frequently identified arrhythmia during the course of sepsis. The aim of this narrative review is to assess the characteristics of patients with new-onset AF related to sepsis and the risk of stroke and death, to understand if there is a need for anticoagulation. We searched for studies on AF and sepsis on PubMed, the Cochrane database, and Web of Science, and 17 studies were included. The mean incidence of new-onset AF in patients with sepsis was 20.6% (14.7% in retrospective studies and 31.6% in prospective). Risk factors for new-onset AF included advanced age, white race, male sex, obesity,...
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
This study investigates whether the Montreal Cognitive Assessment (MoCA) detects more cognitive decline than the Mini Mental State Examination (MMSE) in patients with A...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Elder Adults Source Type: news
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