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VT ablation

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https://www.readbyqxmd.com/read/28727191/anterior-pericardial-access-to-facilitate-electrophysiology-study-and-catheter-ablation-of-ventricular-arrhythmias-a-single-tertiary-center-experience
#1
Ali R Keramati, Deeptankar DeMazumder, Satish Misra, Jonathan Chrispin, Fabrizio R Assis, Chava Raghuram, Swati Dey, Hugh Calkins, Harikrishna Tandri
INTRODUCTION: Epicardial ablation is becoming an important part of management in patients with ventricular tachycardia (VT). Posterior epicardial access via the Sosa or Needle-in-Needle (NIN) approach for epicardial VT ablation is considered to be the method of choice for most electrophysiologists. Anterior epicardial access as an alternative technique has recently been proposed, but there is limited data about its safety, efficacy and the rate of immediate complications. In this study, we report our experience with anterior epicardial access between 2009 and 2016...
July 20, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28722339/structured-pain-management-reduces-patient-discomfort-after-catheter-ablation-and-rhythm-device-surgery
#2
M Dörschner, A Bollmann, B Dinov, S Richter, M Döring, A Arya, A Müssigbrodt, S Kircher, N Dagres, P Sommer, G Hindricks, K Bode
BACKGROUND: The goal was to test the effectiveness of a structured pain management programme after invasive electrophysiological interventions in cardiology including ablation of atrial fibrillation (AF) or ventricular tachycardia (VT) and implantation, or explantation, of pacemakers or implantable cardioverter defibrillators. METHODS: This was a prospective study with a pre-/post-design where a post-intervention group (116 consecutive patients) was compared to a pre-intervention group (102 consecutive patients) after implementation of a structured pain-management programme using the numeric rating scale (NRS 0-10) and classified as moderate-to-severe if NRS > 3...
July 18, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28694398/renal-sympathetic-denervation-assisted-treatment-of-electrical-storm-due-to-polymorphic-ventricular-tachycardia-in-a-patient-with-cathecolaminergic-polymorphic-ventricular-tachycardia
#3
Tolga Aksu, Tümer Erdem Güler, Kazım Serhan Özcan, Serdar Bozyel, Kıvanç Yalın
Electrical storm (ES) is not a rare clinical entity. Sympathetic hyperactivity may play critical role in development and continuation of ES. Some recent reports have demonstrated that catheter-based renal sympathetic denervation (RSD) may reduce sympathetic activation and have a potential role in reducing arrhythmic burden. A 46-year-old man was admitted to clinic with frequent implantable cardioverter defibrillator shocks and ES related to catecholaminergic polymorphic ventricular tachycardia (VT). Tachycardia was unresponsive to administration of beta-blockers, verapamil, and flecainide...
July 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28688990/value-of-cardiac-magnetic-resonance-imaging-and-programmed-ventricular-stimulation-in-patients-with-frequent-premature-ventricular-complexes-undergoing-radiofrequency-ablation
#4
Miki Yokokawa, Konstantinos C Siontis, Hyungjin Myra Kim, Jadranka Stojanovska, Rakesh Latchamsetty, Thomas Crawford, Krit Jongnarangsin, Hamid Ghanbari, Ryan Cunnane, Aman Chugh, Frank Pelosi, Hakan Oral, Fred Morady, Frank Bogun
BACKGROUND: Frequent premature ventricular complexes (PVCs) have been associated with increased mortality. However, the optimal approach to the risk stratification of these patients is unclear. OBJECTIVE: The purpose of this study was to prospectively assess the use of cardiac magnetic resonance imaging (MRI) and programmed ventricular stimulation to identify patients with PVCs undergoing radiofrequency ablation at risk for adverse long-term outcomes. METHODS: A total of 321 consecutive patients (52 ± 15 years; 157 men [49%]; left ventricular ejection fraction 51% ± 12%) underwent PVC ablation between 2004 and 2015, preceded by cardiac MRI to assess for structural heart disease (SHD)...
July 6, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28677887/inferior-lead-discordance-in-ventricular-arrhythmias-a-specific-marker-for-certain-arrhythmia-locations
#5
Andres Enriquez, Rajeev K Pathak, Pasquale Santangeli, Jackson Jeikai Liang, Mohammed Al Rawahi, Tatsuya Hayashi, Danielle Muser, David S Frankel, Gregory Supple, Robert Schaller, David Lin, Saman Nazarian, Erica Zado, Francis E Marchlinski, Fermin C Garcia
BACKGROUND: Most idiopathic ventricular arrhythmias (VAs) originate from the outflow tracts and are characterized by an inferior axis on the 12-lead ECG. A group of patients will exhibit inferior lead discordance (ILD), demonstrating a positive QRS in lead II with negative QRS in III or the opposite finding. METHODS AND RESULTS: We identified patients undergoing ablation of idiopathic premature ventricular contractions (PVCs) or ventricular tachycardia (VT) between 2013 and 2015...
