1
|
Dong Y, Wang H, Ma K, Ling Z, Zhao D, Wang Y, Zhang Z, Shao M, Song H, Jiang W, Yang K, Chen Q, Kojodjojo P, Ullah I, Cao K, Chen M, Zhang F. Half versus normal saline irrigation during catheter ablation of outflow tract ventricular arrhythmias (HALF): a multi-center, parallel, open-label, randomized controlled study. J Interv Card Electrophysiol 2023; 66:2143-2151. [PMID: 37204671 DOI: 10.1007/s10840-023-01558-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Animal studies demonstrated that deeper lesions could be achieved during radio-frequency catheter ablation (RFCA) by using half saline (HS) compared to normal saline (NS) as irrigation. OBJECTIVES This study sought to compare the efficiency and safety of HS and NS for irrigation during RFCA of idiopathic outflow tract ventricular arrhythmia (OT-VA). METHODS In this multicenter, randomized controlled study, 167 patients undergoing RFCA of OT-VA were randomized 1:1 to receive HS- or NS-irrigated ablation. Acute success was defined as the absence of induced targeted premature ventricular contraction (PVC) at the end of the procedure. The 6-month success was defined as a ≥ 80% reduction of pre-procedural PVC burden. RESULTS There were no differences of baseline characteristics between the HS and NS group. Patients in HS group had shorter total ablation time (259.5 ± 155.5 S vs. 355.6 ± 230.7 S, P = 0.04) than that in NS group. The acute and 6-month success rates were similar between the HS and NS group (92.8 vs. 91.7%, P = 0.79; 90.9 vs. 92.1%, P = 0.79, respectively). No significant difference was observed in the incidence of steam pops between the HS and NS group (2.4 vs. 1.2%, P = 0.62). CONCLUSIONS The ablation using HS irrigation achieved similar success rate and safety compared to that using NS irrigation but was associated with a shorter total ablation time. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR2200059205).
Collapse
Affiliation(s)
- Yan Dong
- Section of Pacing and Electrophysiology, Division of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Hongtao Wang
- Department of Cardiology, the Second Affiliated Hospital of Xi'an JiaoTong University, Xi'an, China
| | - Kezhong Ma
- Department of Cardiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Zhiyu Ling
- Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dongsheng Zhao
- Section of Pacing and Electrophysiology, Division of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Yuegang Wang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhiyong Zhang
- Department of Cardiology, the Affiliated Suqian First People's Hospital of Nanjing Medical University, Jiangsu, China
| | - Mingliang Shao
- Department of Cardiology, the Affiliated Xuancheng Hospital of Wannan Medical College, Wuhu, China
| | - Hejian Song
- Department of Cardiology, the First Affiliated Hospital of Kangda College of Nanjing Medical University, Nanjing, China
| | - Wei Jiang
- Department of Cardiology, the Second Affiliated Hospital of Xi'an JiaoTong University, Xi'an, China
| | - Kai Yang
- Department of Cardiology, the First Affiliated Hospital of Kangda College of Nanjing Medical University, Nanjing, China
| | - Qiushi Chen
- Section of Pacing and Electrophysiology, Division of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Pipin Kojodjojo
- National University of Singapore, Asian Heart and Vascular Centre, Singapore, Singapore
| | - Inam Ullah
- Section of Pacing and Electrophysiology, Division of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Kejiang Cao
- Section of Pacing and Electrophysiology, Division of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Minglong Chen
- Section of Pacing and Electrophysiology, Division of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Fengxiang Zhang
- Section of Pacing and Electrophysiology, Division of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China.
