Catheter ablation of idiopathic fascicular ventricular tachycardia: The role of isolated diastolic potentials during mapping in sinus rhythm

2015 ◽  
Vol 201 ◽  
pp. 212-214 ◽  
Author(s):  
Konstantinos P. Letsas ◽  
Michael Efremidis ◽  
Konstantinos Vlachos ◽  
Dimitrios Asvestas ◽  
Stamatis Georgopoulos ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Sinus Rhythm

scholarly journals Ventricular Tachycardia Originating from Moderator Band: New Perspective on Catheter Ablation

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Jin-yi Li ◽  
Jing-bo Jiang ◽  
Yan He ◽  
Jian-chun Luo ◽  
Guo-qiang Zhong
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Sinus Rhythm ◽  
High Frequency ◽  
Conduction Block ◽  
Distal Catheter ◽  
Long Duration ◽  
Moderator Band ◽  
Radiofrequency Current ◽  
New Perspective

A 59-year-old woman was referred to the institution with burdens of idiopathic ventricular tachycardia (IVT). Electroanatomic mapping revealed a complex fractionated, high frequency potential with long duration preceding the QRS onset of the IVT. The real end point of ablation was the disappearance of the conduction block of Purkinje potential during the sinus rhythm besides the disappearance of the inducible tachycardia. Location of distal catheter was at the moderator band (MB) by transthoracic echocardiography (TTE). Only irrigated radiofrequency current was delivered at both insertions of the MB which can completely eliminate the IVT.

scholarly journals Role of ventricular tachycardia ablation in arrhythmogenic right ventricular cardiomyopathy

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Alberto Cipriani ◽  
Riccardo Bariani ◽  
Manuel De Lazzari ◽  
Federico Migliore ◽  
Carlo Angheben ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Right Ventricular ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Ventricular Cardiomyopathy ◽  
Ventricular Tachycardia Ablation ◽  
Fatty Replacement ◽  
Technical Issues ◽  
Long Term Prognosis

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by progressive fibro-fatty replacement of the myocardium that represents the substrate for recurrent sustained ventricular tachycardia (VT). These arrhythmias characterize the clinical course of a sizeable proportion of patients and have significant implications for their quality of life and long-term prognosis. Antiarrhythmic drugs are often poorly tolerated and usually provide incomplete control of arrhythmia relapses. Catheter ablation is a potentially effective strategy to treat frequent VT episodes and ICD shocks in ARVC patients. The aims of this review are to discuss the electrophysiological and electroanatomic substrates of ventricular tachycardia in patients with ARVC and to analyze the role of catheter ablation in their management with particular reference to selection of patients, technical issues, potential complications and outcomes.

Abstract 4090: Substrate Modification Using Electroanatomically-guided Linear Ablation During Sinus Rhythm To Treat Post-infarction Ventricular Tachycardia

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Thomas Deneke ◽  
Bernd Lemke ◽  
Leif-Ilja Boesche ◽  
Bernd Calcum ◽  
Andreas Muegge ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Ventricular Arrhythmia ◽  
Sinus Rhythm ◽  
Border Zone ◽  
Ablation Procedure ◽  
Substrate Modification ◽  
Linear Ablation ◽  
Partial Success

