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entrainment tachycardia

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https://www.readbyqxmd.com/read/29779523/reentrant-atrial-tachycardia-originating-from-the-sinus-venosa-region
#1
Ryo Sasaki, Hisashi Yokoshiki, Yuki Chiba, Motoki Maeno, Hirofumi Mitsuyama, Masaya Watanabe, Taro Tenma, Rui Kamada, Masayuki Takahashi, Minoru Ota
A 78-year old woman with palpitation exhibited an atrial tachycardia (AT) of variable cycle lengths resembling atrial fibrillation (AF). Vague centrifugal activation was noted at the sinus venosa region where overdrive pacing demonstrated entrainment with concealed fusion and the stimulus to P wave approximated the electrogram to the P wave interval of 125ms. Application of radiofrequency energy to this site resulted in termination of the AT as well as formation of a fixed block line manifested by the presence of discrete double potentials...
May 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29759621/analyses-of-the-mode-of-termination-during-diagnostic-ventricular-pacing-to-differentiate-the-mechanisms-of-supraventricular-tachycardias
#2
Mitsunori Maruyama, Shunsuke Uetake, Yasushi Miyauchi, Yoshihiko Seino, Wataru Shimizu
OBJECTIVES: The goal of this study was to determine the diagnostic yield of analyzing the mode of termination during ventricular overdrive pacing (VOP) to differentiate the mechanisms of supraventricular tachycardias (SVTs). BACKGROUND: The majority of the diagnostic criteria for VOP rely on successful entrainment, but termination of SVTs is common during VOP. METHODS: We studied 225 SVTs with a 1:1 atrioventricular relationship, including 34 atrial tachycardias, 67 orthodromic reciprocating tachycardias (ORTs) (including 4 ORTs using accessory pathways [APs] with decremental properties), and 124 atrioventricular nodal re-entrant tachycardias...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759543/long-term-outcomes-of-catheter-ablation-of-electrical-storm-in-nonischemic-dilated-cardiomyopathy-compared-with-ischemic-cardiomyopathy
#3
Daniele Muser, Jackson J Liang, Rajeev K Pathak, Silvia Magnani, Simon A Castro, Tatsuya Hayashi, Fermin C Garcia, Gregory E Supple, Michael P Riley, David Lin, Sanjay Dixit, Erica S Zado, David S Frankel, David J Callans, Francis E Marchlinski, Pasquale Santangeli
OBJECTIVES: The goal of this study was to determine the long-term outcomes of catheter ablation (CA) of electrical storm in patients with nonischemic dilated cardiomyopathy (NIDCM) compared with patients with ischemic cardiomyopathy (ICM). BACKGROUND: CA of ventricular tachycardia (VT) electrical storm has been shown to improve VT-free survival in patients with ICM. Data on the outcomes of CA of electrical storm in patients with NIDCM are insufficient. METHODS: The study included 267 consecutive patients with NIDCM (n = 71; ejection fraction 32 ± 14%) and ICM (n = 196; ejection fraction 28 ± 12%)...
July 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29717782/targeting-an-epicardial-endocardial-breakthrough-in-a-case-with-an-intractable-common-atrial-flutter-using-ultra-high-resolution-3-dimensional-mapping
#4
Satoshi Higuchi, Morio Shoda, Yuji Iwanami, Daigo Yagishita, Koichiro Ejima, Nobuhisa Hagiwara
The recent development of high-density high-spatial resolution 3-dimensional mapping has provided detailed information for understanding complicated atrial activation patterns at a level not previously possible. Using this technology, we report a case with recurrent common atrial flutter, demonstrating the presence of a bridging epicardial fiber that traveled across the previous cavotricuspid isthmus ablation lesion with apparent epicardial-endocardial breakthrough (EEB) sites located on both sides of the ablation line...
