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entrainment tachycardia

Luigi Di Biase, Roderick Tung, Tamás Szili-Torok, J David Burkhardt, Peter Weiss, Rene Tavernier, Adam E Berman, Erik Wissner, William Spear, Xu Chen, Petr Neužil, Jan Skoda, Dhanunjaya Lakkireddy, Bruno Schwagten, Ken Lock, Andrea Natale
PURPOSE: Patients with ischemic cardiomyopathy (ICM) are prone to scar-related ventricular tachycardia (VT). The success of VT ablation depends on accurate arrhythmogenic substrate localization, followed by optimal delivery of energy provided by constant electrode-tissue contact. Current manual and remote magnetic navigation (RMN)-guided ablation strategies aim to identify a reentry circuit and to target a critical isthmus through activation and entrainment mapping during ongoing tachycardia...
January 7, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Linwei Wang, Omar A Gharbia, B Milan Horáček, John L Sapp
BACKGROUND: The majority of life-threatening ventricular tachycardias (VTs) are sustained by heterogeneous scar substrates with narrow strands of surviving tissue. An effective treatment for scar-related VT is to modify the underlying scar substrate by catheter ablation. If activation sequence and entrainment mapping can be performed during sustained VT, the exit and isthmus of the circuit can often be identified. However, with invasive catheter mapping, only monomorphic VT that is hemodynamically stable can be mapped in this manner...
November 2016: Journal of Electrocardiology
Sachin Nayyar, Pawel Kuklik, Anand N Ganesan, Thomas R Sullivan, Lauren Wilson, Glenn D Young, Prashanthan Sanders, Kurt C Roberts-Thomson
BACKGROUND: In ventricular scar, impulse spread is slow because it traverses split and zigzag channels of surviving muscle. We aimed to evaluate scar electrograms to determine their local delay (activation time) and inequality in voltage splitting (entropy), and their relationship to channels. We reasoned that unlike innocuous channels, which are often short with multiple side branches, ventricular tachycardia (VT) supporting channels have very slow impulse spread and possess low entropy because of their longer protected length and relative lack of side-branching...
December 2016: Circulation. Arrhythmia and Electrophysiology
Andrew D Beaser, Kelvin C Chua, Gaurav A Upadhyay, Roderick Tung
No abstract text is available yet for this article.
December 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Roger A Winkle, Ryan Moskovitz, R Hardwin Mead, Gregory Engel, Melissa H Kong, William Fleming, Rob A Patrawala
PURPOSE: The purpose of this study was to evaluate ultra high density-activation sequence mapping (UHD-ASM) for ablating atypical atrial flutters. METHODS: For 23 patients with 31 atypical atrial flutters (AAF), we created UHD-ASM. RESULTS: Demographics age = 65.3 ± 8.5 years, male = 78%, left atrial size = 4.66 ± 0.64 cm, redo ablation 20/23(87%). AAF were left atrial in 30 (97%). For each AAF, 1273 ± 697 points were used for UHD-ASM...
November 10, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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
Qiang Liu, Michael Shehata, Ruhong Jiang, Lu Yu, Shiquan Chen, Jun Zhu, Ashkan Ehdaie, Ali A Sovari, Eugenio Cingolani, Sumeet S Chugh, Chenyang Jiang, Xunzhang Wang
BACKGROUND: The underlying mechanisms of reentry during left posterior fascicular ventricular tachycardia (LPF-VT) remain unclear. The purpose of this study is to describe the components of LPF-VT reentry circuit and their electrophysiological properties. METHODS AND RESULTS: Fourteen consecutive patients with LPF-VT underwent electrophysiology study and radiofrequency ablation. Via a multipolar electrode catheter placed from a retrograde aortic approach, a sharp inflection, high-frequency potential (P1) was detected in 9 patients (64%)...
September 2016: Circulation. Arrhythmia and Electrophysiology
Saurabh Kumar, Samuel H Baldinger, Jorge Romero, Akira Fujii, Saagar N Mahida, Usha B Tedrow, William G Stevenson
INTRODUCTION: Substrate-based ablation for scar-related ventricular tachycardia (VT) has gained prominence: however, there is limited data comparing it to ablation guided predominantly by activation and entrainment mapping of inducible and hemodynamically tolerated VTs. We compared the acute procedural efficacy and outcomes of predominantly substrate-based ablation versus ablation guided predominantly by activation and entrainment mapping. METHODS AND RESULTS: Database searches through April 2016 identified 6 eligible studies (enrolling 403 patients, with 1 randomized study) comparing the 2 strategies...
