Porcine Left Atrial Wall Stress After Ventricular Tachypacing Mimicking the Effects of Early Atrial Fibrillation

2010 ◽  
Author(s):  
Elena S. Di Martino ◽  
Chiara Bellini ◽  
Dale J. Ward ◽  
Nicolas Brown ◽  
David Schwartzman
Keyword(s):  
Atrial Fibrillation ◽  
Wall Stress ◽  
High Impact ◽  
Atrial Wall ◽  
Left Atrial Wall ◽  
The Us ◽  
Human Costs ◽  
Care Costs ◽  
Annual Mortality

Atrial Fibrillation (AF) is the cardiac arrhythmia most commonly encountered in clinical practice. Current statistics referring to the US population indicate a prevalence of AF up to 2.2 million people, projected to increase to 2.66 million by the end of 2010. AF has a high impact on society in terms of human costs, with an annual mortality rate of 11,438 patients. AF also increases the risk of ischemic stroke at least by a factor of 4 and it is responsible for at least 15% of all ischemic strokes, which represent the main cause of long-term disability and one of the main contributors to health care costs [1]. AF results from the synergic action of electrophysiological, biochemical and structural remodeling. Ventricular tachypacing (VTP) has been successfully used in animal models to reproduce relevant features observed in patients suffering from AF, such as ion-channel alterations, fibrosis development and atrial dilatation [2] [3].

The Role of Atrial Fibrosis Detected by Delayed - Enhancement MRI in Atrial Fibrillation Ablation

2020 ◽  
Vol 16 (2) ◽  
pp. 135-144 ◽  
Author(s):  
Zsuzsanna Kis ◽  
Astrid Amanda Hendriks ◽  
Taulant Muka ◽  
Wichor M. Bramer ◽  
Istvan Kovacs ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Imaging Modality ◽  
Final Analysis ◽  
Atrial Fibrosis ◽  
Atrial Wall ◽  
Af Ablation ◽  
Left Atrial Wall ◽  
Cmr Imaging

Introduction: Atrial Fibrillation (AF) is associated with remodeling of the atrial tissue, which leads to fibrosis that can contribute to the initiation and maintenance of AF. Delayed- Enhanced Cardiac Magnetic Resonance (DE-CMR) imaging for atrial wall fibrosis detection was used in several studies to guide AF ablation. The aim of present study was to systematically review the literature on the role of atrial fibrosis detected by DE-CMR imaging on AF ablation outcome. Methods: Eight bibliographic electronic databases were searched to identify all published relevant studies until 21st of March, 2016. Search of the scientific literature was performed for studies describing DE-CMR imaging on atrial fibrosis in AF patients underwent Pulmonary Vein Isolation (PVI). Results: Of the 763 citations reviewed for eligibility, 5 articles (enrolling a total of 1040 patients) were included into the final analysis. The overall recurrence of AF ranged from 24.4 - 40.9% with median follow-up of 324 to 540 days after PVI. With less than 5-10% fibrosis in the atrial wall there was a maximum of 10% recurrence of AF after ablation. With more than 35% fibrosis in the atrial wall there was 86% recurrence of AF after ablation. Conclusion: Our analysis suggests that more extensive left atrial wall fibrosis prior ablation predicts the higher arrhythmia recurrence rate after PVI. The DE-CMR imaging modality seems to be a useful method for identifying the ideal candidate for catheter ablation. Our findings encourage wider usage of DE-CMR in distinct AF patients in a pre-ablation setting.

659Left atrial wall thickness evaluation during atrial fibrillation redo procedures

