Abstract:
INTRODUCTION:Catheter ablation of atrial fibrillation (AF) currently relies on eliminating triggers, and no reliable method exists to map the arrhythmia itself to identify ablation targets. The aim of this multicenter study was to define the use of Focal Impulse and Rotor Modulation (FIRM) for identifying ablation targets. METHODS:We prospectively enrolled the first (n = 14, 11 males) consecutive patients undergoing FIRM-guided ablation for persistent (n = 11) and paroxysmal AF at 5 centers. A 64-pole basket catheter was used for panoramic right and left atrial mapping during AF. AF electrograms were analyzed using a novel system to identify sustained rotors (spiral waves), or focal beats (centrifugal activation to surrounding atrium). Ablation was performed first at identified sources. The primary endpoints were acute AF termination or organization (>10% cycle length prolongation). Conventional ablation was performed only after FIRM-guided ablation. RESULTS:Twelve out of 14 cases were mapped. AF sources were demonstrated in all patients (average of 1.9 ± 0.8 per patient). Sources were left atrial in 18 cases, and right atrial in 5 cases, and 21/23 were rotors. FIRM-guided ablation achieved the acute endpoint in all patients, consisting of AF termination in n = 8 (4.9 ± 3.9 minutes at the primary source), and organization in n = 4. Total FIRM time for all patients was 12.3 ± 8.6 minutes. CONCLUSIONS:FIRM-guided ablation revealed localized AF rotors/focal sources in patients with paroxysmal, persistent and longstanding persistent AF. Brief targeted FIRM-guided ablation at a priori identified sites terminated or substantially organized AF in all cases prior to any other ablation.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Shivkumar K,Ellenbogen KA,Hummel JD,Miller JM,Steinberg JSdoi
10.1111/jce.12000subject
Has Abstractpub_date
2012-12-01 00:00:00pages
1277-85issue
12eissn
1045-3873issn
1540-8167journal_volume
23pub_type
临床试验,杂志文章,多中心研究abstract:INTRODUCTION:We compared the efficacy and safety of amiodarone and dronedarone in patients with persistent atrial fibrillation (AF). METHODS:Five hundred and four amiodarone-naïve patients were randomized to receive dronedarone 400 mg bid (n = 249) or amiodarone 600 mg qd for 28 days then 200 mg qd (n = 255) for at le...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1540-8167.2010.01764.x
更新日期:2010-06-01 00:00:00
abstract:INTRODUCTION:Cardiac resynchronization therapy (CRT) recipients with ischemic cardiomyopathy (ICM) have scar segments that may limit ventricular resynchronization and clinical response. The impact of myocardial viability at the left ventricular (LV) pacing site on CRT response is poorly elucidated. METHODS AND RESULTS...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12348
更新日期:2014-05-01 00:00:00
abstract::When an implanted device is infected, complete explantation of the device system, including lead extraction, is usually required. Superficial problems with wound healing may be managed more conservatively, but distinguishing between a surface process and deeper infection can pose a clinical challenge. We present a cas...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02224.x
更新日期:2012-03-01 00:00:00
abstract::Atrial fibrillation and heart failure are increasing in prevalence, and frequently coexist. Despite the desire to restore sinus rhythm in heart failure patients, large studies comparing rate control to pharmacologic rhythm control have failed to show superiority of either approach. This may in part be due to the ineff...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/jce.13497
更新日期:2018-07-01 00:00:00
abstract:INTRODUCTION:In isolated rabbit hearts, repetitive endocardial focal discharges (REFDs) were consistently observed during ventricular fibrillation (VF) with prolonged (>5 minutes) global ischemia (GI). We hypothesized that BAPTA-AM, a calcium chelator, can suppress these REFDs. METHODS AND RESULTS:Using a two-camera o...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02067.x
更新日期:2011-10-01 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:Functional tricuspid regurgitation (TR) remains a challenging clinical problem with poor outcomes and few effective treatments. Atrial fibrillation (AF) has been associated with functional TR. We sought to determine whether restoring sinus rhythm through catheter ablation of AF can decrease the degree of T...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14707
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:The application of high-frequency current to the AV junctional area results in a temperature rise in the myocardium and may cause accelerated junctional rhythm (AJR). The aim of the study was to characterize heat-induced AJR in an in vitro animal model. METHODS AND RESULTS:Studies were performed in isolat...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00946.x
更新日期:1998-06-01 00:00:00
abstract:INTRODUCTION:Both isoproterenol (Iso) and adenosine (Ado) are used to induce atrial fibrillation (AF) in the electrophysiology lab. However, the utility of Ado has not been systematically established. OBJECTIVE:The purpose of this study was to compare Ado to Iso for the induction of paroxysmal AF. METHODS:Forty patie...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
doi:10.1111/jce.13779
更新日期:2019-02-01 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:INTRODUCTION:Cardiac resynchronization therapy implants entail significant radiation exposure for patients and physicians. A novel 3D electromagnetic cardiovascular navigation system (MediGuide™) was designed to superimpose the real-time location of sensors embedded in delivery tools on prerecorded coronary sinus (CS) ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12290
更新日期:2014-01-01 00:00:00
abstract:INTRODUCTION:Detailed description of longstanding persistent accelerated idioatrial rhythm (AIAR) is lacking. This observational study investigated the clinical manifestations, electrophysiological characteristics, diagnosis, treatment, and prognosis of this unusual arrhythmia. METHODS AND RESULTS:Fifteen patients (11...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13255
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:The clinical role of atrial arrhythmias (AA) in arrhythmogenic right ventricular cardiomyopathy (ARVC) and the echocardiographic variables that predict them are not well defined. We describe the prevalence, types, echocardiographic predictors, and management of AA in patients with ARVC. METHODS:We retrosp...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.14069
更新日期:2019-10-01 00:00:00
