Audit of ablation procedures as long as AF Barts in addition to The London AF burden Framingham Li

Audit of ablation procedures as long as AF Barts in addition to The London AF burden Framingham Li www.phwiki.com

Audit of ablation procedures as long as AF Barts in addition to The London AF burden Framingham Li

West, Erich, Operations Manager has reference to this Academic Journal, PHwiki organized this Journal Audit of ablation procedures as long as AF Barts in addition to The London AF burden Framingham Lifetime risk of developing AF = 25% Mortality: SMR =1.9 1.5 NHS audit 1% of budget spent on AF Quality of life Symptoms of AF Side effects of medication Benjamin, E. J. et al. “Impact of atrial fibrillation on the risk of death: the Framingham Heart Study.” Circulation 98.10 (1998): 946-52. Stewart, S. et al. “Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK.” Heart 90.3 (2004): 286-92 Are effective treatments available Antiarrhythmic drugs Toxicity: AFFIRM No benefit over rate control SR has a prognostic benefit Rate control in addition to anticoagulation As good as AADs: Prognosis QOL Ximelagatran

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Non pharmacological methods Pacemaker Pace to suppress triggers of AF Multisite or biatrial pacing Atrial defibrillators Surgical ablation Catheter ablation Mechanisms of AF Ablation strategies Isolation/destruction of triggers: Target pulmonary vein isolation (PVI) Total PVI ± other triggers Modification of atrial substrate: Linear lesions in left atrium, right atrium or both Wide circumferential lesions around pulmonary veins Catheter maze Left atrial maze in addition to PVI

Pulmonary vein isolation Linear ablation in the left atrium Catheter maze

St in addition to ards from published data Worldwide survey of AF ablation Cappato et al. ESC 2004 Data from 777 centres Number of cases 18 in 1995, 5050 in 2002 Median of 37.5 cases per centre (range 1-600) Commonest procedure 1995-97 Right atrial maze 1998-99 Target PVI 2000-02 Electrical disconnection of all PVs Outcomes 8745 pts in 90 centres 27.3% >1 procedure 76% asymptomatic (24% on antiarrhythmic drugs) 6% major complication rate St Bartholomew’s data PATS database (EP in addition to EP2) Research database Catheter maze study Coarse AF study Patient letters DMS/EPR viewer Telephone patients

Total number of procedures 100 procedures in 73 patients Increasing number of procedures Patients N=73 50±8 years 58M 15F Cardiac diagnosis: Type of AF:

Outcomes: improvement in symptoms Outcomes: maintenance of sinus rhythm Need as long as antiarrhythmic drugs

Need as long as repeat procedures Number of procedures per patient: Success of 1st procedure Procedure times

Complications Major n=4 (4.5%) 2 Tamponade 1 Stroke 1 Severe PV stenosis Up to June 03 (11.4%) Since July 03 (0%) Minor n=7 (8.0%) 2 transient ST elevation 2 mild PV stenosis 1 tip of active fix pacing wire in RA 2 haematoma Catheter maze study Baseline characteristics: 23 patients (19M 4F) 49 ± 9 years AF duration 4 ± 3 years (11 ± 9 months continuously) 2.7 ± 1.7 DCCV 3.3 ± 1 antiarrhythmic drugs LA diameter 4.9 ± 0.9 cm Mean follow up 10±7 months Catheter maze outcome

West, Erich WQRV-FM Operations Manager www.phwiki.com

Results: symptoms in addition to QOL Baseline SR -6 ± 7 +14 ± 1.4 6 months change vs 6 weeks -34 ± 24 -6 ± 37 6 weeks change vs baseline – 58 ± 29 Modified Karolinska (0-140) P < 0.05 AF or AFL Surgical Maze – BRACUS stidy Bipolar Radiofrequency Ablation as long as Chronic atrial fibrillation in patients Undergoing mitral valve Surgery Conclusions Clinical need as long as improved pharmacological or non pharmacological treatments as long as AF AF ablation at St Bartholomew’s is effective in addition to at a level with published data Low but important complication rate St Bartholomew’s as a lead national centre as long as AF ablation Increasing number of cases Prospective symptom, QOL in addition to rhythm collection Publishing in addition to presenting our data Research Catheter Maze Coarse AF BRACUS Training Centre of excellence as long as industry Ensite NavX 4.0 in addition to 5.0 Digital Image fusion

West, Erich Operations Manager

West, Erich is from United States and they belong to WQRV-FM and they are from  Madison, United States got related to this Particular Journal. and West, Erich deal with the subjects like Music Programming

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