Risk Of Systemic Embolic Events Research Articles

Hybrid peratrial double device closure of a patent foramen ovale and sinus venosus defect in an infant with vein of galen malformation

Vein of Galen aneurysmal malformation is the most common cerebral arteriovenous malformation in children. Neurointerventional embolization has improved outcomes with this lesion. An association with cardiac defects has been recognized and can increase the risk of systemic embolic events during treatment. Cardiopulmonary bypass (CPB) to correct the cardiac defect before repair of the malformation may be associated with compromised cerebral perfusion and possible neurologic injury. We describe a successful hybrid peratrial closure of two intracardiac shunts (a patent foramen ovale and a sinus venosus ASD) before neurointervention, avoiding CPB, and eliminating the intracardiac embolic risk during treatment of the vein of Galen malformation.

ATRIAL FIBRILLATION CURRENT AND FUTURE TREATMENTS: RADIOFREQUENCY ABLATION AND NOVEL PACING TECHNIQUES

SUMMARYAtrial fibrillation (AF) is a common clinical arrhythmia with significant symptomatology and is associated with an increased risk of systemic embolic events. Until recently, the treatment options for AF were essentially pharmacological. Recent developments in the understanding of the mechanisms of AF have resulted in a series of non‐pharmacological treatments becoming available. Such treatments include surgical ‘maze’ procedures and, more recently, the introduction of radiofrequency ablation techniques within the atria to prevent fibrillation. Complex pacing procedures, including multisite and biatrial pacing, have been used to treat AF. Tailoring treatment for individual patients is a complex task and this review will attempt to rationalise the non‐pharmacological treatment paths for individual patients with AF.