2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Position Statement on the Management of Ventricular Tachycardia and Fibrillation in Patients With Structural Heart Disease

Deyell, Marc W.; AbdelWahab, Amir; Angaran, Paul; Essebag, Vidal; Glover, Ben; Gula, Lorne J.; Khoo, Clarence; Lane, Charles; Nault, Isabelle; Nery, Pablo B.; Rivard, Léna; Slawnych, Michael; Tulloch, Heather L; Sapp, John L.

doi:10.1016/j.cjca.2020.04.004

Cited by 31 publications

(30 citation statements)

References 94 publications

(93 reference statements)

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“…34 Procedural outcome evaluation using non-inducibility as an objective endpoint is favored. 42 An example case is shown in figure 5.…”

Section: Catheter Ablation For Ventricular Tachycardia In Cardiacsarcoidosismentioning

confidence: 99%

“… 40 , 41 Several substrate-based ablation strategies have been reported, and may be employed according to local expertise. 41 , 42 Irrigated radiofrequency energy is preferred to ablate areas of interest using power of 25–50 W and a target impedance drop of 10–15 ohms. 34 Procedural outcome evaluation using noninducibility as an objective endpoint is favored.…”

Section: Catheter Ablation For Ventricular Tachycardia In Cardiac Sarcoidosismentioning

confidence: 99%

“… 34 Procedural outcome evaluation using noninducibility as an objective endpoint is favored. 42 An example case is shown in Figure 5 .

Figure 5 A: Case example of a 48-year-old female patient who presented with atrioventricular block and developed ventricular tachycardia (VT) 3 months later.…”

Section: Catheter Ablation For Ventricular Tachycardia In Cardiac Sarcoidosismentioning

confidence: 99%

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Management of ventricular tachycardia in patients with cardiac sarcoidosis

2021

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“…34 Procedural outcome evaluation using non-inducibility as an objective endpoint is favored. 42 An example case is shown in figure 5.…”

Section: Catheter Ablation For Ventricular Tachycardia In Cardiacsarcoidosismentioning

confidence: 99%

Section: Catheter Ablation For Ventricular Tachycardia In Cardiac Sarcoidosismentioning

confidence: 99%

“… 34 Procedural outcome evaluation using noninducibility as an objective endpoint is favored. 42 An example case is shown in Figure 5 .

Figure 5 A: Case example of a 48-year-old female patient who presented with atrioventricular block and developed ventricular tachycardia (VT) 3 months later.…”

Section: Catheter Ablation For Ventricular Tachycardia In Cardiac Sarcoidosismentioning

confidence: 99%

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Management of ventricular tachycardia in patients with cardiac sarcoidosis

2021

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“…Based on our experience and previous literature, we have summarized the potential causes and treatment strategies when unexpected VT/VF storm occurs early after uncomplicated ASD repair in Fig. 4 [9,[15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative arrhythmias usually comprise transient atrial-ventricular block, atrial fibrillation or atrial flutter, supraventricular arrhythmia, and bradyarrhythmia [1,4,7,8]. It is rare to encounter electrical storm, which is defined as the occurrence of 3 or more distinct episodes of ventricular tachycardia (VT) or ventricular fibrillation (VF) within 24 h (also known as VT/VF storm) [9]. In this case report, we present a 49-year-old woman without an arrhythmia history who experienced VT/VF storm after ASD repair with combined tricuspid valvuloplasty.…”

Section: Introductionmentioning

confidence: 99%

Electrical storm after correction of an uncomplicated congenital atrial septal defect in an adult: a case report

Liang

Hei

Guan

2021

BMC Cardiovasc Disord

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Background There is a paucity of published literature describing electrical storm after the correction of uncomplicated atrial septal defect (ASD) in an adult. Case presentation We present a 49-year-old woman with a congenital ASD combined with mild tricuspid regurgitation who denied any history of arrhythmia or other medical history. She suffered from electrical storm (≥ 3 episodes of ventricular tachycardias or ventricular fibrillations) in the early stage after ASD repair with combined tricuspid valvuloplasty. During electrical storm, her electrolytes were within normal ranges and no ischemic electrocardiographic changes were detected, which suggested that retained air embolism or acute coronary thrombosis were unlikely. Additionally, echocardiographic findings and her central venous pressure (5–8 mmHg during the interval between attacks) failed to support the diagnosis of pericardial tamponade. After a thorough discussion, the surgeons conducted an emergent re-exploration and repeated closure of the ASD with combined DeVega's annuloplasty. Eventually, the patient recovered uneventfully, without reoccurring arrhythmias during follow-up. Although we fail to determine the definite cause, we speculate that the causes probably are iatrogenic injury of the conduction system due to a rare anatomic variation, poor intraoperative protection, latent coronary distortion during tricuspid valvuloplasty, or idiopathic or secondary abnormalities of the conduction system. Conclusions For most surgeons, performing re-exploration without a known etiology is a difficult decision to make. This case illustrates that re-exploration could be an option when electrical storm occurs in the early stage postoperatively. Nevertheless, surgeons should assess the benefit-risk ratio when taking this unconventional measure.

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Relevance of mexiletine in the era of evolving antiarrhythmic therapy of ventricular arrhythmias

Alhourani,

Wolfes,

Könemann

et al. 2024

Clin Res Cardiol

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Despite impressive developments in the field of ventricular arrhythmias, there is still a relevant number of patients with ventricular arrhythmias who require antiarrhythmic drug therapy and may, e.g., in otherwise drug and/or ablation refractory situations, benefit from agents known for decades, such as mexiletine. Through its capability of blocking fast sodium channels in cardiomyocytes, it has played a minor to moderate antiarrhythmic role throughout the recent decades. Nevertheless, certain patients with structural heart disease suffering from drug-refractory, i.e., mainly amiodarone refractory ventricular arrhythmias, as well as those with selected forms of congenital long QT syndrome (LQTS) may nowadays still benefit from mexiletine. Here, we outline mexiletine’s cellular and clinical electrophysiological properties. In addition, the application of mexiletine may be accompanied by various potential side effects, e.g., nausea and tremor, and is limited by several drug-drug interactions. Thus, we shed light on the current therapeutic role of mexiletine for therapy of ventricular arrhythmias and discuss clinically relevant aspects of its indications based on current evidence. Graphical abstract

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2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Position Statement on the Management of Ventricular Tachycardia and Fibrillation in Patients With Structural Heart Disease

Cited by 31 publications

References 94 publications

Management of ventricular tachycardia in patients with cardiac sarcoidosis

Management of ventricular tachycardia in patients with cardiac sarcoidosis

Electrical storm after correction of an uncomplicated congenital atrial septal defect in an adult: a case report

Relevance of mexiletine in the era of evolving antiarrhythmic therapy of ventricular arrhythmias

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