Document Detail


Thermal mapping of right ventricular outflow tract tachycardia.
MedLine Citation:
PMID:  17367353     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute and long-term success of catheter ablation of right ventricular outflow tract tachycardia (RVOT VT) may be limited by the inability to reproduce the arrhythmia at the time of activation (AM) and pace mapping (PM). We have observed early initiation of the clinical VT when subtherapeutic radiofrequency (RF) energy was applied to the target area (TA), defined as a 2-cm(2) area around a pace match. We describe a novel approach using thermal mapping (TM) to guide the ablation of RVOT VT. METHODS: Thirteen patients (10 female, mean age 46.2 +/- 13.7 years) with symptomatic VT of left bundle branch block (LBBB) inferior axis morphology and no structural heart disease underwent standard electrophysiologic evaluation with PM (n = 13), AM (n = 13), and 3D noncontact mapping (n = 4). Thermal mapping was performed after standard techniques failed to induce stable sustained VT for mapping in all 13 patients: RF was applied for 5-10 seconds in the TA to achieve a tip temperature of 45-50 degrees C. At sites where morphologically consistent with the clinical VT was induced, RF was applied at target temperature between 50 and 60 degrees C for 30-60 seconds. TM was repeated before and after intravenous Isoproterenol infusion until no further VT could be induced by low temperature application. RESULTS: Noninducibility was achieved in all 13 patients. During a mean follow-up of 29 months (9-69 months), all patients remain arrhythmia-free, off antiarrhythmic medications. CONCLUSION: Thermal mapping is a safe and effective adjunctive technique for the mapping and ablation of RVOT VT when sustained tolerated clinical VT cannot be induced.
Authors:
Christopher A Clyne; Haris Athar; Anuj Shah; Rosemarie Kahr; Angel Rentas
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  30     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-19     Completed Date:  2007-05-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  343-51     Citation Subset:  IM    
Affiliation:
Henry Low Heart Center at Hartford Hospital, and University of Connecticut School of Medicine, Hartford, Connecticut, USA. CAClyne@harthosp.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Body Surface Potential Mapping / methods*
Catheter Ablation / methods*
Female
Humans
Male
Middle Aged
Tachycardia, Ventricular / complications,  diagnosis*,  surgery*
Thermography / methods*
Treatment Outcome
Ventricular Outflow Obstruction / complications,  diagnosis*,  surgery*

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


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