Mapping and Radiofrequency Catheter Ablation of the Three Types of Sustained Monomorphic Ventricular Tachycardia in Nonischemic Heart Disease

Delacrétaz, Etienne; Stevenson, William G.; Ellison, Kristin E.; Maisel, William H.; Friedman, Peter L.

doi:10.1111/j.1540-8167.2000.tb00728.x

Cited by 142 publications

(70 citation statements)

References 26 publications

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“…19 -21 Most of our patients demonstrated entrainment in responses to overdrive pacing, with some demonstrating progressive fusion, either from remote sites, 22 or from sites within a reentrant circuit. 12,13 Based on our findings and similar observations by other investigators, 20 reentry appears to play a major role in the mechanism of sustained monomorphic VT in this patient population.…”

Section: Mechanism Of Vt In Nonischemic Cardiomyopathysupporting

confidence: 51%

Characterization of Endocardial Electrophysiological Substrate in Patients With Nonischemic Cardiomyopathy and Monomorphic Ventricular Tachycardia

2003

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Background-Although catheter mapping has been used to define the endocardial electrogram characteristics in patients with ventricular tachycardia (VT) and coronary disease, characterization of the electrophysiological substrate in patients with VT and nonischemic cardiomyopathy is limited. Methods and Results-Left ventricular endocardial electroanatomical mapping was performed in 19 patients with nonischemic cardiomyopathy and monomorphic VT with an average of 178Ϯ83 sites per chamber mapped. Abnormal bipolar electrogram was defined as endocardial voltage signal amplitude of Ͻ1.8 mV. The extent and location of abnormal endocardium was estimated by measuring areas of abnormal electrogram recordings from 3D voltage maps. The origin of VT was approximated by identifying sites of entrainment with concealed fusion or early presystolic activity and/or by pace mapping. Abnormal electrograms were recorded over a 41Ϯ28 cm 2 area that represented 20Ϯ12% of total endocardial surface. The majority of patients (14/19 patients) had only a modest area (Ͻ25%) of endocardial abnormality. All patients had abnormal low-voltage endocardial areas located near the ventricular base in the perivalvular region. There were 3Ϯ1 VT morphologies per patient. The majority (88%) of the 57 mapped VTs originated from the ventricular base, corresponding to regions with abnormal endocardial electrograms. Conclusions-Electroanatomical

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Section: Mechanism Of Vt In Nonischemic Cardiomyopathysupporting

confidence: 51%

Characterization of Endocardial Electrophysiological Substrate in Patients With Nonischemic Cardiomyopathy and Monomorphic Ventricular Tachycardia

2003

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“…In both groups, epicardial ablation has been successfully applied after failure of endocardial ablation. In general, acute success rates of catheter ablation are similar to ischemic ventricular tachycardia patients, but recurrence rates seem to be higher (Soejima, 2004;Delacretaz, 2000;Nazarian, 2005;Verma, 2005;Dalal, 2007). Moreover, catheter ablation has been shown to eliminate electrical storm in patients with and without underlying heart disease by either inhibiting the trigger factors for ventricular tachycardia/ventricular fibrillation, namely ventricular premature beats, or by modifying the substrate for ventricular tachycardia/ventricular fibrillation.…”

Section: Catheter Ablation In Nonischemic Patientsmentioning

confidence: 99%

Prevention of Sudden Death – Implantable Cardioverter Defibrillator and/or Ventricular Radiofrequency Ablation

Colella¹,

Giaccardi²,

Sabatini³

et al. 2011

Cardiac Defibrillation - Prediction, Prevention and Management of Cardiovascular Arrhythmic Events

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“…When the VT mechanism is focal, usually a centrifugally spreading activation pattern from the site of earliest activation is observed in the map generated by the electroanatomic system. Here, the earliest bipolar signal is recorded and, concomitantly, a fast negative intrinsicoid deflection is also recorded in the unipolar recording from [16,17] . A rare but interesting form of focal VT has been described in patients with postinfarction ischemic cardiomyopathy [18,19] .…”

Section: Methodsmentioning

confidence: 99%

Role of catheter ablation of ventricular tachycardia associated with structural heart disease

Ponti

2011

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In patients with structural heart disease, ventricular tachycardia (VT) worsens the clinical condition and may severely affect the short-and long-term prognosis. Several therapeutic options can be considered for the management of this arrhythmia. Among others, catheter ablation, a closed-chest therapy, can prevent arrhythmia recurrences by abolishing the arrhythmogenic substrate. Over the last two decades, different techniques have been developed for an effective approach to both tolerated and untolerated VTs. The clinical outcome of patients undergoing ablation has been evaluated in multiple studies. This editorial gives an overview of the role, methodology, clinical outcome and innovative approaches in catheter ablation of VT. De Ponti R. Role of catheter ablation of ventricular tachycardia associated with structural heart disease.

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Mapping and Radiofrequency Catheter Ablation of the Three Types of Sustained Monomorphic Ventricular Tachycardia in Nonischemic Heart Disease

Abstract: Three different mechanisms of VT are encountered in patients with nonischemic CMP. The mapping and ablation approach varies with the type of VT. In this selected population, the overall efficacy was 77%.

Cited by 142 publications

References 26 publications

Characterization of Endocardial Electrophysiological Substrate in Patients With Nonischemic Cardiomyopathy and Monomorphic Ventricular Tachycardia

Characterization of Endocardial Electrophysiological Substrate in Patients With Nonischemic Cardiomyopathy and Monomorphic Ventricular Tachycardia

Prevention of Sudden Death – Implantable Cardioverter Defibrillator and/or Ventricular Radiofrequency Ablation

Role of catheter ablation of ventricular tachycardia associated with structural heart disease

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