July 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28625728/treatment-of-persistent-ventricular-tachycardia-drugs-or-ablation
#6
REVIEW
Ciorsti J MacIntyre, John L Sapp
Implantable cardioverter defibrillators (ICDs) reduce the mortality risk associated with recurrent ventricular tachycardia (VT) and can frequently terminate VT episodes painlessly, but do not prevent recurrent episodes. For patients with symptomatic recurrences, frequent asymptomatic recurrences, ICD shocks, or VT storm, most clinicians recommend strategies to suppress VT. The proarrhythmic mortality risk of antiarrhythmic drugs (AADs) may be mitigated by the presence of an ICD, but these medications are limited by high recurrence rates, and unfavorable side effect profiles...
May 10, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28624892/a-meta-analysis-of-manual-versus-remote-magnetic-navigation-for-ventricular-tachycardia-ablation
#7
Mohit K Turagam, Donita Atkins, Roderick Tung, Moussa Mansour, Jeremy Ruskin, Jie Cheng, Luigi Di Biase, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: There are limited studies on the safety and efficacy of remote magnetic navigation (RMN) versus manual navigation (MAN) in ventricular tachycardia (VT) ablation. METHODS: A comprehensive literature search was performed using the keywords VT ablation, stereotaxis, RMN and MAN in Pubmed, Ebsco, Web of Science, Cochrane, and Google scholar databases. RESULTS: The analysis included seven studies (one randomized, three prospective observational, and three retrospective) including 779 patients [both structural heart disease (SHD) and idiopathic VT] comparing RMN (N = 433) and MAN (N = 339) in VT ablation...
June 17, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28603002/association-of-preprocedural-cardiac-magnetic-resonance-imaging-with-outcomes-of-ventricular-tachycardia-ablation-in-patients-with-idiopathic-dilated-cardiomyopathy
#8
Konstantinos C Siontis, Hyungjin Myra Kim, Ghaith Sharaf Dabbagh, Rakesh Latchamsetty, Jadranka Stojanovska, Krit Jongnarangsin, Fred Morady, Frank M Bogun
BACKGROUND: Knowledge of complex arrhythmogenic substrates can help plan ventricular tachycardia (VT) ablation in patients with idiopathic dilated cardiomyopathy (DCM). OBJECTIVE: The purpose of this study was to assess whether preprocedural late gadolinium enhancement magnetic resonance imaging (LGE-MRI) can improve ablation outcomes in DCM. METHODS: Consecutive patients (N = 96) with idiopathic DCM underwent VT ablation with open-irrigated catheters (2006-2016)...
June 9, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28597737/extension-of-catheter-ablation-and-outcome-for-ventricular-tachycardia-or-premature-ventricular-contractions-from-the-right-ventricular-outflow-tract
#9
Ki-Hun Kim, Hyoung-Seob Park, Yeo-Jung Song, Jeong-Sook Seo, Han-Young Jin, Dae-Kyeong Kim, Dong-Soo Kim, Young-Soo Lee, Ki-Won Hwang, Guang-Won Seo, Dong-Kie Kim, Pil-Sang Song, Sang-Hoon Seol, Doo-Il Kim, Yoon-Nyun Kim
Objective We aimed to determine whether the extension of ablation could influence the ablation outcome for ventricular tachycardia (VT)/premature ventricular contractions (PVCs) from the right ventricular outflow tract (RVOT). Methods and results The radiofrequency catheter ablation results of 33 VT/6 frequent PVCs from the RVOT were analysed. The ablation extension was divided into 3 categories from the final successful ablation point with the earliest activation: (I) focal ablation (15 cases); ablation at 1 or 2 points; (II) focal with extended ablation (12 cases); focal and surrounding area ablation (maximum ≤1 cm) after elimination of clinical VT/PVCs; and (III) broad ablation (12 cases); continued broad ablation (maximum >1 cm) after elimination of clinical VT/PVCs...
