17 results on '"Michowitz, Yoav"'
Search Results
2. Anatomical accuracy of the KODEX-EPD novel 3D mapping system of the left atrium during pulmonary vein isolation: A correlation with computer tomography imaging.
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Tovia Brodie O, Rav-Acha M, Wolak A, Ilan M, Orenstein DJ, Abuhatzera S, Glikson M, and Michowitz Y
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- Computers, Heart Atria diagnostic imaging, Heart Atria surgery, Humans, Imaging, Three-Dimensional methods, Tomography, X-Ray Computed, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation surgery, Catheter Ablation methods, Pulmonary Veins diagnostic imaging, Pulmonary Veins surgery
- Abstract
Background: A novel 3D mapping system (KODEX-EPD, EPD Solutions) enables catheter localization and real-time 3D cardiac mapping., Objective: To evaluate left atrium (LA) anatomical mapping accuracy created by the KODEX-EPD system during pulmonary vein isolation (PVI) compared with gold standard computed tomography (CT) images acquired from the same patients before the procedure., Methods: In 15 consecutive patients who underwent PVI, 3D mapping of the LA was created on the KODEX-EPD system using the Achieve catheter. Pulmonary vein (PV), posterior wall, and appendage anatomy and diameters, were compared to the CT 3D reconstruction measured on the CARTO 3 system. Measurements were done independently by two physicians in each method. Linear correlation and agreement between CT and EPD measurements were assessed by Spearman correlation and Bland-Altman plot., Results: Mean LA mapping time was 7.7 ± 3.6 min. Very high interobserver correlation was found for both EPD and CT measurements (Spearman r = .9). High correlation (r = .75) was found between CT and EPD measurements. Bland-Altman plot method revealed that measurements assessed by EPD were slightly higher than those assessed by CT. Mean difference was 3.5 mm, p < .01. In 2 (13.5%) patients each, disagreement regarding the presence of a left common PV and a right middle accessory vein anatomy was seen., Conclusion: The new KODEX-EPD mapping system allows quick and accurate mapping of the LA with high correlation to CT imaging. Some differences in left common and accessory right middle vein anatomy were seen., (© 2022 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC.)
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- 2022
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3. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy.
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Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, Barrabés JA, Boriani G, Braunschweig F, Brignole M, Burri H, Coats AJS, Deharo JC, Delgado V, Diller GP, Israel CW, Keren A, Knops RE, Kotecha D, Leclercq C, Merkely B, Starck C, Thylén I, Tolosana JM, Leyva F, Linde C, Abdelhamid M, Aboyans V, Arbelo E, Asteggiano R, Barón-Esquivias G, Bauersachs J, Biffi M, Birgersdotter-Green U, Bongiorni MG, Borger MA, Čelutkienė J, Cikes M, Daubert JC, Drossart I, Ellenbogen K, Elliott PM, Fabritz L, Falk V, Fauchier L, Fernández-Avilés F, Foldager D, Gadler F, De Vinuesa PGG, Gorenek B, Guerra JM, Hermann Haugaa K, Hendriks J, Kahan T, Katus HA, Konradi A, Koskinas KC, Law H, Lewis BS, Linker NJ, Løchen ML, Lumens J, Mascherbauer J, Mullens W, Nagy KV, Prescott E, Raatikainen P, Rakisheva A, Reichlin T, Ricci RP, Shlyakhto E, Sitges M, Sousa-Uva M, Sutton R, Suwalski P, Svendsen JH, Touyz RM, Van Gelder IC, Vernooy K, Waltenberger J, Whinnett Z, and Witte KK
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- Cardiac Pacing, Artificial, Humans, Stroke Volume, Atrial Fibrillation therapy, Cardiac Resynchronization Therapy adverse effects, Heart Failure diagnosis, Heart Failure therapy
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- 2022
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4. "Preventive" pacing in patients with tachy-brady syndrome (TBS): Confirming a common practice.
