Arrhythmia/Ventricular Tachycardia Ablation

2019 ◽  
pp. 330-337
Author(s):  
Suraj Kapa
Keyword(s):  
Ventricular Tachycardia ◽  
Clinical Decision Making ◽  
Structural Heart Disease ◽  
Clinical Decision ◽  
Clinical Situation ◽  
Circulatory Support ◽  
Surgical Ablation ◽  
Ventricular Tachycardia Ablation ◽  
Hemodynamic Support ◽  
Baseline Status

Ventricular tachycardia ablation is a mainstay of treatment for patients with structural heart disease and ventricular arrhythmias but is often compromised by hemodynamic collapse. The decision on when, whether, and what to use for hemodynamic support depends on the clinical situation, the patient’s comorbidities, and the availability of appropriate equipment and staffing. Depending on the clinical situation, a specific circulatory support device might be optimal, as certain ones may impact approach to the procedure. While there is a paucity of data supporting routine use of circulatory support during cardiac ablation, in specific cases there may be utility due to the patient’s baseline status. Other considerations include the use of hemodynamic support during surgical ablation and in the peri-ablation period. This chapter reviews the indications for use, a structured clinical decision-making approach, and the different types of hemodynamic support available for use during ventricular arrhythmia ablation.

P6645Extracorporeal membrane oxygenation for hemodynamic support of ventricular tachycardia ablation

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
L Oyarzabal Rabanal ◽  
P Dallaglio ◽  
I Anguera ◽  
A Di Marco ◽  
M Acena ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Tachycardia Ablation ◽  
Hemodynamic Support ◽  
Membrane Oxygenation

scholarly journals Predicting post-operative right ventricular failure using video-based deep learning

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Rohan Shad ◽  
Nicolas Quach ◽  
Robyn Fong ◽  
Patpilai Kasinpila ◽  
Cayley Bowles ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Clinical Decision Making ◽  
Heart Function ◽  
Clinical Decision ◽  
Right Ventricular Failure ◽  
Circulatory Support ◽  
Ventricular Failure ◽  
Cardiac Wall ◽  
Subjective Assessments ◽  
The Rich

AbstractDespite progressive improvements over the decades, the rich temporally resolved data in an echocardiogram remain underutilized. Human assessments reduce the complex patterns of cardiac wall motion, to a small list of measurements of heart function. All modern echocardiography artificial intelligence (AI) systems are similarly limited by design – automating measurements of the same reductionist metrics rather than utilizing the embedded wealth of data. This underutilization is most evident where clinical decision making is guided by subjective assessments of disease acuity. Predicting the likelihood of developing post-operative right ventricular failure (RV failure) in the setting of mechanical circulatory support is one such example. Here we describe a video AI system trained to predict post-operative RV failure using the full spatiotemporal density of information in pre-operative echocardiography. We achieve an AUC of 0.729, and show that this ML system significantly outperforms a team of human experts at the same task on independent evaluation.

Extracorporeal membrane oxygenation for hemodynamic support of ventricular tachycardia ablation: a 2-center experience

2020 ◽  
Vol 73 (3) ◽  
pp. 264-265
Author(s):  
Paolo D. Dallaglio ◽  
Loreto Oyarzabal Rabanal ◽  
Oriol Alegre Canals ◽  
Karina Osorio Higa ◽  
Nuria Rivas Gandara ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Extracorporeal Membrane Oxygenation ◽  
Ventricular Tachycardia Ablation ◽  
Hemodynamic Support ◽  
Membrane Oxygenation

Ventricular Tachycardia Ablation Remains Treatment of Last Resort in Structural Heart Disease: Argument for Earlier Intervention

2011 ◽  
Vol 22 (10) ◽  
pp. 1123-1128 ◽  
Author(s):  
DAVID S. FRANKEL ◽  
STAVROS E. MOUNTANTONAKIS ◽  
MELISSA R. ROBINSON ◽  
ERICA S. ZADO ◽  
DAVID J. CALLANS ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Structural Heart Disease ◽  
Ventricular Tachycardia Ablation

scholarly journals Limitations and Challenges in Mapping Ventricular Tachycardia: New Technologies and Future Directions

2017 ◽  
Vol 6 (3) ◽  
pp. 118 ◽  
Author(s):  
Adam J Graham ◽  
Michele Orini ◽  
Pier D Lambiase ◽  
◽  
◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
New Technologies ◽  
Therapeutic Option ◽  
Myocardial Damage ◽  
Structural Heart Disease ◽  
Mortality And Morbidity ◽  
Ventricular Tachycardia Ablation ◽  
Life Saving

Recurrent episodes of ventricular tachycardia in patients with structural heart disease are associated with increased mortality and morbidity, despite the life-saving benefits of implantable cardiac defibrillators. Reducing implantable cardiac defibrillator therapies is important, as recurrent shocks can cause increased myocardial damage and stunning, despite the conversion of ventricular tachycardia/ventricular fibrillation. Catheter ablation has emerged as a potential therapeutic option either for primary or secondary prevention of these arrhythmias, particularly in post-myocardial infarction cases where the substrate is well defined. However, the outcomes of catheter ablation of ventricular tachycardia in structural heart disease remain unsatisfactory in comparison with other electrophysiological procedures. The disappointing efficacy of ventricular tachycardia ablation in structural heart disease is multifactorial. In this review, we discuss the issues surrounding this and examine the limitations of current mapping approaches, as well as newer technologies that might help address them.

Evidence-based psychopharmacotherapy. A valid and reliable approach?

2012 ◽  
Vol 09 (04) ◽  
pp. 231-238
Author(s):  
H.-J. Möller
Keyword(s):  
Decision Making ◽  
Clinical Experience ◽  
Clinical Decision Making ◽  
Positive Impact ◽  
Belief Systems ◽  
Clinical Decision ◽  
Clinical Situation ◽  
Phase Iii ◽  
Evidence Based ◽  
Oriented Phase

Summary Objective: Psychopharmacotherapy should now be regulated in the sense of evidence-based medicine (EBM), as is the case in other areas of clinical treatment in medicine. Methods: Descriptive overview of limitations and problems of EBM in pharmacopsychiatry. Results: In general this is a meaningful development, which principally will have a positive impact on routine health care in psychiatry. But several related problems should not be ignored. So far consensus on an internationally accepted evidence graduation could not be reached, due to several difficulties related to this. For example, to focus on the results of meta-analyses instead of considering relevant single studies results in a decision-making logic which is in conflict with the rationale applied by drug authorities in the licensing process. Attempts to regulate psychopharmacotherapy in the sense of EBM come closer to their limits the more complex the clinical situation and the respective decision-making logic are. Conclusion: EBM has severe problems and limitations. Even in times of EBM a large part of complex clinical decision-making in psychopharmacotherapy still relies more on clinical experience and a consensus about clinical experience, traditions and belief systems than on results of efficacy oriented phase-III and effectiveness-oriented phase-IV clinical studies.

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