February 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28597532/substrate-characterization-and-catheter-ablation-in-patients-with-scar-related-ventricular-tachycardia-using-ultra-high-density-3d-mapping
#10
Jana M Nührich, Lukas Kaiser, Ruken Özge Akbulak, Benjamin N Schäffer, Christian Eickholt, Michael Schwarzl, Pawel Kuklik, Julia Moser, Mario Jularic, Stephan Willems, Christian Meyer
BACKGROUND: Ablation of scar-related ventricular tachycardia (VT), especially in non-inducible VT or hemodynamically unstable patients, can be challenging. Thus, we evaluated feasibility of an ultra high-density 3D-mapping approach to characterize the ventricular substrate and, if possible, to map VT. METHODS AND RESULTS: Twenty-two patients (67±2 years, mean LV-EF 36±3%) with both ischemic and non-ischemic cardiomyopathy and documented VT underwent mapping and catheter ablation using a 64-electrode mini-basket catheter...
June 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28597214/-diagnosis-of-ischemia-and-revascularization-in-patients-with-ventricular-tachyarrhythmia
#11
REVIEW
Thomas Deneke, Carsten W Israel
Sustained ventricular tachyarrhythmia usually occurs on the basis of structural heart disease, particularly coronary heart disease (CAD). Although monomorphic ventricular tachycardia (VT) appears mainly in patients with CAD, it is typically not triggered by acute ischemia, in contrast to polymorphic VT or ventricular fibrillation (VF). To judge if VT is caused by acute ischemia is even more difficult in context with an elevated highly sensitive troponin T which is generally elevated in sustained VT because tachycardia in chronic stable coronary artery sclerosis causes a mismatch between increased oxygen demand and limited oxygen supply...
June 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28597213/-3-d-mapping-of-ventricular-tachycardia-in-patients-with-dilative-cardiomyopathy
#12
REVIEW
Daniel Steven, Jan-Hendrik van den Bruck, Jakob Lüker, Tobias Plenge, Arian Sultan
Catheter ablation of ventricular tachycardia (VT) is gaining in importance. The current guidelines suggest considering catheter ablation for VT even in patients with a single sustained and documented episode. This is also underlined by recent data indicating that absence of VT predicts lower mortality and longer transplant-free survival. The majority of patients with VTs have a history of prior myocardial infarction; in a smaller proportion, patients present with dilated cardiomyopathy. The latter has a less structured scar pattern which makes it more complicated to apply efficient ablation strategies...
June 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28595345/supraventricular-arrhythmias-in-patients-with-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy-associate-with-long-term-outcome-after-catheter-ablation-of-ventricular-tachycardias
#13
Andreas Müssigbrodt, Helge Knopp, Elena Efimova, Alexander Weber, Livio Bertagnolli, Sebastian Hilbert, Jedrzej Kosiuk, Borislav Dinov, Kerstin Bode, Simon Kircher, Nikolaos Dagres, Sergio Richter, Philipp Sommer, Daniela Husser, Andreas Bollmann, Gerhard Hindricks, Arash Arya
Aims: This study aimed to assess the impact of supraventricular tachycardia (SVT) on long-term results of radiofrequency catheter ablation therapy of ventricular tachycardia (VT) in a large cohort of patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Methods and results: Supraventricular tachycardia occurrence has been studied in patients from our ARVD/C registry (70 patients, 48 male, age 53.2 ± 14.0, 45 patients (64.3%) with previous VT ablation)...
June 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28579601/efficacy-of-intensive-radiofrequency-energy-delivery-to-the-localized-dense-scar-area-in-post-infarction-ventricular-tachycardia-ablation%C3%A3-a-comparative-study-with-standard-strategy-targeting-the-infarcted-border-zone
#14
Kenji Kuroki, Akihiko Nogami, Kentaro Yoshida, Masahiko Goya, Masato Fukunaga, Kazuaki Kaitani, Naoaki Onishi, Takanao Mine, Takashi Koyama, Masayuki Igawa, Takeshi Machino, Hiro Yamasaki, Dongzhu Xu, Miyako Igarashi, Nobuyuki Murakoshi, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: Several reports have demonstrated the importance of severely low voltage areas as arrhythmogenic substrates of ventricular tachycardia (VT). However, a comparative study of dense scar-targeted and infarcted border zone-targeted strategies has not been reported.Methods and Results:We divided 109 consecutive patients with VT post-infarction from 6 centers into 2 groups according to the ablation strategy used: dense scar-targeted ablation (DS ablation, 48%) or border zone-targeted ablation (BZ ablation, 52%)...
