A Product, News and Clinical Update
for the Electrophysiology Professional
May 15, 2008

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EP Lab Digest - Atrial Fibrillation
During atrial fibrillation, the heart's two small upper chambers (the atria) quiver instead of beating effectively. Atrial Fibrillation is a leading contributor to the heart disease epidemic and EP Lab Digest has covered this condition in great detail. Feel free to browse through our collection of articles.

Right Atrial Ablation in the Management of Atrial Fibrillation: Point of View
Background and rationale. In delivering the prestigious 107th Shattuck Lecture to the annual meeting of the Massachusetts Medical Society (17 May 1997), Dr. Eugene Braunwald warned of two emerging epidemics of cardiovascular disease.1 One is atrial fibrillation (AF), now the most common cardiac arrhythmia, afflicting well over two million individuals in the United States alone.1,2 Indeed, the number of hospital discharges for AF more than doubled from 111,000 in 1984 to 270,000 in 1994.1 The prevalence of AF is likely to rise even more dramatically over the next several decades as the proportion of older individuals in the general population increases and as other non-cardiac risk factors for AF, such as diabetes mellitus, commensurately increase due to a worrisome rise in adult obesity.3



A Review of Cardiac Resynchronization Therapy in Systolic Heart Failure Patients in Sinus Rhythm and Atrial Fibrillation
Disclosure: Dr. Machado serves on the scientific advisory board for Guidant Corporation, and is a consultant for Medtronic, Guidant and Biotronik.



Editorial Opinion: Finally, an Atrial Fibrillation Consensus Statement! Excerpts from the ?HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures, and Foll
The Heart Rhythm Society (HRS), European Heart Rhythm Association (EHRA), and European Cardiac Arrhythmia Society (ECAS) have recently released their Expert Consensus Statement regarding catheter and surgical ablation for atrial fibrillation (AF).1 These recommendations serve as a guide for practicing clinical cardiac electrophysiologists with respect to the performance of ablative procedures to treat AF in a manner that is appropriate with standard clinical practice in 2007.



Spotlight Interview: University of Virginia?s Atrial Fibrillation Center
We are currently in a significant renovation/building phase. In conjunction with the EP lab, AF ablation is the main focus. We perform approximately five AF ablations each week.



What?s New with Antiarrhythmic Drugs?
Vaughn-Williams Drug Classification System2 The Vaughn-Williams drug classification system for antiarrhythmic drugs has been used to describe the actions of antiarrhythmic drugs for two decades. 6. Singh S. Trials of new antiarrhythmic drugs for maintenance of sinus rhythm in patients with atrial fibrillation. Old and new antiarrhythmic drugs for converting and maintaining sinus rhythm in atrial fibrillation: Comparative efficacy and results of trials.



Treating Atrial Fibrillation: What's Next?: Commentary: Further Treatment Options for Atrial Fibrillation
: Commentary: Further Treatment Options for Atrial Fibrillation Features: Treating Atrial Fibrillation: What's Next? : Commentary: Further Treatment Options for Atrial Fibrillation - Mark S. Link, MD Atrial fibrillation is the most common arrhythmia worldwide, is frequently symptomatic, and contributes to significant morbidity and mortality. With the appreciation that recurrent atrial fibrillation in these patients was often secondary to another foci in another pulmonary vein, the concept of...



Simultaneous Multisite Endocardial Mapping of Sustained and Non-Sustained Atrial Fibrillation in Humans
In this research contribution, the authors investigated the differences between sustained and non-sustained forms of atrial fibrillation (AF) by using multielectrode endocardial recordings. They found that the overall degree of atrial fibrillation organization increased significantly from sustained to non-sustained AF. However, the persistent and induced sustained AF was only slightly different in their parameters.



The Role of Atrial Ganglionated Plexi in Atrial Fibrillation Initiation and New Approaches to Treatment
Many of the current approaches to atrial fibrillation (AF) ablation involve ablation of regions where autonomic ganglia have been found. These approaches include the pulmonary vein (PV) isolation approach, trigger elimination, and the mapping and ablation of complex fractionated atrial electrograms, all of which involve modification of the left atrial tissue substrate. The purpose of this review is to examine the research that supports the role of the ganglia in AF initiation and then to look at catheter-based and surgical approaches to AF ablation that target the autonomic sites.



CME: Understanding Pulmonary Vein Recordings: Implications for the Mapping and Ablation of Atrial Fibrillation




Use of Intracardiac Echocardiography During Catheter Ablation for Atrial Fibrillation: Maximizing Safety and Efficacy
Catheter ablation can offer a cure for many patients with atrial fibrillation.1?4 Current approaches generate a lesion set utilizing radiofrequency (RF) energy that can eliminate the triggers of atrial fibrillation, modify the substrate in the left atrium, and electrically isolate the pulmonary veins.




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