Recurrence of Atrial Arrhythmias Following Ablation in Adults with Congenital Heart Disease: New Substrate Formation or Late Procedural Failure?
|
|
- Gabriel Carroll
- 7 years ago
- Views:
Transcription
1 Recurrence of Atrial Arrhythmias Following Ablation in Adults with Congenital Heart Disease: New Substrate Formation or Late Procedural Failure? J. Shuplock MD, G. Barker MD, A. Radbill MD, P. Kannankeril MD MSCI, F. Fish MD Jacqueline Shuplock, MD Pediatric Cardiology Fellow, PGY 6 Vanderbilt Children s Hospital
2 I have no disclosures Disclosures
3 Background Arrhythmias in adults with congenital heart disease (CHD) are a growing problem Most develop late, suggesting an evolving substrate Atrial arrhythmias cause significant morbidity & mortality 3 times increased risk of cardiac intervention 50% increase in mortality In univentricular hearts, atrial arrhythmias may herald and hasten declining ventricular function Bouchardy, J et. Al; Atrial Arrhythmias in Adults with Congenital Heart Disease; Circ 2009;120:
4 Background Ablation is challenging Lower success rates vs. normal cardiac anatomy Complex anatomy & arrhythmia substrates Multiple circuits are common High acute success with current electroanatomic mapping and ablation tools Success rates range from 55 90% Recurrences remain common (not clearly defined) Triedman, J; Arrhythmias in Adults with Congenital Heart Disease; Heart 2002; 87: Walsh, E.P.; Arrhythmias in Adult Patients with Congenital Heart Disease; Circ; 2007;115: Kannankeril, P.J.; Frequency of Late Recurrence of Intra Atrial Reentry Tachycardia after Radiofrequency Catheter Ablation in Patients with Congenital Heart Disease; Am J Card;92; 10/1/03
5 Objective and Hypothesis Examine the outcomes of radiofrequency catheter ablation (RFA) in adults with repaired CHD at our institution Examine the nature of recurrence Risk factors for recurrence Hypothesis Recurrences often represent the development of new substrates
6 Methods Retrospective chart review All adolescents & adults with repaired CHD undergoing RFA at our institution from Jan to Nov Statistical analysis Mann Whitney U test for continuous variables Pearson Chi Square for categorical variables
7 Methods CHD Type Tetralogy type TOF, PA/VSD, DORV (non single ventricle), Rastelli Single Ventricle Atrial switch (TGA) Senning, Mustard Other Septal defects, Coarctation, Anomalous veins, PS/AS, BAV, AVSD, Arterial switch, Shone s, cctga, Scimitar, OHT Triedman, J; Arrhythmias in Adults with Congenital Heart Disease; Heart 2002; 87:
8 Methods Circuit Type Cavo tricuspid isthmus (CTI) dependent Counterclockwise (Common or type 1) atrial flutter Clockwise atrial flutter Scar Non isthmus dependent scar related macro reentry Focal Mostly micro reentrant Atrioventricular reciprocating tachyarrhythmias (AVNRT/AP)
9 Methods Acute procedural success = ablation of all circuits Recurrences warranting clinical intervention Medications Anti tachycardia pacing Cardioversion Repeat EPS/catheter ablation Surgical ablation Specific recurrence type Original substrate New substrate Unmapped recurrence Atrial fibrillation (AFib)
10 Results 118 patients 156 ablation procedures Median age of 35 years Range years 33% 33% Tet Type Single Ventricle Atrial Switch Other Types 13% 21%
11 Circuit Type 252 tachyarrhythmia circuits were targeted CTI & Scar most common Combination of circuits CTI/Scar 16% 6% Focal 13% CTI CTI/Focal 6% 29% 29% Scar Combination CTI/AVNRT/AP Focal/Scar 2% 4% 23% AVNRT/AP CTI/Focal/Scar 1%
12 CHD Type & Circuit Type 50% 40% 30% 20% Focal CTI Scar Combination AVNRT/AP 10% 0% Tet Type Single Ventricle Atrial Switch Other
13 CHD Type & Circuit Type 50% p< % 30% 20% Focal CTI Scar Combination AVNRT/AP 10% 0% Tet Type Single Ventricle Atrial Switch Other
14 CHD Type & Circuit Type 50% p= % 30% 20% Focal CTI Scar Combination AVNRT/AP 10% 0% Tet Type Single Ventricle Atrial Switch Other
15 CHD Type & Circuit Type 50% p= % 30% 20% Focal CTI Scar Combination AVNRT/AP 10% 0% Tet Type Single Ventricle Atrial Switch Other
16 Acute Success 94% (147/156) procedures acutely successful 94% (237/252) targeted tachyarrhythmia circuits
