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https://www.readbyqxmd.com/read/28802656/rethinking-papillary-muscle-resection-for-refractory-ventricular-tachycardia-in-the-lvad-era-a-case-report
#1
Zachary J Il'Giovine, Adam D DeVore, Chetan B Patel, Jason Koontz, Jacob Schroder
We report the case of a 57-year-old man with a history of ischemic cardiomyopathy who presented to the hospital with recurrent episodes of ventricular tachycardia refractory to antiarrhythmic medications. Mapping identified a deep premature ventricular contraction focus in the anterolateral papillary muscle, an area that has been previously identified as difficult to treat with radiofrequency catheter ablation. The hospital course was complicated by cardiogenic shock and VT-storm, and the patient ultimately underwent surgical resection of the anterolateral papillary muscle with left ventricular assist device placement as a successful bridge to cardiac transplantation...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28800178/outcomes-of-catheter-ablation-of-ventricular-tachycardia-with-mechanical-hemodynamic-support-an-analysis-of-the-medicare-database
#2
Arash Aryana, André d'Avila, Christina L Cool, Marc A Miller, Fermin C Garcia, Gregory E Supple, Srinivas R Dukkipati, Dhanunjaya Lakkireddy, T Jared Bunch, Mark R Bowers, Padraig Gearoid O'Neill, Vivek Y Reddy, Francis E Marchlinski
INTRODUCTION: There is a paucity of data in favor of mechanical support during catheter ablation of ventricular tachycardia (VT). This study investigated the outcomes of VT ablation associated with mechanical support using percutaneous ventricular assist device (PVAD) versus intra-aortic balloon pump (IABP). METHODS AND RESULTS: We retrospectively examined the outcomes of patients who underwent VT ablation associated with PVAD versus IABP from 2010-2013, captured by the Medicare Inpatient Standard Analytic File database...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28771538/a-novel-noninvasive-surface-ecg-analysis-using-interlead-qrs-dispersion-in-arrhythmogenic-right-ventricular-cardiomyopathy
#3
Wan-Hsin Hsieh, Chin-Yu Lin, Abigail Louise D Te, Men-Tzung Lo, Cheng-I Wu, Fa-Po Chung, Yi-Chung Chang, Shih-Lin Chang, Chen Lin, Li-Wei Lo, Yu-Feng Hu, Jo-Nan Liao, Yun-Yu Chen, Shih-Jie Jhuo, Sunu Budhi Raharjo, Yenn-Jiang Lin, Shih-Ann Chen
BACKGROUND: This study investigated the feasibility of using the precordial surface ECG lead interlead QRS dispersion (IQRSD) in the identification of abnormal ventricular substrate in arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS: Seventy-one consecutive patients were enrolled and reclassified into 4 groups: definite ARVC with epicardial ablation (Group 1), ARVC with ventricular tachycardia (VT, Group 2), idiopathic right ventricular outflow tract VT without ARVC (Group 3), and controls without VT (Group 4)...
2017: PloS One
https://www.readbyqxmd.com/read/28770255/massive-accumulation-of-myofibroblasts-in%C3%A2-the-critical-isthmus-is-associated-with%C3%A2-ventricular-tachycardia-inducibility-in%C3%A2-post-infarct-swine-heart
#4
Tarvinder S Dhanjal, Nicolas Lellouche, Christopher J von Ruhland, Guillaume Abehsira, David H Edwards, Jean-Luc Dubois-Randé, Konstantinos Moschonas, Emmanuel Teiger, Alan J Williams, Christopher H George
OBJECTIVES: In this study the authors determined the extent of cellular infiltration and dispersion, and regional vascularization in electrophysiologically (EP) defined zones in post-myocardial infarction (MI) swine ventricle. BACKGROUND: The critical isthmus (CI) in post-MI re-entrant ventricular tachycardia (VT) is a target for catheter ablation. In vitro evidence suggests that myofibroblasts (MFB) within the scar border zone (BZ) may increase the susceptibility to slow conduction and VT, but whether this occurs in vivo remains unproven...
July 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28767385/left-anterior-descending-coronary-artery-dissection-during-ventricular-tachycardia-ablation-case-report
#5
Kordic Kresimir, Manola Sime, Zeljkovic Ivan, Benko Ivica, Pavlovic Nikola
Fascicular left ventricular tachycardia (VT) is the second most frequent idiopathic left VT in the setting of a structurally normal heart. Catheter ablation is curative in most patients with low complication rates. We report a case of ostial left anterior descending coronary artery (LAD) occlusion during fascicular ventricular tachycardia ablation. Dissection was the most likely cause of LAD obstruction. To the authors' best knowledge, this is the first case reporting selective LAD dissection during electrophysiology study with no left main coronary artery (LMCA) affection...