| |
Collapse
|
2
|
Zhou B, Yu J, Ju W, Li X, Zhang F, Chen H, Li M, Gu K, Xie X, Cheng D, Wang X, Wu Y, Zhou J, Zhang B, Kojodjojo P, Cao K, Yang B, Chen M. Bipolar Catheter Ablation Strategies for Outflow Tract Ventricular Arrhythmias Refractory to Unipolar Ablation. J Cardiovasc Electrophysiol 2022; 33:1769-1778. [PMID: 35634859 DOI: 10.1111/jce.15579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/02/2022] [Accepted: 05/17/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Benjun Zhou
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingP.R. China
- Department of CardiologyThe Affiliated Jiangning Hospital of Nanjing Medical UniversityNanjingP.R. China
| | - Jinbo Yu
- Department of Cardiology, Shanghai East HospitalTongji University School of MedicineShanghaiP.R. China
| | - Weizhu Ju
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingP.R. China
| | - Xiaorong Li
- Department of Cardiology, Shanghai East HospitalTongji University School of MedicineShanghaiP.R. China
| | - Fengxiang Zhang
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingP.R. China
| | - Hongwu Chen
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingP.R. China
| | - Mingfang Li
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingP.R. China
| | - Kai Gu
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingP.R. China
| | - Xin Xie
- Department of Cardiology, Shanghai East HospitalTongji University School of MedicineShanghaiP.R. China
| | - Dian Cheng
- Department of Cardiology, Shanghai East HospitalTongji University School of MedicineShanghaiP.R. China
| | - Xuecheng Wang
- Department of Cardiology, Shanghai East HospitalTongji University School of MedicineShanghaiP.R. China
| | - Yizhang Wu
- Department of Cardiology, Shanghai East HospitalTongji University School of MedicineShanghaiP.R. China
| | - Jian Zhou
- Department of Cardiology, Shanghai East HospitalTongji University School of MedicineShanghaiP.R. China
| | - Baowei Zhang
- Department of Cardiology, Shanghai East HospitalTongji University School of MedicineShanghaiP.R. China
| | - Pipin Kojodjojo
- Department of CardiologyNg Teng Fong General HospitalSingaporeSingapore
| | - Kejiang Cao
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingP.R. China
| | - Bing Yang
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingP.R. China
- Department of Cardiology, Shanghai East HospitalTongji University School of MedicineShanghaiP.R. China
| | - Minglong Chen
- Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingP.R. China
| |
Collapse
|
3
|
Viwe M, Nery P, Birnie DH. Management of ventricular tachycardia in patients with cardiac sarcoidosis. Heart Rhythm O2 2021; 2:412-422. [PMID: 34430947 PMCID: PMC8369307 DOI: 10.1016/j.hroo.2021.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sarcoidosis is a multisystem granulomatous disease with 2 different phases (inflammation and scar). In the current era of targeted use of implantable cardioverter-defibrillators and modern heart failure therapy, recent data indicate the prognosis of cardiac sarcoidosis (CS) is much improved, and hence more patients are presenting with recurrent ventricular tachycardia (VT). This review highlights our current understanding of the pathophysiology and management of ventricular arrhythmias in CS with the major focus on indications, techniques, and outcomes of ablation. It is likely macroreentry phenomena around areas of fibrosis is the most frequent mechanism of ventricular arrhythmia in CS. It is also possible that inflammation may play a role in initiating reentry with ventricular ectopy in CS patients, or by slowing conduction in diseased tissue. The best available data would suggest annual rates of VT of perhaps 1%-2% and 10%-15% in patients with initially clinically silent and clinically manifest disease, respectively. Current guidelines recommend a stepwise approach to VT management. The first suggested step is treatment with immunosuppression if there is evidence of active inflammation. Antiarrhythmic medications are often started at the same time, with catheter ablation considered if VT cannot be controlled. Activation and entrainment mapping and ablation are favored in the setting of hemodynamically tolerated VT. Substrate ablation targets areas of abnormal electrogram and favorable pace mapping using linear and/or cluster lesion sets with the goal of abolishing critical isthmuses and/or blocking VT exit sites. Epicardial mapping ablation is required in 20%-35% of cases. In general, more morphologies of VT are induced (often 3-4) and subsequent outcomes (recurrence rates 40%-50%) are less favorable than in other forms of nonischemic cardiomyopathy. The prognosis of CS is much improved and, as a result, more patients are developing VT during follow-up. Likely principally related to the complex disease substrate, VT ablation is technically challenging, with moderate outcomes, and much remains to be learned.
