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https://www.readbyqxmd.com/read/28534206/-3-d%C3%A2-mapping-and-ablation-of-recurrent-ventricular-tachycardia-in-patients-with-ischemic-cardiomyopathy
#1
REVIEW
Kristina Wasmer, Lars Eckardt
Catheter ablation of ventricular tachycardia (VT) is an established therapy for patients with ischemic cardiomyopathy to reduce implantable cardioverter-defibrillator (ICD) interventions and is a class I recommendation in international guidelines. Numerous publications confirm its value. Use of three-dimensional mapping systems with or without image integration is standard for ablation of complex arrhythmias. In patients with history of myocardial infarction they help to understand activation of reentrant circuits and are prerequisite for substrate mapping...
May 22, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28534205/outflow-tract-ventricular-arrhythmias-electrocardiographic-features-in-relation-to-mapping-and-ablation
#2
REVIEW
Deepak Padmanabhan, Alan Sugrue, Prakriti Gaba, Samuel J Asirvatham
Ventricular arrhythmia arising from the outflow tracts can manifest itself as frequent premature ventricular complexes (PVCs), salvos of ventricular tachycardia (VT), and/or sustained VT. It is amenable to management with medication and catheter ablation without need for an intracardiac defibrillator. The electrocardiogram (ECG) is a crucial tool in the management of these patients as it is can help localize the site of origin, thereby helping guide the electrophysiologist. An appreciation of the unique anatomy of the outflow tracts as well as their relationships with the surrounding structures is essential in interpreting the ECG...
May 22, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28507740/mark-josephson-pioneer-educator-and-mentor-to-a-generation-of-cardiac-electrophysiologists
#3
William G Stevenson
In January 2017 we lost a giant in cardiac electrophysiology, whose work and teachings touched all of us working in the field. Mark Josephson's early work, building on the work of Hein Wellens in using programmed stimulation and catheter mapping to understand scar-related ventricular tachycardias, led the way to surgical and then catheter ablation as a viable therapy for that arrhythmia. His seminal observations are many and catalogued in 'The Josephson School' a wonderful book with 59 Chapters and extensive commentary devoted to his research...
April 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28506710/outcomes-after-repeat-ablation-of-ventricular-tachycardia-in-structural-heart-disease-an-analysis-from-the-international-vt-ablation-center-collaborative-group
#4
Wendy S Tzou, Roderick Tung, David S Frankel, Luigi Di Biase, Pasquale Santangeli, Marmar Vaseghi, T Jared Bunch, J Peter Weiss, Venkatakrishna N Tholakanahalli, Dhanunjaya Lakkireddy, Rama Vunnam, Timm Dickfeld, Nilesh Mathuria, Usha Tedrow, Pasquale Vergara, Kairav Vakil, Shiro Nakahara, J David Burkhardt, William G Stevenson, David J Callans, Paolo Della Bella, Andrea Natale, Kalyanam Shivkumar, Francis E Marchlinski, William H Sauer
BACKGROUND: Data evaluating repeat radiofrequency ablation (>1RFA) of ventricular tachycardia (VT) are limited. OBJECTIVE: The purpose of this study was to determine the safety and outcomes of VT >1RFA in patients with structural heart disease. METHODS: Patients with structural heart disease undergoing VT RFA at 12 centers with data on prior RFA history were included. Characteristics and outcomes were compared between first-time (1RFA) and >1RFA patients...
April 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28506214/origins-location-of-the-outflow-tract-ventricular-arrhythmias-exhibiting-qrs-pattern-or-qs-pattern-with-a-notch-on-the-descending-limb-in-lead-v1
#5
Cong Lin, Cheng Zheng, De-Pu Zhou, Xiao-Wei Li, Shu-Jie Wu, Jia-Feng Lin
BACKGROUND: Ventricular outflow tract(VOT) ventricular arrhythmias(VAs) presenting qrS pattern or QS pattern with a notch on the descending limb in lead V1 were consistently thought of arising from the commissure between left and right coronary cusp (L-RCC) by previous studies. However, we found they could originate from other anatomic structures in VOT. This study aimed to investigate the exact origin of this kind VAs. METHODS: Forty-nine patients of VOT premature ventricular contrations/ventricular tachycardia(PVCs/VT) with lead V1 presenting qrS pattern or QS pattern with a notch on the descending limb undergoing successful radiofrequency catheter ablation(RFCA) in our center were analyzed...
