Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Feb 2015
Efficacy and safety of apixaban in the patients undergoing the ablation of atrial fibrillation.
Apixaban, a factor Xa (FXa) inhibitor, is a new oral anticoagulant for stroke prevention in atrial fibrillation (AF). However, little is known about its efficacy and safety as a periprocedural anticoagulant therapy for patients who had undergone catheter ablation (CA) for AF. ⋯ The use of apixaban during the periprocedural period of AF ablation seemed as efficacious and safe as warfarin.
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Pacing Clin Electrophysiol · Feb 2015
Controlled Clinical TrialOptimizing radiofrequency ablation of paroxysmal and persistent atrial fibrillation by direct catheter force measurement-a case-matched comparison in 198 patients.
Sufficient electrode-tissue contact is crucial for adequate lesion formation in radiofrequency catheter ablation (RFCA). ⋯ The use of contact force sensing technology is able to significantly reduce ablation, procedure, and fluoroscopy times as well as dose in RFCA of AF in a mixed case-matched group of paroxysmal and persistent AF. Energy delivery is substantially reduced by avoiding radiofrequency ablation in positions with insufficient surface contact. Additionally 12-month outcome data showed increased efficacy. Such time saving and equally safe technology may have a relevant impact on laboratory management and increased cost effectiveness.
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Pacing Clin Electrophysiol · Feb 2015
Case ReportsCreation of partial fascicular block: an approach to ablation of idiopathic left ventricular tachycardia in the pediatric population.
Catheter ablation of idiopathic left ventricular tachycardia in the pediatric population remains challenging. A recent multicenter study reported limited success with 14% not undergoing ablation due to inability to induce ventricular tachycardia (VT) or blood pressure instability during tachycardia. Creating complete or partial fascicular block with radiofrequency catheter ablation is a technique that may eliminate VT. This approach is performed during sinus rhythm, enabling atrioventricular conduction monitoring and maintaining stable hemodynamics. Importantly, induction of VT is not necessary for mapping or assessing efficacy of the procedure. ⋯ The technique of creating partial fascicular block appears to be a safe and effective approach to ablation of idiopathic left ventricular tachycardia in children.
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Pacing Clin Electrophysiol · Dec 2014
Implantable device to monitor cardiac activity with sternal wires.
Sternal wires are used to close the thoracic cavity and facilitate healing after median sternotomy (MS). We invented an implantable device that uses these wires as sensors to monitor cardiac electrical activity and tested its utility in collecting electrocardiography (ECG) data in vivo. ⋯ These initial results showed that our novel device can use sternal wires as electrodes in vivo to monitor cardiac electrical activity and safely capture physiologic signals after surgical placement.
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Pacing Clin Electrophysiol · Nov 2014
Comparative StudyRefinement of ischemic stroke risk in patients with atrial fibrillation and CHA2 DS2 -VASc score of 1.
Patients with atrial fibrillation (AF) with CHA2 DS2 -VASc score of 1 (where CHA2 DS2 -VASc is CHA2 DS2 -Vascular disease, Age 65-74 years, Sex category) are recommended to receive antithrombotic therapy. Nonetheless, it remains unclear whether individual components that constitute CHA2 DS2 -VASc score contribute equally to the ischemic stroke risk, particularly in patients with CHA2 DS2 -VASc score of 1. The objective was to describe and compare the risk of ischemic stroke of the six individual components constituting CHA2 DS2 -VASc among AF patients with CHA2 DS2 -VASc score of 1. ⋯ In AF patients with CHA2 DS2 -VASc score of 1, hypertension confers the highest risk for stroke among other risk factors comprising the score. A more aggressive thromboprophylaxis strategy may be justified among AF patients with CHA2 DS2 -VASc score of 1 due to hypertension.