17 Acute Success 9 procedures 7 patients 1 patient accounted for 3 acutely unsuccessful ablations 2 procedures were not followed by recurrence 6 repeat ablations were performed 4 in the same patient 2 of the 6 repeat ablations were unsuccessful (both in same patient)
18 Recurrence Median follow up: 31 months 10% lost to follow up Recurrence in 49.4% (77/156) No recurrence in 50.6% (79/156) Median time to recurrence: 6 months
19 Recurrence Of those with recurrence Not mapped in 40% Original substrates in 25% New tachycardia substrates in 23% AFib accounted for 12% 35% were a known new substrate Including AFib 25% 40% Original New 23% 12% Afib Not Mapped
20 Age & Recurrence Overall recurrence (p=0.257) No recurrence: 34 years Recurrence: 36 years Specific type of recurrence Original substrate (28y vs. 40y; p<0.001) AFib (47y vs. 36y; p<0.001)
21 CHD Type & Recurrence Single Ventricle (81% recurrence) Tet Type (38.5% recurrence) Atrial switch (40% recurrence) Other types (44% recurrence) 80% 60% 40% p< % 0% Tet Type Single Ventricle Atrial Switch Other
22 Conclusions 94% overall acute success rate Nearly 50% recurrence rate Single ventricle patients had the highest recurrence (81%) Of the recurrences undergoing repeat mapping, a new substrate was found nearly as often as as the original substrate 23% vs. 25% respectively Including AFib as a new substrate, 35% of recurrences represented a known new substrate
23 Conclusions Type of recurrence was influenced by age Original substrate recurred in significantly younger patients AFib developed in significantly older patients Initial circuit ablated relates to underlying CHD Tet Type: more CTI related arrhythmias Single Ventricle: more focal arrhythmias Atrial Switch: more scar related arrhythmias
24 Conclusions Despite high acute procedural success, adults with repaired CHD have frequent recurrences Substantial proportion are attributable to new or evolving substrates Repeat ablation may be warranted New target for ablation may be identified
25 Thank you! Questions?
26 References 1. Triedman, J; Arrhythmias in Adults with Congenital Heart Disease; Heart 2002; 87: Huang, J et. al; Management of Late Arrhythmias in Adults with Repaired Congenital Heart Disease; Current Treatment Options in Cardiovascular Medicine (2013) 15: Oliver Ruiz, J.M.; Congenital Heart Disease in Adults: Residua, Sequelae, and Complications of Cardiac Defects Repaired at an Early Age; Rev Esp Cardiol 2003;56(1): Walsh, E.P.; Arrhythmias in Adult Patients with Congenital Heart Disease; Circulation 2007;115: Bouchardy, J et. Al; Atrial Arrhythmias in Adults with Congenital Heart Disease; Circulation 2009;120: Triedman, J; Influence of Patient Factors and Ablative Technologies on Outcomes of Radiofrequency Ablation of Intra Atrial Re Entrant Tachycardia in Patients with Congenital Heart Disease; Journal of the American College of Cardiology; Vol 39, No 11, Kannankeril, P.J.; Frequency of Late Recurrence of Intra Atrial Reentry Tachycardia after Radiofrequency Catheter Ablation in Patients with Congenital Heart Disease; The American Journal of Cardiology; Vol 92; Oct 1,
Chapter 11. Natasja M.S de Groot, Jael Z. Atary, Nico A. Blom, Martin J. Schalij
Chapter Long-term outcome after ablative therapy of post-operative atrial tachyarrhythmias in patients with congenital heart disease and characteristics of atrial tachyarrhythmia recurrences. Natasja M.S
More informationIntroduction to Electrophysiology. Wm. W. Barrington, MD, FACC University of Pittsburgh Medical Center
Introduction to Electrophysiology Wm. W. Barrington, MD, FACC University of Pittsburgh Medical Center Objectives Indications for EP Study How do we do the study Normal recordings Abnormal Recordings Limitations
More informationHow to get insurance companies to work with you
Paying for Quality ACHD Care How to get insurance companies to work with you Christy Sillman, RN, MSN ACHD nurse coordinator Inpatient ACHD Nurse Educator The Adult Congenital Heart Program Stanford Lucile
More informationPresenter Disclosure Information
2:15 3 pm Managing Arrhythmias in Primary Care Presenter Disclosure Information The following relationships exist related to this presentation: Raul Mitrani, MD, FACC, FHRS: Speakers Bureau for Medtronic.
More informationHow do you decide on rate versus rhythm control?
