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https://www.readbyqxmd.com/read/28104088/myocardial-wall-thinning-predicts-transmural-substrate-in-patients-with-scar-related-ventricular-tachycardia
#1
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
#2
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
https://www.readbyqxmd.com/read/28065832/a-novel-method-to-enhance-phenotype-epicardial-functional-substrates-and-ventricular-tachyarrhythmias-in-brugada-syndrome
#3
Fa-Po Chung, Sunu Budhi Raharjo, 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, Yuan Hung, Abigail Te, Shinya Yamada, Hiroshi Tasaka, Shih-Ann Chen, Chin-Tien Wang
BACKGROUND: Fever is associated with the manifestation of Brugada phenotype and ventricular tachycardia/fibrillation (VT/VF) in patients with Brugada syndrome (BrS). The thermal effect on the pathogenesis of functional substrates in BrS remains unknown. OBJECTIVE: The study aimed to elucidate the thermal effect on BrS phenotype, VT/VF, and electrophysiological characteristics of epicardial functional substrates in BrS. METHODS: We consecutively studied 15 patients with BrS receiving radiofrequency catheter ablation (RFCA) for drug-refractory ventricular tachyarrhythmias...
January 5, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28064433/magnetic-vt-study-a-prospective-multicenter-post-market-randomized-controlled-trial-comparing-vt-ablation-outcomes-using-remote-magnetic-navigation-guided-substrate-mapping-and-ablation-versus-manual-approach-in-a-low-lvef-population
#4
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
https://www.readbyqxmd.com/read/28017938/elucidation-of-hidden-slow-conduction-by-double-ventricular-extrastimuli-a-method-for-further-arrhythmic-substrate-identification-in-ventricular-tachycardia-ablation-procedures
#5
Juan Acosta, David Andreu, Diego Penela, Mario Cabrera, Alicia Carlosena, Viatcheslav Korshunov, Francesca Vassanelli, Roger Borras, Mikel Martínez, Juan Fernández-Armenta, Markus Linhart, José M Tolosana, Lluis Mont, Antonio Berruezo
AIMS: Identification of local abnormal electrograms (EGMs) during ventricular tachycardia substrate ablation (VTSA) is challenging when they are hidden within the far-field signal. This study analyses whether the response to a double ventricular extrastimulus during substrate mapping could identify slow conducting areas that are hidden during sinus rhythm. METHODS AND RESULTS: Consecutive patients (n = 37) undergoing VTSA were prospectively included. Bipolar EGMs with >3 deflections and duration <133 ms were considered as potential hidden slow conduction EGMs (HSC-EGM) if located within/surrounding the scar area...
December 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28011832/a-feasibility-study-of-arrhythmia-risk-prediction-in-patients-with-myocardial-infarction-and-preserved-ejection-fraction
#6
Dongdong Deng, Hermenegild J Arevalo, Adityo Prakosa, David J Callans, Natalia A Trayanova
AIM: To predict arrhythmia susceptibility in myocardial infarction (MI) patients with left ventricular ejection fraction (LVEF)  >35% using a personalized virtual heart simulation approach. METHODS AND RESULTS: A total of four contrast enhanced magnetic resonance imaging (MRI) datasets of patient hearts with MI and average LVEF of 44.0 ± 2.6% were used in this study. Because of the preserved LVEF, the patients were not indicated for implantable cardioverter defibrillator (ICD) insertion...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27995644/excellent-pace-maps-recorded-from-two-remote-sites-inside-and-outside-the-scar-in-a-patient-with-ischemic-vt-what-is-the-mechanism
#7
Taihei Itoh, Takumi Yamada
No abstract text is available yet for this article.
December 20, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27968777/noninvasive-epicardial-and-endocardial-electrocardiographic-imaging-of-scar-related-ventricular-tachycardia
#8
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
https://www.readbyqxmd.com/read/27913399/development-of-time-and-voltage-domain-mapping-v-t-mapping-to-localize-ventricular-tachycardia-channels-during-sinus-rhythm
#9
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
https://www.readbyqxmd.com/read/27788854/scar-homogenization-versus-limited-substrate-ablation-in-patients-with%C3%A2-nonischemic-cardiomyopathy-and%C3%A2-ventricular-tachycardia
#10
Yalçın Gökoğlan, Sanghamitra Mohanty, Carola Gianni, Pasquale Santangeli, Chintan Trivedi, Mahmut F Güneş, Rong Bai, Amin Al-Ahmad, G Joseph Gallinghouse, Rodney Horton, Patrick M Hranitzky, Javier E Sanchez, Salwa Beheiry, Richard Hongo, Dhanunjaya Lakkireddy, Madhu Reddy, Robert A Schweikert, Antonio Dello Russo, Michela Casella, Claudio Tondo, J David Burkhardt, Sakis Themistoclakis, Luigi Di Biase, Andrea Natale
BACKGROUND: Scar homogenization improves long-term ventricular arrhythmia-free survival compared with standard limited-substrate ablation in patients with post-infarction ventricular tachycardia (VT). Whether such benefit extends to patients with nonischemic cardiomyopathy and scar-related VT is unclear. OBJECTIVES: The aim of this study was to assess the long-term efficacy of an endoepicardial scar homogenization approach compared with standard ablation in this population...
