31 – Epicardial Approach to Catheter Ablation of Ventricular Tachycardia

Published on Jan 1, 2011
· DOI :10.1016/B978-1-4377-1368-8.00031-3
Eduardo Sosa5
Estimated H-index: 5
,
Scanavacca M4
Estimated H-index: 4
Source
Abstract
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References37
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#2Victor Bazan (UPenn: University of Pennsylvania)H-Index: 13
Last. Francis E. Marchlinski (UPenn: University of Pennsylvania)H-Index: 119
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Background— ECG criteria identifying epicardial (EPI) origin for ventricular tachycardia (VT) in nonischemic cardiomyopathy have not been determined. Endocardial (ENDO) and EPI basal left ventricle fibrosis characterizes the VT substrate. Methods and Results— We assessed the QRS from 102 basal-superior/lateral EPI and 67 comparable ENDO pace maps in 14 patients with nonischemic cardiomyopathy. Pace mapping focused on low bipolar voltage areas. Published morphology criteria: q wave in lead I (QWL...
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#1Andre D'avilaH-Index: 6
#2Arash AryanaH-Index: 5
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Background:This study of a chronic porcine postinfarction model examined whether linear epicardial cryoablation was capable of creating large, homogenous lesions in regions of the myocardium including scarred ventricle. Endocardial and epicardial focal cryolesions were also compared to determine if there were significant differences in lesion characteristics. Methods:Eighty focal endocardial and 28 focal epicardial cryoapplications were delivered to eight normal caprine and four normal porcine v...
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#1Mark D O'NeillH-Index: 36
#2Pierre JaïsH-Index: 115
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Atrial fibrillation (AF) is a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation with associated deterioration of atrial mechanical function.1 It is the most common cardiac arrhythmia, becomes more prevalent with age,2 and is associated with an increased long-term risk of stroke, heart failure, and all-cause mortality.3 AF can occur in the absence of underlying heart disease but is more frequent in connection with mitral valve disease, heart failure, ischemic heart...
152 CitationsSource
#1Eduardo Sosa (USP: University of São Paulo)H-Index: 29
#2Mauricio Scanavacca (USP: University of São Paulo)H-Index: 32
162 CitationsSource
#1William G. Stevenson (Brigham and Women's Hospital)H-Index: 105
PURPOSE OF REVIEW: Patients with ventricular tachycardia are subject to frequent recurrences and antiarrhythmic drug therapy has been disappointing. Catheter ablation offers an alternative means of controlling ventricular tachycardia. RECENT FINDINGS: The origin and pathophysiology of ventricular tachycardia are being defined for newly recognized types of ventricular tachycardia as well as scar-related ventricular tachycardias. The approach to mapping and ablation of ventricular tachycardia depe...
44 Citations
#1Li-Fern HsuH-Index: 27
#2Pierre JaïsH-Index: 115
Last. Michel HaïssaguerreH-Index: 127
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Background Congestive heart failure and atrial fibrillation often coexist, and each adversely affects the other with respect to management and prognosis. We prospectively evaluated the effect of catheter ablation for atrial fibrillation on left ventricular function in patients with heart failure. Methods We studied 58 consecutive patients with congestive heart failure and a left ventricular ejection fraction of less than 45 percent who were undergoing catheter ablation for atrial fibrillation. W...
758 CitationsSource
Circumferential pulmonary vein (PV) ablation for patients with atrial fibrillation (AF) is an effective treatment that is becoming more widely accepted and practiced.1,2 A significant learning curve exists, however, and periprocedural and postprocedural management is important to maximize success rates and reduce complications. Until recently this procedure was considered a purely anatomic approach without clear electrophysiologic endpoints, operator dependent, and nonreproducible. This article ...
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Last. You-Ho Kim (UOU: University of Ulsan)H-Index: 16
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Right Phrenic Nerve Injury Following Electrical Disconnection of the Right Superior Pulmonary Vein. This report describes a case of transient paresis of the right diaphragm following the transcatheter radiofrequency ablation for the electrical disconnection of pulmonary veins, which recovered completely during the observational period in a 61-year-old woman with paroxysmal atrial fibrillation. For electrical disconnection of pulmonary veins, careful preventive measures for phrenic nerve damage a...
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#1Kyoko Soejima (Brigham and Women's Hospital)H-Index: 29
#2Gregory S. Couper (Brigham and Women's Hospital)H-Index: 54
Last. William G. Stevenson (Brigham and Women's Hospital)H-Index: 105
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Background— Percutaneous epicardial mapping and ablation are successful in some patients with ventricular epicardial reentry circuits but may be impossible when pericardial adhesions are present, such as from prior cardiac surgery. The purpose of this study was to evaluate the feasibility of direct surgical exposure of the pericardial space to allow catheter epicardial mapping and ablation in the electrophysiology laboratory when percutaneous access is not feasible. Methods and Results— In 6 pat...
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#1Eduardo Sosa (USP: University of São Paulo)H-Index: 29
#2Mauricio Scanavacca (USP: University of São Paulo)H-Index: 32
Last. Franchine Ramires (USP: University of São Paulo)H-Index: 1
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Introduction: The subxyphoid pericardial mapping approach can be used to facilitate catheter ablation of postmyocardial-infarction ventricular tachycardia (post-MI VT), but the presence of dense adhesions is thought to preclude this approach in patients who have previously undergone open-chest cardiac surgery.
71 CitationsSource
Cited By4
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#1Roy M. John (Brigham and Women's Hospital)H-Index: 41
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Background— Endovascularly implanted leads risk vascular injury and endocarditis, and can be difficult to locate in desired positions for LV pacing. We evaluated the acute and long-term stability, electric performance and histopathology of a percutaneously placed intrapericardial lead (IPL). Methods and Results— Twelve adult mongrel dogs underwent defibrillator implants incorporating IPLs. Successful uncomplicated percutaneous implantation of an IPL was achieved in all. Early fluoroscopic shift ...
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#1Luigi Di Biase (Yeshiva University)H-Index: 77
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#1Bruno Pereira Valdigem (UNIFESP: Federal University of São Paulo)H-Index: 3
#2Nilton José Carneiro da Silva (UNIFESP: Federal University of São Paulo)H-Index: 4
Last. Angelo Amato Vincenzo de Paola (UNIFESP: Federal University of São Paulo)H-Index: 24
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Background As damage to coronary arteries is a potential complication of epicardial RF catheter ablation (EPRFCA), the procedure must be associated with coronary angiography. Chronic Chagasic cardiomiopathy (CCC) is a disease where epicardial VT are common. Eletroanatomic mapping merged with computed totmography (CT) scan data is a useful tool for mapping the endocardium, and its accuracy in guiding ablation on the epicardium was not adequately evaluated so far.
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