December 2016: Journal of Cardiovascular Electrophysiology
Christopher F Liu, Jim W Cheung, James E Ip, George Thomas, Hua Yang, Sandeep Sharma, Steven M Markowitz, Bruce B Lerman
BACKGROUND: No existing criteria unequivocally differentiate focal atrial tachycardia (AT) caused by microreentry, triggered activity, or enhanced automaticity. Although macroreentrant AT is readily diagnosed based on entrainment criteria, the smaller circuit dimension associated with microreentrant AT makes it challenging to validate the presence of reset with fusion. An algorithm was, therefore, developed that is independent of entrainment but which reliably identifies specific mechanisms of focal AT...
August 2016: Circulation. Arrhythmia and Electrophysiology
Moshe Rav-Acha, Chee Yuan Ng, E Kevin Heist, Guy Rozen, Fadi Chalhoub, William J Kostis, Jeremy Ruskin, Moussa Mansour
INTRODUCTION: The treatment of atrial tachycardia (AT) occurring after ablation for atrial fibrillation (AF) is challenging. The most common ablation strategy relies on entrainment, and electroanatomic activation mapping (EAM) using a conventional window of interest (WOI), centered on the easily detectable atrial signal on the coronary sinus catheter. We describe a novel EAM annotation technique that uses a WOI starting 40 ms prior to the P wave in order to detect the reentrant AT exit site...
August 10, 2016: Journal of Cardiovascular Electrophysiology
Amit Noheria, Siva K Mulpuru, Peter A Noseworthy, Samuel J Asirvatham
We present a case of incessant wide-complex tachycardia in a patient with left-ventricular assist device, and discuss the differential diagnosis with an in-depth analysis of the intracardiac tracings during the invasive electrophysiologic study, including interpretation of the relative timing of the fascicular signals during tachycardia and in sinus rhythm, and interpretation of pacing and entrainment maneuvers.
January 2016: Indian Pacing and Electrophysiology Journal
Akinori Matsumoto, Koji Fukuzawa, Kunihiko Kiuchi, Hiroki Konishi, Hirotoshi Ichibori, Hiroshi Imada, Kiyohiro Hyogo, Jun Kurose, Tomofumi Takaya, Shumpei Mori, Akihiro Yoshida, Ken-Ichi Hirata, Tatsuya Nishii, Atsushi Kono
BACKGROUND: Roof-dependent atrial tachycardia (roof AT) sometimes occurs after pulmonary vein isolation (PVI) of atrial fibrillation (AF). This study aimed to investigate the relationship between the anatomy of the residual left atrial posterior wall and occurrence of roof AT. METHODS: A total of 265 patients with AF who underwent PVI were enrolled. After the PVI, induced or recurrent roof AT was confirmed by an entrainment maneuver or activation mapping using a three-dimensional (3D) mapping system...
October 2016: Pacing and Clinical Electrophysiology: PACE
Elad Anter, Cory M Tschabrunn, Alfred E Buxton, Mark E Josephson
BACKGROUND: In vivo description of ventricular tachycardia (VT) circuits is limited by insufficient spatiotemporal resolution. We used a novel high-resolution mapping technology to characterize the electrophysiological properties of the postinfarction reentrant VT circuit. METHODS: In 15 swine, myocardial infarction was induced by left anterior descending artery balloon occlusion. Animals were studied 6 to 8 weeks after myocardial infarction. Activation mapping of VTs was performed by using the Rhythmia mapping system...
July 26, 2016: Circulation
Elad Anter, Thomas H McElderry, Fernando M Contreras-Valdes, Jianqing Li, Patricia Tung, Eran Leshem, Charles I Haffajee, Hiroshi Nakagawa, Mark E Josephson
BACKGROUND: Rhythmia is a new technology capable of rapid and high-resolution mapping. However, its potential advantage over existing technologies in mapping complex scar-related atrial tachycardias (ATs) has not yet been evaluated. OBJECTIVE: The purpose of this study was to examine the utility of Rhythmia for mapping scar-related ATs in patients who had failed previous ablation procedure(s). METHODS: This multicenter study included 20 patients with recurrent ATs within 2 years after a previous ablation procedure (1...
October 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
B P Betensky, F E Marchlinski
Sustained ventricular tachycardias are common in the setting of structural heart disease, either due to prior myocardial infarction or a variety of non-ischemic etiologies, including idiopathic dilated cardiomyopathy, hypertrophic cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy. Over the past two decades, percutaneous catheter ablation has evolved dramatically and has become an effective tool for the control of ventricular arrhythmias. Single and multicenter observational studies as well as several prospective randomized trials have begun to investigate long-term outcomes after catheter ablation procedures...
