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https://www.readbyqxmd.com/read/28104088/myocardial-wall-thinning-predicts-transmural-substrate-in-patients-with-scar-related-ventricular-tachycardia
#1
Seigo Yamashita, Frédéric Sacher, Darren A Hooks, Benjamin Berte, Jean-Marc Sellal, Antonio Frontera, Nora Al Jefairi, Yuki Komatsu, Sana Amraoui, Arnaud Denis, Nicolas Derval, Maxime Sermesant, François Laurent, Michel Montaudon, Mélèze Hocini, Michel Haïssaguerre, Pierre Jaïs, Hubert Cochet
BACKGROUND: Scar-related ventricular tachycardia (VT) arises from specific substrate according to etiology. OBJECTIVE: The purpose of this study was to evaluate the relationship between wall thinning (WT) on multidetector computed tomography (MDCT) and local abnormal ventricular activity (LAVA) in patients with ischemic cardiomyopathy (ICM), postmyocarditis (PMC), and dilated cardiomyopathy (DCM). METHODS: Forty-two patients (40 male, age 58 ± 13 years, 22 ICM, 11 PMC, 9 DCM) underwent MDCT before a combined endo-/epicardial VT ablation procedure...
February 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28069835/multielectrode-vs-point-by-point-mapping-for-ventricular-tachycardia-substrate-ablation-a-randomized-study
#2
Juan Acosta, Diego Penela, David Andreu, Mario Cabrera, Alicia Carlosena, Francesca Vassanelli, Francisco Alarcón, David Soto-Iglesias, Viatcheslav Korshunov, Roger Borras, Markus Linhart, Mikel Martínez, Juan Fernández-Armenta, Lluis Mont, Antonio Berruezo
AIMS: Ventricular tachycardia (VT) substrate ablation is based on detailed electroanatomical maps (EAM). This study analyses whether high-density multielectrode mapping (MEM) is superior to conventional point-by-point mapping (PPM) in guiding VT substrate ablation procedures. METHODS AND RESULTS: This was a randomized controlled study (NCT02083016). Twenty consecutive ischemic patients undergoing VT substrate ablation were randomized to either group A [n = 10; substrate mapping performed first by PPM (Navistar) and secondly by MEM (PentaRay) ablation guided by PPM] or group B [n = 10; substrate mapping performed first by MEM and second by PPM ablation guided by MEM]...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28065832/a-novel-method-to-enhance-phenotype-epicardial-functional-substrates-and-ventricular-tachyarrhythmias-in-brugada-syndrome
#3
Fa-Po Chung, Sunu Budhi Raharjo, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Chin-Yu Lin, Yao-Ting Chang, Yuan Hung, Abigail Te, Shinya Yamada, Hiroshi Tasaka, Shih-Ann Chen, Chin-Tien Wang
BACKGROUND: Fever is associated with the manifestation of Brugada phenotype and ventricular tachycardia/fibrillation (VT/VF) in patients with Brugada syndrome (BrS). The thermal effect on the pathogenesis of functional substrates in BrS remains unknown. OBJECTIVE: The study aimed to elucidate the thermal effect on BrS phenotype, VT/VF, and electrophysiological characteristics of epicardial functional substrates in BrS. METHODS: We consecutively studied 15 patients with BrS receiving radiofrequency catheter ablation (RFCA) for drug-refractory ventricular tachyarrhythmias...
January 5, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28064433/magnetic-vt-study-a-prospective-multicenter-post-market-randomized-controlled-trial-comparing-vt-ablation-outcomes-using-remote-magnetic-navigation-guided-substrate-mapping-and-ablation-versus-manual-approach-in-a-low-lvef-population
#4
Luigi Di Biase, Roderick Tung, Tamás Szili-Torok, J David Burkhardt, Peter Weiss, Rene Tavernier, Adam E Berman, Erik Wissner, William Spear, Xu Chen, Petr Neužil, Jan Skoda, Dhanunjaya Lakkireddy, Bruno Schwagten, Ken Lock, Andrea Natale
PURPOSE: Patients with ischemic cardiomyopathy (ICM) are prone to scar-related ventricular tachycardia (VT). The success of VT ablation depends on accurate arrhythmogenic substrate localization, followed by optimal delivery of energy provided by constant electrode-tissue contact. Current manual and remote magnetic navigation (RMN)-guided ablation strategies aim to identify a reentry circuit and to target a critical isthmus through activation and entrainment mapping during ongoing tachycardia...
