Catheter Ablation of Scar-Related Ventricular Tachycardia in Patients with Electrical Storm Using Remote Magnetic Catheter Navigation

2010 ◽  
Vol 33 (11) ◽  
pp. 1312-1318 ◽  
Author(s):  
ARASH ARYA ◽  
CHARLOTE EITEL ◽  
ANDREAS BOLLMANN ◽  
ULRIKE WETZEL ◽  
PHILLIPP SOMMER ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Electrical Storm ◽  
Catheter Navigation

scholarly journals A Family History of Dilated Cardiomyopathy Induced by Viral Myocarditis

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Thomas Cognet ◽  
Olivier Lairez ◽  
Pauline Marchal ◽  
Jérôme Roncalli ◽  
Michel Galinier
Keyword(s):  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Chronic Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Viral Myocarditis ◽  
Fulminant Myocarditis ◽  
Electrical Storm ◽  
The Family ◽  
History Of

Myocarditis can lead to acute heart failure, cardiogenic shock, or sudden death and later, dilated cardiomyopathy (DCM) with chronic heart failure. We report the cases of two DCM induced by acute and past myocarditis in the same family and expressed by its two main complications within few weeks: an hemodynamic presentation as a fulminant myocarditis rapidly leading to cardiac tranplantation and a rythmologic presentation as an electrical storm leading to catheter ablation of ventricular tachycardia. These cases ask the question of the family predisposition to viral myocarditis leading to DCM.

P359Outcomes of radiofrequency catheter ablation of ischemic ventricular tachycardia in patients with electrical storm

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M Oksul ◽  
H Yorgun ◽  
Y Z Sener ◽  
A H Ates ◽  
U Canpolat ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Effective Treatment ◽  
Mortality Rates ◽  
Electrical Storm ◽  
P Value ◽  
Effective Treatment Option ◽  
Recurrence Rates ◽  
All Cause Mortality ◽  
Baseline Characteristics

Abstract Background Electrical storm (ES) is defined as 3 or more episodes of sustained ventricular tachycardia (VT) within 24 hours and related with high mortality rates. Catheter ablation is an effective treatment option in patiens with ES.  Purpose   We aimed to evaluate outcomes of VT catheter ablation in patients with ES. Methods   All patients who underwent catheter ablation due to VT ablation between June 2014 and November 2018 were screened and outcomes of patients who admitted with ES were evaluated.  Results A total of 128 patients were included. 52 (40.6%) patients were admitted with ES. Mean age of the patients with ES was 68 ± 10,5 years and 48(92,3) patients were male. Median follow up was 22.5 (8-46)  months. Baseline characteristics were listed in Table- 1.Multivariate regression analysis revealed that hemoglobin level (HR:0.76, CI:0,61-0,94, p = 0.011 ) and antiarrhythmic drug use (HR:0.25, CI:0,10-0.62, p = 0.003) were predictors of ES development. Recurrence rates and number of re-do ablation procedures were significantly higher in patients with ES (Table-1). Cardiovascular and all cause mortality rates were also significantly higher in patients with ES (Table-1).  Conclusion Despite catheter ablation is an effective treatment in patients with ES; presence of ES is related with increased mortality and recurrence rates after ablation. Table-1 Patients with ES Patients without ES p value Age, years 68 ± 10,5 63,8 ± 8,8 0,017* Gender, male, n (%) 48(92,3) 72(94,7) 0,853 Hypetension, n (%) 34(65,4) 59(77,6) 0,158 Diabetes, n (%) 17(32,7) 18(23,7) 0,314 Previous PCI 32(61,5) 51(67,1) 0,574 NYHA >II 17(32,7) 13(17,1) 0,044* LV EF, (%) 27,8 ± 8 29,1 ± 8,3 0,369 LV EDD, mm 64,6 ± 9,1 63,3 ± 8,2 0,431 Hemoglobin, g/dL 13,0 ± 2,1 14,1 ± 1,6 0,002* BNP level (pg/mL) 461(35-3161) 244(10-4517) 0,008* Recurrence 23(44,2) 21(27,6) 0,050* Re-do ablation 0,050* 8(10,5) 0,010* Cardiovascular mortality 16(34,8) 12(16,9) 0,045* All cause mortality 22(42,3) 17(22,4) 0,020* Baseline characteristics and outcomes of catheter ablation in patients with and without ES

scholarly journals Catheter Ablation of Polymorphic Ventricular Tachycardia and Ventricular Fibrillation

2013 ◽  
Vol 2 (2) ◽  
pp. 135 ◽  
Author(s):  
Josef Kautzner ◽  
Petr Peichl ◽  
◽  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Ventricular Fibrillation ◽  
Therapeutic Option ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Polymorphic Ventricular Tachycardia ◽  
Electrical Storm ◽  
The Right

