scholarly journals B-PO05-120 A NOVEL NON-INVASIVE ELECTROCARDIOGRAPHIC IMAGING MAPPING IS A USEFUL TOOL TO PREDICT PREMATURE VENTRICULAR COMPLEXES LOCALIZATION BEFORE CATHETER ABLATION PROCEDURE

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S420-S421
Author(s):  
Krista Lesina ◽  
Mark G. Hoogendijk ◽  
Bakhtawar Mahmoodi Emile Peters ◽  
André de Wit ◽  
Alexander Hirsch ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ablation Procedure ◽  
Electrocardiographic Imaging ◽  
Premature Ventricular Complexes ◽  
Non Invasive

P2567First experience of non-invasive and invasive activation maps merge in carto system for topical diagnosis of focal arrhythmias

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Budanova ◽  
M Chmelevsky ◽  
S Zubarev ◽  
D Potyagaylo ◽  
L Parreira ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Operation Time ◽  
Lateral Wall ◽  
Posterior Wall ◽  
Late Enhancement ◽  
Ablation Procedure ◽  
Electrocardiographic Imaging ◽  
Non Invasive ◽  
Topical Diagnosis ◽  
Endocardial Surface

Abstract Background Correct preoperative topical diagnostics of atrial and ventricular arrhythmias allows for operation time reduction by facilitating the ablation target localization, especially in case of several ectopic sources. Purpose To implement a non-invasive electrocardiographic imaging (ECGI) technique in CARTO system for aiming at topical diagnostics of focal arrhythmias improving. Methods Twelve patients (m/f – 10/2, age (min–max) – 50,5 (32–71)) with focal arrhythmias underwent ECGI in combination with CT or MR imaging. Two subjects had atrial premature contractions (PAC), while ten patients suffered from ventricular premature contractions (PVC) with indications for ablation. Before the ablation procedure Carto LAT mapping was performed in all patients. Using ECGI epi-/endocardial polygonal models of the heart were created, isopotential and activation maps were calculated, uploaded into the Carto system and merged with the CARTO FAM models (Figure 1). Results For six patients with PVC and two patients with PAC, earliest activation zones (EAZs) anatomical locations obtained by invasive and non-invasive methods were the same (RVOT septum, RVOT lateral-anterior and RV lateral-basal walls, right aortic cusp, LVOT, coronary sinus (CS), CS ostium, RA posterior wall), and arrhythmias ablation was successful. Two patients featured coherent EAZs (RV lateral-basal wall and RVOT septum) but a negative ablation outcome. In one patient, EAZs were situated in different anatomical regions: CARTO showed the PVC EAZ in RV septum, whereas Amycard system identified endocardial surface of lateral-basal RV wall. In this patient, PVC was ablated partially. For another patient with MRI late enhancement area in LV lateral wall the EAZs were in the same LV segment but with mismatch in epi/endocardial surface. Conclusion Non-invasive and invasive activation maps merge can improve localization of ablation targets in focal arrhythmias, potentially increasing effectiveness of the EP procedure and reducing operation time.

Catheter ablation of premature ventricular complexes associated with left ventricular false tendons

Heart Rhythm ◽  
2021 ◽  
Author(s):  
Jinlin Zhang ◽  
Ming Liang ◽  
Zulu. Wang ◽  
Xi Zhang ◽  
Jie Fan ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Left Ventricular ◽  
Premature Ventricular Complexes

scholarly journals The Use of Electrocardiographic Imaging in Localising the Origin of Arrhythmias During Catheter Ablation of Ventricular Tachycardia

2021 ◽  
Vol 10 (3) ◽  
pp. 211-217
Author(s):  
Adam J Graham ◽  
Richard J Schilling
Keyword(s):  
Inverse Problem ◽  
Ventricular Arrhythmia ◽  
Clinical Tool ◽  
Electrocardiographic Imaging ◽  
Surface Electrodes ◽  
Non Invasive ◽  
Large Target ◽  
The Us ◽  
Activation Times ◽  
Unipolar Electrograms

Non-invasive electrocardiographic imaging (ECGI) is a novel clinical tool for mapping ventricular arrhythmia. Using multiple body surface electrodes to collect unipolar electrograms and conventional medical imaging of the heart, an epicardial shell can be created to display calculated electrograms. This calculation is achieved by solving the inverse problem and allows activation times to be calculated from a single beat. The technology was initially pioneered in the US using an experimental torso-shaped tank. Accuracy from studies in humans has varied. Early data was promising, with more recent work suggesting only moderate accuracy when reproducing cardiac activation. Despite these limitations, the system has been successfully used in pioneering work with non-invasive cardiac radioablation to treat ventricular arrhythmia. This suggests that the resolution may be sufficient for treatment of large target areas. Although untested in a well conducted clinical study it is likely that it would not be accurate enough to guide more discreet radiofrequency ablation.

