Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
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J Interv Card Electrophysiol · Mar 2014
Prolonged P-wave duration is associated with atrial fibrillation recurrence after successful pulmonary vein isolation for paroxysmal atrial fibrillation.
Pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) is successful in ∼70-80 % after repeated procedures. This suggests a subgroup of PAF patients where electrical abnormalities outside the pulmonary veins are important. Prolonged P-wave duration (PWD), a marker of atrial remodelling, may identify this subgroup. This study's aim was to assess the association of PWD on standard 12 lead ECG with AF recurrence post PVI. ⋯ The presence of pre-existent prolonged PWD is associated with a higher risk of AF recurrence post PVI for paroxysmal AF.
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J Interv Card Electrophysiol · Jan 2014
Atrial fibrillation following open heart surgery: long-term incidence and prognosis.
While early postoperative atrial fibrillation (post op AF) following valve and coronary artery bypass surgery is a known common cause of increased morbidity and mortality, the late recurrence of AF long term in this group of patients has not been well studied. ⋯ Late recurrence of AF is higher than was previously thought to be in patients experiencing early post operative AF with a trend towards higher long-term mortality. Post op AF should not be dismissed as a benign entity and these patients should be followed closely.
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J Interv Card Electrophysiol · Dec 2013
Clinical TrialFemoral vein thrombosis after right-sided electrophysiological procedures.
Electrophysiological studies and radiofrequency catheter ablations require single or multiple sheath placements through femoral vein cannulation. The objective of this study was to determine the incidence, predictors, and outcomes of deep vein thrombosis (DVT) following such procedures. ⋯ Asymptomatic femoral DVT occur in 5% of electrophysiological studies and right-heart radiofrequency catheter ablations, particularly when large sheaths are inserted for a longer period. The role of anticoagulation in this clinical setting warrants further evaluation.
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J Interv Card Electrophysiol · Nov 2013
Controlled Clinical TrialDeep sedation during catheter ablation for atrial fibrillation in elderly patients.
Atrial fibrillation (AF) is the most common cardiac arrhythmia. AF incidence increases with age. AF ablation procedures are routinely performed under deep sedation with propofol. The purpose of the study was to evaluate if propofol deep sedation during AF ablation is safe in elderly patients. ⋯ Deep sedation with propofol and midazolam during AF ablation did not result in an increased rate in sedation-related complications in elderly patients. Similarly, the rate of procedural complications was not significantly different among the study groups. The rate of respiratory infections and renal failure was significantly higher in the elderly. All adverse events were treated successfully without any remaining sequelae.
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J Interv Card Electrophysiol · Oct 2013
Multicenter Study Clinical TrialPhrenic nerve stimulation in CRT patients and benefits of electronic lead repositioning: the ERACE trial.
Despite novel left ventricular (LV) lead technologies, phrenic nerve stimulation (PNS) remains an adverse effect observed in many patients with cardiac resynchronization therapy (CRT). Beyond anatomic repositioning, modern CRT devices allow avoidance of PNS also by software-based adaption of the pacing configuration. The Electronic Repositioning With Acuity and Easytrak Leads study evaluated the incidence of PNS in a CRT population and examined how often LV lead relocation can be avoided by "electronic repositioning" (ER). ⋯ The incidence of inducible PNS in CRT patients is considerable. In this study, PNS could be avoided in the majority of the patients by means of electronic repositioning. Thus, the use of ER should be considered for CRT patients.