Electrical Isolation

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Domenico G. Della Rocca - One of the best experts on this subject based on the ideXlab platform.

  • Abstract 15059: Prevalence of Recovery of Conduction in the Left Atrial Appendage Following Electrical Isolation of the Appendage in Patients With Atrial Fibrillation
    Circulation, 2020
    Co-Authors: Sanghamitra Mohanty, Domenico G. Della Rocca, Chintan Trivedi, Mohamed Bassiouny, Carola Gianni, Faiz M Baqai, Bryan Macdonald, Angel Mayedo, Gerald Gallinghouse, John Burkhardt
    Abstract:

    Background: Electrical Isolation of the left atrial appendage (LAAEI) is considered in patients presenting with recurrence following effective PV Isolation. Objective: We evaluated the prevalence o...

  • Reply: LAA Electrical Isolation: A Tool to Achieve Superior Ablation Success Under Protection of Optimal Anticoagulation
    Journal of the American College of Cardiology, 2020
    Co-Authors: Luigi Di Biase, Domenico G. Della Rocca, Sanghamitra Mohanty, Jorge Romero, Andrea Natale
    Abstract:

    We thank Dr. Adelino and colleagues and Dr. Cohen for their interest in our study ([1][1]). Life-long oral anticoagulation (OAC) therapy is a widely accepted practice for prevention of cardioembolic stroke following left atrial appendage Electrical Isolation (LAAEI). In our study, among patients

  • Electrical Isolation VERSUS FOCAL ABLATION OF THE CORONARY SINUS IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION
    Journal of the American College of Cardiology, 2020
    Co-Authors: Domenico G. Della Rocca, Luigi Di Biase, Sanghamitra Mohanty, Chintan Trivedi, Nicola Tarantino, Rodney Horton, Mohamed Bassiouny, Amin Al-ahmad, Krishna Akella, Ghulam Murtaza
    Abstract:

    Inducible focal firings arising from the coronary sinus (CS) are a common finding during atrial fibrillation (AF) ablation procedures. To date, no studies have compared the clinical impact of Electrical Isolation versus focal ablation of the CS in patients with inducible triggers from this site.

  • benefit of left atrial appendage Electrical Isolation for persistent and long standing persistent atrial fibrillation a systematic review and meta analysis
    Europace, 2018
    Co-Authors: Jorge Romero, Sanghamitra Mohanty, Chintan Trivedi, Juan Carlos Diaz, Carola Gianni, Ricardo Avendano, Gregory F. Michaud, David F. Briceno, Saurabh Kumar, Domenico G. Della Rocca
    Abstract:

    Aims: The long-term outcomes of left atrial appendage Electrical Isolation (LAAEI) in patients with non-paroxysmal atrial fibrillation (AF) have corroborated the significant role of the LAA in this arrhythmia. We sought to investigate the incremental benefit of LAAEI in patients undergoing catheter ablation for persistent AF or long-standing persistent AF (LSPAF). Methods and results: A systematic review of Medline, Cochrane, and Embase for all the clinical studies in which assessment LAAEI in non-paroxysmal AF patients was performed. The benefit of LAAEI in patients with AF was analysed from seven studies that enrolled a total of 930 patients [mean age 63 ± 5 years; male: 69%]. All studies included patients with either persistent AF or LSPAF or the combination of them. The overall freedom from all-arrhythmia recurrence at 12 months of follow-up off antiarrhythmic medications in patients who underwent LAAEI was 75.5% vs. 43.9% in those in whom only standard ablation was performed [56% relative reduction and 31.6% absolute reduction; risk ratio (RR) 0.44, 95% confidence interval (95% CI) 0.31-0.64; P < 0.0001]. The rate of ischaemic stroke in the LAAEI group was 0.4% and in the control group 2.1% at 12 months follow-up (RR 0.40, 95% CI 0.12-1.30; P = 0.13). Acute complications rates were identical between groups [LAAEI 5.5%, control 5.5% (RR 0.99, 95% CI 0.46-2.16; P = 0.99)]. Conclusion: Left atrial appendage Electrical Isolation in addition to standard ablation appears to have a substantial incremental benefit to achieve freedom from ALL atrial arrhythmias in patients with persistent AF and LSPAF without increasing acute procedural complications and without raising the risk of ischaemic stroke.