Collapse
Affiliation(s)
- Mtwesi Viwe
- Division of Cardiology, Department of Medicine, McMaster University, Hamilton, Canada
- Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pablo Nery
- Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Canada
| | - David H. Birnie
- Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Canada
| |
Collapse
|
4
|
Della Bella P, Peretto G, Paglino G, Bisceglia C, Radinovic A, Sala S, Baratto F, Limite LR, Cireddu M, Marzi A, D’Angelo G, Vergara P, Gulletta S, Mazzone P, Frontera A. Bipolar radiofrequency ablation for ventricular tachycardias originating from the interventricular septum: Safety and efficacy in a pilot cohort study. Heart Rhythm 2020; 17:2111-2118. [DOI: 10.1016/j.hrthm.2020.06.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/03/2020] [Accepted: 06/12/2020] [Indexed: 12/21/2022]
|
5
|
Khalil F, Siontis K, Bagameri G, Killu AM. Hybrid Catheter-Based and Surgical Techniques for Ablation of Ventricular Arrhythmias. Arrhythm Electrophysiol Rev 2020; 9:97-103. [PMID: 32983531 PMCID: PMC7491053 DOI: 10.15420/aer.2020.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Catheter ablation is a rapidly expanding and evolving field. The advent of interventional techniques and advances in technology have allowed catheter ablation to supplant antiarrhythmic surgery for ventricular arrhythmia treatment. However, issues related to access and energy delivery limit the use of catheter ablation in some cases. Hybrid catheter-based and surgical techniques represent a novel approach to overcome these limitations. The hybrid technique combines the strengths and minimises the limitations of either catheter or surgical ablation alone. There is a growing body of evidence in the literature supporting the safety and efficacy of the hybrid surgical technique. This review aims to provide an overview of hybrid surgical-catheter ablation for ventricular arrhythmia.
Collapse
Affiliation(s)
- Fouad Khalil
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Mayo Clinic, Rochester, MN, US
| | - Konstantinos Siontis
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Mayo Clinic, Rochester, MN, US
| | - Gabor Bagameri
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, US
| | - Ammar M Killu
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Mayo Clinic, Rochester, MN, US
| |
Collapse
|
6
|
Hadjis A, Frontera A, Limite LR, Bisceglia C, Bognoni L, Foppoli L, Lipartiti F, Paglino G, Radinovic A, Tsitsinakis G, Calore F, Della Bella P. Complete Electroanatomic Imaging of the Diastolic Pathway Is Associated With Improved Freedom From Ventricular Tachycardia Recurrence. Circ Arrhythm Electrophysiol 2020; 13:e008651. [PMID: 32755381 PMCID: PMC7495983 DOI: 10.1161/circep.120.008651] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Supplemental Digital Content is available in the text. The development of multielectrode mapping catheters has expanded the spectrum of mappable ventricular tachycardias (VTs). Full diastolic pathway recording has been associated with a high rate of VT termination during radiofrequency ablation as well as noninducibility at study end. However, the role of diastolic pathway mapping on VT recurrence has yet to be clearly elucidated. We aimed to explore the role of complete diastolic pathway activation mapping on VT recurrence.
Collapse
Affiliation(s)
- Alexios Hadjis
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy.,Division of Cardiology, Hôpital du Sacré-Coeur de Montréal, University of Montreal, Quebec, Canada (A.H.)
