EP Guided Therapy For Atrial Fibrillation
|
|
- Raymond Gray
- 6 years ago
- Views:
Transcription
1 EP Guided Therapy For Atrial Fibrillation Ali Al Mudamgha, MD, FACC, FHRS Cardiac Electrophysiology And Arrhythmia Service St. Joseph s Hospital Syracuse, NY
2 Disclosures Medtronic Advisory Board Afib Physician Educator, St. Jude Medical Physician Trainer and Proctor Spectranetics Corp. Consultant EP Division BSX Medical
3 AFIB Misconceptions Classically Felt to Be a Benign Dysrhythmia Increased Mortality Symptoms from Loss of Atrial Kick Many Variables Minimum Will Complain of Palpitations Most Complain of SOB, DOE and Poor Exercise Tolerance
4
5 Demographic Profile 26% of Men and 28% of Women After Age 40 HTN Obesity Endurance Exercise Sleep Apnea Thyroid Disease ETOH
6 Demographics Age Is Most Powerful Risk Factor Rare Prior to Age 50 10% Of All Individuals Older Than 80 40% Increased Risk Of AFIB If Have A First Degree Relative
7 Demographics 33 Million People Worldwide Have AFIB 3 5 Million In USA AFIB Increases Risk Of Stroke By 5 Fold Average Increased Risk Of SCD Increase Risk Of CHF Increase Risk Of Dementia
8 Demographics Increased Fatigue Decreased Exercise Tolerance Impairment in Quality Of Life Prognosis Is Similar For Symptomatic vs. Asymptomatic Individuals 26 Billion Dollar Annual Increase in US Health Costs
9 Treatment Of AFIB Ideal Therapy Should Abolition of Atrial Fibrillation Restoration of SR Reestablish or Maintain AV Synchrony Restore Atrial Transport Reduce or Eliminate Risk of Thromboembolism
10 Medical Therapy Maintenance of SR with Antiarrhythmic Drugs to Reduce CVA or Death is Unproven No Arrhythmia Can Be 100% Suppressed with an Antiarrhythmic Drug Goal of Therapy is Reduction of Symptoms by Decreasing Recurrence and Prolonging Time Between Episodes Mortality Increases with Drug 0.8% to 2.9%
11 Medical Therapy High Recurrence Rate HTN Enlarged LA CHF AFIB for 1 Year or Longer 23% Remain in SR After 1 Year 16% Remain in SR After 2 Years Significant Side Effects Worsening CHF Bradycardia ProArrhythmia Aggravation of Atrial Function Leading to Thromboembolism
12 Non Drug Therapy Ablate and Pace Ablation of AV Node Leading to CHB Need Rate Responsive Pacemaker Patient Must Remain on Coumadin Most Patients Have Improvement in Symptoms, QOL, and Exercise Tolerance Initial Increase in Torsade from Bradycardia (corrected by 90 bpm for 2 weeks) We Lose to AFIB
13 AFFIRM NIH Sponsored Trial 4060 Patients 65 y.o. Randomized Rate Control Dig, Beta Blockers, Calcium Blockers 80 Rest and minute walk 5% Needed Complete AV Node Ablation Rhythm Control Most Effective Drug After 3.5 years 63% of Patients had tried Amio
14 AFFIRM Results 80% Had Adequate Rate Control 62% Maintained SR After 5 Years No Difference in Mortality, CVA, or QOL Increased Mortality Trend in Rhythm Arm
15 AFFIRM Strengths Confirmed That Use of Antiarrhythmic Drugs Was Not Beneficial Limitations Maintenance of SR Difficult Did Not Have Ablate and Pace Arm Did Not Have Surgical/Ablation Arm
16 EP Guided Therapy Catheter Based Therapy To Treat AFIB Goal Is Restoration Of SR Ablation Means To Destroy Electrical Tissue With A Catheter RF Energy Cryo What Should We Ablate?
17 Left Atrium Jäis 1997 First to Show Cure of Afib with Focal Ablation 9 Patients High Rate of Recurrence and PV Stenosis Pappone Circumferential Ablation 80 91% Effective No PV Stenosis Difficult Procedure Pulmonary Vein Triggers Up to 94% in Many Series LSPV RSPV LIPV RIPV
18 Pulmonary Veins Four Distinct Veins 60% Most Common Variant Is Left Common PV Sleeves Of Cardiac Tissue Extend Onto The PV s PV s Have Shorter APD Compared To Atrium PV Fiber Orientation Promote Reentry Autonomic Nerve Bundles At PV LA Junction
19 Ablation Of Pulmonary Veins Studies Are Clear The PV s Need To Always Be Targeted 70 80% Freedom From AFIB High Recurrence Rate 30% Need Procedure Done Multiple Times Shifting Pendulum Linear Lesions MAZE Non PV Triggers FIRM
20 Technologies RF Most Common For All Ablations Found In Every EP Lab Easier To Use For PV Variant Different Complications CRYO Newer Technology Not Available In Every Center Isolates Vein As A Whole Different Complications
21 How the Arctic Front Advance Cardiac CryoAblation System Works 1. Liquid N 2 O is delivered from the CryoConsole through an injection tube to the inner balloon. 4. The CryoConsole controls safe delivery of N 2 O to the catheter and return of the vapor. Numerous safety systems mitigate potential hazards. 2. Inside the balloon the liquid N 2 O vaporizes and absorbs heat from the surrounding tissue. 3. The vapor is returned to the console through a lumen maintained under vacuum.