Catheter ablation of ventricular tachycardia (VT) in the setting of ischemic cardiomyopathy can be performed to modify the underlying substrate. We evaluated the efficacy of a linear VT ablation procedure based on sinus rhythm (SR) substrate maps to treat ischemic VT in consecutive patients. Methods: In 110 consecutive patients with ischemic VT (56% not tolerated) catheter ablation was attempted. During SR left ventricular scar mapping was performed identifying scar tissue (bipolar voltages 1.5mV). Regionalization of VT-exit regions was performed based on pace-mapping within the scar border zone. Ablation was directed towards the identified exit region performing linear ablation along the scar border. ICD-holter interrogation was performed during follow-up. Results: A mean of 2.7±1.6 different VTs were inducible per patient (total 286). In 97% (107) of all patients (74% of all inducible VTs ablated: 213/286) the clinical VT was successfully ablated. In 68 patients (62%) no sustained monomorphic VT (complete success) was inducible at the end of the ablation procedure whereas in 39 patients (35%) VTs (partial success) were still inducible. Over a median follow-up of 12 months (6 –39) 88 (80%) patients were free from any ventricular arrhythmia. 19 successfully ablated patients had recurrences in between 6 to 36 months post intervention but the number of episodes treated by the ICD was significantly reduced (16±4 within 3 months (3±2) (p=0.02). No difference in patients with tolerated compared to non-tolerated VTs were detected (recurrences in 7/48 (15%) tolerated and 15/62 (24%) non-tolerated; p=0.13). There was a significant difference in freedom from any VT in patients with complete (88%) versus partial success (72%) (p=0.04). Conclusions: Substrate modification targeting only the scar-border zone including the VT exit site based on SR-maps is highly effective in suppressing the occurrence of a clinical VT in patients with remote myocardial infarction (97%). Based on the electro-anatomical findings complete freedom from any ventricular arrhythmia over a median of 1 year can be achieved in 80% of all patients. No difference in regard to freedom from any ventricular arrhythmia can be documented in patients with tolerated and non-tolerated VTs.

scholarly journals Role of Electrophysiological Study and Catheter Ablation for Recurrent Ventricular Tachycardia Complicating Myocarditis

2012 ◽  
Vol 55 (2) ◽  
pp. 96-99
Author(s):  
Emanuele Cecchi ◽  
Serena Fatucchi ◽  
Elena Crudeli ◽  
Cristina Giglioli
Keyword(s):  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Acute Myocarditis ◽  
Electrophysiological Study ◽  
Interventricular Septum ◽  
Arrhythmogenic Substrate ◽  
Rule Out

Here we report the case of a 31-year-old man admitted to our hospital with echocardiografic and Cardiac Magnetic Resonance signs of myocarditis complicated by ventricular tachycardia, initially resolved with direct current shock. After the recurrence of ventricular tachycardia the patient was submitted to electrophysiological study revealing a re-entrant circuit at the level of the medium segment of interventricular septum, successfully treated with transcatheter ablation. This case highlights how the presence of recurrent ventricular arrhythmias at the onset of acute myocarditis, suspected or proven, could be associated with a pre-existing arrhythmogenic substrate, therefore these patients should be submitted to electrophysiological study in order to rule out the presence of arrhythmogenic focuses that can be treated with transcatheter ablation.

scholarly journals Catheter Ablation of Atrial Fibrillation – Techniques and Technology

2012 ◽  
Vol 1 ◽  
pp. 29 ◽  
Author(s):  
George Katritsis ◽  
Hugh Calkins ◽  
◽  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Sinus Rhythm ◽  
The Elderly ◽  
Late Recurrence ◽  
Aged Patients ◽  
Antiarrhythmic Drug Therapy ◽  
Patient Groups ◽  
Maintain Sinus Rhythm

For certain patients with atrial fibrillation (AF) catheter ablation is now an important, therapeutic, intervention. It is established that catheter ablation is more effective than antiarrhythmic drug therapy at maintaining middle-aged patients with paroxysmal AF in sinus rhythm. However, the role of catheter ablation in other patient groups is not yet well defined. Particularly in patients with long-standing persistent AF, heart failure and the elderly, the efficacy of catheter ablation remains uncertain. At experienced centers catheter ablation for AF can be performed with reasonable safety and efficacy. However, major complications can occasionally occur. Late recurrence of AF is not uncommon and many patients will require a further procedure to maintain sinus rhythm. Fortunately, there are promising developments in the techniques and technology used for AF ablation that are likely to improve the outcomes of the procedure.

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