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Catheter Ablation and Cognitive Impairment in Atrial Fibrillation. 心房颤动的导管消融与认知功能损害。
Pub Date : 2019-07-01 DOI: 10.1161/circep.119.007521
L. Rosman, M. Burg, R. Lampert
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引用次数: 1
Repeat Ablation for Atrial Fibrillation Recurrence Post Cryoballoon or Radiofrequency Ablation in the FIRE AND ICE Trial 在FIRE和ICE试验中反复消融治疗低温球囊或射频消融后房颤复发
Pub Date : 2019-05-22 DOI: 10.1161/CIRCEP.119.007247
K. Kuck, J. Albenque, K. Chun, A. Fürnkranz, Mathias Busch, Arif Elvan, M. Schlüter, Kendra M. Braegelmann, F. Kueffer, L. Hemingway, T. Arentz, C. Tondo, J. Brugada, K. Kuck, Andreas Metzner, T. Fink, Christine Lemeš, J. Chun, Shaojie Chen, Boris Schmidt, F. Bologna, Stefano Bordignon, A. Elvan, Mohamed Mouden, T. Arentz, Björn Müller-Eschenborn, Amir S. Jadidi, M. Kühne, C. Sticherling, Mathias Busch, Anne Krüger, Edison Abdiou, L. Mont, Eva M Benito Martín, Francisco Alarcón Sanz, P. Neužil, L. Dujka, R. Ruiz-Granell, A. Barrera, Amalio Ruiz Salas, J. Albenque, Serge Boveda, Volker Kühlkamp, Bogdan Stanciu, N. Pérez‐Castellano, J. Villacastín, V. Cañadas Godoy
BackgroundThe FIRE AND ICE trial assessed efficacy and safety of pulmonary vein (PV) isolation using cryoballoon versus radiofrequency current (RFC) ablation in patients with drug refractory, symptomatic, paroxysmal atrial fibrillation (AF). The purpose of the current study was to assess index lesion durability as well as reablation strategy and outcomes in trial patients undergoing a reablation procedure.MethodsPatients with reablation procedures during FIRE AND ICEwere retrospectively consented and enrolled at 13 trial centers. The first reablation for each patient was included in the analysis. Documented arrhythmias before reablation, number and location of reconnected PVs, lesions created during reablations, procedural characteristics, and acute as well as long-term outcomes were assessed.ResultsEighty-nine (36 cryoballoon and 53 RFC) patients were included in this study. Paroxysmal atrial fibrillation was the predominant recurrent arrhythmia (69%) before reablation. Reablations occurred at a median of 173 and 182 days (P=0.54) in the cryoballoon and RFC cohorts, respectively. The number of reconnected PVs was significantly higher in the RFC than the cryoballoon group (2.1±1.4 versus 1.4±1.1; P=0.010), which was driven by significantly more reconnected left superior PVs and markedly more reconnected right superior PVs. The number of (predominantly RFC) lesions applied during reablation was significantly greater in patients originally treated with RFC (3.3±1.3 versus 2.5±1.5; P=0.015) with no difference in overall acute success (P=0.70). After reablation, no differences in procedure-related rehospitalization or antiarrhythmic drug utilization were observed between cohorts.ConclusionsAt reablation, patients originally treated with the cryoballoon had significantly fewer reconnected PVs, which may reflect RFC catheter instability in certain left atrial regions, and thus required fewer lesions for reablation success. Repeat ablations were predominantly performed with RFC and resulted in similar acute success, duration of hospitalization, and antiarrhythmic drug prescription between the study cohorts.