May 2, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29582363/electrophysiological-characteristics-and-radiofrequency-ablation-of-sustained-monomorphic-ventricular-tachycardia-in-adult-patients-with-isolated-ventricular-noncompaction
#5
Yanhui Li, Yumei Xue, Jianhua Yu, Chenyang Jiang, Zulu Wang, Mackenzi Mbai, Venkatakrishna Tholakanahalli, David G Benditt, Jian-Ming Li
PURPOSE: This study examined electrophysiological characteristics and outcomes of patients with sustained ventricular tachycardia (VT) in the setting of isolated ventricular noncompaction (IVNC). BACKGROUND: In patients with IVNC, VT has been associated with sudden cardiac death. However, the electrophysiological characteristics and optimal management of these VTs are only incompletely understood. METHODS: This retrospective cohort study assessed arrhythmia characteristics and outcomes in IVNC patients with sustained monomorphic VTs...
March 26, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29569094/focal-intra-cavotricuspid-isthmus-atrial-tachycardias-occurring-after-typical-atrial-flutter-ablation-incidence-and-electrocardiographic-and-electrophysiological-characteristics
#6
Taihei Itoh, Yukihiko Yoshida, Itsuro Morishima, Takumi Yamada
PURPOSE: Focal atrial tachycardias (ATs) from the septal cavotricuspid isthmus (CTI) occurring after successful CTI ablation can mimic typical atrial flutter (tAFL). This study investigated the incidence, and electrocardiographic and electrophysiological characteristics of these ATs. METHODS: Among 1082 consecutive patients undergoing successful CTI ablation without any congenital heart diseases, 7 were diagnosed with focal ATs originating from the septal CTI that occurred a median of 74 days after the CTI ablation...
March 22, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29380921/correlation-between-computer-tomography-derived-scar-topography-and-critical-ablation-sites-in-postinfarction-ventricular-tachycardia
#7
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...
March 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29364554/validation-of-a-novel-mapping-system-and-utility-for-mapping-complex-atrial-tachycardias
#8
S Honarbakhsh, R J Hunter, G Dhillon, W Ullah, E Keating, R Providencia, A Chow, M J Earley, R J Schilling
INTRODUCTION: This study sought to validate a novel wavefront mapping system utilizing whole-chamber basket catheters (CARTOFINDER, Biosense Webster). The system was validated in terms of (1) mapping atrial-paced beats and (2) mapping complex wavefront patterns in atrial tachycardia (AT). METHODS AND RESULTS: Patients undergoing catheter ablation for AT and persistent AF were included. A 64-pole-basket catheter was used to acquire unipolar signals that were processed by CARTOFINDER mapping system to generate dynamic wavefront propagation maps...
March 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29327439/the-hidden-concealed-left-sided-accessory-pathway-an-uncommon-cause-of-svt-in-young-people
#9
Robert H Pass, Leonardo Liberman, Eric S Silver, Christopher M Janson, Andrew D Blaufox, Lynn Nappo, Scott R Ceresnak
BACKGROUND: Concealed left-sided accessory pathways (CLAP) are a cause of supraventricular tachycardia (SVT) in the young. Most are mapped with right ventricular (RV) apical/outflow pacing. Rarely, alternative means of mapping are required. We review our experience from three pediatric electrophysiology (EP) centers with a rare form of "hidden" CLAP. METHODS: All patients <21 years undergoing EP study from 2008 to 2014 with a "hidden" CLAP (defined as an accessory pathway [AP] for which RV pacing at cycle lengths [CL] stable for mapping did not demonstrate eccentric retrograde conduction) were included...
April 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29300867/delta-of-the-local-ventriculo-atrial-intervals-at-the-septal-location-to-differentiate-tachycardia-using-septal-accessory-pathways-from-atypical-atrioventricular-nodal-re-entry
#10
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
https://www.readbyqxmd.com/read/29250234/postpacing-interval-during-right-ventricular-overdrive-pacing-to-discriminate-supraventricular-from-ventricular-tachycardia
#11
Kivanc Yalin, Ebru Golcuk, Ekrem Bilal Karaayvaz, Tolga Aksu, Muhammet Arslane, Selma Kenar Tiryakioglu, Ahmet Kaya Bilge, Kamil Adalet
Introduction: Failure to differentiate supraventricular from ventricular arrhythmias is the most frequent cause of inappropriate implantable cardioverter-defibrillator (ICD) therapies. We hypothesized that the postpacing interval (PPI) after overdrive right ventricular pacing may differentiate ventricular (VT) from supraventricular tachycardia (SVT) such as sinus tachycardia, atrial flutter and atrial tachycardia. This hypothesis is based on the entrainment maneuver. Reentrant tachycardia circuit for VTs would haveshorter distance to RV apex than SVTs have, and the conduction time between a ventricular pacing site and the tachycardia origin is expected to be shorter in VTs than in SVTs...
