Abstract 18649: Long-term Outcome and the Mechanisms of Pulmonary Antrum Radial-linear Ablation in Patients With Paroxysmal Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Xue Zhao ◽  
Jianqiang Hu ◽  
Yan Huang ◽  
Yawei Xu ◽  
Yanzhou Zhang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Holter Monitoring ◽  
Pericardial Tamponade ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up ◽  
One Year

Objectives: The aim of this study was to determine the mechanisms and effectiveness of pulmonary antrum radial-linear (PAR) ablation in comparison with pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (AF) after a long-term follow-up. Background: The one-year follow up data suggested that PAR ablation appeared to have a better outcome over the conventional PVI for paroxysmal AF. Methods: The enrollment occurred between March, 2011, and August, 2011, with the last follow-up in May, 2014. A total of 133 patients with documented paroxysmal AF were enrolled from 5 centers and randomized to PAR group or PVI group. Event ECG recorder and Holter monitoring were conductedduring the follow-up for all patients. Results: The average procedure time was 151±23 min in PAR group and 178±43 min in PVI group ( P <0.001). The average fluoroscopy time was 21±7 min in PAR group and 27±11 min in PVI group ( P= 0.002). AF triggering foci were eliminated in 59 patients (89.4%) in PAR group, whereas, only 4 patients (6.0%) in PVI group (P<0.001).At median 36 (37-35) months of follow-up after single ablation procedure, 43 of 66 patients in PAR group (65%) and 28 of 67 patients in PVI group (42%) had no recurrence of AF off antiarrhythmic drug (AAD) (P=0.007); and 47 of 66 patients in PAR group (71%) and 32 of 67 patients in PVI group (48%) had no recurrence of AF with AAD (P=0.006). At the last follow-up, the burden of AF was significantly lower in PAR group than in PVI group (0.9% ± 2.3% vs 4.9% ± 9.9%;90th percentile, 5.5% vs 19.6%; P=0.008). No major adverse event (death, stroke, PV stenosis) was observed in all the patients except one case of pericardial tamponade. Conclusions: PAR ablation is a simple, safe, and effective strategy for the treatment of paroxysmal AF with better long-term outcome than PVI. PAR ablation might exhibit the beneficial effect on AF management through multiple mechanisms. Registration: ChiCTR-TRC-11001191

Abstract 15733: Long-Term Follow-Up of Patients With Paroxysmal Atrial Fibrillation and Severe Left Atrial Scarring: Comparison Between Pulmonary Vein Antrum Isolation Only or PVAI Combined With Either Scar Homogenization or Trigger Ablation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Sanghamitra Mohanty ◽  
Prasant Mohanty ◽  
Luigi Di Biase ◽  
Chintan Trivedi ◽  
Rong Bai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Atrial ◽  
Pulmonary Veins ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Group 3 ◽  
Group 2

Background: Left atrial (LA) scarring, a consequence of cardiac fibrosis is a powerful predictor of procedure-outcome in atrial fibrillation (AF) patients undergoing catheter ablation. We sought to compare the long-term outcome in patients with paroxysmal AF and severe LA scarring/fibrosis identified by 3D mapping undergoing ablation of the pulmonary veins (PVAI) only or PVAI and the entire scar areas (scar homogenization) or PVAI plus ablation of the non-PV triggers. Methods: One-hundred seventy seven consecutive patients with paroxysmal atrial fibrillation and severe left atrial scarring were included in this study. LA scarring was diagnosed by 3D voltage mapping. The degree of scar was described as severe when >60% of the LA area was involved. Non-PV triggers were defined as ectopic triggers originating from sites other than pulmonary veins such as interatrial septum, superior vena cava, left atrial appendage, ligament of Marshall, crista terminalis and coronary sinus. Patients underwent ablation of the pulmonary vein antrum (PVAI) only (n=45, group 1), PVAI extended to the entire scar areas (scar homogenization [n=66, group 2]) or PVAI plus ablation of non-PV triggers (n=66, group 3). Choice of ablation strategy was determined by the operator. Patients were followed up for arrhythmia recurrence with event recorders, ECG and Holter monitoring. Results: Baseline characteristics were not different between the groups (age 63±9 vs 58±10 vs. 60±11 years, p=0.23; male 71%, vs. 72% vs. 73% p= 0.91). After a single procedure, all patients were followed-up for a minimum of two years. The long-term success rate at the end of the follow up was 19% (12 pts) in group 1, 21% (14 pts) in group 2, and 61% (40 pts) in group 3. Kaplan-Meier log-rank test indicated that the cumulative probability of AF-free survival was significantly higher in group 3 (overall log-rank p <0.001, pairwise comparison 1 vs. 3 and 2 vs. 3 was significant at p<0.01). Conclusions: In patients with paroxysmal atrial fibrillation and severe left atrial scarring, PVAI plus ablation of non-PV triggers is associated with significantly better long-term outcome than PVAI alone or when PVAI is combined with scar homogenization.

