Atrial Fibrosis Helps Select the Appropriate Patient and Strategy in Catheter Ablation of Atrial Fibrillation: A DE-MRI Guided Approach

Akoum, Nazem; Daccarett, Marcos; McGann, Chris; Segerson, Nathan M.; Vergara, Gaston; Kuppahally, Suman S.; Badger, Troy J.; Burgon, B S Nathan; Haslam, B S Thomas; Kholmovski, Eugene; MacLeod, Rob S.; Marrouche, Nassir F.

doi:10.1111/j.1540-8167.2010.01876.x

Cited by 312 publications

(275 citation statements)

References 30 publications

Supporting

Mentioning

245

Contrasting

Unclassified

Order By: Relevance

“…Metaanalizler ile pulmoner venler RF ablasyon ile izole edildiğinde büyük oranda AF tekrarlamadığı gösterilmiştir [7,21]. Ablasyon sayısı arttıkça AF ataklarının daha fazla azaldığı gösterilmiştir [22]. Bizim tek sefer olarak uyguladığımız kriyoablasyon tedavisi literatür ile uyumlu bir oranda başarılı olduğunu göstermiştir.…”

Section: Discussionunclassified

Clinical results of atrial fibrillation patients treated with cryoballoon ablation: A single center experience

Aydın

Polat²,

Yüksel³

et al. 2015

J Clin Exp Invest

View full text Add to dashboard Cite

Objective: Atrial fibrillation (AF), the most common arrhythmia in clinical practice, is a major cause of stroke. Atrial fibrillation increases morbidity and mortality. Nowadays cryoablation therapy is being performed efficiently and safely worldwide. In this paper the clinical outcomes of the patients whom were treated with cryoablation were discussed. Methods:Between June 2012 and March 2014, patients with paroxysmal AF who were treated with cryoablation were included in the study. The medical records of the patients were retrospectively reviewed. Patients were called to receive information about the symptom recurrence.Results: Twelve patients were included in the study. Half of the patients were female. The mean age was 48 ± 15 years. Acute procedural success rate of cryoablation was 100%. In one patient transient right phrenic nerve injury occurred which was returned to normal after discontinuation of cryoablation therapy. One patient developed AF episode for 10 minutes in the 4th month of follow-up period. Conclusion:In patients with paroxysmal atrial fibrillation cryoablation effectively decrease symptoms consistent with the literature. J Clin Exp Invest 2014; 5 (4): 599-603

show abstract

Section: Discussionunclassified

Clinical results of atrial fibrillation patients treated with cryoballoon ablation: A single center experience

Aydın

Polat²,

Yüksel³

et al. 2015

J Clin Exp Invest

View full text Add to dashboard Cite

show abstract

“…The combination of small volumes with a decreased emptying index in patients with AF parox strongly suggests restrictive atrial disease as potential cause of LA after-load mismatch [22]. Atrial fibrosis was proposed as risk factor for recurrence of atrial fibrosis based on a magnetic resonance imaging study recently [27]. Speckle strain imaging of the LA to may help to quantify atrial fibrosis in echocardiography and is currently evaluated [21].…”

Section: Discussionmentioning

confidence: 99%

Untitled

2013

J Cardiobiol

View full text Add to dashboard Cite

Purpose: Pulmonary vein isolation (PVI) is established as interventional treatment in atrial fibrillation (AF). Recent studies suggest that atrial reservoir function (preload) is involved in initiation of paroxysmal AF (AFparox) and conduit function (after-load) may be crucial in persistent AF (AFpers). Methods:We enrolled 336 consecutive patients scheduled for PVI (age 60±10 years). Point-to-point radiofrequency ablation was used in the majority of cases. Success was defined as a minimum of 3 months (median 12 months) follow-up as absence of recurrence of AF in any Holter ECG since PVI. in particular pulmonary vein isolation (PVI), can be considered as an early option in the management of patients with AF [5]. Success rates of the initial ablation procedure depend on the definition of success; they vary between 60 and 85% for AFparox and are lower for persistent AF (AFpers) [3,[6][7][8][9].The initiation of AF requires both a trigger and a susceptible substrate. In recurrent AFparox ectopic focal activity is thought to be local and limited to one or a few sites. On the contrary in AFpers there tend to be multiple ectopic sites throughout the atria and advanced damage of atrial myocardium (more susceptible substrate) [10][11][12][13]. Large left atrial (LA) size was found to be a predictor of recurrence of AF after electrical or pharmacological cardio-version as well as after ablative treatment [14][15][16][17]. The prognostic value of volume seems to be absent in AFparox, however [18].LA function comprises three phases: reservoir, conduit and active contraction phase [19]. LA-active function increases with slight volume load as long as LA structural dilatation is limited [19,20]. Thus, in early LA dysfunction as expected in AFparox systolic LA dimensions are ambiguous, because an increased systolic volume may reflect increased loading and/or size (history of dilatation).Recent studies suggest that preserved atrial reservoir function related to preload is a predictor of success [21]. Impairment of atrial reservoir function and poor long-term success of PVI in small left atria was related to enhanced fibrosis [22]. Whereas conduit function related to after-load may become increasingly important for PVI success in large atria with poor emptying.Thus, we tested the hypothesis that in AFparox atrial reservoir function and in AFpers residual conduit function is crucial for success of PVI by an analysis in the function-size plane in a retrospective study in our PVI data-base. As second end points we wanted to identify echocardiographic parameters potentially predicting recurrence of AF after PVI and elucidate the impact of body mass index (BMI) in this context.

show abstract

“…Furthermore, during ablation, MRI offers valuable information on temperature variation of the target tissue. These benefits offer the potential to improve the plan of therapy, prevent complications and enhance procedure efficiency and outcome [51,[56][57][58][59].…”

Section: Cardiac Arrhythmiasmentioning

confidence: 99%