The Role of Left Atrial Muscular Bundles in Catheter Ablation of Atrial Fibrillation

Chang, Shih Lin; Tai, Ching Tai; Lin, Yenn Jiang; Wongcharoen, Wanwarang; Lo, Li Wei; Lee, Kun Tai; Chang, Sheng Hsiung; Tuan, Ta Chuan; Chen, Yi Jen; Hsieh, Ming Hsiung; Tsao, Hsuan Ming; Wu, Mei-Han; Sheu, Ming-Huei; Chang, Cheng Yen; Chen, Shih Ann

doi:10.1016/j.jacc.2007.05.026

Cited by 46 publications

(43 citation statements)

References 38 publications

(34 reference statements)

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“…The PWV of patients with stroke into atrial fibrillation (0.21±0.0665 m/s) is greater than those with both stroke and atrial fibrillation (0.15±0.0502 m/s). Our result agreed with the physiological fact that patients suffering from atrial fibrillation would have excessively high rate of cardiac contraction caused by disorder in the heart's electrical impulses [9]. …”

Section: Pulse Wave Velocity (Pwv)supporting

confidence: 89%

“…Description of the adopted computed tomography protocols have been reported [9,10,11]. The Right Ventricle (RV), left ventricle (LV) and Pulmonary Arterial (PA) images are acquired by electrocardiographically gated, 64-slice multidetector computed tomography scanner (Brilliance CT 64-channel configuration, Philips Healthcare, Amsterdam, Netherlands).…”

Section: Computed Tomography Studymentioning

confidence: 99%

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To Estimate Pulmonary Arterial Compliance and Pulse Wave Velocity in Cerebral-Cardiovascular Patients Using CT Cardiac Images

Hu¹,

Tsao²,

Zhi³

et al. 2017

AJMBR

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Arterial stiffness has been proven to be one of the most promising diagnostic and prognostic features of many cardiovascular diseases (CVD). Arterial compliance (AC) and pulse wave velocity (PWV) allows a good quantitative assessment of arterial stiffness. To estimate pulmonary Arterial Compliance and Pulse Wave Velocity in Cerebral-Cardiovascular Patients using 64-Row Multi-Detector Computed Tomography Cardiac Images. Here in this work, we have used an in house developed three-dimensional reconstruction algorithm that extracts high-resolution cardiac Computer Tomography images in Digital Imaging and Communications in Medicine (DICOM) format from nine subjects. The subjects consist four patients with stroke (SR) turned to atrial fibrillation (AF) and five patients with both SR and AF. The calculation showed strok volume of Left and Right Ventricles, which are near equal to 62.56±12.61 ml and 65.95±13.13 ml, respectively, with a good positive correlation (R = 0.717, p < 0.0001) while pulse wave velocity and arterial compliance are calculated to be 0.21±0.0665 m/s and 0.09 ± 0.0547 ml/mmHg for patients with SR turned AF, 0.15±0.0502 m/s and 0.10 ± 0.0438 for the SR and AF patients. We concluded that the derived methodology for calculation of PWV and AC from 3D cardiac CT images could be used as an index in the evaluation of arterial stiffness.

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Section: Pulse Wave Velocity (Pwv)supporting

confidence: 89%

Section: Computed Tomography Studymentioning

confidence: 99%

To Estimate Pulmonary Arterial Compliance and Pulse Wave Velocity in Cerebral-Cardiovascular Patients Using CT Cardiac Images

Hu¹,

Tsao²,

Zhi³

et al. 2017

AJMBR

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“…23 Chang et al reported a macroreentrant AT rotating around the anteroseptal muscular bundle. 24 We also found a similar LA anterior localized AT confined to the anterior LA irrelevant to the previous ablation line.…”

Section: Mechanism Of Ongoing Atsupporting

confidence: 69%

Atrial Tachycardia During Ongoing Atrial Fibrillation Ablation - EnSite Array Analysis -