  • benefit of left atrial appendage Electrical Isolation for persistent and long standing persistent atrial fibrillation a systematic review and meta analysis
    Europace, 2018
    Co-Authors: Jorge Romero, Sanghamitra Mohanty, Chintan Trivedi, Juan Carlos Diaz, Carola Gianni, Ricardo Avendano, Gregory F. Michaud, David F. Briceno, Saurabh Kumar, Domenico G. Della Rocca
    Abstract:

    Aims The long-term outcomes of left atrial appendage Electrical Isolation (LAAEI) in patients with non-paroxysmal atrial fibrillation (AF) have corroborated the significant role of the LAA in this arrhythmia. We sought to investigate the incremental benefit of LAAEI in patients undergoing catheter ablation for persistent AF or long-standing persistent AF (LSPAF). Methods and results A systematic review of Medline, Cochrane, and Embase for all the clinical studies in which assessment LAAEI in non-paroxysmal AF patients was performed. The benefit of LAAEI in patients with AF was analysed from seven studies that enrolled a total of 930 patients [mean age 63 ± 5 years; male: 69%]. All studies included patients with either persistent AF or LSPAF or the combination of them. The overall freedom from all-arrhythmia recurrence at 12 months of follow-up off antiarrhythmic medications in patients who underwent LAAEI was 75.5% vs. 43.9% in those in whom only standard ablation was performed [56% relative reduction and 31.6% absolute reduction; risk ratio (RR) 0.44, 95% confidence interval (95% CI) 0.31-0.64; P < 0.0001]. The rate of ischaemic stroke in the LAAEI group was 0.4% and in the control group 2.1% at 12 months follow-up (RR 0.40, 95% CI 0.12-1.30; P = 0.13). Acute complications rates were identical between groups [LAAEI 5.5%, control 5.5% (RR 0.99, 95% CI 0.46-2.16; P = 0.99)]. Conclusion Left atrial appendage Electrical Isolation in addition to standard ablation appears to have a substantial incremental benefit to achieve freedom from ALL atrial arrhythmias in patients with persistent AF and LSPAF without increasing acute procedural complications and without raising the risk of ischaemic stroke.

Jorge Romero - One of the best experts on this subject based on the ideXlab platform.

  • Long-Term Outcomes of Left Atrial Appendage Electrical Isolation in Patients With Nonparoxysmal Atrial Fibrillation: A Propensity Score-Matched Analysis.
    Circulation. Arrhythmia and electrophysiology, 2020
    Co-Authors: Jorge Romero, Luigi Di Biase, Sanghamitra Mohanty, Chintan Trivedi, Kavisha Patel, Michael K. Parides, Isabella Alviz, Juan Carlos Diaz, Veronica Natale, Javier Sanchez
    Abstract:

    Background: Left atrial appendage Electrical Isolation (LAAEI) has been proposed for the treatment of nonparoxysmal atrial fibrillation (AF). The long-term clinical outcomes of this approach remain...

  • Reply: LAA Electrical Isolation: A Tool to Achieve Superior Ablation Success Under Protection of Optimal Anticoagulation
    Journal of the American College of Cardiology, 2020
    Co-Authors: Luigi Di Biase, Domenico G. Della Rocca, Sanghamitra Mohanty, Jorge Romero, Andrea Natale
    Abstract:

    We thank Dr. Adelino and colleagues and Dr. Cohen for their interest in our study ([1][1]). Life-long oral anticoagulation (OAC) therapy is a widely accepted practice for prevention of cardioembolic stroke following left atrial appendage Electrical Isolation (LAAEI). In our study, among patients

  • benefit of left atrial appendage Electrical Isolation for persistent and long standing persistent atrial fibrillation a systematic review and meta analysis
    Europace, 2018
    Co-Authors: Jorge Romero, Sanghamitra Mohanty, Chintan Trivedi, Juan Carlos Diaz, Carola Gianni, Ricardo Avendano, Gregory F. Michaud, David F. Briceno, Saurabh Kumar, Domenico G. Della Rocca
    Abstract:

