Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Apr 2012
Randomized Controlled Trial Multicenter StudyThe Modified Ablation Guided by Ibutilide Use in Chronic Atrial Fibrillation (MAGIC-AF) Study: clinical background and study design.
Beyond pulmonary vein isolation (PVI), adjuvant ablation at the sites of complex fractionated atrial electrograms (CFAE) has been shown to improve the long-term success of catheter ablation of persistent atrial fibrillation (AF). However, this approach often requires extensive ablation due to the widespread distribution of CFAE within the left atrium. An optimal strategy would identify areas of CFAE which, when selectively targeted with ablation, result in AF termination with an acceptable long-term freedom from AF. It is possible that the intraprocedural administration of an antiarrhythmic drug may help accomplish this. ⋯ The MAGIC-AF study will assess the utility of a combined pharmaco-ablative strategy in patients with persistent AF undergoing a CFAE based ablation strategy.
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J. Cardiovasc. Electrophysiol. · Apr 2012
Case ReportsInterventricular septal mass in a patient with cardiac sarcoidosis.
Sarcoidosis is a granulomatous disease that may involve multiple organ systems. The prognosis of sarcoidosis is influenced by the presence and severity of cardiac lesions. Thinning of the wall in the ventricular septum has often been reported, whereas an interventricular septal mass is rare. We describe a case of cardiac sarcoidosis resulting in a myocardial mass in the basal portion of the interventricular septum that was sensitive to corticosteroid treatment.
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J. Cardiovasc. Electrophysiol. · Mar 2012
Left atrial deformation imaging with ultrasound based two-dimensional speckle-tracking predicts the rate of recurrence of paroxysmal and persistent atrial fibrillation after successful ablation procedures.
Since predictors of recurrence of atrial fibrillation (AF) after ablation procedures are poorly defined, this prospective study was conducted to assess the value of left atrial (LA) deformation imaging with two-dimensional speckle-tracking (2D-ST) to predict AF recurrences after successful ablation procedures. ⋯ Compared with controls, AF itself seems to decrease LA deformation capabilities. The assessment of global LA strain with 2D-ST identifies patients with high risk for AF recurrence after ablation procedures. This imaging technique may help to improve therapeutic guiding for patients with AF.
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J. Cardiovasc. Electrophysiol. · Mar 2012
Dofetilide reduces the frequency of ventricular arrhythmias and implantable cardioverter defibrillator therapies.
Patients with an implanted cardioverter defibrillator (ICD) and ventricular arrhythmias leading to ICD therapies have poor clinical outcomes and quality of life. Antiarrhythmic agents and catheter ablation are needed to control these arrhythmias. Dofetilide has only been approved for the treatment of atrial fibrillation. The role of dofetilide in the control of ventricular arrhythmias in patients with an ICD has not been established. ⋯ In patients with an ICD and ventricular arrhythmias, dofetilide decreases the frequency of VT/VF and ICD therapies even when other antiarrhythmic agents, including amiodarone, have previously been ineffective. Recurrences still occur in some patients requiring catheter ablation, mechanical support, or heart transplantation.
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J. Cardiovasc. Electrophysiol. · Mar 2012
The importance of class-I antiarrhythmic drug test in the evaluation of patients with syncope: unmasking Brugada syndrome.
The Brugada syndrome (BrS) can first present with syncope. Class-I antiarrhythmic drug (AAD) test is used to unmask the diagnostic coved-type ECG pattern in case it is not spontaneously present. The aim of the study was to analyze patients with BrS presenting with syncope as first manifestation and compare patients with syncope and a spontaneous coved-type ECG to patients with syncope in whom a class-I AAD test unmasked the disease. ⋯ One of 3 patients with BrS presents first with syncope. More than one-third of these patients have a normal ECG at investigation for syncope and the correct diagnosis would have been missed without a class-I AAD test. Patients presenting with syncope are at similar risk irrespective of the presence of a spontaneous coved-type ECG.