Bicuspid aortic valve supporting supravalvular “substrate” for multiple ventricular tachycardias

Kumar, Saurabh; Stevenson, William G.; Tedrow, Usha B.

doi:10.1016/j.hrcr.2016.09.006

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…The impact of a BAV on RA access depends on the degree of valvular dysfunction and the presence of an associated aortopathy. While previous case reports have demonstrated that retrograde access can be performed safely in BAV patients, significant valve stenosis or aneurysmal aortic dilatation may preclude retrograde access. Even in the absence of these abnormalities, VT ablation via the retrograde route may prove challenging as cusp fusion may impinge on valve crossing and restrict catheter manipulation.…”

Section: Ra Access In Specific Circumstancesmentioning

confidence: 93%

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Retrograde aortic access during ventricular tachycardia ablation: Indications, techniques, and challenges

Adlan

Campbell

Fairbairn

et al. 2019

Cardiovasc electrophysiol

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The retrograde aortic (RA) route is a widely used access route for mapping and ablation of ventricular tachycardias (VT) arising from the left ventricular endocardium. With the expanding role of VT ablation in patients with significant comorbidity, the choice between the RA and transseptal access routes is an increasingly important consideration. An individualized decision based on the location of the arrhythmogenic substrate, vascular anatomy, aortic valve morphology, and operator experience is necessary when deciding on the optimal access route. Among patients with challenging vascular anatomy, growing experience from structural interventions such as transcatheter aortic valve replacements and peripheral vascular interventions has provided valuable insights into techniques for safe retrograde access. The present review focuses on patient selection for RA access, potential complications associated with the technique, and optimal approaches for access in patients with challenging vascular or aortic valve anatomy.

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Section: Ra Access In Specific Circumstancesmentioning

confidence: 93%

“…45 The impact of a BAV on RA access depends on the degree of valvular dysfunction and the presence of an associated aortopathy. While previous case reports have demonstrated that retrograde access can be performed safely in BAV patients, 46…”

Section: Congenital Cardiac Abnormalitiesmentioning

confidence: 93%

Retrograde aortic access during ventricular tachycardia ablation: Indications, techniques, and challenges

Adlan

Campbell

Fairbairn

et al. 2019

Cardiovasc electrophysiol

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“…Frequent CAD coexistence in the elderly, often with ischemic scar predisposes patients with severe AS to VAs. Potential source of idiopathic VAs originating from aortic cusps attributed to muscular fibers extending from the outflow tract, is not established in AS ( 101 , 102 ). In studies that analyzed VAs in symptomatic severe AS before TAVI using 24-h Holter monitoring, complex PVCs were present in 48% and non-sustained VT in 9-29% ( 103 , 104 ).…”

Section: Aortic Stenosismentioning

confidence: 99%

Arrhythmias in Patients With Valvular Heart Disease: Gaps in Knowledge and the Way Forward

Kubala

Chillou

Bohbot

et al. 2022

Front. Cardiovasc. Med.

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The prevalence of both organic valvular heart disease (VHD) and cardiac arrhythmias is high in the general population, and their coexistence is common. Both VHD and arrhythmias in the elderly lead to an elevated risk of hospitalization and use of health services. However, the relationships of the two conditions is not fully understood and our understanding of their coexistence in terms of contemporary management and prognosis is still limited. VHD-induced left ventricular dysfunction/hypertrophy and left atrial dilation lead to both atrial and ventricular arrhythmias. On the other hand, arrhythmias can be considered as an independent condition resulting from a coexisting ischemic or non-ischemic substrate or idiopathic ectopy. Both atrial and ventricular VHD-induced arrhythmias may contribute to clinical worsening and be a turning point in the natural history of VHD. Symptoms developed in patients with VHD are not specific and may be attributable to hemodynamical consequences of valve disease but also to other cardiac conditions including arrhythmias which are notably prevalent in this population. The issue how to distinguish symptoms related to VHD from those related to atrial fibrillation (AF) during decision making process remains challenging. Moreover, AF is a traditional limit of echocardiography and an important source of errors in assessment of the severity of VHD. Despite recent progress in understanding the pathophysiology and prognosis of postoperative AF, many questions remain regarding its prevention and management. Furthermore, life-threatening ventricular arrhythmias can predispose patients with VHD to sudden cardiac death. Evidence for a putative link between arrhythmias and outcome in VHD is growing but available data on targeted therapies for VHD-related arrhythmias, including monitoring and catheter ablation, is scarce. Despite growing evidences, more research focused on the prognosis and optimal management of VHD-related arrhythmias is still required. We aimed to review the current evidence and identify gaps in knowledge about the prevalence, prognostic considerations, and treatment of atrial and ventricular arrhythmias in common subtypes of organic VHD.

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Intracardiac Echocardiography to Guide Mapping and Ablation of Arrhythmias in Patients with Congenital Heart Disease

Campbell

Haqqani

Kumar

2021

Cardiac Electrophysiology Clinics

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Bicuspid aortic valve supporting supravalvular “substrate” for multiple ventricular tachycardias

Cited by 4 publications

References 12 publications

Retrograde aortic access during ventricular tachycardia ablation: Indications, techniques, and challenges

Retrograde aortic access during ventricular tachycardia ablation: Indications, techniques, and challenges

Arrhythmias in Patients With Valvular Heart Disease: Gaps in Knowledge and the Way Forward

Intracardiac Echocardiography to Guide Mapping and Ablation of Arrhythmias in Patients with Congenital Heart Disease

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