Recent advances in three-dimensional electroanatomical mapping guidance for the ablation of complex atrial and ventricular arrhythmias

Compagnucci, Paolo; Volpato, Giovanni; Falanga, Umberto; Cipolletta, Laura; Conti, Manuel; Grifoni, Gino; Verticelli, Letizia; Schicchi, Nicolò; Giovagnoni, Andrea; Casella, Michela; Guerra, Federico; Russo, Antonio Dello

doi:10.1007/s10840-020-00781-3

Cited by 23 publications

(19 citation statements)

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“…Endomyocardial biopsy (EMB) remains the gold standard for diagnosis and differentiates between the various types of inflammatory processes and guiding therapy; it is appropriate to use anti-inflammatory drugs and immunosuppressive therapies only in patients with virus-negative acute or chronic active myocarditis [ 23 ]. Electroanatomic voltage mapping (EVM) increases the sensitivity and specificity of EMB by disclosing areas characterized by abnormal voltage, and is currently regarded as the preferred guide to EMB [ 24 , 25 ]. EVM in myocarditis also has a prognostic role, and patients with areas of abnormal bipolar voltage spanning more than 10% of endocardial surface have been found to be at increased risk of major arrhythmias [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Sports Activity and Arrhythmic Risk in Cardiomyopathies and Channelopathies: A Critical Review of European Guidelines on Sports Cardiology in Patients with Cardiovascular Diseases

et al. 2021

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The prediction and prevention of sudden cardiac death is the philosopher’s stone of clinical cardiac electrophysiology. Sports can act as triggers of fatal arrhythmias and therefore it is essential to promptly frame the athlete at risk and to carefully evaluate the suitability for both competitive and recreational sports activity. A history of syncope or palpitations, the presence of premature ventricular complexes or more complex arrhythmias, a reduced left ventricular systolic function, or the presence of known or familiar heart disease should prompt a thorough evaluation with second level examinations. In this regard, cardiac magnetic resonance and electrophysiological study play important roles in the diagnostic work-up. The role of genetics is increasing both in cardiomyopathies and in channelopathies, and a careful evaluation must be focused on genotype positive/phenotype negative subjects. In addition to being a trigger for fatal arrhythmias in certain cardiomyopathies, sports also play a role in the progression of the disease itself, especially in the case arrhythmogenic right ventricular cardiomyopathy. In this paper, we review the latest European guidelines on sport cardiology in patients with cardiovascular diseases, focusing on arrhythmic risk stratification and the management of cardiomyopathies and channelopathies.

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Section: Discussionmentioning

confidence: 99%

Sports Activity and Arrhythmic Risk in Cardiomyopathies and Channelopathies: A Critical Review of European Guidelines on Sports Cardiology in Patients with Cardiovascular Diseases

et al. 2021

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“…Although rst clinical results show the e cacy of catheter ablation using hybrid mapping [8,9,12], a clinical bene t compared to conventional activation mapping is yet to be demonstrated. Since standard ablation catheters have a 3-to 4-mm tip, it seems plausible that a correction for spatial displacement might improve the accuracy of RFC-delivery in a clinically signi cant extent.…”

Section: Discussionmentioning

confidence: 99%

Spatial Correction Improves Accuracy of Catheter Positioning During Ablation of Premature Ventricular Contractions: Differences Between Ventricular Outflow Tracts And Other Localizations.

Nies¹,

Dinshaw²,

Klatt

et al. 2021

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1.1. PurposeHybrid activation mapping is a novel tool to correct for spatial displacement of the mapping catheter due to asymmetrical contraction of myocardium during premature ventricular contractions (PVC). The aim of this study is to describe the extent and cause of spatial displacement during PVC mapping and options for correction using hybrid activation mapping. 1.2. Methods and ResultsWe analyzed 5798 hybrid mapping points in 40 acquired hybrid maps of 22 consecutive patients (age 63±16 years, 45% female) treated for premature ventricular contractions (PVCs). Median PVC-coupling interval was 552 ms (IQR 83 ms). Spatial displacement was determined by measuring the dislocation of the catheter tip during PVC compared to the preceding sinus beat. Mean spatial displacement was 3.8±1.5 mm for all maps. The displacement was 1.3±0.4 mm larger for PVCs with non-outflow-tract origin compared to PVCs originating from the ventricular outflow tracts (RVOT/LVOT; p=0.028). Demographic parameters, PVC-coupling-interval and chamber of origin had no significant influence on the extent of spatial displacement. 1.3. ConclusionEctopic activation of the ventricular myocardium during PVCs results in spatial displacement of mapping points that is significantly larger for PVCs with non-outflow-tract origin. The correction for spatial displacement may improve accuracy of radiofrequency current (RFC)-application in catheter ablation of PVCs.

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“…In case of structural/functional alterations confined to the left ventricle, this latter chamber should be sampled, using either a transseptal or a retrograde arterial (radial or femoral) approach [ 37 ]. Furthermore, electroanatomical voltage mapping (EVM) can be performed during the same procedure as EMB [ 38 ], and has been found to further enhance EMB’s diagnostic yield [ 39 , 40 ], by allowing direct sampling of myocardial segments showing abnormal voltages. EVM-guided EMB currently represents the preferred technique at our institution.…”

Section: Diagnosismentioning

confidence: 99%

Myocardial Inflammation, Sports Practice, and Sudden Cardiac Death: 2021 Update

et al. 2021

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Myocardial inflammation is an important cause of cardiovascular morbidity and sudden cardiac death in athletes. The relationship between sports practice and myocardial inflammation is complex, and recent data from studies concerning cardiac magnetic resonance imaging and endomyocardial biopsy have substantially added to our understanding of the challenges encountered in the comprehensive care of athletes with myocarditis or inflammatory cardiomyopathy (ICM). In this review, we provide an overview of the current knowledge on the epidemiology, pathophysiology, diagnosis, and treatment of myocarditis, ICM, and myopericarditis/perimyocarditis in athletes, with a special emphasis on arrhythmias, patient-tailored therapies, and sports eligibility issues.

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Recent advances in three-dimensional electroanatomical mapping guidance for the ablation of complex atrial and ventricular arrhythmias

Cited by 23 publications

References 20 publications

Sports Activity and Arrhythmic Risk in Cardiomyopathies and Channelopathies: A Critical Review of European Guidelines on Sports Cardiology in Patients with Cardiovascular Diseases

Sports Activity and Arrhythmic Risk in Cardiomyopathies and Channelopathies: A Critical Review of European Guidelines on Sports Cardiology in Patients with Cardiovascular Diseases

Spatial Correction Improves Accuracy of Catheter Positioning During Ablation of Premature Ventricular Contractions: Differences Between Ventricular Outflow Tracts And Other Localizations.

Myocardial Inflammation, Sports Practice, and Sudden Cardiac Death: 2021 Update

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