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27781325/beyond-the-storm-comparison-of-clinical-factors-arrhythmogenic-substrate-and-catheter-ablation-outcomes-in-structural-heart-disease-patients-with-versus-those-without-a-history-of-ventricular-tachycardia-storm
#11
Saurabh Kumar, Akira Fujii, Sunil Kapur, Jorge Romero, Nishaki K Mehta, Shinichi Tanigawa, Laurence M Epstein, Bruce A Koplan, Gregory F Michaud, Roy M John, William G Stevenson, Usha B Tedrow
AIMS: Catheter ablation can be lifesaving in ventricular tachycardia (VT) storm, but the underlying substrate in patients with storm is not well characterized. We sought to compare the clinical factors, substrate, and outcomes differences in patients with sustained monomorphic VT who present for catheter ablation with VT storm versus those with a nonstorm presentation. METHODS: Consecutive ischemic (ICM; n = 554) or nonischemic cardiomyopathy patients (NICM; n = 369) with a storm versus nonstorm presentation were studied (ICM storm 186; NICM storm 101)...
January 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27651061/ecg-imaging-of-ventricular-tachycardia-evaluation-against-simultaneous-non-contact-mapping-and-cmr-derived-grey-zone
#12
Walther H W Schulze, Zhong Chen, Jatin Relan, Danila Potyagaylo, Martin W Krueger, Rashed Karim, Manav Sohal, Anoop Shetty, YingLiang Ma, Nicholas Ayache, Maxime Sermesant, Herve Delingette, Julian Bostock, Reza Razavi, Kawal S Rhode, Christopher A Rinaldi, Olaf Dössel
ECG imaging is an emerging technology for the reconstruction of cardiac electric activity from non-invasively measured body surface potential maps. In this case report, we present the first evaluation of transmurally imaged activation times against endocardially reconstructed isochrones for a case of sustained monomorphic ventricular tachycardia (VT). Computer models of the thorax and whole heart were produced from MR images. A recently published approach was applied to facilitate electrode localization in the catheter laboratory, which allows for the acquisition of body surface potential maps while performing non-contact mapping for the reconstruction of local activation times...
September 20, 2016: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/27635068/signal-averaged-electrocardiography-as-a-noninvasive-tool-for-evaluating-the-outcomes-after-radiofrequency-catheter-ablation-of-ventricular-tachycardia-in-patients-with-ischemic-heart-disease-reassessment-of-an-old-tool
#13
Borislav Dinov, Kerstin Bode, Sebastian Koenig, Sabrina Oebel, Philipp Sommer, Andreas Bollmann, Gerhard Hindricks, Arash Arya
BACKGROUND: Inducibility of ventricular tachycardia (VT) has limited ability to predict recurrent VT after catheter ablation (CA). We sought to correlate the signal-averaged ECG (SAECG) with the endocardial scar characteristics in patients with ischemic VTs. We suggest that successful CA can result in normalization of the SAECG. METHODS AND RESULTS: Fifty patients (42 male; aged 67±10 years, ejection fraction 34±12%) with ischemic VTs were prospectively enrolled...
September 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27574120/substrate-based-ablation-versus-ablation-guided-by-activation-and-entrainment-mapping-for-ventricular-tachycardia-a-systematic-review-and-meta-analysis
#14
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
https://www.readbyqxmd.com/read/27556589/sex-and-catheter-ablation-for-ventricular-tachycardia-an-international-ventricular-tachycardia-ablation-center-collaborative-group-study
#15
David S Frankel, Roderick Tung, Pasquale Santangeli, Wendy S Tzou, Marmar Vaseghi, Luigi Di Biase, Koichi Nagashima, Usha Tedrow, T Jared Bunch, Venkatakrishna N Tholakanahalli, Raghuveer Dendi, Madhu Reddy, Dhanunjaya Lakkireddy, Timm Dickfeld, J Peter Weiss, Nilesh Mathuria, Pasquale Vergara, Mehul Patel, Shiro Nakahara, Kairav Vakil, William H Sauer, David J Callans, Andrea Natale, William G Stevenson, Paolo Della Bella, Kalyanam Shivkumar, Francis E Marchlinski
Importance: Significant differences have been described between women and men regarding presentation, mechanism, and treatment outcome of certain arrhythmias. Previous studies of ventricular tachycardia (VT) ablation have not included sufficient women for meaningful comparison. Objective: To compare outcomes between women and men with structural heart disease undergoing VT ablation. Design, Setting, and Participants: Investigator-initiated, multicenter, observational study performed between 2002 and 2013, conducted by the International VT Ablation Center Collaborative Group, consisting of 12 high-volume ablation centers...