July 26, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28760258/cardiac-magnetic-resonance-aided-scar-dechanneling-influence-on-acute-and-long-term-outcomes
#6
David Andreu, Diego Penela, Juan Acosta, Juan Fernández-Armenta, Rosario J Perea, David Soto-Iglesias, Teresa M de Caralt, Jose T Ortiz-Perez, Susana Prat-González, Roger Borràs, Eduard Guasch, Jose María Tolosana, Lluis Mont, Antonio Berruezo
BACKGROUND: Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) provides tissue characterization of ventricular myocardium and scar that can be depicted as pixel signal intensity (PSI) maps. OBJECTIVE: To assess the possible benefit of guiding the ventricular tachycardia (VT) substrate mapping by integrating these PSI maps into the navigation system. METHODS: In total, 159 consecutive patients (66 ± 11 years old, 151 men [95%]) with scar-related left ventricular (LV) VT were included...
August 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28752279/ablative-radiotherapy-as-a-noninvasive-alternative-to-catheter-ablation-for-cardiac-arrhythmias
#7
REVIEW
Paul C Zei, Scott Soltys
PURPOSE OF REVIEW: Stereotactic radioablation is a commonly utilized technology to noninvasively treat solid tumors with precision and efficacy. Using a robotic arm mounted delivery system, multiple low-dose ionizing radiation beams are delivered from multiple angles, concentrating ablative energy at the target tissue. Recently, this technology has been evaluated for treatment of cardiac arrhythmias. This review will present the basic underlying principles, proof-of-principle studies, and clinical experience with stereotactic arrhythmia radioablation...
September 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28749010/radiofrequency-ablation-of-fast-ventricular-tachycardia-causing-an-icd-storm-in-an-infant-with-hypertrophic-cardiomyopathy
#8
Yakup Ergul, Isa Ozyilmaz, Meki Bilici, Erkut Ozturk, Sertaç Haydin, Alper Guzeltas
An implantable cardioverter defibrillator (ICD) storm involves very frequent arrhythmia episodes and ICD shocks, and it is associated with poor short-term and long-term prognosis. Radiofrequency catheter ablation (RFCA) can be used as an effective rescue treatment for patients with an ICD storm. To our knowledge, this is the first report of an infant with HCM presenting with an ICD storm and undergoing successful radiofrequency catheter ablation salvage treatment for the fast left posterior fascicular VT. This article is protected by copyright...
July 27, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28744991/utility-of-high-density-multielectrode-mapping-during-ablation-of-scar-related-ventricular-tachycardia
#9
Óscar Cano, Diego Plaza, Assumpció Saurí, Joaquín Osca, Pau Alonso, Ana Andrés, María-José Sancho-Tello, Luis Martínez-Dolz
INTRODUCTION: Multielectrode mapping catheters (MEMC) allow the performance of high resolution and density maps but the utility of these catheters in ventricular tachycardia (VT) ablation procedures has not been yet widely described. We sought to evaluate the utility of a MEMC during scar-related VT ablation procedures. METHODS: 85 consecutive scar-related VT ablation procedures were performed in 81 patients. In the first 26 procedures, a standard 3.5 mm tip linear catheter was employed for endocardial/epicardial mapping (control group)...
July 26, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28744873/epicardial-ablation-of-tachyarrhythmia-in-children-experience-at-two-academic-centers
#10
Shailendra Upadhyay, Edward P Walsh, Frank Cecchin, John K Triedman, Juan Villafane, J Philip Saul
BACKGROUND: Experience with percutaneous epicardial ablation of tachyarrhythmia in pediatrics is limited. This case series addresses the feasibility, safety and complications of the procedure in children. METHODS: A total of 9 patients underwent 10 epicardial ablation procedures from 2002 to 2013 at two academic centers. Activation mapping was performed in all cases, and electro-anatomic map was utilized in 9 of the 10 procedures. Patients had undergone 1-3 failed endocardial catheter ablations in addition to medical management, and all had symptoms, a high-risk accessory pathway (AP), aborted cardiac arrest with Wolff-Parkinson-White syndrome (WPW) or ventricular dysfunction...
July 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28744864/impact-of-timing-of-recurrence-following-catheter-ablation-of-scar-related-ventricular-tachycardia-on-subsequent-mortality
#11
Daniele Muser, Todd Mendelson, Joe Fahed, Jackson J Liang, Simon A Castro, Erica Zado, Francis E Marchlinski, Pasquale Santangeli
BACKGROUND: Catheter ablation (CA) has an established role in scar-related ventricular tachycardia (VT), but the risk of recurrences is substantial and the appropriate intensity of post-ablation monitoring unknown. The implication of timing of post-ablation VT recurrence has not been adequately investigated. METHODS: We studied 120 consecutive patients with scar-related VT (age 60±15 years, LVEF 39±16%, 52% ischemic etiology) with at least 2-years of follow-up...
July 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28727191/anterior-pericardial-access-to-facilitate-electrophysiology-study-and-catheter-ablation-of-ventricular-arrhythmias-a-single-tertiary-center-experience
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
September 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
#19
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
#20
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
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