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Amir T, Ilan M, Fishman E, Michowitz Y, Khalameizer V, Katz A, Glikson M, Medina A, and Rav Acha M
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- Aged, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation drug therapy, Atrial Fibrillation etiology, Bradycardia drug therapy, Bradycardia etiology, Female, Heart Atria physiopathology, Humans, Male, Middle Aged, Retrospective Studies, Sick Sinus Syndrome complications, Sick Sinus Syndrome drug therapy, Atrial Fibrillation therapy, Bradycardia therapy, Cardiac Pacing, Artificial statistics & numerical data, Sick Sinus Syndrome therapy
- Abstract
Aims: Many tachy-brady syndrome (TBS) patients, are implanted a permanent pacemaker (PPM) to allow continuation of anti-arrhythmic drug (AAD) therapy to maintain sinus rhythm. Many of these PPM's are implanted as a preventive measure, in absence of symptomatic bradycardia. Our primary aim was to evaluate pacing use among these patients and find predictors for PPM use. Our secondary aim was to appreciate the portion of these patients who progress to permanent atrial fibrillation (AF)., Methods: Retrospective study of TBS patients implanted a PPM as preventive measure, dividing cases into defined categories regarding highest percent atrial and ventricular pacing documented in PPM clinic visits during 3 year follow-up (F/U) period. Patients' baseline characteristics and AAD therapy were compared between cases with a major (>90%) pacing use and cases with <90% pacing use to find predictors for pacing use. Multivariable logistic regression was applied to identify independent variables associated with major pacing use., Results: Our study included 119 TBS patients. Most (86.5%) TBS patients had a moderate (>50%) pacing use and 58% had a major pacing use. Significant association was found between pre-implant severe sinus bradycardia (<40 bpm), first degree atrioventricular block and amiodarone treatment to major pacing use on univariate analysis and severe sinus bradycardia was significantly associated with major pacing on multivariate analysis as well. Only minority (16.8%) of TBS patients progressed to permanent AF during the study F/U period., Conclusion: Our study reveals most TBS patients succeed to maintain sinus rhythm using an AAD with a significant pacing use, suggesting preventive PPM implantation might be advantageous in these cases. Pre-implant severe sinus bradycardia (<40 bpm) is a possible predictor for major pacing use in this population., (© 2020 John Wiley & Sons Ltd.)
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- 2020
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5. Thrombocytopenia and thrombocytosis are associated with different outcome in atrial fibrillation patients on anticoagulant therapy.
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Michowitz Y, Klempfner R, Shlomo N, Goldenberg I, and Koren-Michowitz M
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- Administration, Oral, Aged, Atrial Fibrillation blood, Endpoint Determination, Female, Humans, Kaplan-Meier Estimate, Male, Multivariate Analysis, Platelet Count, Proportional Hazards Models, Thrombocytopenia blood, Thrombocytosis blood, Treatment Outcome, Warfarin therapeutic use, Anticoagulants therapeutic use, Atrial Fibrillation complications, Atrial Fibrillation drug therapy, Thrombocytopenia complications, Thrombocytosis complications
- Abstract
Background: Information regarding the significance of platelet (PLT) count on outcome of atrial fibrillation (AF) patients who are treated with anticoagulants is limited., Methods: We conducted a monocentric observational retrospective cohort study of AF patients treated with either warfarin (n = 6287) or non-vitamin K antagonist oral anticoagulants (NOACs) (n = 5240). Patient were divided into 3 subgroups; low, normal and high PLT for counts < 150 K/ μl, 150-450 K/ μl and > 450 K/ μl, respectively. A multivariate Cox-regression was used to evaluate the association between PLT subgroups and clinical outcomes., Results: During follow-up [median = 40.6 months (IQR 17.6-60)], mortality (HR 1.36, 95 CI 1.1-1.74, p = 0.01) and rate of myocardial infarction (MI) (HR 2.4, 95 CI 1.28-4.57, p = 0.007) were higher in patients with high compared to normal PLT. Transient ischemic attack or cerebrovascular accident (TIA/CVA) rate was lower in patients with low compared to normal PLT (HR 0.69, 95 CI 0.51-0.93, p = 0.02). A comparison between NOACs and warfarin demonstrated a significantly better clinical outcome for patients on NOACs in both the low (lower mortality rates) and normal PLT subgroup (lower mortality, TIA/CVA and systemic emboli rates). For patients on NOACs, low and high compared to normal PLT were associated with a higher combined outcome (HR 1.12, 95 CI 1-1.38, p = 0.047), and a higher systemic emboli rate (HR 7.07, 95 CI 1.66-30.25, p = 0.008), respectively., Conclusions: Abnormal PLT count is associated with different clinical outcome of AF patients on anticoagulants. Further studies are needed in order assess whether PLT level should influence strategies of anticoagulation., Competing Interests: The study was supported by grants Bayer and Pfizer. Bayer and Pfizer had no role in the design and conduct of this study; collection, management, analysis, and interpretation of the data; and preparation or approval of the article. MKM reports receiving honoraria, research and travel grants from Novartis and Pfizer. YM, RK, NS, and IG report no conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
- Published
- 2019
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6. Pulmonary vein duality: A new encounter with an old friend.
