Document Detail


Usefulness of a limited linear ablation of post-myocardial infarction ventricular tachycardia using a standardized approach based on sinus rhythm mapping.
MedLine Citation:
PMID:  20403472     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The ablation of ventricular tachycardia (VT) can be achieved using anatomically guided approaches using differentiated mapping and ablation techniques. The aim of this study was to evaluate the efficacy of limited linear ablation in the VT exit region identified during sinus rhythm mapping alone. One hundred fifteen consecutive patients presenting for ablation of post-myocardial infarction VT were included. After induction of the target VT during invasive electrophysiology, left ventricular substrate mapping during sinus rhythm to identify scar and border zone on the basis of endocardial bipolar voltage was performed. The exit site of the target VT was regionalized by a simplified vector pace mapping approach and targeted using limited linear ablation within the scar border zone. Seventy-seven percent of all inducible VT was successfully ablated. In 71 patients (62%), no sustained VT was inducible at the end of ablation procedure (complete success). During a median follow-up period of 16 + or - 10 months, 89 patients (77%) had no documented sustained ventricular arrhythmia. Seven patients (2%) had recurrences of the initially ablated VT, and 16 (14%) had new-onset VT. Patients with complete success had a significantly lower number of ventricular arrhythmia reoccurrences than patients with incomplete ablation success (11% vs 37%, p = 0.002). In conclusion, postinfarct VT was effectively ablated in 97% of patients without mapping during ongoing VT using a simplified regional linear ablation approach targeting the scar border zone. Freedom from any ventricular arrhythmia was achieved in 77% of patients during midterm follow-up.
Authors:
Thomas Deneke; Thomas Lawo; Peter H Grewe; Bernd Calcum; Ricarda Rausse; Leif B?sche; Dong-In Shin; Markus Zarse; Marc Horlitz; Andreas M?gge; Bernd Lemke
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-11
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-06-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1235-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
University Heart Centre Bochum, BG Clinic Bergmannsheil, Ruhr-Universit?t Bochum, Bochum, Germany. thomas.deneke@rub.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Body Surface Potential Mapping / methods,  standards*
Catheter Ablation*
Female
Follow-Up Studies
Heart Rate / physiology*
Humans
Male
Middle Aged
Myocardial Infarction / complications*,  physiopathology
Recurrence
Reproducibility of Results
Retrospective Studies
Tachycardia, Ventricular / diagnosis,  etiology,  surgery*

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


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