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Cabrera JS, Tapias C, Adams C, Hernandez B, Bautista W, Stozitzky V, Restrepo AJ, Saenz L. Intracardiac echocardiography guided anatomical ablation of the arcuate ridge for drug refractory inappropriate sinus tachycardia. J Cardiovasc Electrophysiol 2024. [PMID: 38741382 DOI: 10.1111/jce.16285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/21/2024] [Accepted: 04/10/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION Inappropriate sinus tachycardia (IST) is a common condition with frequently not tolerated beta-blockers or ivabradine and a high rate of complication in ablation strategy; we describe an alternative anatomical approach of sinus node (SN) modulation. METHODS This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing SN ablation. RESULTS The mean age was 40.6 ± 13.9 years; five of the six patients were female, 100% of patients reported heart palpitations, and 66% reported dizziness, the average heart rate (HR) on a 24-h Holter was 93.2 ± 7.9 bpm. HR during the first stage of a stress test using a standard Bruce protocol was 150 ± 70 bpm, The average HR on 24-h Holter postablation was 75 ± 5.6 bpm, the sinus rate HR during stage 1 of a Bruce protocol exercise stress test was 120 ± 10 bpm. CONCLUSION This is the first case series reporting the acute and long-term results of a novel anatomical approach for SN modulation to treat IST targeting the arcuate ridge (AR) under intracardiac echography (ICE) guidance. The novel anatomic ICE-guided catheter ablation approach aimed to identify the earliest activation at the AR with an extension of RF lesions toward its septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.
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Affiliation(s)
- Juan Sebastian Cabrera
- Electrophysiology Department, Fundación Cardio Infantil, Bogota, Colombia
- Medicine School department, Universidad De La Sabana, Bogota, Colombia
| | - Carlos Tapias
- Electrophysiology Department, Fundación Cardio Infantil, Bogota, Colombia
- Medicine School department, Universidad De La Sabana, Bogota, Colombia
| | - Christian Adams
- Electrophysiology Department, Fundación Cardio Infantil, Bogota, Colombia
- Medicine School department, Universidad De La Sabana, Bogota, Colombia
| | - Boris Hernandez
- Electrophysiology Department, Fundación Cardio Infantil, Bogota, Colombia
- Medicine School department, Universidad De La Sabana, Bogota, Colombia
| | - William Bautista
- Electrophysiology Department, Fundación Cardio Infantil, Bogota, Colombia
- Medicine School department, Universidad De La Sabana, Bogota, Colombia
| | | | - Alejandro Jimenez Restrepo
- Florida Electrophysiology Associates, Atlantis, Florida, USA
- Medicine School department, University of Maryland, Baltimore, Maryland, USA
| | - Luis Saenz
- Electrophysiology Department, Fundación Cardio Infantil, Bogota, Colombia
- Medicine School department, Universidad De La Sabana, Bogota, Colombia
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Maher TR, Raza AS, Tapias C, Garcia F, Reynolds MR, Chaudry GM, Saenz LC, Valderrábano M, d'Avila A. Ventricular septal defect as a complication of bipolar radiofrequency ablation for ventricular tachycardia. Heart Rhythm 2024:S1547-5271(24)00106-1. [PMID: 38309450 DOI: 10.1016/j.hrthm.2024.01.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Affiliation(s)
- Timothy R Maher
- Harvard Thorndike Electrophysiology Institute and Arrhythmia Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
| | - Adnan S Raza
- Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts
| | - Carlos Tapias
- Internacional Arrhythmia Center at Cardioinfantil Foundation, Bogota, Colombia
| | - Fermin Garcia
- Electrophysiology Section, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Matthew R Reynolds
- Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts
| | - G Muqtada Chaudry
- Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts
| | - Luis C Saenz
- Internacional Arrhythmia Center at Cardioinfantil Foundation, Bogota, Colombia
| | - Miguel Valderrábano
- Houston Methodist DeBakey Heart and Vascular Center and Research Institute, Houston, Texas
| | - Andre d'Avila
- Harvard Thorndike Electrophysiology Institute and Arrhythmia Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Valderrábano M, Rojas SCF, Lador A, Patel A, Schurmann PA, Tapias C, Rodríguez D, Sáenz LC, Malahjfi M, Shah DJ, Mathuria N, Dave AS. Substrate Ablation by Multivein, Multiballoon Coronary Venous Ethanol for Refractory Ventricular Tachycardia in Structural Heart Disease. Circulation 2022; 146:1644-1656. [PMID: 36321460 PMCID: PMC9712228 DOI: 10.1161/circulationaha.122.060882] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Ablation of ventricular tachycardia (VT) in the setting of structural heart disease often requires extensive substrate elimination that is not always achievable by endocardial radiofrequency ablation. Epicardial ablation is not always feasible. Case reports suggest that venous ethanol