Raphael Rosso MD, Yuval Levi Med. Eng., Sami Viskin MD Tel Aviv Sourasky Medical Center

Size: px
Start display at page:

Download "Raphael Rosso MD, Yuval Levi Med. Eng., Sami Viskin MD Tel Aviv Sourasky Medical Center"

Transcription

1 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 Raphael Rosso MD, Yuval Levi Med. Eng., Sami Viskin MD Tel Aviv Sourasky Medical Center

2 Disclosures Biosense-Webster Consultation Fee

3 RF ablation is the treatment of choice for patients with symptomatic, drug refractory atrial fibrillation Suboptimal results and long procedural time New technologies aimed to improve efficacy and shorten the procedures

4 Poor contact inaccurate mapping poor efficacy of Ablation processing time lengthened > 30% Redo Excessive Contact Inaccurate mapping risk of perforation damage to tissues / adjacent organs Char steam pop

5 Radiofrequency ablation lesion volume is proportional to applied contact force. Contact force catheters provide real-time feedback of the force applied between the catheter tip and the myocardium Use of contact force catheters in RF ablation of AF has led to less acute pulmonary vein reconnection, fewer gaps in the circumferential isolation lines and has significantly improved outcome after atrial fibrillation ablation. Yokoyama K et al. Circ Arrhythm Electrophysiol2008; 1: Reddy VY et al. Heart Rhythm 2012; 9: Gerstenfeld EP et al. Circ Arrhythm Electrophysiol 2014; 7:5 6. Neuzil P et al. Circ Arrhythm Electrophysiol 2013; 6: Natale A et al. J Am Coll Cardiol Aug 19;64(7): doi: /j.jacc

6 Carto 3 Smart Touch TRANSMITTER coil in the tip sends location reference signal about the Spring. PRECISION SPRING allows small amount of electrode deflection. SENSORS receive transmitter coils location signal and micromovements of the spring.

7 7

8

9 nmarq TM Catheter Loop 10 ring electrodes (Circular) 7 ring electrodes (Crescent) 3 mm long each 4 mm inter-electrode spacing Irrigated electrodes 2.5mm 2 effective surface area 10 irrigation ports per electrode mm variable loop diameter (Circular) mm variable loop diameter (Crescent) Compatible with 8.5 Fr Sheath Fix or Deflectable

10

11 86 consecutive patients with drug refractory paroxysmal and persistent AF referred for ablation between May 2013 and August 2014

12 Combined Modality Imaging 1. Fluoroscopy 2. High resolution gated CT 3. 3-D electroanatomic mapping Carto3 4. General anesthesia and conscious sedation 5. TEE or ICE

13 Pulmonary vein isolation in PAF Persistent AF patient underwent DCR on amiodarone a month prior to the ablation Pulmonary vein isolation ±CFAEs and linear ablation in persistent AF (5/8 with nmarq, 5/11 in SmartTouch)

14 Pre procedural care: Antiarrhythmic agents usually continued before ablation In patients with persistent AF DCR after amiodarone loading and RF during sinus NOACs stopped 24 hours prior to the ablation and restarted the day after the procedure Uninterrupted warfarin General anesthesia or conscious sedation according to a sedation protocol

15 Post procedural care Antiarrhythmic therapy continued for 1-3 months Anticoagulation continued for at least 2 months and indefinitely if CHA2DS2vasc 2 Omeprazole for 2 months

16 Follow up Clinical and electrocardiographic follow-up performed at 3, 6, 9, and 12 months, respectively, and every 6 months thereafter 24 Holter monitoring performed at 2 and 3 months post procedure and then twice every six months Holter recordings and trans-telephonic monitoring also performed when symptoms suggested recurrence AF recurrence defined by the presence of symptoms suggestive of AF and/or electrocardiographic documentation of > 30 seconds AF/atrial flutter/atrial tachycardia > 3months after the procedure.

