Document Detail

Catheter ablation of scar-related ventricular tachycardia in patients with electrical storm using remote magnetic catheter navigation.
MedLine Citation:
PMID:  20723092     Owner:  NLM     Status:  In-Process    
BACKGROUND: A remote magnetic navigation system (MNS) has been used for ablation of ventricular arrhythmias. However, irrigated tip catheter has not been evaluated in large series of patients.
OBJECTIVE: To evaluate acute and long-term efficiency of the newly available irrigated tip magnetic catheter for radiofrequency (RF) ablation of scar-related ventricular tachycardia (VT) in patients with ischemic heart disease.
METHODS: Between January 2008 and October 2009, a total of 30 consecutive patients with ischemic heart disease (26 men, age 70.1 ± 8.7 years, left ventricular ejection fraction: 30 ± 9%) and electrical storm due to monomorphic VT underwent RF ablation using a remote MNS and a magnetic irrigated tip catheter.
RESULTS: Acute success was defined as noninducibility of any monomorphic VT during programmed right and left ventricular stimulation, and obtained in 24 (80%) patients. A total of 1-6 VTs (mean 2.3 ± 1.2, 394 ± 108 ms, 210-660 ms) were inducible during each procedure. The duration of RF energy application was 41.2 ± 23.3 minutes, with total procedure and fluoroscopy times of 158 ± 47 minutes and 9.8 ± 5.3 minutes, respectively. No acute complications were observed during the procedures. During mean follow-up of 7.8 months, 21 patients (70%) had no recurrence of VT and received no implantable cardioverter defibrillator therapy. Among patients who were noninducible during programmed right ventricular stimulation (n = 25), ≥1 monomorphic VT was inducible during programmed left ventricular stimulation in four (16%) that was ablated successfully in three of them.
CONCLUSIONS: Irrigated ablation of scar-related VT using remote MNS is an effective modality for management of the monomorphic VT in patients with ischemic cardiomyopathy with minimal radiation exposure. Programmed left (in addition to right) ventricular stimulation might be necessary to assess acute outcome of the ablation procedure.
Arash Arya; Charlote Eitel; Andreas Bollmann; Ulrike Wetzel; Phillipp Sommer; Thomas Gaspar; Daniella Husser; Christopher Piorkowski; Gerhard Hindricks
Publication Detail:
Type:  Journal Article     Date:  2010-08-17
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1312-8     Citation Subset:  IM    
Copyright Information:
©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Department of Electrophysiology, University of Leipzig, Heart Center, Leipzig, Germany.
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