背景:FIRE和ICE试验评估了低温球囊肺静脉隔离与射频电流(RFC)消融治疗难治性、症状性阵发性心房颤动(AF)患者的有效性和安全性。当前研究的目的是评估再消融患者的指数损伤持久性以及再消融策略和结果。方法回顾性分析13个试验中心接受再消融手术的患者。每位患者的第一次再消融被纳入分析。评估再消融前记录的心律失常、再连接pv的数量和位置、再消融过程中产生的病变、手术特征以及急性和长期结果。结果共纳入89例患者,其中低温球囊36例,RFC 53例。再消融前,阵发性心房颤动是主要的复发性心律失常(69%)。在低温球囊组和RFC组中,分别在173天和182天(P=0.54)出现恢复。RFC中重新连接的pv数明显高于低温球囊组(2.1±1.4比1.4±1.1;P=0.010),其驱动因素是左上pv的再连接显著增加,右上pv的再连接显著增加。最初接受RFC治疗的患者在再消融期间应用的病变数量(主要是RFC)明显更多(3.3±1.3 vs 2.5±1.5;P=0.015),总体急性成功率无差异(P=0.70)。再消融后,在手术相关的再住院或抗心律失常药物的使用方面,在队列之间没有观察到差异。结论在再消融术中,原低温球囊治疗患者的PVs再连接明显减少,这可能反映了RFC导管在左心房某些区域的不稳定性,因此需要较少的病变才能成功再消融术。重复消融主要在RFC中进行,并且在研究队列中导致相似的急性成功、住院时间和抗心律失常药物处方。
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引用次数: 103
Correction to: Factors Associated With High-Voltage Impedance and Subcutaneous Implantable Defibrillator Ventricular Fibrillation Conversion Success 修正:与高压阻抗和皮下植入式除颤器心室颤动转换成功相关的因素
Pub Date : 2019-05-01 DOI: 10.1161/hae.0000000000000038
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引用次数: 0
Efficacy and Limitations of Quinidine in Patients With Brugada Syndrome 奎尼丁治疗Brugada综合征的疗效及局限性
Pub Date : 2019-05-01 DOI: 10.1161/CIRCEP.118.007143
A. Mazzanti, E. Tenuta, M. Marino, E. Pagan, M. Morini, M. Memmi, B. Colombi, V. Tibollo, S. Frassoni, A. Curcio, C. Raimondo, A. Maltret, N. Monteforte, R. Bloise, C. Napolitano, R. Bellazzi, V. Bagnardi, S. Priori
Background: Quinidine at high dose is suggested as antiarrhythmic treatment in patients with Brugada Syndrome (BrS), but its efficacy to prevent life-threatening arrhythmic events (LAE) in this pop...
背景:高剂量奎尼丁被推荐用于Brugada综合征(BrS)患者的抗心律失常治疗,但其预防危及生命的心律失常事件(LAE)的效果尚不明确。
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引用次数: 11
Correction to: Secretoneurin Is an Endogenous Calcium/Calmodulin-Dependent Protein Kinase II Inhibitor That Attenuates Ca 2+ -Dependent Arrhythmia 更正:分泌神经蛋白是一种内源性钙/钙调素依赖性蛋白激酶II抑制剂,可减轻ca2 +依赖性心律失常
Pub Date : 2019-05-01 DOI: 10.1161/hae.0000000000000037
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引用次数: 0
Correction to: Year in Review in Cardiac Electrophysiology 修正:心脏电生理学年度回顾
Pub Date : 2019-04-01 DOI: 10.1161/hae.0000000000000036
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引用次数: 0
Sex Differences in Cardiac Arrhythmias 心律失常的性别差异
Pub Date : 2018-01-01 DOI: 10.1007/978-3-319-71135-5_14
A. Ehdaie, S. Chugh
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引用次数: 3
Circulation: Arrhythmia and Electrophysiology Editors and Editorial Board. 循环:心律失常和电生理学编辑和编辑委员会。
Pub Date : 2018-01-01 DOI: 10.1161/HAE.0000000000000027
L. Wilkins
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引用次数: 0
Effect of Sleep-Disordered Breathing on Appropriate Implantable Cardioverter-Defibrillator Therapy in Patients With Heart Failure: A Systematic Review and Meta-Analysis 睡眠呼吸障碍对心衰患者适当植入式心律转复除颤器治疗的影响:系统回顾和荟萃分析
Pub Date : 2017-02-01 DOI: 10.1161/CIRCEP.116.004609
Younghoon Kwon, R. Koene, O. Kwon, J. Kealhofer, S. Adabag, S. Duval
Background— Patients with heart failure and reduced ejection fraction are at increased risk of malignant ventricular arrhythmias. Implantable cardioverter-defibrillator (ICD) is recommended to prevent sudden cardiac death in some of these patients. Sleep-disordered breathing (SDB) is highly prevalent in this population and may impact arrhythmogenicity. We performed a systematic review and meta-analysis of prospective studies that assessed the impact of SDB on ICD therapy. Methods and Results— Relevant prospective studies were identified in the Ovid MEDLINE, EMBASE, and Google Scholar databases. Weighted risk ratios of the association between SDB and appropriate ICD therapies were estimated using random effects meta-analysis. Nine prospective cohort studies (n=1274) were included in this analysis. SDB was present in 52% of the participants. SDB was associated with a 55% higher risk of appropriate ICD therapies (45% versus 28%; risk ratio, 1.55; 95% confidence interval, 1.32–1.83). In a subgroup analysis based on the subtypes of SDB, the risk was higher in both central (risk ratio, 1.50; 95% confidence interval, 1.11–2.02) and obstructive (risk ratio, 1.43; 95% confidence interval, 1.01–2.03) sleep apnea. Conclusions— SDB is associated with an increased risk of appropriate ICD therapy in patients with heart failure and reduced ejection fraction.