17

18 PV isolation was achieved in 100% of pulmonary veins ablated nmarq mean follow up of 10.6±3 months Smart Touch mean follow-up of 11.4± 7.3 months

19 PAF single Per single nmarq Smart Touch 85 75

20 Pulmonary vein isolation could not be achieved with the nmarq in 4 (11%) patients and was completed with a Navistar. Crossover from Navistar to nmarq was never necessary. nmarq group 5 pts. underwent CPVI with additional CFAEs and linear ablations. 2 out of 5 atrial fibrillation organized into atrial tachycardia and terminated during ablation. 3 pts. the arrhythmia could not be terminated during the ablation and required electrical cardioversion. The three patients who underwent cardioversion had recurrent atrial flutter Smart Touch group 5 pts. underwent CPVI with additional CFAEs and linear ablation. In two out of five the atrial fibrillation organized into atrial tachycardia and terminated during ablation. Both remained in sinus rhythm during follow up. In the remaining 3 pts. electrical cardioversion was perfomed. All three developed recurrent atrial fibrillation during follow up

21 Conclusions: nmarq and Smart Touch give similar results in AF ablation of both paroxysmal and persistent AF Need for crossover from nmarq to Smart Touch in 11% of patients nmarq can be used to perform linear ablation and CFAEs ablation Reassessment of the study results with the second generation of the nmarq catheter

22

Catheter ablation of atrial fibrillation: Indications and tools for improvement of the success rate of the method. Konstantinos P.

Catheter 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 information

Supplementary Online Content

Supplementary 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 information

What s new in my specialty?

What 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 information

Time to recurrence of atrial fibrillation influences outcome following catheter ablation

Time to recurrence of atrial fibrillation influences outcome following catheter ablation Time to recurrence of atrial fibrillation influences outcome following catheter ablation Larraitz Gaztañaga, MD, David S. Frankel, MD, Maria Kohari, MD, Lavanya Kondapalli, MD, Erica S. Zado, PA-C, FHRS,

More information

Percutaneous Transvenous Atrial Fibrillation Ablation and Stroke

Percutaneous 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 information

Clinical Value of Noninducibility by High-Dose Isoproterenol Versus Rapid Atrial Pacing After Catheter Ablation of Paroxysmal Atrial Fibrillation

Clinical Value of Noninducibility by High-Dose Isoproterenol Versus Rapid Atrial Pacing After Catheter Ablation of Paroxysmal Atrial Fibrillation 13 Clinical Value of Noninducibility by High-Dose Isoproterenol Versus Rapid Atrial Pacing After Catheter Ablation of Paroxysmal Atrial Fibrillation THOMAS CRAWFORD, M.D., AMAN CHUGH, M.D., ERIC GOOD,

More information

AF :RHYTHM CONTROL BY DR-MOHAMMED SALAH ASSISSTANT LECTURER CARDIOLOGY DEPARTMENT

AF :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 information

Linear 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. 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 information

480 April 2004 PACE, Vol. 27

480 April 2004 PACE, Vol. 27 Incremental Value of Isolating the Right Inferior Pulmonary Vein During Pulmonary Vein Isolation Procedures in Patients With Paroxysmal Atrial Fibrillation HAKAN ORAL, AMAN CHUGH, CHRISTOPH SCHARF, BURR

More information

AF 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 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 information

Κατάλυση 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. 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 information

Long Standing Persistent AF ; CPVI is enough for it

Long 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 information

Indicatie voor ablatie bij voorkamerfibrillatie. Andrea Sarkozy Cardiologie Universitair Ziekenhuis Antwerpen

Indicatie voor ablatie bij voorkamerfibrillatie. Andrea Sarkozy Cardiologie Universitair Ziekenhuis Antwerpen Indicatie voor ablatie bij voorkamerfibrillatie Andrea Sarkozy Cardiologie Universitair Ziekenhuis Antwerpen Definition and Classification of AF - Practical aspects Classification of AF Paroxysmal, persistent,

More information

PRIMARY 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 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 information

Catheter Ablation of Atrial Fibrillation in Patients with Prosthetic Mitral Valve

