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https://www.readbyqxmd.com/read/29110290/relationship-between-left-ventricular-dyssynchrony-and-scar-burden-in-the-genesis-of-ventricular-tachyarrhythmia
#1
Saurabh Malhotra, Deepak K Pasupula, Ravi K Sharma, Samir Saba, Prem Soman
BACKGROUND: Left ventricular (LV) ejection fraction (EF) has poor predictive value for ventricular tachyarrhythmia (VT). Other parameters such as LV dyssynchrony (LVD), and LV scar burden have also been individually associated with VT, but the interplay of these factors in the genesis of VT has not been explored. This retrospective study sought to evaluate the relationship between LVD and imaging characteristics of the myocardial substrate in predicting VT. METHODS: We identified 183 patients (150 men; mean age: 64 ± 14 years and mean LVEF: 23% ± 7%), who received an implantable cardioverter defibrillator (ICD) for primary prevention and who underwent a gated single-photon emission computed tomography (GSPECT) myocardial perfusion scan prior to ICD implantation...
November 6, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29021859/the-electrical-circuit-of-a-hemodynamically-unstable-and-recurrent-ventricular-tachycardia-diagnosed-in-35%C3%A2-s-with-the-rhythmia-mapping-system
#2
Masateru Takigawa, Antonio Frontera, Nathaniel Thompson, Stefano Capellino, Pierre Jais, Frederic Sacher
Herein, we report a 47-year-old woman with ischemic cardiomyopathy who underwent ablation therapy due to an electrical storm without any triggers. The voltage mapping in sinus rhythm with the Rhythmia system and Orion catheter displayed several LAVAs in and around the anteroapical scar area. Although the patient did not tolerate the induced clinical ventricular tachycardia, which was reproductively induced, 35-second-mapping in the scar zone with the Orion catheter demonstrated the VT circuit with the critical isthmus...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29021848/scar-characteristics-derived-from-two-and-three-dimensional-reconstructions-of-cardiac-contrast-enhanced-magnetic-resonance-images-relationship-to-ventricular-tachycardia-inducibility-and-ablation-success
#3
Kazumasa Sonoda, Yasuo Okumura, Ichiro Watanabe, Koichi Nagashima, Hiroaki Mano, Rikitake Kogawa, Naoko Yamaguchi, Keiko Takahashi, Kazuki Iso, Kimie Ohkubo, Toshiko Nakai, Satoshi Kunimoto, Atsushi Hirayama
BACKGROUND: The relationship between cardiac contrast-enhanced magnetic resonance imaging (CE-MRI)-derived scar characteristics and substrate for ventricular tachycardia (VT) in patients with structural heart disease (SHD) has not been fully investigated. METHODS: This study included 51 patients (mean age, 63.3±15.1 years) who underwent CE-MRI with SHD and VT induction testing before ablation. Late gadolinium-enhanced (LGE) regions on MRI slices were quantified by thresholding techniques...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28940781/right-ventricular-scar-related-ventricular-tachycardia-in-non-ischemic-cardiomyopathy-electrophysiological-characteristics-mapping-and-ablation-of-underlying-heart-disease
#4
Saurabh Kumar, Samuel H Baldinger, Sunil Kapur, Jorge Romero, Nishaki K Mehta, Saagar Mahida, Akira Fujii, Usha B Tedrow, William G Stevenson
BACKGROUND: Right ventricular (RV)-scar related ventricular tachycardia (VT) is often due to arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) or cardiac sarcoidosis (CS), but some patients whose clinical course has not been described do not fulfill diagnostic criteria for these diseases. We sought to characterize the electrophysiologic substrate and catheter ablation outcomes of such patients, termed RV cardiomyopathy of unknown source (RCUS). METHODS AND RESULTS: Data of 100 consecutive patients who presented with RV cardiomyopathy and/or RV-related VT for ablation was reviewed (51 ARVC/D, 22 CS; 27 RCUS)...
September 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28919378/sudden-death-mechanisms-in-nonischemic-cardiomyopathies-insights-gleaned-from-clinical-implantable-cardioverter-defibrillator-trials
#5
Benjamin A Steinberg, Siva K Mulpuru, James C Fang, Bernard J Gersh
Sudden cardiac death (SCD) represents a major cause of death among patients with heart failure. Although scar-based, macroreentrant ventricular tachycardia/ventricular fibrillation is the primary etiology for SCD among patients with ischemic cardiomyopathy, a more diverse set of mechanisms and substrates is likely at play for the diverse group of patients characterized by nonischemic dilated cardiomyopathy (NICM). These causes may include scar-based reentry, but also neurohormonal stimulation (sympathetic, parasympathetic, renin-angiotensin-aldosterone), inflammation, and nonarrhythmic processes occurring in the context of a genetic predisposition...
