The feasibility and safety of substrate modification on the left atrial roof area using a cryoballoon in atrial fibrillation ablation

2021 ◽  
Author(s):  
Shinsuke Miyazaki ◽  
Takayuki Sekihara ◽  
Kanae Hasegawa ◽  
Moe Mukai ◽  
Daisetsu Aoyama ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Atrial Fibrillation Ablation ◽  
Substrate Modification ◽  
Roof Area

scholarly journals Correlations between left atrial strain and left atrial pressures values in patients undergoing atrial fibrillation ablation

2021 ◽  
Vol 79 (11) ◽  
pp. 1223-1230
Author(s):  
Beata Uziębło-Życzkowska ◽  
Paweł Krzesiński ◽  
Agnieszka Jurek ◽  
Krystian Krzyżanowski ◽  
Marek Kiliszek
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Atrial Fibrillation Ablation ◽  
Left Atrial Strain ◽  
Atrial Strain

scholarly journals Left Atrial Appendage Thrombus Prior to Atrial Fibrillation Ablation in the Era of Direct Oral Anticoagulants

2018 ◽  
Vol 82 (11) ◽  
pp. 2715-2721 ◽  
Author(s):  
Masahide Harada ◽  
Masayuki Koshikawa ◽  
Yuji Motoike ◽  
Tomohide Ichikawa ◽  
Kunihiko Sugimoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Atrial Fibrillation Ablation ◽  
Atrial Appendage ◽  
Left Atrial Appendage Thrombus

1244Feasibility, safety and efficacy of tailoring ablation index to left atrial wall thickness (lawt) during atrial fibrillation ablation. The Ablate By-LAW Study

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C Teres ◽  
B Jauregui ◽  
D Soto-Iglesias ◽  
A Ordonez ◽  
A Chauca ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Wall Thickness ◽  
Left Atrial ◽  
Atrial Fibrillation Ablation ◽  
High Rate ◽  
Atrial Wall ◽  
Left Atrial Wall ◽  
Ablation Index ◽  
First Pass ◽  
Catheter Stability

Abstract Funding Acknowledgements Dr Teres was funded by Swiss Heartrhythm Foundation Introduction Circumferential pulmonary vein isolation (PVI) has become a mainstay in the treatment of atrial fibrillation (AF). The utility of ablation index (AI) to dose radiofrequency delivery for the reduction of AF recurrences has already been proven with a target AI ≥ 400 at the posterior wall and ≥550 at the anterior Wall. Nevertheless, the left atrial wall is a thin, heterogeneous structure with an important inter and intra-patient variability of LAWT. Objective To determine if adapting AI to atrial wall thickness (AWT) is feasible, effective and safe during AF ablation. Methods Single-Center study that included 80 consecutive patients referred for a first paroxysmal AF ablation that was performed with a single catheter approach with the intention to reduce vascular access complication rate. All patients had a MDCT prior to the ablation procedure. LAWT maps were semi-automatically computed from the MDCT as the local distance between the LA endo and epicardium. All procedures were performed under general anesthesia with a high-rate low-volume ventilation protocol for obtaining higher catheter stability. The transeptal puncture was TEE-guided. During the procedure, the WT map was fused with the LA anatomy using CARTO-merge. LAWT was categorized into 1mm-layers and the AI was titrated to the local atrial WT as follows: Thickness < 1 mm (red): 300; 1-2 mm (yellow): 350; 2-3 mm (green): 400; 3-4 mm (blue): 450; > 4 mm (purple): 450 (Figure). Maximal inter-lesion distance was set at 6 mm. VisiTag settings were: catheter position stability: minimum time 3 s, maximum range 4 mm; force over time: 25%, minimum force 3 g; lesion tag size: 3 mm. Respiration training was not possible due to the high catheter stability.  The circumferential ablation line was designed in a personalized fashion to avoid thicker regions. Results 80 patients [41 (51,2 %) male, age 60± 11 years] were included. Mean LVEF was 59 ± 5 %, Mean LA diameter 39,1 ± 5,8 mm, Mean LAWT was 1.36 ± 0.63 mm. Mean AI was 352 ± 36 on the RPVs and 356 ± 36 on the LPVs. Procedure time was 60,0 min (IQR 51-70). Fluoroscopy time was 58,5 s (35-97,5). First pass isolation was obtained in 72 (90%) of the RPVs and 75 (93,8%) of the LPVs. Conclusions the present study, assessing a novel, personalized protocol for radiofrequency titration during atrial fibrillation ablation, shows a high rate of first pass isolation with a lower need for RF energy delivery and lower procedure requirements, as compared to previous PV ablation protocols. Further studies are needed to evaluate the long-term results of this approach. Abstract Figure. LAWT-map Visitag points with tailored AI

Adjunctive left anterior line ablation induced left atrial dysfunction and dyssynchrony in atrial fibrillation ablation

2018 ◽  
Vol 34 (2) ◽  
pp. 331-342
Author(s):  
Hirosuke Yamaji ◽  
Takashi Murakami ◽  
Kazuyoshi Hina ◽  
Shunichi Higashiya ◽  
Hiroshi Kawamura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Atrial Fibrillation Ablation ◽  
Left Atrial Dysfunction
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