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Yankelson L, Michowitz Y, Glick A, and Belhassen B
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- Adult, Humans, Male, Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Electrocardiography, Pulmonary Veins physiopathology
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- 2016
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7. Unmasking right atrial fibrillation: A new indication of adenosine triphosphate test?
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Belhassen B and Michowitz Y
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- Adenosine, Electrocardiography, Heart Atria, Heart Conduction System, Humans, Adenosine Triphosphate, Atrial Fibrillation
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- 2016
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8. [Who should undergo atrial fibrillation ablation?].
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Michowitz Y and Belhassen B
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- Aged, Atrial Fibrillation epidemiology, Atrial Fibrillation physiopathology, Humans, Prevalence, Atrial Fibrillation surgery, Catheter Ablation methods
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Atrial fibrillation is the most common sustained arrhythmia and its prevalence increases significantly with age. This editorial discusses the review by Laish-Farkash et al. regarding ablation of atrial fibrillation, especially in the elderly, as well as new ablation modalities.
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- 2014
9. Effects of sex on the incidence of cardiac tamponade after catheter ablation of atrial fibrillation: results from a worldwide survey in 34 943 atrial fibrillation ablation procedures.
- Author
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Michowitz Y, Rahkovich M, Oral H, Zado ES, Tilz R, John S, Denis A, Di Biase L, Winkle RA, Mikhaylov EN, Ruskin JN, Yao Y, Josephson ME, Tanner H, Miller JM, Champagne J, Della Bella P, Kumagai K, Defaye P, Luria D, Lebedev DS, Natale A, Jais P, Hindricks G, Kuck KH, Marchlinski FE, Morady F, and Belhassen B
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- Adult, Age Distribution, Aged, Aged, 80 and over, Cardiac Tamponade etiology, Data Collection, Female, Global Health, Humans, Incidence, Male, Middle Aged, Postoperative Complications, Sex Distribution, Sex Factors, Survival Rate trends, Young Adult, Atrial Fibrillation surgery, Cardiac Tamponade epidemiology, Catheter Ablation adverse effects
- Abstract
Background: Cardiac tamponade is the most dramatic complication observed during atrial fibrillation (AF) ablation and the leading cause of procedure-related mortality. Female sex is a known risk factor for complications during AF ablation; however, it is unknown whether women have a higher risk of tamponade., Methods and Results: A systematic Medline search was used to locate academic electrophysiological centers that reported cases of tamponade occurring during AF ablation. Centers were asked to provide information on cases of acute tamponade according to sex and their mode of management including any case of related mortality. Nineteen electrophysiological centers provided information on 34 943 ablation procedures involving 25 261 (72%) men. Overall, 289 (0.9%) cases of tamponade were reported: 120 (1.24%) in women and 169 (0.67%) in men (odds ratio, 1.83; P<0.001). There was a reciprocal association between center volume and the occurrence of tamponade with substantially lower risk in high-volume centers. Most cases of tamponade occurred during catheter manipulation or ablation; women tended to develop more tamponades during transseptal catheterization. No sex difference in the mode of management was observed. However, 16% cases of tamponade required surgery with lower rates in high-volume centers. Three cases of tamponade (1%) culminated in death., Conclusions: Tamponade during AF ablation procedures is relatively rare. Women have an ≈2-fold higher risk for developing this complication. The risk of tamponade among women decreases substantially in high-volume centers. Surgical backup and acute management skills for treating tamponade are important in centers performing AF ablation.