September 23, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28912073/mapping-of-ventricular-arrhythmias-using-a-novel-noninvasive-epicardial-and-endocardial-electrophysiology-system
#6
Alexey Tsyganov, Erik Wissner, Andreas Metzner, Sergey Mironovich, Maria Chaykovskaya, Vitaly Kalinin, Mikhail Chmelevsky, Christine Lemes, Karl-Heinz Kuck
INTRODUCTION: The aim of this study was to assess the use of a novel noninvasive epicardial and endocardial electrophysiology system (NEEES) for mapping of ventricular arrhythmias. METHODS: Eight patients (2 females, mean age 50±17 years) with ischemic (n=3) and nonischemic (n=5) cardiomyopathy and inducible ventricular arrhythmias during electrophysiology study were enrolled. Noninvasive mapping of ventricular arrhythmias was performed using the NEEES based on body-surface electrocardiograms and computed tomography imaging data...
August 1, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28770255/massive-accumulation-of-myofibroblasts-in%C3%A2-the-critical-isthmus-is-associated-with%C3%A2-ventricular-tachycardia-inducibility-in%C3%A2-post-infarct-swine-heart
#7
Tarvinder S Dhanjal, Nicolas Lellouche, Christopher J von Ruhland, Guillaume Abehsira, David H Edwards, Jean-Luc Dubois-Randé, Konstantinos Moschonas, Emmanuel Teiger, Alan J Williams, Christopher H George
OBJECTIVES: In this study the authors determined the extent of cellular infiltration and dispersion, and regional vascularization in electrophysiologically (EP) defined zones in post-myocardial infarction (MI) swine ventricle. BACKGROUND: The critical isthmus (CI) in post-MI re-entrant ventricular tachycardia (VT) is a target for catheter ablation. In vitro evidence suggests that myofibroblasts (MFB) within the scar border zone (BZ) may increase the susceptibility to slow conduction and VT, but whether this occurs in vivo remains unproven...
July 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28760258/cardiac-magnetic-resonance-aided-scar-dechanneling-influence-on-acute-and-long-term-outcomes
#8
David Andreu, Diego Penela, Juan Acosta, Juan Fernández-Armenta, Rosario J Perea, David Soto-Iglesias, Teresa M de Caralt, Jose T Ortiz-Perez, Susana Prat-González, Roger Borràs, Eduard Guasch, Jose María Tolosana, Lluis Mont, Antonio Berruezo
BACKGROUND: Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) provides tissue characterization of ventricular myocardium and scar that can be depicted as pixel signal intensity (PSI) maps. OBJECTIVE: To assess the possible benefit of guiding the ventricular tachycardia (VT) substrate mapping by integrating these PSI maps into the navigation system. METHODS: In total, 159 consecutive patients (66 ± 11 years old, 151 men [95%]) with scar-related left ventricular (LV) VT were included...
August 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28744991/utility-of-high-density-multielectrode-mapping-during-ablation-of-scar-related-ventricular-tachycardia
#9
Óscar Cano, Diego Plaza, Assumpció Saurí, Joaquín Osca, Pau Alonso, Ana Andrés, María-José Sancho-Tello, Luis Martínez-Dolz
INTRODUCTION: Multielectrode mapping catheters (MEMC) allow the performance of high resolution and density maps but the utility of these catheters in ventricular tachycardia (VT) ablation procedures has not been yet widely described. We sought to evaluate the utility of a MEMC during scar-related VT ablation procedures. METHODS: Eighty-five consecutive scar-related VT ablation procedures were performed in 81 patients. In the first 26 procedures, a standard 3.5-mm tip linear catheter was employed for endocardial/epicardial mapping (control group)...
November 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28744873/epicardial-ablation-of-tachyarrhythmia-in-children-experience-at-two-academic-centers
#10
Shailendra Upadhyay, Edward P Walsh, Frank Cecchin, John K Triedman, Juan Villafane, J Philip Saul
BACKGROUND: Experience with percutaneous epicardial ablation of tachyarrhythmia in pediatrics is limited. This case series addresses the feasibility, safety, and complications of the procedure in children. METHODS: A total of nine patients underwent 10 epicardial ablation procedures from 2002 to 2013 at two academic centers. Activation mapping was performed in all cases, and electroanatomic map was utilized in nine of the 10 procedures. Patients had undergone one to three failed endocardial catheter ablations in addition to medical management, and all had symptoms, a high-risk accessory pathway (AP), aborted cardiac arrest with Wolff-Parkinson-White syndrome (WPW), or ventricular dysfunction...
