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Tachycardia ablation

Amee M Bigelow, Brandon S Arnold, Gregory C Padrutt, John M Clark
In current practice, children with anatomically normal hearts routinely undergo fluoroscopy-free ablations. Infants and children with congenital heart disease (CHD) represent the most difficult population to perform catheter ablation without fluoroscopy. We report two neonatal patients with CHD in whom cardiac ablations were performed without fluoroscopy. The first infant had pulmonary atresia with intact ventricular septum with refractory supraventricular tachycardia, and the second infant presented with Ebstein's anomaly of the tricuspid valve along with persistent supraventricular tachycardia...
October 21, 2016: Cardiology in the Young
Mu Qin, Xu Liu, Shao-Hui Wu, Xiao-Dong Zhang
Several clinically relevant outcomes post atrial substrate modification in patients with atrial fibrillation (AF) have not been systematically analyzed among published studies on adjunctive cardiac ganglionated plexi (GP) or complex fractionated atrial electograms (CFAE) ablation vs. pulmonary vein isolation (PVI) alone. Out of 176 reports identified, the present meta-analysis included 14 randomized and non-randomized controlled trials (1613 patients) meeting inclusion criteria. Addition of GP ablation to PVI significantly increased freedom from atrial tachyarrhythmia in short- (OR: 1...
2016: PloS One
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
Artur Baszko, Wojciech Telec, Piotr Kałmucki, Piotr Iwachów, Karol Kochman, Radosław Szymański, Jan Kłopocki, Stefan Ożegowski, Andrzej Szyszka, Tomasz Siminiak
Bipolar radiofrequency (RF) ablation is effective in treatment of ventricular tachycardia originating from thick interventricular septum. The RF generator and CARTO system can be used to precisely and safely perform ablation. Standard ablation catheter can be used with indifferent ablation electrode connected to the electrode receptacle in RF generator with custom-made cable.
October 2016: Clinical Case Reports
Nobuyuki Murakoshi, Kazutaka Aonuma
Drug treatment and/or implantable cardioverter defibrillator (ICD) implantation are the most widely accepted first-line therapies for channelopathic patients who have recurrent syncope, sustained ventricular tachycardia (VT), or documented ventricular fibrillation (VF), or are survivors of cardiac arrest. In recent years, there have been significant advances in mapping techniques and ablation technology, coupled with better understanding of the mechanisms of ventricular tachyarrhythmia in channelopathies. Catheter ablation has provided important insights into the role of the Purkinje network and the right ventricular outflow tract in the initiation and perpetuation of VT/VF, and has evolved as a promising treatment modality for ventricular tachyarrhythmia even in channelopathies...
October 2016: Journal of Arrhythmia
Naokata Sumitomo
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is induced by emotions or exercise in patients without organic heart disease and may be polymorphic or bidirectional in nature. The prognosis of CPVT is not good, and therefore prevention of sudden death is of utmost importance. Genetic variants of CPVT include RyR2, CASQ2, CALM2, TRD, and possibly KCNJ2 and ANK2 gene mutations. Hypotheses that suggest the causes of CPVT include weakened binding of FKBP12.6 and RyR2, a store overload-induced Ca(2+) release (SOICR), unzipping of intramolecular domain interactions in RyR2, and molecular and functional abnormalities caused by mutations in the CASQ2 gene...
October 2016: Journal of Arrhythmia
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
Demosthenes G Katritsis, Joseph E Marine, Fernando M Contreras, Akira Fujii, Rakesh Latchamsetty, Konstantinos C Siontis, George D Katritsis, Theodoros A Zografos, Roy M John, Laurence M Epstein, Gregory F Michaud, Elad Anter, Ali Sepahpour, Edward Rowland, Alfred E Buxton, Hugh Calkins, Fred Morady, William G Stevenson, Mark E Josephson
BACKGROUND: -Due to its low prevalence, data on atypical atrioventricular nodal reentrant tachycardia (AVNRT) are scarce, and the optimal ablation method is not established. Our study aimed at assessing the efficacy and safety of conventional slow pathway ablation, as applied for typical cases, in atypical AVNRT. METHODS: -We studied 2079 patients with AVNRT subjected to slow pathway ablation. In 113 patients, mean age 48.5±18.1 years, 68 female, atypical AVNRT or co-existent atypical and typical AVNRT without other concomitant arrhythmia was diagnosed...