    Aims: The long-term outcomes of left atrial appendage Electrical Isolation (LAAEI) in patients with non-paroxysmal atrial fibrillation (AF) have corroborated the significant role of the LAA in this arrhythmia. We sought to investigate the incremental benefit of LAAEI in patients undergoing catheter ablation for persistent AF or long-standing persistent AF (LSPAF). Methods and results: A systematic review of Medline, Cochrane, and Embase for all the clinical studies in which assessment LAAEI in non-paroxysmal AF patients was performed. The benefit of LAAEI in patients with AF was analysed from seven studies that enrolled a total of 930 patients [mean age 63 ± 5 years; male: 69%]. All studies included patients with either persistent AF or LSPAF or the combination of them. The overall freedom from all-arrhythmia recurrence at 12 months of follow-up off antiarrhythmic medications in patients who underwent LAAEI was 75.5% vs. 43.9% in those in whom only standard ablation was performed [56% relative reduction and 31.6% absolute reduction; risk ratio (RR) 0.44, 95% confidence interval (95% CI) 0.31-0.64; P < 0.0001]. The rate of ischaemic stroke in the LAAEI group was 0.4% and in the control group 2.1% at 12 months follow-up (RR 0.40, 95% CI 0.12-1.30; P = 0.13). Acute complications rates were identical between groups [LAAEI 5.5%, control 5.5% (RR 0.99, 95% CI 0.46-2.16; P = 0.99)]. Conclusion: Left atrial appendage Electrical Isolation in addition to standard ablation appears to have a substantial incremental benefit to achieve freedom from ALL atrial arrhythmias in patients with persistent AF and LSPAF without increasing acute procedural complications and without raising the risk of ischaemic stroke.

  • benefit of left atrial appendage Electrical Isolation for persistent and long standing persistent atrial fibrillation a systematic review and meta analysis
    Europace, 2018
    Co-Authors: Jorge Romero, Sanghamitra Mohanty, Chintan Trivedi, Juan Carlos Diaz, Carola Gianni, Ricardo Avendano, Gregory F. Michaud, David F. Briceno, Saurabh Kumar, Domenico G. Della Rocca
    Abstract:

    Aims The long-term outcomes of left atrial appendage Electrical Isolation (LAAEI) in patients with non-paroxysmal atrial fibrillation (AF) have corroborated the significant role of the LAA in this arrhythmia. We sought to investigate the incremental benefit of LAAEI in patients undergoing catheter ablation for persistent AF or long-standing persistent AF (LSPAF). Methods and results A systematic review of Medline, Cochrane, and Embase for all the clinical studies in which assessment LAAEI in non-paroxysmal AF patients was performed. The benefit of LAAEI in patients with AF was analysed from seven studies that enrolled a total of 930 patients [mean age 63 ± 5 years; male: 69%]. All studies included patients with either persistent AF or LSPAF or the combination of them. The overall freedom from all-arrhythmia recurrence at 12 months of follow-up off antiarrhythmic medications in patients who underwent LAAEI was 75.5% vs. 43.9% in those in whom only standard ablation was performed [56% relative reduction and 31.6% absolute reduction; risk ratio (RR) 0.44, 95% confidence interval (95% CI) 0.31-0.64; P < 0.0001]. The rate of ischaemic stroke in the LAAEI group was 0.4% and in the control group 2.1% at 12 months follow-up (RR 0.40, 95% CI 0.12-1.30; P = 0.13). Acute complications rates were identical between groups [LAAEI 5.5%, control 5.5% (RR 0.99, 95% CI 0.46-2.16; P = 0.99)]. Conclusion Left atrial appendage Electrical Isolation in addition to standard ablation appears to have a substantial incremental benefit to achieve freedom from ALL atrial arrhythmias in patients with persistent AF and LSPAF without increasing acute procedural complications and without raising the risk of ischaemic stroke.