ablation (VEA) through a multiballoon, multivein approach can lead to effective substrate ablation, but large data sets are lacking. METHODS VEA was performed in 44 consecutive patients with ablation-refractory VT (ischemic, n=21; sarcoid, n=3; Chagas, n=2; idiopathic, n=18). Targeted veins were selected by mapping coronary veins on the epicardial aspect of endocardial scar (identified by bipolar voltage <1.5 mV), using venography and signal recording with a 2F octapolar catheter or by guidewire unipolar signals. Epicardial mapping was performed in 15 patients. Vein segments in the epicardial aspect of VT substrates were treated with double-balloon VEA by blocking flow with 1 balloon while injecting ethanol through the lumen of the second balloon, forcing (and restricting) ethanol between balloons. Multiple balloon deployments and multiple veins were used as needed. In 22 patients, late gadolinium enhancement cardiac magnetic resonance imaged the VEA scar and its evolution. RESULTS Median ethanol delivered was 8.75 (interquartile range, 4.5-13) mL. Injected veins included interventricular vein (6), diagonal (5), septal (12), lateral (16), posterolateral (7), and middle cardiac vein (8), covering the entire range of left ventricular locations. Multiple veins were targeted in 14 patients. Ablated areas were visualized intraprocedurally as increased echogenicity on intracardiac echocardiography and incorporated into 3-dimensional maps. After VEA, vein and epicardial ablation maps showed elimination of abnormal electrograms of the VT substrate. Intracardiac echocardiography demonstrated increased intramural echogenicity at the targeted region of the 3-dimensional maps. At 1 year of follow-up, median of 314 (interquartile range, 198-453) days of follow-up, VT recurrence occurred in 7 patients, for a success of 84.1%. CONCLUSIONS Multiballoon, multivein intramural ablation by VEA can provide effective substrate ablation in patients with ablation-refractory VT in the setting of structural heart disease over a broad range of left ventricular locations.
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Affiliation(s)
- Miguel Valderrábano
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas
| | | | - Adi Lador
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas
| | - Apoor Patel
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas
| | - Paul A. Schurmann
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas
| | | | | | | | - Maan Malahjfi
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas
| | - Dipan J. Shah
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas
| | - Nilesh Mathuria
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas
| | - Amish S. Dave
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas
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Fuentes Rojas SC, Malahjfi M, Tavares L, Patel A, Schurmann PA, Dave AS, Tapias C, Rodríguez D, Sáenz LC, Korolev S, Papiashvili G, Peichl P, Kautzner J, Blaszyk K, Malaczynska-Rajpold K, Chen T, Santangeli P, Shah DJ, Valderrábano M. Acute and Long-Term Scar Characterization of Venous Ethanol Ablation in the Left Ventricular Summit. JACC Clin Electrophysiol 2022; 9:28-39. [PMID: 37166222 DOI: 10.1016/j.jacep.2022.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/09/2022] [Accepted: 08/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Venous ethanol ablation (VEA) can be effective for ventricular arrhythmias from the left ventricular summit (LVS); however, there are concerns about excessive ablation by VEA. OBJECTIVES The purpose of this study was to delineate and quantify the location, extent, and evolution of ablated tissue after VEA as an intramural ablation technique in the LVS. METHODS VEA was performed in 59 patients with LVS ventricular arrhythmias. Targeted intramural veins were selected by electrograms from a 2F octapolar catheter or by guide-wire unipolar signals. Median ethanol delivered was 4 mL (IQR: 4-7 mL). Ablated areas were estimated intraprocedurally as increased echogenicity on intracardiac echocardiography (ICE) and incorporated into 3-dimensional maps. In 44 patients, late gadolinium enhancement cardiac magnetic resonance (CMR) imaged VEA scar and its evolution. RESULTS ICE-demonstrated increased intramural echogenicity (median volume of 2 mL; IQR: 1.7-4.3) at the targeted region of the 3-dimensional maps. Post-ethanol CMR showed intramural scar of 2.5 mL (IQR: 2.1-3.5 mL). Early (within 48 hours after VEA) CMR showed microvascular obstruction (MVO) in 30 of 31 patients. Follow-up CMR after a median of 51 (IQR: 41-170) days showed evolution of MVO to scar. ICE echogenicity and CMR scar volumes correlated with each other and with ethanol volume. Ventricular function and interventricular septum remained intact. CONCLUSIONS VEA leads to intramural ablation that can be tracked intraprocedurally by ICE and creates regions of MVO that are chronically replaced by myocardial scar. VEA scar volume does not compromise septal integrity or ventricular function.
