scholarly journals Catheter ablation of supraventricular tachycardia in patients with and without structural heart disease: insights from the German ablation registry

2021 ◽  
Author(s):  
Charlotte Eitel ◽  
Hüseyin Ince ◽  
Johannes Brachmann ◽  
Karl-Heinz Kuck ◽  
Stephan Willems ◽  
...  
Keyword(s):  
Heart Disease ◽  
Catheter Ablation ◽  
Supraventricular Tachycardia ◽  
Structural Heart Disease ◽  
Similar Proportion ◽  
Reentrant Tachycardia ◽  
Safety And Efficacy ◽  
Kaplan Meier ◽  
Mortality Increase ◽  
Significant Mortality

Abstract Aim To compare patient characteristics, safety and efficacy of catheter ablation of supraventricular tachycardia (SVT) in patients with and without structural heart disease (SHD) enrolled in the German ablation registry. Methods and results From January 2007 until January 2010, a total of 12,536 patients (37.2% with known SHD) were enrolled and followed for at least one year. Patients with SHD more often underwent ablation for atrial flutter (45.8% vs. 20.9%, p < 0.001), whereas patients without SHD more often underwent ablation for atrioventricular nodal reentrant tachycardia (30.2% vs. 11.8%, p < 0.001) or atrioventricular reentrant tachycardia (9.1% vs. 1.6%, p < 0.001). Atrial fibrillation catheter ablation procedures were performed in a similar proportion of patients with and without SHD (38.1% vs. 36.9%, p = 0.21). Overall, periprocedural success rate was high in both groups. Death, myocardial infarction or stroke occurred in 0.2% and 0.1% of patients with and without SHD (p = 0.066). Major non-fatal complications prior to discharge were rare and did not differ significantly between patients with and without SHD (0.5% vs. 0.4%, p = 0.34). Kaplan–Meier mortality estimate at 1 year demonstrated a significant mortality increase in patients with SHD (2.6% versus 0.7%; p < 0.001). Conclusion Patients with and without SHD undergoing SVT ablation exhibit similar success rates and low major complication rates, despite disadvantageous baseline characteristics in SHD patients. These data highlight the safety and efficacy of SVT ablation in patients with and without SHD. Nevertheless Kaplan–Meier mortality estimates at 1 year demonstrate a significant mortality increase in patients with SHD, highlighting the importance of treating the underlying condition and reliable anticoagulation if indicated.

scholarly journals Safety and Efficacy of Catheter Ablation for Ventricular Tachycardia in Elderly Patients With Structural Heart Disease

2015 ◽  
Vol 1 (1-2) ◽  
pp. 52-58 ◽  
Author(s):  
Jackson J. Liang ◽  
Shaan Khurshid ◽  
Robert D. Schaller ◽  
Pasquale Santangeli ◽  
Francis E. Marchlinski ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Elderly Patients ◽  
Structural Heart Disease ◽  
Safety And Efficacy

Non-fluoroscopic cardiac ablation of neonates with CHD

2016 ◽  
Vol 27 (3) ◽  
pp. 592-596 ◽  
Author(s):  
Amee M. Bigelow ◽  
Brandon S. Arnold ◽  
Gregory C. Padrutt ◽  
John M. Clark
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Catheter Ablation ◽  
Supraventricular Tachycardia ◽  
Tricuspid Valve ◽  
Congenital Heart ◽  
Current Practice ◽  
Pulmonary Atresia ◽  
Intact Ventricular Septum ◽  
Cardiac Ablation

AbstractIn current practice, children with anatomically normal hearts routinely undergo fluoroscopy-free ablations. Infants and children with congenital heart disease (CHD) represent the most difficult population to perform catheter ablation without fluoroscopy. We report two neonatal patients with CHD in whom cardiac ablations were performed without fluoroscopy. The first infant had pulmonary atresia with intact ventricular septum with refractory supraventricular tachycardia, and the second infant presented with Ebstein’s anomaly of the tricuspid valve along with persistent supraventricular tachycardia. Both patients underwent uncomplicated, successful ablation without recurrence of arrhythmias. These cases suggest that current approaches to minimising fluoroscopy may be useful even in challenging patients such as neonates with CHD.

scholarly journals Combined Endocardial-Epicardial Versus Endocardial Catheter Ablation Alone for Ventricular Tachycardia in Structural Heart Disease

2019 ◽  
Vol 5 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Jorge Romero ◽  
Roberto C. Cerrud-Rodriguez ◽  
Luigi Di Biase ◽  
Juan Carlos Diaz ◽  
Isabella Alviz ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Structural Heart Disease

