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https://www.readbyqxmd.com/read/29759537/real-time-localization-of-ventricular-tachycardia-origin-from-the-12-lead-electrocardiogram
#1
John L Sapp, Meir Bar-Tal, Adam J Howes, Jonathan E Toma, Ahmed El-Damaty, James W Warren, Paul J MacInnis, Shijie Zhou, B Milan Horáček
OBJECTIVES: The aim of this study was to develop rapid computational methods for identifying the site of origin of ventricular activation from the 12-lead electrocardiogram. BACKGROUND: Catheter ablation of ventricular tachycardia in patients with structural heart disease frequently relies on a substrate-based approach, which may use pace mapping guided by body-surface electrocardiography to identify culprit exit sites. METHODS: Patients undergoing ablation of scar-related VT (n = 38) had 12-lead electrocardiograms recorded during pacing at left ventricular endocardial sites (n = 1,012) identified on 3-dimensional electroanatomic maps and registered to a generic left ventricular endocardial surface divided into 16 segments and tessellated into 238 triangles; electrocardiographic data were reduced for each lead to 1 variable, consisting of QRS time integral...
July 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29753944/outcomes-with-prophylactic-use-of-percutaneous-left-ventricular-assist-devices-in-high-risk-patients-undergoing-catheter-ablation-of-scar-related-vt-a-propensity-matched-analysis
#2
Daniele Muser, Jackson J Liang, Simon A Castro, Tatsuya Hayashi, Andres Enriquez, Gregory S Troutman, Nelson W McNaughton, Gregory Supple, Edo Y Birati, Robert Schaller, Fermin C Garcia, David S Frankel, Sanjay Dixit, David J Callans, Erica S Zado, Francis E Marchlinski, Pasquale Santangeli
BACKGROUND: The PAINESD risk score predicts the risk of periprocedural acute hemodynamic decompensation (AHD) and post-procedural mortality in patients (pts) undergoing catheter ablation (CA) of scar-related ventricular tachycardia (VT). The role of prophylactic placement of percutaneous left ventricular assist devices (pLVAD) in high-risk pts is unknown. OBJECTIVES: We evaluated the outcomes of prophylactic use of pLVAD in high-risk pts undergoing CA of scar-related VT...
April 27, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29747127/wideband-lge-mri-permits-unobstructed-viewing-of-myocardial-scarring-in-a-patient-with-an-mr-conditional-subcutaneous-implantable-cardioverter-defibrillator
#3
Amir Ali Rahsepar, Jeremy D Collins, Bradley P Knight, KyungPyo Hong, James C Carr, Daniel Kim
A subcutaneous implantable cardioverter-defibrillator (S-ICD) is an alternative device for prevention of sudden cardiac death, without any leads within the heart. Patients implanted with any type of ICD may need catheter ablation of ventricular tachycardia (VT) to reduce the overall arrhythmia burden (e.g., recurrent monomorphic VT) and lower the incidence of painful shocks induced by the device. Late gadolinium enhancement (LGE) MRI is a useful pre-test for guiding VT ablation, because it can be used to map myocardial scar and produce better outcomes...
May 4, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29739982/overexpression-of-cx43-in-cells-of-the-myocardial-scar-correction-of-post-infarct-arrhythmias-through-heterotypic-cell-cell-coupling
#4
Wilhelm Roell, Alexandra M Klein, Martin Breitbach, Torsten S Becker, Ashish Parikh, Jane Lee, Katrin Zimmermann, Shaun Reining, Beth Gabris, Annika Ottersbach, Robert Doran, Britta Engelbrecht, Miriam Schiffer, Kenichi Kimura, Patricia Freitag, Esther Carls, Caroline Geisen, Georg D Duerr, Philipp Sasse, Armin Welz, Alexander Pfeifer, Guy Salama, Michael Kotlikoff, Bernd K Fleischmann
Ventricular tachycardia (VT) is the most common and potentially lethal complication following myocardial infarction (MI). Biological correction of the conduction inhomogeneity that underlies re-entry could be a major advance in infarction therapy. As minimal increases in conduction of infarcted tissue markedly influence VT susceptibility, we reasoned that enhanced propagation of the electrical signal between non-excitable cells within a resolving infarct might comprise a simple means to decrease post-infarction arrhythmia risk...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29716709/management-of-electrical-storm-of-unstable-ventricular-tachycardia-in-post-myocardial-infarction-patients-a-single-centre-experience
