scholarly journals Epicardial Ventricular Tachycardia Ablation for Which Patients?

2012 ◽  
Vol 1 ◽  
pp. 39 ◽  
Author(s):  
Laurent Roten ◽  
Frédéric Sacher ◽  
Matthew Daly ◽  
Patrizio Pascale ◽  
Yuki Komatsu ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Implantable Cardioverter Defibrillators ◽  
First Line ◽  
Ventricular Tachycardia Ablation ◽  
Number Of Patients ◽  
Vt Ablation ◽  
Patients Experience ◽  
Cardioverter Defibrillators ◽  
First Line Treatment ◽  
Epicardial Access

With the widespread use of implantable cardioverter-defibrillators, an increasing number of patients present with ventricular tachycardia (VT). Large multicentre studies have shown that ablation of VT successfully reduces recurrent VT and this procedure is being performed by an increasing number of centres. However, for a number of reasons, many patients experience VT recurrence after ablation. One important reason for VT recurrence is the presence of an epicardial substrate involved in the VT circuit which is not affected by endocardial ablation. Epicardial access and ablation is now frequently performed either after failed endocardial VT ablation or as first-line treatment in selected patients. This review will focus on the available evidence for identifying VT of epicardial origin, and discuss in which patients an epicardial approach would be benefitial.

scholarly journals Implantable cardioverter defibrillators at the end of life: future perspectives on clinical practice

2020 ◽  
Vol 28 (11) ◽  
pp. 565-570
Author(s):  
R. Stoevelaar ◽  
A. Brinkman-Stoppelenburg ◽  
R. L. van Bruchem-Visser ◽  
A. G. van Driel ◽  
R. E. Bhagwandien ◽  
...  
Keyword(s):  
End Of Life ◽  
Healthcare Professionals ◽  
Point Of View ◽  
Implantable Cardioverter Defibrillators ◽  
Number Of Patients ◽  
Life Threatening ◽  
The Right ◽  
Patients Experience ◽  
Cardioverter Defibrillators ◽  
Fragmentation Of Care

Abstract The implantable cardioverter defibrillator (ICD) is effective in terminating life-threatening arrhythmias. However, in the last phase of life, ICD shocks may no longer be appropriate. Guidelines recommend timely discussion with the patient regarding deactivation of the shock function of the ICD. However, research shows that such conversations are scarce, and some patients experience avoidable and distressful shocks in the final days of life. Barriers such as physicians’ lack of time, difficulties in finding the right time to discuss ICD deactivation, patients’ reluctance to discuss the topic, and the fragmentation of care, which obscures responsibilities, prevent healthcare professionals from discussing this topic with the patient. In this point-of-view article, we argue that healthcare professionals who are involved in the care for ICD patients should be better educated on how to communicate with patients about ICD deactivation and the end of life. Optimal communication is needed to reduce the number of patients experiencing inappropriate and painful shocks in the terminal stage of their lives.

scholarly journals Long-term Outcomes of Ventricular Tachycardia Ablation in Different Types of Structural Heart Disease

2015 ◽  
Vol 4 (3) ◽  
pp. 177 ◽  
Author(s):  
Jackson J Liang ◽  
Pasquale Santangeli ◽  
David J Callans ◽  
◽  
◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Structural Heart Disease ◽  
Implantable Cardioverter Defibrillators ◽  
Mortality Benefit ◽  
Long Term Outcomes ◽  
Ventricular Tachycardia Ablation ◽  
Different Types ◽  
Vt Ablation

Ventricular tachycardia (VT) often occurs in the setting of structural heart disease and can affect patients with ischaemic or nonischaemic cardiomyopathies. Implantable cardioverter-defibrillators (ICDs) provide mortality benefit and are therefore indicated for secondary prevention in patients with sustained VT, but they do not reduce arrhythmia burden. ICD shocks are associated with increased morbidity and mortality, and antiarrhythmic medications are often used to prevent recurrent episodes. Catheter ablation is an effective treatment option for patients with VT in the setting of structural heart disease and, when successful, can reduce the number of ICD shocks. However, whether VT ablation results in a mortality benefit remains unclear. We aim to review the long-term outcomes in patients with different types of structural heart disease treated with VT ablation.

scholarly journals Delivering an efficient and effective support group for patients with implantable cardioverter-defibrillators (ICDs): patient perspectives of key concerns and predictors of inclination to attend

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn Murray ◽  
Kelly Buttigieg ◽  
Michelle Todd ◽  
Vicky McKechnie
Keyword(s):  
Support Groups ◽  
Support Group ◽  
Qualitative Data ◽  
Implantable Cardioverter Defibrillators ◽  
Cardioverter Defibrillator ◽  
And Coping ◽  
Patients Experience ◽  
The Impact ◽  
Cardioverter Defibrillators ◽  
Patient Concerns

