Journal of atrial fibrillation最新文献

{"title":"Comparison of Fragmented Electrogram Based Strategy and High Frequency Stimulation for Detection of Ganglionated Plexi.","authors":"Tolga Aksu,&nbsp;Erkan Baysal,&nbsp;Dhanunjaya Lakkireddy,&nbsp;Kivanc Yalin,&nbsp;Rakesh Gopinathannair","doi":"10.4022/jafib.2440","DOIUrl":"https://doi.org/10.4022/jafib.2440","url":null,"abstract":"<p><p>Ganglionated plexus (GP) ablation is an emerging technique in patients with cardioinhibitory vasovagal syncope and vagally mediated atrial fibrillation. Localization of GPs can be impacted by the technique used. A reproducible methodology for GP detection is needed to account for individual variations during electrophysiologic study. In this article, we aim to compare and contrast high-frequency stimulation vs. a fragmented electrogram guided strategy for GP localization.</p>","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 4","pages":"2440"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691295/pdf/jafib-13-02440.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39758645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracing the Right Phrenic Nerve - A Systematic Review and Meta-Analysis.","authors":"Kuniewicz M,&nbsp;Mazur M,&nbsp;Karkowski G,&nbsp;Budnicka K,&nbsp;Przybycień W,&nbsp;Walocha J,&nbsp;Lelakowski J","doi":"10.4022/jafib.2305","DOIUrl":"https://doi.org/10.4022/jafib.2305","url":null,"abstract":"<p><strong>Background: </strong>The Right phrenic nerve (RPN) is vulnerable to injury during the isolation of the right pulmonary veins (RPV). The study aimed to provide a comprehensive meta-analysis of the overall prevalence of right phrenic nerve injury (RPNI), its course and its association with the superior and inferior pulmonary veins.</p><p><strong>Methods: </strong>Through December 2017, a database search was performed on PubMed, Science Direct, EMBASE, SciELO, and Web of Science. The references were also extensively searched in the included articles.</p><p><strong>Results: </strong>Detection of the RPN may vary according to the identification method. It ranges from 100% in postmortem studies, 93% in intraoperative, to 57.88% in computer tomography (CT) imaging. Based on the included studies (n-507), the distance from the right superior pulmonary vein (RSPV) ostium to the RPN was 12.48mm (±6.21). In postmortem studies, the distance was 6.92mm (±3.94); in pre or intraoperative techniques, 13.32mm (±5.96) if noninvasive, 13.97mm (±7.8) if invasive. Distances ranged from 0DC342.6 mm. For the right inferior pulmonary vein (RIPV) (n-125) the mean distance was 16.53mm (±8.92) with distances from 0.4 68mm. The risk of RPNI with distance-included studies was 12.46% (47 RPNI in 377 cases). In the meta-analysis, the distance from the RSPV to the RPN that was associated with an increased risk of RPNI was 7.36mm.</p><p><strong>Conclusions: </strong>RPNI is a relatively rare complication. A firm understanding of its course, relation to the PV ostium, and detection are vital for preventing future injuries and complications.</p>","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 3","pages":"2305"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691339/pdf/jafib-13-02305.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39759789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Impact of Atrial Fibrillation in a Cohort of Patients with Hypertrophic Cardiomyopathy in Ireland.","authors":"McClelland S,&nbsp;O'Connor Sa,&nbsp;Donohue S,&nbsp;Lavelle L,&nbsp;McErlean A,&nbsp;Dodd Jd,&nbsp;Meaney J,&nbsp;McCreery Cj,&nbsp;McDonald K,&nbsp;Quinn M,&nbsp;Erwin Je,&nbsp;Quigley Pj,&nbsp;Maurer B,&nbsp;Keane D","doi":"10.4022/jafib.2337","DOIUrl":"https://doi.org/10.4022/jafib.2337","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with hypertrophic cardiomyopathy (HCM), and is associated with deterioration in clinical status and outcome. To date, no data have been published pertaining to AF in an Irish HCM population.