Ablation of Idiopathic Right Ventricular Tachycardia

Wilber, David J.; Joshi, Sandeep

doi:10.1002/9780470696279.ch17

Cited by 4 publications

(3 citation statements)

References 95 publications

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“…The CARTO XP (Biosense Webster, Diamond Bar, CA, USA) EAM system uses magnetic-field-based tracking technology to locate catheter tip position and orientation in the heart. 1,20,21 With this system and others like it, a three-dimensional (3-D) cartoon geometry of the heart chamber is interpolated from a point catalog of acquired mapping catheter positions (NaviStar™; Biosense Webster, Diamond Bar, CA, USA). RF-delivery sites are marked during ablation in the map geometry.…”

Section: Introductionmentioning

confidence: 99%

Contrast in Intracardiac Acoustic Radiation Force Impulse Images of Radiofrequency Ablation Lesions

et al. 2014

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We have previously shown that intracardiac acoustic radiation force impulse (ARFI) imaging visualizes tissue stiffness changes caused by radiofrequency ablation (RFA). The objectives of this in vivo study were to (1) quantify measured ARFI-induced displacements in RFA lesion and unablated myocardium and (2) calculate the lesion contrast (C) and contrast-to-noise ratio (CNR) in two-dimensional ARFI and conventional intracardiac echo images. In eight canine subjects, an ARFI imaging-electroanatomical mapping system was used to map right atrial ablation lesion sites and guide the acquisition of ARFI images at these sites before and after ablation. Readers of the ARFI images identified lesion sites with high sensitivity (90.2%) and specificity (94.3%) and the average measured ARFI-induced displacements were higher at unablated sites (11.23 ± 1.71 μm) than at ablated sites (6.06 ± 0.94 μm). The average lesion C (0.29 ± 0.33) and CNR (1.83 ± 1.75) were significantly higher for ARFI images than for spatially registered conventional B-mode images (C = −0.03 ± 0.28, CNR = 0.74 ± 0.68).

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Section: Introductionmentioning

confidence: 99%

Contrast in Intracardiac Acoustic Radiation Force Impulse Images of Radiofrequency Ablation Lesions

et al. 2014

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“…However, about 10% of patients with VT (idiopathic VT) have no structural heart disease [9, 10]. Patients with SVT may or may not have structural heart disease.…”

Section: Patient History and Physical Examination In Wct Differentialmentioning

confidence: 99%

Current Algorithms for the Diagnosis of wide QRS Complex Tachycardias

Vereckei

2014

CCR

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The differential diagnosis of a regular, monomorphic wide QRS complex tachycardia (WCT) mechanism represents a great diagnostic dilemma commonly encountered by the practicing physician, which has important implications for acute arrhythmia management, further work-up, prognosis and chronic management as well. This comprehensive review discusses the causes and differential diagnosis of WCT, and since the ECG remains the cornerstone of WCT differential diagnosis, focuses on the application and diagnostic value of different ECG criteria and algorithms in this setting and also provides a practical clinical approach to patients with WCTs.

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“…However, myocarditis, dilated cardiomyopathy, congenital heart disease, cardiac infiltrative diseases, arrhythmogenic right ventricular cardiomyopathy, and hypertrophic cardiomyopathy are also known to contribute to an arrhythmogenic substrate. In about 10% of patients, VT occurs in the absence of structural heart disease [ 4 ]. This subset of VT is thought to be either idiopathic or related to primary electrical disease, such as the long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT), or other cardiac ion channelopathies [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Current and Emerging Antiarrhythmic Drug Therapy for Ventricular Tachycardia

Williams

Viswanathan

2013

Cardiol Ther

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Ventricular arrhythmias, including ventricular fibrillation (VF) and sustained ventricular tachycardia (VT), are the principal causes of sudden cardiac death in patients with structural heart disease. While coronary artery disease is the predominant substrate associated with the development of VT, these arrhythmias are known to occur in a variety of disorders, including dilated cardiomyopathy, valvular and congenital heart disease, and cardiac ion channelopathies such as the long QT syndrome. In a minority of patients, VT occurs in the absence of structural heart disease. Despite the established mortality benefit of the implantable cardioverter defibrillator (ICD) in patients at risk of lethal arrhythmias, recurrent VT/VF events continue to be a source of morbidity and impaired quality of life in such patients. Antiarrhythmic therapy is indicated in select patients to treat symptomatic VT episodes, to reduce the incidence of ICD shocks, and potentially to improve quality of life and reduce hospitalizations related to cardiac arrhythmia. The primary adverse effects of antiarrhythmic medications are related to both cardiac and extracardiac toxicity, including the risk of proarrhythmia. Current drug therapy for ventricular arrhythmia has been limited by suboptimal efficacy in many patients, resulting in recurrent VT/VF events, and by drug toxicity or intolerance leading to discontinuation in a large percentage of patients. Amiodarone and sotalol are the principal agents used in the chronic treatment of VT. In addition, dronedarone and dofetilide, agents approved for the treatment of atrial fibrillation, and ranolazine, an antianginal agent, have been demonstrated to be protective against ventricular arrhythmia in small clinical studies. Finally, advances in basic electrophysiology have uncovered new molecular targets for the treatment of ventricular arrhythmia, and pharmacologic agents directed at these targets may emerge as promising VT treatments in the future. The roles of these current and emerging therapies for the treatment of VT in humans will be summarized in this review.

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Ablation of Idiopathic Right Ventricular Tachycardia

Cited by 4 publications

References 95 publications

Contrast in Intracardiac Acoustic Radiation Force Impulse Images of Radiofrequency Ablation Lesions

Contrast in Intracardiac Acoustic Radiation Force Impulse Images of Radiofrequency Ablation Lesions

Current Algorithms for the Diagnosis of wide QRS Complex Tachycardias

Current and Emerging Antiarrhythmic Drug Therapy for Ventricular Tachycardia

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