Abstract Background A subset of patients experience psychological distress following insertion of an implantable cardioverter-defibrillator (ICD) and ICD support groups are recommended, however access to these groups is limited. This study aimed: to gauge a better understanding of patients’ key ICD-related concerns; to determine patient interest in a support group and topics deemed helpful to address in a support group; and to examine factors which affect patient inclination to attend. Methods One hundred and thirty nine patients completed the ICD Patient Concerns Questionnaire – Brief (ICDC-B) and a semi-structured survey. Non-parametric tests were used to examine associations and differences in the quantitative data. Qualitative data were analysed using thematic analysis. Results 42% of respondents said they would attend a support group and inclination to attend was associated with higher ICD concerns and a shorter time since implant. Topics considered important to address in a group were information about heart conditions and devices, the impact of an ICD on daily life and coping with fear of shocks. Conclusion We concluded that there is interest in further support amongst many patients and that ICD support groups may be delivered efficiently by targeting patients who have higher levels of ICD concerns and within the first few years after implant.

Ventricular scar channel entrances identified by new wideband cardiac magnetic resonance sequence to guide ventricular tachycardia ablation in patients with cardiac defibrillators

EP Europace ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 598-606
Author(s):  
Ivo Roca-Luque ◽  
Ana Van Breukelen ◽  
Francisco Alarcon ◽  
Paz Garre ◽  
Jose M Tolosana ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Standard Procedure ◽  
False Negative ◽  
False Negative Rate ◽  
Historical Cohort ◽  
Ventricular Tachycardia Ablation ◽  
Vt Ablation ◽  
Lge Cmr

Abstract Aims Ventricular tachycardia (VT) substrate-based ablation has become a standard procedure. Electroanatomical mapping (EAM) detects scar tissue heterogeneity and define conduction channels (CCs) that are the ablation target. Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) is able to depict CCs and increase ablation success. Most patients undergoing VT ablation have an implantable cardioverter-defibrillator (ICD) that can cause image artefacts in LGE-CMR. Recently wideband (WB) LGE-CMR sequence has demonstrated to decrease these artefacts. The aim of this study is to analyse accuracy of WB-LGE-CMR in identifying the CC entrances. Methods and results Thirteen consecutive ICD-patients who underwent VT ablation after WB-LGE-CMR were included. Number and location of CC entrances in three-dimensional EAM and in WB-LGE-CMR reconstruction were compared. Concordance was compared with a historical cohort matched by cardiomyopathy, scar location, and age (26 patients) with LGE-CMR prior to ICD and VT ablation. In WB-CMR group, 101 and 93 CC entrances were identified in EAM and WB-LGE-CMR, respectively. In historical cohort, 179 CC entrances were identified in both EAM and LGE-CMR. The EAM/CMR concordance was 85.1% and 92.2% in the WB and historical group, respectively (P = 0.66). There were no differences in false-positive rate (CC entrances detected in CMR and absent in EAM: 7.5% vs 7.8% in WB vs. conventional CMR, P = 0.92) nor in false-negative rate (CC entrances present in EAM not detected in CMR: 14.9% vs.7.8% in WB vs. conventional CMR, P = 0.23). Epicardial CCs was predictor of poor CMR/EAM concordance (OR 2.15, P = 0.031). Conclusion Use of WB-LGE-CMR sequence in ICD-patients allows adequate VT substrate characterization to guide VT ablation with similar accuracy than conventional LGE-CMR in patients without an ICD.

Ventricular Pacing Induced Ventricular Tachycardia in Patients with Implantable Cardioverter Defibrillators

1995 ◽  
Vol 18 (3) ◽  
pp. 486-491 ◽  
Author(s):  
MARC ROELKE ◽  
SEAN O'NUNAIN ◽  
STEFAN OSSWALD ◽  
THOMAS G. TROUTON ◽  
J. WARREN HARTHORNE ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Implantable Cardioverter Defibrillators ◽  
Ventricular Pacing ◽  
Cardioverter Defibrillators

The Benefit of a Second Burst Antitachycardia Sequence for Fast Ventricular Tachycardia in Patients with Implantable Cardioverter Defibrillators

2013 ◽  
Vol 37 (4) ◽  
pp. 486-494 ◽  
Author(s):  
IGNASI ANGUERA ◽  
PAOLO DALLAGLIO ◽  
XAVIER SABATÉ ◽  
ELAINE NUÑEZ ◽  
MONTSERRAT GRACIDA ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Implantable Cardioverter Defibrillators ◽  
Cardioverter Defibrillators
Sign in / Sign up

Export Citation Format

Share Document