</p><p><strong>Methods and results: </strong>159 patients with HCM attending St Vincent's University Hospital and Blackrock Clinic, Dublin, were identified. Detailed review of medical notes, Holter monitor, echocardiogram, cardiac MRI (CMR) and implantable cardioverter-defibrillator (ICD) records was performed.Prevalence of AF was 38.4%. HCM patients with AF (HCM-AF) were older (60.6±14.8 v 54.9±17.3 years, P=0.016) and more symptomatic (NYHA II: 29.7% v 16.9%, NYHA III: 4.3% v 1.2%) than HCM patients without AF. History of stroke was recorded in 16.4% of HCM-AF patients, compared with 1% in those without AF.HCM-AF patients had lower left ventricular ejection fraction (echo: 59.5±11.8v68±8, P<0.001; CMR: 62.3%v70.5%, P<0.01) and higher left atrial diameter (echo: 49.8±9.5v40.9±7.4, p<0.001; CMR 62.3±11.3v70.4±9, p<0.001), compared with those without AF. Myocardial fibrosis was detected on CMR in 74% of HCM-AF patients and 62% of those without AF.34% of patients had an ICD in situ, of whom 61% had AF. 24% of these HCM-AF patients received inappropriate shocks, all triggered by AF.</p><p><strong>Conclusion: </strong>AF is common in the Irish HCM population. It is associated with increased risk of stroke, deterioration in symptom status and is a common trigger for inappropriate ICD discharge. We have shown, in-keeping with previous studies, that AF is associated with reduced EF, increased LA diameter and mitral regurgitation in this HCM population.</p>","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 3","pages":"2337"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691344/pdf/jafib-13-02337.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39759791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Troponin in Patients with Atrial Fibrillation Admitted to an Emergency Department: Review and Meta-Analysis.","authors":"Burgos Lucrecia María,&nbsp;Trivi Marcelo,&nbsp;Gil Ramírez Andreina,&nbsp;Costabel Juan Pablo","doi":"10.4022/jafib.2346","DOIUrl":"https://doi.org/10.4022/jafib.2346","url":null,"abstract":"<p><strong>Introduction: </strong>Elevated levels of cardiac troponin (cTn) indicate underlying heart disease and is known to predict adverse events in multiple conditions. Its role in atrial fibrillation (AF) in the acute setting is still not conclusive. We aimed to assess the prognostic value of c-Tn in patients with AF admitted to an emergency department (ED).</p><p><strong>Methods: </strong>Systematic searches were conducted using PubMed and the Cochrane Library and the International Clinical Trials Registry Platform to identify studies from year 2009 to October 2019 reporting on the prognostic value of cTn on all-cause mortality or major adverse cardiac events (MACE) in adult patients with AF in the ED. We pooled hazard ratio (HR) and 95% confidence interval (CI) using fixed and random effects models according the heterogeneity. We planned to conduct a sensitivity and subgroup analyses.</p><p><strong>Results: </strong>Five studies involving 5750 patients were identified. The mean follow-up ranged from 12 to 35 months. An increase in mortality was observed in the elevated cTn group compared to the controls, HR=2.7 (95% CI 1.55-4.72), P for effect<0.001, I2=80%). For MACE, the pooled HR was 2.17 (95%CI 1.60-2.94), P for effect<0.001, I2=0%). In the subgroup analysis we found no significant difference in type of troponin used and study design.</p><p><strong>Conclusions: </strong>The elevation of cardiac troponin was significantly associated with higher mortality and major adverse cardiac events in patients with AF admitted to an ED. In this setting the use of c-Tn could provide prognostic information.</p>","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 3","pages":"2346"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691335/pdf/jafib-13-02346.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39759793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Risk Factors for Atrial Fibrillation: Retrospective Review of a Large Electronic Patient Database.","authors":"Jaclyn Rivington,&nbsp;Patrick Twohig","doi":"10.4022/jafib.2365","DOIUrl":"https://doi.org/10.4022/jafib.2365","url":null,"abstract":"<p><strong>Background: </strong>Despite the numerous comorbidities associated with atrial fibrillation (AF), the relative risk has been varying and not well-documented.