June 3, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28576780/outcomes-of-ventricular-tachycardia-ablation-using-percutaneous-left-ventricular-assist-devices
#15
Shigeki Kusa, Marc A Miller, William Whang, Yoshinari Enomoto, Jorge G Panizo, Jin Iwasawa, Subbarao Choudry, Sean Pinney, Anthony Gomes, Noelle Langan, Jacob S Koruth, Andre d'Avila, Vivek Y Reddy, Srinivas R Dukkipati
BACKGROUND: Although percutaneous left ventricular assist devices (pLVADs) facilitate mapping and ablation of hemodynamically unstable ventricular tachycardia (VT), there is limited data whether clinical outcomes are improved. We sought to retrospectively compare the outcomes of patients undergoing scar-related VT ablation with and without pLVAD support. METHODS AND RESULTS: The study population comprised 194 patients (109 pLVAD and 85 non-pLVAD). The pLVAD group more often had dilated cardiomyopathy (33% versus 13%; P=0...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28575378/long-term-outcomes-of-different-ablation-strategies-for-ventricular-tachycardia-in-patients-with-structural-heart-disease-systematic-review-and-meta-analysis
#16
David F Briceño, Jorge Romero, Pedro A Villablanca, Alejandra Londoño, Juan C Diaz, Ilir Maraj, Syeda Atiqa Batul, Nidhi Madan, Jignesh Patel, Anand Jagannath, Sanghamitra Mohanty, Prasant Mohanty, Carola Gianni, Domenico Della Rocca, Ahlam Sabri, Soo G Kim, Andrea Natale, Luigi Di Biase
Aims: To compare the long-term outcomes of standard ablation of stable ventricular tachycardia (VT) vs. substrate modification, and of complete vs. incomplete substrate modification in patients with structural heart disease (SHD) presenting with VT. Methods and results: An electronic search was performed using major databases. The main outcomes were a composite of long-term ventricular arrhythmia (VA) recurrence and all-cause mortality of standard ablation of stable VT vs...
May 26, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28568013/a-multicenter-review-of-ablation-in-the-aortic-cusps-in-young-people
#17
Minh B Nguyen, Scott R Ceresnak, Christopher M Janson, Steven B Fishberger, Barry A Love, Andrew D Blaufox, Kara S Motonaga, Anne M Dubin, Lynn Nappo, Robert H Pass
BACKGROUND: Ablation within the aortic cusp is safe and effective in adults. There are little data on aortic cusp ablation in the pediatric literature. We investigated the safety and efficacy of aortic cusp ablation in young patients. METHODS: A retrospective, descriptive study of aortic cusp ablation in five pediatric electrophysiology centers from 2008 to 2014 was performed. All patients <21 years of age who underwent ablation in the aortic cusps were included...
June 1, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28567490/ventricular-rate-stabilization-for-treatment-of-recurrent-vt
#18
REVIEW
Mate Vamos, Peter Bogyi, Gabor Z Duray, Noemi Nyolczas, Stefan H Hohnloser
A patient with ischaemic cardiomyopathy received a secondary prevention VVI implantable cardioverter-defibrillator (ICD) after an episode of sustained ventricular tachycardia (VT). Because of recurrent VTs transmitted via CareLink, medical therapy was optimized and VT ablation was performed. Subsequently, a fast VT with a typical short-long-short initiation developed. In addition, there was an increasing need for ventricular pacing due to sinus bradycardia. This new type of VT could be successfully dealt with by upgrading to DDD ICD and activating the Ventricular Rate Stabilization algorithm...
May 31, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28554515/catheter-ablation-of-epicardial-ventricular-tachycardia-from-the-coronary-venous-system-is-endocardial-mapping-always-required
#19
Stéphane Boulé, Gauthier Garret, Zouheir Souissi, Didier Klug
Endocardial mapping is typically considered as the first step of VT ablation procedures. Nevertheless, when the electrocardiogram is highly suggestive of an epicardial VT, a minimally invasive procedure performed exclusively via the coronary sinus might be considered. This straightforward approach avoids all potential complications associated with access to the left ventricular endocardium, the aortic root, and the pericardial space.
May 18, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28546773/successful-bipolar-ablation-for-ventricular-tachycardia-with-potential-substrate-identification-by-pre-procedural-cardiac-magnetic-resonance-imaging
#20
Kazuo Sakamoto, Masatsugu Nozoe, Yoshitomo Tsutsui, Nobuhiro Suematsu, Toru Kubota, Masanori Okabe, Yusuke Yamamoto
Cardiac magnetic resonance imaging (MRI) is a useful tool for detecting the arrhythmogenic substrate in cardiac sarcoidosis. We herein present a case of bipolar radiofrequency catheter ablation for ventricular tachycardia (VT) complicated with cardiac sarcoidosis, guided by pre-procedural cardiac MRI. Neither echocardiography nor endocardial voltage mapping suggested a septal VT substrate. However, MRI alone detected intramural lesions in the septum. Although application of endocardial energy failed to treat the VT, bipolar ablation targeting the potential substrate identified by MRI successfully eliminated the VT...
2017: International Medical Case Reports Journal
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