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- 2014
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10. Radiofrequency ablation of paroxysmal atrial fibrillation with the new irrigated multipolar nMARQ ablation catheter: verification of intracardiac signals with a second circular mapping catheter.
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Rosso R, Halkin A, Michowitz Y, Belhassen B, Glick A, and Viskin S
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- Catheter Ablation methods, Female, Humans, Male, Middle Aged, Pulmonary Veins physiology, Atrial Fibrillation surgery, Catheter Ablation instrumentation, Catheters
- Abstract
Background: During radiofrequency (RF) ablation of paroxysmal atrial fibrillation, a circular multielectrode recording "lasso" catheter is generally positioned within each pulmonary vein (PV) to determine when pulmonary vein potentials (PVPs) are present and when they have been ablated. The new irrigated multipolar nMARQ circular ablation catheter is positioned within the left atrium to create contiguous circular ablation lines around each PV ostium., Objective: To determine whether the recordings obtained from the nMARQ catheter position around the PV ostium accurately reproduce the recordings obtained from a lasso catheter positioned within that vein., Methods: In 10 patients undergoing RF ablation of paroxysmal atrial fibrillation, we placed an nMARQ and a lasso catheter around and within each PV, respectively. Recordings obtained from both catheters at baseline and after RF ablation were compared., Results: At baseline, recordings of PVPs in both catheters were concordant in 92% of all PVs. However, after RF delivery, the concordance between the nMARQ and lasso recordings was poor. The discordant result most commonly observed was disappearance of "PVPs" from the nMARQ catheter with persistence of PVPs in the lasso catheter (12 of 39 [30%]). Conversely, the delivery of RF frequently resulted in fragmented electrograms (pseudo-PVPs) on the nMARQ catheter despite evidence of PV isolation by lasso catheter recordings., Conclusions: The use of an nMARQ catheter alone, as currently recommended, may lead to underestimation and overestimation of the number of RF applications required to achieve PV isolation., (Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
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- 2014
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11. Unipolar and bipolar electrogram characteristics predict exit block during pulmonary vein antral isolation.
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Michowitz Y, Buch E, Bourke T, Tung R, Bradfield J, Mathuria N, Boyle NG, and Shivkumar K
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- Female, Humans, Male, Middle Aged, Treatment Outcome, Atrial Fibrillation diagnosis, Atrial Fibrillation surgery, Body Surface Potential Mapping methods, Catheter Ablation methods, Nerve Block methods, Pulmonary Veins surgery, Surgery, Computer-Assisted methods
- Abstract
Introduction: The usefulness of unipolar electrograms (EGMs) has been reported in assessing lesion transmurality and conduction block along ablation lines. It is unknown whether unipolar and bipolar EGM characteristics predict exit block during pulmonary vein isolation (PVI) procedures., Methods and Results: Twenty patients (63 ± 7 years; 14 males [70%]) undergoing PVI with a circular mapping catheter (CMC) placed outside each PV ostium were retrospectively studied. After entrance block was achieved, pacing at each bipole around the CMC was performed to assess for absence of atrial capture (exit block). Bipolar EGMs recorded before pacing were examined for voltage, duration, fractionation, and monophasic morphology. Unipolar EGMs were examined for positive and negative amplitude, PQ segment elevation, fractionation, and monophasic morphology. The association of these parameters with atrial capture (absence of exit block) at each site was analyzed. After achievement of entrance block, only 23 of 64 PV antra (36%) exhibited exit block. Unipolar EGMs at sites with persistent capture were more likely to be fractionated and had larger negative deflections. Bipolar EGMs at sites with persistent capture showed higher amplitude, longer duration, were more likely to be fractionated, and were less likely to be monophasic. In a multivariate logistic regression model, bipolar and unipolar fractionation, bipolar duration, and lack of bipolar monophasic morphology were independently associated with persistent atrial capture., Conclusion: Specific unipolar and bipolar EGM characteristics are associated with left atrium capture after PV antral isolation. These parameters might be useful in predicting the need for further ablation to achieve exit block., (©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.)