November 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27506821/multicenter-experience-with-catheter-ablation-for-ventricular-tachycardia-in-lamin-a-c-cardiomyopathy
#16
Saurabh Kumar, Alexander F A Androulakis, Jean-Marc Sellal, Philippe Maury, Estelle Gandjbakhch, Xavier Waintraub, Anne Rollin, Pascale Richard, Philippe Charron, Samuel H Baldinger, Ciorsti J Macintyre, Bruce A Koplan, Roy M John, Gregory F Michaud, Katja Zeppenfeld, Frederic Sacher, Neal K Lakdawala, William G Stevenson, Usha B Tedrow
BACKGROUND: Lamin A/C (LMNA) cardiomyopathy is a genetic disease with a proclivity for ventricular arrhythmias. We describe the multicenter experience with percutaneous catheter ablation of sustained monomorphic ventricular tachycardia (VT) in LMNA cardiomyopathy. METHODS AND RESULTS: Twenty-five consecutive LMNA mutation patients from 4 centers were included (mean age, 55±9 years; ejection fraction, 34±12%; VT storm in 36%). Complete atrioventricular block was present in 11 patients; 3 patients were on mechanical circulatory support for severe heart failure...
August 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27453126/characterization-of-the-epicardial-substrate-for-catheter-ablation-of-brugada-syndrome
#17
Pei Zhang, Roderick Tung, Zuwen Zhang, Xia Sheng, Qiang Liu, Ruhong Jiang, Yaxun Sun, Shiquan Chen, Lu Yu, Yang Ye, Guosheng Fu, Kalyanam Shivkumar, Chenyang Jiang
BACKGROUND: Catheter ablation in the right ventricular outflow tract (RVOT) may modify the electrophysiologic substrate for recurrent ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with Brugada syndrome (BrS). OBJECTIVE: The purpose of this study was to investigate the mechanism and arrhythmogenic substrate of VT/VF and to evaluate the long-term outcomes of catheter ablation in patients with BrS. METHODS: Eleven consecutive patients with BrS referred to 2 academic medical centers underwent combined epicardial-endocardial electroanatomic mapping...
November 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27406604/impact-of-new-technologies-and-approaches-for-post-myocardial-infarction-ventricular-tachycardia-ablation-during-long-term-follow-up
#18
Seigo Yamashita, Hubert Cochet, Frédéric Sacher, Saagar Mahida, Benjamin Berte, Darren Hooks, Jean-Marc Sellal, Nora Al Jefairi, Antonio Frontera, Yuki Komatsu, Han S Lim, Sana Amraoui, Arnaud Denis, Nicolas Derval, Maxime Sermesant, François Laurent, Mélèze Hocini, Michel Haïssaguerre, Michel Montaudon, Pierre Jaïs
BACKGROUND: During the past years, many innovations have been introduced to facilitate catheter ablation of post-myocardial infarction ventricular tachycardia. However, the predictors of outcome after ablation were not thoroughly studied. METHODS AND RESULTS: From 2009 to 2013, consecutive patients referred for post-myocardial infarction ventricular tachycardia ablation were included. The end point of the procedure was complete elimination of local abnormal ventricular activities (LAVA) and ventricular tachycardia (VT) noninducibility...
July 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27353322/long-term-benefit-of-first-line-peri-implantable-cardioverter-defibrillator-implant-ventricular-tachycardia-substrate-ablation-in-secondary-prevention-patients
#19
Juan Acosta, Nuno Cabanelas, Diego Penela, Juan Fernández-Armenta, David Andreu, Roger Borràs, Viatcheslav Korshunov, Mario Cabrera, Francesca Vasanelli, Elena Arbelo, Eduard Guasch, Mikel Martínez, Jose M Tolosana, Lluis Mont, Antonio Berruezo
AIMS: This study assessed the benefit of peri-implantable cardioverter-defibrillator implant ventricular tachycardia (VT)-substrate ablation in patients with structural heart disease (SHD). METHODS AND RESULTS: Patients with SHD and indication for secondary prevention ICD implant were prospectively included. Patients presenting with incessant and/or slow VT or frequent (≥2) VT episodes who underwent peri-ICD VT-substrate ablation (the scar dechannelling technique) were compared with those who received ICD alone and did not meet ablation criteria...
June 27, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27294860/epicardial-ventricular-tachycardia-substrate-visualized-by-magnetic-resonance-imaging-need-for-a-transpericardial-ablation-approach
#20
Christopher Reithmann, Bernhard Herkommer, Michael Fiek
BACKGROUND: Sustained ventricular tachycardia (VT) in patients with nonischemic cardiomyopathy (NICM) often involves midmyocardial and epicardial structures. Delayed-enhancement magnetic resonance imaging (DE-MRI) of scar and fibrosis is the method of choice to define the substrate of monomorphic VT. OBJECTIVE: The aim of the study was to compare the outcome of endocardial vs. epicardial VT ablation in patients with epicardial DE-MRI substrates in NICM. RESULTS: Among 44 patients with NICM referred for VT ablation who underwent DE-MRI, 12 patients had an epicardial-only (n = 4) or predominantly epicardial DE-MRI substrate (n = 8)...
October 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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