Ganglionated Plexi Ablation: Physiology and Clinical Applications

Stavrakis, Stavros; Po, Sunny S.

doi:10.15420/aer2017.26.1

Cited by 79 publications

(73 citation statements)

References 58 publications

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“…The use of image integration and electro-anatomical mapping has been associated with fewer complications. [20][21][22][23][24]35,36 Whether CF-guided ablation improves safety requires additional investigation. In a recent meta-analysis, the overall complication and tamponade rates were 3.8 % and 0.5 % for CF and 3.9 % and 0.9 % for non-CF ablation.…”

Section: Complicationsmentioning

confidence: 99%

“…19 Indeed, with irrigation, less micro-embolic signals have been detected with trans-cranial Doppler. 37 Advanced irrigation technology (Thermocool Surround Flow and Abbot FlexAbility) reduces irrigation volume with maintenance of the safety profile. 38 Thromboembolic event rates (stroke and transient ischaemic attack) range between 0.2 and 1 % for irrigated catheters.…”

Section: Complicationsmentioning

confidence: 99%

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The Impact of Advances in Atrial Fibrillation Ablation Devices on the Incidence and Prevention of Complications

Keçe

Zeppenfeld

Trines

2018

Arrhythmia &Amp; Electrophysiology Review

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The number of patients with atrial fibrillation currently referred for catheter ablation is increasing. However, the number of trained operators and the capacity of many electrophysiology labs are limited. Accordingly, a steeper learning curve and technical advances for efficient and safe ablation are desirable. During the last decades several catheter-based ablation devices have been developed and adapted to improve not only lesion durability, but also safety profiles, to shorten procedure time and to reduce radiation exposure. The goal of this review is to summarise the reported incidence of complications, considering device-related specific aspects for point-bypoint, multi-electrode and balloon-based devices for pulmonary vein isolation. Recent technical and procedural developments aimed at reducing procedural risks and complications rates will be reviewed. In addition, the impact of technical advances on procedural outcome, procedural length and radiation exposure will be discussed.

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Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

The Impact of Advances in Atrial Fibrillation Ablation Devices on the Incidence and Prevention of Complications

Keçe

Zeppenfeld

Trines

2018

Arrhythmia &Amp; Electrophysiology Review

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“…The autonomic nervous system (ANS) plays an important role in regulating the function of cardiomyocytes, the conducting system, coronary vessels, contractile function of the myocardium, and also affects the electrophysiological properties of the myocardium [1]. The heart is innervated by both the extrinsic (central) and the intrinsic cardiac autonomic nervous system (CANS) [2]. The adrenergic part of CANS can be noninvasively assessed with Iodine-123 metaiodobenzylguanidine ( 123 I-mIBG), which is a sympathetic neurotransmitter radionuclide analog and aids in the detection of sympathetic innervation abnormalities [3].…”

Section: Introductionmentioning

confidence: 99%

Co-Registered Solid-State 123i-Mibg Spect And Ct Imaging For The Assessment Of Sympathetic Cardiac Innervation In Healthy Individuals And Variation Over Time

Nikitin¹,

Минин²,

Stirrup

et al. 2020

Preprint

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Background. To evaluate global and regional ventricular and atrial cardiac iodine-123 meta-iodobenzylguanidine ( 123 I-mIBG) uptake and consistency over time in healthy individuals using co-registered SPECT and CT imaging. Fifteen healthy individuals (median age 31 years [26; 41]) were included in the study. All participants underwent CT and subsequent baseline 123 I -mIBG SPECT imaging (early and late acquisition) using a dedicated cardiac solid-state gamma camera. The heart-to-mediastinum (H/M) ratio, wash out rate (WR), summed 123 I-mIBG defect score (SDS) as well as presence and patterns of left atrium (LA) discrete 123 I-mIBG uptake areas were assessed. Follow-up SPECT imaging was acquired 5-7 days after initial procedure. Results. At baseline median H/M ratio on the early and late acquisitions were 1.61 [1.57; 1.71] and 1.68 [1.65; 1.71] respectively, the WR was 22.5% [18.8; 22.8]. Areas of reduced 123 I-mIBG uptake were detected in 60% (9/15) of cases and the median SDS was 1 [0; 2]. No significant changes were observed in global and regional 123 I-mIBG cardiac uptake between baseline and follow-up studies. At baseline 36 discrete uptake areas (DUA) were identified, 16 (44%) of which (median per individual 1 [1;1]) had moderate-high confidence score (CS). 5/16, 4/16, 4/16 and 3/16 moderate-high CS DUAs were located around the left sided-, right sided- PV ostia, LA walls, right atrium (RA) or superior vena cava (SVC), respectively. At follow-up 33 DUAs were identified, 16 (48%) of which (median per individual 1 [1;1], p=0.5 vs baseline) had moderate-high CS. Moderate-high CS discrete uptake areas had generally the same location as on the baseline procedure. Conclusion. Co-registered 123 I-mIBG SPECT and CT imaging demonstrated no significant changes in the global and regional 123 I-mIBG cardiac uptake (ventricular and atrial) over a short time interval in healthy individuals.

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“…15 The long-term ([ 2 years) clinical outcomes and innervation results of GPs ablation have not been studied and whether reinnervation causes recurrent AF post-ablation remains uncertain. 16 The dynamics of changes over time in LV innervation after AF ablation can be tracked with MIBG as it was shown by Wenning and Lemery 8,9 and it could be related to AF relapses.…”

mentioning

confidence: 98%

I-123-MIBG cardiac innervation imaging in patients with atrial fibrillation

Teresińska

2020

Journal of Nuclear Cardiology

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Ganglionated Plexi Ablation: Physiology and Clinical Applications

Cited by 79 publications

References 58 publications

The Impact of Advances in Atrial Fibrillation Ablation Devices on the Incidence and Prevention of Complications

The Impact of Advances in Atrial Fibrillation Ablation Devices on the Incidence and Prevention of Complications

Co-Registered Solid-State 123i-Mibg Spect And Ct Imaging For The Assessment Of Sympathetic Cardiac Innervation In Healthy Individuals And Variation Over Time

I-123-MIBG cardiac innervation imaging in patients with atrial fibrillation

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