January 7, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28054710/atypical-surface-ecg-complicating-the-diagnosis-of-bundle-branch-reentry-tachycardia
#5
Christopher Reithmann, Bernhard Herkommer, Thomas Remp, Michael Fiek
BACKGROUND: Typical left bundle branch block (LBBB) during ventricular tachycardia (VT) is a diagnostic criterion of bundle branch reentry tachycardia (BBRT) with activation of the right bundle in the anterograde direction. METHODS AND RESULTS: 11 patients (7 male, 60 ± 12 years) with non-ischemic cardiomyopathy (left ventricular ejection fraction 37 ± 16 %) presenting with BBRT were successfully treated by ablation of the right bundle. Among them, 5 patients had atypical surface ECGs differing from a typical left bundle branch block during the VT...
January 5, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28019045/autonomic-modulation-for-the-treatment-of-ventricular-arrhythmias-therapeutic-use-of-percutaneous-stellate-ganglion-blocks
#6
Marat Fudim, Richard Boortz-Marx, Chetan B Patel, Albert Y Sun, Jonathan P Piccini
Ventricular tachycardia (VT), ventricular fibrillation (VF) and electrical storm are commonly encountered emergency conditions in cardiac and surgical intensive care units. In most cases, recurrent ventricular arrhythmias or electrical storm are associated with a heightened sympathetic tone. These arrhythmias can be difficult to treat and may be refractory to beta-blockade, antiarrhythmic therapy, sedation, and mechanical hemodynamic support. While monomorphic ventricular tachycardia and PVC-triggered polymorphic ventricular tachycardia may sometimes be amenable to successful ablation, some patients may be too critically ill to make such an approach feasible...
December 26, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28017938/elucidation-of-hidden-slow-conduction-by-double-ventricular-extrastimuli-a-method-for-further-arrhythmic-substrate-identification-in-ventricular-tachycardia-ablation-procedures
#7
Juan Acosta, David Andreu, Diego Penela, Mario Cabrera, Alicia Carlosena, Viatcheslav Korshunov, Francesca Vassanelli, Roger Borras, Mikel Martínez, Juan Fernández-Armenta, Markus Linhart, José M Tolosana, Lluis Mont, Antonio Berruezo
AIMS: Identification of local abnormal electrograms (EGMs) during ventricular tachycardia substrate ablation (VTSA) is challenging when they are hidden within the far-field signal. This study analyses whether the response to a double ventricular extrastimulus during substrate mapping could identify slow conducting areas that are hidden during sinus rhythm. METHODS AND RESULTS: Consecutive patients (n = 37) undergoing VTSA were prospectively included. Bipolar EGMs with >3 deflections and duration <133 ms were considered as potential hidden slow conduction EGMs (HSC-EGM) if located within/surrounding the scar area...
December 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28017936/catheter-ablation-reduces-ventricular-tachycardia-burden-in-patients-with-arrhythmogenic-right-ventricular-cardiomyopathy-insights-from-a-north-western-french-multicentre-registry
#8
Zouheir Souissi, Stéphane Boulé, Jean-Sylvain Hermida, Alexandre Doucy, Philippe Mabo, Dominique Pavin, Frédéric Anselme, Nathanaël Auquier, Sandro Ninni, Augustin Coisne, François Brigadeau, Valérie Deken-Delannoy, Didier Klug, Dominique Lacroix
AIMS: Studies assessing radiofrequency ablation (RFA) of ventricular tachycardia (VT) in arrhythmogenic right ventricular cardiomyopathy (ARVC) report VT recurrences, but have not evaluated the impact of RFA on relevant clinical events during follow-up. We aimed to investigate relevant RFA outcomes in a multicentric registry. METHODS AND RESULTS: This study included 49 patients with ARVC (46 with definite diagnosis, 3 with borderline diagnosis according to revised Task Force Criteria) who underwent 92 RFA procedures (83 endocardial, 9 combined endo-epicardial) between 1999-2015...