Heart Rhythm Congress 2014 How do you decide on rate versus rhythm control? Dr Ed Duncan Consultant Cardiologist & Electrophysiologist Define Rhythm Control DC Cardioversion Pharmacological AFFIRM study
More informationSurgeons Role in Atrial Fibrillation
Atrial Fibrillation Surgeons Role in Atrial Fibrillation Steven J Feldhaus, MD, FACS 2015 Cardiac Symposium September 18, 2015 Stages of Atrial Fibrillation Paroxysmal (Intermittent) Persistent (Continuous)
More informationTachyarrhythmias (fast heart rhythms)
Patient information factsheet Tachyarrhythmias (fast heart rhythms) The normal electrical system of the heart The heart has its own electrical conduction system. The conduction system sends signals throughout
More information«cardiopathies congénitales et travail" Dr Iserin Unité des cardiopathies congénitales de l adulte, HEGP et Necker
«cardiopathies congénitales et travail" Dr Iserin Unité des cardiopathies congénitales de l adulte, HEGP et Necker Les adultes plus ou moins complexes que les enfants? En 2000 49% des vivants complexes
More informationATRIAL FIBRILLATION (RATE VS RHYTHM CONTROL)
ATRIAL FIBRILLATION (RATE VS RHYTHM CONTROL) By Prof. Dr. Helmy A. Bakr Mansoura Universirty 2014 AF Classification: Mechanisms of AF : Selected Risk Factors and Biomarkers for AF: WHY AF? 1. Atrial fibrillation
More informationCOVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION
COVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION Question: How should the EGBS Coverage Guidance regarding ablation for atrial fibrillation be applied to the Prioritized List? Question source: Evidence
More informationUniversal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being
Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being Optimizes detection of congenital heart disease (chd) in the general low risk obstetrical population Daniel J. Cohen, M.D. danjcohen@optonline.net
More informationAtrial Fibrillation: Drugs, Ablation, or Benign Neglect. Robert Kennedy, MD October 10, 2015
Atrial Fibrillation: Drugs, Ablation, or Benign Neglect Robert Kennedy, MD October 10, 2015 Definitions 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary.
More informationExperience with radiofrequency catheter ablation (RFCA)
Radiofrequency Catheter Ablation in Infants
More informationCh. 138 CARDIAC CATHETERIZATION SERVICES 28 138.1 CHAPTER 138. CARDIAC CATHETERIZATION SERVICES GENERAL PROVISIONS
Ch. 138 CARDIAC CATHETERIZATION SERVICES 28 138.1 CHAPTER 138. CARDIAC CATHETERIZATION SERVICES Sec. 138.1 Principle. 138.2. Definitions. GENERAL PROVISIONS PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS
More informationRome, Italy December 4-7, 2012 Rome Cavalieri TIMETABLE
Rome, Italy December 4-7, 2012 Rome Cavalieri Monday, December 3 ROOM Terrazza Monte Mario PATIENT MANAGEMENT CONCEPTS AND CONTROVERSIES IN ELECTROPHYSIOLOGY BIOTRONIK International Fellows Program (IFP)
More informationAtrial Fibrillation Cardiac rate control or rhythm control could be the key to AF therapy
Cardiac rate control or rhythm control could be the key to AF therapy Recent studies have proven that an option of pharmacologic and non-pharmacologic therapy is available to patients who suffer from AF.
More informationAtrial Fibrillation The Basics
Atrial Fibrillation The Basics Family Practice Symposium Tim McAveney, M.D. 10/23/09 Objectives Review the fundamentals of managing afib Discuss the risks for stroke and the indications for anticoagulation
More informationCommon types of congenital heart defects
Common types of congenital heart defects Congenital heart defects are abnormalities that develop before birth. They can occur in the heart's chambers, valves or blood vessels. A baby may be born with only
More informationRadiofrequency Ablation for Atrial Fibrillation. A Guide for Adults
Radiofrequency Ablation for Atrial Fibrillation A Guide for Adults Fast Facts n There are different ways to treat atrial fibrillation (A-fib). One kind of treatment involves putting the heart back into
More informationCatheter Ablation. A Guided Approach for Treating Atrial Arrhythmias
Catheter Ablation A Guided Approach for Treating Atrial Arrhythmias A P A T I E N T H A N D B O O K This brochure will provide an overview of atrial arrhythmias (heart rhythm problems affecting the upper
More informationThe Patterns and Public Health Impact of Heart Defects in Texas Pediatric Cardiac Care Conference VI Dell Children s Medical Center, Feb.
The Patterns and Public Health Impact of Heart Defects in Texas Pediatric Cardiac Care Conference VI Dell Children s Medical Center, Feb. 7-8, 2013 Mark Canfield, Ph.D. Manager, Birth Defects Epidemiology
More informationAtrial Fibrillation and Cardiac Device Therapy RAKESH LATCHAMSETTY, MD DIVISION OF ELECTROPHYSIOLOGY UNIVERSITY OF MICHIGAN HOSPITAL ANN ARBOR, MI
Atrial Fibrillation and Cardiac Device Therapy RAKESH LATCHAMSETTY, MD DIVISION OF ELECTROPHYSIOLOGY UNIVERSITY OF MICHIGAN HOSPITAL ANN ARBOR, MI Outline Atrial Fibrillation What is it? What are the associated
More informationSpecific Basic Standards for Osteopathic Fellowship Training in Cardiology
Specific Basic Standards for Osteopathic Fellowship Training in Cardiology American Osteopathic Association and American College of Osteopathic Internists BOT 07/2006 Rev. BOT 03/2009 Rev. BOT 07/2011
More informationCTA OF THE EXTRACORONARY HEART
CTA OF THE EXTRACORONARY HEART Charles White MD Director of Thoracic Imaging Department of Radiology University of Maryland NO DISCLOSURES CWHITE@UMM.EDU CARDIAC CASE DISTRIBUTION Coronary CTA 30% ED chest
More informationManagement of Symptomatic Atrial Fibrillation
Management of Symptomatic Atrial Fibrillation John F. MacGregor, MD, FHRS Associate Medical Director, Cardiac Electrophysiology PeaceHealth St. Joseph Medical Center, Bellingham, WA September 18, 2015
More informationWhat Are Arrhythmias?
