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Tachycardia ablation

Dirk G Dechering, Ruben Schleberger, Eva Greiser, Jannis Dickow, Julia Koebe, Gerrit Frommeyer, Stephan Willems, Lars Eckardt, Boris A Hoffmann, Kristina Wasmer
PURPOSE: Slow pathway modulation is the treatment of choice in patients with atrioventricular nodal reentrant tachycardia (AVNRT). No comparative data on ablation strategies exist. Therefore, we sought to compare two common ablation approaches. METHODS: We analyzed prospective ablation databases of two high-volume tertiary centers (> 1000 ablations/year) using either 30 or 50 W for slow pathway modulation from 2012 to 2013. We analyzed procedural characteristics as well as short- and long-term outcomes...
March 19, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Juanita Hunter, Emmanouil Tsounias, John Cogan, Ming-Lon Young
BACKGROUND Lown-Ganong-Levine syndrome, includes a short PR interval, normal QRS complex, and paroxysmal tachycardia. The pathophysiology of this syndrome includes an accessory pathway connecting the atria and the atrioventricular (AV) node (James fiber), or between the atria and the His bundle (Brechenmacher fiber). Similar features are seen in enhanced atrioventricular nodal conduction (EAVNC), with the underlying pathophysiology due to a fast pathway to the AV node, and with the diagnosis requiring specific electrophysiologic criteria...
March 18, 2018: American Journal of Case Reports
Natalia A Trayanova, Patrick M Boyle, Plamen P Nikolov
The goal of this article is to review advances in computational modeling of the heart, with a focus on recent non-invasive clinical imaging- and simulation-based strategies aimed at improving the diagnosis and treatment of patients with arrhythmias and structural heart disease. Following a brief overview of the field of computational cardiology, we present recent applications of the personalized virtual-heart approach in predicting the optimal targets for infarct-related ventricular tachycardia and atrial fibrillation ablation, and in determining risk of sudden cardiac death in myocardial infarction patients...
March 2018: Current Opinion in Biomedical Engineering
Roy M John, Arvindh N Kanagasundram, William G Stevenson
No abstract text is available yet for this article.
March 2018: Circulation. Arrhythmia and Electrophysiology
Teresa Oloriz, Francesca Baratto, Nicola Trevisi, Melania Barbaro, Caterina Bisceglia, Giuseppe D'Angelo, Miki Yamase, Gabriele Paglino, Andrea Radinovic, Paolo Della Bella
BACKGROUND: Catheter ablation of ventricular tachycardia (VT) is effective to prevent arrhythmia episode-related implantable cardioverter defibrillator shocks. However, recurrences in noninducible patients at programmed ventricular stimulation (PVS) are substantial. METHODS AND RESULTS: From May 2013 to September 2015, 218 PVSs were performed 6 days (5-7) after ablation (186 noninvasive programmed stimulations and 32 invasive PVS) in 210 consecutive patients (ischemic, 48%; median left ventricular ejection fraction, 37%; syncope, 35% with trauma associated 6%), while patients were awake and under β-blocker therapy...
March 2018: Circulation. Arrhythmia and Electrophysiology
Philippa R P Krahn, Sheldon M Singh, Venkat Ramanan, Labonny Biswas, Nicolas Yak, Kevan J T Anderson, Jennifer Barry, Mihaela Pop, Graham A Wright
BACKGROUND: Radiofrequency (RF) ablation has become a mainstay of treatment for ventricular tachycardia, yet adequate lesion formation remains challenging. This study aims to comprehensively describe the composition and evolution of acute left ventricular (LV) lesions using native-contrast cardiovascular magnetic resonance (CMR) during CMR-guided ablation procedures. METHODS: RF ablation was performed using an actively-tracked CMR-enabled catheter guided into the LV of 12 healthy swine to create 14 RF ablation lesions...
March 15, 2018: Journal of Cardiovascular Magnetic Resonance
Andrea Di Marco, Teresa Oloriz Sanjuan, Gabriele Paglino, Francesca Baratto, Pasquale Vergara, Caterina Bisceglia, Nicola Trevisi, Simone Sala, Alessandra Marzi, Simone Gulletta, Manuela Cireddu, Ignasi Anguera, Paolo Della Bella
INTRODUCTION: Late potentials (LP) abolition is recognized as an effective strategy for substrate ablation of ventricular tachycardia (VT). The presence of a chronic total occlusion in a coronary artery responsible for a previous myocardial infarction (infarct related artery CTO, IRA-CTO) is emerging as a predictor of ventricular arrhythmias and VT recurrence after ablation. We sought to analyze the effects of LP abolition, focusing on the high-risk sub-group of patients with IRA-CTO...
