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  • 1
    Online Resource
    Online Resource
    Catheter Ablation of Cardiac Arrhythmias : A Practical Approach (2006)
    Darmstadt : Steinkopff Verlag Darmstadt
    Details Availability
    Keywords: Medicine ; Internal medicine ; Cardiology ; Medicine & Public Health ; Cardiology ; Internal medicine ; Medicine ; Arrhythmias, Cardiac therapy ; Catheter Ablation methods ; Cardiology ; Internal medicine ; Medicine ; Medicine & Public Health ; Aufsatzsammlung ; Herzrhythmusstörung ; Hochfrequenz-Katheterablation
    Description / Table of Contents: Catheter ablation of cardiac arrhythmias is an important field of interventional cardiology. This comprehensive overview is a practical guide for: exact diagnosis of cardiac arrhythmias; mapping of cardiac arrhythmias with newest 3D technology; and catheter ablation of various arrhythmias from WPW syndrome to atrial fibrillation
    Type of Medium: Online Resource
    Pages: Online-Ressource (XII, 283 p., 201 illus., most in color, digital)
    ISBN: 9783798515765
    Series Statement: SpringerLink
    URL: https://doi.org/10.1007/3-7985-1576-X
    URL: http://dx.doi.org/10.1007/3-7985-1576-X
    URL: https://swbplus.bsz-bw.de/bsz280684126inh.htm
    URL: https://swbplus.bsz-bw.de/bsz280684126cov.jpg
    URL: http://www.gbv.de/dms/bowker/toc/9783798515758.pdf
    DOI: 10.1007/3-7985-1576-X
    RVK:
    YB 9215
    Language: English
    Note: Includes bibliographical references and index , Basic principles; Ablation of cardiac arrhythmias - energy sources and mechanisms of lesion formation; Three-dimensional electroanatomic mapping systems; Accessory pathways; Atrioventricular nodal reentrant tachycardia; Cavotricuspid isthmus-dependent atrial flutter - common-type atrial flutter; Atypical atrial flutter; Focal atrial tachycardia; Ventricular tachycardia; Catheter ablation of atrial fibrillation; Mapping and ablation in the pediatric population; Mapping and ablation in congenital heart disease
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  • 2
    Electronic Resource
    Electronic Resource
    LocaLisa Catheter Navigation Reduces Fluoroscopy Time and Dosage in Ablation of Atrial Flutter: (2003)
    350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 14 (2003), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: Catheter ablation has become a well-established therapy for isthmus-dependent right atrial flutter (AFL). Recently, mapping and ablation of AFL have been performed using sophisticated three-dimensional mapping systems, such as electroanatomic and noncontact mapping systems. The LocaLisa system enables nonfluoroscopic navigation of intracardiac electrode catheters based on impedance changes related to catheter movements in transthoracic current fields. The aim of this randomized prospective study was to compare the efficacy of the LocaLisa system with the conventional mapping/ablation approach for radiofrequency ablation of AFL. Methods and Results: Fifty consecutive patients with AFL (39 men and 11 women; age 65 ± 10 years) were studied. The patients were randomly assigned to undergo radiofrequency ablation guided by a conventional fluoroscopy-based approach (24 patients) or by the LocaLisa system (26 patients). Ablation success rate and documentation of bidirectional isthmus block were 100% in both groups. Compared with fluoroscopy-guided approaches, LocaLisa-guided procedures demonstrated a reduction in total fluoroscopy time from 15.9 ± 10.6 minutes to 7.5 ± 6.5 minutes (P 〈 0.005). Total fluoroscopy dosage was reduced from 21.0 ± 19.8 to 8.7 ± 9.5 Gycm2 (P 〈 0.05). Fluoroscopy time required for ablation was significantly shortened in the LocaLisa group (2.6 ± 2.6 min) compared with the conventional approach group (11 ± 10 min, P 〈 0.0005). In 9 (35%) of 26 patients, the ablation could be performed with a fluoroscopy time ≤1 minute. There were no significant differences with regard to the number of radiofrequency applications, fluoroscopy time needed for diagnostic reasons, total procedure time, or other ablation data. Conclusion: Compared with the conventional approach, the LocaLisa system significantly reduces the fluoroscopy times needed for ablation of typical AFL. (J Cardiovasc Electrophysiol, Vol. 14, pp. 587-590, June 2003)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2003.03017.x
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  • 3
    Electronic Resource
    Electronic Resource
    Characterization of Onset Mechanism and Waveform Analysis in Patients with Atrial Fibrillation Using a High-Resolution Noncontact Mapping System (2003)