What Are Arrhythmias? Many people have questions about what the word arrhythmia means, and arrhythmias can be a difficult subject to understand. The text below should give you a better understanding of
More informationHow should we treat atrial fibrillation in heart failure
Advances in Cardiac Arrhhythmias and Great Innovations in Cardiology Torino, 23/24 Ottobre 2015 How should we treat atrial fibrillation in heart failure Matteo Anselmino Dipartimento Scienze Mediche Città
More informationCardiology ARCP Decision Aid August 2014
Cardiology ARCP Decision Aid August 2014 The table that follows includes a column for each training year which documents the targets that have to be achieved for a satisfactory ARCP outcome at the end
More information2013 Medicare Physician Coding and Reimbursement Changes
2013 Medicare Physician Coding and Reimbursement Changes Disclaimer This presentation is intended for educational use. Any duplication is prohibited without written consent of Medtronic s Economic Strategies
More information1p36 and the Heart. John Lynn Jefferies, MD, MPH, FACC, FAHA
1p36 and the Heart John Lynn Jefferies, MD, MPH, FACC, FAHA Director, Advanced Heart Failure and Cardiomyopathy Services Associate Professor, Pediatric Cardiology and Adult Cardiovascular Diseases Associate
More informationCurrent Management of Atrial Fibrillation DISCLOSURES. Heart Beat Anatomy. I have no financial conflicts to disclose
Current Management of Atrial Fibrillation Mary Macklin, MSN, APRN Concord Hospital Cardiac Associates DISCLOSURES I have no financial conflicts to disclose Book Women: Fit at Fifty. A Guide to Living Long.
More informationThe Pattern of Congenital Heart Disease among Neonates Referred for Echocardiography
Bahrain Medical Bulletin, Vol. 36, No. 2, June 2014 ABSTRACT The Pattern of Congenital Heart Disease among Neonates Referred for Echocardiography Hussain Al Khawahur, MD* Hussain Al Sowaiket, MD** Thuria
More informationSECTION I: Request. SECTION II: Need. Program Description
SECTION I: Request This is a formal request for the Utah CARMA Center to be formally recognized by the University of Utah as a large, collaborative medical and academic center whose focus is on comprehensive
More informationAtrial Fibrillation and Ablation Therapy: A Patient s Guide
Atrial Fibrillation and Ablation Therapy: A Patient s Guide ATRIAL FIBRILLATION CENTER AT UNIVERSITY OF ROCHESTER MEDICAL CENTER www.heart.urmc.edu 585-275-4775 INTRODUCTION Our goal at the Atrial Fibrillation
More informationElectrophysiology Heart Study - EPS -
Electrophysiology Heart Study - EPS - What is an EPS? EPS is short for ElectroPhysiology heart Study. This procedure looks at the electrical system of your heart. An EPS will show if you have a heart rhythm
More informationBASIC STANDARDS FOR RESIDENCY TRAINING IN CARDIOLOGY
BASIC STANDARDS FOR RESIDENCY TRAINING IN CARDIOLOGY American Osteopathic Association and the American College of Osteopathic Internists Specific Requirements For Osteopathic Subspecialty Training In Cardiology
More informationFeeding in Infants with Complex Congenital Heart Disease. Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014
Feeding in Infants with Complex Congenital Heart Disease Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014 Objectives Discuss common feeding issues in patients with
More informationRecurrent AF: Choosing the Right Medication.