Catheter 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 information

20% 10/9/2018. Fluoroless Ablation relinquishing an old habit. Prevalence of Atrial Fibrillation. Atrial Fibrillation is a Progressive Disease

20% 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 information

ΚΑΤΑΛΥΣΗ 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 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 information

A Cryo Anatomical Procedure to Everyone? Saverio Iacopino, FACC, FESC

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 information

Role of LAA isolation in AF cure

Role of LAA isolation in AF cure MAM 2017, Zurich Role of LAA isolation in AF cure Sakis Themistoclakis, MD Director, Unit of Electrophysiology and Cardiac Pacing Department of Cardiothoracic & Vascular Medicine Ospedale dell Angelo,

More information

Is 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? 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 information

A MULTIDISCIPLINARY APPROACH TO ATRIAL FIBRILLATION: OUR EXPERIENCE WITH THE CONVERGENT PROCEDURE

A MULTIDISCIPLINARY APPROACH TO ATRIAL FIBRILLATION: OUR EXPERIENCE WITH THE CONVERGENT PROCEDURE A MULTIDISCIPLINARY APPROACH TO ATRIAL FIBRILLATION: OUR EXPERIENCE WITH THE CONVERGENT PROCEDURE Joe Aoun, MD Ioannis Koulouridis, MD, MSc Aleem Mughal, MD Maxwell Eyram Afari, MD Caroline Zahm, MD John

More information

Ablation Index : A new standard for Safety and Efficacy. Dr Franck Halimi Hôpital Privé Parly 2 Le Chesnay, France

Ablation Index : A new standard for Safety and Efficacy. Dr Franck Halimi Hôpital Privé Parly 2 Le Chesnay, France Ablation Index : A new standard for Safety and Efficacy Dr Franck Halimi Hôpital Privé Parly 2 Le Chesnay, France Disclosures Dr Franck Halimi... I have the following potential conflicts of interest to

More information

Mechanism of Immediate Recurrences of Atrial Fibrillation After Restoration of Sinus Rhythm

Mechanism of Immediate Recurrences of Atrial Fibrillation After Restoration of Sinus Rhythm Mechanism of Immediate Recurrences of Atrial Fibrillation After Restoration of Sinus Rhythm AMAN CHUGH, MEHMET OZAYDIN, CHRISTOPH SCHARF, STEVE W.K. LAI, BURR HALL, PETER CHEUNG, FRANK PELOSI, JR, BRADLEY

More information

Since pulmonary veins (PVs) have

Since pulmonary veins (PVs) have Case Report Hellenic J Cardiol 2011; 52: 371-376 Left Atrial-Pulmonary Vein Reentrant Tachycardia Following Pulmonary Vein Isolation Dionyssios Leftheriotis, Feifan Ouyang, Karl-Heinz Kuck II. Med. Abteilung,

More information

New technology to minimize radiation

New technology to minimize radiation Room 103-104 15/April/2016 New technology to minimize radiation Jun Kim University of Ulsan College of Medicine Asan Medical Center Heart Institute Disclosure NONE I have no experience using Carto Univu

More information

Jesus M. Paylos, C. Ferrero, L. Azcona, A. Morales, M. A. Vargas, L. Lacal, V. Gomez Tello.

Jesus 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 information

Original Article Pulmonary vein isolation without left atrial mapping

Original Article Pulmonary vein isolation without left atrial mapping www.ipej.org 142 Original Article Pulmonary vein isolation without left atrial mapping Attila Kardos MD 1, Csaba Foldesi MD 1, Karoly Ladunga MSc, PhD 1, Attila Toth MD 2, Tamas Szili-Torok MD, PhD 1 1

More information

A request for a log book extension must be put in writing and sent to BHRS, Unit 6B, Essex House, Cromwell Business Park, Chipping Norton,

A request for a log book extension must be put in writing and sent to BHRS, Unit 6B, Essex House, Cromwell Business Park, Chipping Norton, 7 7. A request for a log book extension must be put in writing and sent to BHRS, Unit 6B, Essex House, Cromwell Business Park, Chipping Norton, Oxfordshire OX7 5SR. E-mail: admin@bhrs.com. Tel: 01789 867

