Article
Medicine, General & Internal
Shibu Mathew, Islam Saboukh, Parminder Singh, Bastian Fries, Victoria Johnson, Nikita Schneider, Christian Fraebel, Ritvan Chasan, Christian W. W. Hamm, Joern Schmitt
Summary: This study investigated the extension of lesions on the posterior wall and roof of the left atrium after cryoballoon-based pulmonary vein isolation. The results showed that significant portions of the posterior wall and LA roof remained unablated after the procedure, potentially contributing to AF recurrence.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Medicine, General & Internal
Reinhard Kaufmann, Richard Rezar, Bernhard Strohmer, Bernhard Wernly, Michael Lichtenauer, Wolfgang Hitzl, Matthias Meissnitzer, Klaus Hergan, Marcel Granitz
Summary: By calculating the left atrial and left atrial appendage ejection fractions, it is possible to predict AF recurrence more sensitively after PVI. The left atrial function parameters are independent of the type of AF, providing useful predictors for AF recurrence.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Nandor Szegedi, Judit Simon, Balint Szilveszter, Zoltan Sallo, Szilvia Herczeg, Lili Szaraz, Marton Kolossvary, Gabor Orban, Gabor Szeplaki, Klaudia Vivien Nagy, Mohammed El Mahdiui, Jeff M. Smit, Victoria Delgado, Jeroen J. Bax, Pal Maurovich-Horvat, Bela Merkely, Laszlo Geller
Summary: This study evaluated the impact of the spatial relationship between LSPV and LAA on recurrence after catheter ablation for paroxysmal AF. The study found that an abutting LAA-LSPV was associated with a higher chance of AF recurrence.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Hongwu Chen, Chengzong Li, Bing Han, Fangyi Xiao, Fu Yi, Youquan Wei, Chenyang Jiang, Cao Zou, Linsheng Shi, Wei Ma, Weiming Wang, Yuegang Wang, Hong Du, Long Chen, Minglong Chen
Summary: This study found that additional low-voltage-area ablation beyond CPVI decreased the recurrence of atrial tachyarrhythmia in older patients with paroxysmal AF compared with CPVI alone. These findings merit further replication by larger trials with longer follow-up.
Article
Medicine, General & Internal
Moshe Rav Acha, Oholi Tovia-Brodie, Yoav Michowitz, Feras Bayya, Fauzi F. Shaheen, Shalom Abuhatzera, Aharon Medina, Michael Glikson, Arik Wolak
Summary: This study evaluated post-ablation pulmonary vein (PV) ostial gaps in patients with atrial fibrillation (AF) and found that cryoballoon ablation induced PV fibrosis, which correlated with AF recurrence. The study suggests that MRI has the ability to predict AF recurrence.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Giulio Falasconi, Diego Penela, David Soto-Iglesias, Pietro Francia, Cheryl Teres, Andrea Saglietto, Beatriz Jauregui, Daniel Viveros, Aldo Bellido, Jose Alderete, Julia Meca-Santamaria, Paula Franco, Carlo Gaspardone, Rodolfo San Antonio, Marina Huguet, Oscar Camara, Jose-Tomas Ortiz-Perez, Julio Marti-Almor, Antonio Berruezo
Summary: The study aimed to personalize the ablation index (AI) based on left atrial wall thickness (LAWT) and investigate its effectiveness in PV antrum isolation for persistent atrial fibrillation (PeAF). The results showed that this personalized approach was effective and efficient, with low procedure, fluoroscopy, and RF time. The importance of this study lies in providing a new method for the treatment of PeAF.