In the name of God Shiraz E-Medical Journal Vol. 11, No. 3, July 2010 http://semj.sums.ac.ir/vol11/jul2010/89015.htm Recurrent AF: Choosing the Right Medication. Basamad Z. * Assistant Professor, Department
More informationMedical publications on Arrhythmia and Its Interrelated Costs
DOCTORAL THESIS SHORT AND LONG TERM EFFECT OF NON- PHARMACOLOGICAL RATE CONTROL ON SYMPTOMATIC ATRIAL ARRHYTMIA REFLECTED BY THE CARDIO-PEPTIDE SERUM LEVEL CHANGES ANDRÁS CSABA DÉZSI M.D. SEMMELWEIS UNIVERSITY
More informationTreating AF: The Newest Recommendations. CardioCase presentation. Ethel s Case. Wayne Warnica, MD, FACC, FACP, FRCPC
Treating AF: The Newest Recommendations Wayne Warnica, MD, FACC, FACP, FRCPC CardioCase presentation Ethel s Case Ethel, 73, presents with rapid heart beating and mild chest discomfort. In the ED, ECG
More informationechocardiography practice and try to determine the ability of each primary indication to identify congenital heart disease. Patients and Methods
29 ABNORMAL CARDIAC FINDINGS IN PRENATAL SONOGRAPHIC EXAMINATION: AN IMPORTANT INDICATION FOR FETAL ECHOCARDIOGRAPHY? RIMA SAMI BADER Aim: The present study was conducted to evaluate the most common indications
More informationPatient Information Sheet Electrophysiological study
Patient Information Sheet Electrophysiological study Your doctor has recommended performing an electrophysiological study (also called EPS). EPS is a diagnostic procedure designed to test and evaluate
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Catheter Ablation as Treatment Page 1 of 29 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Catheter Ablation as Treatment Professional Institutional Original Effective
More informationRATE VERSUS RHYTHM CONTROL OF ATRIAL FIBRILLATION: SPECIAL CONSIDERATION IN ELDERLY. Charles Jazra
RATE VERSUS RHYTHM CONTROL OF ATRIAL FIBRILLATION: SPECIAL CONSIDERATION IN ELDERLY Charles Jazra NO CONFLICT OF INTEREST TO DECLARE Relationship Between Atrial Fibrillation and Age Prevalence, percent
More informationWorking Towards Neonatal Pulse Oximetry Screening to Detect Critical CHD
Working Towards Neonatal Pulse Oximetry Screening to Detect Critical CHD Dalhousie Fall Refresher Course 2015 Kenny K Wong, MD, FRCPC Pediatric Cardiologist Associate Professor of Pediatrics Objectives
More informationARIZONA ARRHYTHMIA CONSULTANTS
Page 1 BUSINESS ADDRESS Arizona Arrhythmia Consultants, PLC Clinical Research Department 7283 East Earl Drive Scottsdale, Arizona 85251 (602) 234-2800 License Adult Nurse Practitioner with Prescriptive
More informationCatheter ablation of drug resistant supraventricular tachycardia in neonates and infants
ORIGINAL ARTICLE Cardiology Journal 2013, Vol. 20, No. 3, pp. 241 246 DOI: 10.5603/CJ.2013.0068 Copyright 2013 Via Medica ISSN 1897 5593 Catheter ablation of drug resistant supraventricular tachycardia
More informationHow to control atrial fibrillation in 2013 The ideal patient for a rate control strategy
How to control atrial fibrillation in 2013 The ideal patient for a rate control strategy L. Pison, MD Advances in Cardiac Arrhythmias and Great Innovations in Cardiology - Torino, September 28 th 2013
More information«Increased number of uni-ventricular hearts in adulthood. Are we ready?»
«Increased number of uni-ventricular hearts in adulthood. Are we ready?» Augmentation du nombre de coeurs univentriculaires à l'âge adulte. Sommes nous prêts? P. Guérin L institut du thorax Nantes Increased
More informationDelivery Planning for the Fetus with Congenital Heart Disease
Delivery Planning for the Fetus with Congenital Heart Disease Mar y T. Donofrio MD, FAAP, FACC, FASE Director of the Fetal Heart Program Children s National Medical Center Washington DC Objectives Review
More informationScreening for Critical Congenital Heart Disease in the Apparently Healthy Newborn
Screening for Critical Congenital Heart Disease in the Apparently Healthy Newborn A presentation of Texas Pulse Oximetry Project: A Joint Educational Initiative of The University of Texas Health Science
More informationCardiology Fellowship Manual. Goals & Objectives -Cardiac Imaging- 1 Page
Cardiology Fellowship Manual Goals & Objectives -Cardiac Imaging- 1 Page 2015-2016 UNIV. OF NEBRASKA CHILDREN S HOSPITAL & MEDICAL CENTER DIVISION OF CARDIOLOGY FELLOWSHIP PROGRAM CARDIAC IMAGING ROTATION
More informationPRACTICAL APPROACH TO SVT. Graham C. Wong MD MPH Division of Cardiology Vancouver General Hospital University of British Columbia
PRACTICAL APPROACH TO SVT Graham C. Wong MD MPH Division of Cardiology Vancouver General Hospital University of British Columbia CONDUCTION SYSTEM OF THE HEART SA node His bundle Left bundle AV node Right
More informationCorporate Medical Policy
Corporate Medical Policy Catheter Ablation as a Treatment for Atrial Fibrillation File Name: Origination: Last CAP Review: Next CAP Review: Last Review: catheter_ablation_as_a_treatment_for_atrial_fibrillation
More informationCardiac Catheterisation. Cardiology
Cardiac Catheterisation Cardiology Name: Cardiac catheterisation Version: 1 Page 1 of 7 Contents Page Number(s) 1. Introduction 3 2. Management pre operative 3 3. Management post operative 5 4. Discharge
More informationHTEC 91. Topic for Today: Atrial Rhythms. NSR with PAC. Nonconducted PAC. Nonconducted PAC. Premature Atrial Contractions (PACs)
HTEC 91 Medical Office Diagnostic Tests Week 4 Topic for Today: Atrial Rhythms PACs: Premature Atrial Contractions PAT: Paroxysmal Atrial Tachycardia AF: Atrial Fibrillation Atrial Flutter Premature Atrial
More informationThe Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It?
The Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It? Indiana Chapter-ACC 17 th Annual Meeting Indianapolis, Indiana October 19, 2013 Deepak Bhakta MD FACC FACP FAHA FHRS CCDS Associate
More informationWorkshop B: Essentials of Neonatal Cardiology and CHD Anthony C. Chang, MD, MBA, MPH CARDIAC INTENSIVE CARE
SHUNT LESIONS NEONATAL : CONGENITAL CARDIAC MALFORMATIONS AND CARDIAC SURGERY ANTHONY C. CHANG, MD, MBA, MPH CHILDREN S HOSPITAL OF ORANGE COUNTY ATRIAL SEPTAL DEFECT LEFT TO RIGHT SHUNT INCREASED PULMONARY
More informationSurgically Induced Right Bundle-Branch Block with Left Anterior Hemiblock
Surgically Induced Right Bundle-Branch Block with Left Anterior Hemiblock An Ominous Sign in Postoperative Tetralogy of Fallot By GRACE S. WOLFF, M.D., THOMAS W. ROWLAND, M.D., AND R. CURTIS ELLISON, M.D.
More informationMinimally Invasive Mitral Valve Surgery
Minimally Invasive Mitral Valve Surgery Stanford Health Care offers leading, superior options in cardiac surgery, including the latest techniques and research for Minimally Invasive Cardiac surgery. Advanced
More informationUNITED STATES PATENT AND TRADEMARK OFFICE BEFORE THE PATENT TRIAL AND APPEAL BOARD. Ex parte VINOD SHARMA and DANIEL C. SIGG
UNITED STATES PATENT AND TRADEMARK OFFICE BEFORE THE PATENT TRIAL AND APPEAL BOARD Ex parte VINOD SHARMA and DANIEL C. SIGG Appeal 2012-000284 Technology Center 1600 Before ERIC GRIMES, FRANCISCO C. PRATS,
More informationThe Patient s Guide to the Electrophysiologic Study (EPS) and Catheter Ablation
The Patient s Guide to the Electrophysiologic Study (EPS) and Catheter Ablation 2 P a g e Table of Contents Introduction How the Heart Works 3 How the Heart s Electrical System Works 3 Commonly Used Heart
More informationVisited 9/14/2011. What is Atrial Fibrillation? What you need to know about Atrial Fibrillation. The Normal Heart Rhythm. 1 of 7 9/14/2011 10:50 AM
1 of 7 9/14/2011 10:50 AM Current URL: What you need to know about Atrial Fibrillation What is atrial fibrillation? What causes atrial fibrillation? How is atrial fibrillation diagnosed? What are the dangers
More informationSTS Congenital Quality Module - Center Data
STS Congenital Quality Module - Center Data Version 1.0 This document current as of: 05/21/2012 2:00:11 PM STS Congenital Quality Module - Center Data Version: 1.0 Bedside multidisciplinary rounds BedRounds
More informationNutrition in Paediatric Cardiology. Karen Hayes Paediatric Dietitian Addenbrooke s Hospital
Nutrition in Paediatric Cardiology Karen Hayes Paediatric Dietitian Addenbrooke s Hospital Topics Who needs Nutrition support? Energy Requirements Meeting Energy and growth requirements Feeding Issues
More informationManagement of Pacing Wires After Cardiac Surgery
Management of Pacing Wires After Cardiac Surgery David E. Lizotte, Jr. PA C, MPAS, FAPACVS President, Association of Physician Assistants in Cardiovascular Surgery Conflicts: None Indications 2008 Journal
More informationCatheter Ablation of Arrhythmogenic Foci as Treatment for Atrial Fibrillation
Catheter Ablation of Arrhythmogenic Foci as Treatment for Atrial Fibrillation Policy Number: Original Effective Date: MM.06.011 09/01/2009 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration
More informationName of Policy: Transcatheter Ablation of Arrhythmogenic Foci as a Treatment of Atrial Fibrillation
Name of Policy: Transcatheter Ablation of Arrhythmogenic Foci as a Treatment of Atrial Fibrillation Policy #: 283 Latest Review Date: June 2015 Category: Medical Policy Grade: A Background/Definitions:
More informationElectrocardiographic Issues in Williams Syndrome
Electrocardiographic Issues in Williams Syndrome R. Thomas Collins II, MD Assistant Professor, Pediatrics and Internal Medicine University of Arkansas for Medical Sciences Arkansas Children s Hospital