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- 2012
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12. Escape rhythm from a partially disconnected pulmonary vein.
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Michowitz Y, Glick A, and Belhassen B
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- Adult, Atrial Fibrillation physiopathology, Electrocardiography, Heart Atria physiopathology, Heart Conduction System physiopathology, Humans, Male, Atrial Fibrillation surgery, Catheter Ablation, Pulmonary Veins surgery
- Abstract
We present a 34-year-old patient with recurrent episodes of drug refractory paroxysmal atrial fibrillation referred for pulmonary vein (PV) isolation at our institution. During isolation of the right superior PV, a dissociated escape rhythm was observed on a portion of the PV that was disconnected, while the rest of the PV showed clear left atrium to PV conduction. This report demonstrates the rare possibility of escape PV rhythm from only partially disconnected PV, highlighting that dissociated PV rhythm does not necessarily reflect complete PV isolation.
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- 2009
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13. The impact of peri-procedural imaging on safety and efficacy of atrial fibrillation ablation: insights from the Israeli AF Catheter Ablation Registry (ICAR)
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Marai, Ibrahim, Elias, Adi, Rozen, Guy, Beinart, Roy, Nof, Eyal, Michowitz, Yoav, Glikson, Michael, Konstantino, Yuval, Haim, Moti, Luria, David, Omelchenko, Alexander, Laish-Farkash, Avishag, and Suleiman, Mahmoud
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- 2024
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14. Cryoballoon-Induced Circumferential Pulmonary Vein Fibrosis, Assessed by Late Gadolinium-Enhancement Cardiac Magnetic Resonance Imaging, and Its Correlation with Clinical Atrial Fibrillation Recurrence.
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Rav Acha, Moshe, Tovia-Brodie, Oholi, Michowitz, Yoav, Bayya, Feras, Shaheen, Fauzi F., Abuhatzera, Shalom, Medina, Aharon, Glikson, Michael, and Wolak, Arik
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CARDIAC magnetic resonance imaging ,PULMONARY fibrosis ,PULMONARY veins ,ATRIAL fibrillation ,CRYOSURGERY ,MAGNETIC resonance imaging - Abstract
Background: Prior studies evaluating post-atrial fibrillation (AF) ablation pulmonary vein (PV) ostial gaps via magnetic resonance imaging (MRI) have shown circumferential PV fibrosis in a minority of patients, and their correlation with AF recurrence was weak. These studies were mostly based on radio-frequency AF ablations. Aim: We aimed to assess cryoballoon ablation-induced PV fibrosis via MRI and its correlation with AF recurrence. Methods and Results: This was a prospective study of consecutive patients with symptomatic AF who underwent pre- and post-ablation MRI to assess baseline and ablation-induced fibrosis, respectively. Post-ablation PV gaps were assessed by new semi-quantitative visual analysis assisted by computerized ADAS analysis. AF recurrence monitored via multiple ECGs and event monitoring at 6 and 12 months post ablation. Nineteen patients with 80 PVs were included, age 56 ± 11, with paroxysmal and persistent AF in 17/19 and 2/19 patients, respectively. Baseline MRI showed minimal LA fibrosis. All patients underwent successful cryoballoon PV electrical isolation. Post-ablation MRI revealed circumferential PV fibrosis among 63/80 (78.8%) PVs and partial fibrosis with major gaps among 17/80 (21.2%) PVs. AF recurred within one year in 5/9 (55.5%) patients with partial PV fibrosis, while no AF recurred among the 10 patients in whom all PVs had circumferential fibrosis (p < 0.01). Similarly, there were significantly more PVs without circumferential fibrosis (due to major gaps) among patients with AF recurrence as compared with patients without AF recurrence (42.9% vs. 13.5%; p < 0.01). Conclusion: Cryoballoon AF ablation results in circumferential PV fibrosis in the majority of PVs, as assessed by a new clinically relevant MRI-LGE analysis. Significant correlation was found between major PV gaps on post-ablation MRI and AF recurrence, suggesting that MRI might have the ability to predict AF recurrence. [ABSTRACT FROM AUTHOR]
