1/172. Minimally invasive cardiac surgery with surgical ablation of atrial fibrillation.Surgical ablation for atrial fibrillation with mitral valve operations has been often performed in patients who have chronic atrial fibrillation associated with mitral valve disease. We describe a case of the combined operation through a small incision. A 49-year-old woman presented with a 1-month history of left hemiplegia. echocardiography confirmed mitral stenosis and electrocardiogram revealed atrial fibrillation. The duration of the atrial fibrillation before admission was 12 years. Mitral commissurotomy, removal of clots, and surgical ablation for atrial fibrillation was performed through an 8-cm right parasternal incision. The right femoral artery and vein were used for cannulation. Another cannula was inserted into the superior vena cava. The extended use of cryoablation was carried out instead of atriotomy or reanastomosis. The patient was extubated for 5 hours after the operation. atrial fibrillation was converted to a sinus rhythm. On the basis of our experience, this procedure seemed promising.- - - - - - - - - - ranking = 1keywords = ablation (Clic here for more details about this article) |
2/172. Congestive heart failure induced by recipient atrial tachycardia conducted to the donor atrium after orthotopic heart transplantation: complete regression after successful radiofrequency ablation.We describe the case of a 30-year-old female patient who developed an interatrial tachycardia from the recipient to the donor atrium associated with signs of congestive heart failure 5 years after orthotopic heart transplantation. The patient underwent catheter mapping followed by successful radiofrequency (RF) ablation at the site of the presumed electrical connection between the recipient and the donor atria, through the interatrial surgical suture line, with stable recovery of sinus rhythm and disappearance of signs of left ventricular dysfunction. RF catheter ablation is confirmed to be feasible and safe in the treatment of heart transplant patients even in the presence of rare forms of arrhythmias, thus offering a cure for tachycardia to these patients.- - - - - - - - - - ranking = 0.85714285714286keywords = ablation (Clic here for more details about this article) |
3/172. Possibility of focal activation around the left upper pulmonary vein during chronic atrial fibrillation with mitral valve disease.Focal regular activations were sometimes observed during chronic atrial fibrillation (AF) associated with mitral valve disease. We present a 58 year-old male diagnosed with mitral valvular stenosis and regurgitation with chronic atrial fibrillation. Intraoperative mapping of both atria was performed during mitral valvular surgery. Regular and repetitive activations around the left superior pulmonary vein were observed, in contrast to irregular and chaotic activations of the right atrium. This regular activation was supposed to be the focus of chronic AF. Surgical ablation of the posterior left atrium was successfully performed and eliminated the chronic AF, concomitant with mitral valve replacement.- - - - - - - - - - ranking = 0.14285714285714keywords = ablation (Clic here for more details about this article) |
4/172. A practical approach to atrial fibrillation.Management of atrial fibrillation is still an individualized proposition, requiring considerable clinical judgment to select the most effective means of controlling cardiac rate and rhythm and preventing thromboembolism and stroke. The advantages and disadvantages of electric shock cardioversion, catheter ablation, and several medicinal and mechanical agents are discussed.- - - - - - - - - - ranking = 0.14285714285714keywords = ablation (Clic here for more details about this article) |
5/172. The role of atrial electrical remodeling in the progression of focal atrial ectopy to persistent atrial fibrillation.Although atrial fibrillation- (AF) induced changes in atrial refractoriness (atrial electrical remodeling) have been demonstrated in a number of different animal models, the clinical significance of this process is unknown. We describe a patient in whom there has been documented progression of atrial ectopy to persistent AF accompanied by evidence of atrial electrical remodeling, with reversal of remodeling following successful ablation of the focal source of AF. A second patient with focal AF, but with a "nonfocal" appearance on the ECG, is also described. These cases illustrate: (1) the possibility that a significant proportion of younger patients with idiopathic persistent AF may well have a focal source as the underlying abnormality; and (2) atrial electrical remodeling reverses following ablation of the underlying source.- - - - - - - - - - ranking = 0.28571428571429keywords = ablation (Clic here for more details about this article) |