Long-term outcome after second-generation cryoballoon ablation for paroxysmal atrial fibrillation - a 3-years follow-up

2017 ◽  
Vol 49 (1) ◽  
pp. 93-100 ◽  
Author(s):  
Ken Takarada ◽  
Ingrid Overeinder ◽  
Carlo de Asmundis ◽  
Erwin Stroker ◽  
Giacomo Mugnai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Second Generation ◽  
Cryoballoon Ablation ◽  
Term Outcome ◽  
Long Term Outcome

Long-term Follow-up Angiography of Intracranial Aneurysms Treated with Cook Detachable Coil System

2008 ◽  
Vol 21 (5) ◽  
pp. 712-716
Author(s):  
M.I. Pardo ◽  
J.M. Pumar ◽  
D. Abal ◽  
A. Garcia-Allut ◽  
M. Blanco ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Detachable Coil ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Coil System ◽  
Long Term Follow Up ◽  
One Year ◽  
The Stability

The long-term outcome of detachable coil embolization of cerebral aneurysms is still unknown. The purpose of this study was to evaluate the stability of the anatomic occlusion of aneurysms treated with the Cook detachable coil system and assess the rate of recanalization and recurrence. A study involving 250 patients with 271 ruptured aneurysms treated with the Cook detachable system between January 1997 and September 2003 who subsequently underwent six month, one year and two year follow-up angiography were enrolled in the study. Angiographic findings were reviewed to determine the percentage of aneurysm occlusion. Long-term follow-up angiograms (at two years) demonstrated complete occlusion in 75% of cases, and subtotal occlusion in 25% of cases. Overall morbidity was 7.3%, aneurysm recurrence 3.2%, and aneurysm re-treatment 3.2%. Recurrent subarachnoid hemorrhage occurred in only one patient. Angiographic follow-up demonstrated the stability and durability of treatment with the Cook detachable coil system.

What happens >10 years after percutaneous septal ablation for hypertrophic obstructive cardiomyopathy? Ultra long-term follow-up of 120 patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Faber ◽  
S Scholtz ◽  
A Batzner ◽  
H Seggewiss
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Problem ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Functional Class ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Percutaneous Septal Ablation ◽  
Long Term Follow Up

Abstract Introduction and methods Recent registry analyses including the European multicenter registry (Euro-ASA) documented a favourable long-term outcome of septal ablation (ASA/PTSMA) competitive to surgical myectomy. There is no information about the period beyond 10 years. We therefore analyzed the outcome in 120 HOCM patients (pts., mean age @ index intervention: 62±13 years) treated with ASA who survived &gt;10 years. Results Mean CK rise during the index intervention was 537±258 U/l (reference: &lt;80). A DDD-pacemaker (DDD-PM) had to be implanted in 26 pts. (22%) for procedure-related AV conduction problems. A re-intervention for residual or recurrent outflow obstruction (LVOTO) had to be performed in 12 pts. (10%; re-PTSMA: 10 pts.; myectomy: 2 pts). These cases included, at their last follow-up visit 107 pts. (89%) were in functional class I or II. During follow-up (159±33 [range: 122–264] months), 12 pts. (8%) died, of these 6 (4%) from non-cardiac, and 6 (4%) from cardiovascular causes including one sudden death. Furthermore, 4 (3%) ICDs were implanted (1 for secondary, 3 for primary prevention of sudden cardiac death). The most frequent clinical problem was atrial fibrillation which occurred in 27 pts. (23%), and which was refractory to rhythm control attempts in 21 pts. (18%). Conclusions The procedure-related DDD-PM rate in this septal ablation cohort including the early learning curve more than doubled the current one. Nevertheless, during ultra long-term follow up a durable clinical improvement was observed with mortality rates around 1%/year, nearly equivalent to that of 0.8% observed in normal populations. Atrial fibrillation is a frequent problem in this elderly, formerly obstructive HCM population. Funding Acknowledgement Type of funding source: None