October 17, 2016: Circulation
Mi-Na Kim, Donghyuk Cho, Jae-Min Shim, Jong Il Choi, Seong-Mi Park, Young-Hoon Kim, Wan-Joo Shim
OBJECTIVE: Hypertension (HT) is the important risk factor for atrial fibrillation (AF). Hemodynamic overload by increased blood pressure causes atrial wall stretch and atrial dysfunction. Left atrial (LA) dysfunction has been regarded as the most important risk factor for AF recurrence after radiofrequency catheter ablation (RFCA). But there are controversies regarding the role of hypertension as a risk factor of AF recurrence after RFCA. The aim of this study was to assess whether the hypertension is an independent risk factor for AF recurrence after RFCA...
September 2016: Journal of Hypertension
Mukund A Prabhu, B V Srinivas Prasad, Anees Thajudeen, Narayanan Namboodiri
INTRODUCTION: Bundle branch reentry as a mechanism of ventricular tachycardia (VT) in endomyocardial fibrosis (EMF) is not described. CASE REPORT: A 52-year-old woman with left ventricular (LV) EMF had VT needing cardioversion. She had mitral regurgitation and left bundle branch block, but no LV dilation or heart failure. During electrophysiological study, clinical VT could be easily induced, and it was confirmed to be bundle branch reentrant VT (BBRVT). She was treated with ablation of the right bundle branch...
September 2016: Indian Heart Journal
Pranil Bhalchandra Gangurde, Abhay Tidake, Hetan Shah, Ajay Mahajan, Yash Lokhandwala, Pratap Nathani
A 14-year-old male with a history of symptomatic tachycardia was referred for ablation. Sinus rhythm electrocardiogram was not showing any pre-excitation. Tachycardia episode was showing antidromic tachycardia with left bundle branch block morphology. Echocardiographic examination was showing Ebstein's anomaly with septal tricuspid leaflet displaced 24mm apically. The right bundle branch block (RBBB) was concealed during sinus rhythm. The RBBB was revealed with ablation of right posterior atriofascicular accessory pathway...
September 2016: Indian Heart Journal
Ru-Xing Wang, Hon-Chi Lee, Jia-Ping Li, David O Hodge, Yong-Mei Cha, Paul A Friedman, Thomas M Munger, Komandoor Srivathsan, Behzad B Pavri, Win-Kuang Shen
BACKGROUND: Although sudden death (SD) is a rare complication after atrioventricular junction (AVJ) ablation and permanent pacemaker implantation, the risk factors leading to this SD remain unknown. The purpose of this study was to investigate SD and its risk factors after ablate-and-pace strategy for rate control in atrial fibrillation (AF) patients during long-term follow-up. HYPOTHESIS: METHODS: From January 2005 to December 2009, we enrolled into this study 517 AF patients with AVJ ablation and right ventricular pacemaker implantation...