July 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28744864/impact-of-timing-of-recurrence-following-catheter-ablation-of-scar-related-ventricular-tachycardia-on-subsequent-mortality
#11
Daniele Muser, Todd Mendelson, Joe Fahed, Jackson J Liang, Simon A Castro, Erica Zado, Francis E Marchlinski, Pasquale Santangeli
BACKGROUND: Catheter ablation (CA) has an established role in scar-related ventricular tachycardia (VT), but the risk of recurrences is substantial and the appropriate intensity of postablation monitoring unknown. The implication of timing of postablation VT recurrence has not been adequately investigated. METHODS: We studied 120 consecutive patients with scar-related VT (age 60 ± 15 years, left ventricular ejection fraction 39 ± 16%, 52% ischemic etiology) with at least 2 years of follow-up...
July 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28667170/isolated-cardiac-sarcoidosis-masquerading-as-right-ventricular-outflow-tract-ventricular-tachycardia
#12
Auras R Atreya, Mitkumar Patel, Senthil K Sivalingam, Mathias L Stoenescu
A 67-year-old man with coronary artery disease (CAD) and left anterior descending artery (LAD) stent presented with symptomatic monomorphic ventricular tachycardia (VT) at a rate of 190 bpm requiring cardioversion. ECG showed left bundle branch block pattern and inferior axis, suggestive of a right ventricular outflow tract (RVOT) focus rather than left ventricular scar due to LAD territory myocardial infarction (MI). Echocardiography showed normal wall motion. Angiography revealed a patent mid-LAD stent. Cardiac MRI with delayed postcontrast sequence revealed several regions of hyperenhancement abnormality within the basal portion of the interventricular septum...
June 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28597532/substrate-characterization-and-catheter-ablation-in-patients-with-scar-related-ventricular-tachycardia-using-ultra-high-density-3-d-mapping
#13
Jana M Nührich, Lukas Kaiser, Ruken Özge Akbulak, Benjamin N Schäffer, Christian Eickholt, Michael Schwarzl, Pawel Kuklik, Julia Moser, Mario Jularic, Stephan Willems, Christian Meyer
BACKGROUND: Ablation of scar-related ventricular tachycardia (VT), especially in noninducible VT or hemodynamically unstable patients, can be challenging. Thus, we evaluated feasibility of an ultra high-density 3-D mapping approach to characterize the ventricular substrate and, if possible, to map VT. METHODS AND RESULTS: Twenty-two patients (67 ± 2 years, mean LV-EF 36 ± 3%) with both ischemic and nonischemic cardiomyopathy and documented VT underwent mapping and catheter ablation using a 64-electrode mini-basket catheter...
June 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28597213/-3-d-mapping-of-ventricular-tachycardia-in-patients-with-dilative-cardiomyopathy
#14
REVIEW
Daniel Steven, Jan-Hendrik van den Bruck, Jakob Lüker, Tobias Plenge, Arian Sultan
Catheter ablation of ventricular tachycardia (VT) is gaining in importance. The current guidelines suggest considering catheter ablation for VT even in patients with a single sustained and documented episode. This is also underlined by recent data indicating that absence of VT predicts lower mortality and longer transplant-free survival. The majority of patients with VTs have a history of prior myocardial infarction; in a smaller proportion, patients present with dilated cardiomyopathy. The latter has a less structured scar pattern which makes it more complicated to apply efficient ablation strategies...
