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Epicardial ablation

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https://www.readbyqxmd.com/read/28288961/feasibility-of-rapid-linear-endocardial-and-epicardial-ventricular-ablation-using-an-irrigated-multipolar-radiofrequency-ablation-catheter
#1
Babak Nazer, Tomos E Walters, Srikant Duggirala, Edward P Gerstenfeld
BACKGROUND: A common strategy for ablation of scar-based ventricular tachycardia is delivering multiple lesions in a linear pattern. METHODS AND RESULTS: We tested the efficacy of a novel linear irrigated multipolar ablation catheter capable of creating linear lesions with a single application. Healthy swine underwent endocardial and epicardial linear ablation using a novel linear irrigated ablation catheter; control animals underwent focal lesions in a linear pattern over 3...
March 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28285383/adenosine-administration-during-hybrid-atrial-fibrillation-ablation-to-test-dormant-pulmonary-vein-conduction
#2
Mindy Vroomen, Mark La Meir, Jos G Maessen, Harry J Crijns, Laurent Pison
BACKGROUND: Adenosine administration after initial pulmonary vein isolation (PVI) reveals dormant conduction and predicts atrial fibrillation (AF) recurrence. Elimination of dormant conduction when present may increase a long-term success rate of AF ablation procedures. There are no studies till date using adenosine to reveal acute reconduction of pulmonary veins (PVs) after epicardial PVI during a hybrid AF ablation procedure. METHODS: We included 24 patients (21 male, 55 ± 9 years) undergoing hybrid ablation for symptomatic paroxysmal (n = 12) and persistent (n = 12) AF, using an epicardial bipolar radiofrequency clamp to perform PVI...
March 11, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28267588/initial-international-multicenter-human-experience-with-a-novel-epicardial-access-needle-embedded-with-a-real-time-pressure-frequency-monitoring-to-facilitate-epicardial-access-feasibility-and-safety
#3
Luigi Di Biase, J David Burkhardt, Vivek Reddy, Jorge Romero, Petr Neuzil, Jan Petru, Lucie Sadiva, Jan Skoda, Miguel Ventura, Corrado Carbucicchio, Antonio Dello Russo, Zoltan Csanadi, Michela Casella, Gaetano M Fassini, Claudio Tondo, Frederic Sacher, Mike Theran, Srinivas Dukkipati, Jacob Koruth, Pierre Jais, Andrea Natale
BACKGROUD: Epicardial ablation is often necessary for the treatment of complex arrhythmias refractory to endocardial ablation. Conventional needle access into the pericardial space is considered quite challenging, and it is often associated with several potential complications particularly inadvertent right ventricular puncture. The novel EpiAccess Needle tip is embedded with a pressure sensor able to report the pressure waveform in real time when used with the EpiAccess System. OBJECTIVE: We evaluated the feasibility and safety of the EpiAccess®System by EpiEP, Inc...
March 3, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28229201/-sudden-cardiac-death-epidemiology-pathophysiology-and-risk-stratification
#4
B Rudic, E Tülümen, V Liebe, J Kuschyk, I Akin, M Borggrefe
Sudden cardiac death (SCD) remains a major public health burden despite revolutionary progress in the last three decades in the treatment of ventricular tachyarrhythmia with the use of implantable cardioverter defibrillator (ICD) therapy. Survivors of sudden cardiac arrest are at high risk for recurrent tachyarrhythmia events. Early recognition of low left ventricular ejection fractions (≤35%) as a strong predictor of mortality and the causal association between ventricular tachyarrhythmia and SCD has led to a significant development of not only pharmacological antiarrhythmic therapy but also device-based prevention of SCD...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28217232/successful-percutaneous-epicardial-catheter-ablation-of-ventricular-tachycardia-arising-from-the-crux-of-the-heart-in-a-patient-with-prior-coronary-artery-bypass-grafting
#5
Naoki Yoshida, Takumi Yamada
