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BackgroundAtrial fibrillation (AF) is the most prevalent cardiac arrhythmia worldwide, posing significant health burdens. Pulsed field ablation (PFA) is an emerging non-thermal technique that is gaining traction due to the ability to selectively target myocardial cells and minimize damage to surrounding tissues.
In this weeks View, Dr. Eagle looks at arrhythmia recurrence and rhythm control after catheter ablation for atrial fibrillation. He then discusses long-term outcomes in transthyretin amyloid cardiomyopathy in patients treated with tafamidis.
Introduction Catheter ablation is an effective and safe strategy for treating atrial fibrillation patients. Nevertheless, studies on the long-term outcomes of catheter ablation in patients with dilated cardiomyopathy are limited. Among the catheter ablation group, 58.7% ( n = 27) had persistent atrial fibrillation.
Arrhythmias are common in patients with hypertrophic cardiomyopathy (HCM) and are associated with increased morbidity and mortality. Ventricular arrhythmias (VA) are less common compared to supraventricular arrhythmias yet are associated with worse outcomes in this patient population.
A gradual increase in arrhythmia recurrences during 12 months after catheter ablation (CA) of atrial fibrillation (AF) is still reported.1 A gradual increase in arrhythmia recurrences during 12 months after catheter ablation (CA) of atrial fibrillation (AF) is still reported.1
Cheng and Zhang to our paper1, we note that despite ARVC being a relatively uncommon cardiomyopathy, we uniquely report on a large clinical experience with very long-term follow-up after VT ablation and confirm a high incidence of atrial flutter (AFL) and the effectiveness and low risk of catheter ablation of AFL.
Catheter ablation of atrial fibrillation in infiltrative cardiomyopathies ABSTRACT Atrial and ventricular arrhythmias are common in patients with Infiltrative heart diseases. AF is the most common arrhythmia identified in patients with amyloidosis due to cellular infiltration and atrial dilation.
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a family inherited cardiomyopathy associated with ventricular arrhythmias. With the development of molecular biology, histology, imaging, and other dia.
Overview of the study population and effects observed after catheter ablation for atrial fibrillation. Herein we describe the effects of catheter ablation on AF burden, arrhythmia recurrences, and ventricular function in end-stage HF. to 39.18.3% ( p <0.001) following ablation. PVI, pulmonary vein isolation.
Cardiac amyloidosis (CA) involves the abnormal accumulation of misfolded proteins in the heart muscle, leading to restrictive cardiomyopathy.1 Atrial arrhythmias (AA), particularly atrial fibrillation (AF), are prevalent in CA and may impact long-term cardiovascular outcomes, prompting an investigation into early rhythm management strategies.2
As a result, different alternative septal reduction approaches, including transapical septal myomectomy 4, and even catheter-based radiofrequency ablation 5 have been described.
Tachycardia-induced cardiomyopathy refers to changes in cardiac structure and function that result from rapid arrhythmia and can manifest as a continuous or recurrent event. Cardiomyopathy induced by atrial ta.
Ablation will be performed with the use of a substrate-based approach in which the myocardial scar is mapped and ablated while the heart remains predominantly in sinus rhythm. Cardiovascular mortality, driven by sudden cardiac death, is the main reason for dying while waiting for heart transplantation (HTx).
Objective The objective is to evaluate the 5-year follow-up results of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) for hypertrophic obstructive cardiomyopathy (HOCM), including clinical status, electrocardiographic and echocardiographic characteristics. Methods 27 patients (age: 44.3±15.5
Recent advancements in catheter ablation for structural ventricular tachycardia (VT), such as high-density mapping and cardiac imaging-based detection of target areas, have significantly improved the efficacy of ablation procedures.
Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is often accompanied by atrial fibrillation (AF), atrial flutter (AFL), and atrial tachycardia (AT), which are difficult to control because beta-blockers and antiarrhythmic drugs can worsen heart failure (HF).
She remained in flutter despite diuresis, rate control with metoprolol and digoxin, cardioversion, and ablation. She underwent a cesarean section at 32 weeks given ongoing arrhythmia and heart failure symptoms. Her arrhythmia burden continued to lessen. Skin fragility and poor uterine tone were noted intraoperatively.
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a disease characterised by fibrofatty replacement of the ventricular myocardium due to specific mutations, leading to ventricular arrhythmias and sudden cardiac death. Emerging evidence suggests that combining flecainide and bisoprolol may be efficacious.
Supraventricular tachycardias are the most common arrhythmias that occur during pregnancy. When pharmacologic therapy fails, fluoroless catheter ablation utilizing electroanatomic mapping systems and intracardiac echocardiography (ICE) may be considered. Pharmacologic therapy is often preferred in pregnant patients.
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. BACKGROUND:Epicardial approach in ventricular tachycardia (VT) ablation is still regarded as a second-step strategy, due to the risk of complications. The epicardial approach was considered useful if epicardial ablation was performed after epicardial mapping.
Recent research has identified cases of sustained FAT originating from the interatrial septum (IAS); a subset of cases presents a unique challenge, with foci originating from the peri-patent foramen ovale (peri-PFO), requiring specialized management during catheter ablation.
Abstract Introduction Premature ventricular complexes (PVCs) are the most common ventricular arrhythmia that are encountered in the clinical practice. Recent data suggests that high PVC burden may lead to the development of PVC-induced cardiomyopathy (PVC-CM) even in patients without structural heart disease.