December 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27974359/safety-and-mid-term-outcome-of-catheter-ablation-of-ventricular-tachycardia-in-octogenarians
#9
Antonio Frontera, Sandeep Panniker, Alexander Breitenstein, Vito Domenico Bruno, Georgia May Connolly, David Wilson, Teresa Rio, Mehul B Dhinoja, Wajid Hussain, Richard J Schilling, Glyn Thomas, Tom Wong, Ross J Hunter, Frederic Sacher, Pierre Jaïs, Edward Duncan
AIMS: Radiofrequency (RF) catheter ablation (CA) is superior to standard medical therapy in controlling recurrent ventricular tachycardia (VT). The majority of procedures have been performed in a middle-aged population. The outcome of VT ablation in the elderly has not been described. METHODS AND RESULTS: We retrospectively studied the outcome and safety of CA of VT in octogenarians performed in four European centres. The population consisted of patients presenting with recurrent VT refractory to medical therapy...
November 9, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27968777/noninvasive-epicardial-and-endocardial-electrocardiographic-imaging-of-scar-related-ventricular-tachycardia
#10
Linwei Wang, Omar A Gharbia, B Milan Horáček, John L Sapp
BACKGROUND: The majority of life-threatening ventricular tachycardias (VTs) are sustained by heterogeneous scar substrates with narrow strands of surviving tissue. An effective treatment for scar-related VT is to modify the underlying scar substrate by catheter ablation. If activation sequence and entrainment mapping can be performed during sustained VT, the exit and isthmus of the circuit can often be identified. However, with invasive catheter mapping, only monomorphic VT that is hemodynamically stable can be mapped in this manner...
November 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27943299/a-non-fluoroscopic-technique-for-coronary-arteries-three-dimensional-mapping-during-epicardial-ventricular-tachycardia-ablation
#11
Vittorio Calzolari, Gaetano Barbato, Martino Crosato, Luca DE Mattia, Alessandro Daniotti, Stefano Indiani, Paolo Antonio Maria Squasi, Zoran Olivari
When performing epicardial ablation of ventricular tachycardia (VT) caution must be taken not to damage the coronary arteries. We report a case in which a new, non-fluoroscopic technique for incorporating an accurate, real-time reconstruction of the main coronary vessels into a three-dimensional electro-anatomic map was used for epicardial VT ablation. This article is protected by copyright. All rights reserved.
December 10, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27943113/significance-and-clinical-characteristics-of-atrial-fibrillation-post-epicardial-access
#12
Alan Sugrue, Ammar M Killu, David O Hodge, Christopher J McLeod, Thomas M Munger, Siva K Mulpuru, Douglas L Packer, Suraj Kapa, Samuel J Asirvatham, Paul A Friedman
INTRODUCTION: Epicardial access (EpiAcc) has become an important adjunct for ventricular tachycardia (VT) or premature ventricular complex (PVC) ablation. We hypothesized that post-procedural pericarditis may lead to an increased risk of atrial fibrillation (AF), and therefore assessed the incidence and clinical impact of post-procedural AF in patients undergoing EpiAcc. METHODS: We reviewed the records of all patients who underwent EpiAcc as part of an ablation procedure between January 1, 2004 and July 31, 2014 at Mayo Clinic Rochester...
