scholarly journals Estimation of efficiency of epicardial radiofrequency ablation of anatomic zone ganglionic plexi in patients with coronary heart disease and atrial fibrillation

2015 ◽  
Vol 18 (1) ◽  
pp. 14
Author(s):  
A. M. Chernyavskiy ◽  
S. S. Rakhmonov ◽  
Yu. Ye. Kareva ◽  
Ye. A. Pokushalov ◽  
I. A. Pak
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Radiofrequency Ablation ◽  
Rf Ablation ◽  
Ablation Procedure ◽  
The Mean ◽  
Artery Disease

The results of epicardial radiofrequency ablation of anatomic zone ganglionic plexi of the left atrium during CABG of patients with coronary heart disease and atrial fibrillation are analyzed. From 2009 to 2012 RF ablation procedure was performed in 92 patients with atrial fibrillation and coronary artery disease. Depending on the form of AF the patients were randomized into three groups. The mean follow-up was 14.49.6 months (from 3 до 36 months). Freedom from AF during 24 months after surgery was 78.6% for patients with paroxysmal AF, 42.5% for patients with persistent AF and 39% for patients with long-term persistent AF.

scholarly journals Safety and outcome of cryoballoon ablation versus radiofrequency catheter ablation of the pulmonary veins in patients with paroxysmal atrial fibrillation

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
O H M A Riad ◽  
T Wong ◽  
A N Ali ◽  
M T Ibrahim ◽  
M A Abdelhamid ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Paroxysmal Atrial Fibrillation ◽  
Pulmonary Veins ◽  
Cryoballoon Ablation ◽  
The Mean

Abstract Background Pulmonary vein isolation (PVI) has become the mainstay of catheter ablation of atrial fibrillation (AF). There are two commonly used methods to isolate the pulmonary veins, either point-by-point delivery of circumferential lesion sets around ipsilateral pulmonary veins using radiofrequency energy, or the application of the cryoballoon to the pulmonary vein antrum with occlusion of the vein ostium. The cryoballoon has proven to be a reliable alternative to radiofrequency ablation in acute and long-term freedom from AF. We describe our results using both modalities. Aim and Objectives to compare the safety and efficacy of cryoballoon (CB) ablation and radiofrequency (RF) ablation in treatment of paroxysmal atrial fibrillation. Patients and Methods Forty-four consecutive patients having paroxysmal AF underwent PVI using the second generation cryoballoon were compared to a retrospective cohort of 69 patients who had radiofrequency induced PVI, either by conventional RF catheter (n = 32), or a contact-force sensing-catheter (n = 37). The study took place at Ain Shams university hospitals and Royal Brompton & Harefield NHS trust. Patient data, procedural data and follow up data- at 3, 6 and 12 months- were collected and analysed. Recurrence was defined as documented AF or atrial arrhythmias with duration exceeding 30 seconds, either by 12 lead ECG or an ambulatory monitoring device. Results A total of 113 patients were studied. The mean age was 53.84 ± 15.01 for the CB group and 55.78 ± 14.84 for the RF group and females representing 40.9% vs 34.8% respectively. The mean procedural times in minutes were significantly less in the CB group (94.37 ± 39.32 vs 184.57 ± 88.19, p < 0.0001), while the median fluoroscopy times were similar [30 (11.04 - 40) vs 37.25 (14.2 - 70), p = 0.172]. Procedural complications were comparable between the two groups (p = 0.06) with 1 patient (2.3%) having long term phrenic nerve paresis. At 1 year follow up, after an initial 90-day blanking period, recurrence rate of CB was similar to RF (27.3% vs 30.4% respectively, p = 0.719), the Kaplan Meier estimates of AF- free survival for a period of 1 year were comparable between both groups (log rank test, p = 0.606). Conclusion Cryoballoon is a feasible method for pulmonary vein isolation with similar success rates to radiofrequency ablation. Cryoballoon ablation is safe with shorter duration of the procedure.

scholarly journals Predictors and risk model for heart failure hospitalization in atrial fibrillation patients without pre-existing heart failure: the Fushimi AF Registry

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y Hamatani ◽  
M Iguchi ◽  
K Minami ◽  
K Ishigami ◽  
S Ikeda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Risk Model ◽  
The Mean ◽  
Artery Disease

