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Atrial Tachycardias After Atrial Fibrillation Ablation: How to Manage? 房颤消融后的房性心动过速:如何处理?
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-08-01 DOI: 10.15420/aer.2020.07
Yuan Hung, Shih-Lin Chang, Wei-Shiang Lin, Wen-Yu Lin, Shih-Ann Chen
{"title":"Atrial Tachycardias After Atrial Fibrillation Ablation: How to Manage?","authors":"Yuan Hung,&nbsp;Shih-Lin Chang,&nbsp;Wei-Shiang Lin,&nbsp;Wen-Yu Lin,&nbsp;Shih-Ann Chen","doi":"10.15420/aer.2020.07","DOIUrl":"https://doi.org/10.15420/aer.2020.07","url":null,"abstract":"<p><p>With catheter ablation becoming effective for non-pharmacological management of AF, many cases of atrial tachycardia (AT) after AF ablation have been reported in the past decade. These arrhythmias are often symptomatic and respond poorly to medical therapy. Post-AF-ablation ATs can be classified into the following three categories: focal, macroreentrant and microreentrant ATs. Mapping these ATs is challenging because of atrial remodelling and its complex mechanisms, such as double ATs and multiple-loop ATs. High-density mapping can achieve precise identification of the circuits and critical isthmuses of ATs and improve the efficacy of catheter ablation. The purpose of this article is to review the mechanisms, mapping and ablation strategy, and outcome of ATs after AF ablation.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 2","pages":"54-60"},"PeriodicalIF":3.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/72/aer-09-54.PMC7491065.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38428383","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}
引用次数: 11
Ultrasound-guided Axillary Vein Puncture in Cardiac Lead Implantation: Time to Move to a New Standard Access? 超声引导下腋静脉穿刺心脏导联植入:是时候采用新的标准途径了?
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-08-01 DOI: 10.15420/aer.2020.17
Ana Paula Tagliari, Adriano Nunes Kochi, Bernardo Mastella, Rodrigo Petersen Saadi, Andres di Leoni Ferrari, Luiz Henrique Dussin, Leandro de Moura, Márcio Rodrigo Martins, Eduardo Keller Saadi, Carisi Anne Polanczyk
{"title":"Ultrasound-guided Axillary Vein Puncture in Cardiac Lead Implantation: Time to Move to a New Standard Access?","authors":"Ana Paula Tagliari,&nbsp;Adriano Nunes Kochi,&nbsp;Bernardo Mastella,&nbsp;Rodrigo Petersen Saadi,&nbsp;Andres di Leoni Ferrari,&nbsp;Luiz Henrique Dussin,&nbsp;Leandro de Moura,&nbsp;Márcio Rodrigo Martins,&nbsp;Eduardo Keller Saadi,&nbsp;Carisi Anne Polanczyk","doi":"10.15420/aer.2020.17","DOIUrl":"https://doi.org/10.15420/aer.2020.17","url":null,"abstract":"<p><p>Cardiac stimulation therapy has evolved significantly over the past 30 years. Currently, cardiac implantable electronic devices (CIED) are the mainstream therapy for many potentially lethal heart conditions, such as advanced atrioventricular block or sustained ventricular tachycardia or fibrillation. Despite sometimes being lifesaving, the implant is surgical and therefore carries all the inevitable intrinsic risks. In the process of technology evolution, one of the most important factors is to make it safer for the patient. In the context of CIED implants, complications include accidental puncture of intrathoracic structures. Alternative strategies to intrathoracic subclavian vein puncture include cephalic vein dissection or axillary vein puncture, which can be guided by fluoroscopy, venography or, more recently, ultrasound. In this article, the authors analyse the state of the art of ultrasound-guided axillary vein puncture using evidence from landmark studies in this field.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 2","pages":"78-82"},"PeriodicalIF":3.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/0a/aer-09-78.PMC7491067.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38428386","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}
引用次数: 8
Applications of Machine Learning in Cardiac Electrophysiology. 机器学习在心脏电生理中的应用。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-08-01 DOI: 10.15420/aer.2019.19
Rahul G Muthalaly, Robert M Evans
{"title":"Applications of Machine Learning in Cardiac Electrophysiology.","authors":"Rahul G Muthalaly,&nbsp;Robert M Evans","doi":"10.15420/aer.2019.19","DOIUrl":"https://doi.org/10.15420/aer.2019.19","url":null,"abstract":"<p><p>Artificial intelligence through machine learning (ML) methods is becoming prevalent throughout the world, with increasing adoption in healthcare. Improvements in technology have allowed early applications of machine learning to assist physician efficiency and diagnostic accuracy. In electrophysiology, ML has applications for use in every stage of patient care. However, its use is still in infancy. This article will introduce the potential of ML, before discussing the concept of big data and its pitfalls. The authors review some common ML methods including supervised and unsupervised learning, then examine applications in cardiac electrophysiology. This will focus on surface electrocardiography, intracardiac mapping and cardiac implantable electronic devices. Finally, the article concludes with an overview of how ML may impact on electrophysiology in the future.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 2","pages":"71-77"},"PeriodicalIF":3.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/f5/aer-09-71.PMC7491064.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38428384","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}
引用次数: 7