Nagamoto¹,

Tsuchiya²,

Miyamoto³

et al. 2011

Circ J

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Background: Atrial tachycardia (AT) occurring during atrial fibrillation (AF) ablation is sometimes difficult to identify and eliminate. EnSite Array (EA) visualizes beat-to-beat virtual activation of AT. The aim of the present study was to characterize AT occurring during AF ablation during ongoing AF, using EA. Methods and Results:Among 90 patients with AF (paroxysmal, n=67; persistent, n=23) who underwent radiofrequency catheter ablation during ongoing AF, 33 (37%) had 46 ATs that developed during ablation, and 9 (10%) of these patients had 9 ATs that developed before ablation. AT was sustained in 39 and non-sustained in 7. Nineteen ATs resulted from a focal mechanism and 27 from macroreentry. The major AT foci were distributed in the pulmonary vein (n=8) and left atrial roof (n=3), and macroreentrant ATs mainly consisted of peri-mitral AT (n=10), common atrial flutter (n=10), and roof reentrant AT (n=3). After EA-guided ablation of AT, 41 ATs in 28 patients (85%) were eventually rendered non-inducible. During 21±8 months of follow-up, 30 of the 33 patients (91%) were free from AF/AT recurrence. Conclusions:AT occurred in 37% of the patients during ongoing AF ablation, resulting from a focal or reentrant mechanism in diverse locations. Peri-mitral AT, common atrial flutter, and AT from the pulmonary vein were frequently observed. These ATs were eliminated by EA-guided radiofrequency ablation in most cases. (Circ J 2011; 75: 1080 - 1089)

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“…36 -38 Complex subendocardial fiber orientation properties favor conduction block, reentry, and wave break. 37 Heterogeneous fibrosis in the posterior LA anchors reentry and generates conduction delays, wave breaks, and signal fractionation. 38 Cardiac autonomic inputs pass through epicardial ganglionated plexuses.…”

Section: Roles Of Specific Structuresmentioning

confidence: 99%

Atrial Fibrillation Pathophysiology

et al. 2011

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Abstract-Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, is an important contributor to population morbidity and mortality. An arrhythmia that is particularly common in the elderly, AF is growing in prevalence with the aging of the population. Our understanding of the basic mechanisms that govern AF occurrence and persistence has been increasing rapidly. This article reviews the basic pathophysiology of AF over a broad range of levels, touching on the tissue mechanisms that maintain the arrhythmia, the relationship between clinical presentation and basic mechanisms, ion channel and transporter abnormalities that lead to ectopic impulse formation, basic models and tissue determinants of reentry, ion channel determinants of reentry, the nature and roles of electric and structural remodeling, autonomic neural components, anatomic factors, interactions between atrial and ventricular functional consequences of AF, and the basic determinants of atrial thromboembolism. We then review the potential implications of the basic pathophysiology of the arrhythmia for its management. We first discuss consequences for improved rhythm control pharmacotherapy: targeting underlying conditions, new atrium-selective drug targets, new targets for focal ectopic source suppression, and upstream therapy aiming to prevent remodeling. We then review the implications of basic mechanistic considerations for rate control therapy, AF ablation, and the prevention of thromboembolic events. We conclude with some thoughts about the future of translational research related to AF mechanisms. (Circulation. 2011; 124:2264-2274.)Key Words: antiarrhythmia agents Ⅲ arrhythmia Ⅲ calcium Ⅲ electrophysiology Ⅲ reentry A trial fibrillation (AF), the most common sustained cardiac arrhythmia, is becoming progressively more prevalent with population aging. 1 Enormous advances in the understanding of AF pathophysiology have occurred over the past 20 years. 2,3 The present article, part of a thematic series in Circulation on AF, provides a broad overview of AF pathophysiology and the potential implications for AF management. In addition, it furnishes background information on basic mechanisms relevant to other articles in the series dealing with AF epidemiology and genetics, stroke prevention, rate control therapy, sinus rhythm maintenance pharmacotherapy, management in structural heart disease, and catheter ablation. For more comprehensive treatment of specific mechanisms, the reader is referred to detailed review articles. [2][3][4][5]

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The Role of Left Atrial Muscular Bundles in Catheter Ablation of Atrial Fibrillation

Cited by 46 publications

References 38 publications

To Estimate Pulmonary Arterial Compliance and Pulse Wave Velocity in Cerebral-Cardiovascular Patients Using CT Cardiac Images

To Estimate Pulmonary Arterial Compliance and Pulse Wave Velocity in Cerebral-Cardiovascular Patients Using CT Cardiac Images

Atrial Tachycardia During Ongoing Atrial Fibrillation Ablation - EnSite Array Analysis -

Atrial Fibrillation Pathophysiology

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