August 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29236200/electrophysiologic-features-of-protected-channels-in-late-postinfarction-patients-with-and-without-spontaneous-ventricular-tachycardia
#12
Sachin Nayyar, Lauren Wilson, Anand Ganesan, Thomas Sullivan, Pawel Kuklik, Glenn Young, Prashanthan Sanders, Kurt C Roberts-Thomson
PURPOSE: Protected channels of surviving myocytes in late postinfarction ventricular scar predispose to ventricular tachycardia (VT). However, only a few patients develop VT spontaneously. We studied differences in electric remodeling and protected channels in late postinfarction patients with and without spontaneous VT. METHODS: Patients with ischemic cardiomyopathy (ICM) with recurrent sustained monomorphic VT (n = 22) were compared with stable ICM patients without spontaneous VT (control group; n = 5)...
January 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29081399/revisiting-anatomic-macroreentrant-tachycardia-after-atrial-fibrillation-ablation-using-ultrahigh-resolution-mapping-implications-for-ablation
#13
Masateru Takigawa, Nicolas Derval, Antonio Frontera, Ruairidh Martin, Seigo Yamashita, Ghassen Cheniti, Konstantinos Vlachos, Nathaniel Thompson, Takeshi Kitamura, Michael Wolf, Gregoire Massoullie, Claire A Martin, Nora Al-Jefairi, Sana Amraoui, Josselin Duchateau, Nicolas Klotz, Thomas Pambrun, Arnaud Denis, Frederic Sacher, Hubert Cochet, Meleze Hocini, Michel Haïssaguerre, Pierre Jais
BACKGROUND: Anatomic macroreentrant atrial tachycardias (MATs) are conventionally reported to depend on the cavotricuspid isthmus, the mitral isthmus, or the left atrial roof, and are commonly seen following catheter ablation for atrial fibrillation. OBJECTIVES: To define the precise circuits of anatomic MAT with ultrahigh-resolution mapping. METHODS: In 57 patients (mean age, 62 years; 10 female) who developed ≥1 anatomic MAT, we analyzed 88 MAT circuits including 16 peritricuspid, 42 perimitral, and 30 roof-dependent circuits, using high-density mapping and entrainment...
March 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29072996/wide-qrs-tachycardia-in-a-patient-with-pre-excitation-what-are-the-pathways-involved-pacing-manoeuvres-to-characterize-a-unique-pathway
#14
Krishna Kumar Mohanan Nair, Anees Thajudeen, Narayanan Namboodiri, Ajitkumar Valaparambil
A 30year old patient presented to us with recurrent episodes of palpitation and documented tachycardia. In all his presentations a wide QRS tachycardia was recorded. The baseline ECG showed pre excitation. The 12 lead ECG of the tachycardia and the baseline ECG is shown in Fig. 1A. During EP study the patient had baseline pre excitation and the HV interval was 16 ms. A duo-decapolar halo (HL) catheter was used to map right atrium and a decapolar coronary sinus (CS) catheter was used to map coronary sinus...
March 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29026559/verapamil-sensitive-atrial-tachycardia-with-a-slow-conduction-zone-near-the-noncoronary-aortic-sinus-and-his-bundle
#15
Osamu Inaba, Yasutoshi Nagata, Yasuteru Yamauchi, Takamichi Miyamoto, Masahiko Goya, Kenzo Hirao
This report presents a verapamil-sensitive atrial tachycardia, mid-atrium septum activating the earliest. Concealed entrainment was obtained at noncoronary aortic sinus (NCS), where the local activation was delayed compared to mid-septum. The tachycardia was successfully ablated at NCS. The entrance of the slow conduction zone was located at NCS.
