Pub Date : 2019-07-01DOI: 10.1161/circep.119.007521
L. Rosman, M. Burg, R. Lampert
{"title":"Catheter Ablation and Cognitive Impairment in Atrial Fibrillation.","authors":"L. Rosman, M. Burg, R. Lampert","doi":"10.1161/circep.119.007521","DOIUrl":"https://doi.org/10.1161/circep.119.007521","url":null,"abstract":"","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85001628","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}
Pub Date : 2019-05-22DOI: 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
Background The 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. Methods Patients 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. Results Eighty-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. Conclusions At 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。
{"title":"Repeat Ablation for Atrial Fibrillation Recurrence Post Cryoballoon or Radiofrequency Ablation in the FIRE AND ICE Trial","authors":"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","doi":"10.1161/CIRCEP.119.007247","DOIUrl":"https://doi.org/10.1161/CIRCEP.119.007247","url":null,"abstract":"Background\u0000The 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.\u0000\u0000\u0000Methods\u0000Patients 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.\u0000\u0000\u0000Results\u0000Eighty-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.\u0000\u0000\u0000Conclusions\u0000At 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.","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73625063","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}
Pub Date : 2019-05-01DOI: 10.1161/hae.0000000000000038
{"title":"Correction to: Factors Associated With High-Voltage Impedance and Subcutaneous Implantable Defibrillator Ventricular Fibrillation Conversion Success","authors":"","doi":"10.1161/hae.0000000000000038","DOIUrl":"https://doi.org/10.1161/hae.0000000000000038","url":null,"abstract":"","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76038536","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}
Pub Date : 2019-05-01DOI: 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...
{"title":"Efficacy and Limitations of Quinidine in Patients With Brugada Syndrome","authors":"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","doi":"10.1161/CIRCEP.118.007143","DOIUrl":"https://doi.org/10.1161/CIRCEP.118.007143","url":null,"abstract":"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...","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80056907","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}
Pub Date : 2019-05-01DOI: 10.1161/hae.0000000000000037
{"title":"Correction to: Secretoneurin Is an Endogenous Calcium/Calmodulin-Dependent Protein Kinase II Inhibitor That Attenuates Ca\u0000 2+\u0000 -Dependent Arrhythmia","authors":"","doi":"10.1161/hae.0000000000000037","DOIUrl":"https://doi.org/10.1161/hae.0000000000000037","url":null,"abstract":"","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"195 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75541556","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}
Pub Date : 2019-04-01DOI: 10.1161/hae.0000000000000036
{"title":"Correction to: Year in Review in Cardiac Electrophysiology","authors":"","doi":"10.1161/hae.0000000000000036","DOIUrl":"https://doi.org/10.1161/hae.0000000000000036","url":null,"abstract":"","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77604775","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}
Pub Date : 2018-01-01DOI: 10.1007/978-3-319-71135-5_14
A. Ehdaie, S. Chugh
{"title":"Sex Differences in Cardiac Arrhythmias","authors":"A. Ehdaie, S. Chugh","doi":"10.1007/978-3-319-71135-5_14","DOIUrl":"https://doi.org/10.1007/978-3-319-71135-5_14","url":null,"abstract":"","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"92 1","pages":"247-269"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79653980","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}
Pub Date : 2018-01-01DOI: 10.1161/HAE.0000000000000027
L. Wilkins
{"title":"Circulation: Arrhythmia and Electrophysiology Editors and Editorial Board.","authors":"L. Wilkins","doi":"10.1161/HAE.0000000000000027","DOIUrl":"https://doi.org/10.1161/HAE.0000000000000027","url":null,"abstract":"","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"152 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73514287","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}
Pub Date : 2017-02-01DOI: 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 …
{"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}
Pub Date : 2017-02-01DOI: 10.1161/CIRCEP.117.004956
A. Shetty, C. Rinaldi
The implant rates of cardiac resynchronization therapy (CRT) increased rapidly through the first decade of this millennium but have plateaued more recently and may even have started to decrease in Europe and the United States.1,2 The upgrade of existing pacemakers and implantable cardioverter defibrillators (ICDs) to CRT currently accounts for a quarter of all CRT procedures3 and is a potential growth area. Kiehl et al4 recently showed that 12.3% of patients with preserved left ventricular (LV) function who were implanted with a pacemaker for complete heart block developed pacing-induced cardiomyopathy, but the small proportion that underwent CRT upgrades responded well echocardiographically. The 2012 ACCF/AHA/HRS (American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society) Guideline5 gives a class IIA recommendation to CRT upgrade at generator replacement if LV function is severely impaired and the expected pacing requirement is high. The 2013 ESC (European Society of Cardiology) guideline6 goes further and gives a class I (level of evidence B) recommendation to CRT upgrade in device patients with LV ejection fraction 150 ms are most likely to respond to de novo CRT therapy,7 it is not clear whether upgrade patients respond in the same way. See Article by Vamos et al In this respect, Vamos et al8 are to be congratulated for adding to the …
{"title":"Cardiac Resynchronization Therapy Upgrade: Verschlimmbesserung?","authors":"A. Shetty, C. Rinaldi","doi":"10.1161/CIRCEP.117.004956","DOIUrl":"https://doi.org/10.1161/CIRCEP.117.004956","url":null,"abstract":"The implant rates of cardiac resynchronization therapy (CRT) increased rapidly through the first decade of this millennium but have plateaued more recently and may even have started to decrease in Europe and the United States.1,2 The upgrade of existing pacemakers and implantable cardioverter defibrillators (ICDs) to CRT currently accounts for a quarter of all CRT procedures3 and is a potential growth area. Kiehl et al4 recently showed that 12.3% of patients with preserved left ventricular (LV) function who were implanted with a pacemaker for complete heart block developed pacing-induced cardiomyopathy, but the small proportion that underwent CRT upgrades responded well echocardiographically. The 2012 ACCF/AHA/HRS (American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society) Guideline5 gives a class IIA recommendation to CRT upgrade at generator replacement if LV function is severely impaired and the expected pacing requirement is high. The 2013 ESC (European Society of Cardiology) guideline6 goes further and gives a class I (level of evidence B) recommendation to CRT upgrade in device patients with LV ejection fraction 150 ms are most likely to respond to de novo CRT therapy,7 it is not clear whether upgrade patients respond in the same way.\u0000\u0000See Article by Vamos et al \u0000\u0000In this respect, Vamos et al8 are to be congratulated for adding to the …","PeriodicalId":10167,"journal":{"name":"Circulation: Arrhythmia and Electrophysiology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91242276","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}
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