Document Detail


Catheter ablation of stable and unstable ventricular tachycardias in patients with arrhythmogenic right ventricular dysplasia.
MedLine Citation:
PMID:  16684016     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: A reentrant circuit within an area of abnormal myocardium is suspected as the origin of ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular dysplasia (ARVD). OBJECTIVES: To examine the relationship between the reentrant circuits of VT and the abnormal electrograms in ARVD, and to assess the feasibility of a block line formation in the reentrant circuit isthmus utilizing electroanatomical mapping system (CARTO) guidance. METHODS AND RESULTS: An electrophysiological study and catheter ablation (CA) were performed in 17 ARVD patients (13 men, 47 +/- 17 year) using CARTO. Endocardial mapping during sinus rhythm demonstrated electrogram abnormalities extended from the tricuspid annulus (TA) or the right ventricular outflow tract in 16 of 17 patients. In 13 hemodynamically stable VTs, the reentrant circuits and critical slow conduction sites for the CA were investigated during VTs. The entire macro-reentrant pathway was identified in 6/13 stable VTs (figure-of-8 in 4, single loop in 2). In the remaining seven VTs, a focal activation pattern was found in four and an unidentifiable pattern in three. CA successfully abolished all the macro-reentrant and focal tachycardias, however, not effective in three unidentifiable VTs. In the 13 cases with unstable VT, the linear conduction block zone was produced between the sites with abnormal electrograms and the TA. Ultimately, 23/26 VTs (88%) became noninducible after the CA. During follow-up (26 +/- 15 months), 13/17 patients remained free from any VT episodes. CONCLUSIONS: CARTO is useful for characterizing the anatomical and electrophysiological substrates, and for identifying the optimal ablation sites for VT associated with ARVD.
Authors:
Kazuhiro Satomi; Takashi Kurita; Kazuhiro Suyama; Takashi Noda; Hideo Okamura; Kiyoshi Otomo; Wataru Shimizu; Naohiko Aihara; Shiro Kamakura
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  17     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-10     Completed Date:  2006-10-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  469-76     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan. VYW02402@nifty.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arrhythmogenic Right Ventricular Dysplasia / diagnosis*,  surgery*
Body Surface Potential Mapping / methods*
Catheter Ablation / methods*
Feasibility Studies
Female
Humans
Imaging, Three-Dimensional / methods
Male
Middle Aged
Prognosis
Surgery, Computer-Assisted / methods*
Tachycardia, Ventricular / complications,  diagnosis*,  surgery*
Treatment Outcome
Comments/Corrections
Comment In:
J Cardiovasc Electrophysiol. 2006 May;17(5):477-9   [PMID:  16684017 ]

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


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