The Human Atrioventricular Node: Oedipus and the Riddle of the Sphinx. 人类房室结:俄狄浦斯与斯芬克斯之谜。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-08-01 DOI: 10.15420/aer.2020.30
Demosthenes G Katritsis
{"title":"The Human Atrioventricular Node: Oedipus and the Riddle of the Sphinx.","authors":"Demosthenes G Katritsis","doi":"10.15420/aer.2020.30","DOIUrl":"https://doi.org/10.15420/aer.2020.30","url":null,"abstract":"Cardiac pathologists and electrophysiologists have studied the atrioventricular (AV) node for more than 100 years, since 1906, when Tawara first described the inferior extensions of the AV node in the human heart. Still, this important cardiac structure remains “a riddle wrapped up in a mystery, inside an enigma”, to recall the famous Churchill quotation. Perhaps the same can be said about atrioventricular nodal re-entrant tachycardia (AVNRT): it represents the most common regular tachycardia in humans; since 1973 it has been associated with re-entry within or around the node; and still, its exact circuit remains elusive.","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 2","pages":"52-53"},"PeriodicalIF":3.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/94/aer-09-52.PMC7491051.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38428382","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}
引用次数: 1
Atrial Myopathy Underlying Atrial Fibrillation. 心房肌病潜在心房颤动。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-08-01 DOI: 10.15420/aer.2020.13
Harold Rivner, Raul D Mitrani, Jeffrey J Goldberger
{"title":"Atrial Myopathy Underlying Atrial Fibrillation.","authors":"Harold Rivner,&nbsp;Raul D Mitrani,&nbsp;Jeffrey J Goldberger","doi":"10.15420/aer.2020.13","DOIUrl":"https://doi.org/10.15420/aer.2020.13","url":null,"abstract":"<p><p>While AF most often occurs in the setting of atrial disease, current assessment and treatment of patients with AF does not focus on the extent of the atrial myopathy that serves as the substrate for this arrhythmia. Atrial myopathy, in particular atrial fibrosis, may initiate a vicious cycle in which atrial myopathy leads to AF, which in turn leads to a worsening myopathy. Various techniques, including ECG, plasma biomarkers, electroanatomical voltage mapping, echocardiography, and cardiac MRI, can help to identify and quantify aspects of the atrial myopathy. Current therapies, such as catheter ablation, do not directly address the underlying atrial myopathy. There is emerging research showing that by targeting this myopathy we can help decrease the occurrence and burden of AF.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 2","pages":"61-70"},"PeriodicalIF":3.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/67/aer-09-61.PMC7491052.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38428385","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}
引用次数: 23
Cryoballoon Ablation of Atrial Fibrillation in Octogenarians. 低温球囊消融治疗老年房颤。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-08-01 DOI: 10.15420/aer.2020.18
Tauseef Akhtar, Ronald Berger, Joseph E Marine, Usama A Daimee, Hugh Calkins, David Spragg
{"title":"Cryoballoon Ablation of Atrial Fibrillation in Octogenarians.","authors":"Tauseef Akhtar,&nbsp;Ronald Berger,&nbsp;Joseph E Marine,&nbsp;Usama A Daimee,&nbsp;Hugh Calkins,&nbsp;David Spragg","doi":"10.15420/aer.2020.18","DOIUrl":"https://doi.org/10.15420/aer.2020.18","url":null,"abstract":"<p><p>A significant proportion of AF patients with advanced age are being treated in clinical practice. Cryoballoon ablation of AF, given its shorter procedure time and comparable efficacy to radiofrequency ablation, has rapidly become a commonly used tool for AF ablation. Data regarding the outcomes of cryoballoon ablation of AF in octogenarians are limited because of the exclusion of this age group in the previous studies. The authors report outcomes of 15 octogenarian AF patients undergoing index cryoballoon ablation at a single centre. The mean age of the included patients was 83 ± 3 years. In total, 13 patients (87%) presented with paroxysmal AF, and two (13%) had long-standing persistent AF. At 6 and 12 months of follow-up, freedom from AF was 80% and 70%, respectively. None of the patients suffered any procedure-related complications. Cryoballoon ablation appears to be a safe and effective approach for treating symptomatic AF refractory to antiarrhythmic drug therapy in octogenarian patients, based on outcomes in this cohort. These findings require further validation in prospective randomised studies with larger sample sizes.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 2","pages":"104-107"},"PeriodicalIF":3.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/74/aer-09-104.PMC7491081.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38425802","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}
引用次数: 8
The Convergent Atrial Fibrillation Ablation Procedure: Evolution of a Multidisciplinary Approach to Atrial Fibrillation Management. 融合性心房颤动消融程序：心房颤动管理多学科方法的发展。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-08-01 DOI: 10.15420/aer.2019.20
Karan Wats, Andy Kiser, Kevin Makati, Nitesh Sood, David DeLurgio, Yisachar Greenberg, Felix Yang
