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https://www.readbyqxmd.com/read/28329292/surgical-septal-myectomy-or-alcohol-septal-ablation-which-approach-offers-better-outcomes-for-patients-with-hypertrophic-obstructive-cardiomyopathy
#1
Shi Sum Poon, Mark Field, Dhiraj Gupta, Duke Cameron
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether surgical septal myectomy (SM) is more beneficial than alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy. Altogether 218 articles were found using the reported search, of which 15 studies represented the best evidence to answer the clinical question. There were 14 observational studies and 1 meta-analysis study. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these articles are tabulated...
February 28, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28292752/fascicular-ventricular-tachycardia-originating-from-papillary-muscles-purkinje-network-involvement-in-the-reentrant-circuit
#2
Yuki Komatsu, Akihiko Nogami, Kenji Kurosaki, Itsuro Morishima, Keita Masuda, Tomoya Ozawa, Takashi Kaneshiro, Yuichi Hanaki, Yasutoshi Shinoda, Ahmed Karim Talib, Shinya Kowase, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: Verapamil-sensitive fascicular ventricular tachycardia (FVT) has been demonstrated to be a reentrant mechanism using the Purkinje network as a part of its reentrant circuit. Although the papillary muscles (PMs) are implicated in arrhythmogenic structure, reentrant FVT originating from the PMs has not been well defined. METHODS AND RESULTS: We studied 13 patients in whom FVT was successfully eliminated by ablation at the posterior PMs (n=8; PPM-FVT) and anterior PMs (n=5; APM-FVT)...
March 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28286902/catch-22-a-case-of-incessant-ventricular-tachycardia-post-left-ventricular-assist-device-resulting-in-right-ventricular-failure-left-ventricular-cavity-obliteration-and-failure-of-endocardial-ventricular-tachycardia-ablation
#3
Amit J Thosani, Stephen H Bailey, Amresh Raina
Ventricular tachycardia (VT) in the setting of left ventricular assist device (LVAD) therapy has been well described. We present a case of incessant ventricular tachycardia resulting in severe right ventricular (RV) failure and subsequent left ventricular (LV) cavity obliteration, which in turn diminished the feasibility of initial attempt at VT ablation.
March 12, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28282453/the-use-of-a-novel-signal-analysis-to-identify-the-origin-of-idiopathic-right-ventricular-outflow-tract-ventricular-tachycardia-during-sinus-rhythm-simultaneous-amplitude-frequency-electrogram-transformation-mapping
#4
Abigail Louise D Te, Satoshi Higa, Fa-Po Chung, Chin-Yu Lin, Men-Tzung Lo, Che-An Liu, Chen Lin, Yi-Chung Chang, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jonan Liao, Yao-Ting Chang, Chung-Hsing Lin, Yuan Hung, Shinya Yamada, Kuo-Li Pan, Yenn-Jiang Lin, Shih-Ann Chen
INTRODUCTION: The signal characteristics of intracardiac bipolar electrograms at the origin of idiopathic RVOT-VT during sinus rhythm remain unclear. OBJECTIVE: The study sought to develop a novel real-time/online technique, simultaneous amplitude frequency electrogram transformation (SAFE-T), to quantify and localize the diseased ventricular substrate in idiopathic RVOT-VT. METHODS: We retrospectively investigated the intracardiac bipolar recordings in 70 consecutive patients (26% male, mean age 42±12 years) who underwent successful radiofrequency catheter ablation of idiopathic RVOT-VT...