A 63-year-old man with a history of remote inferior myocardial infarction and coronary artery bypass grafting (CABG) underwent catheter ablation of ventricular tachycardia (VT). Epicardial catheter ablation of the VT was successful at the crux of the heart despite limited mapping within the pericardial space due to pericardial adhesion. Percutaneous subxiphoidal pericardial approach is usually impossible in patients with a history of open heart surgery due to pericardial adhesions. This report suggested that epicardial VT arising from the crux of the heart could be successfully treated by catheter ablation via subxiphoidal pericardial approach despite pericardial adhesions complicated by prior CABG...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28217228/spatiotemporal-characteristics-of-atrial-fibrillation-electrograms-a-novel-marker-for-arrhythmia-stability-and-termination
#6
Shivshankar Thanigaimani, Anthony G Brooks, Pawel Kuklik, Darragh J Twomey, Samantha Franklin, Erik Noschka, Darius Chapman, Rajeev K Pathak, Rajiv Mahajan, Prashanthan Sanders, Dennis H Lau
BACKGROUND: Sequentially mapped complex fractionated atrial electrograms (CFAE) and dominant frequency (DF) sites have been targeted during catheter ablation for atrial fibrillation (AF). However, these strategies have yielded variable success and have not been shown to correlate consistently with AF dynamics. Here, we evaluated whether the spatiotemporal stability of CFAE and DF may be a better marker of AF sustenance and termination. METHODS: Eighteen sheep with 12 weeks of "one-kidney, one-clip" hypertension underwent open-chest studies...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28212738/delayed-efficacy-of-radiofrequency-catheter-ablation-on-ventricular-arrhythmias-originating-from-the-left-ventricular-anterobasal-wall
#7
Ligang Ding, Bingbo Hou, Lingmin Wu, Yu Qiao, Wei Sun, Jinrui Guo, Lihui Zheng, Gang Chen, Linfeng Zhang, Shu Zhang, Yan Yao
BACKGROUND: Ventricular arrhythmias (VAs) originating from the left ventricular anterobasal wall (LV-ABW) may represent a therapeutic challenge. OBJECTIVE: The purpose of this study was to investigate the delayed efficacy of radiofrequency catheter (RFCA) ablation without an epicardial approach on VAs originating from the LV-ABW. METHODS: Eighty patients (mean age 46.9 ± 14.9 years; 47 male) with VAs originating from the LV-ABW were enrolled...
March 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28188661/idiopathic-epicardial-ventricular-tachycardia-from-the-coronary-venous-system-from-electrocardiographic-recognition-to-appropriate-therapy
#8
Stéphane Boulé, Claire Federspiel, Eric Verbrugge, Didier Klug
Idiopathic epicardial ventricular tachycardias (VTs) account for 9% of idiopathic VTs. The recognition of this entity is important, as a minimally invasive ablation procedure performed exclusively through the coronary sinus branches may be considered, avoiding the potential risks associated with access to the left ventricular endocardium, the aortic root, and the pericardial space. The electrocardiographic features and therapeutic management of this rare form of tachycardia are discussed.
February 11, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28175981/-catheter-ablation-of-ventricular-extrasystoles-and-ventricular-tachycardia-in-the-elderly
#9
Philipp Halbfaß, Karin Nentwich, Kai Sonne, Elena Ene, Franziska Fochler, Andreas Mügge, Bernhard Schieffer, Thomas Deneke
BACKGROUND: The prevalence of structural heart disease increases with higher age, and thereby the basis for ventricular arrhythmias is created. Catheter ablation has been shown to be an effective therapy option that is very safe and achieves good long-term results in patients with recurrent ventricular tachycardia (VT). Data regarding ablation in patients older than 75 years is sparse, although this patient group was included as a minority in most published VT ablation studies. Data from younger patient collectives may not be transferable to older patient cohorts due to differences in patient comorbidities and baseline characteristics...
February 7, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28167090/ablation-of-ventricular-tachycardia-in-arrhythmogenic-right-ventricular-dysplasia
#10
REVIEW
Rajeev K Pathak, Fermin C Garcia
Endocardial and epicardial electroanatomical mapping and ablation is a safe and effective therapy in the treatment of right ventricle arrhythmias occurring in the setting of arrhythmogenic right ventricular cardiomyopathy (ARVD). Careful mapping and ablation plans must be tailored for each patient based on comorbidities and ventricular tachycardia morphologies. This review focuses on the catheter ablation for ventricular arrhythmias in patients with ARVD.