More informationBASIC CARDIAC ARRHYTHMIAS Revised 10/2001
BASIC CARDIAC ARRHYTHMIAS Revised 10/2001 A Basic Arrhythmia course is a recommended prerequisite for ACLS. A test will be given that will require you to recognize cardiac arrest rhythms and the most common
More informationCurrent status of pediatric cardiac surgery
Current status of pediatric cardiac surgery Sabine H. Daebritz Dept. of Cardio-vascular Surgery Heart Center Duisburg, Germany Normal circulation 1 Complex cardiac lesions Stenoses Shunts Malconnections
More informationHow To Treat A Single Ventricle And Fontan
COACH Columbus Ohio Adult Congenital Heart Disease Program The Heart Center at Nationwide Children s Hospital & The Ohio State University Single Ventricle Defects Normal Heart Structure The heart normally
More information5 MILLION AMERICANS 1. Atrial Fibrillation (AFib) AFib affects an estimated
A Patient s Guide To with Atrial Fibrillation (AFib) CAUSES RISK FACTORS SYMPTOMS DIAGNOSIS TREATMENTS INSIDE The Healthy Heart... 2 Your Heart In AFib... 4 How Do You Get It?... 6 How Do You Know If You
More informationFacts about Congenital Heart Defects
Facts about Congenital Heart Defects Joseph A. Sweatlock, Ph.D., DABT New Jersey Department of Health Early Identification & Monitoring Program Congenital heart defects are conditions that are present
More information3D Ultrasound. Outline. What is 3D US? Volume Sonography. 3D Ultrasound in Obstetrics: Current Modalities & Future Potential. Alfred Abuhamad, M.D.
in Obstetrics: Current Modalities & Future Potential Outline What is 3D US? What are obvious advantages of 3D US? What is the future of 3D US? Alfred Abuhamad, M.D. Eastern Virginia Medical School 2D US
More informationThe choice for quality ECG arrhythmia monitoring
GE Healthcare EK-Pro The choice for quality ECG arrhythmia monitoring David A. Sitzman, MSEE. Mikko Kaski, MSAM. Ian Rowlandson, MSBE. Tarja Sivonen, RN. Olli Väisänen, MD, PhD. Clinical care environments
More informationWhat to Know About. Atrial Fibrillation
Atrial Fibrillation What to Know About Atrial Fibrillation Understanding Afib Atrial fibrillation, or Afib, is a condition in which the heart beats irregularly speeding up or slowing down, or beating too
More informationCoronary Artery Disease leading cause of morbidity & mortality in industrialised nations.
INTRODUCTION Coronary Artery Disease leading cause of morbidity & mortality in industrialised nations. Although decrease in cardiovascular mortality still major cause of morbidity & burden of disease.
More informationPediatric Congenital Cardiac Surgery
Pediatric Congenital Cardiac Surgery in New York State 2006 2009 New York State Department of Health October 2011 Members of the New York State Cardiac Advisory Committee Chair Spencer King, M.D. Executive
More informationGUIDELINE 11.9 MANAGING ACUTE DYSRHYTHMIAS. (To be read in conjunction with Guideline 11.7 Post-Resuscitation Therapy in Adult Advanced Life Support)
AUSTRALIAN RESUSCITATION COUNCIL GUIDELINE 11.9 MANAGING ACUTE DYSRHYTHMIAS (To be read in conjunction with Guideline 11.7 Post-Resuscitation Therapy in Adult Advanced Life Support) The term cardiac arrhythmia
More informationTHE MARY ALLEN ENGLE, MD (1922-2008) PAPERS
MEDICAL CENTER ARCHIVES OF NEWYORK-PRESBYTERIAN/WEILL CORNELL 1300 York Avenue # 34 New York, NY 10065 Finding Aid To THE MARY ALLEN ENGLE, MD (1922-2008) PAPERS Dates of Papers: 1948-1991 52.5 Linear
More informationCARDIOLOGY ROTATION GOALS AND OBJECTIVES
CARDIOLOGY ROTATION GOALS AND OBJECTIVES PGY-1 Core Medicine Rotation The trainee will have the opportunity to develop clinical skills, the ability to analyze patients problems, and make treatment plans
More informationWhat Can I Do about Atrial Fibrillation (AF)?
