scholarly journals CHRONIC ATRIAL FIBRILLATION IMPAIRS ENDOTHELIAL FUNCTION THAT IMPROVES AFTER SINUS RHYTHM RESTORATION BY CATHETER ABLATION

2011 ◽  
Vol 57 (14) ◽  
pp. E1428 ◽  
Author(s):  
Satoshi Yoshino ◽  
Akiko Yoshikawa ◽  
Shuichi Hamasaki ◽  
Sanemasa Ishida ◽  
Naoya Oketani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Endothelial Function ◽  
Sinus Rhythm ◽  
Chronic Atrial Fibrillation

Improved Endothelial Function in Patients with Atrial Fibrillation through Maintenance of Sinus Rhythm by Successful Catheter Ablation

2010 ◽  
Vol 22 (4) ◽  
pp. 376-382 ◽  
Author(s):  
SEUNG YONG SHIN ◽  
JIN OH NA ◽  
HONG EUY LIM ◽  
CHEOL UNG CHOI ◽  
JONG IL CHOI ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Endothelial Function ◽  
Sinus Rhythm

Abstract 17516: Improvement of the Endothelial Function in Patients with Atrial Fibrillation: Effect of Sinus Rhythm Restoration by Catheter Ablation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Hisanori Kanazawa ◽  
Hiroshige Yamabe ◽  
Seigo Sugiyama ◽  
Satomi Iwashita ◽  
Tadashi Hoshiyama ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Sinus Rhythm ◽  
Normal Control ◽  
Control Group ◽  
Serial Change ◽  
Group 3 ◽  
Af Recurrence

Background: Endothelial dysfunction has been shown to be correlated significantly with the presence of atrial fibrillation (AF). However, it is not clear to what extent restoration of sinus rhythm by catheter ablation (CA) can improve the endothelial function in patients with AF. Objectives: The purpose of this study was to examine the serial change in the endothelial function for 6 months periods following CA in AF patients in whom the AF recurrence was not observed. Furthermore, we compared the endothelial functions of these AF patients obtained before and, 3 and 6 months after CA with that of normal control subjects. Methods: Forty-three normal control patients (control group) and 61 consecutive AF patients who underwent CA of AF and showed no AF recurrence for 6 months after the procedure (AF group) were included. AF group consisted of patients without structural heart disease and the history of AF was 4.7±4.9 years. Endothelial function of these two groups were assessed. All patients assessed their endothelial function by the reactive hyperemia-peripheral arterial tonometry (RH-PAT) and the RH-PAT index (RHI) was measured. The RHI was measured before and 3 month and 6 months after CA in AF group. Then the serial change in the RHI was elucidated in AF group. All measurement of RHI was performed during sinus rhythm both in control and AF groups. Results: The RHI in control group was 2.21±0.46. The RHI in the AF group before CA was significantly lower than that in control group (2.06±0.49 vs. 2.22±0.46, p=0.036). The RHI in AF group 3 months after CA was significantly improved compared with that before CA (2.40±0.59 vs. 2.06±0.49, p<0.001). The RHI 6 months after CA in AF group was also significantly higher than that before CA (2.24±0.53, vs. 2.06±0.49, p=0.048). The RHI at 3 and 6 months after CA in AF group were not different from that of control group (3 months; 2.40±0.59 vs. 2.21±0.46, p=NS, 6 months; 2.24±0.53, vs. 2.21±0.46, p=NS). Conclusions: The endothelial dysfunction was present in AF patients even if the sinus rhythm was observed during measurement of RHI before CA. However, the endothelial function in AF patients was improved to the similar level of the normal control subjects when the sinus rhythm was maintained after CA.

scholarly journals An Aggressive Strategy for Maintenance of Sinus Rhythm Including a Combination of Catheter Ablation and Antiarrhythmic Drug Therapy Benefits Patients with Chronic Atrial Fibrillation