Arrhythmias in pregnancy

ESC CardioMed ◽  
2018 ◽  
pp. 2868-2870
Author(s):  
Bozena Ostrowska ◽  
Barbara Kommata ◽  
Helena Malmborg ◽  
Carina Blomström Lundqvist
Keyword(s):  
Heart Disease ◽  
Supraventricular Tachycardia ◽  
Ventricular Arrhythmias ◽  
Structural Heart Disease ◽  
Symptomatic Bradycardia ◽  
First Time ◽  
In Pregnancy

The incidence of supraventricular tachycardia during pregnancy is low. The tachyarrhythmias are often well tolerated but may become more frequent, refractory, and symptomatic, and may even manifest for the first time during pregnancy even in the absence of structural heart disease. Arrhythmia requiring treatment develops in up to 15% of patients with structural heart disease during pregnancy. Ventricular arrhythmias and symptomatic bradycardia are rare.

Sustained and non-sustained ventricular tachycardia and no associated heart disease (idiopathic ventricular tachycardia)

ESC CardioMed ◽  
2018 ◽  
pp. 2288-2293
Author(s):  
Victor Bazan ◽  
Enrique Rodriguez-Font ◽  
Francis E. Marchlinski
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Drug Therapy ◽  
Catheter Ablation ◽  
Beta Blockers ◽  
Young Patients ◽  
Structural Heart Disease ◽  
Holter Monitoring ◽  
Severe Arrhythmia ◽  
The Right

Around 10% of ventricular arrhythmias (VA) occur in the absence of underlying structural heart disease. These so-called ‘idiopathic’ VAs usually have a benign clinical course. Only rarely do these “benign” arrhythmias trigger polymorphic ventricular tachycardia (PVT) and idiopathic ventricular fibrillation (VF). Due to their focal origin and to the absence of underlying myocardial scar, the 12-lead ECG very precisely establishes the right (RV) or left (LV) ventricular site of origin of the arrhythmia and can help regionalizing the origin of VT for ablation. A 12-lead ECG obtained during the baseline rhythm and 24-hour ECG Holter monitoring are indicated in order to identify structural or electrical disorders leading to PVT/VF and to determine the VA burden. The most frequent origin of idiopathic VAs is the RV outflow tract (OT). Other origins include the LVOT, the LV fascicles (fascicular VTs), the LV and RV papillary muscles, the crux cordis, the mitral and tricuspid annuli and the RV moderator band. Recognizing the typical anatomic sites of origin combined with a 12 lead ECG assessment facilitates localization.  Antiarrhythmic drug therapy (including use of beta-blockers) or catheter ablation may be indicated to suppress or eliminate idiopathic VAs, particularly upon severe arrhythmia-related symptoms or if the arrhythmia burden is high and ‘tachycardia’-induced cardiomyopathy is suspected. Catheter ablation is frequently preferred to prevent lifelong drug therapy in young patients.

Sustained monomorphic ventricular tachycardia: the role of catheter ablation

ESC CardioMed ◽  
2018 ◽  
pp. 2279-2288
Author(s):  
Tilman Maurer ◽  
William G. Stevenson ◽  
Karl-Heinz Kuck
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Therapeutic Option ◽  
Structural Heart Disease ◽  
Premature Ventricular Contractions ◽  
Monomorphic Ventricular Tachycardia ◽  
Premature Beats

Monomorphic ventricular tachycardia (VT) may occur in the presence or absence of structural heart disease. The standard therapy for patients with structural heart disease at high risk of sudden cardiac death due to VT is the implantable cardioverter defibrillator (ICD). While ICDs effectively terminate VT and prevent sudden cardiac death, they do not prevent recurrent episodes of VT, since the underlying arrhythmogenic substrate remains unchanged. However, shocks from an ICD increase mortality and impair quality of life. These limitations as well as continuous advancements in technology have made catheter ablation an important treatment strategy for patients with structural heart disease presenting with VT. Idiopathic ventricular arrhythmias include premature ventricular contractions and VT occurring in the absence of overt structural heart disease. In this setting, catheter ablation has evolved as the primary therapeutic option for symptomatic ventricular premature beats and sustained VTs and is curative in most cases. This chapter presents an overview of the principles of invasive diagnosis and treatment of monomorphic VTs in patients with and without structural heart disease and delineates the clinical outcome of catheter ablation. Finally, the chapter provides an outlook to the future, discussing potential directions and upcoming developments in the field of catheter ablation of monomorphic VT.

Sign in / Sign up

Export Citation Format

Share Document