More information

Combined catheter ablation and left atrial appendage closure as a. treatment of atrial fibrillation

Combined 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 information

Long-Term Outcome and Risks of Catheter Ablation for Atrial Fibrillation

Long-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 information

Electrical isolation of the pulmonary veins (PVs) to treat

Electrical isolation of the pulmonary veins (PVs) to treat Mechanisms of Organized Left Atrial Tachycardias Occurring After Pulmonary Vein Isolation Edward P. Gerstenfeld, MD; David J. Callans, MD; Sanjay Dixit, MD; Andrea M. Russo, MD; Hemal Nayak, MD; David

More information

Ruolo della ablazione della fibrillazione atriale nello scompenso cardiaco

Ruolo della ablazione della fibrillazione atriale nello scompenso cardiaco Ruolo della ablazione della fibrillazione atriale nello scompenso cardiaco Matteo Anselmino Division of Cardiology Città della Salute e della Scienza Hospital University of Turin, Italy Disclosure: Honoraria

More information

Atrial Fibrillation Ablation: in Whom and How

Atrial 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 information

Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and

Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and 12 Chapter Atrial Fibrillation Ablation Atrial Fibrillation Ablation George Thomas, MD Amin Al-Ahmad, MD Executive Summary Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and

More information

Debate-STAR AF 2 study. PVI is not enough

Debate-STAR AF 2 study. PVI is not enough Debate-STAR AF 2 study PVI is not enough Debate about STAR AF 2 trial STAR AF trial Substrate and Trigger Ablation for Reduction of Atrial Fibrillation EHJ 2010 STAR-AF 2 trial One Size Fits All? PVI is

More information

Ablation 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 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 information

Progression 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 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 information

AF Today: W. For the majority of patients with atrial. are the Options? Chris Case

AF 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 information

Catheter ablation of AF Where do we stand, where do we go?

Catheter ablation of AF Where do we stand, where do we go? Catheter ablation of AF Where do we stand, where do we go? Sébastien Knecht MD, PhD Hôpital cardiologique du Haut L Evêque, Bordeaux Declaration of conflict of interest ABLATION STRATEGIES Duration proc:

More information

Atrial 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 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 information

Catheter Ablation for Atrial Fibrillation: Patient Selection and Outcomes

Catheter 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 information

Post-ablation Management: Drug therapy, Anticoagulation and long-term Monitoring

Post-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 information

NICE has also published a medtech innovation briefing on the TactiCath Quartz catheter.

NICE has also published a medtech innovation briefing on the TactiCath Quartz catheter. pat hways ThermoCool SmartTouch catheter for percutaneous radiofrequency ablation in atrial fibrillation Medtech innovation briefing Published: 23 March 2016 nice.org.uk/guidance/mib61 Summary ThermoCool

More information

The impact of hypertension on the electromechanical properties and outcome of catheter ablation in atrial fibrillation patients

The impact of hypertension on the electromechanical properties and outcome of catheter ablation in atrial fibrillation patients Original Article The impact of hypertension on the electromechanical properties and outcome of catheter ablation in atrial fibrillation patients Tao Wang 1, Yun-Long Xia 1, Shu-Long Zhang 1, Lian-Jun Gao

More information

Cardiology Department, Ain Shams University, Cairo, Egypt.

Cardiology Department, Ain Shams University, Cairo, Egypt. Early Pulmonary Vein Conduction Recovery After Catheter Ablation Of Atrial Fibrillation Ayman Mortada 1, Saeed Khaled 1, Samir Wafa 1, Hayam Eldamanhoury 1, Ahmed Nabil 1 1 Cardiology Department, Ain Shams

More information

Mapping and Ablation in AF: how can we evaluate the lesion formation?