July 2016: Current Cardiology Reports
Gijsbert F L Kapel, Frédéric Sacher, Olaf M Dekkers, Masaya Watanabe, Nico A Blom, Jean-Benoît Thambo, Nicolas Derval, Martin J Schalij, Zakaria Jalal, Adrianus P Wijnmaalen, Katja Zeppenfeld
AIMS: The majority of ventricular tachycardias (VTs) in repaired tetralogy of Fallot (rTOF) are related to anatomically defined isthmuses. We aimed to identify specific electroanatomical characteristics of anatomical isthmuses (AI) related to VT which may allow for individualized risk stratification and tailored ablation. METHODS AND RESULTS: Seventy-four consecutive rTOF patients (40 ± 16 years, 63% male) underwent VT induction and right ventricular electroanatomical voltage and activation mapping during sinus rhythm (SR) to identify the presence and characteristics of AI (isthmus width, length and conduction velocity index [CVi])...
May 26, 2016: European Heart Journal
Takahiko Kinjo, Shingo Sasaki, Masaomi Kimura, Shingen Owada, Daisuke Horiuchi, Kenichi Sasaki, Taihei Itoh, Yuji Ishida, Yoshihiro Shoji, Kimitaka Nishizaki, Yuichi Tsushima, Hirofumi Tomita, Ken Okumura
BACKGROUNDS: Postpacing interval (PPI) measured after entrainment pacing describes the distance between pacing site and reentrant circuit. However, the influential features to PPI remain to be elucidated. METHODS AND RESULTS: This study included 22 cases with slow/fast atrioventricular (AV) nodal reentrant tachycardia (AVNRT), 14 orthodromic AV reciprocating tachycardia (AVRT) using an accessary pathway, 22 typical atrial flutter (AFL), and 18 other macroreentrant atrial tachycardia (atypical AFL)...
August 2016: Journal of Cardiovascular Electrophysiology
Ken Okumura, Shingo Sasaki, Masaomi Kimura, Daisuke Horiuchi, Kenichi Sasaki, Taihei Itoh, Hirofumi Tomita, Yuji Ishida, Takahiko Kinjo
BACKGROUND: By using a noncontact mapping system, adenosine triphosphate (ATP)-sensitive atrial tachycardia (ATP-AT) originating from the atrioventricular (AV) node vicinity was successfully ablated at the entrance to the slow conduction zone indicated by the manifest entrainment technique. We aimed to prospectively validate the efficacy of the combination of CARTO electroanatomical mapping and manifest entrainment in ablating this ATP-AT. METHODS: Of the 27 AT patients from January 2013 to March 2014, 6 patients with sustained ATP-AT were studied (age, 67±13 years; tachycardia cycle length, 350±95 ms)...
April 2016: Journal of Arrhythmia
Atsushi Doi, Masahiko Takagi, Kouhei Fujimoto, Jun Kakihara, Yusuke Hayashi, Hiroaki Tatsumi, Minoru Yoshiyama
A 71-year-old man with palpitation was referred for electrophysiological study and radiofrequency ablation. Baseline findings of 12-lead electrocardiogram during sinus rhythm and echocardiography were normal. Atrio-His (AH) and His-ventricular (HV) intervals were measured as 113 and 40 ms, respectively. Dual atrioventricular (AV) nodal physiology was observed during programmed atrial stimulation. The earliest atrial activation during ventricular constant pacing was recorded at His bundle region, and para-Hisian pacing showed AV nodal pattern...
April 19, 2016: Journal of Cardiovascular Electrophysiology
Jan Skoda, Arash Arya, Fermin Garcia, Edward Gerstenfeld, Francis Marchlinski, Gerhard Hindricks, John Miller, Jan Petru, Lucie Sediva, Qun Sha, Marek Janotka, Milan Chovanec, Petr Waldauf, Petr Neuzil, Vivek Y Reddy
INTRODUCTION: Catheter ablation is an effective treatment of scar-related ventricular tachycardia (VT), but the overall complexity of the procedure has precluded its widespread use. Remote magnetic navigation (RMN) has been shown to facilitate cardiac mapping and ablation of VT in a retrospective series. STOP-VT is the first multicenter, prospective, single-arm and single-procedure study evaluating RMN-based mapping and ablation of post-infarction VT. METHODS: Patients with documented VT and prior MI, in whom an ICD was implanted either for primary or secondary prevention, were recruited from four EU and US centers...
March 2016: Journal of Cardiovascular Electrophysiology
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