22 First Generation Cryoballoon Outcomes: STOP AF Primary Effectiveness 69.9% freedom from AF at 12 months 3.1% rate of cryoablation procedure events and 3.1% major AF events in ablation arm 19.0% (31/163) repeat ablation rate during the 90 day blanking period N=245: Patients Randomized N=163: Patients Randomized to Cryoablation N= 82: Patients Randomized to AADs Packer, et al. Cryoballoon Ablation of Pulmonary Veins for Paroxysmal Atrial Fibrillation: First Results of the North American Arctic Front (STOP AF) Pivotal Trial. J Am Coll Cardiol. April 23, 2013;61(16):
23 Second Generation Arctic Front Advance Cryoballoon: STOP AF Post Approval Study Results 82.2% freedom from AF at 12 months, 75.3% from AF at 24 months (n=344) 5.8% (20/344) adverse event rate 3.2% (11/344) PNI unresolved at hospital discharge, 0.3% (1/344) ongoing 24 months post ablation Knight BP, et al. Second-generation Cryoballoon Ablation in Paroxysmal Atrial Fibrillation Patients: 24-month safety and efficacy from the STOP AF Post-Approval Study. Presented at HRS 2017 (Moderated Poster). 23
24 STOP AF Trial Key Inclusion Criteria: 2 documented AF Episodes in the prior 2 months Efficacy failure of 1 AAD (flecainide, propafenone, sotalol) Redo ablation n = 31 (19%) N = 245 Randomized 2:1 to CRYO* or DRUG Cryoballoon ablation (CRYO) n = 163 Blanking period (90 day) Follow-up at 1, 3, 6, 9 & 12 Months 26 centers in US and Canada AAD Rx (DRUG) n = 82 AAD optimization * CRYO: Arctic Front System Packer DL, Kowal RC, Wheelan KR, et al. Cryoballoon Ablation of Pulmonary Veins for Paroxysmal Atrial Fibrillation: First Results of the North American Arctic Front (STOP AF) Pivotal Trial. J Am Coll Cardiol. April 23, 2013;61(16): DRUG Crossover n = 65 (79%)
25 CRYO Safety Information STOP AF met primary safety endpoint No atrio esophageal fistula 1/228 stroke (0.4% CRYO patients) related to procedure/device 7/228 (3.1% CRYO patients) pulmonary vein stenosis 29/259 (11.2% CRYO procedures includes DRUG crossovers) phrenic nerve palsy (PNP)
26 FIRE AND ICE Trial Primary Endpoints Cryoballoon Met Non inferiority Efficacy Endpoint TRIAL DESIGN & METHODS (NCT ) Prospective, 1:1 randomized, non inferiority study (762 patients from 16 sites in 8 countries) compared efficacy and safety of PVI using Cryoballoon vs. Radiofrequency (RFC) ablation with CARTO 3D mapping system in patients with PAF. Primary Efficacy Endpoint: Time to first documented recurrence of AF>30s/AT/AFL, prescription of AAD, or repeat ablation. Kuck KH, et al. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation. N Engl J Med. 2016; 374(23):
27 FIRE AND ICE Trial Secondary Analyses Significant Improvements Favoring Cryoballoon European Heart Journal The authors stated, "The extent of reduction in reinterventions and rehospitalizations is not only statistically significant but also clinically relevant. Our presented data are the main events that define the patients perception regarding the procedural success of an AF ablation procedure." Relative to Radiofrequency Cryoballoon Demonstrated: 21% Fewer all cause hospitalizations 33% Fewer Repeat ablations 34% Fewer Cardiovascular hospitalizations 50% Fewer DC cardioversions
28 Cryoballoon vs. Radiofrequency Ablation Meta Analysis Demonstrates Reproducibility of Cryoballoon Ablation 40 Studies Including 11,395 Patients Cryoballoon Demonstrated: Lower Risk of AF Recurrence Reduced Procedure Time No difference in major complication rates Arctic Front vs. AFA Both associated with reduced procedure times vs. radiofrequency Lower AF recurrence rate vs. radiofrequency with AFA but not Arctic Front Reduced rate of major complications with AFA vs. Arctic Front Forest plots of AF recurrence for cryoballoon ablation versus radiofrequency ablation: (A) CB 1 versus RFCA; (B) CB 2 versus RFCA; (C) CB 1 versus MTCA. AF = atrial fibrillation; CB = cryoballoon; MTCA = multiparty catheter; Liu, et al. Pacing Clin Electrophysiol May 16. doi: /pace Epub RFCA = irrigated tip radiofrequency catheter. 28
29 Retrospective Multi Center Analysis Demonstrates Cryoballoon Reproducibility Compared to Radiofrequency Cryoballoon ablation resulted in better midterm efficacy vs. RF ablation at a median follow up of 14 months (p < 0.001) Cryoballoon Ablation * Radiofrequency Ablation Major complications with significant differences: Pericardial effusion (1.7% RF vs. 0.3% Cryoballoon; p=0.036) PNI (0.0% RF vs. 1.8% Cryoballoon; p=0.004). Mean procedure time: 136±57min for RF and 120±36min for Cryo (p <0.001) Mean fluoroscopy time: 21±13min for RF and 23±9min for Cryo (p=0.073). AF ablation procedure caseload was heterogeneous: A and B <100 AF ablations/year C and D AF ablations/year E >200 AF ablations/year F 500 AF ablations/year *Cryoballoon ablation procedures were performed with the first generation Arctic Front catheter and Flexcath steerable sheath. Radiofrequency group, WACA was performed using either a 3.5 or a 4 mm tip irrigated catheter guided by 3D mapping and navigation. The contact sensing catheters were used on 100/467 (21.4%) patients. Providencia et al. Europace pii: euw080. [Epub ahead of print]; French AF (NCT ) 29
30 PV Lesion Durability with Radiofrequency and Cryoballoon Studies Evaluating PV Reconduction after the Index Procedure % of Patients without Gaps During Remapping Procedure 100% 80% 60% RF RF: Contact Sensing Arctic Front Cryoballoon 63% Arctic Front Advance Cryoballoon 67% 78% 40% 20% 30% 23% 8% 35% 0% GAP AF Willems Jiang EFFICAS I EFFICAS II* Ahmed SUPIR Patients (n) n=117 n=40 n=75 n=75 n=24 n=12 n=21 Follow up** 3 Months 3 Months 12 Months 3 Months 3 Months 3 Months 3 Months * Calculated rate from manuscript data reporting 9/24 patients with gaps. **Time between index procedure and re mapping procedure. All patients were evaluated regardless of clinical symptoms 1 Late Breaking Clinical Trials session I at the EHRA EUROPACE 2013 meeting in Athens, Greece; 2 Williems, et al. J Cardiovasc Electrophysiol. 2010; 21(10): ; 3 Jiang, et al. Heart Rhythm. 2014;11(6):969 76; 4 Neuzil, et al. Circ Arrhythm Electrophysiol. (2):327 33; 5 Kautzner, et al. Europace. 2015; 2015 Aug;17(8): ; 6 Ahmed, et al. J Cardiovasc Electrophysiol. 2010;21(7):731 7; 7 Reddy, et al. J Cardiovasc Electrophysiol May;26(5):