| | - Antonio Frontera
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Luca Rosario Limite
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Caterina Bisceglia
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Ludovica Bognoni
- University of Medicine (L.B.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Luca Foppoli
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Felicia Lipartiti
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Gabriele Paglino
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Andrea Radinovic
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Georgio Tsitsinakis
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Paolo Della Bella
- Arrhythmology Department (A.H., A.F., L.R.L., C.B., L.F., F.L., G.P, A.R., G.T., P.D.B.), IRCCS San Raffaele Hospital, Milan, Italy
| |
Collapse
|
7
|
Kim Y, Chen S, Ernst S, Guzman CE, Han S, Kalarus Z, Labadet C, Lin Y, Lo L, Nogami A, Saad EB, Sapp J, Sticherling C, Tilz R, Tung R, Kim YG, Stiles MK. 2019 APHRS expert consensus statement on three-dimensional mapping systems for tachycardia developed in collaboration with HRS, EHRA, and LAHRS. J Arrhythm 2020; 36:215-270. [PMID: 32256872 PMCID: PMC7132207 DOI: 10.1002/joa3.12308] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 01/20/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Young‐Hoon Kim
- Department of Internal MedicineArrhythmia CenterKorea University Medicine Anam HospitalSeoulRepublic of Korea
| | - Shih‐Ann Chen
- Division of CardiologyDepartment of MedicineTaipei Veterans General HospitalTaipeiROC
| | - Sabine Ernst
- Department of CardiologyRoyal Brompton and Harefield HospitalImperial College LondonLondonUK
| | | | - Seongwook Han
- Division of CardiologyDepartment of Internal MedicineKeimyung University School of MedicineDaeguRepublic of Korea
| | - Zbigniew Kalarus
- Department of CardiologyMedical University of SilesiaKatowicePoland
| | - Carlos Labadet
- Cardiology DepartmentArrhythmias and Electrophysiology ServiceClinica y Maternidad Suizo ArgentinaBuenos AiresArgentina
| | - Yenn‐Jian Lin
- Division of CardiologyDepartment of MedicineTaipei Veterans General HospitalTaipeiROC
| | - Li‐Wei Lo
- Division of CardiologyDepartment of MedicineTaipei Veterans General HospitalTaipeiROC
| | - Akihiko Nogami
- Department of CardiologyFaculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Eduardo B. Saad
- Center for Atrial FibrillationHospital Pro‐CardiacoRio de JaneiroBrazil
| | - John Sapp
- Division of CardiologyDepartment of MedicineQEII Health Sciences CentreDalhousie UniversityHalifaxNSCanada
| | | | - Roland Tilz
- Medical Clinic II (Department of Cardiology, Angiology and Intensive Care Medicine)University Hospital Schleswig‐Holstein (UKSH) – Campus LuebeckLuebeckGermany
| | - Roderick Tung
- Center for Arrhythmia CarePritzker School of MedicineUniversity of Chicago MedicineChicagoILUSA
| | - Yun Gi Kim
- Department of Internal MedicineArrhythmia CenterKorea University Medicine Anam HospitalSeoulRepublic of Korea
| | | |
Collapse
|
8
|
Futyma P, Kułakowski P. Bipolar ablation of high-risk posteroseptal accessory pathway: Back to the future. HeartRhythm Case Rep 2020; 6:166-168. [PMID: 32181138 PMCID: PMC7064792 DOI: 10.1016/j.hrcr.2019.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Piotr Futyma
- Invasive Cardiology Department, St. Joseph's Heart Rhythm Center, Rzeszów, Poland
| | - Piotr Kułakowski
- Invasive Cardiology Department, St. Joseph's Heart Rhythm Center, Rzeszów, Poland
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| |
Collapse
|
9
|
Futyma P, Ciąpała K, Głuszczyk R, Sander J, Futyma M, Kułakowski P. Bipolar ablation of refractory atrial and ventricular arrhythmias: Importance of temperature values of intracardiac return electrodes. J Cardiovasc Electrophysiol 2019; 30:1718-1726. [DOI: 10.1111/jce.14025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 06/05/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Piotr Futyma
- Invasive Cardiology DepartmentSt. Joseph's Heart CenterRzeszów Poland
