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https://www.readbyqxmd.com/read/28187168/outcomes-of-ventricular-tachycardia-ablation-in-patients-with-structural-heart-disease-the-impact-of-electrical-storm
#1
Bashar Aldhoon, Dan Wichterle, Petr Peichl, Robert Čihák, Josef Kautzner
AIMS: To investigate predictors of long-term outcomes after catheter ablation (CA) for ventricular tachycardia (VT) and the impact of electrical storm (ES) prior to index ablation procedures. METHODS: We studied consecutive patients with structural heart disease and VT (n = 328; age: 63±12 years; 88% males; 72% ischaemic cardiomyopathy; LVEF: 32±12%) who had undergone CA. According to presenting arrhythmia at baseline, they were divided into ES (n = 93, 28%) and non-ES groups...
2017: PloS One
https://www.readbyqxmd.com/read/28185355/catheter-ablation-of-ventricular-tachycardia-in-patients-with-mitraclip-device-preliminary-findings
#2
Laurent M Haegeli, Giuseppe D'Angelo, Nicola Trevisi, Stefano Stella, Alexander Breitenstein, Firat Duru, Corinna Brunckhorst, Paolo Della Bella
INTRODUCTION: Patients with mitral regurgitation are increasingly treated by percutaneous implantation of a MitraClip device. We investigate the feasibility and safety of the transmitral catheter route for catheter ablation of VT (ventricular tachycardia) in these patients. METHODS: The mitral valve with the MitraClip in situ was crossed under transesophageal three-dimensional echocardiographic and fluoroscopic guidance using a steerable sheath for ablation of the left ventricle...
February 10, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28175981/-catheter-ablation-of-ventricular-extrasystoles-and-ventricular-tachycardia-in-the-elderly
#3
Philipp Halbfaß, Karin Nentwich, Kai Sonne, Elena Ene, Franziska Fochler, Andreas Mügge, Bernhard Schieffer, Thomas Deneke
BACKGROUND: The prevalence of structural heart disease increases with higher age, and thereby the basis for ventricular arrhythmias is created. Catheter ablation has been shown to be an effective therapy option that is very safe and achieves good long-term results in patients with recurrent ventricular tachycardia (VT). Data regarding ablation in patients older than 75 years is sparse, although this patient group was included as a minority in most published VT ablation studies. Data from younger patient collectives may not be transferable to older patient cohorts due to differences in patient comorbidities and baseline characteristics...
February 7, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28167089/alternative-approaches-for-ablation-of-resistant-ventricular-tachycardia
#4
REVIEW
Carola Gianni, Sanghamitra Mohanty, Chintan Trivedi, Luigi Di Biase, Amin Al-Ahmad, Andrea Natale, J David Burkhardt
Ventricular tachycardia (VT) ablation is usually performed with an ablation catheter that delivers unipolar radiofrequency (RF) energy to eliminate the re-entry circuit responsible for VT. However, there are some instances when unipolar RF ablation fails, notably in VTs with a deep intramural origin, or cases in which epicardial access is not attainable due to prior cardiac surgery. To overcome these limitations, several alternative approaches have been used in clinical practice, including alcohol ablation or coil embolization, simultaneous unipolar or bipolar RF ablation, surgical ablation, or noninvasive ablation with stereotactic radiosurgery...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167088/substrate-ablation-of-ventricular-tachycardia-late-potentials-scar-dechanneling-local-abnormal-ventricular-activities-core-isolation-and-homogenization
#5
REVIEW
David F Briceño, Jorge Romero, Carola Gianni, Sanghamitra Mohanty, Pedro A Villablanca, Andrea Natale, Luigi Di Biase
Ventricular arrhythmias are a frequent cause of mortality in patients with ischemic cardiomyopathy and nonischemic cardiomyopathy. Scar-related reentry represents the most common arrhythmia substrate in patients with recurrent episodes of sustained ventricular tachycardia (VT). Initial mapping of scar-related VT circuits is focused on identifying arrhythmogenic tissue. The substrate-based strategies include targeting late potentials, scar dechanneling, local abnormal ventricular activities, core isolation, and homogenization of the scar...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167087/pace-mapping-to-localize-the-critical-isthmus-of-ventricular-tachycardia
#6
REVIEW
Christian de Chillou, Jean-Marc Sellal, Isabelle Magnin-Poull
Most postinfarct ventricular tachycardias (VT) are sustained by a reentrant mechanism. The "protected isthmus" of the reentrant circuit is critical for the maintenance of VTs and the target for catheter ablation. In this article, the authors describe the technique of pace-mapping during sinus rhythm to unmask postinfarct VT isthmuses. A pace-mapping map should be considered as the surrogate of an activation map during VT, in both patients with a normal heart and patients with a structural heart disease. Pace mapping is useful to unmask VT isthmuses in patients with postinfarct reentrant VTs...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167086/entrainment-mapping
#7
REVIEW
Saurabh Kumar, Usha B Tedrow, William G Stevenson