31 Redo with Cryoballoon after index RF De Regibus, et al: 47 patients with PAF underwent CBA after AF recurrence with past RF index procedure Mean f/u of 15±8 months after 3 mo blanking period 83% patients free from any atrial tachycardia or AF De Regibus, et al. Repeat procedures using the second generation cryoballoon for recurrence of atrial fibrillation after initial ablation with conventional radiofrequency. J Interv Card Electrophysiol Feb. [Epub ahead of print] 31
32 Arctic Front Advance Success Among Different Age Groups Abugattas, et al.: 53 patients 75+ years old with drug refractory PAF 106 patients <75 years old with drug refractory PAF 12 month follow up Success rate 81.1% (75+) vs 84.9% (<75) (p=0.54) Pott, et al: 40 patients (mean age 78.3) 77.5% PAF 12 month follow up Success rate 86.4% Moran, et al: 57 patients <40 years old Median follow up 18 ±10 months Freedom from AF 88% 1. Abugattas, et al. Europace Apr 10. [Epub ahead of print]. 2. Pott, et al. J Cardiol Jan;69(1): Moran, et al. Europace Jan 25. [Epub ahead of print]. 32
33 Single Procedure Freedom from AF, AT and AFL Arctic Front Advance Cryoballoon Single Center Published Studies Arctic Front Cryoballoon Arctic Front Advance Cryoballoon 100% 91% 90% 80% 84% 84% 82% 81% p=0.038 p=0.008 p=ns 66% 64% p= % P< % 80% 83% 82% 85% 85% 80% 80% 82% 60% 40% 20% 0% Di Giovanni (n=100) Fürnkranz (n=105) Aryana (n=340) Aytemir (n=306) Greiss (n=376) Metzner (n=49) Chierchia (n=42) Chierchia (n=287) Kumar (n=40) Jourda (n=75) Ciconte (n=143) Tebbenjohanns (n=192) Wissner (n=45) Arrhythmia Monitoring Methods and Definition of Procedure Success (Freedom from AF Only or AF/AT/AFL) Varied Between Studies Di Giovanni, et al. J Cardiovasc Electrophysiol. 2014; 25(8):834-9; Fürnkranz, et al. Journal of Cardiovascular Electrophysiology ;25(8):840-4; Aryana, et al. J Interv Card Electrophysiol. 2014;41(2): ; Aytemir, et al. Europace. 2015;17(3):379-87; Greiss, et al. PACE Jul;38(7):815-24; Metzner, et al. Circ Arrhythm Electrophysiol. 2014; 7(2): ; Chierchia, et al. Europace. 2014; 16(5): ; Chierchia, et al. J Cardiovasc Electrophysiol. 2015; In Press; 16(5): ; Kumar et al. J Interv Card Electrophysiol. 2014;41(1):91-7; Jourda, et al. Europace. 2015;17(2):225-31; Ciconte, et al. Heart Rhythm. 2015;12(4):673-80; Tebbenjohanns, et al. Europace. 2015; Wissner, et al. Europace Aug;17(8): ; 33
34 Multicenter Comparison: Arctic Front Advance vs. Conventional RF 1,196 Procedures Retrospectively Analyzed 773 AFA Patients and 423 RF Patients 100% Freedom From AF/AFL/AT Recurrence At 12 Months CB2 (n=773) RF (n=423) P value 80% 76.6% p<0.001 Procedure Time 145±49 188±42 p<0.001 Fluoro Time 29±13 23±14 p<0.001 Adverse Events 1.6% 2.6% p=0.207 AAD Use 16.7% 22% P=0.024 Repeat Procedures 14.6% 24.1% p< % 40% 20% 60.4% 0% Arctic Front Advance Conventional Catheter Aryana, et al. J Cardiovasc Electrophysiol Aug;26(8):
35 Wide Antral Balloon Ablation with Arctic Front Advance Cryoballoon Post Procedure Voltage Maps Patients 43 Balloon and Application Time Extent of posterior wall ablation 6 month Freedom from AF CB2 28 mm 3 min 73% 95% Kenigsberg, et al. Heart Rhythm. 2014; 12(2):
36 Designed to ablate a broader range of pulmonary vein anatomies Arctic Front Cryoballoon Arctic Front Advance Cryoballoon In Arctic Front Cryoballoon, the most concentrated cooling zone occurs near the equator of the balloon. Aligning the balloon coaxially with the PV may be an important factor, but may be difficult in some vein anatomies. Arctic Front Advance Cryoballoon with EvenCool Cryo Technology is designed to allow more flexibility in balloon positioning to ablate the PVs. 36
37 Cryo Ablation Arctic Front Cryoballoon Achieve Mapping Catheter The cryoballoon creates circumferential lesions, 1 using 2-3 applications per vein to achieve PVI 2 Does not require 3D mapping Achieve Mapping Catheter can be deployed through the cryoballoon guide wire lumen, minimizing catheter exchanges Allows the procedure to be performed using a single transseptal puncture Fluoroscopy image during contrast dye injection shows full occlusion of the left superior pulmonary vein. Image: Courtesy of Dr. Vogt, Herz- und Diabeteszentrum NRW, Germany 1 Sarabanda AV, et al. EffJ Am Coll Cardiol. 2005;46: Medtronic, Inc. Arctic Front Cardiac CryoAblation Catheter clinical reports, in support of FDA premarket approval.
38 Adverse Event Details * Includes vascular pseudoaneurysm, AV fistula, device related infection, hematoma, puncture site hemorrhage, groin pain ** Serious (e.g. hospitalization) and causally related to the therapeutic intervention (e.g. ablation induced or drug induced) *** 8 resolved by 3 month visit, 1 resolved by 6 months visit, 1 unresolved after 12 month visit Kuck KH, et al. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation. N Engl J Med. 2016; 374(23):
39 Phrenic Nerve Palsy (PNP) 29/259 (11.2%) procedures:* 15 subjects asymptomatic 13 subjects symptomatic with DOE, SOB, and/or cough 25/29 (86.2%) resolved by 1 year Median time for CXR resolution 102 days 4/259 subjects (1.5%) had an abnormal CXR at 1 year, 1 (0.4%) remained symptomatic * 29 PNP events out of 259 procedures in 28 subjects
40
41
42
43 PROTOCOL AT ST. JOSEPH S MRI OR CT TO DEFINE PV S Anticoagulation Coumadin 4 Days Prior With Single Dose Arixtra NOAC The Night Before TEE R/O LAA CLOT On Day Of Procedure GETA Access Via Right Femoral Vein Catheter Advanced Into Right Atrium Transeptal Performed Heparin Given Ablation Performed
44 PROTOCOL AT ST. JOSEPH S Discharged Same Day Anticoagulation All Started Night Of Procedure. Everyone Needs Regardless Of CHADS2 VaSC Coumadin Doubled With Single Dose Arixtra Continue 3 Months Regardless Of CHADS2 VaSC Pre Procedure Antiarrhythmic Drugs Blanking Period NO IMPROVEMENT IN FIRST 3 MONTHS!!!!!!!!
