IsthmusArrhythmiasTachycardiaRight atrialParoxysmal atrial fibriArrhythmiaAdditional ablationPersistent atrial fibrillationAppeared after catheter ablationSubstrateRecurrenceLesionsElectrophysiologyIsolationUnderwentIncidenceEpicardialPost-ablationRecurrencesCongenital heart dDrug-refractoryVentricular FibrillationFluoroscopyConclusionsTachyarrhythmiaAnatomicOutcomes10.9LesionTachycardiasMethods and ResultsSinusRetrospectiveContractionPatients without structuralUnstableTypicalWidelyRarelyEfficacy and safetyProcedureSurgical
Isthmus17
- Introduction: The cavotricuspid isthmus can be ablated using an anatomic approach or an electrogram mapping approach in which sites at which there is a gap in the line of block are targeted. (northwestern.edu)
- The aim of this study was to compare the anatomic and electrogram mapping approaches for creating a line of block in the cavotricuspid isthmus after an initial, unsuccessful anatomically directed ablation line. (northwestern.edu)
- Methods and Results: The subjects of this study were 63 patients with isthmus-dependent atrial flutter in whom a single series of contiguous applications of radiofrequency energy guided by fluoroscopy in the cavotricuspid isthmus did not result in complete block. (northwestern.edu)
- Conclusion: When there is incomplete block after an initial series of applications of radiofrequency energy in the cavotricuspid isthmus, complete block is achieved more efficiently with an electrogram mapping approach than with an anatomic approach. (northwestern.edu)
- Value of entrainment mapping in determining the isthmus-dependent nature of atrial flutter in the presence of amiodarone. (univ-brest.fr)
- In patients with isthmus-dependent atrial flutter, entrainment mapping from the isthmus during tachycardia results in postpacing intervals (PPI) close to the tachycardia cycle length (TCL). (univ-brest.fr)
- The aim of our study was to assess the value of entrainment mapping in the presence of amiodarone in patients undergoing radiofrequency ablation (RFA) of isthmus-dependent atrial flutter. (univ-brest.fr)
- METHODS AND RESULTS: The study consisted of 83 patients with isthmus-dependent atrial flutter: 52 were taking amiodarone at the time of RFA (group 1) and 31 were in a drug-free state (group 2). (univ-brest.fr)
- Entrainment mapping was performed from the cavotricuspid isthmus, and PPI minus TCL was determined. (univ-brest.fr)
- In all patients, RFA of the isthmus resulted in termination of tachycardia, confirming the isthmus-dependent nature of the flutter. (univ-brest.fr)
- In this setting, long return cycles exceeding the TCL by >20 msec do not exclude isthmus-dependent atrial flutter. (univ-brest.fr)
- Successful targeting of ablation primarily to the anatomic arrhythmia substrate, as opposed to mapping and targeting ablation based on electrogram characteristics, began with recognition that common atrial flutter passes through a narrow structure known as the cavo-tricuspid isthmus. (rmmj.org.il)
- 20 ms increase in the interval between cavo-tricuspid isthmus (CTI) double potentials during incremental pacing (IP) is a highly specific marker differentiating functional from complete CTI block during typical flutter (AFL) ablation. (houstonmethodist.org)
- Incident atrial fibrillation (AF) is common after cavotricuspid isthmus (CTI) dependent atrial flutter (AFL) ablation. (jafib.com)
- Patients undergoing cavotricuspid isthmus (CTI) ablation of typical right atrial flutter (AFL) frequently develop new-onset atrial fibrillation (AF) within three years after ablation 1 - 3 . (jafib.com)
- It is not clear, however, whether a successful right atrial flutter ablation (cavotricuspid isthmus [CTI] ablation) decreases the risk of future AF development in AFL patients with no previous history of AF. (afibbers.org)
- Increased incidence of cavotricuspid isthmus atrial flutter following slow pathway ablation. (ucdenver.edu)
Arrhythmias11
- For patient education information, see the Heart Health Center , as well as Atrial Flutter , Arrhythmias (Heart Rhythm Disorders) , Stroke , Supraventricular Tachycardia (SVT, PSVT) , and Palpitations . (medscape.com)
- AIMS: To explore the impact of the use of intracardiac echocardiography (ICE) in the ablation of supraventricular arrhythmias requiring transseptal catheterization (TSC), whilst analyzing the reduction in periprocedural complications and complications specifically related to TSC. (bvsalud.org)
- Catheter ablation is a first-line treatment for many cardiac arrhythmias and is generally performed under X-ray fluoroscopy guidance. (rmmj.org.il)
