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cusp ablation

Oholi Tovia-Brodie, Bernard Belhassen, Aharon Glick, Haim Shmilovich, Galit Aviram, Raphael Rosso, Yoav Michowitz
INTRODUCTION: A new imaging software (CARTO® Segmentation Module, Biosense Webster) allows pre-procedural 3-D reconstruction of all heart chambers based on cardiac CT. We describe our initial experience with the new module during ablation of ventricular arrhythmias. METHODS AND RESULTS: Eighteen consecutive patients with idiopathic ventricular arrhythmias or ischemic ventricular tachycardia (VT) were studied. In the latter group, a combined endocardial and epicardial ablation was performed...
October 20, 2016: Journal of Cardiovascular Electrophysiology
Ivo Roca, Nuria Rivas, Jaume Francisco, Jordi Perez, Gabriel Acosta, Gerard Oristrell, Maria Terricabres, David Garcia-Dorado, Angel Moya
BACKGROUND: Ablation in aortic cusps could be necessary in up to 15% of the patients, especially in para-Hisian atrial tachycardia and ventricular arrhythmias arising from outflow tracts. Risk of coronary damage has led to recommendation of systematic coronary angiography (CA) during the procedure. Other image tests as intravascular (ICE) or transesophageal echocardiography (TEE) have been proposed. Both methods have limitations: additional vascular access for ICE and needing for additional CA in some patients in case of TEE...
October 19, 2016: Journal of Cardiovascular Electrophysiology
Takumi Yamada, Harish Doppalapudi, Silvio H Litovsky, H Thomas McElderry, G Neal Kay
BACKGROUND: Radiofrequency catheter ablation (RFCA) of idiopathic ventricular arrhythmias (VAs) originating from the basal portion of the left ventricular (LV) summit, which is divided from the apical LV (A-LV) summit by the great cardiac vein (GCV), is challenging. This study investigated the efficacy of RFCA and electrocardiographic and electrophysiological characteristics of these VAs. METHODS AND RESULTS: Forty-five consecutive patients with symptomatic idiopathic LV summit VAs were studied...
October 2016: Circulation. Arrhythmia and Electrophysiology
Mahipat Soni, Deepak Bohara, Anup Taksande, Ajay Mahajan, Pratap Nathani, Yash Lokhandwala
We present a case of recurrent highly symptomatic atrial tachycardia. During electrophysiology (EP) study, this was found to arise close to the AV node. To avoid conduction system damage by radiofrequency (RF) ablation, the aortic cusps were mapped. The tachycardia focus was close to the non-coronary cusp and ablated safely and successfully from this site.
December 2015: Journal of the Association of Physicians of India
Ting-Yan Zhu, Shen-Rong Liu, Yan-Yu Chen, Liang-Zhen Xie, Li-Wei He, Su-Rong Meng, Jian Peng
OBJECTIVE: To compare the safety, feasibility, and efficacy of a completely nonfluoroscopic approach to radiofrequency catheter ablation (RFCA) using CARTO3 and ablation with conventional fluoroscopic guidance for treatment of idiopathic premature ventricular contractions from the aortic sinus cusp (ASC-PVCs). METHODS: From April 2013 to October 2015, we prospectively enrolled 52 consecutive patients with ASC-PVCs scheduled for either CARTO3 mapping-guided zero-fluoroscopy ablation (group A, n=23) or conventional fluoroscopic ablation (group B, n=29)...
August 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Michael Barkagan, Yoav Michowitz, Aharon Glick, Oholi Tovia-Brodie, Raphael Rosso, Bernard Belhassen
BACKGROUND: A few series of focal atrial tachycardia (AT) originating from the noncoronary sinus of Valsalva (NCSV) have been reported in the literature during the last decade. METHODS AND RESULTS: Of 147 patients with AT referred for radiofrequency ablation (RFA), we identified nine (6%) originating in the vicinity of the NCSV. Clinical AT was induced during electrophysiological study in all patients without (n = 6) and with (n = 3) isoproterenol infusion. Mean cycle length of the induced tachycardia was 399 ± 85 ms...