abstract::The use of multiple His bundle-right bundle branch recordings in electrophysiologic studies has facilitated definition of the mechanism and elucidation of the direction of impulse propagation in bundle branch reentrant tachycardia, "Mahaim" fiber reciprocating tachycardia, and retrograde His depolarization in fascicul...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1994.tb01172.x
更新日期:1994-04-01 00:00:00
abstract:INTRODUCTION:Atrial fibrillation (AF) in the left atrium (LA) is poorly defined in terms of regional differences in the degree of organization, characteristics of paroxysmal and persistent variants, and electrophysiologic events that develop at the onset of episodes. METHODS AND RESULTS:The study population consisted ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.00525.x
更新日期:2002-06-01 00:00:00
abstract::Left-sided anteroseptal accessory pathways that course through the aortomitral fibrous continuity are some of the rarest types of accessory pathways. At this region the atrium and ventricle are separated by their greatest distance because of the intervening aortic valve. These pathways often have a long circuitous cou...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2012.02440.x
更新日期:2013-04-01 00:00:00
abstract:INTRODUCTION:Radiofrequency ablation (RFCA) of ventricular tachycardia (VT) is a potential curative treatment modality. We evaluated the results of RFCA in patients with VT. METHODS AND RESULTS:One hundred fifty-one consecutive patients (122 men and 29 women; age 57 +/- 16 years) with drug-refractory VT were treated. ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.00417.x
更新日期:2002-05-01 00:00:00
abstract:INTRODUCTION:Results of previous studies suggest that atrial resynchronization by multisite atrial pacing may contribute to prevention of recurrences in patients with drug-refractory atrial tachyarrhythmias and significant intra-atrial conduction delay. METHODS AND RESULTS:To verify this hypothesis, a prospective nonc...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb01752.x
更新日期:2000-10-01 00:00:00
abstract:INTRODUCTION:Patient acceptance of implantable device therapy has been established as an important outcome but the operationalization and validation of a measure of patient acceptance of implantable device therapy has not been fully completed. This study sought to validate a new measure of patient acceptance of cardiac...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2005.40134.x
更新日期:2005-04-01 00:00:00
abstract:INTRODUCTION:To assess a potential relationship between sex and outcome in recipients of an implantable cardioverter-defibrillator (ICD). METHODS AND RESULTS:All 1471 ICD recipients between 2000 and 2015 were sex-related analyzed with the following outcome parameters: overall survival (OS), the occurrence of inappropr...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14003
更新日期:2019-09-01 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::The Res-Q Arrhythmia Control Device (Intermedics Inc.) is one of the latest entries into the growing implantable cardioverter defibrillator (ICD) market. Dysrhythmias are classified according to their zone of detection, with a bradycardia zone, up to 3 tachycardia zones, and a fibrillation zone. Detection criterion, t...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.1995.tb00766.x
更新日期:1995-02-01 00:00:00
abstract::Atrial flutter involving either clockwise or counterclockwise rotation around the tricuspid annulus utilizing the subeustachian isthmus has been well described. However, macroreentrant atrial circuits in atypical atrial flutter in patients who have not undergone previous surgery or without atrial disease are not well ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00886.x
更新日期:1998-10-01 00:00:00
abstract:AIMS:We sought to assess (1) clinical outcomes of second-generation cryoballoon (CB) ablation for persistent atrial fibrillation (AF), and (2) the association of baseline and procedural covariates with atrial arrhythmia recurrence (AAR) after ablation. METHODS:A total of 135 patients (63 ± 11 years, 96 men [71%]) with...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.14023
更新日期:2019-09-01 00:00:00
abstract:INTRODUCTION:Echocardiography is widely used to optimize CRT programming, but it is time-consuming. This study aimed to correlate the optimal interventricular pacing (V-V) interval obtained by echo with the optimal V-V interval obtained by a simpler method based on the surface ECG. METHODS AND RESULTS:Three V-V interv...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2007.00983.x
更新日期:2007-12-01 00:00:00
abstract:INTRODUCTION:Immediate reinitiation of atrial tachyarrhythmia (IRAT) is an important cause of failure to maintain sinus rhythm. IRAT prevention by overdrive pacing has not been evaluated in a prospective randomized trial. METHODS AND RESULTS:Patients with a DDDRP pacemaker offering temporary atrial overdrive pacing af...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1540-8167.2003.03160.x
更新日期:2003-09-01 00:00:00
abstract::We describe a patient with bundle branch reentry ventricular tachycardia with 1:1 VA conduction in whom resetting was performed while obtaining simultaneous recordings from the right ventricular apex (V) and His-bundle electrogram. Both the tachycardia return cycle and the V-His interval demonstrated an increasing res...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1996.tb00484.x
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Left bundle branch pacing (LBBP) is emerging as a novel option for physiological ventricular pacing. The impact of current of injury (COI) at left bundle branch (LBB) has not been previously evaluated. METHODS:Consecutive patients with QRS duration less than 120 milliseconds referred for LBBP in whom LBB po...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14377
更新日期:2020-04-01 00:00:00
abstract:AIMS:T-wave alternans (TWA) is an indicator of vulnerability to ventricular arrhythmias and is useful for predicting sudden cardiac death (SCD) in patients with various structural heart diseases. We evaluated whether high levels of time-domain TWA on ambulatory ECG (AECG) are associated with a history of ventricular fi...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12441
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Historically, individuals diagnosed with an inherited arrhythmia or cardiomyopathy have been advised to avoid participating in competitive sports. Consequently, these individuals may be more susceptible to weight gain and obesity. METHODS:A retrospective longitudinal chart review was performed for a populat...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13713
更新日期:2018-12-01 00:00:00