Atrial fibrillation ablation – the value of AF burden monitoring in the long-term follow-up

2020 ◽  
Vol 2 (55) ◽  
pp. 9-13
Author(s):  
Katarzyna Wojewoda ◽  
Katarzyna Wysokińska ◽  
Milena Stachyra ◽  
Andrzej Głowniak
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Monitoring ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Complex Evaluation ◽  
Long Term Follow Up ◽  
Antiarrhythmic Medication ◽  
Recommended Therapy

Atrial fibrillation (AF) is the most common arrhythmia, increasing the risk of stroke and all-cause mortality, predominantly due to cardiovascular diseases. Catheter ablation (CA) is recommended therapy, with far better long-term outcome compared to antiarrhythmic medication, and prolonged cardiac monitoring is crucial in the post-ablation follow-up. Due to technology advancements, we can introduce not only more effective methods for invasive AF treatment, but also the valuation of its long-term outcome. Implantable cardiac monitors (ICMs) provide continuous ECG recording, required to assess the exact time of AF duration. AF burden, defined as the proportion of time an individual is in AF during the monitoring period is an excellent quantitative indicator for more complex evaluation of the AF ablation outcome, presenting it not merely as the binary effect.

Psychopathology 8½ Years Post Parasuicide

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene
Keyword(s):  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Parental Bonding ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Long Term Follow Up

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

Transcatheter closure of defects within the oval fossa using the Amplatzer® Septal Occluder

2002 ◽  
Vol 12 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Haifa Abdul Latiff ◽  
Mazeni Alwi ◽  
Hasri Samion ◽  
Geetha Kandhavel
Keyword(s):  
Transcatheter Closure ◽  
Standard Procedure ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Term Outcome ◽  
Long Term Follow Up ◽  
One Year ◽  
The Right

This study reviewed the short-term outcome of transcatheter closure of the defects within the oval fossa using an Amplatzer® Septal Occluder. From January 1997 to December 2000, 210 patients with defects within the oval fossa underwent successful transcatheter closure. We reviewed a total of 190 patients with left-to-right shunts, assessing the patients for possible complications and the presence of residual shunts using transthoracic echocardiogram at 24 h, 1 month, 3 months and one year. Their median age was 10 years, with a range from 2 to 64 years, and their median weight was 23.9 kg, with a range from 8.9 to 79 kg. In 5 patients, a patent arterial duct was closed, and in 2 pulmonary balloon valvoplasty performed, at the same sitting. The median size of the Amplatzer® device used was 20 mm, with a range from 9 to 36 mm. The median times for the procedure and fluoroscopy were 95 min, with a range from 30 to 210 min, and 18.4 min, with a range from 5 to 144 min, respectively. Mean follow-up was 20.8 ± 12.4 months. Complete occlusion was obtained in 168 of 190 (88%) patients at 24 h, 128 of 133 (96.2%) at 3 months, and 103 of 104 (99%) at one year. Complications occurred in 4 (2.1%) patients. In one, the device became detached, in the second the device embolized into the right ventricular outflow tract, the lower end of the device straddled in the third, and the final patient had significant bleeding from the site of venupuncture. There were no major complications noted on follow-up. We conclude that transcatheter closure of defects within the oval fossa using the Amplatzer® Septal Occluder is safe and effective. Long-term follow-up is required, nonetheless, before it is recommended as a standard procedure.