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Patel A, Nsahlai M, Flautt T, Da-Warikobo A, Lador A, Tapias C, Rodríguez D, Carlos Sáenz L, Schurmann PA, Dave A, Valderrábano M. Advanced Techniques for Ethanol Ablation of Left Ventricular Summit Region Arrhythmias. Circ Arrhythm Electrophysiol 2022; 15:e011017. [PMID: 35917467 PMCID: PMC9388546 DOI: 10.1161/circep.122.011017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Coronary venous ethanol ablation (VEA) can be used as a strategy to treat ventricular arrhythmias arising from the left ventricular summit, but collateral flow and technical challenges cannulating intramural veins in complex venous anatomies can limit its use. Advanced techniques for VEA can capitalize on collateral vessels between target and nontarget sites to improve success. METHODS Of 55 patients with left ventricular summit ventricular arrhythmia, advanced techniques were used in 15 after initial left ventricular summit intramural vein mapping failed to show suitable targets for single vein, single-balloon VEA. All patients had previous radiofrequency ablation attempts. Techniques included: double-balloon for distal protection to block distal flow and target the proximal portion of a large intramural vein where best signal was proximal (n=6); balloons in 2 different left ventricular summit veins for a cross-fire multivein VEA (n=4); intramural collateral vein-to-vein cannulation to reach of targeted vein via collateral with antegrade ethanol and proximal balloon block (n=2); prolonged ethanol dwell time for vein sclerosis of large intramural vein and subsequent VEA (n=3); and intramural collateral VEA (n=1). RESULTS Fifteen (8 females) patients (age 60.6±17.6 years) required advanced techniques. Procedure time was 210±49.9 minutes, fluoroscopy time was 25.3±14.1 minutes, and 113±17.9 cc of contrast was utilized. A median of 7 cc of ethanol was delivered (range, 4-15 cc). Intraprocedural radiofrequency ablation was delivered before ethanol in 9 out of 15 patients but failed. Ethanol achieved acute success in all 15 patients. Ethanol was used as the sole treatment in two patients. At a median follow-up of 194 days, one patient experienced recurrence. CONCLUSIONS Advanced techniques capitalizing on venous anatomy can enable successful VEA and selective targeting of arrhythmogenic sites, by blocking distal flow, utilization of collaterals between nontarget and target veins and multivein VEA. Understanding individual anatomy is critical for VEA success.
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Affiliation(s)
- Apoor Patel
- Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (A.P., M.N., T.F., A.D.-W., A.L., C.T., P.A.S., A.D., M.V.)
| | - Michelle Nsahlai
- Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (A.P., M.N., T.F., A.D.-W., A.L., C.T., P.A.S., A.D., M.V.)
| | - Thomas Flautt
- Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (A.P., M.N., T.F., A.D.-W., A.L., C.T., P.A.S., A.D., M.V.)
| | - Akanibo Da-Warikobo
- Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (A.P., M.N., T.F., A.D.-W., A.L., C.T., P.A.S., A.D., M.V.)
| | - Adi Lador
- Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (A.P., M.N., T.F., A.D.-W., A.L., C.T., P.A.S., A.D., M.V.)
| | - Carlos Tapias
- Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (A.P., M.N., T.F., A.D.-W., A.L., C.T., P.A.S., A.D., M.V.)
| | - Diego Rodríguez
- International Arrhythmia Center, Fundación Cardioinfantil, Bogotá, Colombia (D.R., L.C.S.)
| | - Luis Carlos Sáenz
- International Arrhythmia Center, Fundación Cardioinfantil, Bogotá, Colombia (D.R., L.C.S.)
| | - Paul A Schurmann
- Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (A.P., M.N., T.F., A.D.-W., A.L., C.T., P.A.S., A.D., M.V.)
| | - Amish Dave
- Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (A.P., M.N., T.F., A.D.-W., A.L., C.T., P.A.S., A.D., M.V.)
| | - Miguel Valderrábano
- Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, TX (A.P., M.N., T.F., A.D.-W., A.L., C.T., P.A.S., A.D., M.V.)
