Abstract:
INTRODUCTION:Electrical isolation of the left atrial appendage (LAA) is an important adjunctive ablation strategy in patients with nonparoxysmal atrial fibrillation (AF). Patients who have impaired LAA contractility following isolation may require long-term oral anticoagulant (OAC) therapy irrespective of their CHADS2 -VASc score. Percutaneous LAA occlusion (LAAO) is a potential alternative to life-long OAC therapy. We aimed to assess the rate of OAC discontinuation and thromboembolic (TE) events following percutaneous LAAO in patients who underwent LAA electrical isolation (LAAI). METHODS:This is a retrospective two-center study of patients who underwent percutaneous LAAO following LAAI. Patients with at least 3-month follow-up were included in the study. The antithrombotic therapy and TE events at the time of the last follow-up were noted. RESULTS:The LAA was successfully occluded in 162 (with Watchman device in 140 [86.4%] and Lariat in 22 [13.6%]). A total of 32 patients had leaks detected on the 45-day transesophageal echocardiogram (TEE); 21 (15%) Watchman and 11 (50%) Lariat cases (P = 0.0001). Two (one Watchman and one Lariat) of the 32 leaks were more than 5 mm. After the 45-day TEE, 150 (92.6%) patients were off-OAC. No TE events were reported in the 150 patients who stopped the anticoagulants. Four (2.47%) patients experienced stroke following the LAAO (three Watchman and one Lariat) procedure while on-OAC, two of which were fatal. At the median follow-up of 18.5 months, 159 (98.15%) patients were off-anticoagulant. CONCLUSION:Up to 98% of patients with LAAI could safely discontinue OAC after undergoing the appendage closure procedure.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Gadiyaram VK,Mohanty S,Gianni C,Trivedi C,Al-Ahmad A,Burkhardt DJ,Gallinghouse JG,Hranitzky PM,Horton RP,Sanchez JE,Della Rocca DG,Di Biase L,Price MJ,Couts L,Gibson D,Natale Adoi
10.1111/jce.13838subject
Has Abstractpub_date
2019-04-01 00:00:00pages
511-516issue
4eissn
1045-3873issn
1540-8167journal_volume
30pub_type
杂志文章,多中心研究abstract:BACKGROUND:Focal atrial tachycardias (FAT) originate from areas with poor cell-to-cell coupling. Due to cellular uncoupling extracellular potentials become fractionated. The degree of fragmentation may be used to identify the site of origin of FAT prior to catheter ablation. We studied electrical fragmentation in relat...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2006.00568.x
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:Oral anticoagulation (OAC) based on estimated stroke risk is recommended following catheter ablation (CA) of atrial fibrillation (AF), regardless of the extent of arrhythmia control. However, discontinuing OAC in selected patients may be safe. We sought to evaluate a strategy of OAC discontinuation followi...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14864
更新日期:2020-12-31 00:00:00
abstract:INTRODUCTION:In patients with permanent pacemakers, mode switching events often are interpreted as surrogate markers for atrial tachyarrhythmias. The aim of this study was to determine the accuracy of automatic mode switching algorithms in patients with permanent pacemakers for the diagnosis of atrial tachyarrhythmias....
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.03537.x
更新日期:2004-07-01 00:00:00
abstract:INTRODUCTION:Isolation of pulmonary veins (PVs) and the posterior left atrium (LA) can be safely performed by radiofrequency hot balloon (RHB)-based box isolation. However, data on long-term effects for the treatment of atrial fibrillation (AF) by the use of this method remain limited. METHODS AND RESULTS:We treated 2...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12820
更新日期:2015-12-01 00:00:00
abstract::Catheter ablation for ventricular tachycardia (VT) is becoming an essential component of the successful management of patients with structural heart disease and refractory ventricular arrhythmias. Despite detailed mapping and ablation from the endocardium, nearly a third of VT circuits remain inaccessible. Pericardial...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2008.01427.x
更新日期:2009-06-01 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::The cavotricuspid isthmus (CVTI) is the well-established location of atrial tissue critical for the maintenance of typical atrial flutter. The CVTI begins at the electrically inert tricuspid valve and includes the atrial myocardium up to the inferior vena cava (IVC). In this article, we discuss relevant CVTI and right...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2008.01344.x
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Outflow tract ventricular arrhythmias (OT VAs) are common and catheter ablation is an effective treatment option. We sought to investigate the relationship between age-related anatomic aortic root changes and QRS morphology during left ventricular outflow tract (LVOT) pace-mapping using cardiac magnetic re...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12712
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Current transcatheter ablation of ventricular tachycardia (VT) techniques is limited in part by its invasive nature and superficial depth of ablation lesions. OBJECTIVES:This study was aimed at evaluating the feasibility of targeted ablation of cardiac tissues using high-intensity focused ultrasound (HIFU) ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13459
更新日期:2018-05-01 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:BACKGROUND:Atrial fibrillation (AF) increases morbidity and mortality in patients with previous myocardial infarction and left ventricular systolic dysfunction. The purpose of this study was to identify patients with a high risk for new-onset AF in this population using invasive and noninvasive electrophysiological tes...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2010.01795.x