Mapping during ventricular tachycardia (VT) aims to elucidate mechanism, describe myocardial propagation, and identify the origin and critical regions of VT that can be targeted for ablation, most commonly with radiofrequency ablation. Most VTs in structural heart disease are due to macro-reentry in and around scar. A combination of mapping techniques, including mapping to identify the arrhythmia substrate, activation sequence mapping, pace-mapping, and entrainment mapping, may be used to identify putative ablation targets...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167083/ventricular-tachycardia-ablation-clinical-trials
#8
REVIEW
Jackson J Liang, Daniele Muser, Pasquale Santangeli
Catheter ablation is an increasingly used treatment option for patients with ventricular tachycardia (VT) in the setting of structural heart disease. Although there are extensive data from several retrospective studies as well as prospective nonrandomized observational studies, there are limited data from relatively few randomized controlled trials, especially comparing VT ablation with antiarrhythmic drugs. In this review, the authors aim to summarize the major studies examining efficacy of VT ablation in patients with structural heart disease, discuss barriers to enrollment and completion of randomized clinical trials, and propose areas of future research in the field...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167080/epicardial-catheter-ablation-of-ventricular-tachycardia
#9
REVIEW
Arash Aryana, André d'Avila
Over the last two decades, epicardial catheter ablation has evolved into a practical approach for treatment of ventricular tachycardia (VT). There are certain considerations when performing this procedure. First, presence of epicardial fat can diminish peak-to-peak electrogram amplitude and also impede radiofrequency energy delivery. Hence, epicardial VT ablation should be performed with cooled-tip radiofrequency using reduced irrigation flow within a relatively 'dry' pericardial milieu. Furthermore, catheter orientation is key when performing epicardial ablation...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167079/anatomy-for-ventricular-tachycardia-ablation-in-structural-heart-disease
#10
REVIEW
Jason S Bradfield, Kalyanam Shivkumar
Ablation of ventricular tachycardia (VT) in the setting of structural heart disease, previously reserved for highly experienced specialized centers, is being performed at more centers internationally as cardiac electrophysiologists gain advanced training. Interventional cardiac electrophysiologists need a high level of anatomic knowledge to guide a procedure that can carry significant risk. Understanding cardiac anatomy improves the chance of procedural success and also the likelihood of appropriate decision making if complications are encountered...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167078/ablation-of-ventricular-tachycardia-in-congenital-and-infiltrative-heart-disease
#11
REVIEW
Adrianus P Wijnmaalen, Katja Zeppenfeld
Radiofrequency catheter ablation (RFCA) is an important treatment modality to prevent ventricular tachycardia (VT) recurrence in patients with repaired congenital heart disease. Identification and ablation of anatomic isthmuses has improved acute ablation outcome with excellent VT-free survival in those with preserved biventricular function. Reports on RFCA for VT in patients with infiltrative disease are sparse and cardiac sarcoidosis seems to be the most prevalent cause for ventricular arrhythmia. Patients with active and ongoing inflammation are at high risk for VT recurrence...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167077/electrocardiographic-localization-of-ventricular-tachycardia-in-patients-with-structural-heart-disease
#12
REVIEW
John M Miller, Rahul Jain, Gopi Dandamudi, Thomas R Kambur
The 12-lead electrocardiogram (ECG) during ventricular tachycardia (VT) in patients with structural heart disease contains information that helps to narrow the electrophysiologist's search for target sites for ablation. Although replacement of myocardium by scar might be expected to produce variability in the spread of activation during VT, nonetheless reasonably consistent ECG patterns exist that can regionalize exit sites from VT circuits in up to 75% of cases. Most experience with this comes from patients with prior myocardial infarction, but a growing body of data exists concerning patients with nonischemic cardiomyopathies...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28160298/fluoroless-catheter-ablation-of-cardiac-arrhythmias-a-5-year-experience
#13
Mansour Razminia, M Cameron Willoughby, Hany Demo, Hesam Keshmiri, Theodore Wang, Oliver J D'Silva, Terry A Zheutlin, Hakeem Jibawi, Paul Okumale, Richard F Kehoe
BACKGROUND: Catheter ablations have been traditionally performed with the use of fluoroscopic guidance, which exposes the patient and staff to the inherent risks of radiation. We have developed techniques to eliminate the use of fluoroscopy during cardiac ablations and have been performing completely fluoroless catheter ablations on our patients for over 5 years. METHODS: We present a retrospective analysis of the safety, efficacy, and feasibility data from 500 consecutive patients who underwent nonfluoroscopic catheter ablation, targeting a total of 639 arrhythmias, including atrioventricular reciprocating tachycardia (AVRT), atrioventricular nodal reentrant tachycardia (AVNRT), atrial tachycardia (AT), atrial fibrillation (AF), premature ventricular contractions (PVC), and ventricular tachycardia (VT)...
