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https://www.readbyqxmd.com/read/28546773/successful-bipolar-ablation-for-ventricular-tachycardia-with-potential-substrate-identification-by-pre-procedural-cardiac-magnetic-resonance-imaging
#1
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
#2
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...
May 23, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28507740/mark-josephson-pioneer-educator-and-mentor-to-a-generation-of-cardiac-electrophysiologists
#3
William G Stevenson
In January 2017 we lost a giant in cardiac electrophysiology, whose work and teachings touched all of us working in the field. Mark Josephson's early work, building on the work of Hein Wellens in using programmed stimulation and catheter mapping to understand scar-related ventricular tachycardias, led the way to surgical and then catheter ablation as a viable therapy for that arrhythmia. His seminal observations are many and catalogued in 'The Josephson School' a wonderful book with 59 Chapters and extensive commentary devoted to his research...
April 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28488109/-epicardial-ablation-of-ventricular-tachycardias
#4
REVIEW
E Ene, P Halbfaß, K Nentwich, K Sonne, M Roos, S Fodor, L Lehmkuhl, F Gietzen, S Barth, K Hamm, T Deneke
Ventricular tachycardias (VT) in patients with structural heart diseases have predominantly a scar-associated reentry mechanism so that substrate-based ablation approaches also have to be used in nearly all procedures. In many VT cases-especially in nonischemic cardiomyopathy (NICM) and arrhythmogenic right ventricular cardiomyopathy-a critical epicardial substrate can be identified as an essential component of the reentry circuit so that for the ablation-based modification of the substrate in these cases an epicardial approach is necessary...
May 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28449770/early-mortality-after-catheter-ablation-of-ventricular-tachycardia-in-patients-with-structural-heart-disease
#5
Pasquale Santangeli, David S Frankel, Roderick Tung, Marmar Vaseghi, William H Sauer, Wendy S Tzou, Nilesh Mathuria, Shiro Nakahara, Timm M Dickfeldt, Dhanunjaya Lakkireddy, T Jared Bunch, Luigi Di Biase, Andrea Natale, Venkat Tholakanahalli, Usha B Tedrow, Saurabh Kumar, William G Stevenson, Paolo Della Bella, Kalyanam Shivkumar, Francis E Marchlinski, David J Callans
BACKGROUND: In patients referred for radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT) in the setting of structural heart disease, early post-procedural mortality (EM) has not been previously investigated. OBJECTIVES: The purpose of this study was to evaluate EM after catheter ablation of scar-related VT. METHODS: Associations between clinical and procedural variables and EM (within 31 days of the procedure) were tested in patients with structural heart disease undergoing RFCA of VT at 12 international centers...
May 2, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28429512/tailored-approach-for-management-of-ventricular-tachycardia-in-cardiac-sarcoidosis
#6
Sachin Yalagudri, Ngwe Zin Thu, Soumen Devidutta, Daljeet Saggu, Ajit Thachil, Sridevi Chennapragada, Calambur Narasimhan
INTRODUCTION: Treating ventricular tachycardia (VT) in patients with cardiac sarcoidosis (CS) is challenging as patients present in different phase of the disease (inflammatory, scar or sometimes both). A customized approach to treatment is required for better outcomes. We describe our experience in the management of VT in CS based on the phase of the disease. METHODS AND RESULTS: Patients were considered to have myocardial inflammation if there was an increased myocardial (18) Fluoro Deoxy Glucose (FDG) uptake in PET-CT scan of the chest (n=14)...
April 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28409519/off-line-analysis-of-electro-anatomical-mapping-in-ventricular-arrhythmias
#7
Daniele Muser, Jackson J Liang, Pasquale Santangeli
Sudden cardiac death due to ventricular tachycardia (VT) is a major health issue in patients with structural heart disease and depressed ejection fraction. If from one side, implantable cardioverter defibrillator (ICD) therapy has significantly improved survival of these patients, on the other hand, it has led to frequent ICD shocks as an emerging problem, being associated with poor quality of life, frequent hospitalizations and increased mortality. Scar-related reentry due to the coexistence of surviving myocardial fibers within fibrotic tissue is the most common mechanism subtending VT both in ischemic and non-ischemic cardiomyopathies...