Mapping 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 information

Outcomes of AF Ablation

Outcomes 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 information

Cardiac Electrical Therapies. By Omar AL-Rawajfah, PhD, RN

Cardiac Electrical Therapies. By Omar AL-Rawajfah, PhD, RN Cardiac Electrical Therapies By Omar AL-Rawajfah, PhD, RN Outlines What are cardiac electrical therapies Ablation Defibrillation Cardioversion What are the nursing considerations for each type of therapy

More information

CARDIOINSIGHT TM NONINVASIVE 3D MAPPING SYSTEM CLINICAL EVIDENCE SUMMARY

CARDIOINSIGHT TM NONINVASIVE 3D MAPPING SYSTEM CLINICAL EVIDENCE SUMMARY CARDIOINSIGHT TM NONINVASIVE 3D MAPPING SYSTEM CLINICAL EVIDENCE SUMMARY April 2017 SUPPORTING EVIDENCE RHYTHM AF VT PUBLICATIONS Driver Domains in Persistent Atrial Fibrillation (Haissaiguerre, et al)

More information

Invasive and Medical Treatments for Atrial Fibrillation. Thomas J Dresing, MD Section of Electrophysiology and Pacing Cleveland Clinic

Invasive 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 information

Balloon and Mesh Catheter Ablation of Pulmonary Veins

Balloon 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 information

Can the UK afford ablation for persistent AF? cost efficacy analysis. Dr Derick Todd Liverpool Heart & Chest Hospital

Can the UK afford ablation for persistent AF? cost efficacy analysis. Dr Derick Todd Liverpool Heart & Chest Hospital Can the UK afford ablation for persistent AF? cost efficacy analysis Dr Derick Todd Liverpool Heart & Chest Hospital Conflicts of Interest Speaker fees / Consultancy / Travel support: Bayer Boehringer

More information

Catheter Ablation of Atrial Fibrillation

Catheter 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 information

The pulmonary veins have been demonstrated to often

The pulmonary veins have been demonstrated to often Pulmonary Vein Isolation for Paroxysmal and Persistent Atrial Fibrillation Hakan Oral, MD; Bradley P. Knight, MD; Hiroshi Tada, MD; Mehmet Özaydın, MD; Aman Chugh, MD; Sohail Hassan, MD; Christoph Scharf,

More information

The Future of Catheter Ablation

The Future of Catheter Ablation The Future of Catheter Ablation KH Kuck, MD Asklepios Klink St. Georg, Hamburg Disclosure Statement Research Grants Consultant / Advisory Board Ownership Interests Speaker s Bureau Honoraria Biosense Webster,

More information

AF ABLATION Concepts and Techniques

AF 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 information

Dr Mark Earley MD FRCP Consultant Cardiologist

Dr Mark Earley MD FRCP Consultant Cardiologist Dr Mark Earley MD FRCP Consultant Cardiologist PERSONAL DETAILS ADDRESS (NHS) (Private practice) Dominion House, St Olaf House, St Bartholomew s London Bridge Hospital Hospital, 27 Tooley Street, London,

More information

Επιπλοκές κατάλυσης πνευµονικών φλεβών

Επιπλοκές 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 information

RADAR-AF Trial. A Randomized Multicenter Comparison of Radiofrequency Catheter Ablation of Drivers vs. Circumferential Pulmonary Vein

RADAR-AF Trial. A Randomized Multicenter Comparison of Radiofrequency Catheter Ablation of Drivers vs. Circumferential Pulmonary Vein RADAR-AF Trial A Randomized Multicenter Comparison of Radiofrequency Catheter Ablation of Drivers vs. Circumferential Pulmonary Vein Isolation in Patients with Atrial FibRillation Felipe Atienza, MD, PhD,

More information

CLINICAL 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 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 information

This overview was prepared in October 2011, and updated in March 2012.

