Heart rhythm : the official journal of the Heart Rhythm Society
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Quantitative measures of the ventricular fibrillation waveform at the outset of resuscitation are associated with survival. However, little is known about the course of these measures during resuscitation and how this course is related to outcome. ⋯ Given their prognostic and dynamic qualities, quantitative waveform measures may provide an effective real-time strategy to guide individual treatment and improve survival.
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Late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) of ventricular scar has been shown to be accurate for detection and characterization of arrhythmia substrates. However, the majority of patients referred for ventricular tachycardia (VT) ablation have an implantable cardioverter-defibrillator (ICD), which obscures image integrity and the clinical utility of MRI. ⋯ Wideband LGE MRI improves the ability to visualize myocardium for clinical interpretation, which correlated well with EAM findings during VT ablation.
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Comparative Study
Short- and long-term electrical performance of the 5086MRI pacing lead.
Owing to potential patient harm, magnetic resonance imaging (MRI) in patients with cardiac implantable electronic devices has traditionally been contraindicated. Following the EnRhythm MRI SureScan Study, an MR conditional pacemaker with modified leads was approved by the Food and Drug Administration. Electrical and handling characteristics of MR conditional pacing leads compared with those of traditional leads have not been established. ⋯ The 5086MRI lead demonstrates clinically acceptable electrical characteristics while providing safe access to MR-guided diagnostics. However, compared with the 5076 lead, the 5086MRI lead exhibits lower ventricular sensing, slightly higher ventricular capture thresholds, and higher acute lead dislodgement rate.
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Editorial Comment
Simplifying atrial fibrillation ablation: how far can we go?
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Randomized Controlled Trial Multicenter Study
The CURE-AF trial: a prospective, multicenter trial of irrigated radiofrequency ablation for the treatment of persistent atrial fibrillation during concomitant cardiac surgery.
Ablation technology has been introduced to replace the surgical incisions of the Cox-Maze procedure in order to simplify the operation. However, the efficacy of these ablation devices has not been prospectively evaluated. ⋯ Irrigated radiofrequency ablation for treatment of AF during cardiac surgery was associated with a low complication rate. No device-related complications occurred. The Cox-Maze lesion set was effective at restoring sinus rhythm and had higher success rates in patients with smaller left atrial diameters and longer ablation times.