June 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28588820/endocardial-and-epicardial-focal-activation-pattern-due-to-microreentry-ventricular-tachycardia-in-a-patient-with-cardiac-sarcoidosis
#15
Hiroshi Kawakami, Ikutaro Nakajima, Mitsuru Wada, Kazuhiro Satomi, Kengo Kusano
Majority of ventricular tachycardias (VTs) are caused by scar-related macroreentry in patients with cardiac sarcoidosis. These VTs usually exhibit the reentry circuit on electroanatomic maps. We here describe a rare case of VT that exhibits a focal activation pattern on the electroanatomic map despite reentrant VT.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28586587/laser-myringotomy-versus-ventilation-tubes-in-otitis-media-with-effusion
#16
Mohammad Yousaf, Suhail Ahmad Malik, Tahir Haroon
BACKGROUND: Otitis media with effusion (OME) is a leading cause of difficulty in hearing in paediatric population. Otitis media with effusion must be detected and managed early to prevent conductive hearing loss in children. It was aimed to compare results of laser myringotomy and ventilation tube insertion, in terms of hearing improvement and recurrence of Middle ear effusion (MEE). METHODS: This randomized controlled trial was conducted from February 2012 to January 2015...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28579601/efficacy-of-intensive-radiofrequency-energy-delivery-to-the-localized-dense-scar-area-in-post-infarction-ventricular-tachycardia-ablation%C3%A3-a-comparative-study-with-standard-strategy-targeting-the-infarcted-border-zone
#17
Kenji Kuroki, Akihiko Nogami, Kentaro Yoshida, Masahiko Goya, Masato Fukunaga, Kazuaki Kaitani, Naoaki Onishi, Takanao Mine, Takashi Koyama, Masayuki Igawa, Takeshi Machino, Hiro Yamasaki, Dongzhu Xu, Miyako Igarashi, Nobuyuki Murakoshi, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: Several reports have demonstrated the importance of severely low voltage areas as arrhythmogenic substrates of ventricular tachycardia (VT). However, a comparative study of dense scar-targeted and infarcted border zone-targeted strategies has not been reported.Methods and Results:We divided 109 consecutive patients with VT post-infarction from 6 centers into 2 groups according to the ablation strategy used: dense scar-targeted ablation (DS ablation, 48%) or border zone-targeted ablation (BZ ablation, 52%)...
June 3, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28576780/outcomes-of-ventricular-tachycardia-ablation-using-percutaneous-left-ventricular-assist-devices
#18
COMPARATIVE STUDY
Shigeki Kusa, Marc A Miller, William Whang, Yoshinari Enomoto, Jorge G Panizo, Jin Iwasawa, Subbarao Choudry, Sean Pinney, Anthony Gomes, Noelle Langan, Jacob S Koruth, Andre d'Avila, Vivek Y Reddy, Srinivas R Dukkipati
BACKGROUND: Although percutaneous left ventricular assist devices (pLVADs) facilitate mapping and ablation of hemodynamically unstable ventricular tachycardia (VT), there is limited data whether clinical outcomes are improved. We sought to retrospectively compare the outcomes of patients undergoing scar-related VT ablation with and without pLVAD support. METHODS AND RESULTS: The study population comprised 194 patients (109 pLVAD and 85 non-pLVAD). The pLVAD group more often had dilated cardiomyopathy (33% versus 13%; P=0...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28546773/successful-bipolar-ablation-for-ventricular-tachycardia-with-potential-substrate-identification-by-pre-procedural-cardiac-magnetic-resonance-imaging
#19
Kazuo Sakamoto, Masatsugu Nozoe, Yoshitomo Tsutsui, Nobuhiro Suematsu, Toru Kubota, Masanori Okabe, Yusuke Yamamoto
Cardiac magnetic resonance imaging (MRI) is a useful tool for detecting the arrhythmogenic substrate in cardiac sarcoidosis. We herein present a case of bipolar radiofrequency catheter ablation for ventricular tachycardia (VT) complicated with cardiac sarcoidosis, guided by pre-procedural cardiac MRI. Neither echocardiography nor endocardial voltage mapping suggested a septal VT substrate. However, MRI alone detected intramural lesions in the septum. Although application of endocardial energy failed to treat the VT, bipolar ablation targeting the potential substrate identified by MRI successfully eliminated the VT...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28536891/myocardial-voltage-ratio-in-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy
#20
REVIEW
Andreas Müssigbrodt, Livio Bertagnolli, Elena Efimova, Jedrzej Kosiuk, Borislav Dinov, Kerstin Bode, Simon Kircher, Nikolaos Dagres, Michael Döring, Sergio Richter, Philipp Sommer, Daniela Husser, Andreas Bollmann, Gerhard Hindricks, Arash Arya
AIMS: This study aimed to analyze the influence of scar distribution between the endocardium and the epicardium in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). METHODS: Electroanatomical mapping data were derived from our ARVD/C registry. Myocardial voltage distribution between the endocardium and the epicardium was analyzed in 28 patients (18 men, 49.9 ± 13.0 years) with previous ventricular tachycardia (VT) ablation and complete right ventricular maps...
June 2017: Herzschrittmachertherapie & Elektrophysiologie
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