Ablation of Idiopathic Ventricular Tachycardia

Schreiber, Doreen; Kottkamp, Hans

doi:10.1007/s11886-010-0121-x

Cited by 11 publications

(8 citation statements)

References 47 publications

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“…Scar-related VT (SRVT) could have several causes such as myocardial infarction (MI), dilated cardiomyopathy (DCMP), arrhythmogenic RV cardiomyopathy (ARVC) and hypertrophic cardiomyopathy (HCMP) [6]. Idiopathic VT originated in most cases from the outflow tract regions or the fascicles of the left ventricle in patients with structurally normal hearts (SNH) [23]. VTs originating from the left ventricular outflow tract (LVOT) and VT originating from above the pulmonary and aortic valve are recognized more often than before [24–26].…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of the remote magnetic navigation for ablation of ventricular tachycardias—a systematic review

Akca

Önsesveren

Jordaens

et al. 2011

J Interv Card Electrophysiol

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ObjectiveRemote magnetic navigation (RMN) is considered to be a solution for mapping and ablation of several arrhythmias. In this systematic review we aimed to assess the safety and efficacy of RMN in ablation of ventricular tachycardia (VT).MethodsThe National Library of Medicine’s PubMed database was searched for articles containing any of a predetermined set of search terms that were published prior to November 1, 2011. Quality of evidence was rated using the GRADE system.ResultsThe database search resulted in 11 relevant articles evaluating the usefulness of RMN. Three groups of VTs were studied: VT in patients with ischemic cardiomyopathy (ICMP), non-ischemic cardiomyopathy (NICMP) and structurally normal hearts (SNH). The use of RMN in patients with ICMP has been associated with success rates ranging from 71 to 80%. RMN has been shown to be a feasible and effective method for ablation of VT in NICMP and SNH patients. Success rates between 50% and 100% have been reported in NICMP populations. Rates ranging from 86% to 100% have been reported for SNH patients. The lowest rates of arrhythmia recurrence are reported for SNH patients (0–17%). In ICMP and NICMP, recurrence rates of 0–30% and 14–50%, respectively, have been reported. One patient experienced total heart block, and one patient experienced a thromboembolic event after RMN catheter ablation procedures.ConclusionsRMN has been shown to be an effective and safe method for ablation of VT in various patient populations with low recurrence and complication rates. However, more comparative and randomized studies are necessary, and therefore the true value of RMN for VT ablation remains still unknown.

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Section: Introductionmentioning

confidence: 99%

Safety and efficacy of the remote magnetic navigation for ablation of ventricular tachycardias—a systematic review

Akca

Önsesveren

Jordaens

et al. 2011

J Interv Card Electrophysiol

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“…The main features of the dynamics of protein association can be conceptualized within the framework of the encounter complex [6]. To this end, the association is divided into two parts.…”

Section: Introductionmentioning

confidence: 99%

Dynamics of protein-protein encounter: A Langevin equation approach with reaction patches

Schluttig

Alamanova

Helms

et al. 2008

The Journal of Chemical Physics

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We study the formation of protein-protein encounter complexes with a Langevin equation approach that considers direct, steric, and thermal forces. As three model systems with distinctly different properties we consider the pairs barnase:barstar, cytochrome c-cytochrome c peroxidase, and p53:MDM2. In each case, proteins are modeled either as spherical particles, as dipolar spheres, or as collection of several small beads with one dipole. Spherical reaction patches are placed on the model proteins according to the known experimental structures of the protein complexes. In the computer simulations, concentration is varied by changing box size. Encounter is defined as overlap of the reaction patches and the corresponding first passage times are recorded together with the number of unsuccessful contacts before encounter. We find that encounter frequency scales linearly with protein concentration, thus proving that our microscopic model results in a well-defined macroscopic encounter rate. The number of unsuccessful contacts before encounter decreases with increasing encounter rate and ranges from 20 to 9000. For all three models, encounter rates are obtained within one order of magnitude of the experimentally measured association rates. Electrostatic steering enhances association up to 50-fold. If diffusional encounter is dominant (p53:MDM2) or similarly important as electrostatic steering (barnase:barstar), then encounter rate decreases with decreasing patch radius. More detailed modeling of protein shapes decreases encounter rates by 5%-95%. Our study shows how generic principles of protein-protein association are modulated by molecular features of the systems under consideration. Moreover it allows us to assess different coarse-graining strategies for the future modeling of the dynamics of large protein complexes.

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“…Idiopathic ventricular tachyarrhythmia originating from the right ventricular outflow tract (RVOT) is one of the most frequent ventricular arrhythmias observed in clinical practice [1]. Although RVOT arrhythmias rarely cause sudden cardiac death [2–4], frequent RVOT arrhythmias can reduce left ventricular contraction in some patients [5,6].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of non‐contact mapping for catheter ablation of ventricular tachycardias originating at the right ventricular outflow tract

Hoshiyama

Yamabe

Koyama

et al. 2014

Journal of Arrhythmia

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Background Different QRS morphologies are often observed in idiopathic ventricular tachycardias or premature ventricular contractions originating from the right ventricular outflow tract (RVOT). However, the precise mechanism underlying multiple QRS morphologies has not been clarified adequately. The purpose of this study was to examine the mechanism underlying different QRS morphologies in RVOT arrhythmia. We also investigated the usefulness of non‐contact mapping guided radiofrequency catheter ablation for RVOT arrhythmia. Methods Endocardial mapping of RVOT was performed using a non‐contact mapping system in 20 patients with RVOT arrhythmia. We analyzed the underlying mechanism that produces different QRS morphologies during catheter ablation of RVOT arrhythmia. Results Forty‐six QRS morphologies of RVOT arrhythmia were observed in 20 patients. Five patients showed monofocal QRS morphology, whereas the remaining 15 patients showed multiple QRS morphologies (from 2 to 4 morphologies each). Among these, all patients presented a shift in the origin of tachycardia. Additionally, different QRS morphologies were observed in 5 of these patients that were caused by a change in the local activation after radiofrequency energy delivery. Radiofrequency energy application to the site of origin of the RVOT arrhythmia using non‐contact mapping navigation eliminated the RVOT arrhythmias in all patients. However, 1 patient presented a recurrence of RVOT arrhythmia (success rate, 95.0%). Conclusions The multiple QRS morphologies of RVOT arrhythmia were caused by a shift in the origin of tachycardia or by a change in the local activation following the radiofrequency energy application. Non‐contact mapping was useful to identify the appropriate target site of RVOT arrhythmia irrespective of the changes in QRS morphologies.

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Ablation of Idiopathic Ventricular Tachycardia

Cited by 11 publications

References 47 publications

Safety and efficacy of the remote magnetic navigation for ablation of ventricular tachycardias—a systematic review

Safety and efficacy of the remote magnetic navigation for ablation of ventricular tachycardias—a systematic review

Dynamics of protein-protein encounter: A Langevin equation approach with reaction patches

Usefulness of non‐contact mapping for catheter ablation of ventricular tachycardias originating at the right ventricular outflow tract

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