May 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28500178/electrical-substrate-elimination-in-135-consecutive-patients-with-brugada-syndrome
#6
Carlo Pappone, Josep Brugada, Gabriele Vicedomini, Giuseppe Ciconte, Francesco Manguso, Massimo Saviano, Raffaele Vitale, Amarild Cuko, Luigi Giannelli, Zarko Calovic, Manuel Conti, Paolo Pozzi, Andrea Natalizia, Simonetta Crisà, Valeria Borrelli, Ramon Brugada, Georgia Sarquella-Brugada, Marco Guazzi, Alessandro Frigiola, Lorenzo Menicanti, Vincenzo Santinelli
BACKGROUND: There is emerging evidence that localization and elimination of abnormal electric activity in the epicardial right ventricular outflow tract may be beneficial in patients with Brugada syndrome. METHODS AND RESULTS: A total of 135 symptomatic Brugada syndrome patients having implantable cardiac defibrillator were enrolled: 63 (group 1) having documented ventricular tachycardia (VT)/ventricular fibrillation (VF) and Brugada syndrome-related symptoms, and 72 (group 2) having inducible VT/VF without ECG documentation at the time of symptoms...
May 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28488109/-epicardial-ablation-of-ventricular-tachycardias
#7
REVIEW
E Ene, P Halbfaß, K Nentwich, K Sonne, M Roos, S Fodor, L Lehmkuhl, F Gietzen, S Barth, K Hamm, T Deneke
Ventricular tachycardias (VT) in patients with structural heart diseases have predominantly a scar-associated reentry mechanism so that substrate-based ablation approaches also have to be used in nearly all procedures. In many VT cases-especially in nonischemic cardiomyopathy (NICM) and arrhythmogenic right ventricular cardiomyopathy-a critical epicardial substrate can be identified as an essential component of the reentry circuit so that for the ablation-based modification of the substrate in these cases an epicardial approach is necessary...
May 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28484842/conventional-mapping-and-ablation-of-focal-ventricular-tachycardias-in-the-healthy-heart
#8
REVIEW
Sonia Busch, Johannes Brachmann, Ahmed Saleh, Mathias Forkmann
Ventricular tachycardias (VT) in the healthy heart, also known as idiopathic VTs, often have a focal origin. Triggered activity due to delayed after-depolarization is the most likely mechanism of focal VTs. Localization of the site of origin of focal VTs is based on activation mapping with or without combination with pace mapping. The characteristic anatomic site of origin of idiopathic VTs is the right and left outflow tract. Other sites include the tricuspid and mitral annulus, the papillary muscles, and Purkinje fibers...
May 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28484841/-bundle-branch-reentry-vt-diagnosis-mapping-and-ablation
#9
REVIEW
Christopher Reithmann
Macroreentry in the His-Purkinje system can result in sustained ventricular tachycardia (VT) termed bundle branch reentry VT. Bundle branch reentry is usually associated with His-Purkinje disease and depressed left ventricular function. In the case of typical bundle branch reentry, the right bundle is activated in the anterograde direction and ventricular depolarization begins at the distal end of the right bundle on the ventricular septum generating a typical left bundle branch block QRS morphology. However, atypical surface ECGs can also be found in patients with severe left ventricular dysfunction and involvement of the right ventricle complicating the diagnosis of bundle branch reentry VT...
May 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28471068/stellate-ganglion-blockade-and-bilateral-cardiac-sympathetic-denervation-in-patients-with-life-threatening-ventricular-arrhythmias
#10
Ricardo Cardona-Guarache, Santosh K Padala, Luis Velazco-Davila, Anthony Cassano, Antonio Abbate, Kenneth A Ellenbogen, Jayanthi Koneru
Autonomic modulation is being increasingly employed as a strategy to treat ventricular arrhythmias refractory to beta-blockers, antiarrhythmic drugs and catheter-based ablation procedures. We report 6 patients with refractory ventricular tachycardia (VT) or ventricular fibrillation (VF) treated with stellate ganglion blockade (SGB) and/or bilateral cardiac sympathetic denervation (CSD). Our case series emphasizes the concept that the cardiac sympathetic nerves are important targets in the management of ventricular arrhythmias...
