CHARACTERISTICS ASSOCIATED WITH LONG-TERM MAINTENANCE OF SINUS RHYTHM AFTER PULMONARY VEINS ISOLATION

2019 ◽  
Vol 25 (2) ◽  
pp. 115-119
Author(s):  
Azamat M. Baymukanov ◽  
I. A Khamnagadaev ◽  
S. A Termosesov ◽  
I. L Ilyich ◽  
G. E Gendlin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Pulmonary Veins ◽  
First Year ◽  
First Line ◽  
Supraventricular Tachyarrhythmia ◽  
Term Maintenance

Atrial fibrillation is the most frequent supraventricular tachyarrhythmia. Pulmonary veins isolation can be performed as the first line of treatment for this arrhythmia. Unfortunately, approximately 30% of patients in the first year after ablation have recurrence of atrial fibrillation. In this regard, we have attempted to identify the characteristics associated with long-term maintenance of sinus rhythm after pulmonary veins isolation.

Antiarrhythmic Drug Therapy for Rhythm Control in Atrial Fibrillation

2016 ◽  
Vol 22 (1) ◽  
pp. 3-19 ◽  
Author(s):  
Jonathan W. Waks ◽  
Peter Zimetbaum
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Synergistic Effects ◽  
Rhythm Control ◽  
Cardiac Implantable Electronic Devices ◽  
Randomized Controlled Studies ◽  
Life Threatening ◽  
Safe Discontinuation ◽  
Term Maintenance

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and affects over 33 million people worldwide. AF is associated with stroke and systemic thromboembolism, unpleasant symptoms and reduced quality of life, heart failure, and increased mortality, and treatment of AF and its complications are associated with significant cost. Antiarrhythmic drugs (AADs) can suppress AF, allowing long-term maintenance of sinus rhythm, and have the potential to relieve symptoms and reverse or prevent adverse effects associated with AF. However, large randomized controlled studies evaluating use of AADs have not demonstrated a clear benefit to maintaining sinus rhythm, and AADs often have significant limitations, including a modest rate of overall success at maintaining sinus rhythm, frequent side effects, and potentially life-threatening toxicities. Although some of the currently available AADs have been available for almost 100 years, better tolerated and more efficacious AADs have recently been developed both for long-term maintenance of sinus rhythm and for chemical cardioversion of AF to sinus rhythm. Advances in automated AF detection with cardiac implantable electronic devices have suggested that AADs might be useful for suppressing AF to allow safe discontinuation of anticoagulation in select patients who are in sinus rhythm for prolonged periods of time. AADs may also have synergistic effects with catheter ablation of AF. This review summarizes the pharmacology and clinical use of currently available AADs for treatment of AF and discusses novel AADs and future directions for rhythm control in AF.

Sotalol versus propafenone for long-term maintenance of normal sinus rhythm in patients with recurrent symptomatic atrial fibrillation

2004 ◽  
Vol 94 (12) ◽  
pp. 1563-1566 ◽  
Author(s):  
George E. Kochiadakis ◽  
Nikos E. Igoumenidis ◽  
Michail E. Hamilos ◽  
Panagiotis G. Tzerakis ◽  
Nikos C. Klapsinos ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Normal Sinus ◽  
Term Maintenance

scholarly journals Real-time dominant frequency mapping and ablation of dominant frequency sites in atrial fibrillation with left-to-right frequency gradients predicts long-term maintenance of sinus rhythm

Heart Rhythm ◽  
2009 ◽  
Vol 6 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Felipe Atienza ◽  
Jesús Almendral ◽  
José Jalife ◽  
Sharon Zlochiver ◽  
Robert Ploutz-Snyder ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Real Time ◽  
Dominant Frequency ◽  
Term Maintenance

Long-term Maintenance of Normal Sinus Rhythm in Patients With Current Symptomatic Atrial Fibrillation

CHEST Journal ◽  
2004 ◽  
Vol 125 (2) ◽  
pp. 377-383 ◽  
Author(s):  
George E. Kochiadakis ◽  
Nikos E. Igoumenidis ◽  
Michail I. Hamilos ◽  
Panos G. Tzerakis ◽  
Nikos C. Klapsinos ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Normal Sinus ◽  
Term Maintenance

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.

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