Abstract:
INTRODUCTION:Sinus node dysfunction (SND) commonly manifests with atrial arrhythmias alternating with sinus pauses and sinus bradycardia. The underlying process is thought to be because of atrial fibrosis. We assessed the value of atrial fibrosis, quantified using late gadolinium enhanced-MRI (LGE-MRI), in predicting significant SND requiring pacemaker implant. METHODS:Three hundred forty-four patients with atrial fibrillation (AF) presenting for catheter ablation underwent LGE-MRI. Left atrial (LA) fibrosis was quantified in all patients and right atrial (RA) fibrosis in 134 patients. All patients underwent catheter ablation with pulmonary vein isolation with posterior wall and septal debulking. Patients were followed prospectively for 329 ± 245 days. Ambulatory monitoring was instituted every 3 months. Symptomatic pauses and bradycardia were treated with pacemaker implantation per published guidelines. RESULTS:The average patient age was 65 ± 12 years. The average wall fibrosis was 16.7 ± 11.1% in the LA, and 5.3 ± 6.4% in the RA. RA fibrosis was correlated with LA fibrosis (R(2) = 0.26; P < 0.01). Patients were divided into 4 stages of LA fibrosis (Utah I: <5%, Utah II: 5-20%, Utah III: 20-35%, Utah IV: >35%). Twenty-two patients (mean atrial fibrosis, 23.9%) required pacemaker implantation during follow-up. Univariate and multivariate analysis identified LA fibrosis stage (OR, 2.2) as a significant predictor for pacemaker implantation with an area under the curve of 0.704. CONCLUSIONS:In patients with AF presenting for catheter ablation, LGE-MRI quantification of atrial fibrosis demonstrates preferential LA involvement. Significant atrial fibrosis is associated with clinically significant SND requiring pacemaker implantation.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Akoum N,McGann C,Vergara G,Badger T,Ranjan R,Mahnkopf C,Kholmovski E,Macleod R,Marrouche Ndoi
10.1111/j.1540-8167.2011.02140.xsubject
Has Abstractpub_date
2012-01-01 00:00:00pages
44-50issue
1eissn
1045-3873issn
1540-8167journal_volume
23pub_type
杂志文章abstract:BACKGROUND:Atrio-esophageal fistulas have been described as a consequence of radiofrequency (RF) ablation for the treatment of atrial fibrillation (AF). However, whether cryoablation can avoid this potential fatal complication remains unclear. METHODS AND RESULTS:We studied the effects of direct application of RF and ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.00790.x
更新日期:2007-06-01 00:00:00
abstract:INTRODUCTION:Bundle branch reentry (BBR) typically occurs in patients with dilated cardiomyopathy and infra-Hisian conduction system disease. The macroreentrant circuit of BBR is confined to the His-Purkinje system (HPS) and ventricular myocardium. As such, the atrioventricular (AV) node plays no role in the tachycardi...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1995.tb00414.x
更新日期:1995-05-01 00:00:00
abstract::The debate between the use of radiofrequency (RF) or cryoenergy for ablation near the atrioventricular (AV) conducting system or small coronaries has been fueled by the relative efficacies and risks of the two technologies, particularly in smaller hearts. The manuscript by Schneider et al adds another chapter to that ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 评论,社论
doi:10.1111/jce.13987
更新日期:2019-07-01 00:00:00
abstract:INTRODUCTION:Complex fractionated atrial electrograms (CFAE) may identify critical sites for perpetuation of atrial fibrillation (AF) and provide useful targets for ablation. Current assessment of CFAE is subjective; automated detection algorithms may improve reproducibility, but their utility in guiding ablation has n...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01189.x
更新日期:2008-06-01 00:00:00
abstract:INTRODUCTION:The most frequent complications of AF ablation (AFA) are related to vascular access, but there is little evidence as to how these can be minimized. METHODS:Consecutive patients undergoing AFA at a high-volume center received either standard care (Group S) or routine ultrasound-guided vascular access (Grou...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12404
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Data comparing dabigatran with rivaroxaban regarding the resolution of left atrial/left atrial appendage (LA/LAA) thrombus in patients with nonvalvular atrial fibrillation (AF) are scarce. This study aimed to compare the efficacy and safety of dabigatran vs rivaroxaban regarding the resolution of LA/LAA thro...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14365
更新日期:2020-03-01 00:00:00
abstract::The search for a mechanism to explain atrial fibrillation (AF) has lasted for over a century and continues. Significant progress in understanding this arrhythmia accelerated with the era of operative treatment of this arrhythmia and intensified with the advent of catheter ablation. Through considerable trial and some ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 历史文章,杂志文章