March 15, 2018: Journal of Cardiovascular Electrophysiology
Demosthenes G Katritsis, Roy M John, Rakesh Latchamsetty, Rahul G Muthalaly, Theodoros Zografos, George D Katritsis, William G Stevenson, Igor R Efimov, Fred Morady
BACKGROUND: Immunohistochemistry studies suggest that the anatomic substrate of the slow pathway in atrioventricular nodal reentrant tachycardia (AVNRT) is the left inferior nodal extension. We hypothesized that slow pathway ablation from the left septum is an effective alternative to right-sided ablation. METHODS AND RESULTS: We analyzed our databases of AVNRT in search of cases that had used slow pathway ablation from the left septum because of failure of right septal ablation, and then prospectively subjected consenting patients to a left septal-only procedure...
March 2018: Circulation. Arrhythmia and Electrophysiology
Huan Wang, Xiaoru Che
INTRODUCTION: Differentiation of wide QRS complex tachycardia required repeated electrophysiological stimuli and mapping. However, instability of tachycardia would increase the difficulty in differential diagnosis. SYMPTOMS AND CLINICAL FINDINGS: In this paper, we reported a wide QRS tachycardia following ablation of an atrioventricular reentrant tachycardia participated by a poster-septal accessory pathway. Limited differentiation strategy was performed because the wide QRS tachycardia was self-limited and with unstable hemodynamics...
March 2018: Medicine (Baltimore)
Michał Orczykowski, Karolina Borowiec, Elzbieta Biernacka, Robert Bodalski, Piotr Urbanek, Pawel Derejko, Katarzyna Kodziszewska, Olgierd Wozniak, Aneta Fronczak, Kamil Marcinkiewicz, Krystyna Guzek, Agnieszka Fil, Grzegorz Warminski, Piotr Hoffman, Maria Bilinska, Lukasz Szumowski
BACKGROUND: After the surgical correction of Tetralogy of Fallot (TOF), surgical scars and natural obstacles form pathways capable of supporting an atrial tachyarrhythmia (AT). Radiofrequency ablation is effective, although the few studies to date on this topic had relatively short follow-up periods. AIM: The aims of the study were to evaluate the acute and long-term effects of RF ablation of AT and examine the characteristics of arrhythmia recurrence. METHODS: Tetralogy of Fallot patients (N 16, age 44...
March 14, 2018: Kardiologia Polska
Cristiano F Pisani, Maria Antonieta Albanez de Medeiros Lopes, Hugo Bellotti, Liliane Kopel, Silvia G Lage, Mauricio I Scanavacca
No abstract text is available yet for this article.
March 7, 2018: Europace: European Pacing, Arrhythmias, and Cardiac 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
Shuanglun Xie, Benoit Desjardins, Maciej Kubala, Jackson Liang, Jiandu Yang, Rob J van der Geest, Robert Schaller, Michael Riley, David Callans, Erica Zado Pac, Francis Marchlinski, Saman Nazarian
BACKGROUND: Criteria for identification of anatomic ventricular tachycardia (VT) substrates in arrhythmogenic right ventricular cardiomyopathy (ARVC) on late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) are unclear. OBJECTIVE: We sought to define a) the association of regional RV epicardial voltage amplitude with the distribution of LGE, and b) appropriate image signal intensity (SI) thresholds for VT substrate identification, in ARVC. METHODS: Pre-procedural LGE-CMR and epicardial electrogram mapping were performed in 10 ARVC patients...
March 1, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Mark R de Jong, Annemiek F Hoogerwaard, Ahmet Adiyaman, Jaap Jan J Smit, Anand R Ramdat Misier, Jan-Evert Heeg, Boudewijn A A M van Hasselt, Isabelle C Van Gelder, Harry J G M Crijns, Ignacio Fernández Lozano, Jorge E Toquero Ramos, F Javier Alzueta, Borja Ibañez, José M Rubio, Fernando Arribas, José M Porres Aracama, Josep Brugada, Lluís Mont, Arif Elvan
BACKGROUND: Hypertension is an important, modifiable risk factor for the development of atrial fibrillation (AF). Even after pulmonary vein isolation (PVI), 20-40% experience recurrent AF. Animal studies have shown that renal denervation (RDN) reduces AF inducibility. One clinical study with important limitations suggested that RDN additional to PVI could reduce recurrent AF. OBJECTIVE: The goal of this multicenter randomized controlled study is to investigate whether RDN added to PVI reduces AF recurrence...
