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Ventricular tachycardia localization

Mosab Al Shakaki, Angelo M Dell'Aquila, Andreas Rukosujew
Typical symptoms of cardiac tamponade are jugular venous distension, pulsus paradoxus, hypotension, and rest dyspnea. However, these clinical symptoms can be masked in patients with ventricular assist device and even more in patients supported with a biventricular-HeartWare ventricular assist device. Hereby, we report the case of a 30-year-old man supported with a biventricular-HeartWare ventricular assist device, who underwent a computed tomography scan due to suspect of ventricular assist device thrombosis...
March 1, 2018: International Journal of Artificial Organs
Maciej Kubala, Rajeev K Pathak, Shuanglun Xie, Ruben Casado Arroyo, Cory M Tschabrunn, Tatsuya Hayashi, Fermin C Garcia, Gregory E Supple, Pasquale Santangeli, David S Frankel, Erica S Zado, David J Callans, Francis E Marchlinski
BACKGROUND: Repolarization abnormalities in arrhythmogenic right ventricular (RV) cardiomyopathy and their relationship to ventricular tachycardia substrate are incompletely understood. METHODS AND RESULTS: In 40 patients (29 men, mean age 38 years) with arrhythmogenic RV cardiomyopathy, we compared the extent and location of abnormal T (NegT) waves ≥1 mm in depth (n=32) and downsloping elevated ST segment (n=13), in ≥2 adjacent leads, to area and location of endocardial bipolar (<1...
March 2018: Circulation. Arrhythmia and Electrophysiology
Prabhpreet Singh, Amit Noheria
Invasive electrophysiology (EP) mapping and catheter ablation has increasingly become the standard of care for many cardiac arrhythmias like supraventricular tachycardias, atrial fibrillation, premature ventricular complexes (PVC), and monomorphic ventricular tachycardia. In this review, we discuss the recent progress made in the mapping and ablation of ventricular fibrillation (VF). Ventricular activation during VF is apparently disorganized, making mapping and interpretation difficult. Prolonged mapping during VF would require mechanical circulatory support as VF causes complete hemodynamic collapse...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
S Serge Barold
This report describes a digitalis-induced regular fascicular ventricular tachycardia characterized by marked QRS alternans a manifestation not usually associated with this arrhythmia. The striking alternation of QRS configuration suggested alternating ventricular activation from either a single focus with two exits in distal branches of the left anterior fascicle or 2 different foci localized in the Purkinje-myocardial network of the left anterior fascicle.
February 8, 2018: Journal of Electrocardiology
Michael Wolf, Frédéric Sacher, Hubert Cochet, Takeshi Kitamura, Masateru Takigawa, Seigo Yamashita, Konstantinos Vlachos, Ghassen Cheniti, Antonio Frontera, Ruairidh Martin, Nathaniel Thompson, Grégoire Massoullié, Anna Lam, Claire Martin, Florent Collot, Josselin Duchateau, Thomas Pambrun, Arnaud Denis, Nicolas Derval, Mélèze Hocini, Michel Haïssaguerre, Pierre Jaïs
BACKGROUND: Long-term results of substrate modification for ablation of ventricular tachycardia (VT) have not been reported. We report long-term outcomes of substrate elimination targeting local abnormal ventricular activities (LAVA) for post-myocardial infarction VT. METHODS AND RESULTS: One hundred fifty-nine consecutive patients undergoing first ablation were included (65±11 years, 92% implantable cardioverter defibrillators, 54% storms, and 73% appropriate shocks)...
February 2018: Circulation. Arrhythmia and Electrophysiology
Fei Lü, Wei Huang, David G Benditt
BACKGROUND: Current transcatheter ablation of ventricular tachycardia (VT) techniques is limited in part by its invasive nature and superficial depth of ablation lesions. OBJECTIVES: This study was aimed at evaluating the feasibility of targeted ablation of cardiac tissues using high-intensity focused ultrasound (HIFU) as a potential means for non-invasive ablation of VT. METHODS: Ablation of ventricular myocardium was performed in anesthetized closed-chest dogs using a HIFU therapeutic system that is currently used clinically for ablation of human solid tumors...
February 12, 2018: Journal of Cardiovascular Electrophysiology
Michael Ghannam, Hubert Cochet, Pierre Jais, Maxime Sermesant, Smita Patel, Konstantinos C Siontis, Fred Morady, Frank Bogun
BACKGROUND: Myocardial wall thickness (WT) in patients with a prior myocardial infarction has been used to indicate scarring. However, the correlation of WT with sites critical to ventricular tachycardia (VT) has not been previously investigated. The purpose of this study was to correlate electroanatomic mapping data obtained during VT ablation with WT determined by cardiac computed tomography (CT). METHODS AND RESULTS: Cardiac CTs were performed in 15 consecutive patients (mean age 63±10 years, 86% male, left ventricular ejection fraction 27±12%) with a prior infarct referred for VT ablation...
