Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 19, 2022 02:06PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 19, 2022 04:20PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 19, 2022 04:47PM |
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susan.d
Obviously the goal of a successful ablation is to cause enough scar tissue to cage the firing areas. But how much is enough? How much Myocardial healthy tissue does one need?
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 19, 2022 06:18PM |
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susan.d
Obviously the goal of a successful ablation is to cause enough scar tissue to cage the firing areas.
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Research Needs and Priorities for Catheter Ablation of Atrial Fibrillation:
[pubmed.ncbi.nlm.nih.gov]
Al-Khatib, Sana M et al.
“Research Needs and Priorities for Catheter Ablation of Atrial Fibrillation: A Report From a National Heart, Lung, and Blood Institute Virtual Workshop.”
Circulation vol. 141,6 (2020): 482-492.
doi:10.1161/CIRCULATIONAHA.119.042706
Page 4:
It is noteworthy that experts recommend defining “successful ablation” as freedom from symptomatic or asymptomatic atrial arrhythmia lasting for >30 seconds within 1 year of follow-up.[9] However, this definition may underestimate the real potential net benefit of AF ablation because many patients who do not meet this definition have a significant reduction in arrhythmia burden and improvement in quality of life and heart function.[19] While standardizing the definition of “successful ablation” is not within the scope of this paper, investigators are encouraged to define it clearly at the inception of any future study.
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 19, 2022 08:17PM |
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Comparisons of the underlying mechanisms of left atrial remodeling after repeat circumferential pulmonary vein isolation with or without additional left atrial linear ablation in patients with recurrent atrial fibrillation
[pubmed.ncbi.nlm.nih.gov]
Yang, Chia-Hung et al.
“Comparisons of the underlying mechanisms of left atrial remodeling after repeat circumferential pulmonary vein isolation with or without additional left atrial linear ablation in patients with recurrent atrial fibrillation.”
International journal of cardiology vol. 228 (2017): 449-455.
doi:10.1016/j.ijcard.2016.11.020
Conclusions: In patients with recurrent AF, a successful repeat CPVI with or without additional LA linear ablation reduced LA size without significant deleterious effects on LA function and mechanical dispersion.
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 19, 2022 09:27PM |
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Cardiac Remodeling After Atrial Fibrillation Ablation
page 38:
From current evidences, it is still not sufficient to ignore the damage of the left atrial function caused by ablation. Avoidance of over-ablating the unnecessary atrial myocardium is important.
[pubmed.ncbi.nlm.nih.gov]
Lo, Li-Wei, and Shih-Ann Chen.
“Cardiac Remodeling After Atrial Fibrillation Ablation.”
Journal of atrial fibrillation
vol. 6,1 877. 30 Jun. 2013,
doi:10.4022/jafib.877
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 20, 2022 12:15AM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 20, 2022 01:44AM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 20, 2022 08:47AM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 20, 2022 09:59AM |
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Ken
However, one issue remains, but the source (ablation, age, ?) has surfaced in the last 5 years. Maximal heart rate is only 125, achieved on a maximal stress test. I would like to see it higher.
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 21, 2022 11:18AM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 21, 2022 01:55PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 21, 2022 01:59PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 21, 2022 04:32PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 22, 2022 08:25AM |
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Kwilk
[peterattiamd.com]
Thanks for that link. 2+ hrs discussion. Only had time fore the first 40min, but something clicked in me regarding the importance of structured exercise as opposed to lifestyle exercise. So it's potentially a life-changing video for me. Thanks. They also mention how the hazard ratio for exercise is a magnitude greater than all other factors such as sleep, nutrition,.... Speaking critically, though, they are in each other's bubble. So no debate / critique / etc. Maybe it comes in later.
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 22, 2022 10:40PM |
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GeorgeN
Attia is certainly in the category of being pro exercise. I'm a paid subscriber, so get his "Ask Me Anything" podcasts and many are on the exercise topic. He's an interesting fellow, undergrad is Mech Engineering, MD @ Stanford and trained as a cancer surgeon at Hopkins, then an NIH fellow. After a stint as a McKinsey & Company consultant, he now has a concierge practice for very successful people focusing on longevity. The number of patients he treats is very small, so a lot attention to each person. He has a staff of 7 analysts to gather information from the research for how he treats his patients. He gives out much of this info in his podcasts, so a self-motivated non-patient can get much of the benefit. He also has a number of doctors on his staff treating patients. He also promotes sleep, nutrition and all the lifestyle stuff too. He was doing a 7 day fast once a quarter and now does a 3 day fast once a month. He's worn a CGM for a number of years. He also focuses on mental health as well.Quote
kwilk
All that being said, I think there are ways to get much of the benefit of exercise without as much time commitment as Attia advocates. I'm also one who pushes also all the lifestyle buttons (sleep, nutrition, as well as certain small molecules & etc.).
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 22, 2022 11:32PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 23, 2022 12:33AM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 24, 2022 10:31AM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 24, 2022 08:08PM |
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Kwilk
I'm not sure I understand. Are you saying something different than "Findings do not support the use of MRI-guided fibrosis ablation for the treatment of persistent AF."
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 24, 2022 11:47PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 25, 2022 01:48PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 25, 2022 02:50PM |
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Kwilk
Hence ablating all the fibrotic tissue
All? Where does that come from?
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 25, 2022 03:09PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 25, 2022 03:24PM |
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GeorgeN
My pick is Andrea Natale.
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 25, 2022 06:23PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 25, 2022 07:32PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 25, 2022 11:01PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias September 26, 2022 02:01PM |
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Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias October 02, 2022 04:36PM |
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web
... it is still uncertain which ablation approach is the most effective. Whether to ablate the “triggers” that initiate AF or the “substrate” that supports it.
researchgate.com: Non-Invasive Identification of Atrial Fibrillation Driver Location Using the 12-lead ECG: Pulmonary Vein Rotors vs. other Locations
Re: Markers of Myocardial Damage, Tissue Healing, and Inflammation After Radiofrequency Catheter Ablation of Atrial Tachyarrhythmias October 02, 2022 05:14PM |
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web
Recently, Narayan et al. developed a computational mapping technique capable of identifying AF localized sources that may correspond to organized reentrant circuits (i.e., rotors) or focal impulses that have been reported in animal models of AF.50 The benefit of ablation of these localized sources—called Focal Impulses and Rotor Modulation (FIRM) ablation—has been tested against conventional ablation in a multicenter observational study including 92 patients with predominantly persistent AF (72%).51 Localized rotors or focal impulses were found in 97% of cases, and ablation of these sites resulted in AF termination or consistent slowing in 86%. After a median follow-up of 273 days, patients who underwent FIRM ablation had higher freedom from recurrent AF compared to conventional ablation (single procedure success: 82.4% vs. 44.9%, P < 0.001). Overall, the results reported by Narayan et al. are promising ....
Authors Santangeli and Lin (Santangeli being a Natale mentee according to another forum member)
nih.gov: Catheter Ablation of Paroxysmal Atrial Fibrillation