Document Detail


Substrate Mapping and Ablation for Ventricular Tachycardia: The LAVA approach.
MedLine Citation:
PMID:  25328104     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Catheter ablation of ventricular tachycardia (VT) is proven effective therapy particularly in patients with frequent defibrillator shocks. However, the optimal endpoint for VT ablation has been debated and additional endpoints have been proposed. At the same time, ablation strategies aiming at homogenizing the substrate of scar related VT have been reported. Our method to homogenize the substrate consists of local abnormal ventricular activity (LAVA) elimination. LAVA are high frequency sharp signals that represent near-field signals of slowly conducting tissue and hence potential VT isthmuses. Pacing maneuvers are sometimes required to differentiate them from far-field signals. Delayed enhancement on cardiac MRI and/or wall thinning on Multi-Detector Computed Tomography are also extremely helpful to identify the areas of interest during ablation A strategy aiming at careful LAVA mapping, ablation and elimination is feasible and can be achieved in about 70% of patients with scar related VT. Complete LAVA elimination is associated with a better outcome when compared to LAVA persistence even when VT is rendered non-inducible. This is a simple approach, with a clear endpoint and the ability to ablate in sinus rhythm. This strategy significantly benefits from high definition imaging, mapping, and epicardial access. This article is protected by copyright. All rights reserved.
Authors:
Frederic Sacher; Han S Lim; Nicolas Derval; Arnaud Denis; Benjamin Berte; Seigo Yamashita; Meleze Hocini; Michel Haissaguerre; Pierre Jaïs
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-18
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-20     Completed Date:  -     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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