Article
Cardiac & Cardiovascular Systems
Alena Yakimenka, Dina Labib, Steven Dykstra, Yoko Mikami, Alessandro Satriano, Jacqueline Flewitt, Patricia Feuchter, Sandra Rivest, Andrew G. Howarth, Carmen P. Lydell, F. Russell Quinn, Stephen B. Wilton, James A. White
Summary: This prospective cohort study aimed to evaluate the sex-based differences in cardiac phenotype and their influence on AF recurrence following first-time PVI. The study found that females had significantly poorer left atrial (LA) contractile health and higher risk of AF recurrence. Assessment of LA contractile health may be valuable in identifying female patients at elevated risk of AF recurrence.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Medicine, General & Internal
Sebastian Weyand, Viola Adam, Matthias Beuter, Simon Hanger, David Heinzmann, Willibald Schrezenmeier, Peter Seizer
Summary: For patients undergoing radiofrequency pulmonary vein isolation, the necessity of pulmonary vein angiography was investigated after the use of high-resolution mapping catheters and high-power, short-duration ablation technique. The study found that omitting pulmonary vein angiography had no significant impact on the efficacy, efficiency, and complications of the ablation procedure. Therefore, avoiding pulmonary vein angiography may be useful, especially for young patients and those with chronic renal disease, when using this protocol.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Leon Zwimpfer, Stefanie Aeschbacher, Philipp Krisai, Michael Coslovsky, Anne Springer, Rebecca E. Paladini, Marc Girod, Janik Hufschmid, Sven Knecht, Patrick Badertscher, Jurg H. Beer, Leo H. Bonati, Christine S. Zuern, Laurent Roten, Tobias Reichlin, Christian Sticherling, David Conen, Stefan Osswald, Michael Kuhne
Summary: In the Swiss Atrial Fibrillation Cohort study, there was no consistent evidence of an association between pulmonary vein isolation (PVI) and neurocognitive function in atrial fibrillation patients.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Lilla Szuromi, Orsolya Hajas, Edina Nagy-Balo, Ildiko N. Forgacs, Laszlo T. Nagy, Miklos Fagyas, Attila Toth, Bela Nagy Jr, Janos Kappelmayer, Zoltan Csanadi
Summary: This study aimed to evaluate the association between the concentrations of different biomarkers and the long-term success of pulmonary vein isolation (PVI) in patients with a structurally normal heart. The levels of CA-125, Caspase-3, Cathepsin L, and Galectin-3 were found to be unrelated to AF recurrence after PVI in patients with a structurally normal heart and primarily paroxysmal AF. Except for CA-125, all the other biomarkers demonstrated a significant decrease during a 3-year follow-up post-ablation. Furthermore, there was a positive correlation between Caspase-3 levels and LA dimensions in patients with AF recurrence.
REVIEWS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Medicine, General & Internal
Rahel Zuercher, Anique Herling, Marc T. Schmidt, Marta Bachmann, Stephan Winnik, Firat Duru, Urs Eriksson
Summary: This retrospective study evaluates the safety of standardized, transesophageal echocardiography (TEE)-guided transseptal access to the left atrium in consecutive patients who underwent endovascular pulmonary vein isolation (PVI). The results showed that there were no complications related to transseptal access, confirming the safety of the TEE-guided approach.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Janko Szavits Nossan, Igor Sesto, Kresimir Stambuk, Tomislav Sipic, Robert Bernat, Ivan Gudelj, Luka Rotkvic, Marinko Zulj, Jure Mirat
Summary: The study found that more than half of AF patients undergoing PVI (47%) had advanced fibrosis in the LA. However, there was no significant correlation between BMI and the extent or number of fibrotic areas in these patients.
KARDIOLOGIA POLSKA
(2021)
Article
Cardiac & Cardiovascular Systems
Lihong Huang, Mingyang Gao, Yiwei Lai, Qi Guo, Songnan Li, Changyi Li, Nian Liu, Wei Wang, Xiaoxia Liu, Song Zuo, Xueyuan Guo, Xin Zhao, Chenxi Jiang, Caihua Sang, Ribo Tang, Deyong Long, Xin Du, Jianzeng Dong, Chang-sheng Ma
Summary: This study assessed the effect of ethanol infusion into the vein of Marshall (EIVOM) on the acute success of left pulmonary vein isolation in persistent atrial fibrillation (PeAF). The results showed that ethanol infusion can improve the success rate of left pulmonary vein isolation and reduce the occurrence of acute pulmonary vein reconnection.