  • Abstract 17344: Benefit of Left Atrial Appendage Electrical Isolation for Persistent and Long-Standing Persistent Atrial Fibrillation. A Systematic Review and Meta-Analysis
    Circulation, 2017
    Co-Authors: Jorge Romero, Juan Carlos Diaz, Stefano Bordignon, Ricardo Avendano, Gregory F. Michaud, William G. Stevenson, David F. Briceno, Saurabh Kumar, Mario J. Garcia, Andrea Natale
    Abstract:

    Background: The results of the effect of left atrial appendage Electrical Isolation (LAAEI) on long-term procedure outcome in patients with non-paroxysmal atrial fibrillation(AF) has been described...

Sanghamitra Mohanty - One of the best experts on this subject based on the ideXlab platform.

T. Nicol - One of the best experts on this subject based on the ideXlab platform.

  • Low-Thermal-Resistance, High-Electrical-Isolation Heat Intercept Connection
    Advances in Cryogenic Engineering, 1994
    Co-Authors: R. C. Niemann, J. D. Gonczy, T. Nicol
    Abstract:

    A method for providing a low-thermal-resistance, high-Electrical-Isolation heat intercept connection is presented. Electrical conductors often require the removal of heat produced from their normal operation. The heat can be removed by mechanical connection to a refrigeration source. Such connections require both effective heat removal (low thermal resistance) and effective Electrical Isolation (high Electrical resistance and high dielectric strength). Such connections should be straightforward to fabricate and should provide reliable performance that is independent of operating temperature. The connection method described here involves clamping, by thermal interference fit, an Electrically insulating cylinder between an outer metallic ring and an inner metallic disk.

Chintan Trivedi - One of the best experts on this subject based on the ideXlab platform.

  • Abstract 15059: Prevalence of Recovery of Conduction in the Left Atrial Appendage Following Electrical Isolation of the Appendage in Patients With Atrial Fibrillation
    Circulation, 2020
    Co-Authors: Sanghamitra Mohanty, Domenico G. Della Rocca, Chintan Trivedi, Mohamed Bassiouny, Carola Gianni, Faiz M Baqai, Bryan Macdonald, Angel Mayedo, Gerald Gallinghouse, John Burkhardt
    Abstract:

    Background: Electrical Isolation of the left atrial appendage (LAAEI) is considered in patients presenting with recurrence following effective PV Isolation. Objective: We evaluated the prevalence o...

  • Long-Term Outcomes of Left Atrial Appendage Electrical Isolation in Patients With Nonparoxysmal Atrial Fibrillation: A Propensity Score-Matched Analysis.
    Circulation. Arrhythmia and electrophysiology, 2020
    Co-Authors: Jorge Romero, Luigi Di Biase, Sanghamitra Mohanty, Chintan Trivedi, Kavisha Patel, Michael K. Parides, Isabella Alviz, Juan Carlos Diaz, Veronica Natale, Javier Sanchez
    Abstract:

    Background: Left atrial appendage Electrical Isolation (LAAEI) has been proposed for the treatment of nonparoxysmal atrial fibrillation (AF). The long-term clinical outcomes of this approach remain...

  • Electrical Isolation VERSUS FOCAL ABLATION OF THE CORONARY SINUS IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION
    Journal of the American College of Cardiology, 2020
    Co-Authors: Domenico G. Della Rocca, Luigi Di Biase, Sanghamitra Mohanty, Chintan Trivedi, Nicola Tarantino, Rodney Horton, Mohamed Bassiouny, Amin Al-ahmad, Krishna Akella, Ghulam Murtaza
    Abstract:

    Inducible focal firings arising from the coronary sinus (CS) are a common finding during atrial fibrillation (AF) ablation procedures. To date, no studies have compared the clinical impact of Electrical Isolation versus focal ablation of the CS in patients with inducible triggers from this site.