Abstract Background Atrial fibrillation (AF) increases the risk of hospitalization for heart failure (HF), as well as that of thromboembolism. The strategy for prediction of thromboembolism has been well-established; however, little focus has been placed on the risk stratification for and prevention of HF hospitalization in AF patients. Purpose The aim of this study is to investigate the predictors and risk model of HF hospitalization in non-valvular AF patients without pre-existing HF. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,472 patients by the end of October 2020. From the registry, we excluded patients without a pre-existing HF (defined as having one of the following; prior hospitalization for HF, New York Heart Association class ≥2, or left ventricular ejection fraction [LVEF] <40%), and those with valvular AF (mitral stenosis or prosthetic heart valve). Among 3,188 non-valvular AF patients without pre-existing HF, we explored the risk factors for the HF hospitalization during follow-up period. The risk model for predicting HF hospitalization was determined by the cumulative numbers of risk factors which were significant on multivariate analysis. Results The mean age was 72.4±10.8 years, 1197 were female and 1787 were paroxysmal AF. The mean CHADS2 and CHA2DS2-VASc scores were 1.7±1.2 and 2.9±1.6, respectively. During the median follow-up period of 5.1 years, HF hospitalization occurred in 285 (8.9%), corresponding to an annual incidence of 1.8 events per 100 person-years. In multivariable Cox regression analysis, advanced age (≥75 years), valvular heart disease, coronary artery disease, reduced LVEF (<60%), chronic obstructive pulmonary disease (COPD) and anemia were independently associated with the higher incidence of HF hospitalization (all P<0.001) (Picture 1). A risk model based on these 6 variables could stratify the incidence of HF hospitalization during follow-up period (log-rank; P<0.001) (Picture 2). Patients with ≥3 risk factors had an 11-fold higher incidence of HF hospitalization compared with those not having any of these risk factors (hazard ratio: 11.3, 95% confidence interval: 7.0–18.4; P<0.001). Conclusions Advanced age, coronary artery disease, valvular heart disease, reduced LVEF, COPD and anemia were independently associated with the risk of HF hospitalization in AF patients without pre-existing HF. There was good prediction for endpoint of HF hospitalization using these 6 variables, providing the opportunities for the implementation of strategies to reduce the incidence of HF among AF patients. FUNDunding Acknowledgement Type of funding sources: None.

The long-term effect of physical activity on incidence of coronary heart disease: A 12-year follow-up study

2005 ◽  
Vol 41 (1) ◽  
pp. 219-225 ◽  
Author(s):  
Kristina Sundquist ◽  
Jan Qvist ◽  
Sven-Erik Johansson ◽  
Jan Sundquist
Keyword(s):  
Physical Activity ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Term Effect ◽  
Follow Up Study ◽  
Long Term Effect

scholarly journals Multi-catheter cryotherapy compared with radiofrequency ablation in long-standing persistent atrial fibrillation: a randomized clinical trial

EP Europace ◽  
2020 ◽  
Author(s):  
Mark M Gallagher ◽  
Gang Yi ◽  
Hanney Gonna ◽  
Lisa W M Leung ◽  
Idris Harding ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Persistent Atrial Fibrillation ◽  
Rf Ablation ◽  
Ablation Efficiency ◽  
Mapping System ◽  
3D Mapping System ◽  
Front Advance

Abstract Aims Restoring sinus rhythm (SR) by ablation alone is an endpoint used in radiofrequency (RF) ablation for long-standing persistent atrial fibrillation (AF) but not with cryotherapy. The simultaneous use of two cryotherapy catheters can improve ablation efficiency; we compared this with RF ablation in chronic persistent AF aiming for termination to SR by ablation alone. Methods and results Consecutive patients undergoing their first ablation for persistent AF of >6 months duration were screened. A total of 100 participants were randomized 1:1 to multi-catheter cryotherapy or RF. For cryotherapy, a 28-mm Arctic Front Advance was used in tandem with focal cryoablation catheters. Open-irrigated, non-force sensing catheters were used in the RF group with a 3D mapping system. Pulmonary vein (PV) isolation and non-PV triggers were targeted. Participants were followed up at 6 and 12 months, then yearly. Acute PVI was achieved in all cases. More patients in the multi-catheter cryotherapy group were restored to SR by ablation alone, with a shorter procedure duration. Sinus rhythm continued to the last available follow-up in 16/49 patients (33%) in the multi-catheter at 3.0 ± 1.6 years post-ablation and in 12/50 patients (24%) in the RF group at 4.0 ± 1.2 years post-ablation. The yearly rate of arrhythmia recurrence was similar. Conclusion Multi-catheter cryotherapy can restore SR by ablation alone in more cases and more quickly than RF ablation. Long-term success is difficult to achieve by either methods and is similar with both.