January 30, 2018: Journal of Cardiovascular Electrophysiology
Petra Maagh, Arnd Christoph, Markus Sebastian Müller, Henning Dopp, Gunnar Plehn, Axel Meissner
PURPOSE: This study was conducted with the purpose of determining whether or not the potential technical advantages of multi-electrode mapping catheters in catheter ablation (CA) of ventricular tachycardia (VT) result in any relevant clinical benefit for VT patients. METHODS: A single-center VT study, having taken place from 2012 to 2014 using a standard 3.5-mm catheter (Thermocool SF® group 1) and from 2014 to 2016 using a 1-mm multi-electrode-mapping catheter (PentaRay® group 2), was conducted...
January 22, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Petra Maagh, Arnd Christoph, Henning Dopp, Markus Sebastian Mueller, Gunnar Plehn, Axel Meissner
Background: High-density mapping of ventricular tachycardia (VT) with PentaRay ® (Biosense-Webster) provides high resolution with discrimination of local abnormal electrograms and slow conducting channels. We evaluate the feasibility of PentaRay ® to characterize the anatomical substrate and assume an influence of the outcome despite limitations. Methods: Over a 24-month period, 26 endocardial and four epicardial maps were obtained of 26 VT patients (18 ischemic cardiomyopathy (ICM, 69...
December 2017: Cardiology Research
David Calvo, Diego Pérez, José Rubín, Daniel García, Pablo Ávila, F Javier García-Fernández, Marta Pachón, Loreto Bravo, Jesús Hernández, Ángel L Miracle, Irene Valverde, Mar Gozalez-Vasserot, Miguel Ángel Árias, Javier Jimenez-Candíl, César Morís
Aims: Tachycardia mediated by septal accessory pathways (AP) and atypical atrioventricular nodal re-entry (AVNRT) require careful electrophysiologic evaluation for differential diagnosis. We aim to describe the differential behaviour of local ventriculo-atrial (VA) intervals which predicts the tachycardia mechanism. Methods and results: The local VA intervals at the para-Hisian septum were measured under three different situations: (i) tachycardia; (ii) sustained entrainment from the right ventricular apex (RVA); and (iii) continuous pacing from the RVA during sinus rhythm...
January 2, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Olesya G Bernikova, Ksenia A Sedova, Natalia V Arteyeva, Aleksey O Ovechkin, Sergey N Kharin, Dmitry N Shmakov, Jan E Azarov
BACKGROUND: Aim of the study was to find out which myocardial repolarization parameters predict reperfusion ventricular tachycardia and fibrillation (VT/VF) and determine how these parameters express in ECG. METHODS: Coronary occlusion and reperfusion (30/30min) was induced in 24 cats. Local activation and end of repolarization times (RT) were measured in 88 intramyocardial leads. Computer simulations of precordial electrograms were performed. RESULTS: Reperfusion VT/VF developed in 10 animals...
December 6, 2017: Journal of Electrocardiology
Peter Magnusson, Stellan Mörner
INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease associated with sudden cardiac death (SCD) mainly due to ventricular tachycardia (VT) or fibrillation even though life-threatening bradycardia occurs. Risk stratification takes several variables into consideration including non-sustained VT (NSVT). An implantable cardioverter defibrillator effectively prevents SCD.Atrial fibrillation (AF) is common among patients with HCM and warrants anticoagulation even without conventional risk factors according to European guidelines...
December 12, 2017: BMJ Open
Cheyenne Beach, Christopher W Follansbee, Lee Beerman, Sharon Mazzocco, Li Wang, Gaurav Arora
BACKGROUND: Successful ablation sites in Wolff-Parkinson-White syndrome (WPW) are characterized by short atrioventricular (AV) intervals. Approximately 15% of patients with WPW have adenosine-sensitive accessory pathways (APs). We sought to determine if local AV intervals of adenosine-sensitive APs are different from those of adenosine-insensitive APs in patients with WPW. METHODS: Patients ≤21 years with WPW and adenosine-sensitive APs who underwent successful ablation over a 9-year period were included...
