Identification And Ablation Of Dormant Conduction In Atrial Fibrillation Using Adenosine
Ablation; Adenosine; antiarrhythmic-drug therapy; Arrhythmias; Atrial fibrillation; catheter ablation; Electrophysiology; end-points; expert consensus; follow-up; General & Internal Medicine; patient-management; procedural techniques; pulmonary vein isolation; recommendations; statement; surgical ablation
Luni F K; Khan A R; Singh H; Riaz H; Malik S A; Khawaja O; Farid T; Cummings J; Taleb M
American Journal of the Medical Sciences
2018
2018-01
Journal Article or Conference Abstract Publication
n/a
Pharmacologic and Nonpharmacologic Management of Atrial Fibrillation
amiodarone; Antiarrhythmic drugs; antiarrhythmic-drugs; Atrial fibrillation; cardioversion; catheter ablation; Catheter ablation; dronedarone; efficacy; heart-failure; maintaining sinus rhythm; mortality; Pharmacologic management; therapy
October 2019 Update
Atrial fibrillation (AF) is the most common arrhythmia and its management may be organized into risk stratification and/or treatment of heart failure, stroke prevention, and symptom control. At the core of symptom control, treatment is tailored to either allow AF continue with controlled heart rates, so-called rate control, versus restoring and maintaining sinus rhythm or rhythm control. Rate control strategies mainly use rate-modulating medications, whereas rhythm control treatment includes therapy aimed at restoring sinus rhythm, including pharmacologic and direct current cardioversion, as well as maintenance of sinus rhythm, including anti-arrhythmic medications and ablation therapy.
Dahya Vishal; Taigen Tyler L
Medical Clinics of North America
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.mcna.2019.04.004" target="_blank" rel="noreferrer noopener">10.1016/j.mcna.2019.04.004</a>
Isolation of canine coronary sinus musculature from the atria by radiofrequency catheter ablation prevents induction of atrial fibrillation.
*Catheter Ablation; Acetylcholine; Action Potentials; Animal; Animal Studies; Animals; Artificial; atrial fibrillation; Atrial Fibrillation – Etiology; Atrial Fibrillation – Physiopathology; Atrial Fibrillation – Prevention and Control; Atrial Fibrillation/etiology/physiopathology/*prevention & control; Biological; Body Surface Potential Mapping; Cardiac Pacing; catheter ablation; Catheter Ablation; coronary sinus; Coronary Sinus/physiopathology/*surgery; Coronary Vessels – Physiopathology; Coronary Vessels – Surgery; Disease Models; Dogs; Heart Atria/physiopathology/surgery; Heart Atrium – Physiopathology; Heart Atrium – Surgery; Male; Models; optical Vm mapping; Time Factors
BACKGROUND: The junction between the coronary sinus (CS) musculature and both atria contributes to initiation of atrial tachyarrhythmias. The current study investigated the effects of CS isolation from the atria by radiofrequency catheter ablation on the induction and maintenance of atrial fibrillation (AF). METHODS AND RESULTS: Using an optical mapping system, we mapped action potentials at 256 surface sites in 17 isolated and arterially perfused canine atrial tissues containing the entire musculature of the CS, right atrial septum, posterior left atrium, left inferior pulmonary vein, and vein of Marshal. Rapid pacing from each site before and after addition of acetylcholine (0.5 mumol/L) was applied to induce AF. Epicardial radiofrequency catheter ablation at CS-atrial junctions isolated the CS from the atria. Rapid pacing induced sustained AF in all tissues after acetylcholine. Microreentry within the CS drove AF in 88% of preparations. Reentries associated with the vein of Marshall (29%), CS-atrial junctions (53%), right atrium (65%), and pulmonary vein (76%) (frequently with 2-4 simultaneous circuits) were additional drivers of AF. Radiofrequency catheter ablation eliminated AF in 13 tissues before acetylcholine (P\textless0.01) and in 5 tissues after acetylcholine. Radiofrequency catheter ablation also abbreviated the duration of AF in 12 tissues (P\textless0.01). CONCLUSIONS: CS and its musculature developed unstable reentry and AF, which were prevented by isolation of CS musculature from atrial tissue. The results suggest that CS can be a substrate of recurrent AF in patients after pulmonary vein isolation and that CS isolation might help prevent recurrent AF.
Morita Hiroshi; Zipes Douglas P; Morita Shiho T; Wu Jiashin
Circulation. Arrhythmia and electrophysiology
2014
2014-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1161/CIRCEP.114.001578" target="_blank" rel="noreferrer noopener">10.1161/CIRCEP.114.001578</a>
Contrast-enhanced ultrasound detection and treatment guidance in a renal transplant patient with renal cell carcinoma.
*Fluorocarbons; Aged; Angiography; Biopsy; Carcinoma; Catheter Ablation; Catheter Ablation/*methods; Computer-Assisted/methods; Contrast Media; Equipment and Supplies; Humans; Kidney Neoplasms/*diagnostic imaging/*surgery; Magnetic Resonance Imaging; Male; Renal Cell – Diagnosis; Renal Cell – Epidemiology; Renal Cell/*diagnostic imaging/*surgery; Surgery; Tomography; Treatment Outcome; Ultrasonography; Ultrasonography/*methods
Contrast-enhanced ultrasonography (CEUS) is an imaging modality that shows promise in the detection and characterization of renal masses, as well as treatment through CEUS-guided percutaneous radiofrequency ablation. These techniques may be especially valuable in challenging patients who cannot tolerate traditional contrast agents, such as those with diminished renal function, and those who cannot tolerate more invasive surgical treatment. The following case report details an incidence of renal cell carcinoma in a renal transplant patient whose tumor was diagnosed with CEU and successfully treated with CEUS-guided percutaneous RFA.
Sanchez Kimberly; Barr Richard G
Ultrasound quarterly
2009
2009-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/RUQ.0b013e3181b4f9cf" target="_blank" rel="noreferrer noopener">10.1097/RUQ.0b013e3181b4f9cf</a>