45 Post Ablation Protocol Holter At 1 and 3 Months Cardiovert And Start AAD After 4 Weeks If Needed SOB First Few Days: R/O Pericardial Effusion Late: Consider Phrenic Nerve Injury GI Symptoms Very Common Early: Consider PPI etc After 2 Weeks Consider Atrio Esophageal Fistula EGD Or CT
46 Post Ablation Protocol After 3 Months Anticoagulate Based On CHADS2 VaSC Stop Meds If No AFIB Consider Second Ablation If Symptomatic After 6 9 Months
47 Conclusions AFIB Is A Hemorrhoid For Electrophysiologists Look For Symptoms Beyond Palpitations No Benefit In Restoring SR Unless Symptoms Ablation Is Superior To Meds Consider Ablation In All Symptomatic Individuals Ablate and PACE Excellent Results Chronic AFIB Low Ablation Success Rate Patients
A Cryo Anatomical Procedure to Everyone? Saverio Iacopino, FACC, FESC
A Cryo Anatomical Procedure to Everyone? Saverio Iacopino, FACC, FESC AF Clinical/Referral Challenge Asymptomatic 40% 3 Rx Effective 30% Failed Rx Ablation Atrial fibrillation (AF) is the most common Candidate
More informationΚατάλυση παροξυσμικής κολπικής μαρμαρυγής Ποια τεχνολογία και σε ποιους ασθενείς; Χάρης Κοσσυβάκης Καρδιολογικό Τμήμα Γ.Ν.Α. «Γ.
Κατάλυση παροξυσμικής κολπικής μαρμαρυγής Ποια τεχνολογία και σε ποιους ασθενείς; Χάρης Κοσσυβάκης Καρδιολογικό Τμήμα Γ.Ν.Α. «Γ. ΓΕΝΝΗΜΑΤΑΣ» Rhythm control antiarrhythmic drugs vs catheter ablation Summary
More informationΠαροξυσμική Κολπική μαρμαρυγή σε νέο άτομο 40 ετών
Παροξυσμική Κολπική μαρμαρυγή σε νέο άτομο 40 ετών Ιωάννης Σκιαδάς MD, FESC, EHRA Accredited in Cardiac Pacing Καρδιολογικό Τμήμα Ιπποκράτειο ΓΝΑ Prevalence, percent AF Prevalence: Age and Gender Prevalence
More informationPersistent AF: when and why using the Cryo Technology
Persistent AF: when and why using the Cryo Technology Cesare Storti Electrophysiology and Cardiac Pacing Unit Istituto di Cura Città di Pavia, Pavia, Italy Persistent AF: when and why using the Cryo Technology
More informationAblation Should Not Be Used as Primary Therapy for Treatment of Patients with Atrial Fibrillation
Ablation Should Not Be Used as Primary Therapy for Treatment of Patients with Atrial Fibrillation 25 October 2008 Update in Electrocardiography and Arrhythmias Zian H. Tseng, M.D., M.A.S. Assistant Professor
More informationBalloon and Mesh Catheter Ablation of Pulmonary Veins
Balloon and Mesh Catheter Ablation of Pulmonary Veins ISHNE 2009 Atul Verma, MD FRCPC Cardiology/Electrophysiology Heart Rhythm Program, Division of Cardiology Southlake Regional Health Centre Newmarket,
More information8/26/2016. Historical Perspective (1) Is Cryoballoon the Preferred Approach to Ablation of Paroxysmal AF? Historical Perspective (2)
California Heart Rhythm Symposium September 9-10, 2016 Is Cryoballoon the Preferred Approach to Ablation of Paroxysmal AF? Peter Guerra Institut de Cardiologie de Montréal Historical Perspective (1) 1992
More informationCatheter Ablation for Atrial Fibrillation: Patient Selection and Outcomes
Catheter Ablation for Atrial Fibrillation: Patient Selection and Outcomes Francis Marchlinski, MD Richard T and Angela Clark President s Distinguished Professor Director Cardiac Electrophysiolgy University
More informationWhat s new in my specialty?
What s new in my specialty? Jon Melman, MD Heart Rhythm Specialists McKay-Dee Hospital some would say some would say my specialty 1 some would say my specialty First pacemaker 1958 some would say my specialty
More informationAtrial Fibrillation Ablation: in Whom and How
Update on Consensus Statement on Management of Atrial Fibrillation: EHRA 2012 Atrial Fibrillation Ablation: in Whom and How Update of HRS/EHRA AF/ECAS Ablation Document 2012 Anne M Gillis MD FHRS Professor
More informationTREATING PAROXYSMAL ATRIAL FIBRILLATION WITH CRYOBALLOON ABLATION
TREATING PAROXYSMAL ATRIAL FIBRILLATION WITH CRYOBALLOON ABLATION ABOUT YOUR AF Atrial fibrillation (AF or Afib) is an irregular heart rhythm that affects the upper chambers (atria) of the heart. This
More informationJesus M. Paylos, C. Ferrero, L. Azcona, A. Morales, M. A. Vargas, L. Lacal, V. Gomez Tello.
CRYO-BALLOON CATHETER ABLATION EFFICACY RESTORING AND MAINTAINING SINUS-RHYTHM IN PATIENTS TREATED FOR PERSISTENT LONG STANDING ATRIAL FIBRILLATION AFTER ACUTE COMPLETE ELECTRICAL ISOLATION OF THE PULMONARY
More informationPulmonary Vein Isolation for AF RF or Cryo? Dr. Yuen Ho Chuen Princess Margaret Hospital
Pulmonary Vein Isolation for AF RF or Cryo? Dr. Yuen Ho Chuen Princess Margaret Hospital PV as a Source of Ectopic Activity Haissaguerre, et al. NEJM 1998 RF Ablation Gold standard Point by point ablation
More informationThe Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It. Chandra Kumbar MD FACC FHRS The Heart Group, Evansville IN
The Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It Chandra Kumbar MD FACC FHRS The Heart Group, Evansville IN Disclosures Consultant Advisory Board, Medtronic Atrial fibrillation
More informationCatheter Ablation of Atrial Fibrillation
Cardiology Update 2011 Catheter Ablation of Atrial Fibrillation Laurent Haegeli University Hospital Zurich February 16, 2011 Willem Einthoven and Sir Thomas Lewis The first ECG in 1903 Willem Einthoven
More informationCombined catheter ablation and left atrial appendage closure as a. treatment of atrial fibrillation
Combined catheter ablation and left atrial appendage closure as a hybrid procedure for the treatment of atrial fibrillation Giulio Molon, MD FACC, FESC, Fellow ANMCO Card Dept, S.Cuore hospital Negrar
More informationLong-Term Outcome and Risks of Catheter Ablation for Atrial Fibrillation
Long-Term Outcome and Risks of Catheter Ablation for Atrial Fibrillation Carlo Pappone, MD, PhD, FACC EP Director, Villa Maria Hospital Group How many times AF can increase mortality DO MORTALITY REALLY
More informationFibrillation Atriale Paroxystique : ablation, résultats, complications
Fibrillation Atriale Paroxystique : ablation, résultats, complications DIU Rythmologie Paris, le 27/01/16 sboveda@clinique-pasteur.com 1 A disease with bad consequences RR de patients en FA comparé avec
More informationDO YOU HAVE PAROXYSMAL ATRIAL FIBRILLATION?
