Abstract:
BACKGROUND:Focal impulse and rotor modulation (FIRM) has been proposed as a novel approach for the treatment of atrial fibrillation (AF). OBJECTIVE:This study aimed to investigate the efficacy of FIRM as a stand-alone procedure for the treatment of paroxysmal AF. METHODS:A total of 27 patients with paroxysmal AF underwent sequential biatrial computational mapping. Sites with repetitive centrifugal or spiral reentry-like activity were considered to be AF-sustaining sources and targeted by irrigated radiofrequency (RF) ablation. All patients were seen in the outpatient clinic after 1, 3, and 6 months and thereafter every 6 months. Cardiac monitors were implanted 3 months before ablation in 17 patients (63%). RESULTS:Repetitive activity interpreted as sustained AF sources was found in all patients, with an average of 3.0 ± 1.1 sources located in the left atrium and 0.6 ± 0.6 sources in the right atrium. The majority of sources were rotors (95%). The total source-ablation radiofrequency time was 20.0 ± 9.0 minutes. At 15.2 ± 3.9 months of follow-up, the prespecified end point of <1% AF burden (outside a 3-month blanking period) was achieved in 2 of the 17 continuously monitored patients (12%). Of all the 27 patients who underwent FIRM, AF episodes of ≥30 minutes were recorded in 23 (85%), while AF episodes ≥60 minutes were recorded in 21 patients (78%). CONCLUSION:This study suggest that biatrial ablation of localized patient-specific sources alone, as detected by this method, is not sufficient to reduce paroxysmal AF burden in the majority of patients.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Berntsen RF,Håland TF,Skårdal R,Holm Tdoi
10.1016/j.hrthm.2016.04.016subject
Has Abstractpub_date
2016-09-01 00:00:00pages
1768-74issue
9eissn
1547-5271issn
1556-3871pii
S1547-5271(16)30257-0journal_volume
13pub_type
杂志文章相关文献
HEART RHYTHM文献大全abstract:BACKGROUND:Experience with retrieval of the Micra transcatheter pacing system (TPS) is limited because of its relatively newer technology. Although abandonment of the TPS at end of life is recommended, certain situations such as endovascular infection or device embolization warrant retrieval. OBJECTIVE:The purpose of ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.02.008
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Different P-wave morphologies during sinus rhythm as displayed on standard ECGs have been postulated to correspond to differences in interatrial conduction. OBJECTIVE:The purpose of this study was to evaluate the hypothesis by comparing P-wave morphologies using left atrial activation maps. METHODS:Twenty-...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2007.12.017
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Pulmonary vein isolation (PVI) is a central procedure for the treatment of paroxysmal atrial fibrillation (PAF). However, in patients with PAF and structural atrial disease, PVI may fail and cause progressive atrial remodeling, often leading to persistent/permanent atrial fibrillation. OBJECTIVE:We performe...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2015.06.009
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Negative tracheal pressure (NTP) during tracheal obstruction in obstructive apnea increases vagal tone and causes pronounced shortening of the atrial effective refractory period (AERP), thereby perpetuating atrial fibrillation (AF). The role of different atrial potassium channels under those conditions has n...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.07.018
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Pulmonary vein isolation by cryoballoon ablation is an accepted method of treating atrial fibrillation. Little data exist regarding factors affecting late electrical reconnection of pulmonary veins following cryoballoon ablation. OBJECTIVE:To investigate factors determining pulmonary vein reconnection in pa...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.06.014
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Catheter contact is important for radiofrequency (RF) ablation. Local electrical catheter-to-tissue coupling has been described as a tool to objectively measure contact. OBJECTIVE:We hypothesized that pulmonary vein isolation (PVI) ablation using electrical coupling information (ECI) would yield higher rate...
journal_title:Heart rhythm
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.hrthm.2012.10.010
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Once chamber geometry is determined, the EnSite 3000 noncontact mapping system can create a voltage map during a single cardiac cycle. The EnSite uses an inverse solution to the Laplace equation to process the amplified far-field signals from the noncontact catheter. This process creates a three-dimensional ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2007.10.026
更新日期:2008-02-01 00:00:00
abstract::Ventricular fibrillation (VF), despite its declining incidence as a cause of sudden cardiac death, is still a major health problem. The underlying mechanisms for the maintenance of VF are still disputed. Studies suggest that VF is unlikely one static mechanism but rather a dynamic process of electrical derangement tha...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2008.11.005
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:T-peak to T-end (TPE) interval on the electrocardiogram is a measure of myocardial dispersion of repolarization and is associated with an increased risk of ventricular arrhythmias. The genetic factors affecting the TPE interval are largely unknown. OBJECTIVE:To identify common genetic variants that affect t...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2012.02.019
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Marshall bundles (MBs) are the muscle bundles within the ligament of Marshall. OBJECTIVE:This trial sought to the electrophysiological characteristics of the MB and the anatomical connections between MB and left atrium (LA) in patients with persistent atrial fibrillation (AF). METHODS:We enrolled 72 patien...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.02.028
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Early repolarization syndrome (ERS) is associated with polymorphic ventricular tachycardia (PVT) and ventricular fibrillation, leading to sudden cardiac death. OBJECTIVE:The present study tests the hypothesis that the transient outward potassium current (Ito)-blocking effect of phosphodiesterase-3 (PDE-3) i...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2016.01.024
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Patients with heart failure and sleep apnea are at increased risk for developing arrhythmias. Whether treatment of sleep apnea reduces arrhythmias is unknown. OBJECTIVE:The purpose of this study was to determine whether adaptive servo-ventilation (ASV) with optimal medical therapy (OMT) reduces atrial fibri...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2018.07.027
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Pectoral nerve blocks (PECs) can reduce intraprocedural anesthetic requirements and postoperative pain. Little is known about the utility of PECs in reducing pain and narcotic use after pacemaker (PM) or implantable cardioverter-defibrillator (ICD) placement in children. OBJECTIVE:The purpose of this study ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.03.009
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Ventricular fibrillation (VF) is induced during implantable cardioverter-defibrillator (ICD) implantation to ensure that the ICD will sense, detect, and defibrillate VF. ICD implant guidelines state that the amplitude of the sinus rhythm R wave recorded from the ventricular electrogram should have amplitude ...
