Article
Health Care Sciences & Services
Aikaterini Vraka, Vicente Bertomeu-Gonzalez, Lorenzo Facila, Jose Moreno-Arribas, Raul Alcaraz, Jose J. Rieta
Summary: This study analyzes the crucial steps of coronary sinus catheterization and left and right pulmonary veins isolation in pulmonary veins catheter ablation for atrial fibrillation. The results show that P-waves are more affected than local activation waves by the ablation process, and LPVI has the most significant impact on P-wave duration.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Dan Qi, Jianjun Zhang
Summary: This study investigated the potential relationship between anatomical characteristics of pulmonary veins (PVs) and atrial fibrillation recurrence (AFR) following radiofrequency catheter ablation (RFCA). The results showed that patients with AFR had a significantly larger mean PV diameter compared to those without AFR. This suggests that PV diameter could serve as a potential predictor of the risk of AFR following RFCA.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Tristram D. Bahnson, Anna Giczewska, Daniel B. Mark, Andrea M. Russo, Kristi H. Monahan, Hussein R. Al-Khalidi, Adam P. Silverstein, Jeanne E. Poole, Kerry L. Lee, Douglas L. Packer
Summary: According to the CABANA trial, catheter ablation is most effective in younger patients, while no prognostic benefits were observed in the oldest patients. Catheter ablation is more effective than drug therapy in preventing atrial fibrillation recurrence, with few complications regardless of age.
Article
Cardiac & Cardiovascular Systems
Taiki Sato, Yohei Sotomi, Shungo Hikoso, Daisaku Nakatani, Hiroya Mizuno, Katsuki Okada, Tomoharu Dohi, Tetsuhisa Kitamura, Akihiro Sunaga, Hirota Kida, Bolrathanak Oeun, Yoshio Furukawa, Akio Hirata, Yasuyuki Egami, Tetsuya Watanabe, Hitoshi Minamiguchi, Miwa Miyoshi, Nobuaki Tanaka, Takafumi Oka, Masato Okada, Takashi Kanda, Yasuhiro Matsuda, Masato Kawasaki, Masaharu Masuda, Koichi Inoue, Yasushi Sakata
Summary: This study found that the extensive ablation strategy was superior to the PVI-alone strategy in both men and women with persistent AF, with no significant difference in efficacy between the sexes.
CIRCULATION JOURNAL
(2022)
Article
Cardiac & Cardiovascular Systems
Jonathan M. Kalman, Ahmed M. Al-Kaisey, Ramanathan Parameswaran, Joshua Hawson, Robert D. Anderson, Michael Lim, David Chieng, Stephen A. Joseph, Alex McLellan, Joseph B. Morton, Paul B. Sparks, Geoffrey Lee, Prashanthan Sanders, Peter M. Kistler
Summary: This study aimed to determine if the timing of catheter ablation for atrial fibrillation (AF) affects arrhythmia outcomes. The results showed that there was no significant difference in the atrial arrhythmia free survival at 12 months post-ablation between patients who underwent early ablation and those who underwent delayed ablation. Other secondary outcomes also showed no significant difference. Therefore, delaying AF ablation by 12 months for antiarrhythmic drug management does not reduce the efficacy of ablation.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Stepan Havranek, Zdenka Fingrova, Tomas Skala, Adrian Reichenbach, Milan Dusik, Pavel Jansa, David Ambroz, Vladimir Dytrych, Dalibor Klimes, Martin Hutyra, Josef Kautzner, Ales Linhart, Dan Wichterle
Summary: This study aimed to investigate whether more extensive radiofrequency catheter ablation of the bi-atrial arrhythmogenic substrate instead of clinical arrhythmia ablation alone results in superior clinical outcomes in patients with pulmonary arterial hypertension (PH) and supraventricular arrhythmias. The results showed similar arrhythmia recurrence rates between the two treatment groups, and no excess of procedural complications or clinical events in the extensive ablation group.
Article
Cardiac & Cardiovascular Systems
Andreas Metzner, Karl-Heinz Kuck, Julian K. R. Chun
Summary: Atrial fibrillation ablation is an important treatment option for symptomatic patients, with electrical isolation of the pulmonary veins as the cornerstone. The lack of persistent isolation limits the understanding of the impact on AF suppression, necessitating the development of novel ablation systems to improve success rates.