October 17, 2016: Clinical Cardiology
Antonio Berruezo, Juan Acosta, Juan Fernández-Armenta, Alonso Pedrote, Alberto Barrera, Eduardo Arana-Rueda, Andrés Ignacio Bodegas, Ignasi Anguera, Luis Tercedor, Diego Penela, David Andreu, Rosario Jesus Perea, Susana Prat-González, Lluis Mont
BACKGROUND: First-line endoepicardial ventricular tachycardia (VT) ablation has been proposed for patients with arrhythmogenic cardiomyopathy (AC). This study reports procedural safety, outcomes, and predictors of recurrence. METHODS AND RESULTS: Forty-one consecutive patients [12 with left ventricle (LV) involvement, 7 left-dominant] underwent first-line endoepicardial VT substrate ablation. Standard bipolar and unipolar thresholds were used to define low-voltage areas (LVA)...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Alessandro Giamberti, Francesca R Pluchinotta, Massimo Chessa, Alessandro Varrica, Raffaele Vitale, Alessandro Frigiola, Carlo Pappone, Marco Ranucci
AIMS: Supraventricular arrhythmias are a major cause of morbidity and mortality in adult patients with congenital heart disease (CHD). Intraoperative ablation offers an alternative for patients who failed ablation procedures or are requiring concomitant surgical intervention. We present our long-term results with the surgical treatment of arrhythmias in adults with CHD (ACHD) undergoing elective cardiac surgery and the clinical predictors for arrhythmia recurrence. METHODS AND RESULTS: Between 2002 and 2013, 80 consecutive patients with CHD, mean age of 39 years, underwent intraoperative ablation with monopolar irrigated radiofrequency during cardiac surgery procedures...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Per Insulander, Hamid Bastani, Frieder Braunschweig, Nikola Drca, Göran Kennebäck, Jonas Schwieler, Jari Tapanainen, Mats Jensen-Urstad
AIMS: Cryoablation is an alternative method to radiofrequency ablation for treatment of atrioventricular nodal re-entrant tachycardia (AVNRT). This study investigates the long-term safety and efficacy of cryoablation in AVNRT. METHODS AND RESULTS: We studied 515 consecutive patients (317 women, mean age 50 years, range 13-89 years) undergoing a first cryoablation for AVNRT between 2003 and 2008. Ablations were performed with a 6-mm Freezor Xtra catheter. Six patients were acute failures; 494 out of 509 (97%) primarily successfully ablated patients were followed up for a mean of 7...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Paolo Della Bella, Nicola Trevisi
No abstract text is available yet for this article.
October 2016: Circulation. Arrhythmia and Electrophysiology
Guo Jincun, Zhou Faguang, Huang Weibin, Wang Yan, Dong Kang, Roderick Tung
No abstract text is available yet for this article.
October 2016: Circulation. Arrhythmia and Electrophysiology
Daniele Muser, Pasquale Santangeli, Simon A Castro, Rajeev K Pathak, Jackson J Liang, Tatsuya Hayashi, Silvia Magnani, Fermin C Garcia, Mathew D Hutchinson, Gregory G Supple, David S Frankel, Michael P Riley, David Lin, Robert D Schaller, Sanjay Dixit, Erica S Zado, David J Callans, Francis E Marchlinski
BACKGROUND: Catheter ablation (CA) of ventricular tachycardia (VT) in patients with nonischemic dilated cardiomyopathy can be challenging because of the complexity of underlying substrates. We sought to determine the long-term outcomes of endocardial and adjuvant epicardial CA in nonischemic dilated cardiomyopathy. METHODS AND RESULTS: We examined 282 consecutive patients (aged 59±15 years, 80% males) with nonischemic dilated cardiomyopathy who underwent CA. Ablation was guided by activation/entrainment mapping for tolerated VT and pacemapping/targeting of abnormal electrograms for unmappable VT...
October 2016: Circulation. Arrhythmia and Electrophysiology
Xiaobo Pu, Xingbin Liu, Kaijun Cui
No abstract text is available yet for this article.
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Bingbo Hou, Lihui Zheng, Guodong Niu, Lingmin Wu, Yu Qiao, Wei Sun, Ligang Ding, Gang Chen, Shu Zhang, Reginald Liew, Yan Yao
AIMS: This study was aimed to report the characteristics and treatment of ventricular tachycardia (VT) following surgical treatment of pulmonary stenosis with intact ventricular septum. METHODS AND RESULTS: Five patients underwent radiofrequency catheter ablation for sustained monomorphic left bundle branch block (LBBB) type VT who previously underwent surgical treatment of pulmonary stenosis. Except stimulation, voltage and activation mapping was performed using three-dimensional (3D) electro-anatomic mapping and ablation was applied accordingly...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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