</p><p><strong>Aim: </strong>To quantify the risk of diseases associated with AF.</p><p><strong>Methods: </strong>Population-based retrospective analysis in IBM Explorys (1999-2019), an electronic database with over 63 million patients in the United States. Odds ratios were calculated between AF and other diseases. AF patients were also stratified by age, gender, and race to assess trends of AF in different demographic groups.</p><p><strong>Results: </strong>1,812,620 patients had AF in the database. Congestive heart failure had the highest association with AF (OR 42.95). Cardiomyopathy, coronary artery disease, hypertension, and myocardial infarction all had odds greater than 15. Anemia of chronic disease and chronic kidney disease had odds greater than 18, the highest for chronic inflammatory conditions. Other conditions commonly associated with AF were found to have odds less than 8, including hyperthyroidism, alcohol use, and sleep apnea. Helicobacter pylori infection had the lowest odds at 1.98.</p><p><strong>Conclusions: </strong>Epidemiologic information could be integrated with current clinical algorithms to more rapidly identify patients at risk of AF.</p>","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 3","pages":"2365"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691333/pdf/jafib-13-02365.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39847488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Uncommon Dilemma: Cardiac Resynchronization Therapy in Patients with Persistent Left Superior Vena Cava Draining into the Coronary Sinus.","authors":"Omar R Kahaly,&nbsp;Muhammad R Afzal,&nbsp;Toshimasa Okabe,&nbsp;Mahmoud Houmsse","doi":"10.4022/jafib.2339","DOIUrl":"https://doi.org/10.4022/jafib.2339","url":null,"abstract":"","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 3","pages":"2339"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691343/pdf/jafib-13-02339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39759792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Calcification in Pre-Atrial Fibrillation Ablation Scans: A Missed Opportunity?","authors":"Harmon E,&nbsp;Allam S,&nbsp;Kutinsky I,&nbsp;Villines T,&nbsp;Mehta N","doi":"10.4022/jafib.2379","DOIUrl":"https://doi.org/10.4022/jafib.2379","url":null,"abstract":"Corresponding Author Nishaki Mehta,","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 3","pages":"2379"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691331/pdf/jafib-13-02379.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39847490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Perplexing Electrocardiogram A Perplexing Electrocardiogram.","authors":"Rashmi Hottigoudar,&nbsp;Dhanunjaya Lakkireddy,&nbsp;Rakesh Gopinathannair","doi":"10.4022/jafib.2451","DOIUrl":"https://doi.org/10.4022/jafib.2451","url":null,"abstract":"Corresponding Author Rakesh Gopinathannair, Cardiac EP Lab Director, Kansas City Heart Rhythm Institute and Research Foundation Professor of Medicine, University of Missouri-Columbia 5100 W 110th St, Ste 200, Overland Park, KS 66211","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 3","pages":"2451"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691340/pdf/jafib-13-02451.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39758638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ablation in Atrial Fibrillation with Ventricular Pacing Results in Similar Spatial Catheter Stability as Compared to Ablation in Sinus Rhythm with Atrial Pacing.","authors":"Matthew Dai,&nbsp;Chirag Barbhaiya,&nbsp;Anthony Aizer,&nbsp;Jonathan Hyde,&nbsp;Edward Kogan,&nbsp;Douglas Holmes,&nbsp;Scott Bernstein,&nbsp;Michael Spinelli,&nbsp;David S Park,&nbsp;Larry A Chinitz,&nbsp;Lior Jankelson","doi":"10.4022/jafib.2373","DOIUrl":"https://doi.org/10.4022/jafib.2373","url":null,"abstract":"<p><strong>Background: </strong>Improved catheter stability is associated with decreased arrhythmia recurrence after atrial fibrillation (AF) ablation. Recently, atrial voltage mapping in AF was demonstrated to correlate better with scar as compared to mapping in sinus rhythm (SR). However, it is unknown whether ablation of persistent AF in sinus rhythm with atrial pacing or in atrial fibrillation with ventricular pacing results in differences in catheter stability or arrhythmia recurrence.