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JournalISSN: 1941-3084

Circulation-arrhythmia and Electrophysiology 

Lippincott Williams & Wilkins
About: Circulation-arrhythmia and Electrophysiology is an academic journal published by Lippincott Williams & Wilkins. The journal publishes majorly in the area(s): Catheter ablation & Atrial fibrillation. It has an ISSN identifier of 1941-3084. Over the lifetime, 2355 publications have been published receiving 98498 citations. The journal is also known as: Arrhythmia and electrophysiology.


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Journal ArticleDOI
TL;DR: When analyzed in a large number of electrophysiology laboratories worldwide, catheter ablation of AF shows to be effective in ≈80% of patients after 1.3 procedures per patient, with ≈70% of them not requiring further antiarrhythmic drugs during intermediate follow-up.
Abstract: Background— The purpose of this study was to provide an updated worldwide report on the methods, efficacy, and safety of catheter ablation of atrial fibrillation (AF). Methods and Results— A questi...

2,626 citations

Journal ArticleDOI
TL;DR: The types of atrial remodeling, their underlying pathophysiology, the molecular basis of their occurrence, and finally, their potential therapeutic significance are reviewed.
Abstract: Atrial fibrillation (AF) is the most common arrhythmia in clinical practice It can occur at any age but is very rare in children and becomes extremely common in the elderly, with a prevalence approaching 20% in patients >85 years of age1 AF is associated with a wide range of potential complications and contributes significantly to population morbidity and mortality Present therapeutic approaches to AF have major limitations, including limited efficacy and significant adverse effect liability These limitations have inspired substantial efforts to improve our understanding of the mechanisms underlying AF, with the premise that improved mechanistic insights will lead to innovative and improved therapeutic approaches2 Our understanding of AF pathophysiology has advanced significantly over the past 10 to 15 years through an increased awareness of the role of “atrial remodeling” Any persistent change in atrial structure or function constitutes atrial remodeling Many forms of atrial remodeling promote the occurrence or maintenance of AF by acting on the fundamental arrhythmia mechanisms illustrated in Figure 1 Both rapid ectopic firing and reentry can maintain AF Reentry requires a suitable vulnerable substrate, as well as a trigger that acts on the substrate to initiate reentry Ectopic firing contributes to reentry by providing triggers for reentry induction Atrial remodeling has the potential to increase the likelihood of ectopic or reentrant activity through a multitude of potential mechanisms This article reviews the types of atrial remodeling, their underlying pathophysiology, the molecular basis of their occurrence, and finally, their potential therapeutic significance Figure 1 General schema representing AF mechanisms and the role of remodeling The mechanisms underlying AF are portrayed schematically in Figure 2 AF can be maintained by rapid focal firing, which may itself be regular but result in fibrillatory activity because of wave breakup in portions of the atrium that …

964 citations

Journal ArticleDOI
TL;DR: In this article, it is unknown if brief episodes of device-detected atrial fibrillation (AF) increase thromboembolic event (TE) risk, and it is also unknown if AF-detection increases the risk of stroke.
Abstract: Background— It is unknown if brief episodes of device-detected atrial fibrillation (AF) increase thromboembolic event (TE) risk. Methods and Results— TRENDS was a prospective, observational study e...

728 citations

Journal ArticleDOI
TL;DR: In this article, the relative safety and efficacy of radiofrequency catheter ablation (RFA) for atrial fibrillation were evaluated using a randomized clinical trial, and the results showed that RFA is safe and effective.
Abstract: Background— Although radiofrequency catheter ablation (RFA) has evolved from an experimental procedure to an important treatment option for atrial fibrillation, the relative safety and efficacy of ...

723 citations

Journal ArticleDOI
TL;DR: This novel ablation catheter, which accurately measures CF, confirmed CF is a major determinant of RF lesion size and may optimize the selection of RF power and application time to maximize lesion formation and reduce the risk of steam pop and thrombus.
Abstract: Background— An open-irrigated radiofrequency (RF) ablation catheter was developed to measure contact force (CF). Three optical fibers measure microdeformation of the catheter tip. The purpose of this study was to (1) validate the accuracy of CF sensor (CFS) (bench test); and (2) determine the relationship between CF and tissue temperatures, lesion size, steam pop, and thrombus during RF ablation using a canine thigh muscle preparation. Methods and Results— CFS measurements (total 1409) from 2 catheters in 3 angles (perpendicular, parallel, and 45°) were compared with a certified balance (range, 0 to 50 g). CFS measurements correlated highly ( R 2≥0.988; mean error, ≤1.0 g). In 10 anesthetized dogs, a skin cradle over the thigh muscle was superfused with heparinized blood at 37°C. A 7F catheter with 3.5-mm saline-irrigated electrode and CFS (Endosense) was held perpendicular to the muscle at CF of 2, 10, 20, 30, and 40 g. RF was delivered (n=100) for 60 seconds at 30 or 50 W (irrigation 17 or 30 mL/min). Tissue temperature (3 and 7 mm depths), lesion size, thrombus, and steam pop increased significantly with increasing CF at each RF power. Lesion size was greater with applications of lower power (30 W) and greater CF (30 to 40 g) than at high power (50 W) with lower CF (2 to 10 g). Conclusions— This novel ablation catheter, which accurately measures CF, confirmed CF is a major determinant of RF lesion size. Steam pop and thrombus incidence also increases with CF. CFS in an open-irrigated ablation catheter that may optimize the selection of RF power and application time to maximize lesion formation and reduce the risk of steam pop and thrombus. Received July 10, 2008; accepted October 6, 2008. # CLINICAL PERSPECTIVE {#article-title-2}

557 citations

Performance
Metrics
No. of papers from the Journal in previous years
YearPapers
202378
2022110
2021133
2020178
2019158
2018169