- However, current techniques for ablating complex arrhythmias such as atrial fibrillation and ventricular tachycardia are associated with sub-optimal success rates and prolonged radiation exposure. (rmmj.org.il)
- Pre-procedure 3-D magnetic resonance imaging (MRI) has improved understanding of the anatomic basis of complex arrhythmias and is being used for planning and guidance of ablation procedures. (rmmj.org.il)
- In the future, intra-procedure real-time MRI, together with the ability to image complex 3-D arrhythmogenic anatomy and target additional ablation to regions of incomplete lesion formation, may allow for more successful treatment of even complex arrhythmias without exposure to ionizing radiation. (rmmj.org.il)
- Radiofrequency (RF) catheter ablation has advanced over the last 25 years from an experimental procedure to the first-line treatment for a number of cardiac arrhythmias including atrioventricular re - entrant tachycardia, accessory pathway-associated tachycardias, and typical atrial flutter. (rmmj.org.il)
- The clinical indications for anatomy-based catheter ablation have since expanded to more complex arrhythmias such as atrial fibrillation and scar-based ventricular tachycardia. (rmmj.org.il)
- While the feasibility of X-ray fluoroscopy guidance has been demonstrated for these complex arrhythmias, precise targeting of ablation lesions is limited by fluoroscopy's inherently poor ability to visualize cardiovascular soft tissue anatomy. (rmmj.org.il)
- Combined endo- and epicardial approach to radiofrequency catheter ablation in ventricular arrhythmias of different genesis: a retrospective analysis. (escardio.org)
- Effect of radiofrequency ablation of atrial flutter on the natural history of subsequent atrial arrhythmias. (afibbers.org)
Tachycardia8
- A supraventricular tachycardia with a ventricular heart rate of 150 beats per minute is suggestive (though not necessarily diagnostic) of atrial flutter. (wikipedia.org)
- Administration of adenosine in the vein (intravenously) can help medical personnel differentiate between atrial flutter and other forms of supraventricular tachycardia. (wikipedia.org)
- AFL is the second most common pathologic supraventricular tachycardia but occurs at a rate less than one-tenth of the most common supraventricular tachycardia (atrial fibrillation). (wikipedia.org)
- With catheter ablation becoming effective for non-pharmacological management of AF, many cases of atrial tachycardia (AT) after AF ablation have been reported in the past decade. (aerjournal.com)
- 9-12 However, atrial tachycardia (AT) occurring after AF ablation is often symptomatic, complex and poorly controlled by anti-arrhythmic agents. (aerjournal.com)
- Flecainide is an IC antiarrhythmic drug approved in 1984 from Food and Drug Administration for the suppression of sustained ventricular tachycardia and later for acute cardioversion of atrial fibrillation (AF) and for sinus rhythm maintenance. (encyclopedia.pub)
- Dr. Olgin's basic research lab is interested in atrial and ventricular remodeling and how these processes occur to develop a substrate for atrial fibrillation and ventricular tachycardia. (ucsf.edu)
- Open surgical ablation of ventricular tachycardia: Utility and feasibility of contemporary mapping and ablation tools. (ucdenver.edu)
Right atrial1
- A right atrial flutter ablation is usually successful and, according to this study, materially reduces the need for cardioversions and antiarrhythmic medications. (afibbers.org)
Paroxysmal atrial fibri2
- Pulmonary vein isolation (PVI) is currently recommended for paroxysmal atrial fibrillation (AF) catheter ablation, but persistent AF remains a clinical challenge 1 - 3 . (jafib.com)
- The investigators hypothesized that a combination of circumferential ablation with high-frequency-stimulation-identified GP ablation is superior to conventional circumferential ablation for the prevention of recurrences of paroxysmal atrial fibrillation (AF). (novoclinica.com)
Arrhythmia3
- Atrial fibrillation (AF) is a common arrhythmia, and its prevalence is increasing worldwide 6 . (researchsquare.com)
- Examples of electrospatial mapping guidance of complex arrhythmia ablation. (rmmj.org.il)
- The main goal of treatment for atrial fibrillation (AF) is to treat symptoms and/or arrhythmia-induced heart failure. (biomedcentral.com)
Additional ablation3
- The patients were randomly assigned to additional ablation on an anatomic basis (n = 31) or guided by single potentials or narrowly split double potentials during coronary sinus pacing (n = 32). (northwestern.edu)