| | - Kamil Ciąpała
- Invasive Cardiology DepartmentSt. Joseph's Heart CenterRzeszów Poland
| | - Ryszard Głuszczyk
- Invasive Cardiology DepartmentSt. Joseph's Heart CenterRzeszów Poland
| | - Jarosław Sander
- Invasive Cardiology DepartmentSt. Joseph's Heart CenterRzeszów Poland
| | - Marian Futyma
- Invasive Cardiology DepartmentSt. Joseph's Heart CenterRzeszów Poland
| | - Piotr Kułakowski
- Invasive Cardiology DepartmentSt. Joseph's Heart CenterRzeszów Poland
- Department of Cardiology, Postgraduate Medical SchoolGrochowski HospitalWarsaw Poland
| |
Collapse
|
10
|
Futyma P, Kułakowski P. To the Editor— Bipolar ablation of refractory VT circuits: Current opportunities and limitations. HeartRhythm Case Rep 2019; 5:288. [PMID: 31193213 PMCID: PMC6522429 DOI: 10.1016/j.hrcr.2019.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Piotr Futyma
- Department of Invasive Cardiology, St. Joseph’s Heart Center, Rzeszów, Poland
| | - Piotr Kułakowski
- Department of Invasive Cardiology, St. Joseph’s Heart Center, Rzeszów, Poland
- Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland
| |
Collapse
|
11
|
Roca‐Luque I, Rivas‐Gándara N, Francisco‐Pascual J, Rodriguez‐Sanchez J, Cuellar‐Calabria H, Rodriguez‐Palomares J, García‐Del Blanco B, Pérez‐Rodon J, Santos‐Ortega A, Rosés‐Noguer F, Marsal R, Rubio B, García DG, Moya Mitjans A. Preprocedural imaging to guide transcoronary ethanol ablation for refractory septal ventricular tachycardia. J Cardiovasc Electrophysiol 2019; 30:448-456. [PMID: 30556327 DOI: 10.1111/jce.13816] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/29/2018] [Accepted: 12/07/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Ivo Roca‐Luque
- Arrhythmia UnitCardiology Service, Hospital Universitari Vall d'HebronBarcelona Spain
| | - Nuria Rivas‐Gándara
- Arrhythmia UnitCardiology Service, Hospital Universitari Vall d'HebronBarcelona Spain
| | | | - Jose Rodriguez‐Sanchez
- Cardiovascular Image UnitCardiology Service, Hospital Universitari Vall d'HebronBarcelona Spain
| | - Hug Cuellar‐Calabria
- Cardiovascular Image UnitCardiology Service, Hospital Universitari Vall d'HebronBarcelona Spain
| | | | - Bruno García‐Del Blanco
- Interventional Cardiology UnitCardiology Service, Hospital Universitari Vall d'HebronBarcelona Spain
| | - Jordi Pérez‐Rodon
- Arrhythmia UnitCardiology Service, Hospital Universitari Vall d'HebronBarcelona Spain
| | - Alba Santos‐Ortega
- Arrhythmia UnitCardiology Service, Hospital Universitari Vall d'HebronBarcelona Spain
| | - Ferran Rosés‐Noguer
- Arrhythmia UnitCardiology Service, Hospital Universitari Vall d'HebronBarcelona Spain
| | - Roger Marsal
- Engineering UnitAbbott Medical, St. Paul Minnesota
| | | | | | - Angel Moya Mitjans
- Arrhythmia UnitCardiology Service, Hospital Universitari Vall d'HebronBarcelona Spain
| |
Collapse
|
12
|
Futyma P, Głuszczyk R, Futyma M, Kułakowski P. Right atrial position of a return electrode for bipolar ablation of the left posterosuperior process ventricular tachycardia. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 42:474-477. [PMID: 30461031 DOI: 10.1111/pace.13554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/20/2018] [Accepted: 11/15/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Radiofrequency (RF) catheter ablation (RFCA) of ventricular tachycardia (VT) is an effective method of treatment. However, when arrhythmia has ischemic etiology and originates from the posterosuperior process (PSP) of the left ventricular (LV) base, ablation performed with conventional unipolar energy sources may be challenging or impossible. METHOD AND RESULT A 67-year-old male after six unsuccessful RFCA for highly symptomatic VT originating from PSP of LV base underwent successful RFCA using multiple bipolar RF applications delivered between two electrodes located at LV endocardium and adjacent right atrial sites. CONCLUSION This case report shows that bipolar RFCA can be used for safe and successful treatment of VT originating from deep PSP of LV base.