DO YOU HAVE PAROXYSMAL ATRIAL FIBRILLATION? Do you have atrial fibrillation ()? Do you think you might have it? If so, the time to take control is now. There are three important things to do. 1. If you
More informationContemporary Strategies for Catheter Ablation of Atrial Fibrillation
Contemporary Strategies for Catheter Ablation of Atrial Fibrillation Suneet Mittal, MD Director, Electrophysiology Medical Director, Snyder Center for Atrial Fibrillation The Arrhythmia Institute at The
More informationAF ABLATION Concepts and Techniques
AF ABLATION Concepts and Techniques Antony F Chu, M.D. Director of Complex Ablation Arrhythmia Services Section Division of Cardiology at the Rhode Island and Miriam Hospital HIGHLIGHTS The main indications
More information20% 10/9/2018. Fluoroless Ablation relinquishing an old habit. Prevalence of Atrial Fibrillation. Atrial Fibrillation is a Progressive Disease
Fluoroless Ablation relinquishing an old habit Robert Percell, MD, FACC Cardiac Electrophysiologist, Bryan Heart Institute Lincoln, NE Prevalence of Atrial Fibrillation 3.1 Million + 1 Million by 2020
More informationIs cardioversion old hat? What is new in interventional treatment of AF symptoms?
Is cardioversion old hat? What is new in interventional treatment of AF symptoms? Joseph de Bono Consultant Electrophysiologist University Hospitals Birmingham Atrial Fibrillation (AF) Affects 2% of the
More informationAtrial Fibrillation: Rate vs. Rhythm. Michael Curley, MD Cardiac Electrophysiology
Atrial Fibrillation: Rate vs. Rhythm Michael Curley, MD Cardiac Electrophysiology I have no relevant financial disclosures pertaining to this topic. A Fib Epidemiology #1 Most common heart rhythm disturbance
More informationThe EP Perspective: Should We Do Hybrid Ablation, and Who Should We Do It On?
The EP Perspective: Should We Do Hybrid Ablation, and Who Should We Do It On? L. Pison, MD PhD FESC AATS Surgical Treatment of Arrhythmias and Rhythm Disorders November 17-18, 2017 Miami Beach, FL, USA
More informationAtrial Fibrillation: Catheter Ablation with New Technologies, Improving Quality of Life and Outcomes in Various Disease States
Atrial Fibrillation: Catheter Ablation with New Technologies, Improving Quality of Life and Outcomes in Various Disease States Srinivas R. Dukkipati, MD Co-Director, Cardiac Arrhythmia Service The Mount
More informationAtrial Fibrillation 2009
Atrial Fibrillation 2009 Michael Glikson, MD Director of Pacing & Electrophysiology Leviev Heart Center Sheba medical Center Sheba Medical Center Tel Hashomer The Leviev Heart Center Rhythm vs rate control
More information3/25/2017. Program Outline. Classification of Atrial Fibrillation
Alternate Strategies to Antiarrhythmic Therapy: The Role of Ablation Jennifer El Aile, MS, AGPCNP-BC Electrophysiology Nurse Practitioner Clinical Lecturer at the University of Michigan Program Outline
More informationAF and arrhythmia management. Dr Rhys Beynon Consultant Cardiologist and Electrophysiologist University Hospital of North Staffordshire
AF and arrhythmia management Dr Rhys Beynon Consultant Cardiologist and Electrophysiologist University Hospital of North Staffordshire Atrial fibrillation Paroxysmal AF recurrent AF (>2 episodes) that
More informationRaphael Rosso MD, Yuval Levi Med. Eng., Sami Viskin MD Tel Aviv Sourasky Medical Center
Radiofrequency Ablation of Atrial Fibrillation: Comparison of Success Rate of Circular Ablation vs Point-by-Point Ablation with Contact Force Assessment in Paroxysmal and Persistent Atrial Fibrillation
More informationCatheter Ablation for Treatment of Atrial Fibrillation 2010 and Beyond
Catheter Ablation for Treatment of Atrial Fibrillation 2010 and Beyond John M. Miller, MD Professor of Medicine Indiana University School of Medicine Director, Clinical Cardiac Electrophysiology Krannert
More informationComplications During Cardiovascular Interventions: Management and Prevention
Complications During Cardiovascular Interventions: Management and Prevention Helmut Pürerfellner, MD Public Hospital Elisabethinen Academic Teaching Hospital Linz, Austria Atrial Tachycardia/Atypical left
More informationAblation Update and Case Studies. Lawrence Nair, MD, FACC Director of Electrophysiology Presbyterian Heart Group
Ablation Update and Case Studies Lawrence Nair, MD, FACC Director of Electrophysiology Presbyterian Heart Group Disclosures No financial relationships to disclose Objectives At the conclusion of this activity,
More informationOutcomes of AF Ablation
2017 춘계심혈관통합학술대회 AF Summit: Atrial Fibrillation Apr.21(Fri) 14:40-16:10 Rm.300B 15:00-15:10 Outcomes of AF Ablation Gi-Byoung Nam MD Asan Medical Center, UUCM 2017 Annual Spring Scientific Conference of
More informationJay Simonson, MD, FACC, FHRS Medical Director, Cardiac Electrophysiology Park Nicollet Heart and Vascular Center
Jay Simonson, MD, FACC, FHRS Medical Director, Cardiac Electrophysiology Park Nicollet Heart and Vascular Center A-Fib Facts Yes, you may be able to blame your parents It is more of a nuisance than a
More informationΚΑΤΑΛΥΣΗ ΚΟΛΠΙΚΗΣ ΜΑΡΜΑΡΥΓΗΣ. ΥΠΕΡ. Michalis Efremidis MD Second Department of Cardiology Evangelismos General Hospital
ΚΑΤΑΛΥΣΗ ΚΟΛΠΙΚΗΣ ΜΑΡΜΑΡΥΓΗΣ. ΥΠΕΡ. Michalis Efremidis MD Second Department of Cardiology Evangelismos General Hospital Rate control versus Rhythm control for Atrial Fibrillation AFFIRM N Engl J Med 2002;347:1825-33
More informationSEVEN YEARS OF CRYO-BALLOON CATHETER ABLATION
SEVEN YEARS OF CRYO-BALLOON CATHETER ABLATION. FOLLOW-UP ANALYSIS, RESULTS, RECURRENCES, COMPLICATIONS AND SIDE EFFECTS IN PATIENTS TREATED FOR PAROXYSMAL ATRIAL FIBRILLATION, WITH A PROSPECTIVE PROTOCOL
More informationAF Ablation in 2015 Why, Who, What and How? Steve Wilton ACC Rockies, Banff March 10, 2015
AF Ablation in 2015 Why, Who, What and How? Steve Wilton ACC Rockies, Banff March 10, 2015 Disclosures Research grant: St. Jude medical Speaking: Boehringer-Ingelheim Consulting: Arca Biopharma Learning
More informationLong-Term Outcomes After Cryoballoon Pulmonary Vein Isolation
Journal of the American College of Cardiology Vol. 61, No. 16, 2013 2013 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jacc.2012.09.033
More informationAF Today: W. For the majority of patients with atrial. are the Options? Chris Case
AF Today: W hat are the Options? Management strategies for patients with atrial fibrillation should depend on the individual patient. Treatment with medications seems adequate for most patients with atrial
More informationCatheter Ablation of Atrial Fibrillation in Patients with Prosthetic Mitral Valve
Catheter Ablation of Atrial Fibrillation in Patients with Prosthetic Mitral Valve Luigi Di Biase, MD, PhD, FHRS Senior Researcher Texas Cardiac Arrhythmia Institute at St. David s Medical Center, Austin,
More information2015 Atrial Fibrillation Therapy Meds, Shock, or Ablate? D. Scott Kirby MD, FACC Cardiac Electrophysiologist
2015 Atrial Fibrillation Therapy Meds, Shock, or Ablate? D. Scott Kirby MD, FACC Cardiac Electrophysiologist Todays Objectives Atrial Fibrillation evaluation and treatment from an EP perspective Multimodal
More informationCatheter ablation of atrial fibrillation: Indications and tools for improvement of the success rate of the method. Konstantinos P.
