| Ultra high-density multipolar mapping with double ventricular access: a novel technique for ablation of ventricular tachycardia. | |
| | |
MedLine Citation:
|
PMID: 20653813 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
Ultra High-Density Multipolar Mapping With Double Ventricular Access. Background: Analogous to the use of circular loop catheters to guide ablation around the pulmonary veins, it may be advantageous to use a multipolar catheter in the ventricle for rapid mapping and to guide ablation. We describe a technique using double access into the left ventricle for multipolar electroanatomic mapping and ablation of scar-mediated ventricular tachycardia (VT). Methods: Double access into the left ventricle was obtained via transseptal technique. Endocardial mapping was performed via the first transseptal sheath using a steerable duodecapolar catheter. Higher density mapping was performed in areas of dense scar (<0.5 mV) and border zone (0.5-1.5 mV). All late potentials (LPs) observed on the 20 poles were tagged and pacemapping was performed at these sites for comparison with the clinical or induced VT 12-lead template. If VT was hemodynamically tolerated, entrainment mapping was attempted at sites demonstrating diastolic activity. Ablation was performed through the second transseptal sheath with an open-irrigated catheter at target sites identified by LPs, pacemapping, and/or entrainment on the duodecapolar catheter. Results: Seventeen patients (88% ischemic cardiomyopathy) underwent electroanatomic mapping and ablation with double transseptal access. The mean number of endocardial mapping points was 819 ± 357 with an average mapping time of 31 ± 7 minutes. The mean number of VTs induced was 2.8 ± 1.6, mean cycle length 418 ms ± 101. LPs were seen in all patients during endocardial mapping with the duodecapolar catheter. Good (56%) and perfect (44%) pacemaps were seen in all patients when performed. Concealed entrainment, guided by the earliest diastolic activity seen on the duodecapolar catheter, was demonstrated in 4 patients (24%). Acute success was achieved in 94% of patients with complete success in 47% and partial success in 47%. The intermediate success rate (free of VT recurrence) was 69%, with an average follow-up of 8 ± 3 months. Conclusion: Mapping and ablation of scar-mediated VT using a multipolar catheter results in ultra high-density delineation of the left ventricular substrate. A novel double ventricular access strategy has the potential to facilitate identification of LPs, pacemapping, and entrainment mapping. (J Cardiovasc Electrophysiol, Vol. 22, pp. 49-56, January 2011). |
| | |
Authors:
|
Roderick Tung; Shiro Nakahara; Giuseppe Maccabelli; Eric Buch; Isaac Wiener; Noel G Boyle; Corrado Carbucicchio; Paolo Della Bella; Kalyanam Shivkumar |
Related Documents
:
|
10962753 - Percutaneous electrocatheter technique for on-line detection of healed transmural myoca... 9732893 - Influence of guidewire and catheter type on the frequency of cerebral microembolic sign... 23530553 - Assessment tools for unrecognized myocardial infarction: a cross-sectional analysis of ... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of cardiovascular electrophysiology Volume: 22 ISSN: 1540-8167 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2011 Jan |
Date Detail:
|
Created Date: 2011-01-17 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
|
Languages: eng Pagination: 49-56 Citation Subset: IM |
Copyright Information:
|
© 2010 Wiley Periodicals, Inc. |
Affiliation:
|
UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA Centro Cardiologico Monzino, Institute of Cardiology of University of Milan, Milan, Italy. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Reversal of tachycardiomyopathy due to left atrial tachycardia by ivabradine.
Next Document: Stroke risk stratification in a "real-world" elderly anticoagulated atrial fibrillation population.