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 Relationship of Arrhythmogenic Substrate and Frequent Ventricular Extrasystoles in Patients with Nonischemic Cardiomyopathy

2020 ◽  
Vol 33 (1) ◽  
pp. 46-50
Author(s):  
Cristiano de Oliveira Dietrich
Keyword(s):  
Ventricular Tachycardia ◽  
Case Report ◽  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Nonischemic Cardiomyopathy ◽  
Premature Ventricular Contractions ◽  
Ventricular Extrasystoles ◽  
Arrhythmogenic Substrate ◽  
Myocardial Fibers ◽  
Relationship Of

Cardiomyopathies (CMP) are related with scarring tissue due to fibrotic and disarrangement of myocardial fibers that promote an slowed conduction and substrate for sustained reentrant ventricular arrhythmias. Sometimes, CMP can be associated with ventricular extrasystoles but uncommonly originated from scarring tissue. The case report show a patient with nonischemic CMP, frequents premature ventricular contractions and sustained ventricular tachycardia submitted to catheter ablation.

scholarly journals Catheter Ablation of Ventricular Tachycardia in LMNA Cardiomyopathy: Out of Sight but not Out of Mind

2021 ◽  
Author(s):  
Ahmad Halawa ◽  
Paul Zei ◽  
Neal Lakdawala ◽  
William Sauer ◽  
Usha Tedrow ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Success Rate ◽  
Ventricular Arrhythmias ◽  
Cycle Length ◽  
Electrical Storm ◽  
Arrhythmogenic Substrate ◽  
Ablation Success ◽  
Endocardial Mapping ◽  
Activation Mapping

Lamin Cardiomyopathy (LC) is associated with refractory ventricular arrhythmias. Catheter ablation success rate is low due to presence of multiple circuits and intramural substrate. We present a LC case presented with electrical storm. During catheter ablation, arrhythmia was easily inducible but activation mapping, including full epicardial and endocardial mapping, failed to demonstrate the full tachycardia cycle length (70% only) suggesting intramural activation. Critical isthmus was not identified even with successful concealed entrainment on both Endo/epicardial surfaces. This case shows that even combined endocardial and epicardial catheter approach can be ineffective in identifying the full arrhythmogenic substrate in LC.

scholarly journals Catheter ablation of Idiopathic Ventricular Arrhythmias in Nepal-5 Years Single Centre Experience

2021 ◽  
Vol 18 (2) ◽  
pp. 33-37
Author(s):  
Roshan Raut ◽  
Murari Dhungana ◽  
Man Bahadur KC ◽  
Mukunda Sharma ◽  
Surakshya Joshi ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Clinical Success ◽  
Electrophysiological Study ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Single Centre Experience ◽  
Single Operator ◽  
Acute Success

Background and Aims: Idiopathic ventricular arrhythmia (IVAs) is defined as premature ventricular complexes (PVCs), nonsustained ventricular tachycardia or sustained ventricular tachycardia (VT) in the absence of obvious structural heart disease. Catheter ablation has become an established treatment strategy for wide varieties of idiopathic ventricular arrhythmias. The aim of this study is to report the efficacy and safety of catheter ablation of idiopathic ventricular arrhythmias, for the first time in Nepal. Methods: This is a retrospective observational descriptive study of all patients who underwent electrophysiological study and radiofrequency catheter ablation for IVAs from March, 2015 to February 2020 at Shahid Gangalal National Heart center (SGNHC). Results: Altogether 101 patients underwent an EP study with intent to ablations for idiopathic ventricular arrhythmias. In 13 patients, ventricular arrhythmias were not present on the procedure day and also could not be induced in the lab, therefore ablation was performed in 88 patients only. RVOT was the most common site of these arrhythmias comprising 51% of all cases, followed by fascicular VT (34%) and basal left ventricular IVAs (15%). Out of 88 patients, the acute success of 7 patients could not be assessed because of very infrequent PVCs. Out of remaining 81 patients, acute success achieved in 77 patients (95%). Recurrence occurred in 9 patients (10.7%) and 4 patients underwent repeat ablation giving rise to over clinical success during follow up in 78 patients (88.7%). There were two major complications, one pulmonary embolism and another cardiac tamponade both managed successfully. Conclusion: This single-center single operator study demonstrates that catheter ablation of idiopathic ventricular arrhythmias has a high success and low complication rate

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.

Emergency catheter ablation of refractory ventricular tachycardia

1989 ◽  
Vol 9 (5) ◽  
pp. 36-40 ◽  
Author(s):  
LL Stevens ◽  
RM Redd ◽  
TA Buckingham
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Pharmacologic Therapy ◽  
Emergency Therapy

Catheter ablation, in extreme cases, can be used successfully as emergency therapy for VT in the CCU. In the hands of a physician experienced in electrophysiologic procedures, catheter ablation may prove to be an alternative to surgical or pharmacologic therapy in acutely ill patients with refractory ventricular arrhythmias.

Agreement between gadolinium-enhanced cardiac magnetic resonance and electro-anatomical maps in patients with non-ischaemic dilated cardiomyopathy and ventricular arrhythmias

EP Europace ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. 1392-1399
Author(s):  
Federica Torri ◽  
Csilla Czimbalmos ◽  
Livio Bertagnolli ◽  
Sabrina Oebel ◽  
Andreas Bollmann ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
Dilated Cardiomyopathy ◽  
Ventricular Arrhythmias ◽  
Low Voltage ◽  
Gadolinium Enhancement ◽  
Lge Cmr ◽  
Good Agreement

Abstract Aims We sought to investigate the overlap between late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) and electro-anatomical maps (EAM) of patients with non-ischaemic dilated cardiomyopathy (NIDCM) and how it relates with the outcomes after catheter ablation of ventricular arrhythmias (VA). Methods and results We identified 50 patients with NIDCM who received CMR and ablation for VA. Late gadolinium enhancement was detected in 16 (32%) patients, mostly in those presenting with sustained ventricular tachycardia (VT): 15 patients. Low-voltage areas (<1.5 mV) were observed in 23 (46%) cases; in 7 (14%) cases without evidence of LGE. Using a threshold of 1.5 mV, a good and partially good agreement between the bipolar EAM and LGE-CMR was observed in only 4 (8%) and 9 (18%) patients, respectively. With further adjustments of EAM to match the LGE, we defined new cut-off limits of median 1.5 and 5 mV for bipolar and unipolar maps, respectively. Most VT exits (12 out of 16 patients) were found in areas with LGE. VT exits were found in segments without LGE in two patients with VT recurrence as well as in two patients without recurrence, P = 0.77. In patients with VT recurrence, the LGE volume was significantly larger than in those without recurrence: 12% ± 5.8% vs. 6.9% ± 3.4%; P = 0.049. Conclusions In NIDCM, the agreement between LGE and bipolar EAM was fairly poor but can be improved with adjustment of the thresholds for EAM according to the amount of LGE. The outcomes were related to the volume of LGE.

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