April 12, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28402404/long-term-outcome-of-surgical-cryoablation-for-refractory-ventricular-tachycardia-in-patients-with-non-ischemic-cardiomyopathy
#8
Jackson J Liang, Brian P Betensky, Daniele Muser, Erica S Zado, Elad Anter, Nimesh D Desai, David J Callans, Rajat Deo, David S Frankel, Mathew D Hutchinson, David Lin, Michael P Riley, Robert D Schaller, Gregory E Supple, Pasquale Santangeli, Michael A Acker, Joseph E Bavaria, Wilson Y Szeto, Prashanth Vallabhajosyula, Francis E Marchlinski, Sanjay Dixit
Aims: Limited data exist on the long-term outcome of patients (pts) with non-ischemic cardiomyopathy (NICM) and ventricular tachycardia (VT) refractory to conventional therapies undergoing surgical ablation (SA). We aimed to investigate the long-term survival and VT recurrence in NICM pts with VT refractory to radiofrequency catheter ablation (RFCA) who underwent SA. Methods and results: Consecutive pts with NICM and VT refractory to RFCA who underwent SA were included...
April 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28396753/catheter-ablation-of-hemodynamically-unstable-ventricular-tachycardia-in-ischemic-cardiomyopathy-using-high-resolution-mapping
#9
Lukas Kaiser, Mario Jularic, Ruken Özge Akbulak, Jana Nührich, Stephan Willems, Christian Meyer
Catheter ablation is a recommended therapy option for ventricular tachycardia (VT). The antegrade transseptal approach for targeting VT with left ventricular origin is feasible with the high-resolution basket catheter. High-resolution mapping offers the potential to quickly acquire detailed voltage and activation maps. This may help to identify the crucial VT-substrate even in patients with huge scar areas and hemodynamically unstable VT.
April 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28371837/characterization-of-the-arrhythmogenic-substrate-in-patients-with-arrhythmogenic-right-ventricular-cardiomyopathy-undergoing-ventricular-tachycardia-ablation
#10
Senthil Kirubakaran, Caterina Bisceglia, John Silberbauer, Teresa Oloriz, Giulia Santagostino, Miki Yamase, Giuseppe Maccabelli, Nicola Trevisi, Paolo Della Bella
Aims: Arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC) is associated with ventricular arrhythmias, even without RV structural disease. We aimed to characterize the RV substrate using electroanatomical mapping and to define outcomes following ventricular tachycardia (VT) ablation in patients with and without RV structural abnormalities. Methods and results: Twenty-nine patients with definite or suspected ARVC undergoing VT ablation were classified as 'electrical' and 'structural' cardiomyopathy based on the absence or presence of major structural criteria...
March 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28353573/aneurysm-related-ischemic-ventricular-tachycardia-safety-and-efficacy-of-catheter-ablation
#11
Jin-Rui Guo, Li-Hui Zheng, Ling-Min Wu, Li-Gang Ding, Yan Yao
Left ventricular aneurysm (LVA) postmyocardial infarction (MI) might be an arrhythmogenic substrate. We examined the safety and efficacy of catheter ablation of LVA-related ventricular tachycardia (VT).Thirty-three consecutive patients who underwent primary catheter ablation of ischemic VT were divided into LVA group (11 patients, mean age 61.9 years, 10 men) and none LVA group. Acute procedural outcomes, complications, and long-term outcomes were assessed.In LVA group, average number of induced VTs were 3...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28236155/cardiac-magnetic-resonance-imaging-and-electroanatomic-voltage-discordance-in-non-ischemic-left-ventricle-ventricular-tachycardia-and-premature-ventricular-depolarizations
#12
Brian P Betensky, Wei Dong, Benjamin A D'Souza, Erica S Zado, Yuchi Han, Francis E Marchlinski
PURPOSE: Magnetic resonance imaging (MRI) with late gadolinium enhancement is commonly performed in patients with non-ischemic LV ventricular tachycardia/ventricular premature depolarizations (non-ischemic LV-VT/VPDs) to define VT substrate prior to catheter ablation. We investigated the prevalence of abnormal voltage and VT localized to areas of the myocardium not reported to have late gadolinium enhancement (LGE) on routine pre-procedural MRI and sought to determine if quantitative MRI analysis could reduce this discordance...