February 27, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Andrés Alonso-García, Felipe Atienza, Pablo Ávila, Clara Ugueto, Miriam Centeno, Reyes Álvarez, Tomás Datino, Esteban González-Torrecilla, Evaristo Castellanos, Gerard Loughlin, Constancio Medrano, Ángel Arenal, Francisco Fernández-Avilés
INTRODUCTION AND OBJECTIVES: Catheter ablation has become the treatment of choice in an increasing number of arrhythmias in children and adolescents. There is still limited evidence of its use at a national level in Spain. The aim was to describe the characteristics and results of a modern monocentric series form a referral tertiary care centre. METHODS: Retrospective register of invasive procedures between 2004 and 2016 performed in patients under 17 years and recorded clinical characteristic, ablation methodology and acute and chronic results of the procedure...
February 23, 2018: Revista Española de Cardiología
Mathew D Hutchinson, Hyon-He K Garza
As we have witnessed in other arenas of catheter-based therapeutics, ventricular tachycardia (VT) ablation has become increasingly anatomical in its execution. Multi-modality imaging provides anatomical detail in substrate characterization, which is often complex in nonischemic cardiomyopathy patients. Patients with intramural, intraseptal, and epicardial substrates provide challenges in delivering effective ablation to the critical arrhythmia substrate due to the depth of origin or the presence of adjacent critical structures...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
Carlee D Ruediger, Bobby John, Sathesh Kumar, Han S Lim, Geetanjali Rangnekar, Kurt C Roberts-Thomson, Glenn D Young, David Chase, Prashanthan Sanders, Scott R Willoughby
BACKGROUND: It has been suggested that ethnicity can make a significant difference to the likelihood of thromboembolic stroke related to atrial fibrillation. Ethnic differences have been shown to alter inflammatory and haemostatic factors; however, this may all be confounded by differences in cardiovascular risk factors between different ethnicity. The impact of different ethnicities on the thrombogenic profile is not known. The aim of this study was to investigate differences in markers of inflammation, endothelial function and tissue remodelling between Caucasian and Indian populations with supraventricular tachycardia (SVT)...
January 2018: Indian Pacing and Electrophysiology Journal
Taner Kasar, Pelin Ayyildiz, Gulhan Tunca Sahin, Erkut Ozturk, Selman Gokalp, Sertac Haydin, Alper Guzeltas, Yakup Ergul
BACKGROUND: We aimed to evaluate rhythm abnormalities in cases of congenitally corrected transposition of the great arteries (ccTGA) and associated treatment strategies. PATIENTS AND METHODS: This retrospective cohort study included 65 pediatric patients with ccTGA who were admitted to the clinic between 2009 and 2017. The patients were divided into two groups, and surgical data, Holter electrocardiographic (ECG) recordings, ECG recordings, electrophysiological data, and device implantation data on the two groups were compared...
February 24, 2018: Congenital Heart Disease
Katie A Walsh, Joseph Galvin, John Keaney, Edward Keelan, Gabor Szeplaki
AIMS: Zero- and near-zero-fluoroscopic ablation techniques reduce the harmful effects of ionizing radiation during invasive electrophysiology procedures. We aimed to test the feasibility and safety of a zero-fluoroscopic strategy using a novel integrated magnetic and impedance-based electroanatomical mapping system for radiofrequency ablation (RFA) of supraventricular tachycardias (SVTs). METHODS: We retrospectively studied 92 consecutive patients undergoing electrophysiology studies with/without RFA for supraventricular tachycardia (SVT) performed by a single operator at a single center...
February 23, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Ilan A Marcuschamer, Aryeh Abelow, Ran Kornowski
The Impella is a mechanical circulatory support device that supports ventricular function. Since 2008, when the first Impella device received Food and Drug Administration clearance, its use has become increasingly prevalent. A variety of Impella devices are available, and are differentiated by size, power, and insertion techniques. These versions of the Impella have been used in a multitude of clinical scenarios, both emergent and elective, including high-risk coronary interventions, acute myocardial infarction complicated by cardiogenic shock, decompensated left and right heart failure, high-risk ventricular tachycardia ablations, and aortic valvuloplasty...
February 20, 2018: Coronary Artery Disease
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