scholarly journals Impact of substrate-based ablation for ventricular tachycardia in patients with frequent appropriate implantable cardioverter-defibrillator therapy and dilated cardiomyopathy: Long-term experience with high-density mapping

2021 ◽  
Author(s):  
Mário Oliveira ◽  
Pedro Cunha ◽  
Bruno Valente ◽  
Guilherme Portugal ◽  
Ana Lousinha ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Dilated Cardiomyopathy ◽  
Implantable Cardioverter Defibrillator ◽  
High Density ◽  
Implantable Cardioverter Defibrillator Therapy ◽  
Cardioverter Defibrillator ◽  
Density Mapping ◽  
Long Term Experience

scholarly journals Cardioverter-Defibrillator Implantation to Treat Cardiac Fibroma-Induced Ventricular Tachycardia in a 70-Year-Old Woman

2014 ◽  
Vol 41 (3) ◽  
pp. 329-331 ◽  
Author(s):  
Fayaz Ahmad Hakim ◽  
Anil Pandit ◽  
Farouk Mookadam ◽  
Sylvia Mamby
Keyword(s):  
Ventricular Tachycardia ◽  
Implantable Cardioverter Defibrillator ◽  
Clinical Symptoms ◽  
Surgical Excision ◽  
Orthotopic Heart Transplantation ◽  
Implantable Cardioverter Defibrillator Therapy ◽  
Cardiac Fibroma ◽  
Outflow Obstruction ◽  
Cardioverter Defibrillator

Benign cardiac fibroma is rarely reported in adults. Its clinical symptoms are related to outflow obstruction or dysrhythmias. We present the case of a 70-year-old woman who had a syncopal episode from ventricular tachycardia caused by cardiac fibroma. Because of unfavorable tumor anatomy, the patient was not a candidate for surgical excision, and she declined orthotopic heart transplantation. To prevent sudden cardiac death, we placed an implantable cardioverter-defibrillator, and the patient remained well throughout the 2-year follow-up period. To our knowledge, this is the first report of implantable cardioverter-defibrillator therapy to treat an adult patient's unresectable cardiac fibroma.

P1457Does high density mapping increase the efficacy of ischemic ventricular tachycardia ablation?

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Nunes Ferreira ◽  
G Silva ◽  
N Cortez-Dias ◽  
P Silverio-Antonio ◽  
T Rodrigues ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
High Density ◽  
Electrical Storm ◽  
High Morbidity ◽  
Amiodarone Therapy ◽  
Ventricular Tachycardia Ablation ◽  
Density Mapping ◽  
Vt Ablation

Abstract Introduction  The treatment of ventricular tachycardia (VT) in patients (pts) with ischemic heart disease (IHD) represents a challenge because of its high morbidity and mortality rates and low long-term success rates. In the VANISH clinical trial, 51% of pts undergoing the conventional ablation technique developed within 2 years the combined outcome of mortality or electrical storm (ES) or appropriate CDI shock. The use of high-density substrate maps can lead to greater precision in substrate evaluation and ideally to improved ablation success. Objectives  To assess the efficacy of substrate-guided ischemic VT ablation using high-density mapping. Methods  Single-center prospective study of consecutive IHD pts submitted to endocardial ablation of substrate-guided VT using multipolar catheters (PentaRayTM or HDGridTM) and three-dimensional mapping systems with automatic annotation software. The maps were evaluated in order to identify the intra-cicatricial channels (areas of bipolar voltage <1.5mV) in which sequential propagation of local abnormal ventricular activities (LAVAs) were observed, during or after QRS. The ablation strategy aimed at the abolition of all intra-cicatricial LAVAs, directing the radiofrequency applications primarily to the entrances of the channels. The success of ablation was assessed by the primary outcome (death by any cause or ES or appropriate CDI shock) at 2 years and compared to the population of the VANISH study undergoing conventional ablation, using Cox regression and Kaplan- Meier survival analysis. Results  We included 40 patients, 95% males, 70 ± 8 years, mean ejection fraction 34 ± 10%. 82% on previous amiodarone therapy and 72% were ICD carriers. 32% underwent ablation during hospitalization for ES and 20% had previously undergone VT ablation. The median duration of substrate mapping was 74 minutes, with a mean of 2290 collected points. Major complications were seen in 1 patient (aortic dissection). During a mean follow-up time of 17.3 ± 12.9 months, the long-term success rate of VT ablation was 75%. Additionally, there was a reduction in the proportion of patients receiving amiodarone before vs after ablation (82% vs. 45% respectively). The rate of events observed during follow-up was lower than expected, namely by comparison with the population of the VANISH study undergoing conventional ablation (25% vs 51% at 24 months, HR 0.42 CI 95% 0.2-0.88, p = 0.022), reflecting a relative risk reduction of 58%. Conclusions  High density mapping allows a detailed characterization of the dysrhythmic substrate in patients with VT in an IHD context. Our results suggest that these technological innovations may be improving the clinical success of VT ablation. Abstract Figure.

scholarly journals Inducible Ventricular Tachycardia Due to Dermatomyositis-Related Cardiomyopathy in the Era of Implantable Cardioverter-Defibrillator Therapy

Circulation ◽  
2012 ◽  
Vol 125 (7) ◽  
pp. 967-969 ◽  
Author(s):  
Polychronis Dilaveris ◽  
Panagiota Pietri ◽  
Dimitris Tsiachris ◽  
Konstantinos Gatzoulis ◽  
Christodoulos Stefanadis
Keyword(s):  
Ventricular Tachycardia ◽  
Implantable Cardioverter Defibrillator ◽  
Implantable Cardioverter Defibrillator Therapy ◽  
Cardioverter Defibrillator
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