January 2018: Pacing and Clinical Electrophysiology: PACE
L Castro, S Pecha, M Linder, J Vogler, N Gosau, C Meyer, S Willems, H Reichenspurner, S Hakmi
BACKGROUND: The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Optimal treatment is complete extraction of the infected device. To protect these patients from sudden cardiac arrest while waiting for reimplantation and to avoid recurrent infection, a wearable cardioverter defibrillator (WCD) seems to be a valuable solution. Therefore, we investigated the management and outcome of patients with ICD or CRT-D infections using the WCD as a bridge to re-implantation after lead extraction procedures...
November 25, 2017: Journal of Cardiothoracic Surgery
Sana Ouali, Manel Ben Halima, Selim Boudiche, Anissa Gharbi, Khedher Nadim, Kaouthar Hakim, Fatma Ouarda, Mohamed Sami Mourali
A 04-year-old boy was referred to our institution with severe, progressive heart failure of 4-months duration associated with a persistent wide QRS tachycardia with left bundle branch block and severe left ventricular dysfunction. Because of incessant wide QRS tachycardia refractory to antiarrhythmic drugs, he was referred for electrophysiological study. The ECG was suggestive of VT arising from the right ventricle near the His area. Electrophysiological study revealed that origin of tachycardia was septum of the right ventricle, near His bundle, however the procedure was not successful and an inadvertent complete atrioventricular conduction block occurred...
November 4, 2017: Indian Pacing and Electrophysiology Journal
Gulhan Tunca Sahin, Erkut Ozturk, Taner Kasar, Alper Guzeltas, Yakup Ergul
BACKGROUND: In this study, we aim to evaluate the results of non-operational sustained tachyarrhythmias in patients younger than 1 year of age in our center. METHODS: Between November 2010 and November 2016, the demographic characteristics, type and localization of the tachyarrhythmia, echocardiographic findings, and medical and/or ablation therapies applied for patients under 1 year of age who had sustained tachyarrhythmias were evaluated. RESULTS: Among 99 patients, 91 had sustained supraventricular tachycardia, and eight had sustained ventricular tachycardia...
October 25, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
Elizabeth M Annoni, Shivaram Poigai Arunachalam, Suraj Kapa, Siva K Mulpuru, Paul A Friedman, Elena G Talkachova
OBJECTIVE: Clinical studies identifying rotors confirming these sites for ablation in treating cardiac arrhythmias have had inconsistent results with the current analysis techniques available. The aim of this study is to evaluate four new signal analysis approaches - multiscale frequency (MSF), Shannon entropy (SE), Kurtosis (Kt), and multiscale entropy (MSE) - in their ability to identify the pivot point of rotors. METHODS: Optical mapping movies of ventricular tachycardia were used to evaluate the performance and robustness of SE, Kt, MSF and MSE techniques with respect to several clinical limitations: decreased time duration, reduced spatial resolution, and the presence of meandering rotors...
October 16, 2017: IEEE Transactions on Bio-medical Engineering
Mari Amino, Koichiro Yoshioka, Sachie Tanaka, Noboru Kawabe, Hiroyuki Kurosawa, Keisuke Uchida, Shinobu Oshikiri, Tadashi Hashida, Shigetaka Kanda, Sadaki Inokuchi, Yuji Ikari
BACKGROUND: Iodine-123 metaiodobenzylguanidine ((123) I-MIBG) is useful for detecting sympathetic innervation in the heart, and has been closely associated with fatal arrhythmias. However, such imaging is typically calibrated to the area of highest uptake and thus is unable to identify areas of hyperinnervation. We hypothesized that normal (123) I-MIBG uptake regions in the denervated heart would demonstrate nerve sprouting and correlate with the potential for arrhythmogenesis. METHODS: Twenty New Zealand white rabbits treated with phenol or sham were prepared under anesthesia...
August 31, 2017: Pacing and Clinical Electrophysiology: PACE
Hae Yoon Grace Choung, Monika Vyas, Daniel Jacoby, Brian West
A 26year old east African professional athlete presented to the obstetric clinic for a routine visit at 36 weeks gestation. She had a history of Right Ventricular Outflow Tract - Ventricular Tachycardia (RVOT-VT) with an episode of cardiac arrest in the past, and had been treated with ablation 4 years earlier. Her current visit was uneventful, her pregnancy progressing normally. Following the visit she went to a local restaurant where she suffered a cardiac arrest that was unresponsive to therapy. Chest compressions were continued from the time of her collapse until an emergency caesarian section was performed, delivering a healthy female infant...
October 2017: Pathology, Research and Practice
Jin Xu, Yingmin Chen, Xiaoying Ying, Ben He
No abstract text is available yet for this article.
August 2017: HeartRhythm Case Reports
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