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167089/alternative-approaches-for-ablation-of-resistant-ventricular-tachycardia
#11
REVIEW
Carola Gianni, Sanghamitra Mohanty, Chintan Trivedi, Luigi Di Biase, Amin Al-Ahmad, Andrea Natale, J David Burkhardt
Ventricular tachycardia (VT) ablation is usually performed with an ablation catheter that delivers unipolar radiofrequency (RF) energy to eliminate the re-entry circuit responsible for VT. However, there are some instances when unipolar RF ablation fails, notably in VTs with a deep intramural origin, or cases in which epicardial access is not attainable due to prior cardiac surgery. To overcome these limitations, several alternative approaches have been used in clinical practice, including alcohol ablation or coil embolization, simultaneous unipolar or bipolar RF ablation, surgical ablation, or noninvasive ablation with stereotactic radiosurgery...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167085/catheter-ablation-for-ventricular-tachycardia-in-patients-with-nonischemic-cardiomyopathy
#12
REVIEW
Nathaniel Thompson, Antonio Frontera, Masateru Takigawa, Ghassen Cheniti, Gregoire Massoullie, Hubert Cochet, Arnaud Denis, Arnaud Chaumeil, Nicolas Derval, Meleze Hocini, Michel Haissaguerre, Pierre Jais, Frederic Sacher
Although catheter ablation has been successful in reducing the recurrence of ventricular tachycardia in patients with ischemic disease, outcomes in patients with nonischemic cardiomyopathy (NICM) have not met with the same results. Success is predicated on a methodical approach to diagnosis of disease type and identification of critical substrate, and the ablation strategies used. Cardiac MRI with delayed enhancement is able to identify areas of substrate involvement, particularly in situations when conventional catheter mapping is not able to do so...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167084/ventricular-tachycardia-in-ischemic-heart-disease
#13
REVIEW
Ronald Lo, Karin K M Chia, Henry H Hsia
Ventricular arrhythmias are a significant cause of morbidity and mortality in patients with ischemic structural heart disease. Endocardial and epicardial mapping strategies include scar characterization channel identification, and recording and ablation of late potentials and local abnormal ventricular activities. Catheter ablation along with new technology and techniques of bipolar ablation, needle catheter, and autonomic modulation may increase efficacy in difficult to ablate ventricular arrhythmias. Catheter ablation of ventricular arrhythmias seem to confer mortality and morbidity benefits in patients with ischemic heart disease...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167080/epicardial-catheter-ablation-of-ventricular-tachycardia
#14
REVIEW
Arash Aryana, André d'Avila
Over the last two decades, epicardial catheter ablation has evolved into a practical approach for treatment of ventricular tachycardia (VT). There are certain considerations when performing this procedure. First, presence of epicardial fat can diminish peak-to-peak electrogram amplitude and also impede radiofrequency energy delivery. Hence, epicardial VT ablation should be performed with cooled-tip radiofrequency using reduced irrigation flow within a relatively 'dry' pericardial milieu. Furthermore, catheter orientation is key when performing epicardial ablation...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28144262/staged-hybrid-ablation-for-persistent-and-longstanding-persistent-atrial-fibrillation-effectively-restores-sinus-rhythm-in-long-term-observation
#15
Michal Zembala, Krzysztof Filipiak, Oskar Kowalski, Piotr Buchta, Tomasz Niklewski, Pawel Nadziakiewicz, Rafał Koba, Mariusz Gąsior, Zbigniew Kalarus, Marian Zembala
INTRODUCTION: Hybrid ablation (HABL) of atrial fibrillation combining endoscopic, minimally invasive, closed chest epicardial ablation with endocardial CARTO-guided accuracy was introduced to overcome the limitations of current therapeutic options for patients with persistent (PSAF) and longstanding persistent atrial fibrillation (LSPAF). The purpose of this study was to evaluate the procedural safety and feasibility as well as effectiveness of HABL in patients with PSAF and LSPAF 1 year after the procedure...
February 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28131707/the-application-of-signal-average-ecg-in-the-prediction-of-recurrences-after-catheter-ablation-of-ventricular-arrhythmias-in-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy
#16
Ying-Chieh Liao, Fa-Po Chung, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Chin-Yu Lin, Yao-Ting Chang, Ming-Hsiung Hsieh, Shih-Ann Chen
BACKGROUND: The changes of signal averaged ECG (SAECG) in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) undergoing radiofrequency catheter ablation (RFCA) of ventricular arrhythmias (VAs) remains unknown. METHODS: Between 2010 and 2014, a total of 81 ARVD/C patients underwent endocardial and/or epicardial RFCA for drug-refractory VAs. Seventy patients (mean age 46.2±14.1years, 37 males) achieving acute procedure success (negative inducibility) were enrolled...