August 24, 2016: Pacing and Clinical Electrophysiology: PACE
Konstantinos E Iliodromitis, Sokratis Pastromas, Stylianos Tzeis, George Andrikopoulos
Radiofrequency ablation is the therapy of choice for the suppression of medically intractable symptomatic ventricular arrhythmias. Here we present the case report of a 50-year-old woman with bicuspid aortic valve (BAV) and symptomatic nonsustained ventricular tachycardia arising from the left ventricular outflow tract (LVOT). The origin of the ventricular arrhythmia was confirmed in the left coronary cusp (LCC) of the BAV. The patient underwent a successful radiofrequency ablation. LCC of a tricuspid aortic valve is a common origin of idiopathic LVOT tachycardia; however, little is known for these types of arrhythmias when located in the cusps of a BAV...
August 17, 2016: Cardiology
Li Yue-Chun, Lin Jia-Feng, Guan Xue-Qiang, Chen Peng
No abstract text is available yet for this article.
August 2016: Circulation. Arrhythmia and Electrophysiology
Cheng Zheng, Jin Li, Jia-Xuan Lin, Lu-Ping Wang, Jia-Feng Lin
BACKGROUND: In recent years, radiofrequency catheter ablation(RFCA) has been established as an effective therapy for idiopathic premature ventricular contractions (PVCs), however, its effect on the narrow PVCs (QRS duration < 130 msec) with qR pattern in inferior leads, may not been fully concluded. METHODS: Characteristics of 12-lead electrocardiogram (ECG) and electrophysiologic recordings were analyzed in 40 patients with symptomatic PVCs manifesting narrow QRS complex with qR pattern in inferior leads...
2016: BMC Cardiovascular Disorders
Oholi Tovia-Brodie, Yoav Michowitz, Aharon Glick, Raphael Rosso, Bernard Belhassen
BACKGROUND: Left ventricular outflow tract (LVOT) arrhythmias are increasingly recognized. Data regarding the distribution of the sites of origin (SOO) of the arrhythmias are sparse. OBJECTIVES: To describe the clinical characteristics of patients with LVOT arrhythmias and the distribution of their SOO. METHODS: All 42 consecutive patients with LVOT arrhythmias who underwent radiofrequency (RF) ablation during the period 2000-2014 were included...
February 2016: Israel Medical Association Journal: IMAJ
Ahmed Taha Hussein Abdelwahed, Heikki Mäkynen, M J Pekka Raatikainen
A 59-year-old female with structurally normal heart was admitted to our hospital for treatment of highly symptomatic, drug refractory atrial premature beats (APB). ECG revealed atrial parasystolic trigeminy. The arrhythmogenic focus was mapped and ablated using magnetic remote navigation and 3D electroanatomical mapping system. To our knowledge, this is the first report on successful ablation of frequent APBs in the non-coronary aortic cusp.
July 2015: Indian Pacing and Electrophysiology Journal
Yasunori Kanzaki, Itsuro Morishima, Yoshifumi Awaji, Rinya Kato
This report describes a case of premature ventricular contractions with the preferential pathway traveling from the left coronary cusp (LCC) to the right ventricular outflow tract (RVOT) via the right coronary cusp (RCC). The earliest activation was recorded within the LCC, while the successful ablation site was the RCC, where the second earliest prepotential was recorded. The remediable ablation site for ventricular arrhythmias (VAs) arising from the left ventricular (LV) ostium may not necessarily be the site of the earliest activation, but may be the site with the potential representing the preferential pathway...
May 2015: Indian Pacing and Electrophysiology Journal
Pasquale Santangeli, David Lin, Francis E Marchlinski
The left ventricular summit is a common site of origin of idiopathic ventricular arrhythmias. These arrhythmias are most commonly ablated within the coronary venous system or from other adjacent structures, such as the right ventricular and left ventricular outflow tract or coronary cusp region. When ablation from adjacent structures fails, a percutaneous epicardial approach can be considered, but is rarely successful in eliminating the arrhythmias due to proximity to major coronary vessels and/or epicardial fat...
March 2016: Cardiac Electrophysiology Clinics
Hussam Ali, Guido DE Ambroggi, Angelica Fundaliotis, Riccardo Cappato
No abstract text is available yet for this article.
August 2016: Journal of Cardiovascular Electrophysiology
Ibrahim Marai, Monther Boulos, Jonathan Lessick, Sobhi Abadi, Miry Blich, Mahmoud Suleiman
BACKGROUND: Ablation of outflow flow ventricular arrhythmia (VA) originating from aortic cusps can be challenging. The aim of this study was to describe our approach for this ablation. METHODS: All patients with outflow VA suspected to originate from aortic cusps according to ECG or after failed ablation from right ventricular outflow tract (RVOT) underwent cardiac CT and radiofrequency ablation. CT image of aortic cusps and coronary arteries was integrated into electroanatomic mapping system by point (left main ostium)-based registration...
