Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
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J Interv Card Electrophysiol · Sep 2013
Comparative StudyContinuous warfarin versus periprocedural dabigatran to reduce stroke and systemic embolism in patients undergoing catheter ablation for atrial fibrillation or left atrial flutter.
Left atrial catheter ablation for patients with atrial fibrillation (AF) requires periprocedural anticoagulation to minimize thromboembolic complications. High rates of major bleeding complications using dabigatran etexilate for periprocedural anticoagulation have been reported, raising concerns regarding its safety during left atrial catheter ablation. We sought to evaluate the safety and efficacy of a dabigatran use strategy versus warfarin, at a single high-volume AF ablation center. ⋯ In patients undergoing left atrial catheter ablation for AF or left atrial flutter, use of periprocedural dabigatran etexilate provides a safe and effective anticoagulation strategy compared to warfarin. A prospective randomized study is warranted.
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J Interv Card Electrophysiol · Sep 2013
Randomized Controlled Trial Multicenter StudyDabigatran versus warfarin anticoagulation before and after catheter ablation for the treatment of atrial fibrillation.
Systemic thromboembolism and bleeding remain the two most common and serious complications of catheter ablation of atrial fibrillation. A variety of periprocedure anticoagulation strategies have been proposed to mitigate these risks. Although operators are now routinely administering dabigatran for anticoagulation in this setting, its relative safety and effectiveness compared to warfarin are unknown. ⋯ In a retrospective pilot trial comparing the risks of systemic thromboembolism or bleeding complications in patients treated with warfarin or dabigatran anticoagulation, the outcomes were similar. A prospective trial is warranted.
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J Interv Card Electrophysiol · Jun 2013
Randomized Controlled TrialPredictive value of total atrial conduction time measured with tissue Doppler imaging for postoperative atrial fibrillation after coronary artery bypass surgery.
Postoperative atrial fibrillation (POAF) complicating coronary artery bypass grafting surgery (CABG) increases morbidity and stroke risk. Total atrial conduction time (PA-TDI duration) has been identified as an independent predictor of new-onset atrial fibrillation (AF). We aimed to assess whether PA-TDI duration is a predictor of AF after CABG. ⋯ In this study, LA maximum volume and PA-TDI duration were found to be the independent predictors of the development of POAF after CABG. Echocardiographic predictors of left atrial electromechanical dysfunction may be useful in risk stratifying of patients in terms of POAF development after CABG.
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J Interv Card Electrophysiol · Apr 2013
Clinical TrialReverse atrial electrical remodelling induced by continuous positive airway pressure in patients with severe obstructive sleep apnoea.
Obstructive sleep apnoea (OSA) is associated with cardiovascular morbidity and mortality, including atrial arrhythmias. Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA; its impact on atrial electrical remodelling has not been fully investigated. Signal-averaged p-wave (SAPW) duration is an accepted marker for atrial electrical remodelling. ⋯ CPAP induced reverse atrial electrical remodelling in patients with severe OSA as represented by a significant reduction in SAPW duration.
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J Interv Card Electrophysiol · Apr 2013
Clinical evaluation of a new technique to monitor return electrode skin temperature during radiofrequency ablation.
Return electrode burns occur occasionally in cardiac radiofrequency ablation and more frequently in tumor radiofrequency ablation. A return electrode incorporating a thermochromic liquid crystal (TLC) layer, which changes color with temperature, has been shown in sheep studies to accurately indicate underlying skin temperature. We aimed to validate the accuracy of TLC-coated return electrodes in indicating skin temperature in the clinical setting of cardiac radiofrequency ablation. ⋯ TLC-coated return electrodes accurately indicate underlying skin temperature in cardiac radiofrequency ablation and may help prevent burns. This technology might be essential in high energy radiofrequency ablation.