Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
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J Interv Card Electrophysiol · Sep 2015
Comparative Study Controlled Clinical TrialDetection of left atrial thrombus by intracardiac echocardiography in patients undergoing ablation of atrial fibrillation.
The role of intracardiac echocardiography (ICE) to detect thrombus within left atrium (LA) before atrial fibrillation (AF) ablation despite a recent transesophageal echocardiogram (TEE) is not well defined. We examined the prevalence of LA/left atrial appendage (LAA) thrombus using ICE immediately prior to AF ablation in patients in whom anticoagulation was not withheld. ⋯ The results of our staged imaging approach suggest that ICE has a complimentary value in re-screening the LA/LAA for thrombus after a recent negative or equivocal TEE. The presence of SEC during TEE increases the probability of finding a thrombus with ICE, which could potentially be dislodged during catheter manipulation.
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J Interv Card Electrophysiol · Sep 2015
Transcutaneous carbon dioxide monitoring to avoid hypercapnia during complex catheter ablations: a feasibility study.
The aim of this study was to determine if transcutaneous CO(2) monitoring (TCO(2)) is feasible to avoid hypercapnia during complex catheter ablation. Cumulative analgesic and anxiolytic effects during complex catheter ablation can rarely provoke hypoventilation and respiratory complications. End tidal CO(2) monitors have limitations in non-ventilated patients, and frequent arterial blood gas sampling is impractical. ⋯ Transcutaneous CO2 monitoring is feasible during complex catheter ablation and correlates with invasively obtained data. However, further development is needed to achieve the desired level of agreement.
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J Interv Card Electrophysiol · Aug 2015
The Thebesian valve and coronary sinus in cardiac magnetic resonance.
There is no complex research exploring usefulness of cardiac magnetic resonance in the evaluation of the coronary sinus including Thebesian valve, which can be useful before selected electrophysiology procedures. ⋯ In most of the cases, it is possible to visualize and measure the coronary sinus using cardiac magnetic resonance with SSFP sequence. In selected cases, it is necessary to perform additional dedicated short sequences. Thebesian valve was visualized in almost 50% of patients.
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J Interv Card Electrophysiol · Aug 2015
Safety and efficacy outcomes of protamine administration for heparin reversal following cryoballoon-based pulmonary vein isolation.
Anticoagulation with heparin is required during catheter ablation of atrial fibrillation (AF) to reduce systemic thromboembolism. In this study, we aim to compare safety and efficacy outcomes between patients who receive protamine administration for reversal of heparin and those who do not, following cryoballoon-based pulmonary vein isolation (PVI) for AF. ⋯ To the best of our knowledge, this is one of the largest series showing that protamine administration for heparin reversal in patients undergoing cryoballoon-based PVI allows quicker sheath removal and minimizes the risk of potential vascular complications without causing an increase in thrombotic events.
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J Interv Card Electrophysiol · Mar 2015
Randomized Controlled Trial Comparative StudyFast atrial activity predicts recurrence of atrial fibrillation after pulmonary vein isolation: results from a prospective randomized study.
Recurrence of atrial fibrillation (AF) after ablative treatment is common. We hypothesized that AF recurrence is heralded by fast ectopic atrial activity occurring after electrical reconnection of previously isolated pulmonary veins. ⋯ In patients with atrial fibrillation and after the first PVI procedure, appearance of symptomatic fast atrial activity is associated with a high risk of AF recurrence. Re-isolation of reconnected pulmonary veins in these pts significantly reduces the risk of AF recurrence.