Article
Cardiac & Cardiovascular Systems
Daehoon Kim, Taehyun Hwang, Min Kim, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
Summary: Extra-pulmonary vein triggers are commonly found in atrial fibrillation patients and associated with poorer rhythm outcomes after both de novo and repeat catheter ablation procedures.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Cardiac & Cardiovascular Systems
Gianluigi Bisleri, Arjun K. Pandey, Subodh Verma, Syed M. Ali Hassan, Bobby Yanagawa, Masud Khandaker, Mario Gaudino, Andrea M. Russo, Atul Verma, Deepak L. Bhatt, Andrew C. T. Ha
Summary: Hybrid ablation is a novel therapy that combines minimally invasive surgical and percutaneous catheter-based techniques for the management of atrial fibrillation (AF). Observational studies have shown approximately 70% success rates but higher risks compared to catheter-based ablation. Hybrid ablation is typically offered to patients with persistent or longstanding persistent AF, requiring two procedures. While a randomized trial demonstrated its superiority over catheter-based ablation, it also showed higher complication rates. Contemporary studies have shown a decrease in the incidence of serious complications. Additional randomized trials are needed to determine the risks, benefits, and cost effectiveness of hybrid ablation in clinical practice.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Timothy M. Markman, Mirmilad Khoshknab, Saman Nazarian
Summary: Catheter ablation is increasingly used for atrial fibrillation patients, with ongoing challenges and limitations despite advancements in technology. The evolution of multimodality imaging, particularly cardiac CT and MRI, offers significant opportunities to improve safety and efficacy in ablation procedures.
Article
Cardiac & Cardiovascular Systems
Geoffroy Ditac, Pierre Jean Cottinet, Minh Quyen Le, Daniel Grinberg, Josselin Duchateau, Kevin Gardey, Arnaud Dulac, Antoine Deliniere, Christelle Haddad, Julie Boussuge-Roze, Frederic Sacher, Pierre Jais, Philippe Chevalier, Francis Bessiere
Summary: Atrial fibrillation (AF) catheter ablation procedure contributes significantly to GHG emissions, with a carbon footprint of 76.9 kg CO2-e. With approximately 600,000 annual procedures worldwide, AF catheter ablation leads to 125 tons of CO2 emissions every day, equivalent to a daily car ride of 700,000 km. Electrophysiology catheters and patches are identified as the main contributors to the carbon footprint, highlighting the importance of reducing, reusing, and recycling these items.
Review
Cardiac & Cardiovascular Systems
Thomas J. Buist, Douglas P. Zipes, Arif Elvan
Summary: Catheter ablation is an established treatment for atrial fibrillation, with pulmonary vein isolation as the gold standard. AF recurrence is often due to recovery of conduction from the pulmonary veins. Various technologies are being developed to improve lesion quality and safety in AF ablation procedures.
CLINICAL RESEARCH IN CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Yun Young Choi, Jong-Il Choi, Joo Hee Jeong, Hyoung Seok Lee, Yun Gi Kim, Mi-Na Kim, Seung-Young Roh, Jaemin Shim, Jin Seok Kim, Seong-Mi Park, Young-Hoon Kim
Summary: This study found that a higher pulmonary artery pressure (PAP) is associated with an increased risk of recurrence after radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation, suggesting a mechanism by which pulmonary vascular dysfunction may lead to pulmonary vein impairment and left atrial remodeling.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Karim Benali, Paul Khairy, Nefissa Hammache, Adrian Petzl, Antoine Da Costa, Atul Verma, Jason G. Andrade, Laurent Macle
Summary: A systematic review and pooled analysis of randomized control trials showed that catheter ablation of atrial fibrillation is associated with low rates of procedure-related complications and mortality, which have declined over the past decade.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Review
Biochemistry & Molecular Biology
Alfredo Parra-Lucares, Eduardo Villa, Esteban Romero-Hernandez, Gabriel Mendez-Valdes, Catalina Retamal, Geovana Vizcarra, Ignacio Henriquez, Esteban A. J. Maldonado-Morales, Juan H. Grant-Palza, Sofia Ruiz-Tagle, Victoria Estrada-Bobadilla, Luis Toro
Summary: Atrial fibrillation (AF) is a common cardiac condition that primarily affects older adults and is characterized by irregular heartbeat rhythm. It often leads to significant disability and increased mortality rates. Recent studies have highlighted the importance of early restoration of sinus rhythm in improving patient outcomes.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Tolga Aksu, Dhiraj Gupta
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Jim O'Brien, Mohammed Obeidat, Nikola Kozhuharov, Wern Yew Ding, Lilith Tovmassian, Cedric Bierme, Shui Hao Chin, Gavin S. Chu, Vishal Luther, Richard L. Snowdon, Dhiraj Gupta
Summary: The study found that AI-guided 50W ablation for AF is as safe and effective as lower powers, resulting in reduced ablation and procedure times, with similar success rates and complication rates.
