Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Oct 2011
ReviewNon-surgical left atrial appendage closure for stroke prevention in atrial fibrillation.
Non-Surgical Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation. The most feared complication associated with atrial fibrillation (AF) is stroke, the risk of which increases with advanced age. Because of its complex anatomy and diminished blood flow during AF, the left atrial appendage (LAA) has been a common site of left atrial thrombi and presumed source of thromboembolism. ⋯ The nonsurgical approaches to excluding the LAA from the central circulation can be divided into 3 broad categories: transseptally placed devices, percutaneous epicardial approach, and hybrid approaches. The availability of several approaches will allow physician selection of the optimal approach for a given patient based on clinical, physiological, and anatomical considerations. LAA exclusion stands to become an increasingly attractive option for patients with nonvalvular AF because it can be offered to elderly AF patients, and eliminates the long-term cumulative bleeding risks and adherence challenge of anticoagulants.
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J. Cardiovasc. Electrophysiol. · Oct 2011
Case ReportsUse of ventricular synchronized triggered atrial pacing to facilitate hemodynamic support during mapping and catheter ablation of ventricular vachycardia.
Use of VSTAP to Facilitate Hemodynamic Support. The ablation of hemodynamically unstable ventricular tachycardia (VT) is challenging and frequently requires alternative mapping techniques or the use of percutaneous mechanical support devices. ⋯ In this case, triggered atrial pacing permitted activation mapping and, subsequently, successful ablation of the patient's unstable VT. Thus, VSTAP is a readily available and noninvasive technique that may provide adequate hemodynamic support during catheter ablation of unstable VT.
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J. Cardiovasc. Electrophysiol. · Oct 2011
Long-term follow-up in patients with presumptive Brugada syndrome treated with implanted defibrillators.
Risk stratification for patients with suspected Brugada syndrome (BS) remains difficult. Implantation of cardioverter-defibrillators (ICDs) in high-risk patients provides continuous long-term arrhythmia protection. ⋯ Risk stratification for patients with BS for primary prevention remains challenging. The low risk of arrhythmic events that is exceeded by ICD-related adverse effects should inform discussions with patients who do not have a prior history of cardiac arrest.
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J. Cardiovasc. Electrophysiol. · Aug 2011
Comparative StudyPatients treated with catheter ablation for atrial fibrillation have long-term rates of death, stroke, and dementia similar to patients without atrial fibrillation.
Atrial fibrillation (AF) adversely impacts mortality, stroke, heart failure, and dementia. AF ablation eliminates AF in most patients. We evaluated the long-term impact of AF ablation on mortality, heart failure (HF), stroke, and dementia in a large system-wide patient population. ⋯ AF ablation patients have a significantly lower risk of death, stroke, and dementia in comparison to AF patients without ablation. AF ablation may eliminate the increased risk of death and stroke associated with AF.