2009 ◽  
Vol 25 (2) ◽  
pp. 63-69
Author(s):  
Tetsuya Haruna ◽  
Shigeru Ikeguchi ◽  
Shinsaku Takeda ◽  
Naoki Amaya ◽  
Tatsuhiko Hata ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Catheter Ablation ◽  
Sinus Rhythm ◽  
Antiarrhythmic Drug ◽  
Chronic Atrial Fibrillation ◽  
Antiarrhythmic Drug Therapy

Simultaneous Catheter and Epicardial Ablations Enable a Comprehensive Atrial Fibrillation Procedure

2011 ◽  
Vol 6 (4) ◽  
pp. 243-247 ◽  
Author(s):  
Andy C. Kiser ◽  
Mark D. Landers ◽  
Ker Boyce ◽  
Matjaž šinkovec ◽  
Andrej Pernat ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Sinus Rhythm ◽  
Pulmonary Veins ◽  
Persistent Atrial Fibrillation ◽  
Chronic Atrial Fibrillation ◽  
Lesion Pattern ◽  
Atrial Size ◽  
Cardiac Surgeon ◽  
Successful Collaboration

Objective Transmural and contiguous ablations and a comprehensive lesion pattern are difficult to create from the surface of a beating heart but are critical to the successful treatment of persistent, isolated atrial fibrillation. A codisciplinary simultaneous epicardial (surgical) and endocardial (catheter) procedure (Convergent procedure) addresses these issues. Methods Patients with symptomatic atrial fibrillation who failed medical treatment were evaluated. Using only pericardioscopy, the surgeon performed near-complete epicardial isolation of the pulmonary veins and a “box” lesion on the posterior left atrium using unipolar radiofrequency ablation. Simultaneous endocardial catheter radiofrequency ablation completed pulmonary vein isolation, performed a mitral annular and cavotricuspid isthmus line of block, and debulked the coronary sinus. Twelve-month results for the Convergent procedure were compared with 12-month results for concomitant and pericardioscopic (stand-alone transdiaphragmatic/thoracoscopic) atrial fibrillation procedures using unipolar radiofrequency ablation. Results Sixty-five patients underwent the Convergent procedure (mean age, 62 y; mean body surface area, 2.17 m2; mean atrial fibrillation duration, 4.8 y; mean left atrial size, 5.2 cm). Ninety-two percent were in persistent or long-standing persistent atrial fibrillation. At 12 months, evaluation with 24-hour Holter monitors found 82% of patients in sinus rhythm, while only 47% of pericardioscopic and 77% of concomitant patients treated with unipolar radiofrequency ablation were in sinus rhythm. Conclusions Simultaneous epicardial and endocardial ablation improves outcomes for patients with persistent or longstanding persistent atrial fibrillation. This successful collaboration between cardiac surgeon and electrophysiologist is an important treatment option for patients with large left atriums and chronic atrial fibrillation.

scholarly journals Mechanism of and Therapeutic Strategy for Atrial Fibrillation Associated with Diabetes Mellitus

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Yubi Lin ◽  
Hairui Li ◽  
Xianwu Lan ◽  
Xianghui Chen ◽  
Aidong Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Sinus Rhythm ◽  
Renin Angiotensin System ◽  
Hypoglycemic Agents ◽  
Angiotensin System ◽  
Low Levels ◽  
Upstream Therapy

Diabetes mellitus (DM) is one of the most important risk factors for atrial fibrillation (AF) and is a predictor of stroke and thromboembolism. DM may increase the incidence of AF, and when it is combined with other risk factors, the incidence of stroke and thromboembolism may also be higher; furthermore, hospitalization due to heart failure appears to increase. Maintenance of well-controlled blood glucose and low levels of HbA1c in accordance with guidelines may decrease the incidence of AF. The mechanisms of AF associated with DM are autonomic remodeling, electrical remodeling, structural remodeling, and insulin resistance. Inhibition of the renin-angiotensin system is suggested to be an upstream therapy for this type of AF. Studies have indicated that catheter ablation may be effective for AF associated with DM, restoring sinus rhythm and improving prognosis. Catheter ablation combined with hypoglycemic agents may further increase the rate of maintenance of sinus rhythm and reduce the need for reablation.

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