This 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 information

Catheter Ablation of Long-Standing Persistent Atrial Fibrillation

Catheter Ablation of Long-Standing Persistent Atrial Fibrillation Journal of the American College of Cardiology Vol. 60, No. 19, 2012 2012 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jacc.2012.04.060

More information

Original Article Short- and long-term experience in pulmonary vein segmental ostial ablation for paroxysmal atrial fibrillation*

Original Article Short- and long-term experience in pulmonary vein segmental ostial ablation for paroxysmal atrial fibrillation* www.ipej.org 6 Original Article Short- and long-term experience in pulmonary vein segmental ostial ablation for paroxysmal atrial fibrillation* *English version of "Langzeit-Ergebnisse der ostialen Pulmonalvenenisolation

More information

INTRODUCTION. Key Words:

INTRODUCTION. Key Words: Original Article Acta Cardiol Sin 2015;31:317 324 doi: 10.6515/ACS20141218A EPS and Arrhythmia The Electrical Characteristics and Clinical Significance of the Effect of Adenosine on Dissociated Activity

More information

Peri-Mitral Atrial Flutter with Partial Conduction Block between Left Atrium and Coronary Sinus

Peri-Mitral Atrial Flutter with Partial Conduction Block between Left Atrium and Coronary Sinus Accepted Manuscript Peri-Mitral Atrial Flutter with Partial Conduction Block between Left Atrium and Coronary Sinus Ryota Isogai, MD, Seiichiro Matsuo, MD, Ryohsuke Narui, MD, Shingo Seki, MD;, Michihiro

More information

Treating 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 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 information

Catheter Ablation for Persistent Atrial Fibrillation

Catheter Ablation for Persistent Atrial Fibrillation Catheter Ablation for Persistent Atrial Fibrillation Saeed Oraii MD, Cardiologist Interventional Electrophysiologist Tehran Arrhythmia Clinic April 2016 Atrial Fibrillation First reported by Sir William

More information

EP Studies, Ablation, and 3-D Cardiac Mapping. Diagnosis and Treatment of Heart Arrhythmias

EP Studies, Ablation, and 3-D Cardiac Mapping. Diagnosis and Treatment of Heart Arrhythmias EP Studies, Ablation, and 3-D Cardiac Mapping Diagnosis and Treatment of Heart Arrhythmias April 14, 2018 Territory Manager: Matt Dodge Clinical Account Specialist: Chris Rutherford Regional Technology

More information

Atrial Fibrillation: Rate vs. Rhythm. Michael Curley, MD Cardiac Electrophysiology

Atrial 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 information

SEVEN YEARS OF CRYO-BALLOON CATHETER ABLATION

SEVEN 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 information

Catheter-Induced Linear Lesions in the Left Atrium in Patients With Atrial Fibrillation An Electroanatomic Study

Catheter-Induced Linear Lesions in the Left Atrium in Patients With Atrial Fibrillation An Electroanatomic Study Journal of the American College of Cardiology Vol. 42, No. 7, 2003 2003 by the American College of Cardiology Foundation ISSN 0735-1097/03/$30.00 Published by Elsevier Inc. doi:10.1016/s0735-1097(03)00940-9

More information

Rate and Rhythm Control of Atrial Fibrillation

Rate 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 information

New Parameter to Predict Recurrence of Paroxysmal Atrial Fibrillation after Pulmonary Vein Isolation by the P-Wave Signal-Averaged Electrocardiogram

New Parameter to Predict Recurrence of Paroxysmal Atrial Fibrillation after Pulmonary Vein Isolation by the P-Wave Signal-Averaged Electrocardiogram Showa Univ J Med Sci 29 2, 141 150, June 2017 Original New Parameter to Predict Recurrence of Paroxysmal Atrial Fibrillation after Pulmonary Vein Isolation by the P-Wave Signal-Averaged Electrocardiogram

More information

Atrial ectopic beats within the pulmonary veins (PVs) are

Atrial ectopic beats within the pulmonary veins (PVs) are Phased-Array Intracardiac Echocardiography Monitoring During Pulmonary Vein Isolation in Patients With Atrial Fibrillation Impact on Outcome and Complications Nassir F. Marrouche, MD; David O. Martin,

More information

Left atrial catheter ablation subsequent to Watchman w left atrial appendage device implantation: a single centre experience

Left atrial catheter ablation subsequent to Watchman w left atrial appendage device implantation: a single centre experience Europace (2015) 17, 1402 1406 doi:10.1093/europace/euv037 CLINICAL RESEARCH Ablation for atrial fibrillation Left atrial catheter ablation subsequent to Watchman w left atrial appendage device implantation:

