Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Sep 2016
Randomized Controlled TrialBiomarkers in Persistent AF and Heart Failure: Impact of Catheter Ablation Compared with Rate Control.
To investigate the effects of catheter ablation and rate control strategies on cardiac and inflammatory biomarkers in patients with heart failure and persistent atrial fibrillation (AF). ⋯ Catheter ablation, compared with rate control, in patients with heart failure and persistent AF was associated with significant reduction in MR-proANP, which correlated with physiological and symptomatic improvement. Ablation-based rhythm control may induce beneficial cardiac remodeling, unrelated to changes in inflammatory state. This may have prognostic implications, which require confirmation by event end point studies.
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Pacing Clin Electrophysiol · May 2016
Case ReportsCompound Heterozygous Triadin Mutation Causing Cardiac Arrest in Two Siblings.
We present the case of two siblings who both presented with an out-of-hospital cardiac arrest at 2 years of age. Both siblings underwent internal cardiac defibrillator implantation and both had recurrent episodes of ventricular fibrillation (VF). ⋯ The combination of these mutations has resulted in a particularly arrhythmogenic phenotype, with cardiac arrest occurring at a very young age and recurrent episodes of VF despite β-blockade. Flecainide seems to have been very effective in preventing clinical arrhythmias for this particular mutation.
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Pacing Clin Electrophysiol · Nov 2015
Importance of Ventricular Tachycardia Induction and Mapping for Patients Referred for Epicardial Ablation.
Many nonischemic cardiomyopathy (NICMP) patients referred for catheter ablation of ventricular tachycardia (VT) undergo an initial epicardial approach under general anesthesia (GA). However, GA may suppress inducibility and decrease tolerance of induced VT, leaving substrate modification as the sole ablation method. ⋯ An initial approach of PES and entrainment mapping under conscious sedation is critically important for patients with NICMP referred for epicardial ablation. Empiric ablation of endocardial/epicardial scar would have missed the clinical VT in 20% of patients.
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Pacing Clin Electrophysiol · Sep 2015
Clinical TrialWireless Ultrasound Guidance for Femoral Venous Cannulation in Electrophysiology: Impact on Safety, Efficacy, and Procedural Delay.
Ultrasound (US) guidance increases safety and efficacy in vascular cannulation and is considered the standard of care. However, barriers including workflow interference and the need to be assisted by a second operator limit its adoption in clinical routine. The use of wireless US (WUS) may overcome these barriers. The aim of this study was to assess the impact of a novel WUS probe during its initial implantation in an electrophysiology (EP) laboratory. ⋯ WUS guidance resulted in faster, safer, and more effective femoral venous cannulation than the anatomical landmark approach without adding significant workflow interference. The application of wireless technology in this setting contributed to overcoming some of the barriers preventing a more widespread clinical use of US guidance.
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Pacing Clin Electrophysiol · Sep 2015
Clinical TrialPulmonary Vein Isolation Using the First-Generation Cryoballoon Technique in Chinese Patients.
Cryoballoon ablation is an alternative for the treatment of atrial fibrillation (AF). We assess the relationship among pulmonary vein (PV) electrophysiology, balloon temperature, and persistent PV isolation (PVI), and report procedural properties, safety, and efficacy of this technique in a Chinese center for the first time. ⋯ Real-time PV potentials can be recorded in most PVs. The time to isolation is predictive of the persistency of PVI. The nadir balloon temperature, not the balloon temperature at isolation, is significantly lower in PVs without reconduction.