January 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28122031/long-term-outcomes-of-radio-frequency-catheter-ablation-on-ventricular-tachycardias-due-to-arrhythmogenic-right-ventricular-cardiomyopathy-a-single-center-experience
#17
Wei Wei, Hongtao Liao, Yumei Xue, Xianhong Fang, Jun Huang, Yang Liu, Hai Deng, Yuanhong Liang, Zili Liao, Fangzhou Liu, Weidong Lin, Xianzhang Zhan, Shulin Wu
AIMS: To summarize our experience of radiofrequency catheter ablation (RFCA) for recurrent drug-refractory ventricular tachycardias (VTs) due to arrhythmogenic right ventricular cardiomyopathy (ARVC) in our center over the past 11 years and its related factors. METHODS AND RESULTS: We reviewed 48 adults (mean age 39.9 ± 12.9 years, range: 14 to 65) who met the present ARVC diagnostic criteria and accepted RFCA for VTs from December 2004 to April 2016. The patients received a total of 70 procedures using two ablation approaches, the endocardial approach in 52 RFCAs, and the combined epicardial and endocardial approach (the combined approach) in 18 RFCAs...
2017: PloS One
https://www.readbyqxmd.com/read/28116751/cardiac-sympathetic-afferent-reflex-control-of-cardiac-function-in-normal-and-chronic-heart-failure-states
#18
Han-Jun Wang, George J Rozanski, Irving H Zucker
KEY POINTS: Cardiac sympathetic afferents are considered to be essential pathways for transmission of cardiac nociception to the central nervous system during myocardial ischaemia. However, a potential contribution of the CSAR control of cardiac dysfunction in both normal and chronic heart failure (CHF) states remains unknown. We found that activation of the CSAR evokes little increase in cardiac contractility with an exaggerated peripheral vasoconstriction in the CHF state. CSAR inhibition by epicardial lidocaine decreased cardiac contractility to a greater extent in CHF rats than sham rats...
January 24, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28113283/identification-of-rotors-during-human-atrial-fibrillation-using-contact-mapping-and-phase-singularity-detection-technical-considerations
#19
Pawel Kuklik, Stef Zeemering, Arne van Hunnik, Bart Maesen, Laurent Pison, Dennis Lau, Jos Maessen, Piotr Podziemski, Christian Meyer, Benjamin Schaffer, Harry Crijns, Stephan Willems, Ulrich Schotten
OBJECTIVE: To explore technical challenges of phase singularity mapping during Atrial Fibrillation (AF) using direct contact electrograms. METHODS: AF mapping was performed in high-density epicardial recordings of human paroxysmal (PAF) or persistent (PersAF) (N=20 pts) AF with an array of 16x16 electrodes placed on atrial epicardium. Phase singularity (PS) points were detected using subsets of electrodes forming rings of varying size. RESULTS: PS detection using a 2x2 electrode ring identified 0...
April 15, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28106019/pulmonary-vein-anatomy-and-its-variations-in-a-turkish-atrial-fibrillation-cohort-undergoing-cryoballoon-based-catheter-ablation
#20
Duygu Koçyiğit, Kadri Murat Gürses, Muhammed Ulvi Yalçın, Gamze Türk, Banu Evranos, Uğur Canpolat, Hikmet Yorgun, Tuncay Hazırolan, Kudret Aytemir
OBJECTIVE: Pulmonary vein (PV) anatomy has drawn attention since assumption that atrial fibrillation (AF) may originate from PVs and that electrical isolation of PVs may be beneficial in eliminating these triggers. The present study aims to investigate PV anatomy and its variations in a sample of Turkish patients undergoing PV isolation (PVI) for AF. METHODS: 250 patients underwent multidetector computed tomography before cryoballoon-based PVI for AF. PV and left atrial (LA) anatomy were evaluated in 3-dimensional epicardial reconstructions...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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