Additional Device Information 9529 Reveal XT Insertable Cardiac Monitor The Reveal XT Insertable Cardiac Monitor is an implantable patientactivated and automatically activated monitoring system that records
More informationAtrial Fibrillation: The heart of the matter
Atrial Fibrillation: The heart of the matter This booklet has been written especially for people with atrial fibrillation (AF), a heart condition often described as an irregular heartbeat (also known
More informationCardiovascular surgery: Overview and outcomes
Cardiovascular surgery: Overview and outcomes Heart Services Health 1 s vision for cardiovascular care provides cardiovascular services that: Produce superior outcomes Design care around the patient experience
More informationAtrial Fibrillation (AF) March, 2013
Atrial Fibrillation (AF) March, 2013 This handout is meant to help with discussions about the condition, and it is not a complete discussion of AF. We hope it will complement your appointment with one
More informationSumma cardiovascular institute. A Patient s Guide to AFib Treatment
Summa cardiovascular institute A Patient s Guide to AFib Treatment Healthy Heart Atrial Fibrillation Risk Factors Normal impulse Sinoatrial (SA) node Left Atrium According to the Heart Rhythm Society,
More informationMassachusetts General Hospital Fellowship Training Program in Clinical Cardiac Electrophysiology
Massachusetts General Hospital Fellowship Training Program in Clinical Cardiac Electrophysiology Program Director: Jeremy N. Ruskin, M.D. Program Administrators: Elizabeth Kelly, RN and Lisa DeFabritiis
More informationThe Decision Tree for Ablation Therapy in Atrial Fibrillation Colin Movsowitz, MD, FACC Cardiology Consultants of Philadelphia Director of Electrophysiology Einstein Medical Center Montgomery Co-Director
More informationResuscitation in congenital heart disease. Peter C. Laussen MBBS FCICM Department Critical Care Medicine Hospital for Sick Children Toronto
Resuscitation in congenital heart disease Peter C. Laussen MBBS FCICM Department Critical Care Medicine Hospital for Sick Children Toronto Evolution of Congenital Heart Disease Extraordinary success: Overall
More informationAbnormal cardiac finding in prenatal sonographic examination: an important indication for fetal echocardiography?
Abnormal cardiac finding in prenatal sonographic examination: an important indication for fetal echocardiography? Rima Bader MD,PhD, FASE, FACC, FRCPCH Prof of Pediatric and Perinatal Cardiology King Abdul
More informationReal-Time 3-Dimensional Transesophageal Echocardiography in the Evaluation of Post-Operative Mitral Annuloplasty Ring and Prosthetic Valve Dehiscence
Journal of the American College of Cardiology Vol. 53, No. 17, 2009 2009 by the American College of Cardiology Foundation ISSN 0735-1097/09/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2008.12.059
More informationAddendum to the Guideline on antiarrhythmics on atrial fibrillation and atrial flutter
22 July 2010 EMA/CHMP/EWP/213056/2010 Addendum to the Guideline on antiarrhythmics on atrial fibrillation and atrial flutter Draft Agreed by Efficacy Working Party July 2008 Adoption by CHMP for release
More informationAtrial Fibrillation (AF) Explained
James Paget University Hospitals NHS Foundation Trust Atrial Fibrillation (AF) Explained Patient Information Contents What are the symptoms of atrial fibrillation (AF)? 3 Normal heartbeat 4 How common
More informationAtrial Fibrillation: A Different Perspective. Michael Heffernan MD PhD FRCPC FACC Staff Cardiologist Oakville Hospital
Atrial Fibrillation: A Different Perspective Michael Heffernan MD PhD FRCPC FACC Staff Cardiologist Oakville Hospital Faculty/Presenter Disclosure Faculty: Dr. Michael Heffernan Relationships with commercial
More informationDiagnosis Code Crosswalk : ICD-9-CM to ICD-10-CM Cardiac Rhythm and Heart Failure Diagnoses
Diagnosis Code Crosswalk : to 402.01 Hypertensive heart disease, malignant, with heart failure 402.11 Hypertensive heart disease, benign, with heart failure 402.91 Hypertensive heart disease, unspecified,
More informationDisclosures. Not as Pink as You Think 3/17/2014. Not As Pink As You Think: Pulse Oximetry Screening For Critical Congenital Heart Disease
March of Dimes New York State Chapter 36th Annual Perinatal Nurses Conference Promoting Perinatal Health Through Evidence Based Practice Not As Pink As You Think: Pulse Oximetry Screening For Critical
More informationPOLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY
Original Issue Date (Created): April 26, 2011 Most Recent Review Date (Revised): January 27, 2015 Effective Date: April 1, 2015 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT
More information21st Annual OSF Cardiovascular Symposium
21st Annual OSF Cardiovascular Symposium new waves in cardiac electrophysiology saturday 18 october 2014 7:00 a.m. 4:00 p.m. embassy suites conference center east peoria, illinois OBJECTIVES Overall Program:
More informationManaging the Patient with Atrial Fibrillation
Pocket Guide Managing the Patient with Atrial Fibrillation Updated April 2012 Editor Stephen R. Shorofsky, MD, Ph.D. Assistant Editors Anastasios Saliaris, MD Shawn Robinson, MD www.hrsonline.org DEFINITION
More information