Article
Cardiac & Cardiovascular Systems
J. Pongratz, L. Riess, S. Hartl, B. Brueck, C. Tesche, U. Ebersberger, T. Helmberger, A. Crispin, M. Wankerl, U. Dorwarth, E. Hoffmann, F. Straube
Summary: In patients with persistent atrial fibrillation (AF) undergoing cryoballoon ablation, the volume of the left atrial appendage (LAA) and the severity of mitral regurgitation were identified as independent predictors for arrhythmia recurrence.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Chemistry, Analytical
Aikaterini Vraka, Vicente Bertomeu-Gonzalez, Fernando Hornero, Aurelio Quesada, Raul Alcaraz, Jose J. Rieta
Summary: This study investigates the assessment of atrial substrate modification after PVI in patients with PAF by analyzing P-wave duration in the ECG. The results show that the shortening of P-wave duration after PVI mainly comes from the second half of the P-wave. Therefore, noninvasive estimation of LA conduction time is critical for the study of atrial substrate modification after PVI.
Article
Cardiac & Cardiovascular Systems
Edward J. Vigmond, Julien Bouyssier, Jason Bayer, Michel Haissaguerre, Hiroshi Ashikaga
Summary: Research suggests that anatomical re-entry using the Purkinje network is possible through reduced gap junctional coupling leading to slowed conduction. Active and passive lesions in the Purkinje network have different characteristics which determine their ability to support re-entry, with active tissue robustly maintaining re-entry while passive tissue cannot support it.
Article
Cardiac & Cardiovascular Systems
Cory M. Tschabrunn, Sara Attalla, Jonathan Salas, David S. Frankel, Matthew C. Hyman, Emily Simon, Tiffany Sharkoski, David J. Callans, Gregory E. Supple, Saman Nazarian, David Lin, Robert D. Schaller, Sanjay Dixit, Francis E. Marchlinski, Pasquale Santangeli
Summary: Active esophageal cooling using the Attune Medical Esophageal Heat Transfer Device may reduce the occurrence of severe endoscopically detected esophageal thermal lesions, offering potential benefits in preventing complications following radiofrequency catheter ablation for atrial fibrillation.
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Robert D. Schaller, Tamara Brunker, Michael P. Riley, Francis E. Marchlinski, Saman Nazarian, Harold Litt
Summary: MRI in patients with abandoned CIED leads was found to be safe in this study, questioning the absolute contraindication for MRI in this patient population.
Article
Cardiac & Cardiovascular Systems
Lohit Garg, Naga Venkata K. Pothineni, Alonso Arroyo, Diego Rodriguez, Fermin C. Garcia, Matthew C. Hyman, Ramanan Kumareswaran, Jeffrey S. Arkles, Robert D. Schaller, Gregory E. Supple, David S. Frankel, Michael P. Riley, Saman Nazarian, David Lin, Sanjay Dixit, David J. Callans, Erica S. Zado, Francis E. Marchlinski, Luis C. Saenz, Pasquale Santangeli
Summary: IAS-ATs are rare tachycardias that typically occur in patients with a history of atrial fibrillation ablation or cardiac surgery. These patients often have evidence of interatrial septum substrate abnormalities. Catheter ablation of IAS-ATs can be challenging and may require sequential unipolar or bipolar ablation techniques for successful outcomes.
Article
Cardiac & Cardiovascular Systems
Mirmilad Khoshknab, Ling Kuo, Tarek Zghaib, Jeffrey Arkles, Pasquale Santangeli, Francis E. Marchlinski, Yuchi Han, Benoit Desjardins, Saman Nazarian
Summary: Esophageal luminal temperature rises during RF lesion delivery are associated with shorter lesion distance from the esophagus and lower baseline impedance, suggesting that selecting sites with higher baseline impedance may improve safety when RF delivery near the esophagus is required.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2021)
Editorial Material
Medicine, General & Internal
Tharian S. Cherian, Saman Nazarian, David S. Frankel
Summary: This case report presents the findings of echocardiogram and intracardiac recordings in a patient in their 70s with fatigue, light-headedness, and dyspnea on exertion during the previous week.