Hypertrophic cardiomyopathy is a genetic disorder with a guarded prognosis which occurs in about 1:500 individuals. The most common symptom of hypertrophic cardiomyopathy is dyspnoea which occurs in 90% of cases and is due to elevated left ventricular diastolic pressures as a consequence of the diastolic dysfunction.
In all probability, this dilation is a form of atrial tachycardia and atrial cardiomyopathy. Spatial relationship of sites for atrial fibrillation drivers and atrial tachycardia in patients with both arrhythmias July 2017 International Journal of Cardiology 248(3) AF begets AF. Implications for electrophysiologists.
Circulation: Arrhythmia and Electrophysiology, Volume 16, Issue 11 , Page e012191, November 1, 2023. BACKGROUND:The cause of hypertrophic cardiomyopathy (HCM) in the young is highly varied. Ablation was acutely successful in 13 of 14 patients with recurrence in 3.
Atrial fibrillation (AF), a common cardiac arrhythmia, often results in significant atrial remodeling, including atrial cardiomyopathy and dilatation. Notably, aFMR is linked to a higher recurrence rate of AF after catheter ablation. Notably, aFMR is linked to a higher recurrence rate of AF after catheter ablation.
Belhassen’s ventricular tachycardia is an uncommon arrhythmia in infants. Ivabradine, which has no inotropic effects, has been increasingly utilized for treatment of refractory arrhythmias. Ivabradine, which has no inotropic effects, has been increasingly utilized for treatment of refractory arrhythmias.
Atrial tachycardia (AT) originating from the left atrial appendage (LAA) is uncommon and the most difficult arrhythmia to eliminate. Therefore, we present the case of a 5-year-old girl with tachycardia-induced.
ABSTRACT Atrial fibrillation (AF) is the most common cause of arrhythmia-induced cardiomyopathy. Effective management strategies include medical therapy for rate and rhythm control, catheter ablation (CA), and goal-directed medical therapy.
Background:Obstructive sleep apnoea (OSA) is highly prevalent in patients with obstructive hypertrophic cardiomyopathy (oHCM), and the severity of OSA appears to worsen following septal myoectomy. Circulation, Volume 150, Issue Suppl_1 , Page A4139913-A4139913, November 12, 2024. During a median follow-up of 23.1
It was ablated. == MY Comment , by K EN G RAUER, MD ( 6/28 /2023 ): == There is a tendency for clinicians to interpret cardiac arrhythmias in binary fashion. In my opinion — it is a mistake to interpret arrhythmias in strict "binary" fashion — since rather than "either/or" — optimal interpretation is more of a probability statement.
Fragmented QRS is a marker of myocardial scar and consequent arrhythmias in ischemic and nonischemic cardiomyopathy. Multiple accessory pathways can occur and radiofrequency catheter ablation is effective. Splintered and polyphasic QRS of Ebstein’s anomaly can also be considered as fragmented QRS as per the new terminology.
Medical treatment for heart failure was optimized and after a few days the patient was discharged with referral to VT ablation procedure. There is almost always the possibility of exceptions ( ie, prior infarction or cardiomyopathy that might result in a very abnormal baseline tracing ).
They had a history of non-ischemic cardiomyopathy (EF 30%), as well as PCI with one stent. Ablation to prevent recurrent flutter was performed. In most middle-aged patients with a history of cardiomyopathy, a WCT will usually be VT. Fragmentation suggests scarring (ie, from prior MI and/or cardiomyopathy ).
My understanding is that the decision was made for today's patient to be formally evaluated by EP cardiology with consideration given to ablation and/or insertion of an ICD ( I mplantable C ardioverter D efibrillator ). I offer the above as retrospective reflection to stimulate discussion on actions to consider.
See this even more interesting and more dramatic and fascinating case: History of Hypertrophic Cardiomyopathy (HOCM), with Tachycardia and High Lactate = My Comment by K EN G RAUER, MD ( 10/28 /2023 ): = QUESTION: For clarity in Figure-1 — I've reproduced today's ECG without the long lead rhythm strip. Abnormal ST-T wave abnormalities.
The patient was found to have a "concealed" posteroseptal pathway (WPW without delta waves) confirmed to have SVT at EP study and was ablated. Here is the Electrophysilogist's note: "Only 1 pathway attachment could be ablated, the second one deep within the CS could not be ablated with high power.
By 1909 ECGs were being used to diagnose cases of arrhythmia; by 1910 to diagnose indicators of a heart attack. to develop an AI-algorithm for identifying and triaging patients with Hypertrophic cardiomyopathy (HCM), a condition currently undetected in 80% of cases.
Atrail electroanatomic voltage mapping (Atrial-EAVM) and late gadolinium enhancement imaging (Atrial-LGE) quantify the functional and anatomic extent of atrial fibrosis, a central component of atrial cardiomyopathy. Both measures predicted the likelihood of arrhythmia recurrence. Key Finding. Take Home Message.
Whenever I see PVCs with the morphology and axis seen in todays case I always look for signs of AC ( Arrhythmogenic Cardiomyopathy ). Arrhythmogenic cardiomyopathy often manifests with PVCs from the RV. The ECG in Figure-1 however, shows no signs of arrhythmogenic cardiomyopathy. What will be your next measure?
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