Role of Alternative Interventional Procedures When Endo- and Epicardial Catheter Ablation Attempts for Ventricular Arrhythmias Fail

2015 ◽  
Vol 8 (3) ◽  
pp. 606-615 ◽  
Author(s):  
Saurabh Kumar ◽  
Chirag R. Barbhaiya ◽  
Piotr Sobieszczyk ◽  
Andrew C. Eisenhauer ◽  
Gregory S. Couper ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Interventional Procedures

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 Role of Catheter Ablation for Ventricular Arrhythmias in Brugada Syndrome

2021 ◽  
Vol 23 (5) ◽  
Author(s):  
Ronpichai Chokesuwattanaskul ◽  
Koonlawee Nademanee
Keyword(s):  
Catheter Ablation ◽  
Brugada Syndrome ◽  
Ventricular Arrhythmias ◽  
Structural Heart Disease ◽  
Therapeutic Modalities ◽  
Good Target ◽  
Arrhythmogenic Substrate ◽  
Life Threatening ◽  
The Right

Abstract Purpose of Review To discuss the role of catheter ablation in treating life-threatening ventricular arrhythmias associated with Brugada syndrome (BrS), by presenting recent findings of BrS arrhythmogenic substrate, mechanisms underlying ventricular arrhythmias, and how they can be treated with catheter ablation. Recent Findings Almost three decades ago when the clinical entity of Brugada syndrome (BrS) was described in patients who had abnormal coved-type ST elevation in the right precordial EKG leads in patients who had no apparent structural heart disease but died suddenly from ventricular fibrillation. Since its description, the syndrome has galvanized explosive research in this field over the past decades, driving major progress toward better understanding of BrS, gaining knowledge of the genetic pathophysiology and risk stratification of BrS, and creating significant advances in therapeutic modalities. One of such advances is the ability for electrophysiologists to map and identify the arrhythmogenic substrate sites of BrS, which serve as good target sites for catheter ablation. Subsequently, several studies have shown that catheter ablation of these substrates normalizes the Brugada ECG pattern and is very effective in eliminating these substrates and preventing recurrent VF episodes. Summary Catheter ablation has become an important addition for treatment of symptomatic BrS patients with recurrent VT/VF episodes.

scholarly journals Papillary Muscle Ventricular Tachycardia or Ectopy: Diagnostics, Catheter Ablation and the Role of Intracardiac Echocardiography

2019 ◽  
Vol 8 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Josef Kautzner ◽  
Petr Peichl
Keyword(s):  
Catheter Ablation ◽  
Papillary Muscle ◽  
Ventricular Arrhythmias ◽  
Radiofrequency Catheter Ablation ◽  
Intracardiac Echocardiography ◽  
Imaging Method ◽  
Papillary Muscles ◽  
Catheter Tip ◽  
Activation Mapping

Ventricular arrhythmias originating from the papillary muscle of the left or right ventricle are specific clinical entities. They are usually focal in origin and can be identified by a characteristic ECG pattern. Intracardiac echocardiography appears to be the most suitable imaging method for assessment of the exact location of the focus at papillary muscles in association with activation mapping. We recently confirmed that ectopic foci were located within the distal, mid, or proximal (basal) third of the papillary muscle in 67%, 19%, and 14% of patients, respectively. Radiofrequency ablation has the potential to cure these specific arrhythmias. However, the procedure is usually challenging for catheter instability, despite navigation with intracardiac echocardiography. Cryoablation, which ensures catheter tip stability, could be a viable alternative in cases of the failure of radiofrequency catheter ablation.

The role of imaging in catheter ablation of ventricular arrhythmias

2021 ◽  
Author(s):  
Antonio Berruezo ◽  
Diego Penela ◽  
Beatriz Jáuregui ◽  
David Soto‐Iglesias
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias

The Expanding Role of Echocardiography in Interventional Cardiology

2010 ◽  
Vol 6 (2) ◽  
pp. 71 ◽  
Author(s):  
Lindsay A Smith ◽  
Amit Bhan ◽  
Mark J Monaghan ◽  
◽  
◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Imaging Modality ◽  
Interventional Cardiology ◽  
Design And Technology ◽  
Team Approach ◽  
Medical Problems ◽  
Multidisciplinary Team Approach ◽  
Case Selection ◽  
Optimal Imaging

Echocardiography provides excellent realtime imaging of the heart, making it the imaging modality of choice immediately before, during and after cardiac interventional procedures. It helps to guide case selection and execution of the intervention, evaluates the effects of the intervention and enables early detection of complications. Advances in the design and technology of medical devices and delivery systems, coupled with demand for alternative non-surgical therapies for common medical problems, have led to an increase in the volume, variety and complexity of non-coronary cardiac interventional procedures performed. Many of these procedures require a multidisciplinary team approach and demand optimal imaging to ensure successful outcomes. The aim of this article is to review the expanding role of echocardiography in non-coronary interventional cardiology in adults.