More information

Circumferential Pulmonary-Vein Ablation for Chronic Atrial Fibrillation

Circumferential Pulmonary-Vein Ablation for Chronic Atrial Fibrillation The new england journal of medicine original article Circumferential Pulmonary-Vein Ablation for Chronic Atrial Fibrillation Hakan Oral, M.D., Carlo Pappone, M.D., Aman Chugh, M.D., Eric Good, D.O., Frank

More information

Dipen Shah Cardiology Service, University Hospitals, Geneva Switzerland

Dipen Shah Cardiology Service, University Hospitals, Geneva Switzerland Dipen Shah Cardiology Service, University Hospitals, Geneva Switzerland Disclosures Research Grants: Biosense Webster, St. Jude, Bard, Endosense, Biotronik Speakers Honoraria: Biosense Webster, Endosense,

More information

Purse-String Pv Box Isolation: A Less Invasive Modified Maze Procedure For Non-Mitral Atrial Fibrillation

Purse-String Pv Box Isolation: A Less Invasive Modified Maze Procedure For Non-Mitral Atrial Fibrillation Purse-String Pv Box Isolation: A Less Invasive Modified Maze Procedure For Non-Mitral Atrial Fibrillation T. Taguchi, K. Imai, M. Watanabe, H. Kodama, K. Katayama, S. Takahashi, T. Kurosaki, T. Sueda Department

More information

PVI and What Else for Persistent AF Lessons Learned from STAR AF 2 CCCEP 2015 October 31, New York

PVI and What Else for Persistent AF Lessons Learned from STAR AF 2 CCCEP 2015 October 31, New York PVI and What Else for Persistent AF Lessons Learned from STAR AF 2 CCCEP 2015 October 31, New York Atul Verma, MD FRCPC FHRS Director, Arrhythmia Services Southlake Regional Health Centre Faculty of Medicine

More information

The 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? 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 information

Pulmonary vein isolation (PVI) is

Pulmonary vein isolation (PVI) is Case Report Hellenic J Cardiol 2012; 53: 163-167 The Use of the Multi-Electrode Duty-Cycled Radiofrequency Ablation Catheter PVAC for the Ablation of a Left Atrial Tachycardia Dionyssios Leftheriotis 1,

More information

Time to Cardioversion of Recurrent Atrial Arrhythmias After Catheter Ablation of Atrial Fibrillation and Long-Term Clinical Outcome

Time to Cardioversion of Recurrent Atrial Arrhythmias After Catheter Ablation of Atrial Fibrillation and Long-Term Clinical Outcome Time to Cardioversion of Recurrent Atrial Arrhythmias After Catheter Ablation of Atrial Fibrillation and Long-Term Clinical Outcome TIMIR S. BAMAN, M.D., SANJAYA K. GUPTA, M.D., SREEDHAR R. BILLAKANTY,

More information

Intracardiac Echocardiography in Premature Ventricular Complex/Ventricular Tachycardia Ablation

Intracardiac Echocardiography in Premature Ventricular Complex/Ventricular Tachycardia Ablation Intracardiac Echocardiography in Premature Ventricular Complex/Ventricular Tachycardia Ablation Tae-Seok Kim Sung-Hwan Kim ECG & EP CASES Tae-Seok Kim, MD, Sung-Hwan Kim, MD Department of Internal Medicine,

More information

Storia dell ablazione della fibrillazione atriale: da dove siamo partiti, dove siamo, dove andremo. Prof. Fiorenzo Gaita

Storia dell ablazione della fibrillazione atriale: da dove siamo partiti, dove siamo, dove andremo. Prof. Fiorenzo Gaita Storia dell ablazione della fibrillazione atriale: da dove siamo partiti, dove siamo, dove andremo Prof. Fiorenzo Gaita Knowledge Idea Serendipity Technology (right tools) Serendipity - discovery of a

More information

Catheter Ablation of Atrial Tachycardia Originating from the Tip of Right Atrial Appendage

Catheter Ablation of Atrial Tachycardia Originating from the Tip of Right Atrial Appendage Case Report Catheter Ablation of Atrial Tachycardia Originating from the Tip of Right Atrial Appendage Masaru Inoue MD, Takao Matsubara MD, Toshihiko Yasuda MD, Kenji Miwa MD, Tadatsugu Gamou MD, Hounin

More information

CLINICAL 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 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 information

2015 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 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 information

Catheter ablation of atrial fibrillation in the elderly: Where do we stand?