Abstract 4496: Percutaneous Coronary Intervention in Stable Coronary Heart Disease: Value of Nt-Probnp for Stratification of Long-Term Risk

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Pedro Carmo ◽  
Carlos Aguiar ◽  
Jorge Ferreira ◽  
Luis Raposo ◽  
Pedro Goncalves ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Intervention ◽  
Inter Quartile Range ◽  
Quartile Range ◽  
Stable Coronary Heart Disease ◽  
Percutaneous Coronary

Purpose: N-terminal fragment of the B type-natriuretic peptide (NT-proBNP) is an established tool for assessing acute dyspnoea and stratifying risk in heart failure, acute coronary syndromes (ACS), and stable coronary heart disease (SCHD). The aim of this study was to determine the value of NT-proBNP in predicting long-term risk of patients (Pts) submitted to elective percutaneous coronary intervention (PCI) in the setting of SCHD. Methods: We prospectively studied 291 Pts (age 64.3±9.6 years, 64 female) with SCHD submitted to successful elective PCI, and determined NT-proBNP immediately before PCI. Pts were divided into 2 groups according to NT-proBNP level: group T3 formed by Pts with NT-proBNP level in the highest tertile and group T1+T2 formed by all remaining Pts. The study endpoint was time to the first occurrence of death (D) or non-fatal myocardial infarction (MI) during the mean follow-up of 568 ± 322 days. Multivariable analyses were performed to adjust the prognostic value of NT-proBNP for the effects of factors known to influence NT-proBNP (age, gender, renal function, body mass index) and of other potential predictors of outcome (cardiovascular risk factors, prior cardiovascular events, left ventricular ejection fraction, and PCI characteristics). Results: NT-proBNP ranged from 5 pg/ml to 104 pg/ml in the 1st tertile (T1), 105 pg/ml to 358 pg/ml in the 2nd tertile (T2), and 364 pg/ml to 33.991 pg/ml in the 3rd tertile (T3). During follow-up, 8 Pts died and 11 suffered a non-fatal MI. NT-proBNP was significantly higher in Pts who experienced an adverse outcome (440 pg/ml [inter-quartile range, 104 –1712] vs 174 pg/ml [inter-quartile range, 78 – 460) in Pts with uneventful follow-up; P= 0.007). An NT-proBNP level ≥364 pg/ml was associated with a higher endpoint rate (13.4% vs 3.1% in group T1+T2) and independently predicted outcome: adjusted hazard ratio 3.11, 95% CI, 1.15– 8.37, P=0.025. The sensitivity, specificity, predictive positive value, and negative predictive value for the criterion NT-proBNP ≥364 pg/ml were 68.4%, 69.1%, 13.4%, and 96.9%, respectively. Conclusion: In the setting of SCHD, the level of NT-proBNP is a powerful prognostic marker even after successful PCI.

Abstract P075: Influence of Systemic Interleukin-6 on the Inverse Association between Your-Choice American Heart Diet and a 41-Year Mortality Risk from Coronary Heart Disease among Men

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jun Dai ◽  
Anthony J Acton ◽  
Robert V Considine ◽  
Ruth E Krasnow ◽  
Terry Reed
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systemic Inflammation ◽  
Mortality Risk ◽  
Interleukin 6 ◽  
Reactive Protein ◽  
Chd Risk ◽  
Long Term Mortality

