scholarly journals Accuracy of automatic abnormal potential annotation for substrate identification in scar‐related ventricular tachycardia

2021 ◽  
Author(s):  
Yosuke Nakatani ◽  
Philippe Maury ◽  
Anne Rollin ◽  
F. Daniel Ramirez ◽  
Cyril Goujeau ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Substrate Identification

130Long-term outcomes of ventricular tachycardia substrate ablation incorporating hidden slow conduction analysis

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Acosta Martinez ◽  
D Soto-Iglesias ◽  
B Jauregui-Garrido ◽  
J Fernandez-Armenta ◽  
D Penela ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Border Zone ◽  
Procedure Time ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Scar Area ◽  
Slow Conduction ◽  
Substrate Identification ◽  
Short And Long Term

Abstract Introduction Ventricular tachycardia substrate ablation (VTSA) incorporating hidden slow conduction (HSC) analysis allows further arrhythmic substrate identification. This study evaluates whether the analysis and elimination of HSC electrograms (HSC-EGMs) during VTSA procedures result in better short and long-term outcomes.  Methods Consecutive patients (n = 70, 63% ischaemic, 64 ± 14.6 years) undergoing VTSA were prospectively included. Bipolar EGMs with >3 deflections and duration <133 ms were considered as potential HSC-EGM, if located within/surrounding the scar area. Whenever a potential HSC-EGM was identified, a double ventricular extrastimulus was delivered. If a local potential showed up as a delayed component, it was annotated as HSC-EGM. The incidence of HSC-EGM in core, border-zone, and normal-voltage regions was determined. Ablation was delivered at conducting channel entrances and HSC-EGMs. Procedure time, radiofrequency time, VT inducibility after VTSA and VT recurrence at 12 months after the procedure were compared with data from a historic control group (n = 66, 70% ischaemic, 65.2 ± 12 years). Results 5076 EGMs were analyzed. 1029 (20.2%) qualified as potential HSC-EGM, and 453 of them were tagged as HSC-EGMs. Scars in patients with HSC-EGMs (n = 43, 61.4%) were smaller (39.66 ± 28.2 vs 69.4 ± 38.2 cm2; p = 0.005) and more heterogeneous (core/scar area ratio 0.24 ± 0.2 vs 0.43 ± 0.17; p = 0.03). 29.6% of HSC-EGMs were located in normal-voltage tissue; 83.5% were targeted for ablation. Patients undergoing VTSA incorporating HSC analysis needed less procedure time (213 ± 75 vs 242 ± 60 min; p = 0.018), less RF time (15.9 ± 10 vs 25 ± 12,7 minutes; p < 0.001), had a lower rate of VT inducibility (27.5% vs 51.5%; p = 0.005) and a higher 2-year VT/VF-free survival (82.8% vs 59.7%; log rank p = 0.047) after VTSA than the historic controls . Conclusion VTSA incorporating HSC analysis allowed further arrhythmic substrate identification (especially in normal-voltage areas) and resulted in increased  VTSA efficiency and better short and long-term outcomes. Abstract Figure. VT Recurrence-Free Survival

scholarly journals Impact of Scar, Viable Myocardium, and Epicardial Fat on Substrate Identification of Ventricular Tachycardia in a Case with Nonischemic Cardiomyopathy

2011 ◽  
Vol 35 (12) ◽  
pp. e345-e348 ◽  
Author(s):  
TAKESHI SASAKI ◽  
JAMES MUDD ◽  
CHARLES STEENBERGEN ◽  
MENEKHEM M. ZVIMAN ◽  
CHRISTOPHER F. MILLER ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Viable Myocardium ◽  
Epicardial Fat ◽  
Nonischemic Cardiomyopathy ◽  
Substrate Identification
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