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) venograms while adjusting for patient movement and variations in heart rate under different C-arm angulations. We studied the accuracy and efficacy of MediGuide™ in reducing radiation exposure during LV lead implants. METHODS AND RESULTS:Fluoroscopy durations and radiation exposures were measured in 6 canines undergoing both conventional and MediGuide™-guided LV lead implants. The in vivo accuracy of MediGuide™ was evaluated by obtaining CS venograms at 3 different C-arm angulations at 3 different heart rates and measuring the separation between the projected sensor icon of a MediGuide™ sensor-enabled guidewire and the encompassing branch on prerecorded venograms. RESULTS:Mediguide™-guided implants resulted in significant reductions in fluoroscopy time (52 ± 120 [median 6] vs 129 ± 118 [median 90] sec, P < 0.001) and radiation exposure (13.8 ± 32.4 [median 1.7] vs 49.2 ± 45.3 [median 27.2] μGym(2) , P = 0.03) compared to conventional implants. LV lead delivery time was not significantly different between the 2 implant techniques (P = 0.27). The mean separation between the projected guidewire sensor icon and its encompassing branch was 0.48 ± 0.94 (median 0.00) mm. System accuracy was not affected by variations in heart rate or C-arm angulations. CONCLUSION:The novel 3D cardiovascular navigation system enabled accurate and reliable tracking of sensor-enabled tools at varying heart rates and C-arm angulations with minimal need for fluoroscopy guidance, significantly reducing fluoroscopy time and radiation exposure.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Valderrabano M,Greenberg S,Razavi H,More R,Ryu K,Heist EKdoi
10.1111/jce.12290subject
Has Abstractpub_date
2014-01-01 00:00:00pages
87-93issue
1eissn
1045-3873issn
1540-8167journal_volume
25pub_type
杂志文章abstract:BACKGROUND:Despite growing attention to performance and quality measures, national standards for reporting of outcomes after all electrophysiology (EP) procedures have not yet been developed. We sought to characterize the incidence and timing of adverse events up to 30 days after EP procedures at a tertiary academic me...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12639
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Esophageal injury during left atrial ablation is associated with a significant risk of mortality and morbidity. There are no validated approaches to reduce injury outside of avoidance, a strategy critically dependent on a precise understanding of the esophageal anatomy and location. Intracardiac ultrasound (...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2012.02441.x
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:Although balloon-based techniques, such as the laser balloon (LB) ablation have simplified pulmonary vein isolation (PVI), procedural fluoroscopy usage remains higher in comparison to radiofrequency PVI approaches due to limited 3-dimensional mapping system integration. METHODS:In this prospective study, ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14546
更新日期:2020-07-01 00:00:00
abstract:INTRODUCTION:Pulmonary vein potentials reflect depolarization of muscle fascicles within the myocardial sleeves that surround the pulmonary veins. The response of pulmonary vein potentials to premature stimulation has not been described. METHODS AND RESULTS:In 31 patients with paroxysmal atrial fibrillation referred f...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2002.00033.x
更新日期:2002-01-01 00:00:00
abstract::Cost-efficacy assessment of implantable cardioverter defibrillator (ICD) therapy has proved contentious and may have limited uptake of ICD therapy, particularly in Europe. Published modeling assessments are too inaccurate to determine clinical practice, and assessments based on clinical studies are incomplete (from th...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2002.tb01964.x
更新日期:2002-01-01 00:00:00
abstract:INTRODUCTION:Despite the importance of neurogenic initiation of rapid firing from pulmonary veins (PVs), the mechanism of autonomic modulation of electrophysiological properties of the PV myocardium to form a substrate for atrial arrhythmia remains poorly understood. METHODS AND RESULTS:A 2-microelectrode technique wa...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12738
更新日期:2015-10-01 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:Lead dysfunction can lead to serious consequences including failure to treat ventricular tachycardia or fibrillation (VT/VF). The incidence and mechanisms of lead dysfunction following left ventricular assist device (LVAD) implantation are not well-described. We sought to determine the incidence, mechanism...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14487
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Manual, point-by-point electroanatomical mapping requires the operator to directly evaluate each point during map construction. Consequently, point collection can be a slow process. An automated 3D mapping system was developed with the goal of improving key mapping metrics, including map completion time an...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13368
更新日期:2018-01-01 00:00:00
abstract::We report a case of initial transient success during ablation for typical AV nodal reentrant tachycardia utilizing traditional right-sided approaches, followed by recurrence of the same tachycardia and an ultimately successful ablation on the posteromedial mitral annulus. ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2000.01281.x
更新日期:2000-11-01 00:00:00
abstract::Macro-Reentrant ARVC epi-VT with a Focal Endo-Activation. A 55-year-old man with arrhythmogenic right ventricular cardiomyopathy underwent catheter ablation of ventricular tachycardia (VT) with left bundle branch block and left superior axis QRS morphology with an early precordial transition. Endocardial mapping durin...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01395.x
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION:Patients with bradycardia requiring permanent pacing frequently suffer from additional atrial tachyarrhythmias (ATs). This study evaluated the safety and efficacy of atrial antitachycardia pacing (ATP) and the performance of pacing for AT prevention implemented into a new pacemaker. METHODS AND RESULTS:In...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1046/j.1540-8167.2001.01121.x
更新日期:2001-10-01 00:00:00