May 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28460764/safety-and-efficacy-of-epicardial-approach-to-catheter-ablation-of-ventricular-tachycardia-an-institutional-experience
#11
Jayapandian Pandian, Daljeet Kaur, Sachin Yalagudri, Soumen Devidutta, Gomathi Sundar, Sridevi Chennapragada, Calambur Narasimhan
BACKGROUND AND AIM: Epicardial approach to VT ablation increases the success rate of ablation but is not without complications. We studied the safety and efficacy of epicardial VT ablations performed at our institute. METHODS: All patients who underwent epicardial VT ablation at our institute were studied retrospectively. The outcome of VT ablation was among three groups: ischaemic cardiomyopathy (ICM), non-ischaemic cardiomyopathy (NICM) and granulomatous myocarditis (GM)...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28457242/clinical-aspects-and-ablation-of-ventricular-arrhythmias-in-tetralogy-of-fallot
#12
REVIEW
Katja Zeppenfeld, Adrianus P Wijnmaalen
Life expectancy of patients with rToF has considerably improved due to refined surgical interventions. Monomorphic fast VTs are frequently encountered in adult patients with rToF. The dominant substrate of VT is anatomical isthmuses bordered by surgical incisions, patch material and valve annuli. Substrate based ablation strategies aim to transect all slow conducting anatomical isthmuses (SCAI) as identified by electroanatomical mapping. Procedural success is defined as non-inducibility of VT and confirmed conduction block over the SCAI resulting in long-term VT free survival in most patients...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457241/development-of-tachyarrhythmias-late-after-the-fontan-procedure-the-role-of-ablative-therapy
#13
REVIEW
Natasja M S de Groot, Ad J J C Bogers
Patients with a Fontan circulation are at a high risk of developing a variety of cardiac dysrhythmias after cardiac surgery. These dysrhythmias are most often supraventricular tachyarrhythmias (SVT), but ventricular tachyarrhythmias (VT) may also occur. Mechanisms underlying SVT are variable, including both ectopic activity and reentry. Over time, successive SVT may be caused by different mechanisms. The acute success rate of ablative therapy of atrial tachyarrhythmias is considerably high yet during long-term follow-up 'recurrences' frequently occur...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28449771/risk-factors-for-early-mortality-after-vt%C3%A2-ablation-how-sick-is-too-sick
#14
EDITORIAL
Frédéric Sacher, Ruairidh Martin
No abstract text is available yet for this article.
May 2, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28449770/early-mortality-after-catheter-ablation-of-ventricular-tachycardia-in-patients-with-structural-heart-disease
#15
Pasquale Santangeli, David S Frankel, Roderick Tung, Marmar Vaseghi, William H Sauer, Wendy S Tzou, Nilesh Mathuria, Shiro Nakahara, Timm M Dickfeldt, Dhanunjaya Lakkireddy, T Jared Bunch, Luigi Di Biase, Andrea Natale, Venkat Tholakanahalli, Usha B Tedrow, Saurabh Kumar, William G Stevenson, Paolo Della Bella, Kalyanam Shivkumar, Francis E Marchlinski, David J Callans
BACKGROUND: In patients referred for radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT) in the setting of structural heart disease, early post-procedural mortality (EM) has not been previously investigated. OBJECTIVES: The purpose of this study was to evaluate EM after catheter ablation of scar-related VT. METHODS: Associations between clinical and procedural variables and EM (within 31 days of the procedure) were tested in patients with structural heart disease undergoing RFCA of VT at 12 international centers...
May 2, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28449078/surface-electrocardiography-characteristics-and-radiofrequency-catheter-ablation-of-idiopathic-ventricular-arrhythmias-originating-from-the-left-infero-septal-papillary-muscles-differences-from-those-originating-from-the-left-posterior-fascicle
#16
Shixing Li, Zulu Wang, Zhaoliang Shan, Xiangmin Shi, Ming Liang, Yanchun Liang, Zhiqing Jin, Yaling Han, Yutang Wang
Aims: Distinguishing between ventricular arrhythmias originating from the left ventricular infero-septal papillary muscles (PM) and those from the left posterior fascicle (LPF) by surface electrocardiography (ECG) is very difficult. This study aimed to report the ECG characteristics and radiofrequency catheter ablation of PM and LPF ventricular arrhythmias. Methods and results: A total of 127 patients underwent catheter ablation of idiopathic ventricular arrhythmias originating from the LPF (n = 106; 85 males; 10-70 years) or PM (n = 21; 14 males; 4-68 years) were studied...