    350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 14 (2003), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Characterization of AF with Noncontact Mapping. Introduction: Information on the spatiotemporal organization of atrial activity at the onset of atrial fibrillation (AF) is limited. Methods and Results: The study consisted of 26 consecutive patients (22 men and 4 women; mean age 56 ± 9 years) with AF in whom the left atrium (LA) was mapped using a noncontact mapping system. At the onset of AF, the AF cycle lengths and wavefronts were analyzed at the site of origin of the triggering atrial premature complex (APC) and five predefined sites within the LA (superior, anterior, posterior, lateral, and septal walls). If repetitive activity was observed at the site of origin of APCs, triggered AF episodes were considered as focally driven. APCs that induced AF had shorter coupling intervals than APCs that did not induce AF (300 ± 41 msec vs 392 ± 64 msec, P 〈 0.001). Immediately after AF onset, repetitive firing was crucial for maintenance of arrhythmia in 52 (80%) of 65 AF episodes. In 13 AF onset episodes (20%), AF was maintained by other mechanisms. The number of LA wavefronts after AF onset was lower in focally driven AF episodes compared with episodes in which no focally driven activity was observed (1.9 ± 0.6 v. 2.3 ± 2.3 wavefronts, P 〈 0.05). After the onset of AF, the posterior wall of the LA showed the earliest disorganized activity (after 5.2 ± 3.1 cycles). Conclusion: In the majority of AF episodes (80%), repetitive firing from the triggering foci may play an important role in maintaining AF immediately after arrhythmia onset. In 20% of the episodes, AF at early stages seems to be maintained by other mechanisms. The capability of APCs to induce AF depends on the coupling interval and the focus localization. The posterior wall of the LA shows the earliest disorganization of wavefronts at the onset of AF. (J Cardiovasc Electrophysiol, Vol. 14, pp. 176-181, February 2003)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2003.02322.x
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  • 4
    Electronic Resource
    Electronic Resource
    Do Current Dual Chamber Cardioverter Defibrillators Have Advantages Over Conventional Single Chamber Cardioverter Defibrillators in Reducing Inappropriate Therapies? A Randomized, Prospective Study (2001)
    Oxford, UK : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 12 (2001), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Dual Chamber vs Single Chamber Cardioverter Defibrillators. Introduction: Supraventricular tachyarrhythmias are the main cause of inappropriate therapies in patients with conventional single chamber implantable cardioverter defibrillators (VVI-ICD). It was anticipated that dual chamber cardioverter defibrillators (DDD-ICD), with their capacity to analyze atrial and ventricular rhythm, could substantially reduce inappropriate therapies. Methods and Results: Our prospective study included 92 patients (87 men; mean age 61 ± 12.7 years) who were randomly assigned to a VVI-ICD (45 patients) or a DDD-ICD (47 patients). Both groups were followed for 7.5 ± 3.5 and 7.6 ± 4.1 months, respectively. During the follow-up period, overall 725 ventricular tachycardia (VT)/ventricular fibrillation (VF) episodes were recorded in 45 (49%) of 92 patients. Of these episodes, 404 (56%) occurred in the VVI-ICD group and 321 (44%) episodes occurred in the DDD-ICD group. Twenty-three (51%) patients in the VVI-ICD group and 22 (47%) patients in the DDD-ICD group (P = 0.8) developed VT/VF. Overall, 73 (10%) of 725 treated episodes were inappropriate in 6 (13%) patients in the VVI group and in 10 (21%) patients in the DDD-ICD group (P = 0.2). There were 22 (31%) inappropriately treated episodes in the VVI-ICD group and 51 (69%) in the DDD-ICD group. Thirty-two of the 51 inappropriate episodes in the DDD-ICD patients resulted from intermittent atrial sensing problems that led to failure of the respective dual chamber algorithms. Nonfatal complications occurred in 6 (13%) patients in the VVI-ICD group and in 3 (6%) patients in the DDD-ICD group (P = 0.7). Conclusion: We conclude that the implanted DDD-ICD and conventional VVI-ICD are equally safe and effective for therapy of life-threatening ventricular tachyarrhythmias. Although DDD-ICDs allow better rhythm classification, the applied detection algorithms do not offer benefits in avoiding inappropriate therapies during supraventricular tachyarrhythmias.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2001.00134.x
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  • 5
    Electronic Resource
    Electronic Resource