  • Thromboembolic events and need for anticoagulation therapy following left atrial appendage occlusion in patients with Electrical Isolation of the appendage
    Journal of cardiovascular electrophysiology, 2019
    Co-Authors: Varuna Gadiyaram, Sanghamitra Mohanty, Chintan Trivedi, Rodney Horton, Amin Al-ahmad, Carola Gianni, David Burkhardt, Joseph G. Gallinghouse, Patrick Hranitzky, Javier Sanchez
    Abstract:

    Introduction Electrical Isolation of the left atrial appendage (LAA) is an important adjunctive ablation strategy in patients with nonparoxysmal atrial fibrillation (AF). Patients who have impaired LAA contractility following Isolation may require long-term oral anticoagulant (OAC) therapy irrespective of their CHADS2 -VASc score. Percutaneous LAA occlusion (LAAO) is a potential alternative to life-long OAC therapy. We aimed to assess the rate of OAC discontinuation and thromboembolic (TE) events following percutaneous LAAO in patients who underwent LAA Electrical Isolation (LAAI). Methods This is a retrospective two-center study of patients who underwent percutaneous LAAO following LAAI. Patients with at least 3-month follow-up were included in the study. The antithrombotic therapy and TE events at the time of the last follow-up were noted. Results The LAA was successfully occluded in 162 (with Watchman device in 140 [86.4%] and Lariat in 22 [13.6%]). A total of 32 patients had leaks detected on the 45-day transesophageal echocardiogram (TEE); 21 (15%) Watchman and 11 (50%) Lariat cases (P = 0.0001). Two (one Watchman and one Lariat) of the 32 leaks were more than 5 mm. After the 45-day TEE, 150 (92.6%) patients were off-OAC. No TE events were reported in the 150 patients who stopped the anticoagulants. Four (2.47%) patients experienced stroke following the LAAO (three Watchman and one Lariat) procedure while on-OAC, two of which were fatal. At the median follow-up of 18.5 months, 159 (98.15%) patients were off-anticoagulant. Conclusion Up to 98% of patients with LAAI could safely discontinue OAC after undergoing the appendage closure procedure.

  • benefit of left atrial appendage Electrical Isolation for persistent and long standing persistent atrial fibrillation a systematic review and meta analysis
    Europace, 2018
    Co-Authors: Jorge Romero, Sanghamitra Mohanty, Chintan Trivedi, Juan Carlos Diaz, Carola Gianni, Ricardo Avendano, Gregory F. Michaud, David F. Briceno, Saurabh Kumar, Domenico G. Della Rocca
    Abstract:

    Aims: The long-term outcomes of left atrial appendage Electrical Isolation (LAAEI) in patients with non-paroxysmal atrial fibrillation (AF) have corroborated the significant role of the LAA in this arrhythmia. We sought to investigate the incremental benefit of LAAEI in patients undergoing catheter ablation for persistent AF or long-standing persistent AF (LSPAF). Methods and results: A systematic review of Medline, Cochrane, and Embase for all the clinical studies in which assessment LAAEI in non-paroxysmal AF patients was performed. The benefit of LAAEI in patients with AF was analysed from seven studies that enrolled a total of 930 patients [mean age 63 ± 5 years; male: 69%]. All studies included patients with either persistent AF or LSPAF or the combination of them. The overall freedom from all-arrhythmia recurrence at 12 months of follow-up off antiarrhythmic medications in patients who underwent LAAEI was 75.5% vs. 43.9% in those in whom only standard ablation was performed [56% relative reduction and 31.6% absolute reduction; risk ratio (RR) 0.44, 95% confidence interval (95% CI) 0.31-0.64; P < 0.0001]. The rate of ischaemic stroke in the LAAEI group was 0.4% and in the control group 2.1% at 12 months follow-up (RR 0.40, 95% CI 0.12-1.30; P = 0.13). Acute complications rates were identical between groups [LAAEI 5.5%, control 5.5% (RR 0.99, 95% CI 0.46-2.16; P = 0.99)]. Conclusion: Left atrial appendage Electrical Isolation in addition to standard ablation appears to have a substantial incremental benefit to achieve freedom from ALL atrial arrhythmias in patients with persistent AF and LSPAF without increasing acute procedural complications and without raising the risk of ischaemic stroke.

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