Long-term outcome of catheter ablation for left posterior fascicular ventricular tachycardia with the development of left posterior fascicular block and characteristics of repeat procedures

Luo, Baoming; Zhou, Gong‐Bu; Guo, Xiaogang; Liu, Xu; Yang, Jian‐Du; Sun, Qi; Ma, Jun; Zhang, Shu

doi:10.1016/j.ijcard.2017.01.152

Cited by 12 publications

(16 citation statements)

References 18 publications

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“…Twenty-five patients were male, and eight were female. The mean weight of the patients was 39.6 ± 10.4 kg (22-86), and the mean age was 13.6 ± 2.5 years (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The indication for ablation was decreased left ventricular systolic function, revealed by echocardiography (EF: 45%) in one patient due to incessant fascicular tachycardia.…”

Section: Resultsmentioning

confidence: 99%

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Transcatheter radiofrequency ablation using near-zero fluoroscopy in children with fascicular ventricular tachycardia: a single-centre experience

2020

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Objective:Fascicular tachycardia is a common form of sustained idiopathic left ventricular tachycardia. This study aimed to achieve successful results with catheter ablation procedures performed through three-dimensional electroanatomic mapping using near-zero fluoroscopy in fascicular tachycardia patients.Methods and results:In this study, we included 33 consecutive children with fascicular tachycardia, for whom we performed a transcatheter radiofrequency ablation procedure using the EnSite® system. Activation mapping was performed in all patients during tachycardia, and the earliest presystolic purkinje potentials were the target site for radiofrequency lesions.Results:Twenty-five patients were male, and eight were female. The mean weight of the patients was 39.6 ± 10.4 kg, and the mean age was 13.6 ± 2.5 years. The mean procedure time was 121.3 ± 44.3 minutes. The mean follow-up period was 18.4 ± 6.5 months. No fluoroscopy was needed in 30 patients. The mean fluoroscopy time in the remaining patients was 166.6 ± 80 seconds. All of the patients had left posterior fascicular tachycardia except for one who had left anterior fascicular tachycardia. The acute success rate was perfect (100%). No patients developed left bundle branch block or complete atrioventricular block. Recurrence developed in one patient.Conclusion:We suggest that radiofrequency ablations via an electroanatomic mapping system are quite safe and effective, with high success rates in paediatric patients with fascicular tachycardia. This method has the advantage of avoiding ionising radiation exposure for both the patient and operator, thus reducing the lifetime risk of malignancy in the paediatric population.

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Section: Resultsmentioning

confidence: 99%

“…However, these techniques are associated with lower success rates and higher recurrence rates when compared to those performed during tachycardia. 10,[14][15][16] In our study, we tried to map the earliest fascicular and purkinje potentials during ventricular tachycardia. Fascicular entrainment was also performed whenever possible.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter radiofrequency ablation using near-zero fluoroscopy in children with fascicular ventricular tachycardia: a single-centre experience

2020

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“…14 Similarly, there have been adult population studies reporting that an ablation based on the Purkinje potentials performed by creating a left posterior fascicular block in the sinus rhythm is reliable and that a correction of the left posterior fascicular block during the follow-up is associated with a recurrence. 15 However, in another study evaluating 117 patients, it was reported that the development of a new left posterior fascicular block did not decrease the recurrence, and it was associated with basal ablation, which is riskier. 11 Further studies are needed regarding this issue, especially in children.…”

Section: Discussionmentioning

confidence: 96%

Catheter ablation of left posterior fascicular ventricular tachycardia in children with limited fluoroscopy exposure

et al. 2019

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Introduction:Catheter ablation of left posterior fascicular ventricular tachycardia in the pediatric population remains challenging, and most studies about this topic have been conducted on adult patients. This study aimed to assess the clinical presentation features and outcomes of catheter ablations performed using limited fluoroscopy with three-dimensional electroanatomic mapping system guidance in a pediatric left posterior fascicular ventricular tachycardia patient group.Methods:A total of 20 consecutive patients undergoing left posterior fascicular ventricular tachycardia ablation at a single tertiary centre were enrolled. All children with left posterior fascicular ventricular tachycardia underwent electrophysiological studies using the EnSite NavX system guidance. Ablations were performed during the sinus rhythm based on the Purkinje potentials in all patients.Results:The mean patient age was 12.7 years (range 2–16), and the mean patient weight was 51 kg (range 11–84). The mean procedure and median fluoroscopy times were 143.1 minutes and 3.4 minutes, respectively. No fluoroscopy was used in three patients. Acute success was achieved in 19 patients (95%). During a mean follow-up of 38.6 ± 19.35 months, left posterior fascicular ventricular tachycardia recurred in four patients (20%). Repeat ablations were performed successfully in those patients who developed recurrences. No complications were seen.Conclusions:Catheter ablation of left posterior fascicular ventricular tachycardia in children can be performed safely and effectively with low fluoroscopy exposure using a three-dimensional electroanatomic mapping system.

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“…18,19 Conversely, ablation of LPF area was reported to produce LPF block. 20 Table 1. All patients had standard indications for pacemaker implantation (two patients received implantable cardioverterdefibrillator).…”

Section: Introductionmentioning

confidence: 99%

“…In particular, a left anterior fascicular block (LAFB) pattern has been noted when pacemapping the left posterior fascicle (LPF) area 18,19 . Conversely, ablation of LPF area was reported to produce LPF block 20 . Therefore, it is possible that pacing from different parts of the atrioventricular (AV) septum may result in variable electrocardiographic characteristics due to preferential recruitment of alternative conduction fibers.…”

Section: Introductionmentioning

confidence: 99%

His bundle pacing insights from electroanatomical mapping: Topography and pacing targets

Orlov

Jahangir

McKelvey

et al. 2020

Cardiovasc electrophysiol

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Long-term outcome of catheter ablation for left posterior fascicular ventricular tachycardia with the development of left posterior fascicular block and characteristics of repeat procedures

Cited by 12 publications

References 18 publications

Transcatheter radiofrequency ablation using near-zero fluoroscopy in children with fascicular ventricular tachycardia: a single-centre experience

Transcatheter radiofrequency ablation using near-zero fluoroscopy in children with fascicular ventricular tachycardia: a single-centre experience

Catheter ablation of left posterior fascicular ventricular tachycardia in children with limited fluoroscopy exposure

His bundle pacing insights from electroanatomical mapping: Topography and pacing targets

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