June 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28167088/substrate-ablation-of-ventricular-tachycardia-late-potentials-scar-dechanneling-local-abnormal-ventricular-activities-core-isolation-and-homogenization
#13
REVIEW
David F Briceño, Jorge Romero, Carola Gianni, Sanghamitra Mohanty, Pedro A Villablanca, Andrea Natale, Luigi Di Biase
Ventricular arrhythmias are a frequent cause of mortality in patients with ischemic cardiomyopathy and nonischemic cardiomyopathy. Scar-related reentry represents the most common arrhythmia substrate in patients with recurrent episodes of sustained ventricular tachycardia (VT). Initial mapping of scar-related VT circuits is focused on identifying arrhythmogenic tissue. The substrate-based strategies include targeting late potentials, scar dechanneling, local abnormal ventricular activities, core isolation, and homogenization of the scar...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167086/entrainment-mapping
#14
REVIEW
Saurabh Kumar, Usha B Tedrow, William G Stevenson
Mapping during ventricular tachycardia (VT) aims to elucidate mechanism, describe myocardial propagation, and identify the origin and critical regions of VT that can be targeted for ablation, most commonly with radiofrequency ablation. Most VTs in structural heart disease are due to macro-reentry in and around scar. A combination of mapping techniques, including mapping to identify the arrhythmia substrate, activation sequence mapping, pace-mapping, and entrainment mapping, may be used to identify putative ablation targets...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167077/electrocardiographic-localization-of-ventricular-tachycardia-in-patients-with-structural-heart-disease
#15
REVIEW
John M Miller, Rahul Jain, Gopi Dandamudi, Thomas R Kambur
The 12-lead electrocardiogram (ECG) during ventricular tachycardia (VT) in patients with structural heart disease contains information that helps to narrow the electrophysiologist's search for target sites for ablation. Although replacement of myocardium by scar might be expected to produce variability in the spread of activation during VT, nonetheless reasonably consistent ECG patterns exist that can regionalize exit sites from VT circuits in up to 75% of cases. Most experience with this comes from patients with prior myocardial infarction, but a growing body of data exists concerning patients with nonischemic cardiomyopathies...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28153106/isolated-subepicardial-right-ventricular-outflow-tract-scar-in-athletes-with-ventricular%C3%A2-tachycardia
#16
Jeroen Venlet, Sebastiaan R D Piers, Jan D H Jongbloed, Alexander F A Androulakis, Yoshihisa Naruse, Dennis W den Uijl, Gijsbert F L Kapel, Marta de Riva, J Peter van Tintelen, Daniela Q C M Barge-Schaapveld, Martin J Schalij, Katja Zeppenfeld
BACKGROUND: High-level endurance training has been associated with right ventricular pathological remodeling and ventricular tachycardia (VT). Although overlap with arrhythmogenic right ventricular cardiomyopathy (ARVC) has been suggested, the arrhythmogenic substrate for VTs in athletes is unknown. OBJECTIVES: The goal of this study was to evaluate whether electroanatomic scar patterns related to sustained VT can distinguish exercise-induced arrhythmogenic remodeling from ARVC and post-inflammatory cardiomyopathies...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28120237/hibernating-substrate-of-ventricular-tachycardia-a-three-dimensional-metabolic-and-electro-anatomic-assessment
#17
Ayman A Hussein, Michelle Niekoop, Vasken Dilsizian, Yousra Ghzally, Mohammed Abdulghani, Ramazan Asoglu, Wengen Chen, Mark Smith, Vincent See, Stephen R Shorofsky, Timm-Michael Dickfeld
PURPOSE: Hibernating myocardium (HM) is associated with sudden cardiac death (SCD). Little is known about the electrophysiological properties of HM and the basis of its association with SCD. We aimed to electrophysiologically characterize HM in patients with ventricular tachycardia (VT). METHODS: Endocardial voltage mapping, metabolic (18)FDG-positron emission tomography (PET) and perfusion (82)Rb, (201)Tl, or (99m)Tc scans were performed in 61 ischemic heart disease patients with VT...
