scholarly journals Compass Mapping, Double Potentials, Activation Patterns Can Identify and Track Rotational Activity Sites in the Left Atrium of Humans with Persistent Atrial Fibrillation.

2018 ◽  
Vol 11 (2) ◽  
Author(s):  
Donald S. Rubenstein
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Persistent Atrial Fibrillation ◽  
Activation Patterns

scholarly journals Pre-Procedural Prediction of Termination of Persistent Atrial Fibrillation by Catheter Ablation as an Indicator of Reverse Remodeling of the Left Atrium

2013 ◽  
Vol 77 (6) ◽  
pp. 1416-1423 ◽  
Author(s):  
Koji Kumagai ◽  
Tamotsu Sakamoto ◽  
Keijiro Nakamura ◽  
Mamoru Hayano ◽  
Eiji Yamashita ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrium ◽  
Persistent Atrial Fibrillation ◽  
Reverse Remodeling

scholarly journals P330Reverse remodelling of the left atrium occurs early after catheter ablation for persistent atrial fibrillation

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii55-iii55
Author(s):  
B. Maille ◽  
A. Hussein ◽  
V. Chaturvedi ◽  
M. Morgan ◽  
C. Ronayne ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrium ◽  
Persistent Atrial Fibrillation

scholarly journals P842Outcome following thoracoscopic epicardial ablation of patients with persistent atrial fibrillation or with severe left atrium dilatation

EP Europace ◽  
2018 ◽  
Vol 20 (suppl_1) ◽  
pp. i156-i156
Author(s):  
M Cireddu ◽  
L Foppoli ◽  
C Bisceglia ◽  
F Baratto ◽  
C M Barbaro ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Persistent Atrial Fibrillation ◽  
Epicardial Ablation

scholarly journals Hot balloon ablation of persistent atrial fibrillation with a dilated left atrium in a case of dilated cardiomyopathy

2017 ◽  
Vol 4 (2) ◽  
pp. 28
Author(s):  
Ayako Okada ◽  
Morio Shoda ◽  
Takahiro Takeuchi ◽  
Ken Kato ◽  
Wataru Shoin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Left Atrium ◽  
Persistent Atrial Fibrillation ◽  
Left Ventricular Ejection ◽  
Lv Dysfunction ◽  
Intravenous Drip ◽  
Balloon Ablation

A 70-year-old man who developed dilated cardiomyopathy with persistent atrial fibrillation (PSAF) was admitted to our hospital. He was already drug-resistant. The left atrium (LA) was severely enlarged. The left ventricular ejection fraction (LVEF) was 39%, and contraction was severely reduced. For AF ablation, catheter ablation (CA) was used for mild to moderate LV dysfunction without severe left atrial dilatation. In severe LV dysfunction, excessive intravenous drip volume may precipitate congestive heart failure. On the other hand, shorter isolation time has been reported with balloon ablation as compared to CA. Therefore, the intravenous drip volume is small. We planned to use the balloon technique for a patient with LA dilatation and severe LV dysfunction despite another hospital not having done so. After the procedure, the pulmonary veins were successfully isolated, and congestive heart failure recovered after sinus rhythm termination. There was no recurrence of AF after the procedure. Hot balloon ablation can be effective for PSAF with severe heart failure.

scholarly journals Modulation of SERCA in Patients with Persistent Atrial Fibrillation Treated by Epicardial Thoracoscopic Ablation: The CAMAF Study

2020 ◽  
Vol 9 (2) ◽  
pp. 544 ◽  
Author(s):  
Celestino Sardu ◽  
Gaetano Santulli ◽  
Germano Guerra ◽  
Maria Consiglia Trotta ◽  
Matteo Santamaria ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Persistent Atrial Fibrillation ◽  
Epicardial Ablation ◽  
Multicenter Observational Study ◽  
Endoplasmic Reticulum Calcium ◽  
One Year ◽  
Left Atrium Volume ◽  
First Time ◽  
Af Recurrence