Ioannina 2015 Catheter ablation of atrial fibrillation: Indications and tools for improvement of the success rate of the method Konstantinos P. Letsas, MD, FESC SECOND DEPARTMENT OF CARDIOLOGY LABORATORY
More informationRecent observations have focused attention on the PVs as a source of ectopic activity i determining i AF
Atrial Fibrillation in 2010 Panos Vardas Professor of Cardiology President of EHRA Atrial Fibrillation Pathophysiology of AF Triggers Recent observations have focused attention on the PVs as a source of
More informationAblazione della fibrillazione atriale: dubbi presenti e prospettive future
Ablazione della fibrillazione atriale: dubbi presenti e prospettive future Carlo Pappone, MD, PhD, FACC Cardiac Pacing & Electrophysiology Department, Director Villa Maria Group, Italy Atrial Fibrillation
More informationAtrial Fibrillation Christopher L. Fellows, MD, FACC, FHRS Virginia Mason Medical Center Seattle, Wa.
Atrial Fibrillation 2017 Christopher L. Fellows, MD, FACC, FHRS Virginia Mason Medical Center Seattle, Wa. Hering HE. Das Elektrocardiogramm des Irregularis perpetuus. Deutsches Archiv fur Klinische Medizin.
More informationPRIMARY RESULTS OF RF CATHETER ABLATION FOR AF IN VIETNAM HEART INSTITUTE. PHAM QUOC KHANH, MD, PhD. et al Vietnam Heart Institute
PRIMARY RESULTS OF RF CATHETER ABLATION FOR AF IN VIETNAM HEART INSTITUTE PHAM QUOC KHANH, MD, PhD. et al Vietnam Heart Institute Background - Forms of Atrial Fibrillation - Clinical type of AF: + paroxysmal
More informationΕπιπλοκές κατάλυσης πνευµονικών φλεβών
Επιπλοκές κατάλυσης πνευµονικών φλεβών Παναγιώτης Ιωαννίδης Διευθυντής Τµήµατος Αρρυθµιών & Επεµβατικής Ηλεκτροφυσιολογίας Βιοκλινικής Αθηνών ΣΕΜΙΝΑΡΙΑ ΟΜΑΔΩΝ ΕΡΓΑΣΙΑΣ Ιωάννινα, 27-2-2015 Solving an equation
More informationTranscatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins for the Treatment of Atrial Fibrillation
Medical Coverage Policy Effective Date... 1/15/2018 Next Review Date... 1/15/2019 Coverage Policy Number... 0469 Transcatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins for the Treatment of
More informationAF ablation Penn experience. Optimal approach to the ablation of PAF: Importance of identifying triggers 9/25/2009
Optimal approach to the ablation of PAF: Importance of identifying triggers David J. Callans, MD University of Pennsylvania School of Medicine AF ablation Penn experience Antral (circumferential) PV ablation
More informationInnovations in AF Management
Innovations in AF Management Barry Boilson MD PhD FRCPI boilson.barry@mayo.edu Disclosures Relevant None financial relationship(s) with industry None Off Label Usage None Overview Mechanisms of AF AF as
More informationLong Standing Persistent AF ; CPVI is enough for it
Long Standing Persistent AF ; CPVI is enough for it Kee-Joon Choi, MD University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea Boston AF Symposium 2012 In a patient undergoing AF ablation
More informationABLATION TECHNIQUES FOR ATRIAL FIBRILLATION
ABLATION TECHNIQUES FOR ATRIAL FIBRILLATION Demosthenes G. Katritsis, MD, PhD(Lon), FRCP Athens Euroclinic Ablation for AF Cox JL, et al. Surgery for atrial fibrillation. Semin Thorac Cardiovasc Surg.
More informationCLINICAL COMPENDIUM. The HeartLight Endoscopic Ablation System Putting a New Level of PVI Precision Close at Hand. CardioFocus.com
CLINICAL COMPENDIUM The HeartLight Endoscopic Ablation System Putting a New Level of PVI Precision Close at Hand CardioFocus.com Published results noted below may include references to both on-label and
More informationLinear Ablation Should Not Be a Standard Part of Ablation in Persistent AF. Disclosures. LA Ablation vs. Segmental Ostial Ablation With PVI for PAF
Linear Ablation Should Not Be a Standard Part of Ablation in Persistent AF The CA Heart Rhythm Symposium September 7, 2012 Gregory K. Feld, MD Professor of Medicine Director, Cardiac EP Program University
More informationAtrial Fibrillation Ablation Recent Clinical Trials That Changed (or not) My Practice
Atrial Fibrillation Ablation Recent Clinical Trials That Changed (or not) My Practice Walid Saliba, MD, FHRS Director, Atrial Fibrillation Center Director EP laboratory Heart and Vascular Institute Cleveland
More informationCryoballoon Ablation for Atrial Fibrillation: a Comprehensive Review and Practice Guide
Korean Circ J. 2018 Feb;48(2):114-123 pissn 1738-5520 eissn 1738-5555 Review Article Cryoballoon Ablation for Atrial Fibrillation: a Comprehensive Review and Practice Guide Eun-Sun Jin, MD, PhD 1, and
More informationIncidence and Disease Burden. Role of Catheter ablation Outcomes Data
Management of Atrial Fibrillation Nitish Badhwar, MD, FACC University of California, San Francisco Risk Appraisal Forum April 23, 2010 Incidence and Disease Burden Drug therapy Role of Catheter ablation
More informationAblation of persistent AF Is it different than paroxysmal?