{"title":"The Convergent Atrial Fibrillation Ablation Procedure: Evolution of a Multidisciplinary Approach to Atrial Fibrillation Management.","authors":"Karan Wats,&nbsp;Andy Kiser,&nbsp;Kevin Makati,&nbsp;Nitesh Sood,&nbsp;David DeLurgio,&nbsp;Yisachar Greenberg,&nbsp;Felix Yang","doi":"10.15420/aer.2019.20","DOIUrl":"10.15420/aer.2019.20","url":null,"abstract":"<p><p>The treatment of AF has evolved over the past decade with increasing use of catheter ablation in patients refractory to medical therapy. While pulmonary vein isolation using endocardial catheter ablation has been successful in paroxysmal AF, the results have been more controversial in patients with long-standing persistent AF where extrapulmonary venous foci are increasingly recognised in the initiation and maintenance of AF. Hybrid ablation is the integration of minimally invasive epicardial ablation with endocardial catheter ablation, and has been increasingly used in this population with better results. The aim of this article was to analyse and discuss the evidence for the integration of catheter and minimally invasive surgical approaches to treat AF with specific focus on convergent ablation and exclusion of the left atrial appendage using a surgically applied clip.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 2","pages":"88-96"},"PeriodicalIF":3.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/f1/aer-09-88.PMC7491068.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38425800","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}
引用次数: 21
Mobile Health for Cardiovascular Disease: The New Frontier for AF Management: Observations from the Huawei Heart Study and mAFA-II Randomised Trial. 心血管疾病的移动医疗:房颤管理的新前沿:来自华为心脏研究和mAFA-II随机试验的观察
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-06-03 DOI: 10.15420/aer.2020.12
Yutao Guo, Gregory Yh Lip
{"title":"Mobile Health for Cardiovascular Disease: The New Frontier for AF Management: Observations from the Huawei Heart Study and mAFA-II Randomised Trial.","authors":"Yutao Guo,&nbsp;Gregory Yh Lip","doi":"10.15420/aer.2020.12","DOIUrl":"https://doi.org/10.15420/aer.2020.12","url":null,"abstract":"Cardiovascular disease (CVD) is the leading cause of death and disease globally, representing 31% of all global deaths. The traditional management of CVD has largely depended on the face-to-face clinic visits once the clinical events occurred. CVD contributes to and exacerbates the economic burden on households. However, most of these complications could be avoided with early diagnosis and effective prevention or interventions.","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 1","pages":"5-7"},"PeriodicalIF":3.0,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/d6/aer-09-5.PMC7330727.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38135932","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}
引用次数: 6
Use of Electrophysiological Studies in Transcatheter Aortic Valve Implantation. 电生理研究在经导管主动脉瓣植入术中的应用。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-06-03 DOI: 10.15420/aer.2019.38.3
Oholi Tovia-Brodie, Yoav Michowitz, Bernard Belhassen
{"title":"Use of Electrophysiological Studies in Transcatheter Aortic Valve Implantation.","authors":"Oholi Tovia-Brodie,&nbsp;Yoav Michowitz,&nbsp;Bernard Belhassen","doi":"10.15420/aer.2019.38.3","DOIUrl":"https://doi.org/10.15420/aer.2019.38.3","url":null,"abstract":"<p><p>New conduction disturbances requiring permanent pacemaker implantation remain common complications following transcatheter aortic valve implantation (TAVI). It has been suggested that electrophysiological studies could help identify patients who will require permanent pacemaker implantation after TAVI. This article summarises contemporary data on the use of electrophysiological studies in patients undergoing TAVI.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 1","pages":"20-27"},"PeriodicalIF":3.0,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/57/d7/aer-09-20.PMC7330728.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38135935","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}
引用次数: 8
The Role of the Electrophysiologist in Convergent Ablation. 电生理学家在会聚消融中的作用。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2020-06-03 DOI: 10.15420/aer.2019.06
Nadeev Wijesuriya, Nikos Papageorgiou, Edd Maclean, Bunny Saberwal, Syed Ahsan
{"title":"The Role of the Electrophysiologist in Convergent Ablation.","authors":"Nadeev Wijesuriya,&nbsp;Nikos Papageorgiou,&nbsp;Edd Maclean,&nbsp;Bunny Saberwal,&nbsp;Syed Ahsan","doi":"10.15420/aer.2019.06","DOIUrl":"https://doi.org/10.15420/aer.2019.06","url":null,"abstract":"<p><p>Catheter ablation is a well-established treatment for patients with AF in whom sinus rhythm is desired. Both radiofrequency catheter ablation and cryoablation are widely performed, rapidly developing techniques. Convergent ablation is a novel hybrid technique combining an endocardial radiofrequency ablation with a minimally invasive epicardial surgical ablation. Some suggest that hybrid ablation may be more effective than lone endocardial ablation in achieving the elusive goal of maintaining sinus rhythm in patients with non-paroxysmal AF. In this article, the authors examine the safety and efficacy of catheter ablation and convergent ablation for long-standing, persistent AF. We also outline the crucial role that electrophysiologists play, not only as a procedure operator, but also as the coordinator and developer of this multidisciplinary service.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"9 1","pages":"8-14"},"PeriodicalIF":3.0,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/5a/aer-09-8.PMC7330726.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38135933","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}
引用次数: 3
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