2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary

Calkins, Hugh; Hindricks, Gerhard; Cappato, Riccardo; Kim, Young Hoon; Saad, Eduardo; Aguinaga, Luis; Akar, Joseph G.; Badhwar, Vinay; Brugada, Josép; Camm, John; Chen, Peng Sheng; Chen, Shih Ann; Chung, Mina K.; Nielsen, Jens Cosedis; Curtis, Anne B.; Davies, D. Wyn; Day, John D.; d’Ávila, André; Groot, Natasja M.S. de; Biase, Luigi Di; Duytschaever, Mattias; Edgerton, James R.; Ellenbogen, Kenneth A.; Ellinor, Patrick T.; Ernst, Sabine; Fenelon, Guilherme; Gerstenfeld, Edward P.; Haines, David E.; Haı̈ssaguerre, Michel; Helm, Robert H.; Hylek, Elaine M.; Jackman, Warren M.; Jalife, José; Kalman, Jonathan M.; Kautzner, Josef; Kottkamp, Hans; Kuck, Karl Heinz; Kumagai, Koji; Lee, Richard; Lewalter, Thorsten; Lindsay, Bruce D.; Macle, Laurent; Mansour, Moussa; Marchlinski, Francis E.; Michaud, Gregory F.; Nakagawa, Hiroshi; Natale, Andrea; Nattel, Stanley; Okumura, Ken; Packer, Douglas L.; Pokushalov, Evgeny; Reynolds, Matthew R.; Sanders, Prashanthan; Scanavacca, Maurício; Schilling, Richard J.; Tondo, Claudio; Tsao, Hsuan Ming; Verma, Atul; Wilber, David J.; Yamane, Teiichi

doi:10.1016/j.joa.2017.08.001

Cited by 363 publications

(115 citation statements)

References 581 publications

(573 reference statements)

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“…To overcome sustained AF, it is crucial that these regions are and remain nonconductive. Nevertheless, the high rate of reoccurrence of AF after catheter ablation [39,40] suggests that scars may fail to block re-entries. This is at least in part caused by the resumption of electrical conductance due to heterocellular coupling in the scar tissue.…”

Section: Direct Coupling Of Cardiomyocytes and Fibroblastsmentioning

confidence: 99%

Cardiac fibroblasts

Klesen

Jakob

Emig

et al. 2018

Herzschr Elektrophys

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Fibrotic areas in cardiac muscle-be it in ventricular or atrial tissue-are considered as obstacles for conduction of the excitatory wave and can therefore facilitate re-entry, which may contribute to the sustenance of cardiac arrhythmias. Persistence of one of the most frequent arrhythmias, atrial fibrillation (AF), is accompanied by enhanced atrial fibrosis. Any kind of myocardial perturbation, whether via mechanical stress or ischemic damage, inflammation, or irregular and high-frequency electrical activity, activates fibroblasts. This leads to the secretion of paracrine factors and extracellular matrix proteins, especially collagen, and to the differentiation of fibroblasts into myofibroblasts. Excessive collagen production is the hallmark of fibrosis and impairs regular impulse propagation. In addition, direct electrical coupling between cardiomyocytes and nonmyocytes, such as fibroblasts and macrophages, via gap junctions affects conduction. Although fibroblasts are not electrically excitable, they express functional ion channels, in particular K channels and mechanosensitive channels, some of which could be involved in tissue remodeling. Here, we briefly review these aspects with special reference to AF.

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Section: Direct Coupling Of Cardiomyocytes and Fibroblastsmentioning

confidence: 99%

Cardiac fibroblasts

Klesen

Jakob

Emig

et al. 2018

Herzschr Elektrophys

View full text Add to dashboard Cite

show abstract

“…Ablation of non-PV triggers, if found, was given a Class IIA recommendation. 4 The most commonly used cardiac mapping approach is isochronal or activation mapping, which is based on non-fluoroscopic visualisation of mapping catheters and a partial model of the wavefront excitation sequence created by the manipulation of a mapping catheter. 32…”

Section: Methods Of Analysing the Extent And Severity Of Scarring Prementioning

confidence: 99%

High-resolution Mapping in Patients with Persistent Atrial Fibrillation: A Case-based Review of the PENTARAYTM Catheter

Andronache¹,

Drca²,

Viola³

2019

Arrhythm Electrophysiol Rev

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“…It is well recognized that different populations have variable response to treatment of AF. 25 Recently, for example, the Catheter Ablation versus Standard conventional Treatment in patients with LEft ventricular dysfunction and Atrial Fibrillation (CASTLE-AF) trial demonstrated that patients with symptomatic congestive heart failure with ejection fraction <35% obtain mortality benefit and reduction in heart failure hospitalizations with catheter ablation. 26 This was also suggested in the intention-to-treat primary endpoint (all cause mortality, disabling stroke, serious bleeding, cardiac arrest) sub-group analysis of not only heart failure patients, but also patients aged <65 years and those in minority populations in the Catheter ABlation versus ANtiarrhythmic drug therapy for Atrial fibrillation (CABANA) trial.…”

Section: Population-based Carementioning

confidence: 99%

The Next 10 Years in Atrial Fibrillation

Turner

Marrouche

2019

US Cardiology Review

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Predicting future advancements in arrhythmia management – specifically AF – with any certainty is impossible. The clinical approach to AF has changed markedly since the turn of the century in ways that could never have been foreseen, but the current methods of identification and treatment remain far from perfect. Over the next decade we expect significant continued progress in AF management. However, if asked to forecast the future, we consider it wise to predict advancements in the nearer term. We believe there will be widespread expansion in digital health and mobile devices, altering the way we detect and monitor the arrhythmia. We expect substantial growth in advanced MRI to aid in early detection, evaluation, and possibly non-invasive treatment of AF substrate. We imagine there will be increasing focus on individual populations to identify at-risk groups and personalize early management. We also anticipate improvement in anticoagulation employment and left atrial appendage modification. Finally, recognizing the benefit of improvement in modifiable risk factors such as mandatory tobacco cessation and weight loss in obese patients, we predict that reimbursement will be dependent on successfully addressing modifiable risk. For now, several questions remain unanswered, and while no one can predict the next 10 years in AF, there is, without doubt, an abundance of opportunity.

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2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary

Cited by 363 publications

References 581 publications

Cardiac fibroblasts

Cardiac fibroblasts

High-resolution Mapping in Patients with Persistent Atrial Fibrillation: A Case-based Review of the PENTARAYTM Catheter

The Next 10 Years in Atrial Fibrillation

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