Ablation of persistent AF Is it different than paroxysmal? Steven J. Kalbfleisch, MD Medical Director Electrophysiology Laboratory Ohio State University Wexner Medical Center Ross Heart Hospital Columbus,
More informationStand alone maze: when and how?
Stand alone maze: when and how? Dong Seop Jeong Department of Thoracic and Cardiovascular Surgery, HVSI Samsung Medical Center Type of atrial fibrillation First diagnose AF Paroxysmal AF: self-terminating
More informationArrhythmias and Heart Failure Dr Chris Lang Consultant Cardiologist and Electrophysiologist Royal Infirmary of Edinburgh
Arrhythmias and Heart Failure Dr Chris Lang Consultant Cardiologist and Electrophysiologist Royal Infirmary of Edinburgh Arrhythmias and Heart Failure Ventricular Supraventricular VT/VF Primary prevention
More informationModest Medtronic. Modest Boehringer Ingelheim
Adults With AF (millions) Modest Medtronic Modest Boehringer Ingelheim Changing Modalities of Care for Atrial Fibrillation Jill Repoley MSN, CRNP, CCDS, CEPS, FHRS 7 6 5 4 3 2 1 2.08 2.26 2.44 2.66 2.94
More informationLaser balloon ablation for AF: A systematic review and meta analysis
Received: 31 May 2018 Revised: 26 June 2018 Accepted: 9 July 2018 DOI: 10.1111/jce.13698 ORIGINAL ARTICLE Laser balloon ablation for AF: A systematic review and meta analysis Matthew R. Reynolds MD, MSc,
More informationSupplementary Online Content
Supplementary Online Content Verma A, Champagne J, Sapp J, et al. Asymptomatic episodes of atrial fibrillation before and after catheter ablation: a prospective, multicenter study. JAMA Intern Med. Published
More informationAtrial Fibrillation: Classification and Electrophysiology. Saverio Iacopino, MD, FACC, FESC
Atrial Fibrillation: Classification and Electrophysiology Saverio Iacopino, MD, FACC, FESC Sinus Rythm Afib (first episode) AFib Paroxistic AFib Spontaneous conversion Permanent AFib Recurrence Sinus Rythm
More informationAF :RHYTHM CONTROL BY DR-MOHAMMED SALAH ASSISSTANT LECTURER CARDIOLOGY DEPARTMENT
AF :RHYTHM CONTROL BY DR-MOHAMMED SALAH ASSISSTANT LECTURER CARDIOLOGY DEPARTMENT 5-2014 Atrial Fibrillation therapeutic Approach Rhythm Control Thromboembolism Prevention: Recommendations Direct-Current
More informationThe influence of varying energy settings on efficacy and safety of endoscopic pulmonary vein isolation
The influence of varying energy settings on efficacy and safety of endoscopic pulmonary vein isolation Andreas Metzner, MD,* Erik Wissner, MD, FHRS,* Bas Schoonderwoerd, MD,* Andre Burchard, MD, Roland
More informationCLINICAL COMPENDIUM. The HeartLight Endoscopic Ablation System Putting a New Level of PVI Precision Close at Hand. CardioFocus.com
CLINICAL COMPENDIUM The HeartLight Endoscopic Ablation System Putting a New Level of PVI Precision Close at Hand CardioFocus.com Published results summarized in this compendium may include references to
More informationDescription. Section: Medicine Effective Date: July 15, 2014 Subsection: Cardiology Original Policy Date: December 7, 2011 Subject:
Page: 1 of 24 Last Review Status/Date: June 2014 Description Radiofrequency ablation using a percutaneous catheter-based approach is widely used to treat supraventricular arrhythmias. Atrial fibrillation
More informationProgression of atrial fibrillation: can we prevent it? Early catheter ablation will stop progression of atrial fibrillation pro
Progression of atrial fibrillation: can we prevent it? Early catheter ablation will stop progression of atrial fibrillation pro Jerónimo Farré MD, Madrid, ES AF: the kingdom of wishful thinking In AF we
More informationAtrial Fibrillation and Heart Failure: Rate vs. Rhythm Control Time for Re-evaluation
Atrial Fibrillation and Heart Failure: Rate vs. Rhythm Control Time for Re-evaluation ANIL K. BHANDARI, M.D, Director, Electrophysiology and EPS Fellowship Program Good Samaritan Hospital/ Harbor UCLA
More informationHow to improve procedural outcome of cryoballoon ablation in persistent AF Experience from Redo procedures
How to improve procedural outcome of cryoballoon ablation in persistent AF Experience from Redo procedures Kyoung-Ryul Julian Chun Cardioangiologisches Centrum Bethanien (CCB) Markus Krankenhaus, Med.
More informationAre Drugs Better? Dr Mauro Lencioni. Drugs or ablation as first line treatment for AF? Consultant Cardiologist & Electrophysiologist
Are Drugs Better? Drugs or ablation as first line treatment for AF? Dr Mauro Lencioni Consultant Cardiologist & Electrophysiologist The Philosophical Issue What do we mean by Better? Outcome measures Measurement
More informationCLINICAL OUTCOME OF AF ABLATION Who Benefits from Catheter Ablation?? Dr Gamal Shaban MD FESC Fellow of EHRA ECR AFA AFIB ALLIANCE NHI
CLINICAL OUTCOME OF AF ABLATION Who Benefits from Catheter Ablation?? Dr Gamal Shaban MD FESC Fellow of EHRA ECR AFA AFIB ALLIANCE NHI RHYTHM IS THE SOUL OF LIFE AF the last remaining challenge Considerable
More informationUnderstanding Atrial Fibrillation
Understanding Atrial Fibrillation Todd J. Florin, M.D. Table of Contents The Normal Heart...1 What is Atrial Fibrillation...3 Risks of Afib: Stroke...5 Treatment Options...7 Radiofrequency Ablation...9
More informationCatheter Ablation for AF: Patients, Procedures, Outcomes
Catheter Ablation for AF: Patients, Procedures, Outcomes John Sapp Director Heart Rhythm, QEII Health Sciences Centre Professor of Medicine, Dalhousie University Atrial Fibrillation Atrial Fibrillation
More informationCigna Medical Coverage Policy
Cigna Medical Coverage Policy Subject Transcatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins for the Treatment of Atrial Fibrillation Table of Contents Coverage Policy... 1 General Background...