</p><p><strong>Methods: </strong>We analyzed 53 consecutive patients undergoing first-time persistent AF ablation with pulmonary vein and posterior wall isolation: 27 were cardioverted, mapped, and ablated in sinus rhythm with atrial pacing, and 26 were mapped and ablated in AF with ventricular pacing. Ablation data was extracted from the mapping system and analyzed using custom MATLAB software to determine high-frequency (60Hz) catheter excursion as a novel metric for catheter spatial stability.</p><p><strong>Results: </strong>There was no difference in catheter stability as assessed by maximal catheter excursion, mean catheter excursion, or contact force variability between the atrial-paced and ventricular-paced patients. Ventricular-paced patients had significantly greater mean contact force as compared to atrial-paced patients. Contact-force variability demonstrated poor correlation with catheter excursion. One year arrhythmia-free survival was similar between the atrial paced and ventricular paced patients.</p><p><strong>Conclusions: </strong>For patients with persistent AF, ablation in AF with ventricular pacing results in similar catheter stability and arrhythmia recurrence as compared to cardioversion and ablation in sinus rhythm with atrial pacing. Given the improved fidelity of mapping in AF, mapping and ablating during AF with ventricular pacing may be preferred.</p>","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 3","pages":"2373"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691334/pdf/jafib-13-02373.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39847925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Cerebrovascular Thromboembolic Event Rate Long after Unsuccessful Catheter Ablation for Atrial Fibrillation.","authors":"Zsuzsanna Kis,&nbsp;Mihran Martirosyan,&nbsp;Astrid Armanda Hendriks,&nbsp;Dominic Theuns,&nbsp;Rohit Bhagwandien,&nbsp;Sip Wijchers,&nbsp;Sing-Chien Yap,&nbsp;Tamas Szili-Torok","doi":"10.4022/jafib.2294","DOIUrl":"https://doi.org/10.4022/jafib.2294","url":null,"abstract":"<p><strong>Background: </strong>Although catheter ablation (CA) is an accepted therapeutic option for atrial fibrillation (AF), data is lacking concerning the long-term thromboembolic event (TE) and mortality rate of patients after unsuccessful CA for AF.</p><p><strong>Objective: </strong>The aim of the current study was to detect the long-term TE and mortality rate of patients with successful CA (group A) of AF and compared those with unsuccessful ablation (group B).</p><p><strong>Methods: </strong>Following a 4-years of follow-up (FU) 330 patients were included into the groupA, and 105 patients into the group B. Primary outcome was defined as all stroke/TIA occurrence. Secondary outcome was considered as all-cause mortality and stroke - and TIA only occurrence.</p><p><strong>Results: </strong>Seventeen patients developed a stroke/TIA during a median of 5.8 [5.1-7.3] years of FU. In the group A 8 (2.4%) patients developed a stroke/TIA during a FU of 2037 person-years (incidence rate 3.92 per 1000 person-years), compared to 9 patients in the group B during a FU of 726 person-years (incidence rate 12.4 per 1000 person-years). The crude HR for primary outcome was 2.84 (95% CI 1.078-7.48) in the group B compared with the group A. Cumulative TIA-alone incidence (3.97, CI 1.10-14.34, p=0.035) and the annualized TIA-alone incidence rate was significantly higher in the group B. (p=0.029). Neither the mortality rate nor the incidence rate of stroke-alone differed significantly among the groups.</p><p><strong>Conclusions: </strong>The risk of all stroke/TIA and TIA-alone is higher among patients after unsuccessful CA of AF compared to those after successful ablation.</p>","PeriodicalId":15072,"journal":{"name":"Journal of atrial fibrillation","volume":"13 3","pages":"2294"},"PeriodicalIF":0.0,"publicationDate":"2020-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691342/pdf/jafib-13-02294.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39759788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}