scholarly journals Feasibility of “Natural Surface” Epicardial Mapping from the Pulmonary Artery for Management of Atrial Arrhythmias

2021 ◽  
Author(s):  
Jeffrey J. Smietana ◽  
Fermin C. Garcia ◽  
Naga Venkata K. Pothineni ◽  
Kelvin Bush ◽  
Mirmilad Khoshknab ◽  
...  
2015 ◽  
Vol 18 (4) ◽  
pp. 96 ◽  
Author(s):  
M. S. Khlynin ◽  
S. V. Popov ◽  
S. N. Krivolapov ◽  
R. Ye. Batalov

The aim of this study was to measure the accuracy of noninvasively obtained ventricular activation (isolated epicardial vs combined endo-epicardial mapping) as compared with that of standard invasive mapping in patients with ventricular arrhythmias. 94 patients (35 males and 59 females) aged 20 to 67 years (mean age 42.6 years) with ventricular arrhythmias of different localization and etiology and 8 patients (4 males and 4 females) aged 21 to 65 years (mean age 48.8 years) with atrial arrhythmias were examined. All patients underwent noninvasive electrophysiological examination, which was performed with Amycard System, subsequent intracardiac mapping and radiofrequency catheter ablation. The arrythmogenic focus localizations coincided in 83 cases, in 11 patients with ventricular arrhythmias some variances were observed and in patients with atrial arrhythmias no such variances were found. Thus, the accuracy of noninvasive mapping turned out to be 89.2%.


2018 ◽  
Author(s):  
Erik Soule

Indwelling vascular catheters may be maintained for extended periods of time especially for critically ill or hospitalized patients requiring frequent blood draws. If they become knotted within the vasculature, serious iatrogenic sequelae can result, such as: pneumothorax, atrial arrhythmias, ventricular arrhythmias, pulmonary embolism, pulmonary hemorrhage, intracardiac rupture, pulmonary artery rupture, balloon rupture, bacteremia, and death. Surgical cut-down may be indicated for removal of knots that preclude catheter retrieval and are refractory to intravascular removal modalities. Three such knots were untied using the intraluminal technique described in this report. The technique utilizes balloon angioplasty in conjunction with a wire to safely and effectively untie knotted catheters. Keywords: Vascular catheters, Arrhythmias, Angioplasty balloon.


2017 ◽  
Vol 16 (1) ◽  
pp. 75 ◽  
Author(s):  
Federico Ferrando-Castagnetto ◽  
Roberto Ricca-Mallada ◽  
Valentina Selios ◽  
Rodolfo Ferrando

2004 ◽  
Vol 107 (3) ◽  
pp. 297-302 ◽  
Author(s):  
Ali R. ERBAY ◽  
Mehmet B. YILMAZ ◽  
Mustafa BALCI ◽  
Irfan SABAH

In the present study, we have examined whether increased N-ANP (N-terminal pro-ANP) levels before and after surgery in patients with ASD (atrial septal defect) along with echocardiographic findings provide a better insight into the pathophysiology and increased morbidity and mortality following corrective surgery. Eighteen adult ASD patients (>20 years of age; six male and 12 female) with shunts (Qp/Qs≥2, where Qp/Qs is the pulmonary blood flow/systemic blood flow) had complete echocardiographic, clinical and laboratory parameters evaluated before and 6 months after surgery. Eight age- and sex-matched individuals (three male and five female) were enrolled as a control group. Blood samples for N-ANP analysis were obtained in both groups. N-ANP levels in the peripheral blood sample from ASD patients before surgery were significantly higher than those in the control group. In patients with ASD, mean N-ANP levels obtained from the pulmonary artery were significantly higher than that obtained from the peripheral vein. RA (right atrial) area, adjusted for body surface area, and RA long-axis and short-axis measurements were significantly higher in the patient group than the control group. N-ANP was correlated significantly with these parameters. Following corrective surgery, N-ANP values and RA area, RA long-axis and short-axis normalization decreased significantly and were accompanied by a decrease in systolic mean pulmonary artery pressure. N-ANP levels were normalized following septal closure in most patients, except in those with atrial fibrillation attacks following corrective surgery. In conclusion, we have shown correlations among variables indicating changes in the architecture of the right atrium along with temporal changes in ANP providing insights into the pathophysiology of post-operative atrial arrhythmias.


2019 ◽  
Vol 133 (20) ◽  
pp. 2045-2059 ◽  
Author(s):  
Da Zhang ◽  
Xiuli Wang ◽  
Siyao Chen ◽  
Selena Chen ◽  
Wen Yu ◽  
...  

Abstract Background: Pulmonary artery endothelial cell (PAEC) inflammation is a critical event in the development of pulmonary arterial hypertension (PAH). However, the pathogenesis of PAEC inflammation remains unclear. Methods: Purified recombinant human inhibitor of κB kinase subunit β (IKKβ) protein, human PAECs and monocrotaline-induced pulmonary hypertensive rats were employed in the study. Site-directed mutagenesis, gene knockdown or overexpression were conducted to manipulate the expression or activity of a target protein. Results: We showed that hydrogen sulfide (H2S) inhibited IKKβ activation in the cell model of human PAEC inflammation induced by monocrotaline pyrrole-stimulation or knockdown of cystathionine γ-lyase (CSE), an H2S generating enzyme. Mechanistically, H2S was proved to inhibit IKKβ activity directly via sulfhydrating IKKβ at cysteinyl residue 179 (C179) in purified recombinant IKKβ protein in vitro, whereas thiol reductant dithiothreitol (DTT) reversed H2S-induced IKKβ inactivation. Furthermore, to demonstrate the significance of IKKβ sulfhydration by H2S in the development of PAEC inflammation, we mutated C179 to serine (C179S) in IKKβ. In purified IKKβ protein, C179S mutation of IKKβ abolished H2S-induced IKKβ sulfhydration and the subsequent IKKβ inactivation. In human PAECs, C179S mutation of IKKβ blocked H2S-inhibited IKKβ activation and PAEC inflammatory response. In pulmonary hypertensive rats, C179S mutation of IKKβ abolished the inhibitory effect of H2S on IKKβ activation and pulmonary vascular inflammation and remodeling. Conclusion: Collectively, our in vivo and in vitro findings demonstrated, for the first time, that endogenous H2S directly inactivated IKKβ via sulfhydrating IKKβ at Cys179 to inhibit nuclear factor-κB (NF-κB) pathway activation and thereby control PAEC inflammation in PAH.


2005 ◽  
Vol 6 (1) ◽  
pp. 64-64
Author(s):  
A CESARIO ◽  
D ONORATI ◽  
V CARDACI ◽  
S MARGARITORA ◽  
V PORZIELLA ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document