JAMA INTERNAL MEDICINE
(2021)
Editorial Material
Cardiac & Cardiovascular Systems
Tarek Zghaib, Timothy M. Markman, Saman Nazarian
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Mirmilad Khoshknab, Tarek Zghaib, Lingyu Xu, Jeffrey Arkles, Pasquale Santangeli, Francis E. Marchlinski, Yuchi Han, Benoit Desjardins, Saman Nazarian
Summary: Despite the risk of esophageal injury during atrial fibrillation ablation, our study found that image segmentation for esophageal visualization can impact radiofrequency power delivery decisions, but is not associated with changes in radiofrequency time, LET, or long-term safety.
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Tarek Zghaib, Saman Nazarian
Letter
Cardiac & Cardiovascular Systems
Timothy M. M. Markman, Francis E. E. Marchlinski, Andrew E. E. Epstein, Saman Nazarian
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Lingyu Xu, Benoit Desjardins, Walter R. Witschey, Saman Nazarian
Summary: Myocardial lipomatous metaplasia is increasingly being reported in postinfarct patients, and noninvasive imaging techniques like cardiac magnetic resonance and cardiac contrast-enhanced computed tomography have been used to detect and quantify myocardial LM. This review summarizes the advantages and disadvantages, clinical applications, and imaging features of different imaging techniques in LM detection. It also explores the prevalence of LM in postinfarct patients and the clinical utility of cardiac imaging in understanding its arrhythmogenic substrate.
CIRCULATION-CARDIOVASCULAR IMAGING
(2023)
Article
Cardiac & Cardiovascular Systems
Jennifer Chee, Aung N. Lin, Howard Julien, David Lin, Robert D. Schaller, David S. Frankel, Gregory E. Supple, Pasquale Santangeli, Michael P. Riley, Saman Nazarian, Rajat Deo, Jeffrey Arkles, Ramanan Kumareswaran, Matthew C. Hyman, Gustavo Guandalini, Andrew E. Epstein, Erica S. Zado, David J. Callans, Francis E. Marchlinski, Sanjay Dixit
Summary: Lesions delivered during catheter ablation of ventricular arrhythmias originating from left ventricular papillary muscles can be safely performed without adverse impact on mitral valve function, as demonstrated by this study.
JACC-CLINICAL ELECTROPHYSIOLOGY
(2022)
Letter
Cardiac & Cardiovascular Systems
Timothy M. Markman, Mirmilad Khoshknab, Pasquale Santangeli, Francis E. Marchlinski, Saman Nazarian
JACC-CLINICAL ELECTROPHYSIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Daniele Muser, Gaetano Nucifora, Simon A. Castro, Andres Enriquez, C. Anwar A. Chahal, Silvia Magnani, Ramanan Kumareswaran, Jeffrey Arkles, Gregory Supple, Robert Schaller, Matthew Hyman, Sanjay Dixit, David Lin, Erica S. Zado, Cory Tschabrunn, David J. Callans, Saman Nazarian, David S. Frankel, Francis E. Marchlinski, Pasquale Santangeli
Summary: The study aimed to characterize the relationship between DF, EAM substrate, and outcomes of catheter ablation of VT in NICM patients. It found that DF estimated using post-contrast T-1 mapping correlates with voltage abnormality at EAM and likely impacts post-ablation outcomes.
JACC-CLINICAL ELECTROPHYSIOLOGY
(2021)
Article
Clinical Neurology
Anjali Bhatla, Yuliya Borovskiy, Ronit Katz, Matthew C. Hyman, Parin J. Patel, Jeffrey Arkles, David J. Callans, Neel Chokshi, Sanjay Dixit, Andrew E. Epstein, David S. Frankel, Fermin C. Garcia, Ramanan Kumareswaran, Jackson J. Liang, David Lin, Steven R. Messe, Saman Nazarian, Michael P. Riley, Pasquale Santangeli, Robert D. Schaller, Gregory E. Supple, Scott E. Kasner, Francis Marchlinski, Rajat Deo
Summary: This study assessed the prognosis of patients with ischemic stroke based on the timing of AF diagnosis. The findings indicated that patients diagnosed with AF after stroke within <= 6 months had the highest risk of death.