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- 2023
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15. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA)
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Glikson, Michael, Nielsen, Jens Cosedis, Kronborg, Mads Brix, Michowitz, Yoav, Auricchio, Angelo, Barbash, Israel Moshe, Barrabés, José A., Boriani, Giuseppe, Braunschweig, Frieder, Brignole, Michele, Burri, Haran, Coats, Andrew J. S., Deharo, Jean-Claude, Delgado, Victoria, Diller, Gerhard-Paul, Israel, Carsten W., Keren, Andre, Knops, Reinoud E., Kotecha, Dipak, and Leclercq, Christophe
- Published
- 2022
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16. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA)
- Author
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Glikson, Michael, Nielsen, Jens Cosedis, Kronborg, Mads Brix, Michowitz, Yoav, Auricchio, Angelo, Barbash, Israel Moshe, Barrabés, José A, Boriani, Giuseppe, Braunschweig, Frieder, Brignole, Michele, Burri, Haran, Coats, Andrew J S, Deharo, Jean-Claude, Delgado, Victoria, Diller, Gerhard-Paul, Israel, Carsten W, Keren, Andre, Knops, Reinoud E, Kotecha, Dipak, and Leclercq, Christophe
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EPIDEMIOLOGY ,GENETIC testing ,TILT-table test - Published
- 2021
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17. Electrophysiological Differences between the Epicardium and the Endocardium of the Left Atrium.
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MICHOWITZ, YOAV, NAKAHARA, SHIRO, BOURKE, TARA, BUCH, ERIC, VASEGHI, MARMAR, DE DIEGO, CARLOS, WIENER, ISAAC, MAHAJAN, AMAN, and SHIVKUMAR, KALYANAM
- Subjects
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HEART atrium , *PERICARDIUM physiology , *ENDOCARDIUM , *ANALYSIS of variance , *ANIMAL experimentation , *ARRHYTHMIA , *ATRIAL fibrillation , *CATHETER ablation , *CATHETERIZATION , *CONFIDENCE intervals , *ELECTROPHYSIOLOGY , *EPIDEMIOLOGY , *RESEARCH funding , *SWINE , *DATA analysis , *SECONDARY analysis , *REPEATED measures design , *PHYSIOLOGY - Abstract
Electrophysiological properties of the atrial endocardium compared to epicardium are not well understood. The purpose of this study was to compare the electrophysiological properties and vulnerability to arrhythmia induction from these regions. Transseptal endocardial and percutaneous epicardial mapping were performed in a porcine model (n = 7). Two opposing 4-mm electrophysiological catheters were positioned endocardially and epicardially. A circular mapping catheter (CMC) was positioned at the ostium of the common inferior pulmonary vein (CIPV) recording left atrial (LA)-PV potentials. Endocardial and epicardial effective refractory periods (ERPs) at two basic cycle lengths (CLs) of 600 and 400 ms were recorded from four anatomic locations (CIPV, LA appendage, right superior PV, and LA posterior wall). Atrial repetitive response (ARR) induction was also tested from endocardial and epicardial sites. Overall, 254 ERP measurements (mean 36.3 per animal) and 84 induction attempts (mean 12 per animal) were performed. The ERP was significantly shorter in the epicardium compared to the endocardium at basic CL of 400 ms (P = 0.006) but not at CL of 600 ms (P = 0.2). In addition, only the epicardium demonstrated ERP shortening when the CL of the basic drive was shortened (P = 0.03). ARR could be induced more often from the epicardium (P = 0.002) and fibrillatory activity with epicardial/endocardial dissociation was recorded (n = 3). Also, the earliest PV activation site on the CMC was noted to be different in 16.5% of cases during epicardial and endocardial pacing. The electrophysiological characteristics of the atrial epicardium are different from the endocardium with a shorter ERP and more frequent ARR induction by programed stimulation. (PACE 2011; 37-46) [ABSTRACT FROM AUTHOR]
- Published
- 2011
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