    Noncontact Mapping-Guided Catheter Ablation of Atrial Fibrillation Associated with Left Atrial Ectopy (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 11 (2000), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Noncontact Mapping of Atrial Fibrillation. We report the use of a novel noncontact mapping system used to perform left atrial mapping and to guide radiofrequency ablation in two patients, each with atrial fibrillation (AF) triggered by left atrial ectopy. A noncontact multielectrode probe and ablation catheter were advanced into the left atrium through a transseptal puncture or a patent foramen ovale. Isopotential mapping delineated the focal origin at the ostium of the right lower pulmonary vein in one patient and close to the ostium of the left upper pulmonary vein in the other patient. The ablation catheter was guided to the target sites using a locator signal. The foci were ablated successfully in both patients. No recurrences of AF were observed during follow-up at 4 and 6 months, respectively.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.2000.tb00345.x
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  • 6
    Electronic Resource
    Electronic Resource
    Paradoxical Atrial Undersensing Due to Inappropriate Atrial Noise Reversion of Atrial Fibrillation in Dual-Chamber Pacemakers (2005)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 16 (2005), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Paradoxical atrial undersensing at high atrial sensing levels was described as false atrial noise reversion of dual-chamber pacemakers during atrial fibrillation in a sheep model. It is unknown whether this phenomenon occurs in humans. Methods: In total, 71 patients with implanted dual-chamber pacemakers and atrial fibrillation were tested for the occurrence of paradoxical atrial undersensing. After determination of the sensing threshold of atrial fibrillation (30 seconds of continuous mode switch), the atrial sensing level was stepwise increased. If, after correct mode switch behavior at insensitive levels, loss of mode switch occurred at higher sensing levels and if the pacing mode was consistent with atrial noise reversion, paradoxical atrial undersensing was assumed. Results: Paradoxical atrial undersensing could be provoked in 9 of 71 (13%) patients at a median sensing level of 0.4 (range 0.15–2.0) mV. Six different pacemaker models of five different manufacturers were affected. The occurrence of paradoxical atrial undersensing was significantly associated with the sensing threshold of atrial fibrillation (2.7 ± 1.5 mV for patients with paradoxical undersensing compared to 1.6 ± 1.3 mV for those without, P = 0.02). Decreasing the atrial sensing level avoided paradoxical undersensing in 8 of 9 patients while maintaining an adequate safety margin for the detection of atrial fibrillation. Conclusion: Paradoxical atrial undersensing is inherent to all current dual-chamber pacemakers. The incidence is about 13% when using very high atrial sensing levels. Inappropriate atrial noise reversion can be resolved in most of the cases by decreasing atrial sensing levels and knowledge of this phenomenon is important to avoid unwarranted atrial lead revisions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.2005.40762.x
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  • 7
    Electronic Resource
    Electronic Resource
    Necessity for Biatrial Ablation to Achieve Bidirectional Cavotricuspid Isthmus Conduction Block in a Patient Following Senning Operation (2004)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 15 (2004), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report the case of a 28-year-old male patient with a 17-year history of recurrent symptomatic atrial tachyarrhythmia following Senning operation for transposition of the great arteries. Biatrial electroanatomic mapping and entrainment mapping revealed counterclockwise peri-tricuspid annulus reentry in which cavotricuspid isthmus tissue in both systemic and pulmonary venous atria was involved. Linear ablation of the cavotricuspid isthmus in the pulmonary venous atrium terminated the tachycardia but did not block the isthmus conduction, and the tachycardia was reinduced. Bidirectional isthmus conduction block could be achieved only after additional linear ablation targeting the cavotricuspid isthmus tissue in the systemic venous atrium. We conclude that biatrial ablation may be necessary in order to achieve bidirectional isthmus block and prevent tachycardia recurrence in some patients following Senning or Mustard operation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2004.03628.x
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  • 8
    Electronic Resource
    Electronic Resource