doi:10.1111/j.1540-8167.2006.00738.x
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Unfortunately, some patients with long QT syndrome (LQTS) experience breakthrough cardiac events (BCEs) despite maximal therapy. Small studies have shown that refractory LQTS cases may benefit from intentional permanent atrial pacing (IPAP). As such, we sought to determine the genotype-specific utilization a...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14920
更新日期:2021-01-29 00:00:00
abstract::Calcium/calmodulin-dependent kinase II (CaMKII) is a multifunctional serine/threonine kinase widely distributed in a number of tissue types. Activation of CaMKII has been linked to important downstream physiological processes, including apoptosis, hypertrophy, and arrhythmia in the heart. Pharmacological or genetic in...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01295.x
更新日期:2008-12-01 00:00:00
abstract:INTRODUCTION:Torsades de pointes have been observed during treatment with droperidol, a butyrophenone neuroleptic agent. Our objectives were (1) to characterize the effects of droperidol on cardiac repolarization and (2) to evaluate effects of droperidol on a major time-dependent outward potassium current involved in c...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1999.tb00224.x
更新日期:1999-12-01 00:00:00
abstract:UNLABELLED:VT Ablation in Apical Hypertrophic Cardiomyopathy. INTRODUCTION:Monomorphic ventricular tachycardia (VT) is uncommon in apical hypertrophic cardiomyopathy (HCM). The purpose of this study was to define the substrate and role of catheter ablation for VT in apical HCM. METHODS:Four patients with apical HCM ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2010.01875.x
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Although premature beats originating in areas of ischemia have been shown to be important in initiating ventricular fibrillation (VF), the participation of the ischemic zone in maintenance of VF has not been investigated. METHODS AND RESULTS:Ten normal dogs underwent induction of two separate episodes of ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1999.tb00282.x
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Low conduction velocity (CV) in the area showing low electrogram amplitude (EA) is characteristic of reentry circuit of atypical atrial flutter (AFL). The quantitative relationship between CV and EA remains unclear. We characterized AFL reentry circuit in the right atrium (RA), focusing on the relationship b...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12329
更新日期:2014-04-01 00:00:00
abstract:INTRODUCTION:To explore the relationship between recurrence of atrial fibrillation (AF) and the autonomic nervous activity evaluated by heart rate variability (HRV) indices after radiofrequency catheter ablation (RFCA) in the early period. METHODS:We enrolled 102 patients with paroxysmal AF and tested the HRV indices ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14448
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Cardiac sympathetic activation facilitates atrial electrical remodeling during atrial fibrillation (AF). Selective ablation of the distal part of the ligament of Marshall (LOMLSPV ) could decrease cardiac sympathetic innervation. This study aimed to investigate the effects of LOMLSPV ablation on atrial ele...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13658
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Atrial tachycardias (ATs) are commonly observed following catheter ablation of atrial fibrillation (AF). The aim of this study was to identify ECG characteristics that differentiate focal from macroreentrant ATs after circumferential pulmonary vein isolation (CPVI). METHODS AND RESULTS:One hundred and twent...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2010.02002.x
更新日期:2011-07-01 00:00:00
abstract:UNLABELLED:Baroreflex sensitivity in paced patients. INTRODUCTION:The baroreceptor-heart rate (HR) reflex has prognostic value in cardiovascular medicine. However, it cannot be used in chronotropically incompetent or paced patients. In healthy subjects, the baroreceptor-stroke volume (SV) reflex, with power spectral a...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.40767.x
更新日期:2005-07-01 00:00:00
abstract::A 70-year-old man with a single-chamber implantable cardioverter defibrillator (ICD) placed for ventricular tachycardia presented with syncope. He was found to have ventricular flutter/fibrillation with capacitor charge time in excess of 1 minute before defibrillation. The excessive charge time was secondary to ICD ca...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.01078.x
更新日期:2001-09-01 00:00:00