October 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28940739/entrainment-mapping-theoretical-considerations-and-practical-implementation
#16
REVIEW
Benjamin Schaeffer, William G Stevenson
Entrainment mapping enables the diagnosis and characterization of reentrant arrhythmias from analysis of the specific interaction between pacing maneuvers and tachycardia. Described 40 years ago, the implementation and interpretation of pacing maneuvers to entrain tachycardias has evolved into an indispensible tool for diagnosis and mapping reentrant cardiac arrhythmias. For complex re-entry pathways entrainment mapping allows determination of the relation of pacing sites to the re-entry circuit and discrimination of relevant re-entry parts from bystander areas...
January 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28832375/contemporary-diagnosis-and-management-of-atrial-flutter-a-continuum-of-atrial-fibrillation-and-vice-versa
#17
Antonis S Manolis
Atrial flutter (AFlu) is usually a fast (>240 bpm) and regular right atrial macroreentrant tachycardia, with a constrained critical region of the reentry circuit located at the cavotricuspid isthmus (CTI; typical CTI-dependent AFlu). However, a variety of right and left atrial tachycardias, resulting from different mechanisms, can also present as AFlu (atypical non-CTI-dependent AFlu). The electrocardiogram can provide clues to its origin and location; however, additional entrainment and more sophisticated electroanatomical mapping techniques may be required to identify its mechanism, location, and target area for a successful ablation...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28776822/ripple-mapping-initial-multicenter-experience-of-an-intuitive-approach-to-overcoming-the-limitations-of-3d-activation-mapping
#18
Vishal Luther, Nuno Cortez-Dias, Luís Carpinteiro, João de Sousa, Richard Balasubramaniam, Sharad Agarwal, David Farwell, Mark Sopher, Girish Babu, Richard Till, Nikki Jones, Stuart Tan, Anthony Chow, Martin Lowe, Jem Lane, Naveen Pappachan, Nicholas Linton, Prapa Kanagaratnam
BACKGROUND: Ripple mapping (RM) displays electrograms as moving bars over a three-dimensional surface displaying bipolar voltage, and has shown in a single-center series to be effective for atrial tachycardia (AT) mapping without annotation of local activation time or window-of-interest assignment. We tested the reproducibility of these findings in operators naïve to RM, using it for the first time in postablation AT. METHODS: Maps were collected with multielectrode catheters and CARTO ConfiDENSE...
November 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28733070/spatial-relationship-of-sites-for-atrial-fibrillation-drivers-and-atrial-tachycardia-in-patients-with-both-arrhythmias
#19
Tina Baykaner, Junaid A B Zaman, Albert J Rogers, Rachita Navara, Mahmood AlHusseini, Ryan T Borne, Shirley Park, Paul J Wang, David E Krummen, William H Sauer, Sanjiv M Narayan
INTRODUCTION: Atrial fibrillation (AF) often converts to and from atrial tachycardia (AT), but it is undefined if these rhythms are mechanistically related in such patients. We tested the hypothesis that critical sites for AT may be related to regional AF sources in patients with both rhythms, by mapping their locations and response to ablation on transitions to and from AF. METHODS: From 219 patients undergoing spatial mapping of AF prior to ablation at 3 centers, we enrolled 26 patients in whom AF converted to AT by ablation (n=19) or spontaneously (n=7; left atrial size 42±6cm, 38% persistent AF)...
December 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28625927/entrainment-and-high-density-three-dimensional-mapping-in-right-atrial-macroreentry-provide-critical-complementary-information-entrainment-may-unmask-visual-reentry-as-passive
#20
Bhupesh Pathik, Geoffrey Lee, Chrishan Nalliah, Stephen Joseph, Joseph B Morton, Paul B Sparks, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman
BACKGROUND: With the recent advent of high-density (HD) 3-dimensional (3D) mapping, the utility of entrainment is uncertain. However, the limitations of visual representation and interpretation of these high-resolution 3D maps are unclear. OBJECTIVE: The purpose of this study was to determine the strengths and limitations of both HD 3D mapping and entrainment mapping during mapping of right atrial macroreentry. METHODS: Fifteen patients were studied...
October 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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