6/172. Symptomatic atrioventricular dual pathway double responses: a role for slow pathway ablation.Two patients with symptomatic fast/slow pathway double responses were evaluated with electrophysiology studies. Chronic palpitations were resistant or worsened by medical therapy. No reentry tachycardias were induced. A nonreentrant paroxysmal supraventricular tachycardia was documented. Radiofrequency ablation of the slow pathway was safely and successfully performed. patients remain asymptomatic for 16-18 months. Ablation of the slow pathway for this substrate is a viable option.- - - - - - - - - - ranking = 0.71428571428571keywords = ablation (Clic here for more details about this article) |
7/172. Left atrial tachycardia after right atrial separation for chronic atrial fibrillation with atrial septal defects.A right atrial separation procedure was performed for the ablation of chronic atrial fibrillation in four cases, concomitant with the repair of the atrial septal defect. After the operation, chronic atrial fibrillation disappeared in three of them and left atrial tachycardia occurred in the other one. Left atrial tachycardia is an arrhythmia encountered after a right atrial separation procedure.- - - - - - - - - - ranking = 0.14285714285714keywords = ablation (Clic here for more details about this article) |
8/172. Radiofrequency catheter ablation of atrial fibrillation initiated by pulmonary vein ectopic beats.Ectopic beats from the pulmonary veins (PVs) have been demonstrated to initiate atrial fibrillation (AF). This article describes the conceptual approach to mapping, interpretation of different electrograms, and ablation of AF initiated by PV ectopic beats.- - - - - - - - - - ranking = 0.71428571428571keywords = ablation (Clic here for more details about this article) |
9/172. atrial fibrillation and continuous hypotension induced by sildenafil in an intermittent WPW syndrome patient.A 55-year-old Japanese man was hospitalized for palpitations and severe chest oppression one hour after he ingested about 1500 ml of beer and sildenafil (Viagra) 50 mg. At 43 years of age, he had been diagnosed with intermittent WPW syndrome following a paroxysmal supraventricular tachycardia (PSVT) attack. He took a 1 mg tablet of doxazosin daily for mild hypertension. On admission, his blood pressure was 90/54 mmHg and his heart beat was weak and irregular with a rate of about 220/min. Since atrial fibrillation (Af) was diagnosed on an electrocardiogram (minimum RR interval; 0.22 seconds), direct current shock was performed with 100 joules and 150 joules but conversion to sinus rhythm failed. Sinus rhythm returned spontaneously from Af four hours after taking sildenafil. Since blood pressure was 50/17 mmHg despite the return to sinus rhythm, blood pressure was maintained by dopamine for twelve hours after sinus rhythm returned. The patient underwent catheter ablation for curative therapy and thereafter has not had any further episodes of tachycardia.- - - - - - - - - - ranking = 0.14285714285714keywords = ablation (Clic here for more details about this article) |
10/172. Exit block of focal repetitive activity in the superior vena cava masquerading as a high right atrial tachycardia.An unusual case of atrial tachycardia (AT) originating from the superior vena cava (SVC) is reported. A 34-year-old man without structural heart disease underwent catheter ablation for drug-resistant AT. During the tachycardia, low-amplitude spiky electrograms with a cycle length of 120 to 175 msec were recorded in the SVC and exhibited 2:1 exit block to the atria, masquerading as the atrial activation observed with high right AT. These spiky electrograms also were observed during sinus rhythm, but they appeared immediately after the local atrial electrograms. The spikes were traced to a point 3 cm above the junction of the right atrium. Radiofrequency ablation at the site of the earliest appearance of the spike in the SVC successfully eliminated the tachycardia. During the following 15 months, no clinically significant atrial arrhythmias, including atrial fibrillation, occurred. This report indicates that careful mapping, including inside the SVC, will be a requisite in patients with high right atrial tachyarrhythmias.- - - - - - - - - - ranking = 0.28571428571429keywords = ablation (Clic here for more details about this article) |
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