Catheter ablation of atrial fibrillation in the elderly: Where do we stand? REVIEW ARTICLE Cardiology Journal 2009, Vol. 16, No. 2, pp. 113 120 Copyright 2009 Via Medica ISSN 1897 5593 Catheter ablation of atrial fibrillation in the elderly: Where do we stand? Darren Traub, James

More information

Radiofrequency catheter ablation for paroxysmal atrial fibrillation: outcomes during a 3-year follow-up period

Radiofrequency catheter ablation for paroxysmal atrial fibrillation: outcomes during a 3-year follow-up period Clinical Research Report Radiofrequency catheter ablation for paroxysmal atrial fibrillation: outcomes during a 3-year follow-up period Journal of International Medical Research 2019, Vol. 47(4) 1636 1648!

More information

High density substrate mapping In AF

High density substrate mapping In AF High density substrate mapping In AF A Pisapia J Seitz C Bars M Bremondy A Ferracci * J Khalifa ** * St Joseph Hospital Marseille ** Ann Arbor University Turin 2016 Hôpital Saint Joseph Marseille jseitz@hopital-saint-joseph.fr

More information

Recent observations have focused attention on the PVs as a source of ectopic activity i determining i AF

Recent 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 information

Patient Presentation

Patient Presentation Update on Current Perspectives and Management Options for Atrial Fibrillation Burr Hall, M.D. March 20, 2015 Patient Presentation 72 year old active male farmer and tow truck operator from Hemlock, NY

More information

Ablation of persistent AF Is it different than paroxysmal?

Ablation 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 information

ATRIAL FIBRILLATION 2018: AN UPDATE ON RECENT DEVELOPMENTS IN DIAGNOSIS AND MANAGEMENT PANOS E. VARDAS, MD, PhD

ATRIAL FIBRILLATION 2018: AN UPDATE ON RECENT DEVELOPMENTS IN DIAGNOSIS AND MANAGEMENT PANOS E. VARDAS, MD, PhD ATRIAL FIBRILLATION 2018: AN UPDATE ON RECENT DEVELOPMENTS IN DIAGNOSIS AND MANAGEMENT PANOS E. VARDAS, MD, PhD Author affiliations: Heart Sector, Hygeia Group Hospitals, Athens, Greece Address for correspondence:

More information

How to Distinguish Focal Atrial Tachycardia from Small Circuits and Reentry

How to Distinguish Focal Atrial Tachycardia from Small Circuits and Reentry How to Distinguish Focal Atrial Tachycardia from Small Circuits and Reentry Pierre Jaïs; Bordeaux, France IHU LIRYC ANR-10-IAHU-04 Equipex MUSIC imaging platform ANR-11-EQPX-0030 Eutraf HEALTH-F2-2010-261057

More information

2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation

2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation Summary of Expert Consensus Statement for CLINICIANS 2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation This is a summary of the Heart

More information

עדכונים באלקטרופיזיולוגיה Electrophysiology Unit Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev

עדכונים באלקטרופיזיולוגיה Electrophysiology Unit Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev עדכונים באלקטרופיזיולוגיה 2014 Electrophysiology Unit Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev 1 מבנה הצגת היחידה פעילות ביחידה סקירה על הטיפול באלקטרופיזיולוגיה

More information

8/26/2016. Historical Perspective (1) Is Cryoballoon the Preferred Approach to Ablation of Paroxysmal AF? Historical Perspective (2)

8/26/2016. 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 information

The 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 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 information