Introduction: Whole diet evaluated using dietary pattern is associated with systemic inflammation and coronary heart disease (CHD). Systemic inflammation also contributes to CHD risk. Genetic factors explain variations in whole diet, systemic inflammation, and CHD. However, it is unknown whether systemic inflammation is a mechanism linking whole diet to the long-term mortality risk from coronary heart disease independent of genes. Hypothesis: Systemic inflammation measured as plasma interleukin-6 levels medicates the association between whole diet and long-term mortality risk from coronary heart disease independent of genes. Methods: From the National Heart, Lung, and Blood Institute Twin Study, we included 554 white, middle-aged, veteran male twins (105 monozygotic and 109 dizygotic twin pairs; 65 monozygotic and 61 dizygotic unpaired twins). The twins were not on antihypertensive medication and had diastolic blood pressure below 105 mmHg at baseline (1969-1973) and did not have suspected acute inflammation [plasma levels of interleukin-6 (IL-6) above 10 pg/mL or C-reactive protein above 30 mg/L)]. Usual dietary data at baseline were collected through nutritionist-administered dietary history interview. Your-Choice American Heart Diet (YCARD) score was devised to quantitatively evaluate whole diet. Plasma interleukin-6 and C-reactive protein levels were measured with ELISA. Data on vital status and death causes were collected through death certificates until Dec 31, 2010. A frailty survival model was used to estimate various associations: overall (equivalent to the association in the general population), within-pair (independent of genes and environment common to co-twins), and between-pair (indicating influence of the common factors). We controlled for total caloric intake and known CHD risk factors including body mass index and modified Framingham Risk Score. Results: There were 75 CHD deaths during a 41-year follow-up (median follow-up of 34 years). The adjusted overall association between YCARD score and the CHD mortality risk was negative [partial coefficient for a 10-unit increment in the YCARD score: βo (95% confidence interval (CI)): -0.13 (-0.24, -0.02); hazard ratio (95% CI): 0.88 (0.78, 0.98)]. The partial regression coefficient was -0.02 [95% CI (-0.23, 0.19)] for the within-pair effect of YCARD (βw) and -0.12 [95% CI (-0.26, 0)] for the between-pair effect of YCARD (βb) in relation to CHD mortality risk. Additional adjustment for IL-6 led to a 15.4% reduction in the βo, a 100% increment in the βw, and a 16.7% reduction in the βb. Conclusions: Systemic inflammation measured as interleukin-6 mediates the association between whole diet and long-term coronary heart mortality risk, which is largely through genetic and environmental factors shared between co-twins.

Radiation-induced heart disease: surveillance and management

ESC CardioMed ◽  
2018 ◽  
pp. 1153-1156
Author(s):  
Ersilia M. DeFilippis ◽  
Anju Nohria
Keyword(s):  
Heart Disease ◽  
Disease Surveillance ◽  
Cardiovascular Effects ◽  
Pericardial Disease ◽  
Long Term Follow Up ◽  
Radiation Induced ◽  
Artery Disease ◽  
Effects Of Radiation

Radiation-induced heart disease is a major cause of morbidity and mortality among cancer survivors. It encompasses many clinical entities, including pericardial disease, coronary artery disease, valvular disease, cardiomyopathy, conduction system abnormalities, autonomic dysfunction, and peripheral vascular disease. As the cardiovascular effects of radiation manifest many years after treatment, long-term follow-up with regular screening is essential. This chapter reviews the epidemiology and pathogenesis of radiation-induced heart disease as well as existing consensus recommendations regarding surveillance and management.

scholarly journals O6C.3 The association between long-term exposure from heavy physical work load and coronary heart disease in middle aged men

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A56.2-A56
Author(s):  
Tomas Hemmingsson ◽  
Jenny Selander ◽  
Katarina Kjellberg
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Work Environment ◽  
Work Load ◽  
Physical Work ◽  
Physical Work Load ◽  
Strenuous Work ◽  
Heavy Physical Work

ObjectivesPrevious studies have shown conflicting results concerning the association between heavy physical work load and risk of coronary heart disease (CHD). The aim of this study was to investigate the association between long-term exposure to heavy physical work load in middle age and risk of CHD among Swedish men during almost 20 years of follow-up.MethodsThe study is based on a cohort of around 40 000 Swedish males, born 1949–51, with census information on occupation in 1985 and 1990 (at ages 34–41). Aspects of physical workload was estimated from job exposure matrices based on questions concerning heavy lifting, strenuous work postures, and physically strenuous work from the Swedish Work Environment Surveys 1989–97. Mean values for each physical exposure variable were assigned to over 300 occupational titles from the censuses conducted in 1985 and 1990. Only those 29 530 subjects who were in the same quintile of exposure both years were included in the analyses. Information on smoking behavior and body mass index (BMI) was collected at compulsory conscription for military training in 1969/70 (at 18–20 years of age), and follow up data on CHD (1457 cases) between the years 1991–2009.ResultsAn increased relative risk of CHD were found among workers in the quintiles with medium low (HR=1.36 CI95%=1.14–1.62), medium (HR=1.46 CI95%=1.23–1.74), medium-high (HR=1.62 CI95%=1.36–1.91), and high (HR=1.45 CI95%=1.22–1.71) exposure to heavy lifting at work compared with those in the quintile with low exposure to heavy lifting. After adjustment for smoking and BMI the risk estimates were somewhat lower but still significantly increased. Risk estimates of the same magnitude were seen for a number of other aspects of the physical work environment.ConclusionThere was an association between long-term exposure from heavy physical work load and CHD even after adjustement for smoking and BMI.

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