Objectives: To evaluate atrial fibrillation (AF) recurrence and Sarcoplasmic Endoplasmic Reticulum Calcium ATPase (SERCA) levels in patients treated by epicardial thoracoscopic ablation for persistent AF. Background: Reduced levels of SERCA have been reported in the peripheral blood cells of patients with AF. We hypothesize that SERCA levels can predict the response to epicardial ablation. Methods: We designed a prospective, multicenter, observational study to recruit, from October 2014 to June 2016, patients with persistent AF receiving an epicardial thoracoscopic pulmonary vein isolation. Results: We enrolled 27 patients. Responders (n = 15) did not present AF recurrence after epicardial ablation at one-year follow-up; these patients displayed a marked remodeling of the left atrium, with a significant reduction of inflammatory cytokines, B type natriuretic peptide (BNP), and increased levels of SERCA compared to baseline and to nonresponders (p < 0.05). Furthermore, mean AF duration (Heart rate (HR) 1.235 (1.037–1.471), p < 0.05), Left atrium volume (LAV) (HR 1.755 (1.126–2.738), p < 0.05), BNP (HR 1.945 (1.895–1.999), p < 0.05), and SERCA (HR 1.763 (1.167–2.663), p < 0.05) were predictive of AF recurrence. Conclusions: Our data indicate for the first time that baseline values of SERCA in patients with persistent AF might be predictive of failure to epicardial ablative approach. Intriguingly, epicardial ablation was associated with increased levels of SERCA in responders. Therefore, SERCA might be an innovative therapeutic target to improve the response to epicardial ablative treatments.

scholarly journals Endocardial-Epicardial Phase Mapping of Prolonged Persistent Atrial Fibrillation Recordings

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Ramanathan Parameswaran ◽  
Jonathan M. Kalman ◽  
Alistair Royse ◽  
John Goldblatt ◽  
Marco Larobina ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Temporal Heterogeneity ◽  
Activation Patterns ◽  
3 Dimensional ◽  
Transmural Migration ◽  
Endocardial Mapping ◽  
Phase Mapping ◽  
Insight Into ◽  
Activation Mapping

Background: Endocardial-epicardial dissociation and focal breakthroughs in humans with atrial fibrillation (AF) have been recently demonstrated using activation mapping of short 10-second AF segments. In the current study, we used simultaneous endo-epi phase mapping to characterize endo-epi activation patterns on long segments of human persistent AF. Methods: Simultaneous intraoperative mapping of endo- and epicardial lateral right atrium wall was performed in patients with persistent AF using 2 high-density grid catheters (16 electrodes, 3 mm spacing). Filtered unipolar and bipolar electrograms of continuous 2-minute AF recordings and electrodes locations were exported for phase analyses. We defined endocardial-epicardial dissociation as phase difference of ≥20 ms between paired endo-epi electrodes. Wavefronts were classified as rotations, single wavefronts, focal waves, or disorganized activity as per standard criteria. Endo-Epi wavefront patterns were simultaneously compared on dynamic phase maps. Complex fractionated electrograms were defined as bipolar electrograms with ≥5 directional changes occupying at least 70% of sample duration. Results: Fourteen patients with persistent AF undergoing cardiac surgery were included. Endocardial-epicardial dissociation was seen in 50.3% of phase maps with significant temporal heterogeneity. Disorganized activity (Endo: 41.3% versus Epi: 46.8%, P =0.0194) and single wavefronts (Endo: 31.3% versus Epi: 28.1%, P =0.129) were the dominant patterns. Transient rotations (Endo: 22% versus Epi: 19.2%, P =0.169; mean duration: 590±140 ms) and nonsustained focal waves (Endo: 1.2% versus Epi: 1.6%, P =0.669) were also observed. Apparent transmural migration of rotational activations (n=6) from the epi- to the endocardium was seen in 2 patients. Electrogram fractionation was significantly higher in the epicardium than endocardium (61.2% versus 51.6%, P <0.0001). Conclusions: Simultaneous endo-epi phase mapping of prolonged human persistent AF recordings shows significant Endocardial-epicardial dissociation marked temporal heterogeneity, discordant and transitioning wavefronts patterns and complex fractionations. No sustained focal activity was observed. Such complex 3-dimensional interactions provide insight into why endocardial mapping alone may not fully characterize the AF mechanism and why endocardial ablation may not be sufficient. Graphic Abstract: A graphic abstract is available for this article.

Identification of repetitive atrial activation patterns in persistent atrial fibrillation by direct contact high‐density electrogram mapping

2019 ◽  
Vol 30 (12) ◽  
pp. 2704-2712 ◽  
Author(s):  
Michael Wolf ◽  
René Tavernier ◽  
Ziad Zeidan ◽  
Milad El Haddad ◽  
Yves Vandekerckhove ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Direct Contact ◽  
Persistent Atrial Fibrillation ◽  
High Density ◽  
Activation Patterns ◽  
Atrial Activation
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