#5
B Hygriv Rao, Mohammed Sadiq Azam, Geetesh Manik
OBJECTIVE: This is a case series of consecutive patients with past myocardial infarction presenting with Electrical Storm (ES) of unstable ventricular tachycardia (VT) treated by a protocol directed algorithm. METHODS: Management protocol involved treatment of reversible causes, ventilatory & hemodynamic support, administration of antiarrhythmic drugs (AAD) & maximally tolerated doses of beta-blockers, stellate ganglionectomy and Radiofrequency ablation (RFA) guided by Electro Anatomic Mapping (EAM)...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29684187/non-invasive-epicardial-and-endocardial-electrocardiographic-imaging-for-scar-related-ventricular-tachycardia
#6
Linwei Wang, Omar A Gharbia, Saman Nazarian, B Milan Horácek, John L Sapp
Aims: Contact mapping is currently used to guide catheter ablation of scar-related ventricular tachycardia (VT) but usually provides incomplete assessment of 3D re-entry circuits and their arrhythmogenic substrates. This study investigates the feasibility of non-invasive electrocardiographic imaging (ECGi) in mapping scar substrates and re-entry circuits throughout the epicardium and endocardium. Methods and results: Four patients undergoing endocardial and epicardial mapping and ablation of scar-related VT had computed tomography scans and a 120-lead electrocardiograms, which were used to compute patient-specific ventricular epicardial and endocardial unipolar electrograms (CEGMs)...
April 18, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29574594/endomyocardial-biopsy-at-the-time-of-ablation-or-device-implantation
#7
Ammar M Killu, Nishaki Mehta, Qi Zheng, Piotr Sobieszczyk, Usha B Tedrow, William G Stevenson, Roy M John
PURPOSE: Cardiomyopathies frequently lead to conduction system disease and/or arrhythmias necessitating device therapy, catheter ablation, or both. Endomyocardial biopsy (EMB) is avoided with recent right ventricle (RV) lead implants and optimal timing is uncertain. We determined outcomes of EMB at the time of ablation or device implantation procedures. METHODS: We retrospectively analyzed patients undergoing EMB during their electrophysiological procedure between January 2014 and July 2016...
March 24, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29572643/novel-mapping-strategies-for-ventricular-tachycardia-ablation
#8
REVIEW
Zaid Aziz, Roderick Tung
Despite advances in antiarrhythmic and device therapy, ventricular tachycardia (VT) continues to be a major cause of increased morbidity and mortality. During scar-mediated monomorphic ventricular tachycardia ablation, the search for critical isthmus sites continues to be the primary goal during successful ablative procedures. However, given the overwhelming hemodynamic instability of most ventricular arrhythmias (> 70%), VT ablation is increasingly performed during sinus rhythm. This technique requires either a greater reliance on isthmus surrogates, or more extensive ablation techniques and is a more probabilistic approach to substrate modification...
March 23, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29536321/assessment-of-remote-myocardium-heterogeneity-in-patients-with-ventricular-tachycardia-using-texture-analysis-of-late-iodine-enhancement-lie-cardiac-computed-tomography-cct-images
#9
Antonio Esposito, Anna Palmisano, Sofia Antunes, Caterina Colantoni, Paola Maria Vittoria Rancoita, Davide Vignale, Francesca Baratto, Paolo Della Bella, Alessandro Del Maschio, Francesco De Cobelli
PURPOSE: Diffuse remodeling of myocardial extra-cellular matrix is largely responsible for left ventricle (LV) dysfunction and arrhythmias. Our hypothesis is that the texture analysis of late iodine enhancement (LIE) cardiac computed tomography (cCT) images may improve characterization of the diffuse extra-cellular matrix changes. Our aim was to extract volumetric extracellular volume (ECV) and LIE texture features of non-scarred (remote) myocardium from cCT of patients with recurrent ventricular tachycardia (rVT), and to compare these radiomic features with LV-function, LV-remodeling, and underlying cardiac disease...
