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Pulsed electric fields have emerged as the ultimate cardiac ablation technique. At present, several clinical trials in humans are investigating PEF as an ablation scheme for both atrial and ventricular arrhythmias, with early results showing promising promise. PEF biophysics and principles are notably different from current energy modalities.
Source link: https://europepmc.org/article/MED/35426908
Background Cardiac ablation catheters are small in diameter and pose ergonomic problems that can affect catheter stability. We tested a novel torque device to reduce muscle contraction when manipulating catheters and raise perceived workload of ablation tasks. Methods cardiology attendings and fellows were fitted with surface electromyographic sensors on six key muscle groups in the left hand and forearm. Subjects guided the catheter tip to six specific electrophysiologic goals, including a 1-min simulated radiofrequency ablation lesion, after a standard ablation catheter was introduced into a pediatric cardiac ablation simulator and subjects navigated the catheter tip to six specific electrophysiologic goals, including a 1-min simulated radiofrequency ablation lesion. At the conclusion of each task, the participant was able to complete a NASA Task Load Index survey. In 4 of 6 muscle groups, muscle activation was reduced. Conclusions The catheter torque device can be used to reduce muscle pain caused by manipulating catheters and may reduce muscle cramp caused by catheterization.
Source link: https://europepmc.org/article/MED/35999487
The patient had suspected IDCM, left ventricular segmental dysfunction, cardiac systolic dysfunction, and a 29 percent ejection percentage. He had unusually large ventricular aneurysm in the left ventricle's posterior wall with left ventricular end diastolic dimension of 90 mm.
Source link: https://europepmc.org/article/MED/36010305
However, ablation failure is often attributed to high impedance in the transitional area of the distal great cardiac vein. Methods: A total of 156 patients with VA arising from the TAODGCV received RFCA therapy at our center from October 2009 to August 2021, which was retrospectively reviewed. We used the following steps to overcome high impedance: reset the upper limit impedance to 300 mL/min; turn off the upper limit impedance; use high-flow-rate irrigation systems; and raise the upper limit temperature.
Source link: https://europepmc.org/article/MED/36005428
Background Prior studies have shown that myocardial fibrosis can be detected by late gadolinium enhancement of cardiac magnetic resonance, which may be related to a higher risk of hypertrophic cardiomyopathy. This research was carried out to see whether CMR in patients with hypertrophic obstructive cardiomyopathy with alcohol septal ablation was beneficial. Materials and methods We conducted a retrospective study that included 183 patients with symptomatic drug-refractory HOCM who underwent CMR for diagnosis of myocardial fibrosis before ASA. 7 years The cohort consisted of 74 women with a mean age of 51, averaging of 81 years old. In 148 patients, preoperative myocardial fibrosis was confirmed. Conclusion After ASA in these patients, preoperative myocardial fibrosis measured by LGE-CMR was an independent predictor of adverse clinical outcomes in patients with HOCM who were undergoing ASA and could be used for pre-operative risk stratification and long-term prognosis.
Source link: https://europepmc.org/article/MED/36035960
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