scholarly journals An update of the long-term outcome of patients with nonspecific pleurisy at medical thoracoscopy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan-Xia Yu ◽  
Yuan Yang ◽  
Yan-Bing Wu ◽  
Xiao-Juan Wang ◽  
Li-Li Xu ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Disease ◽  
Long Term Outcomes ◽  
Benign Diseases ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Medical Thoracoscopy ◽  
One Year

Abstract Background Medical thoracoscopy (MT) is recommended in patients with undiagnosed exudative pleural effusion and offers a degree of diagnostic sensitivity for pleural malignancy. However, not all patients who undergo MT receive an exact diagnosis. Our previous investigation from 2014 summarized the long-term outcomes of these patients with nonspecific pleurisy (NSP); now, we offer updated data with the goal of refining our conclusions. Methods Between July 2005 and August 2018, MT with pleural biopsies were performed in a total of 1,254 patients with undiagnosed pleural effusions. One hundred fifty-four patients diagnosed with NSP with available follow-up data were included in the present study, and their medical records were reviewed. Results A total of 154 patients were included in this study with a mean follow-up duration of 61.5 ± 43.7 months (range: 1–180 months). No specific diagnosis was established in 67 (43.5%) of the patients. Nineteen patients (12.3%) were subsequently diagnosed with pleural malignancies. Sixty-eight patients (44.2%) were diagnosed with benign diseases. Findings of pleural nodules or plaques during MT and the recurrence of pleural effusion were associated with malignant disease. Conclusions Although most NSP patients received a diagnosis of a benign disease, malignant disease was still a possibility, especially in those patients with nodules or plaques as noted on the MT and a recurrence of pleural effusion. One year of clinical follow-up for NSP patients is likely sufficient. These updated results further confirm our previous study’s conclusions.

Abstract 16668: Long-term Outcomes After Endo-epicardial Catheter Ablation of Ventricular Tachycardia in Nonischemic Cardiomyopathy

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Erica S Zado ◽  
Pasquale Santangeli ◽  
Francis E Marchlinski
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Substantial Improvement ◽  
Nonischemic Cardiomyopathy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Linear Ablation ◽  
Long Term Follow Up

Introduction: Endo-epicardial catheter ablation of ventricular tachycardia (VT) in patients (pts) with nonischemic cardiomyopathy (NICM) has been reported to have satisfactory results at the short- and mid-term follow-up. We sought to determine the outcomes at the long-term follow-up of endo-epicardial ablation of VT in NICM. Hypothesis: Catheter ablation provides satisfactory long term outcome Methods: We prospectively enrolled 128 pts (age 59±13 years, 116 [91%] males) with NICM who underwent endo-epicardial radiofrequency catheter ablation at our Institution. After substrate mapping, all critical sites for the clinical or induced VT(s), identified with activation, entrainment or pace-mapping, together with late, split and fractionated potentials were targeted with focal and/or linear ablation. The procedural endpoint was noninducibility of sustained monomorphic VT. Pts were followed with ICD interrogation. Results: A total of 108 (73%) pts had idiopathic dilated NICM. The remaining 20 (14%) pts had hypertrophic CM (n=11), suspected inflammatory CM (n=6), or valvular CM (n=3). The mean LV ejection fraction was 33±15%. After a mean follow-up of 19 months (max 97 months), a total of 36 (28%) pts died and 17 (13%) underwent heart transplant. Cumulative survival free from any recurrent VT was 53% (68/128 patients) (Figure A). In the remaining 60 (47%) patients with VT recurrences, catheter ablation still resulted in a significant beneficial clinical impact on VT burden, with 25/60 (42%) having only isolated (1-2) VT episodes over follow-up, and a striking reduction of VT storm in the remaining pts (Figure B). Conclusions: In patients with NICM and VT, endo-epicardial substrate-based ablation is effective in achieving long-term freedom from any VT in 53% of patients, with a substantial improvement in VT burden in many of the remaining patients.

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