February 3, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28154593/the-role-of-intravenous-dopamine-on-hemodynamic-support-during-radiofrequency-catheter-ablation-of-poorly-tolerated-idiopathic-ventricular-tachycardia
#14
Jinhee Ahn, Dong-Hyeok Kim, Seung-Young Roh, Kwang No Lee, Dae-In Lee, Jaemin Shim, Jong-Il Choi, Young-Hoon Kim
BACKGROUND AND OBJECTIVES: Hemodynamically unstable idiopathic ventricular tachycardias (VTs) are a challenge for activation or entrainment mapping technique. Mechanical circulatory support is an option, but is not always readily available. In this study, we investigated the safety and efficacy of hemodynamic support using intravenous (IV) dopamine solely during radiofrequency catheter ablation (RFCA) of hemodynamically unstable VT. SUBJECTS AND METHODS: Seven out of 86 patients with hemodynamically unstable idiopathic VT underwent de novo RFCA using dopamine in our single center...
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28153106/isolated-subepicardial-right-ventricular-outflow-tract-scar-in-athletes-with-ventricular%C3%A2-tachycardia
#15
Jeroen Venlet, Sebastiaan R D Piers, Jan D H Jongbloed, Alexander F A Androulakis, Yoshihisa Naruse, Dennis W den Uijl, Gijsbert F L Kapel, Marta de Riva, J Peter van Tintelen, Daniela Q C M Barge-Schaapveld, Martin J Schalij, Katja Zeppenfeld
BACKGROUND: High-level endurance training has been associated with right ventricular pathological remodeling and ventricular tachycardia (VT). Although overlap with arrhythmogenic right ventricular cardiomyopathy (ARVC) has been suggested, the arrhythmogenic substrate for VTs in athletes is unknown. OBJECTIVES: The goal of this study was to evaluate whether electroanatomic scar patterns related to sustained VT can distinguish exercise-induced arrhythmogenic remodeling from ARVC and post-inflammatory cardiomyopathies...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28122031/long-term-outcomes-of-radio-frequency-catheter-ablation-on-ventricular-tachycardias-due-to-arrhythmogenic-right-ventricular-cardiomyopathy-a-single-center-experience
#16
Wei Wei, Hongtao Liao, Yumei Xue, Xianhong Fang, Jun Huang, Yang Liu, Hai Deng, Yuanhong Liang, Zili Liao, Fangzhou Liu, Weidong Lin, Xianzhang Zhan, Shulin Wu
AIMS: To summarize our experience of radiofrequency catheter ablation (RFCA) for recurrent drug-refractory ventricular tachycardias (VTs) due to arrhythmogenic right ventricular cardiomyopathy (ARVC) in our center over the past 11 years and its related factors. METHODS AND RESULTS: We reviewed 48 adults (mean age 39.9 ± 12.9 years, range: 14 to 65) who met the present ARVC diagnostic criteria and accepted RFCA for VTs from December 2004 to April 2016. The patients received a total of 70 procedures using two ablation approaches, the endocardial approach in 52 RFCAs, and the combined epicardial and endocardial approach (the combined approach) in 18 RFCAs...
2017: PloS One
https://www.readbyqxmd.com/read/28119381/brain-emboli-after-left-ventricular-endocardial-ablation
#17
Isaac R Whitman, Rachel A Gladstone, Nitish Badhwar, Henry H Hsia, Byron Lee, S Andrew Josephson, Karl M Meisel, William P Dillon, Christopher Hess, Edward P Gerstenfeld, Gregory M Marcus
BACKGROUND: -Catheter ablation for ventricular tachycardia (VT) and premature ventricular complexes (PVCs) is common. Catheter ablation of atrial fibrillation is associated with a risk of cerebral emboli attributed to cardioversions and numerous ablation lesions in the low-flow left atrium, but cerebral embolic risk in ventricular ablation has not been evaluated. METHODS: -We enrolled 18 consecutive patients meeting study criteria scheduled for VT or PVC ablation over a 9-month period...
January 24, 2017: Circulation
https://www.readbyqxmd.com/read/28104088/myocardial-wall-thinning-predicts-transmural-substrate-in-patients-with-scar-related-ventricular-tachycardia
#18
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
#19
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
#20
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/ventricular fibrillation (VT/VF) in patients with Brugada syndrome (BrS). The thermal effect on the pathogenesis of functional substrates in BrS remains unknown. OBJECTIVE: This 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 for drug-refractory ventricular tachyarrhythmias...
January 6, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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