2017: PloS One
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#5
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28267588/initial-international-multicenter-human-experience-with-a-novel-epicardial-access-needle-embedded-with-a-real-time-pressure-frequency-monitoring-to-facilitate-epicardial-access-feasibility-and-safety
#6
Luigi Di Biase, J David Burkhardt, Vivek Reddy, Jorge Romero, Petr Neuzil, Jan Petru, Lucie Sadiva, Jan Skoda, Miguel Ventura, Corrado Carbucicchio, Antonio Dello Russo, Zoltan Csanadi, Michela Casella, Gaetano M Fassini, Claudio Tondo, Frederic Sacher, Mike Theran, Srinivas Dukkipati, Jacob Koruth, Pierre Jais, Andrea Natale
BACKGROUD: Epicardial ablation is often necessary for the treatment of complex arrhythmias refractory to endocardial ablation. Conventional needle access into the pericardial space is considered quite challenging, and it is often associated with several potential complications particularly inadvertent right ventricular puncture. The novel EpiAccess Needle tip is embedded with a pressure sensor able to report the pressure waveform in real time when used with the EpiAccess System. OBJECTIVE: We evaluated the feasibility and safety of the EpiAccess®System by EpiEP, Inc...
March 3, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28238349/long-term-outcome-of-catheter-ablation-for-left-posterior-fascicular-ventricular-tachycardia-with-the-development-of-left-posterior-fascicular-block-and-characteristics-of-repeat-procedures
#7
Bin Luo, Gongbu Zhou, Xiaogang Guo, Xu Liu, Jiandu Yang, Qi Sun, Jian Ma, Shu Zhang
OBJECTIVE: The present study aimed to retrospectively investigate long-term clinical outcomes of patients undergoing catheter ablation of left posterior fascicular ventricular tachycardia (LPF-VT) with the development of left posterior fascicular block (LPF block) and characteristics of repeat procedures. METHODS AND RESULTS: A total of 195 patients (mean age 29.76±1.03years, 16.4% females) who underwent catheter ablation for LPF-VT were consecutively enrolled...
February 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28236155/cardiac-magnetic-resonance-imaging-and-electroanatomic-voltage-discordance-in-non-ischemic-left-ventricle-ventricular-tachycardia-and-premature-ventricular-depolarizations
#8
Brian P Betensky, Wei Dong, Benjamin A D'Souza, Erica S Zado, Yuchi Han, Francis E Marchlinski
PURPOSE: Magnetic resonance imaging (MRI) with late gadolinium enhancement is commonly performed in patients with non-ischemic LV ventricular tachycardia/ventricular premature depolarizations (non-ischemic LV-VT/VPDs) to define VT substrate prior to catheter ablation. We investigated the prevalence of abnormal voltage and VT localized to areas of the myocardium not reported to have late gadolinium enhancement (LGE) on routine pre-procedural MRI and sought to determine if quantitative MRI analysis could reduce this discordance...
February 24, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28229198/-catheter-ablation-of-ventricular-tachycardia-what-have-we-achieved
#9
T Konrad, B A Hoffmann, T Rostock
The role of catheter ablation in patients with ventricular tachycardia (VT) has evolved over the last two decades into an established treatment option. In patients with idiopathic VT catheter ablation is the gold standard treatment option with high effectiveness and low risk of complications. Due to the high risk of side effects the use of antiarrhythmic drugs is only indicated in exceptional cases. In patients with structural heart diseases, such as ischemic and dilated cardiomyopathy, VT is the most frequent cause of death...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28217232/successful-percutaneous-epicardial-catheter-ablation-of-ventricular-tachycardia-arising-from-the-crux-of-the-heart-in-a-patient-with-prior-coronary-artery-bypass-grafting
#10
Naoki Yoshida, Takumi Yamada
A 63-year-old man with a history of remote inferior myocardial infarction and coronary artery bypass grafting (CABG) underwent catheter ablation of ventricular tachycardia (VT). Epicardial catheter ablation of the VT was successful at the crux of the heart despite limited mapping within the pericardial space due to pericardial adhesion. Percutaneous subxiphoidal pericardial approach is usually impossible in patients with a history of open heart surgery due to pericardial adhesions. This report suggested that epicardial VT arising from the crux of the heart could be successfully treated by catheter ablation via subxiphoidal pericardial approach despite pericardial adhesions complicated by prior CABG...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28187168/outcomes-of-ventricular-tachycardia-ablation-in-patients-with-structural-heart-disease-the-impact-of-electrical-storm
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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