March 13, 2018: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/29508083/ablation-approaches-for-ventricular-fibrillation
#10
REVIEW
Prabhpreet Singh, Amit Noheria
Invasive electrophysiology (EP) mapping and catheter ablation has increasingly become the standard of care for many cardiac arrhythmias like supraventricular tachycardias, atrial fibrillation, premature ventricular complexes (PVC), and monomorphic ventricular tachycardia. In this review, we discuss the recent progress made in the mapping and ablation of ventricular fibrillation (VF). Ventricular activation during VF is apparently disorganized, making mapping and interpretation difficult. Prolonged mapping during VF would require mechanical circulatory support as VF causes complete hemodynamic collapse...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29427821/image-based-criteria-to-identify-the-presence-of-epicardial-arrhythmogenic-substrate-in-patients-with-transmural-myocardial-infarction
#11
David Soto-Iglesias, Juan Acosta, Diego Penela, Juan Fernández-Armenta, Mario Cabrera, Mikel Martínez, Francesca Vassanelli, Alejandro Alcaine, Markus Linhart, Beatriz Jáuregui, Elena Efimova, Rosario J Perea, Susana Prat-González, José T Ortiz-Pérez, Xavier Bosch, Luis Mont, Oscar Camara, Antonio Berruezo
BACKGROUND: Patients with transmural myocardial infarction (MI) who undergo endocardial-only substrate ablation are at increased risk for ventricular tachycardia recurrence. Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) can be used to assess infarct transmurality (IT). However, the degree of IT associated with an epicardial arrhythmogenic substrate (AS) has not been determined. OBJECTIVE: The purpose of this study was to determine the degree of IT observed by LGE-CMR and multidetector computed tomography (MDCT) that predicts the presence of epicardial AS...
February 7, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29409086/-update-ventricular-tachycardia
#12
Alexander Fürnkranz, Hisaki Makimoto
Idiopathic ventricular tachycardia: Frequent monomorphic premature ventricular contractions or non-sustained ventricular tachycardia without underlying structural heart disease is not a rare condition and may cause significant symptoms. A subgroup of patients develops IVT-associated cardiomyopathy. Current ESC guidelines recommend primary catheter ablation in symptomatic patients with right ventricular outflow tract IVT. Catheter ablation is also recommended in symptomatic patients with a left ventricular outflow tract (or other rare) origin, if antiarrhythmic drugs are ineffective or not desired...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29380921/correlation-between-computer-tomography-derived-scar-topography-and-critical-ablation-sites-in-postinfarction-ventricular-tachycardia
#13
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/29338024/quantitative-in-vivo-mapping-of-myocardial-mitochondrial-membrane-potential
#14
Nathaniel M Alpert, Nicolas Guehl, Leon Ptaszek, Matthieu Pelletier-Galarneau, Jeremy Ruskin, Moussa C Mansour, Dustin Wooten, Chao Ma, Kazue Takahashi, Yun Zhou, Timothy M Shoup, Marc D Normandin, Georges El Fakhri
BACKGROUND: Mitochondrial membrane potential (ΔΨm) arises from normal function of the electron transport chain. Maintenance of ΔΨm within a narrow range is essential for mitochondrial function. Methods for in vivo measurement of ΔΨm do not exist. We use 18F-labeled tetraphenylphosphonium (18F-TPP+) to measure and map the total membrane potential, ΔΨT, as the sum of ΔΨm and cellular (ΔΨc) electrical potentials. METHODS: Eight pigs, five controls and three with a scar-like injury, were studied...
2018: PloS One
https://www.readbyqxmd.com/read/29317972/high-density-mapping-in-ventricular-tachycardia-ablation-a-pentaray-%C3%A2-study
#15
Petra Maagh, Arnd Christoph, Henning Dopp, Markus Sebastian Mueller, Gunnar Plehn, Axel Meissner
Background: High-density mapping of ventricular tachycardia (VT) with PentaRay® (Biosense-Webster) provides high resolution with discrimination of local abnormal electrograms and slow conducting channels. We evaluate the feasibility of PentaRay® to characterize the anatomical substrate and assume an influence of the outcome despite limitations. Methods: Over a 24-month period, 26 endocardial and four epicardial maps were obtained of 26 VT patients (18 ischemic cardiomyopathy (ICM, 69...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29236200/electrophysiologic-features-of-protected-channels-in-late-postinfarction-patients-with-and-without-spontaneous-ventricular-tachycardia
#16
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/29110290/relationship-between-left-ventricular-dyssynchrony-and-scar-burden-in-the-genesis-of-ventricular-tachyarrhythmia
#17
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-s-with-the-rhythmia-mapping-system
#18
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
#19
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-nonischemic-cardiomyopathy-electrophysiological-characteristics-mapping-and-ablation-of-underlying-heart-disease
#20
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 were reviewed (51 ARVC/D, 22 CS; 27 RCUS)...
January 2018: Journal of Cardiovascular Electrophysiology
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