January 25, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28117536/cardiovascular-magnetic-resonance-guided-management-of-mild-to-moderate-left-ventricular-systolic-dysfunction-cmr-guide-study-protocol-for-a-randomized-controlled-trial
#18
Joseph B Selvanayagam, Trent Hartshorne, Laurent Billot, Suchi Grover, Graham S Hillis, Werner Jung, Henry Krum, Sanjay Prasad, Andrew D McGavigan
BACKGROUND: The majority of sudden cardiac death (SCD) in patients with heart failure occurs in those with mild-moderate left ventricular (LV) systolic dysfunction (LVEF 36-50%) who under current guidelines are ineligible for primary prevention implantable cardiac defibrillator (ICD) therapy. Recent data suggest that cardiac magnetic resonance (CMR) evidence of replacement fibrosis forms a substrate for malignant arrhythmia and therefore potentially identifies a subgroup at increased risk of SCD...
January 24, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28104088/myocardial-wall-thinning-predicts-transmural-substrate-in-patients-with-scar-related-ventricular-tachycardia
#19
Seigo Yamashita, Frédéric Sacher, Darren A Hooks, Benjamin Berte, Jean-Marc Sellal, Antonio Frontera, Nora Al Jefairi, Yuki Komatsu, Sana Amraoui, Arnaud Denis, Nicolas Derval, Maxime Sermesant, François Laurent, Michel Montaudon, Mélèze Hocini, Michel Haïssaguerre, Pierre Jaïs, Hubert Cochet
BACKGROUND: Scar-related ventricular tachycardia (VT) arises from specific substrate according to etiology. OBJECTIVE: The purpose of this study was to evaluate the relationship between wall thinning (WT) on multidetector computed tomography (MDCT) and local abnormal ventricular activity (LAVA) in patients with ischemic cardiomyopathy (ICM), postmyocarditis (PMC), and dilated cardiomyopathy (DCM). METHODS: Forty-two patients (40 male, age 58 ± 13 years, 22 ICM, 11 PMC, 9 DCM) underwent MDCT before a combined endo-/epicardial VT ablation procedure...
February 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28069835/multielectrode-vs-point-by-point-mapping-for-ventricular-tachycardia-substrate-ablation-a-randomized-study
#20
Juan Acosta, Diego Penela, David Andreu, Mario Cabrera, Alicia Carlosena, Francesca Vassanelli, Francisco Alarcón, David Soto-Iglesias, Viatcheslav Korshunov, Roger Borras, Markus Linhart, Mikel Martínez, Juan Fernández-Armenta, Lluis Mont, Antonio Berruezo
AIMS: Ventricular tachycardia (VT) substrate ablation is based on detailed electroanatomical maps (EAM). This study analyses whether high-density multielectrode mapping (MEM) is superior to conventional point-by-point mapping (PPM) in guiding VT substrate ablation procedures. METHODS AND RESULTS: This was a randomized controlled study (NCT02083016). Twenty consecutive ischemic patients undergoing VT substrate ablation were randomized to either group A [n = 10; substrate mapping performed first by PPM (Navistar) and secondly by MEM (PentaRay) ablation guided by PPM] or group B [n = 10; substrate mapping performed first by MEM and second by PPM ablation guided by MEM]...
January 8, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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