Document Detail


Catheter ablation of haemodynamically unstable or non-sustained ventricular tachycardia.
MedLine Citation:
PMID:  17536605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ventricular tachycardia (VT) may be haemodynamically unstable or non-sustained, interfering with detailed activation mapping. Non-contact mapping permits beat-by-beat analysis of VT, projected upon a 3-dimensional reconstructed geometry of the cardiac chamber. Objective - The aim of the present study is to determine the utility of non-contact endocardial mapping to guide ablation of haemodynamically unstable VT or non-sustained VT. METHODS AND RESULTS: Eighteen VTs in 17 patients were induced (cycle length 336 +/- 58 ms) and mapped. Three patients were mapped during premature ventricular complexes (PVCs) because sustained VT could not be induced. Analysis of the archived non-contact activation maps was performed to identify the exit point and/or the diastolic pathway of theVT reentry circuit. The endocardial exit points (10 +/- 16 ms before QRS) were defined in 17/18 VTs (94%). A diastolic pathway was identified in 5/6 ischaemic VTs. The earliest activation sites were identified in all 3 patients with PVCs. Radiofrequency current was applied around the exit point or to create a line of block across the diastolic pathway. Catheter ablation was performed in 17/18 VTs, including 3 patients mapped using only PVCs. Ablation was successful in 16/18 VTs (89%) and in 1 5/17 patients (82%). Catheter ablation was not performed in one patient (peri-hisian VT) and was unsuccessful in one patient (mapped during PVCs). CONCLUSIONS: Non-contact endocardial mapping is useful to guide radiofrequency catheter ablation of untolerated or non-sustained VTs.
Authors:
Suhua Wu; Walter F Kerwin; C Thomas Peter; Eli S Gang; Hong Ma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  62     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-05-31     Completed Date:  2007-10-02     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  163-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan road 2, GuangZhou 510080, China. wusuhua168@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Body Surface Potential Mapping
Catheter Ablation*
Diastole
Electrodes, Implanted
Electrophysiologic Techniques, Cardiac
Endocardium / physiopathology,  surgery
Female
Heart Conduction System / physiopathology,  surgery
Humans
Male
Middle Aged
Research Design
Signal Processing, Computer-Assisted
Tachycardia, Ventricular / physiopathology*,  surgery*
Treatment Outcome
Ventricular Premature Complexes / physiopathology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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