Recently, catheter ablation (CA) has become a therapeutic option to target focal triggers of polymorphic ventricular tachycardia and ventricular fibrillation (VF) in the setting of electrical storm (ES). This strategy was first described in subjects without organic heart disease (i.e. idiopathic VF) and subsequently in other conditions, especially in patients with ischaemic heart disease. In the majority of cases, the triggering focus originates in the ventricular Purkinje system. In patients with Brugada syndrome, besides ablation of focal trigger in the right ventricular outflow tract, modification of a substrate in this region has been described to prevent recurrences of VF. In conclusion, CA appears to be a reasonable strategy for intractable cases of ES due to focally triggered polymorphic ventricular tachycardia and VF. Therefore, early transport of the patient into the experience centre for CA should be considered since the procedure could be in some cases life-saving. Therefore, the awareness of this entity and link to the nearest expert centre are important.

scholarly journals Catheter ablation of repetitive ventricular tachycardia in patients with ischemic heart disease – our experience

2017 ◽  
Vol 86 (7-8) ◽  
Author(s):  
Matjaž Šinkovec ◽  
Andrej Pernat ◽  
Bor Antolič ◽  
Luka Klemen
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Ischemic Heart Disease ◽  
Myocardial Revascularization ◽  
Significant Risk ◽  
Ischemic Heart ◽  
Electrical Storm ◽  
Inferior Wall ◽  
Diagnostic Catheter

Ventricular tachycardia (VT) poses a significant risk for sudden death and heart failure exacerbation in patients with ischemic heart disease. Catheter-based radiofrequency ablation is the last treatment option for patients with frequent VT recurrences despite antiarrhythmic drugs. The aim was to present our retrospective catheter ablation data in this group of patients.The majority of 34 patients, who underwent percutaneous endocardial radiofrequency catheter ablation, were male, median age 67.5 years, who presented with electrical storm, had underlying cardiomyopathy after remote inferior wall myocardial infarction and preceding myocardial revascularization procedure, and had been implanted with cardioverter-defibrillator (ICD). Two ablation methods were used: linear ablation and/or scar homogenization. Acute ablation success (non-inducibility of any VT) was achieved in 59 % of procedures. VT could not be interrupted in 2 (6 %) patients. Pericardial tamponade that needed surgical intervention occurred in one procedure (2 %), and was related to inadvertent perforation of the right ventricular apex with a diagnostic catheter. Seven (20 %) patients died and additional 3 were lost from the median of 31 (6–151, rank) months of follow-up. No late VT recurrences were demonstrated in 20 (59 %) patients, and rare in 4 (12 %). Overall, the ablation procedure was successful in 71 % of patients.Catheter ablation gave very good long-term clinical result in about two-thirds of our patients with ischaemic cardiomyopathy and frequent VT recurrences. Catheter ablation, preferably with scar homogenization approach, should be considered early to reduce the number of VT episodes and ICD discharges.

P980Evaluation of the outcomes of radiofrequency catheter ablation in patients with ischemic ventricular tachycardia

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M Oksul ◽  
H Yorgun ◽  
Y Z Sener ◽  
A H Ates ◽  
U Canpolat ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Cardiovascular Mortality ◽  
Nyha Class ◽  
Electrical Storm ◽  
All Cause Mortality ◽  
Effective Option ◽  
Acute Success ◽  
Baseline Characteristics ◽  
Ischemic Attack

Abstract Background Ablation of ventricular tachycardia (VT) is an effective and safe treatment option in symptomatic patients under antiarrhythmic drugs or patients with frequent ICD therapies. Purpose We aimed to evaluate outcomes of VT catheter ablation in patients with ischemic VT. Methods All of the patients who underwent VT catheter ablation between June 2014 and November 2018 were included. Results 128 patients (120 male, 8 female) were included and mean age was 65 ± 10 years. Mean ejection fraction was 28.6 ± 8.2 %. Baseline characteristics were listed in Table-1.  Mean follow-up was 22.3 ± 6.4  months. 52 (46.6 %) patients were admitted with electrical storm. Acute success rate was 96.6%. Complications including transient ischemic attack, deep venous thrombosis, pericardial effusion and inguinal hematoma were developed in 6 patients.  Recurrence of VT was occured in 44 (34.4 %) patients and the presence of PCI history and admission with electrical storm were predictors of recurrence. All cause mortality was occured in  39 patients and predictors of all cause mortality was detected as follows; diabetes, NYHA stage >2, lower levels of EF and higher BNP levels. Cardiovascular mortality was developed in 28 patients and predictors were defined as, lower levels of EF, higher BNP levels and number of shock after index ablation. VT recurrence was not found to be related with both cardiovascular and all cause mortality. Conclusion VT ablation is a safe and effective option in patients with ischemic VT who are symptomatic despite optimal medical treatment. Admission with electrical storm and history of PCI were predictors of VT recurrence after ablation. Higher levels of BNP, lower EF values are related with both all cause and cardiovascular mortality. Table-1 Gender, male, (%) 120(93,8) Age(year) 65,5 ± 9,7 HT 93(72,7) DM 35(27,3) AF 41(32,0) NYHA class(pre-ablation) IIIIII IV 71(55,5)27(21,1)25(19,5) 5(3,9) Previous PCI 83(64,8) Previous Cardiac surgery CABG AVR MVR 72(56,3) 70(54,7 1(0,8) 4(3,1) LV EF (%)≤3031-40 ≥41 28,6 ± 8,290(70,3)28(21,9) 10(7,8) Electrical storm 52(40,6) LV EDD (mm) 63,8 ± 8,5 Baseline characteristics

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