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C Teres ◽  
D Soto ◽  
B Jauregui ◽  
D Penela ◽  
A Ordonez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Wall Thickness ◽  
Atrial Wall ◽  
Ablation Procedure ◽  
Left Atrial Wall ◽  
Local Distance ◽  
The Mean ◽  
The Right ◽  
The Relationship ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Dr Teres was funded by Swiss Heartrhythm Foundation Introduction pulmonary vein (PV) reconnections due to gaps on circumferential ablation lines are responsible for atrial fibrillation recurrences after catheter ablation. We sought to analyze the local left atrial wall thickness (LAWT) of PV line gaps at AF redo ablation during real-time catheter positioning. LAWT was measured on the MDCT 3D reconstruction and fused with the LA anatomy using CARTO-merge. Objective To analyze the relationship between local reconnection gaps and the LAWT during AF redo procedures. Methods Single-Center cohort study that included 41 consecutive patients referred for AF redo procedure. 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. Each PV line was subdivided into 8 segments and mean LAWT was computed. During the procedure, the local gap was defined as the earliest activation site at the reconnected segment of the circumferential PV line (Figure 1A & 1B). Results 41 patients [31 (75.6%) male, age 60 ± 10 years] were included. Mean LAWT was 1.36 ± 0.20 mm. Mean PV circumferential line WT was higher in left PVs than in the right PVs 1.68 ± 0.57 vs. 1.31 ± 0.39 mm p < 0.001 respectively. Mean WT of the reconnected points was 44% higher than the mean WT of the segment where the reconnection was located. Mean reconnection point WT was at the 87th percentile of the circumferential line in the LPVs and at the 76th percentile in the RPVs. The reconnected point WT was higher in the LPVs than RPVs 2.13 ± 1.14 vs. 1.47 ± 0.48 mm p < 0.001 respectively.  The most frequent location for reconnections was the left anterior carina (71%), with a mean WT of 2.24 ± 0.91mm; and the right anterior carina (56%) with a mean WT of 1.57 ± 0.62mm (Figure 2A & 2B). Conclusions Reconnection points were more frequently present in the thicker segments of the PV circumferential line. The most frequently reconnected segment was the anterior carina in both right and left PVs. Atrial wall thickness maps derived from MDCT are useful to guide AF redo procedures. Abstract Figure. 1) Activation & WT map; 2) Segment WT

scholarly journals Clinical correlates of echocardiographic tissue velocity imaging abnormalities of the left atrial wall during atrial fibrillation

EP Europace ◽  
2014 ◽  
Vol 16 (11) ◽  
pp. 1546-1553 ◽  
Author(s):  
I. Limantoro ◽  
C. B. de Vos ◽  
T. Delhaas ◽  
B. Weijs ◽  
Y. Blaauw ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Atrial Wall ◽  
Clinical Correlates ◽  
Tissue Velocity ◽  
Velocity Imaging ◽  
Left Atrial Wall

Abstract 16088: Mortality Trend Among Patients With Atrial Fibrillation on Long Term Anticoagulation Who Developed Intracranial Hemorrhage: Insights From the National Inpatient Database From 2006 to 2014

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Karol Quelal ◽  
Andrea Torres ◽  
Christian Torres ◽  
Alfonso Tafur
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Mortality ◽  
Intracranial Hemorrhage ◽  
Vitamin K Antagonists ◽  
Hospital Death ◽  
Chi Square ◽  
Fda Approval ◽  
The Us ◽  
Inpatient Database

Introduction: Intracranial hemorrhage (ICH), is a potential complication of anticoagulation use in atrial fibrillation (AF). During the last decade, guidelines have evolved from recommending vitamin K antagonists to a preference for DOACs in the case of non-valvular AF after FDA approval in 2010. Data have reported that DOACs have a lower rate of ICH and an overall better clinical profile when compared to VKA. Aim: We sought to describe the rate of ICH and its associated mortality h with the increment in the use of DOACs over the period of 2006 to 2014 in the US population with AF. Methods: We queried the NIS database 2006-2014. AF patients, patients using long term anticoagulation, and intracranial hemorrhage admissions were selected using the appropriate ICD-9 codes. Time trend was analyzed using Chi-square. In-hospital mortality was evaluated by binomial logistic regression. Results: We found a 30740346 weighted population with AF between 2006 and 2014. 16.8 % were long term users of anticoagulants. Of them, 1.1% (n: 56400) were admitted due to ICH. Long term anticoagulation use in AF went from 13.3% in 2006 to 17.3% in 2010 (p<0.001). Among AF patients, 30.7% of patients had in-hospital death when admitted for ICH using long term anticoagulation. Long term anticoagulation was associated with increased in-hospital death in ICH patients aOR 1.31 (95% CI 1.24 - 1.39) when compared to those not using long term anticoagulation. Patients with AF and long term use of anticoagulants showed an increased frequency of in-hospital mortality from 32.7% in 2006 to 34.2% in 2007 and a decrease to 30.9% up to 2010. The decrease in mortality rate was more notorious from 2010 to 2014 going to 25.8% (p< 0.001). Conclusions: The rate of ICH diagnosis among anticoagulated atrial fibrillation patients has remained stable after the introduction of DOACs. Rates of inpatient death have decreased from 2006 to 2014 having the most notorious inflection point in 2010 after the progressive introduction of DOACs .

scholarly journals Correlation of left atrial wall thickness and atrial remodeling in atrial fibrillation

Medicine ◽  
2019 ◽  
Vol 98 (15) ◽  
pp. e15170 ◽  
Author(s):  
Kun Zuo ◽  
Kuibao Li ◽  
Min Liu ◽  
Jing Li ◽  
Xiaoqing Liu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Wall Thickness ◽  
Left Atrial ◽  
Atrial Remodeling ◽  
Atrial Wall ◽  
Left Atrial Wall
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