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Related Concept Videos

Assessment of apical radial pulse01:25

Assessment of apical radial pulse

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Apical-Radial (A-R) Pulse Assessment
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
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Assessment of apical pulse01:17

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Assessing the apical pulse is a critical nursing procedure, particularly indicated for:
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Preprocedural Screening Tool to Guide Nonpulmonary Vein Trigger Testing in First-Time Atrial Fibrillation Ablation.

Alireza Oraii1, Corentin Chaumont1, Oriol Rodriguez-Queralto1

  • 1Section of Cardiac Electrophysiology, Division of Cardiovascular Medicine, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.

Circulation. Arrhythmia and Electrophysiology
|December 20, 2024
PubMed
Summary

A new risk score helps identify patients likely to have non-pulmonary vein (PV) triggers during atrial fibrillation (AF) ablation. This tool aids in planning ablation strategies for better patient outcomes.

Keywords:
atrial fibrillationcardiac surgical procedurescatheter ablationisoproterenolrisk factorssick sinus syndrome

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Informatics

Background:

  • Atrial fibrillation (AF) ablation success can be improved by targeting non-pulmonary vein (PV) triggers.
  • Identifying patients at high risk for non-PV triggers pre-ablation can optimize procedural planning.

Purpose of the Study:

  • To develop and validate a preprocedural screening tool for predicting non-PV triggers in patients undergoing their first AF ablation.

Main Methods:

  • A retrospective analysis of 2038 patients undergoing first-time AF ablation was conducted.
  • Non-PV triggers were identified through provocative maneuvers and spontaneous firing.
  • A multivariable logistic regression model identified risk factors to create a risk score.

Main Results:

  • 163 patients (8.0%) had non-PV triggers.
  • Key predictors included female sex, sinus node dysfunction, prior cardiac surgery, left atrial enlargement, and cardiac sarcoidosis/amyloidosis.
  • The risk score stratified patients into low (4.3% risk), intermediate (10.5% risk), and high-risk (22.6% risk) groups for non-PV triggers.

Conclusions:

  • A validated preprocedural risk score effectively identifies patients at risk for non-PV triggers during initial AF ablation.
  • This tool can guide clinicians in performing targeted non-PV trigger testing, potentially improving ablation efficacy.
  • Further external validation is recommended to confirm the score's generalizability.