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Arroyo A, Tejeda-Camargo MJ, Tapias C, Rodríguez D, Sáenz LC. Implante de un electrodo de estimulación ventricular izquierdo mediante doble canulación del seno coronario, técnica de snare y acceso retrógrado de la vena posterolateral. RCCAR 2022. [DOI: 10.24875/rccar.m22000132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Tejeda-Camargo MJ, Villa J, Arroyo A, Tapias C, Rodríguez D. Alcoholización de la vena de Marshall: una alternativa rápida, útil y efectiva en el tratamiento del aleteo auricular perimitral. Una descripción de la técnica. RCCAR 2022. [DOI: 10.24875/rccar.m22000130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Rodriguez Guerrero DA, Tapias C, Saenz LC, Salazar L, Villa J. B-PO04-133 INTRACARDIAC ECHOCARDIOGRAPHY AS AN ADJUNCTIVE TOOL FOR RECURRENT ACCESSORY PATHWAYS ABLATION. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Briceño DF, Enriquez A, Romero J, Tapias C, Santangeli P, Schaller R, Supple G, Rodriguez D, Saenz LC, Garcia FC. How to use intracardiac echocardiography to identify ventricular tachycardia substrate in ischemic cardiomyopathy. HeartRhythm Case Rep 2020; 6:663-670. [PMID: 33101930 PMCID: PMC7573343 DOI: 10.1016/j.hrcr.2020.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- David F. Briceño
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
| | - Andres Enriquez
- Heart Rhythm Service, Department of Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Jorge Romero
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
| | - Carlos Tapias
- Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia
| | - Pasquale Santangeli
- Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert Schaller
- Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gregory Supple
- Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Diego Rodriguez
- Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia
| | - Luis C. Saenz
- Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia
| | - Fermin C. Garcia
- Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia
- Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Address reprint requests and correspondence: Dr Fermin C. Garcia, Associate Professor of Medicine, Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce St, Philadelphia, PA 19104.
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Tapias C, Muratore C, Tentori M, Lara S, Pérez F, Pérez A, Peterson B, Rodríguez DA. Evaluación del impacto de la terapia de resincronización cardiaca en pacientes de Latinoamérica. Revista Colombiana de Cardiología 2020. [DOI: 10.1016/j.rccar.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Enriquez A, Briceno D, Tapias C, Shirai Y, Muser D, Liang J, Hayashi T, Santangeli P, Frankel DS, Supple GE, Schaller RD, Arkles J, Rodriguez D, Callans DJ, Marchlinski FE, Saenz L, Garcia FC. Ischemic ventricular tachycardia from below the posteromedial papillary muscle, a particular entity: Substrate characterization and challenges for catheter ablation. Heart Rhythm 2019; 16:1174-1181. [DOI: 10.1016/j.hrthm.2019.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Indexed: 11/16/2022]
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Enriquez A, Tapias C, Rodriguez D, Ramirez J, Rosso R, Viskin S, Schaller R, Marchlinski F, Saenz L, Garcia F. Role of intracardiac echocardiography for guiding ablation of tricuspid valve arrhythmias. HeartRhythm Case Rep 2018; 4:209-213. [PMID: 29922578 PMCID: PMC6006487 DOI: 10.1016/j.hrcr.2018.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Andres Enriquez
- Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Carlos Tapias
- International Arrhythmia Center at CardioInfantil Foundation-Cardiac Institute, Bogotá, Colombia
| | - Diego Rodriguez
- International Arrhythmia Center at CardioInfantil Foundation-Cardiac Institute, Bogotá, Colombia.,Universidad de la Sabana, Bogotá, Colombia
| | - Juan Ramirez
- International Arrhythmia Center at CardioInfantil Foundation-Cardiac Institute, Bogotá, Colombia
| | - Raphael Rosso
- Department of Cardiac Electrophysiology, Cardiology Division, Sourasky Medical Center, Tel Aviv, Israel
| | - Sami Viskin
- Department of Cardiac Electrophysiology, Cardiology Division, Sourasky Medical Center, Tel Aviv, Israel
| | - Robert Schaller
- Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Francis Marchlinski
- Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Luis Saenz
- International Arrhythmia Center at CardioInfantil Foundation-Cardiac Institute, Bogotá, Colombia.,Universidad de la Sabana, Bogotá, Colombia
| | - Fermin Garcia
- Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Altamar J, Tapias C, Rodríguez D, Sáenz L. Arritmias ventriculares como manifestación de sarcoidosis cardiaca primaria. Revista Colombiana de Cardiología 2017. [DOI: 10.1016/j.rccar.2017.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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