背景-心力衰竭和射血分数降低的患者发生恶性室性心律失常的风险增加。植入式心律转复除颤器(ICD)被推荐用于预防这些患者的心源性猝死。睡眠呼吸障碍(SDB)在这一人群中非常普遍,并可能影响心律失常。我们对评估SDB对ICD治疗影响的前瞻性研究进行了系统回顾和荟萃分析。方法和结果:相关的前瞻性研究在Ovid MEDLINE、EMBASE和Google Scholar数据库中被确定。使用随机效应荟萃分析估计SDB与适当的ICD治疗之间关联的加权风险比。本分析纳入了9项前瞻性队列研究(n=1274)。52%的参与者存在SDB。SDB与适当的ICD治疗风险增加55%相关(45%对28%;风险比,1.55;95%置信区间为1.32-1.83)。在基于SDB亚型的亚组分析中,中心风险比(风险比,1.50;95%可信区间,1.11-2.02)和阻塞性(风险比,1.43;95%可信区间,1.01-2.03)睡眠呼吸暂停。结论:在心力衰竭和射血分数降低的患者中,SDB与适当的ICD治疗风险增加相关。
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引用次数: 20
Electrophysiological Twisting: Electrical Alternans in Congenital Dilated Cardiomyopathy. 电生理扭曲:先天性扩张型心肌病的电交替。
Pub Date : 2017-02-01 DOI: 10.1161/CIRCEP.116.004953
Rimsha Arif, A. Hussain, S. Dhillon
A male infant weighing 3.5 kg with unremarkable cardiac examination developed mild oxygen desaturation. ECG showed sinus rhythm with low voltages (Figure [A]). Echocardiogram demonstrated severely dilated and echogenic left ventricle with markedly depressed biventricular systolic function (Movie I in the Data Supplement; Figure [B and C]). The late opening of mitral valve only with atrial contraction (A wave; Figure [C and H]) suggested significant diastolic dysfunction. He developed alternating normal and abnormal QRS complexes in association with hypokalemia (serum potassium 2.3–2.9 mg/dL), generating systolic blood pressure only with …
一名男婴体重3.5公斤,心脏检查无异常,出现轻度氧饱和度下降。心电图显示低电压窦性心律(图[A])。超声心动图显示左心室严重扩张和回声增强,双心室收缩功能明显下降(资料补充影片1;图[B和C])。二尖瓣晚开仅伴心房收缩(A波;图[C和H])提示明显的舒张功能不全。他出现了与低钾血症(血清钾2.3-2.9 mg/dL)相关的交替正常和异常QRS复合物,只有在低钾血症时才产生收缩压。
{"title":"Electrophysiological Twisting: Electrical Alternans in Congenital Dilated Cardiomyopathy.","authors":"Rimsha Arif, A. Hussain, S. Dhillon","doi":"10.1161/CIRCEP.116.004953","DOIUrl":"https://doi.org/10.1161/CIRCEP.116.004953","url":null,"abstract":"A male infant weighing 3.5 kg with unremarkable cardiac examination developed mild oxygen desaturation. ECG showed sinus rhythm with low voltages (Figure [A]). Echocardiogram demonstrated severely dilated and echogenic left ventricle with markedly depressed biventricular systolic function (Movie I in the Data Supplement; Figure [B and C]). The late opening of mitral valve only with atrial contraction (A wave; Figure [C and H]) suggested significant diastolic dysfunction. He developed alternating normal and abnormal QRS complexes in association with hypokalemia (serum potassium 2.3–2.9 mg/dL), generating systolic blood pressure only with …","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77968148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Circulation: Arrhythmia and Electrophysiology
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