December 9, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27932426/extracorporeal-membrane-oxygenation-for-hemodynamic-support-of-ventricular-tachycardia-ablation
#13
Francesca Baratto, Federico Pappalardo, Teresa Oloriz, Caterina Bisceglia, Pasquale Vergara, John Silberbauer, Nicolò Albanese, Manuela Cireddu, Giuseppe D'Angelo, Ambra Licia Di Prima, Fabrizio Monaco, Gabriele Paglino, Andrea Radinovic, Damiano Regazzoli, Simona Silvetti, Nicola Trevisi, Alberto Zangrillo, Paolo Della Bella
BACKGROUND: We report the experience in a cohort of consecutive patients receiving extracorporeal membrane oxygenation during catheter ablation of unstable ventricular tachycardia (VT) at our center. METHODS AND RESULTS: From 2010 to 2015, extracorporeal membrane oxygenation was initiated in 64 patients (average age: 63±15 years; left ventricular ejection fraction in 27±9%; cardiogenic shock in 23%, and electrical storm in 62% of patients) undergoing 74 unstable VT catheter ablation procedures...
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27923805/prognostic-impact-of-the-timing-of-recurrence-of-infarct-related-ventricular-tachycardia-after-catheter-ablation
#14
Konstantinos C Siontis, Hyungjin Myra Kim, William G Stevenson, Akira Fujii, Paolo Della Bella, Pasquale Vergara, Kalyanam Shivkumar, Roderick Tung, Duc H Do, Emile G Daoud, Toshimasa Okabe, Katja Zeppenfeld, Marta de Riva Silva, Gerhard Hindricks, Arash Arya, Alexander Weber, Karl-Heinz Kuck, Andreas Metzner, Shibu Mathew, Johannes Riedl, Miki Yokokawa, Krit Jongnarangsin, Rakesh Latchamsetty, Fred Morady, Frank M Bogun
BACKGROUND: Recurrence of ventricular tachycardia (VT) after ablation in patients with previous myocardial infarction is associated with adverse prognosis. However, the impact of the timing of VT recurrence on outcomes is unclear. METHODS AND RESULTS: We analyzed data from a multicenter collaborative database of patients who underwent catheter ablation for infarct-related VT. Multivariable Cox regression analyses investigated the effect of the timing of VT recurrence on the composite outcome of death or heart transplantation using VT recurrence as a time-varying covariate...
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27920830/impact-of-catheter-ablation-of-ventricular-tachycardia-in-patients-with-prior-myocardial-infarctions
#15
Masato Fukunaga, Masahiko Goya, Kenichi Hiroshima, Kentaro Hayashi, Masatsugu Ohe, Yu Makihara, Michio Nagashima, Yoshimori An, Shinichi Shirai, Kenji Ando, Hiroyoshi Yokoi, Masashi Iwabuchi
BACKGROUND: Catheter ablation can reduce episodes of ventricular tachycardia (VT) after myocardial infarction (MI). However, the optimal endpoint of the ablation procedure remains unclear. METHODS: Fifty-one consecutive patients who received catheter ablation for VT after MI were included. The procedures targeted the isthmus of all the induced, sustained VTs. When the patients with induced VTs were hemodynamically stable, radiofrequency energy was delivered at the mid-diastolic potential recording site during VT...
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27913399/development-of-time-and-voltage-domain-mapping-v-t-mapping-to-localize-ventricular-tachycardia-channels-during-sinus-rhythm
#16
Sachin Nayyar, Pawel Kuklik, Anand N Ganesan, Thomas R Sullivan, Lauren Wilson, Glenn D Young, Prashanthan Sanders, Kurt C Roberts-Thomson
BACKGROUND: In ventricular scar, impulse spread is slow because it traverses split and zigzag channels of surviving muscle. We aimed to evaluate scar electrograms to determine their local delay (activation time) and inequality in voltage splitting (entropy), and their relationship to channels. We reasoned that unlike innocuous channels, which are often short with multiple side branches, ventricular tachycardia (VT) supporting channels have very slow impulse spread and possess low entropy because of their longer protected length and relative lack of side-branching...