- Therefore, although several multicentre randomised trials showed no difference between PVI alone and additional ablation within the left atrium (LA), various methods, including linear ablation and substrate modification, have been introduced to achieve favourable results. (aerjournal.com)
- The risk of recurrence was significantly decreased compared to pulmonary vein isolation (PVI) alone for PVI with renal denervation (RR: 0.60, CI: 0.38-0.94), PVI with ganglia-plexi ablation (RR: 0.62, CI: 0.41-0.94), PVI with additional ablation lines (RR: 0.8, CI: 0.68-0.95) and PVI in combination with bi-atrial modification (RR: 0.32, CI: 0.11-0.88). (biomedcentral.com)
Persistent atrial fibrillation3
- The efficacy of posterior wall isolation (PWI) on top of pulmonary vein isolation (PVI) in patients affected by persistent atrial fibrillation (AF) is still controversial and little is known about the impact of contact-force (CF) technology. (jafib.com)
- A total of 73 consecutive patients (20.5% female) affected by persistent atrial fibrillation (10.9% long-standing) underwent PWI as an adjunctive therapy to PVI using CF sensing catheters. (jafib.com)
- In persistent atrial fibrillation, PWI on top of PVI using CF sensing catheters is safe and effective, providing great reduction of burden of ARs. (jafib.com)
Appeared after catheter ablation1
- De novo CMBs frequently appeared after catheter ablation therapy. (researchsquare.com)
Substrate2
- Electrical Substrate Ablation for Refractory Ventricular Fibrillation: Results of the AVATAR Study. (stanford.edu)
- VF electrical substrate ablation (VESA) was then performed. (stanford.edu)
Recurrence6
- In the Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial, the catheter ablation group had superior quality of life compared with the anti-arrhythmic drug group and less AF recurrence after blanking through intention-to-treat analysis. (aerjournal.com)
- 7,8 Hence, catheter ablation has become widely used for treating symptomatic drug-refractory AF, even though the recurrence rates of AF ablation remain high, especially in persistent AF and longstanding persistent AF. (aerjournal.com)
- In this study, however, 26% of patients subjected to GP ablation alone without circumferential lesions were free of AF-recurrence up to one year after the ablation procedure. (novoclinica.com)
- Left atrial (LA) function can be impaired by the atrial fibrillation (AF) ablation and might be associated with the risk of recurrence. (biomedcentral.com)
- We sought to determine whether the post-procedural changes in LA function impact the risk of recurrence following AF ablation. (biomedcentral.com)
- The primary endpoint was atrial tachyarrhythmia recurrence after ablation. (biomedcentral.com)
Lesions4
- 23-25 Linear ablation combined with PVI may result in reentrant ATs because of conduction gaps and non-transmural lesions caused by ablation lesions. (aerjournal.com)
- A particular strength of MRI compared to other imaging modalities is the ability to visualize ablation lesions. (rmmj.org.il)
- 4 , 5 The basis of these strategies is to target specific anatomic regions and often to create extended ablation "lines" by aligning multiple point lesions or by dragging the catheter along the endocardial surface while applying ablative energy. (rmmj.org.il)
- Contact-force (CF) technology was not, however, routinely used in previous prospective studies on percutaneous PWI, even if it provides deeper and more durable lesions when integrated in ablation catheters either in paroxysmal or in persistent AF ablations 12 - 14 . (jafib.com)
Electrophysiology2
- Previous studies investigating risk factors for incident AF after AFL ablation have not consistently identified LAVI as a predictor and have not commonly included detailed and complete echocardiographic and electrophysiology study data 4 - 6 . (jafib.com)
- We aimed to investigate risk factors, including detailed echocardiography data, and invasive electrophysiology study data, for development of incident AF following AFL ablation. (jafib.com)
Isolation5
- 1 Triggers from the pulmonary vein (PV) have been identified as crucial ectopic sources that initiate AF and pulmonary vein isolation (PVI) is the cornerstone for catheter ablation of AF. (aerjournal.com)
- Among strategies to achieve atrial compartmentalization and de-bulking, posterior wall isolation (PWI) allows the reduction of LA critical mass and also the suppression of AF triggers and drivers 5 . (jafib.com)