January 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Zheng Liu, Yu-He Jia, Lan Ren, Pi-Hua Fang, Gong-Bu Zhou, Jia He, Shu Zhang
BACKGROUND: Multiple intercostal recordings were supposed to get a more comprehensive view of the depolarization vector of the outflow tract ventricular arrhythmia (OT-VA), which may help to identify the OT-VA more accurately. This study was undertaken to develop a more accurate electrocardiogram (ECG) criterion for differentiating between left and right OT-VA origins. METHODS: We studied OT-VA with a left bundle branch block pattern and inferior axis QRS morphology in 47 patients with successful catheter ablation in the right ventricular OT (RVOT; n = 37) or aortic coronary cusp (ACC; n = 10)...
February 2016: Pacing and Clinical Electrophysiology: PACE
Yoshiaki Kaneko, Shigeto Naito, Kaoru Okishige, Itsuro Morishima, Takeshi Tobiume, Tadashi Nakajima, Tadanobu Irie, Masaki Ota, Takafumi Iijima, Takashi Iizuka, Mio Tamura, Shuntaro Tamura, Akihiro Saito, Osamu Igawa, Ritsushi Kato, Kazuo Matsumoto, Fumio Suzuki, Masahiko Kurabayashi
BACKGROUND: The existence of an atypical fast-slow (F/S) atrioventricular nodal reentrant tachycardia (AVNRT) including a superior (sup) pathway with slow conductive properties and an atrial exit near the His bundle has not been confirmed. METHODS AND RESULTS: We studied 6 women and 2 men (age, 74 ± 7 years) with sup-F/S-AVNRT who underwent successful radiofrequency ablation near the His bundle. Programmed ventricular stimulation induced retrograde conduction over a superior SP with an earliest atrial activation near the His bundle, a mean shortest spike-atrial interval of 378 ± 119 milliseconds, and decremental properties in all patients...
January 12, 2016: Circulation
Antonio Madaffari, Anett Große, Michele Brunelli, Markus Frommhold, Tanja Dähne, Giuseppe Oreto, Santi Raffa, J Christoph Geller
INTRODUCTION: Radiofrequency (RF) ablation of atrial tachycardia (AT) with earliest activation at the His-bundle may be associated with the risk of AV block, and detection of this AT origin using the electrocardiogram (ECG) would be helpful in planning ablation. Aim of this study was to characterize the P-wave morphology and intracardiac electrograms at the successful ablation site for this group of ATs. METHODS: All consecutive patients undergoing ablation for AT with earliest activation at the His-bundle were included...
February 2016: Journal of Cardiovascular Electrophysiology
Hiro Yamasaki, Hiroshi Tada, Yukio Sekiguchi, Kazutaka Aonuma
A previous study demonstrated that ventricular premature contractions (VPCs) and ventricular fibrillation (VF) are provoked during sodium channel blocker challenge tests in Brugada syndrome (BrS) patients (Morita et al., J Am Coll Cardiol 42:1624-1631, 2003). The right ventricular outflow tract (RVOT) is a major arrhythmogenic focus and isolated VPCs originating from that area have been shown to initiate VF (Kakishita et al., J Am Coll Cardiol 36:1646-1653, 2000). Here, we describe a case report of a BrS patient with VPCs arising from the posterior aspect of the RVOT epicardium which was provoked by a low-dose of pilsicainide, a pure sodium channel blocker, and was successfully ablated from the right coronary cusp...
August 2016: Heart and Vessels
Dursun Aras, Ozcan Ozeke, Serkan Cay, Firat Ozcan, Meryem Kara, Serkan Topaloglu
Transseptal catheterization has become part of the interventional electrophysiologist׳s technical armamentarium since the development of left atrial catheter ablation and percutaneous technologies for treating mitral and aortic valve disease. Although frequently performed, the procedure׳s most feared complication is aortic root penetration. Focal atrial tachycardia has been described as the most common late sequela of surgical valve replacements. We present a complicated case involving the inadvertent delivery of an 8 French sheath across the noncoronary cusp during radiofrequency catheter ablation for left atrial tachycardia originating from the mitral annulus in a patient with prior mitral valve replacement...
August 2015: Journal of Arrhythmia
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