National Registry on Cardiac Electrophysiology (2010 and 2011)

Madeira, Francisco; Oliveira, Mário; Ventura, Miguel; Primo, João; Bonhorst, D; Morais, Carlos

doi:10.1016/j.repce.2013.01.010

Cited by 8 publications

(2 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[16][17][18] Endocardial ablation of ventricular arrhythmias is performed in a large number of centers, but some ventricular arrhythmias can better be ablated from the epicardial side. 19,20 An epicardial approach, however, is associated with severe complications like cardiac tamponade, ventricular arrhythmias, phrenic nerve damage, and damage to the coronary arteries.…”

Section: Discussionmentioning

confidence: 99%

Safety and Feasibility of Closed Chest Epicardial Catheter Ablation Using Electroporation

Neven

Driel

Wessel

et al. 2014

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

Background-Permanent coronary artery damage is a hazardous complication of epicardial radiofrequency ablation.Irreversible electroporation (IRE) is a promising nonthermal ablation modality able to create deep myocardial lesions. We investigated the effects of epicardial IRE on luminal coronary artery diameter and lesion depth. Methods and Results-In 5 pigs (60-75 kg), the pericardium was exposed using surgical subxiphoidal epicardial access. A custom deflectable octopolar 12-mm circular catheter with 2-mm ring electrodes was introduced in the pericardium via a steerable sheath. After coronary angiography (CAG), the proximal, mid, and distal left anterior descending, and circumflex coronary arteries were targeted with a single, cathodal 200 J application. CAG was repeated after IRE and after 3 months follow-up. Using quantitative CAG, the minimal luminal diameter at the lesion site was compared with the average of the diameters just proximal and distal to that lesion. Study ProtocolThe study was performed in 6 pigs (weight 60-75 kg). Amiodarone therapy was started 1 week before the index procedure (400 mg once daily) to prevent procedure-related arrhythmias. Carbasalate calcium (80 mg once daily) and clopidogrel (75 mg once daily) therapy was started 3 days before the index procedure and continued until euthanasia. The animals were sedated, intubated, and anesthetized according to standard procedures. Using a surgical subxiphoidal pericardial approach, a custom deflectable octopolar 12-mm circular catheter with 2-mm ring electrodes was introduced in the pericardial space via a 40-cm 8.5F deflectable sheath (Agilis EPI Steerable Introducer; St Jude Medical, St Paul, MN; Figure 1). After left anterior descending artery (LAD) and circumflex coronary artery (RCx) angiography, the mid and distal LAD and RCx were targeted with electroporation catheter ablation ( Figure 2). A single, cathodal 200 J application was delivered. This was repeated at 2 or 3 different locations over the LAD and RCx while avoiding overlap. The energy was generated by a monophasic external defibrillator (Lifepak 9; Physio-Control, Inc, Redmond, WA). A large skin patch (7506; Valleylab Inc, Boulder, CO) on the lower back served as indifferent electrode. A cathodal polarity was chosen because that has the highest threshold for arcing in a blood environment. 13 Coronary angiography (CAG) was repeated after the last application.After 3-month survival, CAG of the LAD and RCx was repeated, the thorax was opened by sternotomy, and the animal was euthanized by exsanguination. After the heart was removed, the pericardium was peeled off and the areas with ablation lesions were excised and fixated in formalin. Measurement of Coronary DiametersLuminal diameters of the coronary artery, proximal and distal to the application site, and the minimal diameter at the application site were measured using quantitative CAG. The latter value was then compared with the average value of the diameters proximal and distal to the application site. Histological Evaluation...

show abstract

Section: Discussionmentioning

confidence: 99%

Safety and Feasibility of Closed Chest Epicardial Catheter Ablation Using Electroporation

Neven

Driel

Wessel

et al. 2014

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

show abstract

“…AF accounted for 26% of interventions, for the first time exceeding atrioventricular nodal reentrant tachycardia (25%), followed by atrioventricular accessory pathways (20%) and atrial flutter (17.4%), similar percentages to previous years. 2 Ablation of ventricular arrhythmia and atrial tachycardia remained uncommon indications (≤5% each), despite technical advances in the procedure and improved success rates with the use of three-dimensional mapping systems. Atrioventricular junction ablation continued to be the least frequent intervention (3.1%), although this represents an increase of 1%, probably due to its indication for patients with permanent AF treated by ventricular resynchronization therapy for heart failure.…”