Collapse
Affiliation(s)
- Piotr Futyma
- Invasive Cardiology Department, St. Joseph's Heart Center, Rzeszów, Poland
| | - Ryszard Głuszczyk
- Invasive Cardiology Department, St. Joseph's Heart Center, Rzeszów, Poland
| | - Marian Futyma
- Invasive Cardiology Department, St. Joseph's Heart Center, Rzeszów, Poland
| | - Piotr Kułakowski
- Invasive Cardiology Department, St. Joseph's Heart Center, Rzeszów, Poland.,Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland
| |
Collapse
|
13
|
Sauer PJ, Kunkel MJ, Nguyen DT, Davies A, Lane C, Tzou WS. Successful ablation of ventricular tachycardia arising from a midmyocardial septal outflow tract site utilizing a simplified bipolar ablation setup. HeartRhythm Case Rep 2018; 5:105-108. [PMID: 30820408 PMCID: PMC6379518 DOI: 10.1016/j.hrcr.2018.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Peter J Sauer
- Section of Cardiac Electrophysiology, University of Colorado, Aurora, Colorado
| | - Megan J Kunkel
- Section of Cardiac Electrophysiology, University of Colorado, Aurora, Colorado
| | - Duy T Nguyen
- Section of Cardiac Electrophysiology, University of Colorado, Aurora, Colorado
| | - Austin Davies
- Section of Cardiac Electrophysiology, University of Colorado, Aurora, Colorado
| | - Curtis Lane
- Section of Cardiac Electrophysiology, University of Colorado, Aurora, Colorado
| | - Wendy S Tzou
- Section of Cardiac Electrophysiology, University of Colorado, Aurora, Colorado
| |
Collapse
|
14
|
Tzou WS. The answer lies somewhere in between: Important lessons in understanding and conquering midmyocardial ventricular arrhythmias arising from the outflow tract. J Cardiovasc Electrophysiol 2018; 29:1672-1674. [PMID: 30378712 DOI: 10.1111/jce.13755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 09/24/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Wendy S Tzou
- Section of Cardiac Electrophysiology, University of Colorado, Aurora, Colorado
| |
Collapse
|
15
|
Baszko A. Bipolar radiofrequency ablation: can we control parameters of return electrode?-Author's reply. Europace 2018; 20:1562. [PMID: 29432523 DOI: 10.1093/europace/euy011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Artur Baszko
- 2nd Department of Cardiology, HCP Medical Center, Poznan University of Medical Sciences, ul. 28 czerwca 1956 Nr 194, Poznan, Poland
| |
Collapse
|
16
|
Batul SA, Olshansky B, Fisher JD, Gopinathannair R. Recent advances in the management of ventricular tachyarrhythmias. F1000Res 2017; 6:1027. [PMID: 28721212 PMCID: PMC5497814 DOI: 10.12688/f1000research.11202.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2017] [Indexed: 01/14/2023] Open
Abstract
Ventricular arrhythmias are an important cause of cardiovascular morbidity and mortality, particularly in those with structural heart disease, inherited cardiomyopathies, and channelopathies. The goals of ventricular arrhythmia management include symptom relief, improving quality of life, reducing implantable cardioverter defibrillator shocks, preventing deterioration of left ventricular function, reducing risk of arrhythmic death, and potentially improving overall survival. Guideline-directed medical therapy and implantable cardioverter defibrillator implantation remain the mainstay of therapy to prevent sudden cardiac death in patients with ventricular arrhythmias in the setting of structural heart disease. Recent advances in imaging modalities and commercial availability of genetic testing panels have enhanced our mechanistic understanding of the disease processes and, along with significant progress in catheter-based ablative therapies, have enabled a tailored and more effective management of drug-refractory ventricular arrhythmias. Several gaps in our knowledge remain and require further research. In this article, we review the recent advances in the diagnosis and management of ventricular arrhythmias.
Collapse
Affiliation(s)
- Syeda Atiqa Batul
- Arrhythmia Division, Montefiore Medical Center, Bronx, New York, USA
| | | | - John D Fisher
- Arrhythmia Division, Montefiore Medical Center, Bronx, New York, USA
| | - Rakesh Gopinathannair
- Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, USA
| |
Collapse
|