- Multiple randomized trials have demonstrated the benefit of prophylactic pulmonary vein isolation (PVI) for patients undergoing CTI dependent AFL ablation 9 - 13 . (jafib.com)
- We also aimed at comparing these two approaches with a combination of GP ablation and PV isolation. (novoclinica.com)
- Patients are subjected to conventional PV isolation through circumferential ablation 1-2 cm from the PV ostium. (novoclinica.com)
Underwent6
- A total of 101 patients who underwent ablation therapy for AF were prospectively registered, and 72 patients completed the assessment with MRI 6 months after catheter ablation. (researchsquare.com)
- Ten patients underwent repeat ablations during the follow-up. (jafib.com)
- Retrospective chart review identified 114 consecutive patients without a history of AF or prior cardiac surgery who underwent typical CTI dependent AFL ablation between December 2013 to November 2018, who also had a complete preoperative transthoracic echocardiogram, and at least 1 year of follow-up at our medical center. (jafib.com)
- All patients in groups 1 and 2 underwent a successful CTI ablation and were then, along with the members of the control group, followed for 5 years. (afibbers.org)
- We retrospectively reviewed patients who underwent AF ablation between 2009 and 2011 and underwent transthoracic echocardiography before ablation, 1-day and 3-month after ablation. (biomedcentral.com)
- Patients with symptomatic and drug-refractory AF who underwent first time AF ablation at Mayo Clinic (Rochester, MN) between April 2009 and May 2011 were included. (biomedcentral.com)
Incidence3
- In this review, we summarise the incidence, mechanism, mapping and ablation techniques, and outcomes of AT after AF ablation. (aerjournal.com)
- The incidence of AT after AF ablation varies from less than 5% to 40% and is associated with the index ablation strategy and duration of AF. (aerjournal.com)
- In multivariable analysis LAVI remained the sole independent predictor of incidence AF after CTI AFL ablation. (jafib.com)
Epicardial1
- Impact of epicardial adipose tissue and catheter ablation strategy on biophysical parameters and ablation lesion characteristics. (ucdenver.edu)
Post-ablation1
- Risk factors for the development of AF post ablation are not well understood. (jafib.com)
Recurrences2
- We aimed to assess the impact of IP in reducing AFL recurrences after CTI ablation. (houstonmethodist.org)
- Conclusions The addition of the IP maneuver for the diagnosis of complete CTI block reduces AFL long-term recurrences after ablation. (houstonmethodist.org)
Congenital heart d1
- 18 years old, had previous AF ablation or cardiac surgery procedure, valvular AF, congenital heart disease, previous atrioventricular node ablation, permanent pacing or no follow-up data. (biomedcentral.com)
Drug-refractory1
- The investigators are, therefore, conducting a randomized study comparing conventional circumferential ablation to a combination of circumferential ablation plus specific right and left atrial GP ablation in patients with drug-refractory paroxysmal AF. (novoclinica.com)
Ventricular Fibrillation1
- Background - Refractory ventricular fibrillation (VF) is a challenging clinical entity, for which ablation of triggering premature ventricular complexes (PVCs) is described. (stanford.edu)
Fluoroscopy1
- Results No intergroup differences were noted in baseline characteristics, ablation settings and fluoroscopy/radiofrequency times. (houstonmethodist.org)
Conclusions1
- Conclusions - VESA is associated with a reduction in the combined endpoint compared with the non-ablation reference group. (stanford.edu)
Tachyarrhythmia1
- Atrial flutter is the second most common tachyarrhythmia, after atrial fibrillation . (medscape.com)
Anatomic2
- The investigators have recently shown that anatomic ganglionated plexi (GP) ablation is inferior to circumferential pulmonary vein (PV) ablation for the treatment of paroxysmal AF. (novoclinica.com)
- Patients are subjected to specific, HF stimulation-guided and anatomic ablation of the main right and left atrial GP. (novoclinica.com)
Outcomes1
- Outcomes were compared against reference patients with VF who were unable or unwilling to undergo catheter ablation. (stanford.edu)
10.91
- An average of 3.3±0.5 sites of localized reentry during VF were targeted for radiofrequency ablation (38.3±10.9 minutes) during sinus rhythm, rendering VF non-inducible with pacing. (stanford.edu)
Lesion3
- Post-procedure MRI is now being applied to assess ablation lesion location and permanence with the goal of identifying factors leading to procedure success and failure. (rmmj.org.il)