scholarly journals Dabigatran in the ischemic patient undergoing atrial fibrillation ablation

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 154-157
Author(s):  
Roberto Spoladore
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Anticoagulant Therapy ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Poor Response ◽  
Rf Ablation ◽  
Ablation Procedure ◽  
Total Period ◽  
Hemorrhagic Events

Trans-catheter ablation of atrial fibrillation (AF) is a common treatment for symptomatic AF. Among the major complications of AF ablation are stroke, transient ischemic attacks and peri-procedural cardiac tamponade. Various clinical trials have shown that uninterrupted treatment with vitamin K antagonists (VKA) is associated with a lower incidence of embolic events compared to discontinuation of therapy; until recently, in the absence of equally solid evidence, this practice was not extended to the new oral anticoagulants (NOAC) not VKA due to the fear of hemorrhagic complications potentially associated with the use of an "irreversible" anticoagulant. The case of a patient suffering from numerous comorbidities is reported here. In light of the poor response to anti-arrhythmics, a TC-RF ablation was performed, with suspension of dabigatran administration only on the day of the procedure (for a total period <24 hours). Although the fear of the risk of bleeding potentially associated with the trans-catheter ablation procedure may still induce clinicians to stop anticoagulant therapy, even the decision to discontinue anticoagulant therapy with dabigatran on the day of surgery alone is challenged by recent evidence in the literature supporting the efficacy of dabigatran in reducing the incidence of hemorrhagic events during and after ablation, including the results of the RE-CIRCUIT study (Cardiology)

scholarly journals Optimization of CRT programming using non‐invasive electrocardiographic imaging to assess the acute electrical effects of multipoint pacing

2019 ◽  
Vol 35 (2) ◽  
pp. 267-275 ◽  
Author(s):  
Benjamin J. Sieniewicz ◽  
Tom Jackson ◽  
Simon Claridge ◽  
Helder Pereira ◽  
Justin Gould ◽  
...  
Keyword(s):  
Electrocardiographic Imaging ◽  
Non Invasive ◽  
Multipoint Pacing

Effect of radiofrequency catheter ablation of accessory pathways on autonomic tone in children

1999 ◽  
Vol 9 (4) ◽  
pp. 377-383 ◽  
Author(s):  
Ruchir Sehra ◽  
Joyce E. Hubbard ◽  
Susan P. Straka ◽  
Naomi S. Fineberg ◽  
Douglas P. Zipes ◽  
...  
Keyword(s):  
Heart Rate ◽  
Catheter Ablation ◽  
Supraventricular Tachycardia ◽  
Radiofrequency Catheter Ablation ◽  
Autonomic Function ◽  
Accessory Pathways ◽  
Non Invasive ◽  
Autonomic Changes ◽  
Before And After ◽  
Autonomic Blockade

AbstractBackgroundRadiofrequency catheter ablation is standard treatment for children with re-entrant supraventricular tachycardias. Autonomic changes have been noted after such ablation for atrioventricular nodal re-entry tachycardia, but not as well documented with atrioventricular re-entry over an accessory pathway.Methods and resultsIn 10 normal paediatric volunteers and 12 children referred for electrophysiologic testing and radiofrequency ablation of supraventricular tachycardia, non-invasive autonomic function tests and tilt-table testing were performed, and the variability in 24-h heart rate was analysed. Patients with supraventricular tachycardia underwent these tests both 24–72 h before and 24 h after ablation. Patients with tachycardia underwent additional autonomic testing to assess the sensitivity of baroreceptors and the intrinsic heart rate with autonomic blockade immediately before and after ablation. One non-invasive autonomic function test, namely handgrip, demonstrated significant differences (p < 0.05) in diastolic blood pressure before and after ablation, though these values did not differ from controls. Significant decreases were noted in two indexes of the variability of heart rate before and after ablation (p < 0.05). Certain tilt test variables also demonstrated significant differences between controls and those with tachycardia subsequent to ablation. Intracardiac testing demonstrated changes (p < 0.05) in sinus cycle lengths, effective refractory periods and/or blood pressures at baseline and during testing of the sensitivity of baroreceptors before and after ablation. These changes were consistent with increased sympathetic or decreased parasympathetic tone. With autonomic blockade, these differences were abolished.ConclusionsCatheter ablation of accessory pathways in children was associated with changes consistent with increased sympathetic or decreased parasympathetic tone. These autonomic changes persisted 24 h after the ablation procedure.

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