journal_title:Heart rhythm
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.hrthm.2015.08.012
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Radiofrequency ablation of epicardial and mid-myocardial ventricular arrhythmias is limited by lesion depth. OBJECTIVE:The purpose of this study was to generate deep mid-interventricular septal (IVS) lesions using high-intensity ultrasound (US) from an endocardial catheter-based approach. METHODS:Irrigated...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.12.027
更新日期:2020-12-29 00:00:00
abstract:BACKGROUND:A considerable rate of atrial fibrillation (AF) recurrence is one of the major limitations of pulmonary vein isolation (PVI). Although endothelin-1 (ET-1) is involved in atrial remodeling, it is unknown whether plasma ET-1 level before PVI can be used as a predictive factor for AF recurrence. OBJECTIVE:The ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2009.02.027
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Specific 12-lead ECG criteria have been reported to predict an epicardial site of origin (SoO) of induced ventricular tachycardias (VTs) in left ventricular nonischemic cardiomyopathy. OBJECTIVE:The purpose of this study was to (1) determine the value of ECG criteria to predict an epicardial SoO of clinical...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.03.001
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Pericardial effusion, a sign of cardiac perforation, may complicate permanent pacemaker placement. Risk factors for development of post-permanent pacemaker effusion have not been evaluated. OBJECTIVES:The purpose of this study was to determine the predictors of symptomatic pericardial effusion after permane...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2005.06.011
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Loss-of-function mutations in SCN5A are associated in ∼20% of Brugada syndrome (BrS) patients. Copy number variations (CNVs) have been shown to be associated with several inherited arrhythmia syndromes. OBJECTIVE:The purpose of this study was to investigate SCN5A CNVs among BrS probands. METHODS:The study ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.03.033
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) and atrial ablation procedures currently lack a noninvasive imaging modality for reliable treatment planning and monitoring. Electromechanical wave imaging (EWI) is an ultrasound-based method that has previously been shown to be capable of noninvasively and transmurall...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.02.028
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Autonomic regulation therapy (ART) with chronic vagus nerve stimulation improves ventricular function in patients with chronic heart failure, but its effects on quantitative T-wave alternans (TWA), ventricular tachycardia (VT), baroreflex sensitivity, and autonomic tone remained unknown. OBJECTIVE:Effects o...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2015.11.030
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES/BACKGROUND:Previous in vitro studies have suggested full repolarization of the epicardium coincides with the peak of the T wave (T(peak)) and that of the M cells coincides with the end of the T wave (T(end)). However, in vivo validation of the theory is lacking. METHODS:Monophasic action potentials (MAPs) w...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2004.11.011
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Good catheter-tissue contact force (CF) is critical for transmural and durable lesion formation during radiofrequency (RF) ablation but is difficult to assess in clinical practice. Tissue heating during RF application results in an impedance decrease at the catheter tip. OBJECTIVE:The purpose of this study ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.10.048
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Early detection of cardiac involvement in sarcoidosis is difficult but essential to achieve optimal treatment. Signal-averaged electrocardiography (SAECG) can detect subtle cardiac electrical abnormalities termed late potentials (LPs) and would be useful for the early diagnosis of cardiac involvement. OBJEC...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.03.013
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Complete circumferential antral ablation may not be necessary for successful pulmonary vein (PV) isolation in patients with paroxysmal atrial fibrillation (AF). OBJECTIVE:We examined the feasibility of a noncircumferential approach limited to segments of the antra required for PV-atrial conduction. METHODS...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.09.069
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Although left cardiac sympathetic denervation (LCSD) is an effective antiarrhythmic therapy for patients with long QT syndrome (LQTS), direct evidence of reduced sympathetic activity after LCSD in humans is limited. OBJECTIVE:The purpose of this study was to assess skin sympathetic nerve activity (SKNA) in ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.03.023
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Enhanced dispersion of action potential duration (APD) is a major contributor to long QT syndrome (LQTS)-related arrhythmias. OBJECTIVE:To investigate spatial correlations of regional heterogeneities in cardiac repolarization and mechanical function in LQTS. METHODS:Female transgenic LQTS type 2 (LQT2; n =...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.07.038
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Mutations in LMNA cause an arrhythmogenic cardiomyopathy (cardiolaminopathy) with high risk of ventricular tachycardia (VT). The natural history of VT among patients with cardiolaminopathy is incompletely understood. OBJECTIVE:The purpose of this study was to determine the longitudinal burden and progressio...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.05.023
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:In recent years, upgrade and revision procedures of cardiac implantable electronic devices (CIEDs) have become increasingly frequent. Patency of the access veins is critical for procedural success. OBJECTIVE:The purpose of this study was to determine the incidence of venous obstruction at the time of system...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2019.08.012
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Myocardial fibrosis (macroscopic scar or diffuse reactive fibrosis) is one of the determinants of impaired left ventricular (LV) global longitudinal strain (GLS) in heart failure (HF) patients. OBJECTIVE:The purpose of this study was to evaluate the prognostic value of LV GLS in HF patients treated with car...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.03.034
更新日期:2018-10-01 00:00:00