Article
Cardiac & Cardiovascular Systems
Monika Gawalko, David Duncker, Martin Manninger, Rachel M. J. van der Velden, Astrid N. L. Hermans, Dominique V. M. Verhaert, Laurent Pison, Ron Pisters, Martin Hemels, Arian Sultan, Daniel Steven, Dhiraj Gupta, Hein Heidbuchel, Afzal Sohaib, Petra Wijtvliet, Robert Tieleman, Henri Gruwez, Julian Chun, Boris Schmidt, John J. Keaney, Patrick Mueller, Piotr Lodzinski, Emma Svennberg, Olga Hoekstra, Ward P. J. Jansen, Lien Desteghe, Tom de Potter, David R. Tomlinson, Lis Neubeck, Harry J. G. M. Crijns, Nikki A. H. A. Pluymaekers, Jeroen M. Hendriks, Dominik Linz
Summary: The TeleCheck-AF project aimed to maintain care delivery for AF patients during COVID-19 through teleconsultations and heart rate monitoring. Most participating centres were academic with AF outpatient clinics. The inclusion rate was highest during lockdown and decreased after easing restrictions.
Article
Cardiac & Cardiovascular Systems
Dhiraj Gupta, Johan Vijgen, Tom De Potter, Daniel Scherr, Hugo Van Herendael, Sebastien Knecht, Richard Kobza, Benjamin Berte, Niels Sandgaard, Jean-Paul Albenque, Gabor Szeplaki, Yorick Stevenhagen, Philippe Taghji, Matt Wright, Mattias Duytschaever
Summary: PVI guided by a standardised CLOSE protocol improved QOL and decreased healthcare utilisation significantly. QOL improvement was closely related to AF burden and baseline conditions. Cardiovascular hospitalisations decreased significantly after ablation, with some patients lacking substantial QOL improvement.
Editorial Material
Cardiac & Cardiovascular Systems
Jacopo Francesco Imberti, Giuseppe Boriani, Dhiraj Gupta, Gregory Y. H. Lip
EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES
(2021)
Article
Cardiac & Cardiovascular Systems
Tolga Aksu, Tom De Potter, Leah John, Jose Osorio, David Singh, Daniel Alyesh, Erkan Baysal, Kapil Kumar, Javad Mikaeili, Alexander dal Forno, Kivanc Yalin, Baris Akdemir, Christopher E. Woods, Jonathan Salcedo, Mahmoud Eftekharzadeh, Taylan Akgun, Sri Sundaram, Dursun Aras, Wendy S. Tzou, Rakesh Gopinathannair, Jeffrey Winterfield, Dhiraj Gupta, Andre Davila
Summary: This multi-center study compared the acute procedural characteristics of first-time operators and a high-volume operator performing FE-guided GP ablation in patients with VMB. Results showed differences between the two groups, but none of the patients experienced syncope during the follow-up period.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2022)
Article
Medicine, General & Internal
G. Andre Ng, Amar Mistry, Michelle Newton, Fernando Soares Schlindwein, Craig Barr, Matthew G. D. Bates, Jane Caldwell, Moloy Das, Mohsin Farooq, Neil Herring, Pier Lambiase, Faizel Osman, Manav Sohal, Andrew Staniforth, Muzahir Tayebjee, David Tomlinson, Zachary Whinnett, Arthur Yue, Will B. Nicolson
Summary: The purpose of this study is to evaluate the ability of two new ECG markers to predict sudden cardiac death or ventricular arrhythmia events in patients with ischaemic cardiomyopathy undergoing implantation of an implantable cardioverter defibrillator. The ECG data obtained during an electrophysiological study will be analyzed in a core lab. The results will inform the design of a future randomized controlled trial.