April 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28444174/catheter-ablation-for-ventricular-tachycardia-in-patients-with-cardiac-sarcoidosis-a-systematic-review
#17
Nikolaos Papageorgiou, Rui Providência, Konstantinos Bronis, Dirk G Dechering, Neil Srinivasan, Lars Eckardt, Pier D Lambiase
Aims: Cardiac sarcoidosis (CS) is associated with a poor prognosis. Important features of CS include heart failure, conduction abnormalities, and ventricular arrhythmias. Ventricular tachycardia (VT) is often refractory to antiarrhythmic drugs (AAD) and immunosuppression. Catheter ablation has emerged as a treatment option for recurrent VT. However, data on the efficacy and outcomes of VT ablation in this context are sparse. Methods and results: A systematic search was performed on PubMed, EMBASE, and Cochrane database (from inception to September 2016) with included studies providing a minimum of information on CS patients undergoing VT ablation: age, gender, VT cycle length, CS diagnosis criteria, and baseline medications...
April 21, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28431063/left-ventricular-dysfunction-is-associated-with-frequent-premature-ventricular-complexes-and-asymptomatic-ventricular-tachycardia-in-children
#18
R A Bertels, L M Harteveld, L H Filippini, S A Clur, N A Blom
Aims: To assess the risk factors for left ventricular (LV) dysfunction in a paediatric population with idiopathic frequent premature ventricular contractions (PVCs) and asymptomatic ventricular tachycardias (VTs). Methods and Results: Paediatric patients with the diagnosis of idiopathic frequent PVCs and asymptomatic VTs were retrospectively evaluated. Frequent PVCs were defined as ≥5% on 24 h Holter recording. Left ventricular dysfunction was defined as a shortening fraction of ≤28%...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28431051/safety-long-term-outcomes-and-predictors-of-recurrence-after-first-line-combined-endoepicardial-ventricular-tachycardia-substrate-ablation-in-arrhythmogenic-cardiomyopathy-impact-of-arrhythmic-substrate-distribution-pattern-a-prospective-multicentre-study
#19
Antonio Berruezo, Juan Acosta, Juan Fernández-Armenta, Alonso Pedrote, Alberto Barrera, Eduardo Arana-Rueda, Andrés Ignacio Bodegas, Ignasi Anguera, Luis Tercedor, Diego Penela, David Andreu, Rosario Jesus Perea, Susana Prat-González, Lluis Mont
Background: First-line endoepicardial ventricular tachycardia (VT) ablation has been proposed for patients with arrhythmogenic cardiomyopathy (AC). This study reports procedural safety, outcomes, and predictors of recurrence. Methods and Results: Forty-one consecutive patients [12 with left ventricle (LV) involvement, 7 left-dominant] underwent first-line endoepicardial VT substrate ablation. Standard bipolar and unipolar thresholds were used to define low-voltage areas (LVA)...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28429512/tailored-approach-for-management-of-ventricular-tachycardia-in-cardiac-sarcoidosis
#20
Sachin Yalagudri, Ngwe Zin Thu, Soumen Devidutta, Daljeet Saggu, Ajit Thachil, Sridevi Chennapragada, Calambur Narasimhan
INTRODUCTION: Treating ventricular tachycardia (VT) in patients with cardiac sarcoidosis (CS) is challenging as patients present in different phase of the disease (inflammatory, scar or sometimes both). A customized approach to treatment is required for better outcomes. We describe our experience in the management of VT in CS based on the phase of the disease. METHODS AND RESULTS: Patients were considered to have myocardial inflammation if there was an increased myocardial (18) Fluoro Deoxy Glucose (FDG) uptake in PET-CT scan of the chest (n=14)...
April 21, 2017: Journal of Cardiovascular Electrophysiology
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