Search results for "Coronary sinus"
showing 10 items of 20 documents
Reliability of Local Activation Waves Features to Characterize Paroxysmal Atrial Fibrillation Substrate During Sinus Rhythm
2020
[EN] Analysis of coronary sinus (CS) electrograms (EGMs) is vastly used for the assessment of the atrial fibrillation (AF) substrate. As a catheter consists of five dipoles (distal, mid-distal, medial, mid-proximal, proximal), results may vary upon the employed channel: myocardial contraction and bad contact are unavoidable factors affecting the recording. This work aims to specify the most reliable channels in catching AF dynamics, using 44 multichannel bipolar CS recordings in sinus rhythm (SR) of paroxysmal AF with 1-5 minutes duration. Local activation waves (LAWs) were detected and main features obtained: duration, amplitude, area and correlation between dominant morphologies of each c…
A New Technical Approach For Retrograde Administration of Cardioplegic Solutions
1989
Myocardial protection via the coronary sinus is now currently used by several groups. Although it has generally provided satisfactory results, some of its problems are still not completely resolved. We present a new technique of cardioplegia delivery through the coronary sinus with a Pezzer catheter inserted into it and secured in place by a purse string suture. We believe that this method is safer and more reliable than others.
Non-invasive localization of atrial ectopic beats by using simulated body surface P-wave integral maps
2017
Non-invasive localization of continuous atrial ectopic beats remains a cornerstone for the treatment of atrial arrhythmias. The lack of accurate tools to guide electrophysiologists leads to an increase in the recurrence rate of ablation procedures. Existing approaches are based on the analysis of the P-waves main characteristics and the forward body surface potential maps (BSPMs) or on the inverse estimation of the electric activity of the heart from those BSPMs. These methods have not provided an efficient and systematic tool to localize ectopic triggers. In this work, we propose the use of machine learning techniques to spatially cluster and classify ectopic atrial foci into clearly diffe…
Extracellular matrix fiber microarchitecture is region-specific in bicuspid aortic valve-associated ascending aortopathy
2016
Abstract Objective Ascending thoracic aortic aneurysm (ATAA) in patients with bicuspid aortic valve (BAV) commonly dilate asymmetrically compared with patients with tricuspid aortic valve (TAV). This discrepancy in aneurysm geometry led us to hypothesize that microarchitectural differences underlie the observed asymmetric dilatation pattern. The purpose of this study was to characterize the microarchitectural distinctions of the extracellular matrix of the 2 phenotypes with a focus on the proportion of radially oriented elastin and collagen fibers in different circumferential aortic regions. Methods Aortic tissue rings were obtained just distal to the sinotubular junction from patients with…
Analysis of in-silico body surface P-wave integral maps show important differences depending on the connections between coronary sinus and left atrium
2016
The electrical connections between the atrial coronary sinus (CS) and the left atrial (LA) myocardium have an effect on the overall atrial activation pattern and the P-wave morphology. In this study, we use our validated multi-scale 3D human atrial-torso model to elucidate which electro-anatomical configuration of connections between CS and LA more accurately reproduces a set of body surface P-wave integral maps (BSPiM) acquired in the clinic. We performed atrial biophysical simulations by pacing in distal and proximal LA sites. The corresponding in-silico BSPiM were then computed and compared with published clinical patterns obtained from patients. Important differences in BSPiM were obser…
Advanced Protocol for Three-Dimensional Transesophageal Echocardiography Guidance Implementing Real-Time Multiplanar Reconstruction for Transcatheter…
2019
Transcatheter direct annuloplasty has been introduced as a novel interventional treatment option for severe mitral valve regurgitation. Until now, only one direct annuloplasty device (Edwards Cardioband) has been commercially available, being implanted in more than 250 patients worldwide. Yet this procedure poses greater challenges regarding optimal fluoroscopic and echocardiographic guidance compared with edge-to-edge repair: correct localization and orientation of the anchors upon penetration into the fibrous mitral annulus tissue and the basal left ventricular myocardium are preconditions for an optimal result and essential to avoid damage of the neighboring structures (atrioventricular …
Myocardial Protection by Retrograde Cardioplegic Perfusion in the Presence of Acute Coronary Artery Obstruction: An Experimental Study
1992
To investigate retrograde delivery of cardioplegic solutions as a means of enhancing myocardial protection in the presence of coronary artery occlusion, a two-part experimental model was devised. In part 1 (in vitro) the possibility of retroperfusing the entire myocardium during acute occlusion of the left anterior descending artery (LAD) was assessed. In part 2 (in vivo) acute LAD occlusion was performed in dogs, and during 2 hours of aortic cross-clamping crystalline cardioplegic solution was infused at 20-minute intervals. In group I the infusion was antegrade, via the aortic root, and in group II it was retrograde, via the coronary sinus. Thereafter the LAD snare was released and the do…
Coronary venous therapy to improve microvascular dysfunction.
2021
The coronary circulation is a complex system in which vascular resistances are determined by an interplay of forces in at least three compartments: the epicardial, the microvascular, and the venous district. Cardiologists, and particularly interventional cardiologists, normallly place the focus of their attention on diseases of the epicardial coronary circulation as possible causes of coronary syndromes and neglect the importance of the other two compartments of coronary circulation. The study of the coronary microcirculation, an increasingly recognized source of ischemia, has long been disregarded, but is witnessing a revival since the (re-)introduction of diagnostic tools in the better eq…
Ectasia and Aneurysm of the Right Coronary Artery Resulting From a Shunt to the Coronary Sinus
1998
A 65-year-old woman presented with a systolic-diastolic murmur. Further MRI investigations as well as angiography revealed an arteriovenous shunt to the coronary sinus via an enlarged right coronary artery (Figure 1A⇓ and 1B⇓). The distal part of this coronary artery was transformed to a large coronary aneurysm of such extent that the left atrium was compressed …
Management of refractory angina: an update.
2020
Abstract Despite the use of anti-anginal drugs and/or percutaneous coronary interventions (PCI) or coronary artery bypass grafting, the proportion of patients with coronary artery disease who have daily or weekly angina ranges from 2% to 24%. Refractory angina refers to long-lasting symptoms (for >3 months) due to established reversible ischaemia, which cannot be controlled by escalating medical therapy with the use of 2nd- and 3rd-line pharmacological agents, bypass grafting, or stenting. While there is uncertain prognostic benefit, the treatment of refractory angina is important to improve the quality of life of the patients affected. This review focuses on conventional pharmacolog…