Section: Electrophysiologic Studies and Catheter Ablationsmentioning

confidence: 99%

National Registry on Cardiac Electrophysiology (2012)

Oliveira

Madeira

Bonhorst³

et al. 2014

Revista Portuguesa de Cardiologia (English Edition)

Self Cite

View full text Add to dashboard Cite

Based on a survey sent to Portuguese centers that perform diagnostic and interventional electrophysiology and/or implantable cardioverter-defibrillator (ICD) implantations, the authors analyze the number and type of procedures performed during 2012 and compare these data with previous years.In 2012, a total of 2561 diagnostic electrophysiologic studies were performed, which were followed by ablation in 2017 cases, representing a steady situation compared with the previous year. There was a 12% increase in the number of ablation procedures for atrial fibrillation, making it for the first time the most frequent indication for ablation, overtaking atrioventricular nodal reentrant tachycardia.The total number of first ICD implantations was 1048 (around 100 per million population), of which 375 were cardiac resynchronization devices (BiV ICDs). This represents a slight decrease (3.3%) in the total number of new implants, with a relative increase of 10% in the number of BiV ICDs compared to the previous year. However, there was a considerable increase in the number of ICD generator replacements, resulting in an overall increase of 3.5% in implantations performed in 2012.Some comments are made regarding developments in this activity and its current status, and on some factors that may influence the dynamics of this area of interventional cardiology. Document downloaded from http://www.elsevier.pt, day 04/12/2014. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. 584M. Oliveira et al. O número total de primeiras implantações de CDI foi de 1.048 (cerca de 100/milhão de habitantes), sendo que, destes, 375 eram CDI com ressincronização ventricular (CDI BIV). Estes dados traduzem um ligeiro decréscimo (3,3%) do número de primeiras implantações, com um aumento relativo de 10% no número de CDI BIV face ao ano anterior. No entanto, verificou-se um crescimento muito significativo no número de substituições de geradores de CDI, de que resultou um acréscimo de 3,5% no total de implantações efetuadas em 2012. São feitas algumas considerações acerca da evolução e estado atual desta atividade hospitalar e sobre alguns fatores que poderão influenciar a dinâmica verificada nesta área da cardiologia de intervenção. PALAVRAS-CHAVE

show abstract

Catheter ablation in the treatment of electrical storm: Integrative review

Leal

Monteiro

Júnior

2017

Indian Pacing and Electrophysiology Journal

View full text Add to dashboard Cite

BackgroundThe incidence of electrical storm (ES) has been increasing with the rise of the indicated uses of implantable cardioverter defibrillators (ICDs). It is estimated that 20% of patients will evolve to have this complication. Ablative therapy stands out as the treatment for this condition when it is refractory to antiarrhythmic treatment. The objective was to define the current role of catheter ablation in the treatment of electrical storm.MethodsAn integrative literature review was performed using the PubMed and BVS databases. All identified articles were screened and verified for eligibility by the authors.ResultsTwenty-five out of the initial 951 articles were used in the final analysis. The categories listed for analysis included indication for ablation in ES, modality of the approach, therapeutic success, complications related to the procedure, mortality and cardiovascular follow-up and alternative therapeutic modalities by frequency of these categories in the articles researched.ConclusionCatheter ablation is the initial therapy for patients with ischemic cardiomyopathy (ICM) and ES. The endocardial approach presents more relevant success rates than the other therapeutic methods presented.

show abstract

National Registry on Cardiac Electrophysiology (2010 and 2011)

Cited by 8 publications

References 1 publication

Safety and Feasibility of Closed Chest Epicardial Catheter Ablation Using Electroporation

Safety and Feasibility of Closed Chest Epicardial Catheter Ablation Using Electroporation

National Registry on Cardiac Electrophysiology (2012)

Catheter ablation in the treatment of electrical storm: Integrative review

Contact Info

Product

Resources

About