abstract:INTRODUCTION:Frequent premature ventricular contractions (PVCs) can cause cardiomyopathy (CM). Postextrasystolic potentiation (PESP) and irregularity have been in implicated as triggers of PVC-CM. Because both phenomena can also be found in premature atrial contractions (PACs), it is speculated that frequent PACs have ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14067
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:The role of increased dispersion of repolarization in the genesis of torsades de pointes in patients with long QT syndrome has been clarified, but its role in the genesis of idiopathic ventricular fibrillation (VF) is not yet known. To investigate the pathogenesis of VF, we recorded monophasic action poten...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00869.x
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:Risk factors of embolic stroke (ES) after atrial fibrillation (AF) ablation have not been fully elucidated especially among the Asian subjects, particularly regarding epicardial adipose tissue (EAT) in cardiac imaging. We aimed to assess the incidence of ES during a long-term follow-up period after AF abla...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.14154
更新日期:2019-11-01 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::Application of radiofrequency energy to arrhythmogenic substrates after careful cardiac mapping could ensure a high success rate in eliminating certain types of tachyarrhythmias. Future studies of catheter ablation will focus on how to improve ablation efficacy and achieve a better result in various types of tachyarrh...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.1995.tb00360.x
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:We prospectively compared the efficacy, safety, and quality of life (QoL) impact of catheter ablation versus antiarrhythmic drugs (AAD) in elderly patients with persistent atrial fibrillation (AF). METHODS AND RESULTS:Four hundred and twelve consecutive patients, aged ≥ 70 years, underwent ablation (Group A...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/jce.12126
更新日期:2013-07-01 00:00:00
abstract::Heart failure is a common debilitating condition for which pharmacologic therapy thus far has provided only partial relief. Despite, and sometimes because of, medical therapy, the overall prognosis remains poor, with high rates of sudden death and death from progressive heart failure. Device-based therapies offer cons...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2002.tb01958.x
更新日期:2002-01-01 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:Pulmonary vein (PV) reconnection is frequent in patients showing atrial fibrillation (AF) recurrence after PV isolation (PVI). Its detection with cardiac magnetic resonance (CMR) may help predict outcome and guide redo procedures. We assessed the relationship between scar on CMR and PV reconnection after c...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13908
更新日期:2019-05-01 00:00:00
abstract:INTRODUCTION:The value of noninvasive markers reflecting repolarization and/or conduction abnormalities in identifying patients with abnormal ECG showing a pattern of atypical right bundle branch block and ST elevation syndrome (Brugada syndrome) at risk for life-threatening arrhythmias is controversial. Because right ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.00742.x
更新日期:2002-08-01 00:00:00
abstract:INTRODUCTION:The incidence of spontaneous transition of 2:1 AV block to 1:1 AV conduction during AV nodal reentrant tachycardia has not been well reported. Among previous studies, controversy also existed about the site of the 2:1 AV block during AV nodal reentrant tachycardia. METHODS AND RESULTS:In patients with 2:1...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2003.03198.x
更新日期:2003-12-01 00:00:00
abstract::QT dispersion is defined as the difference in QT interval between the different leads of the surface 12-lead ECG. This may provide an indirect measure of the underlying inhomogeneity of myocardial repolarization, which is believed to be important in arrhythmogenesis. Methodology for determining QT dispersion varies si...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.1994.tb01190.x
更新日期:1994-08-01 00:00:00
abstract:INTRODUCTION:Discriminating between ventricular tachycardia (VT) with 1:1 ventriculoatrial association and sinus tachycardia can be difficult, even when assisted by intracardiac tracings. In this study, we used a new computer algorithm to perform correlation waveform analyses on intracardiac atrial electrograms to help...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2001.00145.x
更新日期:2001-02-01 00:00:00
abstract:INTRODUCTION:To determine if collagenase-dispersed epicardial myocytes overlying myocardial infarction reproduce the same altered electrophysiology observed in intact epicardium, multicellular tissue preparations and enzymatically-dispersed myocytes from ischemically-injured canine subepicardium were examined 1 and 4 d...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1993.tb01208.x
更新日期:1993-02-01 00:00:00
abstract::The remedē system is a novel fully implantable transvenous phrenic nerve stimulation (TPNS) device developed to treat central sleep apnea. No information is published on how to explant or replace its leads. An eighty-one year-old had a fractured lead and we removed it over a wire. However, unbreachable resistances occ...
journal_title:Journal of cardiovascular electrophysiology
pub_type:
doi:10.1111/jce.14725
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:The mechanisms by which atrial stretch favors the development of a substrate for atrial fibrillation (AF) are not fully understood. In this study, the role of stretch-induced conduction changes in the creation of a proarrhythmic substrate has been investigated by quantifying the spatial distribution of loc...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2010.01939.x
更新日期:2011-04-01 00:00:00
abstract:INTRODUCTION:A male patient with an atriofascicular pathway underwent catheter ablation of the atriofascicular pathway during atrial fibrillation. METHODS AND RESULTS:The patient had preexcited atrial fibrillation both clinically and repeatedly during electrophysiologic study. A preexcited tachycardia with a 1:1 AV re...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1994.tb01123.x
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Implantable cardioverter defibrillators (ICDs) reduce all-cause mortality among cardiomyopathy patients. Whether or not antitachycardia pacing (ATP) is equally effective in ischemic (ICM) and nonischemic (NICM) cardiomyopathy patients remains poorly understood. We describe the distribution of monomorphic (MV...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14688
更新日期:2020-10-01 00:00:00