Heart rhythm : the official journal of the Heart Rhythm Society
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Comparative Study
Real-time lesion assessment using a novel combined ultrasound and radiofrequency ablation catheter.
Assessment of lesion size and transmurality is currently via indirect measures. Real-time image assessment may allow ablation parameters to be titrated to achieve transmurality and reduce recurrences due to incomplete lesions. ⋯ Real-time lesion assessment using high-frequency ultrasound integrated into an ablation catheter is feasible and allows differentiation between true necrosis and hemorrhage. This may lead to safer and more efficient power delivery, allowing more effective lesion formation.
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Atrial fibrillation is associated with an increased risk of embolic events. The left atrial appendage (LAA) is believed to be an incubator for thrombus formation. LAA exclusion has been advocated to potentially reduce embolic events arising from the LAA. ⋯ Catheter-based surgical suture ligation of the LAA is feasible in humans. This novel catheter approach may be appropriate for patients with atrial fibrillation who are ineligible for anticoagulation therapy. Further investigation is needed to demonstrate the long-term safety and efficacy of LAA closure.
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Magnetic resonance imaging (MRI) allows visualization of location and extent of radiofrequency (RF) ablation lesion, myocardial scar formation, and real-time (RT) assessment of lesion formation. In this study, we report a novel 3-Tesla RT -RI based porcine RF ablation model and visualization of lesion formation in the atrium during RF energy delivery. ⋯ MRI-compatible catheters can be navigated and RF energy safely delivered under 3-Tesla RT MRI guidance. Recording electrograms during RT imaging also is feasible. RT visualization of lesion as it forms during RF energy delivery is possible and was demonstrated using T2W HASTE imaging.
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Cryoballoon ablation has emerged as a novel treatment strategy for patients with atrial fibrillation (AF). ⋯ Differences in the extent of myocardial injury and patterns of PV reconnection were observed between cryoballoon ablation and RF ablation of paroxysmal AF.