More informationComparative Effectiveness of Radiofrequency Catheter Ablation for Atrial Fibrillation Executive Summary
Number 15 Effective Health Care Comparative Effectiveness of Radiofrequency Catheter Ablation for Atrial Fibrillation Executive Summary Background The Agency for Healthcare Research and Quality commissioned
More information5/5/2010. World incidence 720, 000 new cases / year. World prevalence 5.55 million AF prevalence increasing with aging of population
Atrial Fibrillation: Guidelines through clinical cases and 2010 updates Samy Claude ELAYI Cardiac Clinical Pacing and Electrophysiology UK World incidence 720, 000 new cases / year World prevalence 5.55
More informationSupplementary Online Content
Supplementary Online Content Morillo CA, Verma A, Connolly SJ, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line Treatment of Paroxysmal Atrial Fibrillation (RAAFT-2): a randomzied clinical
More informationTranscatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins for the Treatment of Atrial Fibrillation
Medical Coverage Policy Effective Date... 6/15/2018 Next Review Date... 1/15/2019 Coverage Policy Number... 0469 Transcatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins for the Treatment of
More informationRate and Rhythm Control of Atrial Fibrillation
Rate and Rhythm Control of Atrial Fibrillation April 21, 2017 춘계심혈관통합학술대회 Jaemin Shim, MD, PhD Arrhythmia Center Korea University Anam Hospital Treatment of AF Goal Reducing symptoms Preventing complication
More informationPercutaneous Transvenous Atrial Fibrillation Ablation and Stroke
Percutaneous Transvenous Atrial Fibrillation Ablation and Stroke Vivek Y. Reddy, MD Helmsley Trust Professor of Medicine Director, Cardiac Arrhythmia Service The Mount Sinai Hospital Disclosures Grant
More informationBasics of Atrial Fibrillation. By Mini Thannikal NP-BC Mount Sinai St Luke s Hospital New York, NY
Basics of Atrial Fibrillation By Mini Thannikal NP-BC Mount Sinai St Luke s Hospital New York, NY Atrial Fibrillation(AF) is a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation
More informationDisclosures. Managing Atrial Fibrillation in Atrial Fibrillation: A Growing Problem. Objectives. Atrial Fibrillation: Prevalence Estimates
Managing Atrial Fibrillation in 2010 Jennifer Cummings, MD FACC Director, Cardiac Electrophysiology Akron General Medical Center Disclosures Company Boston Scientific St. Jude Medical Medtronic Sanofi-Aventis
More informationSurgical Ablation for Lone AF: What have we learned after 30 years?
Surgical Ablation for Lone AF: What have we learned after 30 years? Ralph J. Damiano, Jr., MD Evarts A. Graham Professor of Surgery Chief of Cardiothoracic Surgery Vice Chairman, Department of Surgery
More informationCATHETER ABLATION for ATRIAL FIBRILLATION
CATHETER ABLATION for ATRIAL FIBRILLATION Atrial Fibrillation Clinic Dr. Richard Leather, Dr. Larry Sterns, Dr Paul Novak, Dr. Chris Lane and Dr. Sikkel Royal Jubilee Hospital Block 3 rd floor, Rm 343
More informationMapping and Ablation in AF: how can we evaluate the lesion formation?
Innovative Cardiac Arrhythmias solutions in only one technology Venice Arrhythmias 17 Oct 2015 Mapping and Ablation in AF: how can we evaluate the lesion formation? Dhiraj Gupta MD DM FRCP Consultant Cardiologist
More informationManagement strategies for atrial fibrillation Thursday, 20 October :27
ALTHOUGH anyone who has had to run up a flight of steps or has had a frightening experience is quite familiar with a racing heartbeat, for the more than 2 million Americans who suffer from atrial fibrillation
More informationInvasive and Medical Treatments for Atrial Fibrillation. Thomas J Dresing, MD Section of Electrophysiology and Pacing Cleveland Clinic
Invasive and Medical Treatments for Thomas J Dresing, MD Section of Electrophysiology and Pacing Cleveland Clinic Disclosures Fellow s advisory panel for St Jude Medical Speaking honoraria from: Boston
More informationTreating Atrial Fibrillation. Richard Schilling. St Bartholomew's Hospital, Queen Mary s University of London
Treating Atrial Fibrillation Richard Schilling St Bartholomew's Hospital, Queen Mary s University of London AF burden Framingham Lifetime risk of developing AF = 25% Mortality: SMR =1.9 1.5 NHS audit 1%
More informationOne-year clinical success of a no-bonus freeze protocol using the second-generation 28 mm cryoballoon for pulmonary vein isolation
Europace (2015) 17, 1236 1240 doi:10.1093/europace/euv024 CLINICAL RESEARCH Ablation for atrial fibrillation One-year clinical success of a no-bonus freeze protocol using the second-generation 28 mm cryoballoon
More informationThis overview was prepared in October 2011, and updated in March 2012.
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of percutaneous balloon cryoablation for pulmonary vein isolation in atrial fibrillation
More informationDevices to Protect Against Stroke in Atrial Fibrillation
Devices to Protect Against Stroke in Atrial Fibrillation Jonathan C. Hsu, MD, MAS Associate Clinical Professor Division of Cardiology, Section of Cardiac Electrophysiology June 2, 2018 Disclosures Honoraria
More informationEctopic Atrial Tachycardia
Europace Madrid, 26-29 June 2011 Ectopic Atrial Tachycardia P. Loh, MD, PhD University of Utrecht Division Heart & Lungs Epidemiology Nonsustained atrial tachycardia Frequent finding on holter registrations
More informationIntroduction. CLINICAL RESEARCH Ablation for atrial fibrillation
Europace (2016) 18, 71 77 doi:10.1093/europace/euv224 CLINICAL RESEARCH Ablation for atrial fibrillation Electrophysiological findings following pulmonary vein isolation using radiofrequency catheter guided
More informationAtrial Fibrillation What are the Options in 2016?
Atrial Fibrillation What are the Options in 2016? David Spragg, MD, FHRS Johns Hopkins Hospital Cardiovascular Disease Management October, 2016 Disclosures Consulting, Biosense Webster Overview What is
More informationIndex. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A AADs. See Antiarrhythmic drugs (AADs) ACE inhibitors. See Angiotensin-converting enzyme (ACE) inhibitors ACP in transseptal approach to
More informationPost-ablation Management: Drug therapy, Anticoagulation and long-term Monitoring
Catheter Ablation of Atrial Fibrillation: State of the Art Post-ablation Management: Drug therapy, Anticoagulation and long-term Monitoring Dipen Shah Service de Cardiologie Hospital Cantonal de Genève
More informationAtrial Fibrillation New Approaches, Techniques, and Technology
New Cardiovascular Horizons 2015 May 28, 2015 New Orleans, Louisiana Atrial Fibrillation New Approaches, Techniques, and Technology State of the Art - - 2015 Richard Abben, M D Director, Cardiac Arrhythmia
More information