    Left Atrial Fibrillation with Regular Right Atrial Activation and a Single Left-to-Right Electrical Interatrial Connection: (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 11 (2000), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Multisite Mapping of Dissimilar Atrial Rhythms. We report two patients who had isolated atrial fibrillation in the left atrium and regular activation of the entire right atrium. Mapping of the arrhythmia was performed using a 64-electrode basket catheter that was inserted intravenously and deployed in the right and left atria. Both patients manifested a single, stable interatrial electrical connection conducting in a left-to-right direction, consistent with Bachmann's bundle location. The right and left sides of the interatrial septum were activated discordantly, each reflecting activation characteristics of the respective atria. A filtering effect at the level of interatrial septum was demonstrated by calculating the fibrillation intervals on both sides of the operative interatrial connection. It was concluded that differences in activation of the left and right surfaces of the interatrial septum and preferential use and the filtering effect of the interatrial connections play a significant role in explaining the differences in activation patterns of the left and right atria in patients with atrial fibrillation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.2000.tb00014.x
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  • 9
    Electronic Resource
    Electronic Resource
    Delineation of Intra-Atrial Reentrant Tachycardia Circuits After Mustard Operation for Transposition of the Great Arteries Using Biatrial Electroanatomic Mapping and Entrainment Mapping (2003)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 14 (2003), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: Intra-atrial reentrant tachycardia (IART) circuits after Mustard operation remain incompletely understood due to the complex atrial anatomy after extensive surgical procedures. The aim of this study was to delineate IART circuits and their relations to the individual anatomic boundaries in Mustard patients. Methods and Results: Twelve patients (10 men and 2 women; age 29 ± 4.6 years) with atrial tachyarrhythmias after Mustard operation were included in this study. During 14 IARTs and 2 focal atrial tachycardias, electroanatomic mapping and entrainment mapping were performed in both the systemic venous atrium and the pulmonary venous atrium. The latter was accessed via a retrograde transaortic approach. Thirteen IARTs used a single-loop reentrant circuit, and 1 IART used a dual-loop reentrant circuit. Ten (77%) of 13 single-loop reentrant circuits used the tricuspid annulus (TA) as their central barrier. The remaining 3 IARTs rotated around the inferior vena cava (IVC) (n = 2) or ostium of the right upper pulmonary vein (n = 1). In 6 (60%) of the 10 peritricuspid IARTs, both pulmonary venous atrium and systemic venous atrium components of the mid-portion of the TA-IVC isthmus were demonstrated to be part of the reentry. Overall, 12 (86%) of 14 IARTs in 10 patients were successfully ablated by bridging two barriers that constrained the reentrant circuit. Eight (80%) of 10 peritricuspid circuits were abolished by linear ablation connecting the TA to the IVC (n = 4), incisional scar (n = 2), patch (n = 1), and atriotomy (n = 1). Conclusions: In Mustard patients, the TA serves as the most frequent central barrier of IART. Biatrial electroanatomic mapping combined with entrainment mapping facilitates delineation of IART circuits in relation to their anatomic barriers and enables the design of individual ablation strategies to achieve high success. (J Cardiovasc Electrophysiol, Vol. 14, pp. 1302-1310, December 2003)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2003.03292.x
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  • 10
    Electronic Resource
    Electronic Resource
    Ectopic Tachycardia Originating from the Superior Vena Cava (2002)
    Oxford, UK : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 13 (2002), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Ectopic Tachycardia from the SVC. We report a 65-year-old female patient with a 3-year history of symptomatic paroxysmal supraventricular tachycardia. Electroanatomic and basket catheter mapping revealed a focal tachycardia originating in the superior vena cava (SVC), 5 cm above the SVC-right atrium (SVC-RA) junction. An area of fractionated potentials and slow conduction was found on the anterior wall of the SVC. A line of conduction block extending downwardly and obliquely from the anteroseptal aspect to anterolateral aspect of the SVC forcing the impulse to enter the RA via the posterior aspect of SVC-RA junction was observed. Entrainment attempts from multiple sites within the SVC failed to demonstrate reentry as a mechanism of arrhythmia. The ablation approach consisted of isolation of the arrhythmogenic area from the rest of the SVC.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2002.00620.x
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