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Successful Catheter Ablation (successful + catheter_ablation)
Selected AbstractsSuccessful Catheter Ablation and Documentation of the Activation and Propagation Pattern During a Left Atrial Focal Tachycardia in a Patient with Cor Triatriatum SinisterJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2010KOICHIRO EJIMA M.D. Atrial Tachycardia in Cor Triatriatum. We report a case of an atrial tachycardia (AT) originating from the left atrium (LA) associated with cor triatriatum sinister. Electroanatomical mapping of the 2 subdivided chambers of the LA during the AT revealed a centrifugal activation pattern from the posterior wall of the accessory chamber near the left superior pulmonary vein. The propagation map on the CARTO system revealed that the AT wave front spread centrifugally over the "accessory chamber," turned around the edge of the membrane subdividing the LA, and then spread over the "main chamber." A single radiofrequency application successfully abolished the AT. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1050-1054, September 2010) [source] Successful Catheter Ablation of Two Types of Ventricular Tachycardias Triggered by Cardiac Resynchronization Therapy: A Case ReportJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2007PETR PEICHL M.D., Ph.D. We report a case of a patient with nonischemic dilated cardiomyopathy and implantable cardioverter-defibrillator, in whom an upgrade to biventricular pacing triggered multiple episodes of ventricular tachycardias (VTs) of two morphologies. First VT presented as repetitive nonsustained arrhythmia of the same morphology as isolated ectopic beats, suggesting its focal origin. Second VT was reentrant and was triggered by the former ectopy, leading to a therapy from the device. Electroanatomical mapping of the left ventricle revealed relatively small low voltage area in the left ventricular outflow tract and identified both an arrhythmogenic focus as well as critical isthmus for reentrant VT. Radiofrequency catheter ablation successfully abolished both VTs. After the procedure, biventricular pacing was continued without any recurrences during a period of 24 months. The report emphasizes the role of catheter ablation in management of VTs triggered by cardiac resynchronization therapy. [source] Successful Catheter Ablation of Reentrant Junctional Tachycardia in a Patient with Asplenia Syndrome before Total Cavo-Pulmonary ConnectionPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2010KEIKO TOYOHARA M.D. Asplenia syndrome is commonly associated with complex structural cardiac malformations, and junctional tachycardia (JT), which may compromise hemodynamic status, has been reported in association with asplenia syndrome.1,We report successful radiofrequency catheter ablation of reentrant JT in a patient with asplenia syndrome. (PACE 2010; e43,e45) [source] Successful Radiofrequency Catheter Ablation of Ventricular Tachycardia Originating from Underneath the Mechanical Prosthetic Aortic ValvePACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2008TAKUMI YAMADA M.D. A 67-year-old man who developed sustained ventricular tachycardia (VT) 4 years after a prosthetic aortic valve replacement, underwent electrophysiologic testing and catheter ablation. The mechanism of the VT was suggested to be triggered activity because the VT could be induced by programmed ventricular stimulation, and burst ventricular pacing demonstrated overdrive suppression without a transient entrainment. Successful catheter ablation using a transseptal approach was achieved underneath the mechanical prosthetic aortic valve on the blind side for that approach. This case demonstrated that catheter mapping and ablation of the entire LV using a transseptal approach might be possible. [source] Idiopathic Left Ventricular Arrhythmias Originating Adjacent to the Left Aortic Sinus of Valsalva: Electrophysiological Rationale for the Surface ElectrocardiogramJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2010TAKUMI YAMADA M.D. IVT Arising Adjacent to the Left Sinus of Valsalva.Background: Idiopathic ventricular arrhythmias (VAs) may be amenable to catheter ablation within or adjacent to the left sinus of Valsalva (LSOV). However, features that discriminate these sites have not been defined. The purpose of this study was to determine the electrocardiographic and electrophysiological features of VAs originating within or adjacent to the LSOV. Methods and Results: We studied 48 consecutive patients undergoing successful catheter ablation of idiopathic VAs originating from the left coronary cusp (LCC, n = 29), aortomitral continuity (AMC, n = 10) and great cardiac vein or anterior interventricular cardiac vein (Epi, n = 9). A small r wave, or rarely an R wave, was typically observed in lead I during the VAs and pacing in these regions. An S wave in lead V5 or V6 occurred significantly more often during both the VAs and pacing from the AMC than during that from the LCC and Epi (p < 0.05 to 0.0001). For discriminating whether VA origins can be ablated endocardially or epicardially, the maximum deflection index (MDI = the shortest time to the maximum deflection in any precordial lead/QRS duration) was reliable for VAs arising from the AMC (100%), but was less reliable for LCC (73%) and Epi (67%) VAs. In 3 (33%) of the Epi VAs, the site of an excellent pace map was located transmurally opposite to the successful ablation site (LCC = 1 and AMC = 2). Conclusions: The MDI has limited value for discriminating endocardial from epicardial VA origins in sites adjacent to the LSOV probably due to preferential conduction, intramural VA origins or myocardium in contact with the LCC. (J Cardiovasc Electrophysiol, Vol. 21, pp. 170-176, February 2010) [source] Catheter Ablation of Atrial Fibrillation Versus Atrioventricular Junction Ablation Plus Pacing Therapy for Elderly Patients with Medically Refractory Paroxysmal Atrial FibrillationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 5 2005MING-HSIUNG HSIEH M.D. Background: Catheter ablation of atrial fibrillation (AF) has become another nonpharmacologic therapeutic option for medically refractory paroxysmal AF. Whether this method is better than atrioventricular (AV) junction ablation plus pacing therapy is unknown. The purpose of this study was to compare the very long-term (longer than 4 years) clinical outcomes of the 2 methods in elderly patients (>65 years old) with medically refractory paroxysmal AF. Methods: From January 1995 to December 2001, 71 elderly patients with medically refractory paroxysmal AF were included; group 1 included 32 patients with successful AV junction ablation plus pacing therapy and group 2, 37 patients with successful catheter ablation of AF. Results: After a mean follow-up of more than 52 months, the AF was better controlled in the group 1 patients than group 2 (100% vs 81%, P = 0.013), however, they had a significantly higher incidence of persistent AF (69% vs 8%, P < 0.001) and heart failure (53% vs 24%, P = 0.001). Furthermore, the incidence of ischemic stroke and cardiac death was similar between the 2 groups. Compared with the preablation values, a significant increase in the NYHA functional class (1.7 ± 0.9 vs 1.4 ± 0.7, P = 0.01) and significant decrease in the left ventricular ejection fraction (44 ± 8% vs 51 ± 10%, P = 0.01) were noted in the group 1 patients, but not in the group 2 patients. Conclusions: Although AV junction ablation plus pacing therapy better controlled the AF in elderly patients with medically refractory paroxysmal AF, that method was associated with a higher incidence of persistent AF and heart failure than catheter ablation of AF in the very long-term follow-up. [source] |