abstract::Torsades de pointes is a potentially lethal arrhythmia that occasionally appears as an adverse effect of pharmacotherapy. Recently developed understanding of the underlying electrophysiology allows better estimation of the drug-induced risks and explains the failures of older approaches through the surface ECG. This a...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1046/j.1540-8167.2004.03534.x
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Ablation of atrial tachycardia (AT) that occurs after cardiac surgery or prior ablation often requires complex lesion sets. In combination with the pre-existing atrial scar, these lesion sets may result in inadvertent intra-atrial conduction block. This study reports the phenomenon of incidental isolation of...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14037
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Thrombi form mainly in the left rather than the right atria of patients with atrial fibrillation (AF), the reason of this predilection being unknown. OBJECTIVE:The purpose of this study was to investigate whether atrial-specific differences in endothelial damage, leukocyte activation, platelet stimulation, ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/jce.12312
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) is commonly used to manage heart failure, yet published guidelines do not distinguish between recommendations for pacemakers (CRT-P) and defibrillators (CRT-D) despite significant differences in size, longevity, and cost between these devices. The purpose of this study...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12951
更新日期:2016-06-01 00:00:00
abstract::About one fifth of all deaths occur suddenly and unexpectedly, often as the first manifestation of heart disease. Several tests have been developed during the past 2 decades for risk stratification of such an event, but only a minority of victims can be identified as being at high risk before sudden death occurs. Impr...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.14.ss9.1.x
更新日期:2003-09-01 00:00:00
abstract:INTRODUCTION:Two hypotheses have been proposed to explain the mechanisms of vulnerability and related failure of defibrillation therapy: the cross-field-induced critical point hypothesis and the virtual electrode-induced phase singularity hypothesis. These two hypotheses predict the opposite effect of preshock repolari...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb00172.x
更新日期:2000-09-01 00:00:00
abstract:INTRODUCTION:The upper limit of vulnerability (ULV) correlates with the defibrillation threshold (DFT). The ULV can be determined with a single episode of ventricular fibrillation and is more reproducible than the single-point DFT. The critical-point hypothesis of defibrillation predicts that the relation between the U...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.1998.tb00922.x
更新日期:1998-04-01 00:00:00
abstract:INTRODUCTION:Evaluation of conduction over a linear ablation lesion at the anterior mitral annulus can be time-consuming and difficult during ongoing radiofrequency application. The purpose of this study was to validate conduction time from the beginning of the p wave and from the coronary sinus ostium to the left atri...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12670
更新日期:2015-07-01 00:00:00
abstract:INTRODUCTION:Endpoints confirming block in the critical isthmus in sinus rhythm and with pace mapping have not been established. METHODS AND RESULTS:A 44-year-old man with a history of Tetralogy of Fallot presented with recurrent ventricular tachycardia (VT). Entrainment mapping was consistent with a macroreentrant ci...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01596.x
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:Recent studies described the occurrence of conduction block within pulmonary veins. The purpose of this study was to evaluate the prevalence of exit block during arrhythmias that arise in pulmonary veins. METHODS AND RESULTS:Twenty-five patients with atrial tachycardia/fibrillation underwent successful ab...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb00332.x
更新日期:2000-04-01 00:00:00
abstract::Idiopathic ventricular tachycardia (IVT) in patients without structural heart disease commonly arises from the right or left outflow tracts, but there remain arrhythmias that can only be ablated by an epicardial approach. We report a case of an epicardial ventricular tachycardia originating within the left main corona...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.40773.x
更新日期:2005-11-01 00:00:00
abstract:INTRODUCTION:The autonomic nervous system richly innervates the peri-AV nodal region and may be activated during radiofrequency (RF) ablation for AV nodal reentrant tachycardia, resulting in the generation of junctional tachycardia. The purpose of this prospective study was to determine the role of the autonomic nervou...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1999.tb00642.x
更新日期:1999-01-01 00:00:00