- Continuous ablation improves lesion maturation compared with intermittent ablation strategies. (ucdenver.edu)
- Bipolar radiofrequency ablation creates different lesion characteristics compared to simultaneous unipolar ablation. (ucdenver.edu)
Tachycardias2
- Atrial Tachycardias After Atrial Fibrillation Ablation: How to Manage? (aerjournal.com)
- 30 seconds at follow up and in addition, in patients provided with insertable cardiac monitors (ICM), as burden of AF or atrial tachycardias (AT) at relevant time points. (jafib.com)
Methods and Results1
- Methods and Results We used 5-year follow-up data from the Swiss-Atrial Fibrillation prospective cohort, which enrolled 2415 patients with prevalent AF from 2014 to 2017. (journalfilter.com)
Sinus3
- 2,3 Per the European and US AF guidelines, catheter ablation of AF is currently recommended as the first-line therapy if anti-arrhythmic agents fail to maintain sinus rhythm. (aerjournal.com)
- Currently, flecainide is mostly used for sinus rhythm maintenance in atrial fibrillation patients without structural cardiomyopathy although recent studies enrolling different patient population demonstrated a good effectiveness and safety profile. (encyclopedia.pub)
- Peak left atrial contraction strain (PACS) and left atrial emptying fraction (LAEF) were evaluated during sinus rhythm and compared across the three time points. (biomedcentral.com)
Retrospective3
- METHODS: A retrospective multicenter study collecting data from consecutive atrial fibrillation (AF) and supraventricular ablation procedures that required TSC was performed in five Italian centers. (bvsalud.org)
- In this retrospective study, we present our experience with PWI using CF sensing catheters and its efficacy and safety as an adjunctive ablation strategy on top of PVI for management of patients with persistent and longstanding persistent AF. (jafib.com)
- Machine Learning Methodologies for Prediction of Rhythm-Control Strategy in Patients Diagnosed With Atrial Fibrillation: Observational, Retrospective, Case-Control Study. (ucdenver.edu)
Contraction1
- Similar to the abnormal heart rhythm atrial fibrillation, atrial flutter also leads to poor contraction of the atrial chambers of the heart. (wikipedia.org)
Patients without structural1
- The study involved 87 atrial flutter patients (group 1) with no structural heart disease (lone AFL), 50 atrial flutter patients (group 2) with structural heart disease, and a control group of 59 atrial flutter patients without structural heart disease who were treated with medication only (control group). (afibbers.org)
Unstable2
- Atrial flutter in an unstable patient should be treated immediately with synchronized cardioversion. (medscape.com)
- If the affected person is having chest pain, has lost consciousness, or has low blood pressure (unstable atrial flutter), then an urgent electrical shock to the heart to restore a normal heart rhythm is necessary. (wikipedia.org)
Typical2
- At the time of this update, there is no consensus on the optimal management of atrial flutter in the emergency department, due to a lack of robust evidence, as well as a wide variation in typical management. (medscape.com)
- LAVI ≥ 30 ml/m 2 is associated with significantly increased risk of incident AF following CTI ablation for typical AFL. (jafib.com)
Widely2
- However, prophylactic PVI during AFL ablation is not widely performed, and not included in clinical guidelines 14 . (jafib.com)
- Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure. (e-arrhythmia.org)
Rarely1
- Rarely, atrial fibrillation or atrial flutter may be due to pericardial disease or effusion or caused by carbon monoxide intoxication. (medscape.com)
Efficacy and safety1
- The objective of this study was to compare the efficacy and safety of different CA strategies for AF ablation through network meta-analysis (NMA). (biomedcentral.com)
Procedure2
- Catheter and surgical ablation of AF are highly complex procedures, therefore a decision to perform catheter or surgical AF ablation should only be made after a patient carefully considers the risks, benefits, and alternatives to the procedure. (e-arrhythmia.org)
- In the present study, we sought to determine the pattern of LA performance change immediately and short-term after AF ablation and whether such alternation of LA function is related the procedure outcome at long-term follow-up. (biomedcentral.com)
Surgical2
- Catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. (e-arrhythmia.org)
- Surgical ablation of AF is available in most major hospitals throughout the world. (e-arrhythmia.org)