更新日期:2010-09-01 00:00:00
abstract:INTRODUCTION:Ablation electrode-tissue contact has been shown to be an important determinant of lesion size and safety during nonirrigated ablation but little data are available during irrigated ablation. We aimed to determine the importance of contact force during irrigated-tip ablation. METHODS AND RESULTS:Freshly e...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01693.x
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:Radiofrequency ablation of some right-sided accessory pathways continues to be challenging. The purpose of this study was to evaluate the efficacy of introducing a multielectrode microcatheter in the right coronary artery to localize accessory pathways when conventional mapping was unsuccessful. METHODS A...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.04100.x
更新日期:2004-11-01 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:The mechanisms by which Class IC drugs slow the rate of functional reentrant arrhythmias are not completely understood. We hypothesized that flecainide widens the excitable gap beyond the pivot point of premature turning wavefronts. METHODS AND RESULTS:In eight perfused subepicardial layers of rabbit left...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.01010.x
更新日期:2001-09-01 00:00:00
abstract::Due to expanding clinical indications and an aging society there has been an increase in the use of implantable pacemakers. At the same time, due to increased diagnostic yield over other imaging modalities and the absence of ionizing radiation, there has been a surge in demand for magnetic resonance imaging (MRI) asse...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/jce.12238
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Long QT syndrome (LQTS) is a dangerous arrhythmia disorder that often presents in childhood and adolescence. The exercise stress test (EST) and QT-stand test may unmask QT interval prolongation at key heart rate transition points in LQTS, but their utility in children is debated. OBJECTIVE:To determine if t...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14865
更新日期:2020-12-31 00:00:00
abstract::This is a case of atrial tachycardia 2 years after pulmonary transplantation. After excluding right atrial involvement, tachycardia origin was located in a scar region medial to the anastomosis of the left inferior pulmonary donor vein. Tachycardia mechanism was microreentry. Noninvasive electrocardiographic mapping p...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02250.x
更新日期:2012-05-01 00:00:00
abstract::Atrial fibrillation is the most common sustained tachyarrhythmia and, as such, has become the recent focus of intense clinical and experimental interest. Because of its associated morbidity and mortality, there is a multidisciplinary effort to understand the pathophysiology that may ultimately lead to improved therape...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.1997.tb00855.x
更新日期:1997-08-01 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::Vagus nerve activity can change heart rate substantially within one cardiac cycle, and the chronotropic effects decay almost completely within one cardiac cycle after cessation of vagal activity. The ability of the vagus nerves to regulate heart rate beat by beat can be explained in large part by the speed at which th...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1993.tb01222.x
更新日期:1993-04-01 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:BACKGROUND:This study aimed to assess manpower and resource consumption of the HomeGuide workflow model for remote monitoring (Biotronik Home Monitoring [HM], Biotronik SE & Co. KG, Berlin, Germany) of cardiac implantable electronic devices in daily clinical practice. METHODS:The model established a cooperative intera...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.12482
更新日期:2014-11-01 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::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:Repolarization heterogeneity (RH) is functionally linked to dispersion in refractoriness and to arrhythmogenicity. In the current study, we validate several proposed electrocardiogram (ECG) indices for RH: T-wave amplitude, -area, -complexity, and -symmetry ratio, QT dispersion, and the Tapex-end interval ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.40758.x
更新日期:2005-10-01 00:00:00
abstract:INTRODUCTION:Disturbance of sympathetic and vagal nervous system participates in the pathogenesis of hypertension and atrial fibrillation (AF). Renal denervation (RDN) can modulate autonomic nervous activity and reduce blood pressure (BP) in hypertensive patients. We aimed to evaluate the effect of RDN combined with pu...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,meta分析
doi:10.1111/jce.13858
更新日期:2019-05-01 00:00:00
abstract:INTRODUCTION:The utility of "virtual" imaging systems for left atrial (LA) navigation has been hampered by inadequate spatial detail, as well as inaccurate integration of more detailed preoperative images, such as those generated by computed tomography (CT). CartoSound is an intracardiac echocardiography (ICE)-based te...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01672.x
更新日期:2010-06-01 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:INTRODUCTION:Implantable cardioverter defibrillators (ICDs) are proven to prevent sudden death in patients at elevated risk for sustained ventricular tachycardia or fibrillation. Complications related to ICD failure can stem from lead dysfunction, manufacturing defects, patient characteristics, or implantation techniqu...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14523
更新日期:2020-06-01 00:00:00