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27907904/a-new-cryoenergy-for-ventricular-tachycardia-ablation-a-proof-of-concept-study
#17
Benjamin Berte, Frédéric Sacher, Jean-Yves Wielandts, Saagar Mahida, Xavier Pillois, Rukshen Weerasooriya, Olivier Bernus, Pierre Jaïs
INTRODUCTION: Lack of transmural lesion formation during radiofrequency (RF) ablation for ventricular tachycardia (VT) is an important determinant of arrhythmia recurrence. The aim of this proof-of-concept study was to evaluate safety and efficacy of a new and more powerful cryoablation system for ventricular ablation. METHODS AND RESULTS: Five healthy female sheep (59 ± 6 kg) underwent a surgical sternotomy for epicardial and endocardial access [endocardial access via right atrial appendage and left ventricular (LV) apex]...
October 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27900527/should-all-patients-with-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy-undergo-epicardial-catheter-ablation
#18
Andreas Müssigbrodt, Elena Efimova, Helge Knopp, Livio Bertagnolli, Nikolaos Dagres, Sergio Richter, Daniela Husser, Andreas Bollmann, Gerhard Hindricks, Arash Arya
BACKGROUND: Epicardial radiofrequency catheter ablation is currently considered as the therapeutic option of choice in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and recurrent ventricular tachycardia (VT). We hypothesised that inducibility of VT may guide the ablation strategy and thereby affect long-term results. Additional epicardial ablation was only performed if VT were still inducible after thorough endocardial ablation. METHODS: The objective was to examine an inducibility-guided ablation approach by comparing the long-term results between endocardial and epi-endocardial radiofrequency catheter ablation of VT in a large cohort of patients with ARVD/C...
November 30, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27899863/left-ventricular-perforation-due-to-radiofrequency-catheter-ablation-for-incessant-ventricular-tachycardia-in-a-post-myocardial-infarction-patient
#19
Ahmet Öz, Mehmet Bozbay, Emrah Bozbeyoğlu, Mert İlker Hayıroğlu, Burcu Akyol, Ahmet Taha Alper, Ahmet İlker Tekkeşin, Özlem Yıldırımtürk, Mehmet Eren, Seçkin Pehlivanoğlu
Left ventricular (LV) myocardial perforation is a rare complication following ventricular tachycardia (VT) ablation with radiofrequency (RF); this complication should be diagnosed and treated promptly. LV free wall rupture after elective RF ablation for sustained VT refractory to medical treatment is rarely reported in the medical literature. Herein we discuss an interesting case which contributes to the ongoing literature, regarding a patient who developed LV perforation due to RF ablation for VT which was resistant to pharmacotherapy and repeated cardioversion attempts after acute myocardial infarction...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27890738/ventricular-arrhythmias-associated-with-left-ventricular-noncompaction-electrophysiologic-characteristics-mapping-and-ablation
#20
Daniele Muser, Jackson J Liang, Walter Rt Witschey, Rajeev K Pathak, Simon Castro, Silvia Magnani, Erica S Zado, Fermin C Garcia, Benoit Desjardins, David J Callans, David S Frankel, Francis E Marchlinski, Pasquale Santangeli
BACKGROUND: Left ventricular noncompaction (LVNC) is a primary cardiomyopathy that can present with recurrent ventricular arrhythmias (VAs). Data on the benefit of catheter ablation of VAs in LVNC are lacking. OBJECTIVE: The purpose of this study was to describe the electrophysiologic features and outcomes of catheter ablation of VAs in LVNC. METHODS: The cohort consisted of 9 patients (age 42 ± 15 years) with diagnosis of LVNC based on established criteria and VA (ventricular tachycardia [VT] in 3 and frequent premature ventricular contractions (PVCs) in 6) despite treatment with a mean of 2 ± 1 antiarrhythmic drugs...
November 24, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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