RESEARCH THE VALUE OF THE COMBINATION OF T WAVE ALTERNANS AND NT-PROBNT IN PREDICTING SUDDEN CARDIAC DEATH

2012 ◽  
pp. 74-83
Author(s):  
Anh Tien Hoang ◽  
Nhat Quang Nguyen
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Healthy Person ◽  
Treadmill Test ◽  
T Wave ◽  
T Wave Alternans

Background: Decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-to-bedside foundation makes TWA, NT-ProBNP a very plausible index of susceptibility to ventricular arrythmia, and motivates the need to define optimal combination of TWA and NT-ProBNP in predicting ventricular arrythmia in myocardial infarction patients. We research this study with 2 targets: 1. To evaluate the role of TWA in predicting sudden cardiac death in myocardial infarction patients. 2. To evaluate the role of NT-ProBNP in predicting sudden cardiac death in myocardial infarction patients 3. Evaluate the role of the combined NT-ProBNP and TWA in predicting sudden cardiac death in myocardial infarction patients. Methods: Prospective study with follow up the mortality in 2 years: 71 chronic myocardial infarction patients admitted to hospital from 5/2009 to 5/20011 and 50 healthy person was done treadmill test to caculate TWA; ECG, echocardiography, NT-ProBNP. Results: Cut-off point of NT-ProBNP in predicting sudden cardiac death is 3168 pg/ml; AUC = 0,86 (95% CI: 0,72 - 0,91); Cut-off point of TWA in predicting sudden cardiac death is 107 µV; AUC = 0,81 (95% CI: 0,69 - 0,87); NT-ProBNP can predict sudden cardiac death with OR= 7,26 (p<0,01); TWA can predict sudden cardiac death with OR= 8,45 (p<0,01). The combined NT-ProBNP and TWA in predicting ventricular arrythmia in heart failure patients: OR= 17,91 (p<0,001). Conclusions: The combined NT-ProBNP and TWA have the best predict value of sudden cardiac death in myocardial infarction patients, compare to NT-ProBNP or TWA alone

Myocardial Noncompaction

2018 ◽  
Vol 69 (8) ◽  
pp. 2209-2212
Author(s):  
Alexandru Radu Mihailovici ◽  
Vlad Padureanu ◽  
Carmen Valeria Albu ◽  
Venera Cristina Dinescu ◽  
Mihai Cristian Pirlog ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Specific Treatment ◽  
Left Ventricular ◽  
Left Ventricular Noncompaction ◽  
Ventricular Noncompaction ◽  
Genetic Transmission ◽  
Asymptomatic Patients ◽  
Increased Risk ◽  
Patients With Heart Failure

Left ventricular noncompaction is a primary cardiomyopathy with genetic transmission in the vast majority of autosomal dominant cases. It is characterized by the presence of excessive myocardial trabecularities that generally affect the left ventricle. In diagnosing this condition, echocardiography is the gold standard, although this method involves an increased risk of overdiagnosis and underdiagnosis. There are also uncertain cases where echocardiography is inconclusive, a multimodal approach is needed, correlating echocardiographic results with those obtained by magnetic resonance imaging. The clinical picture may range from asymptomatic patients to patients with heart failure, supraventricular or ventricular arrhythmias, thromboembolic events and even sudden cardiac death. There is no specific treatment of left ventricular noncompaction, but the treatment is aimed at preventing and treating the complications of the disease. We will present the case of a young patient with left ventricular noncompactioncardiomyopathy and highlight the essential role of transthoracic echocardiography in diagnosing this rare heart disease.

scholarly journals Catheter Ablation of Life-Threatening Ventricular Arrhythmias in Athletes

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 205
Author(s):  
Nicola Tarantino ◽  
Domenico G. Della Rocca ◽  
Nicole S. De Leon De La Cruz ◽  
Eric D. Manheimer ◽  
Michele Magnocavallo ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Individual Factors ◽  
Substantial Part ◽  
Arrhythmogenic Substrate ◽  
Life Threatening ◽  
History Of ◽  
Anatomic Distribution ◽  
Artery Disease ◽  
Surveillance Analysis

A recent surveillance analysis indicates that cardiac arrest/death occurs in ≈1:50,000 professional or semi-professional athletes, and the most common cause is attributable to life-threatening ventricular arrhythmias (VAs). It is critically important to diagnose any inherited/acquired cardiac disease, including coronary artery disease, since it frequently represents the arrhythmogenic substrate in a substantial part of the athletes presenting with major VAs. New insights indicate that athletes develop a specific electro-anatomical remodeling, with peculiar anatomic distribution and VAs patterns. However, because of the scarcity of clinical data concerning the natural history of VAs in sports performers, there are no dedicated recommendations for VA ablation. The treatment remains at the mercy of several individual factors, including the type of VA, the athlete’s age, and the operator’s expertise. With the present review, we aimed to illustrate the prevalence, electrocardiographic (ECG) features, and imaging correlations of the most common VAs in athletes, focusing on etiology, outcomes, and sports eligibility after catheter ablation.

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