Article
Biochemistry & Molecular Biology
Wern Yew Ding, Ian G. Davies, Dhiraj Gupta, Gregory Y. H. Lip
Summary: There are significant changes in fibrin clot properties with AF and CKD, which may contribute to an increased risk of thromboembolic complications. However, these changes are not attributable to alterations in lipoprotein distribution.
Article
Cardiac & Cardiovascular Systems
Dhiraj Gupta, Wern Yew Ding, Peter Calvert, Emmanuel Williams, Moloy Das, Lilith Tovmassian, Muzahir H. Tayebjee, Guy Haywood, Claire A. Martin, Kim Rajappan, Matthew G. D. Bates, Ian Peter Temple, Tobias Reichlin, Zhong Chen, Richard N. Balasubramaniam, Christina Ronayne, Nichola Clarkson, Maureen Morgan, Janet Barton, Ian Kemp, Saagar Mahida, Christian Sticherling
Summary: The study compared cryoballoon pulmonary vein isolation (PVI) with standard radiofrequency cavotricuspid isthmus (CTI) ablation for the first-line treatment of typical atrial flutter (AFL). The results showed that cryoballoon PVI was equally effective as CTI ablation in preventing the recurrence of atrial arrhythmia and better at preventing new-onset atrial fibrillation (AF).
Review
Biology
Tolga Aksu, Dhiraj Gupta, Jamario R. Skeete, Henry H. Huang
Summary: Atrial fibrillation (AF) is a common supraventricular arrhythmia associated with higher cardiovascular morbidity and mortality. Recent evidence suggests that catheter-based pulmonary vein isolation (PVI) may be a superior alternative to antiarrhythmic drug therapy for long-term freedom from AF episodes. Imbalances in the autonomic nervous system (ANS) may contribute to AF, leading to increased interest in neuromodulation techniques for the intrinsic cardiac ANS.
Review
Cardiac & Cardiovascular Systems
Ioanna Koniari, Andreas Gerakaris, Nicholas Kounis, Dimitrios Velissaris, Archana Rao, Mark Ainslie, Ahmed Adlan, Panagiotis Plotas, Ignatios Ikonomidis, Virginia Mplani, Ming-Yow Hung, Cesare de Gregorio, Theofilos Kolettis, Dhiraj Gupta
Summary: This review examines the literature on the use of atrioventricular node ablation and pacing in heart failure and atrial fibrillation patients. It shows that this strategy improves symptoms and cardiac performance, but may have complications such as worsening heart failure, arrhythmias, and sudden death. Cardiac resynchronization therapy is the optimal treatment, while His bundle pacing and left bundle branch pacing are potential alternatives.
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
(2023)
Article
Cardiac & Cardiovascular Systems
Ignacio Garcia-Bolao, Pablo Ramos, Armin Luik, Matthew S. Sulkin, Sarah R. Gutbrod, Tobias Oesterlein, Jacob Laughner, Elizabeth Richards, Christian Meyer, Arthur Yue, Waqas Ullah, Ewen Shepherd, Moloy Das
Summary: This analysis evaluated the role of local impedance drop in predicting durable block and mature lesion formation during pulmonary vein isolation. The results suggest that radiofrequency ablation guided by local impedance may be beneficial in patients with paroxysmal atrial fibrillation.
JACC-CLINICAL ELECTROPHYSIOLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Saad Javed, Ioanna Koniari, David Fox, Chris Skene, Gregory Y. H. Lip, Dhiraj Gupta
Summary: Atrial fibrillation and heart failure, often coexisting in patients, are complex clinical entities with increasing prevalence. Traditional approaches of rate and rhythm control are being challenged by recent evidence supporting catheter ablation for AF in patients with concomitant HF, suggesting potential survival benefits.
JOURNAL OF GERIATRIC CARDIOLOGY
(2021)
Letter
Cardiac & Cardiovascular Systems
Dhiraj Gupta, Mattias Duytschaever, Benjamin Berte, Tom De Potter
Review
Cardiac & Cardiovascular Systems
Agnieszka Kotalczyk, Wern Yew Ding, Dhiraj Gupta, David Justin Wright, Gregory Y. H. Lip
Summary: In managing AF, rhythm control strategy is recommended to alleviate symptoms and improve quality of life, but further research is needed to fully assess the impact of early rhythm control strategies on clinical outcomes.
EXPERT REVIEW OF CARDIOVASCULAR THERAPY
(2021)