Long-term outcomes after catheter ablation of ventricular tachycardia in patients with and without structural heart disease

Kumar, Saurabh; Romero, Jorge; Mehta, Nishaki; Fujii, Akiko; Kapur, Sunil; Baldinger, Samuel H.; Barbhaiya, Chirag R.; Koplan, Bruce A.; John, Roy M.; Epstein, Laurence M.; Michaud, Gregory F.; Tedrow, Usha B.; Stevenson, William G.

doi:10.1016/j.hrthm.2016.07.001

Cited by 132 publications

(81 citation statements)

References 23 publications

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“…This acute electrical stabilization of infarct border zones provides an insight into the antiarrhythmic mechanisms of VNS and has important implications for patients with ischemic cardiomyopathy who suffer from refractory VT and defibrillator shock weeks to years after the initial insult. Approximately 30% of patients with cardiomyopathy and defibrillator shocks continue to experience recurrent arrhythmias despite medical therapy and catheter ablation procedures, presenting a dilemma for clinical electrophysiologists (11)(12)(13)41). VNS represents a potential therapeutic option that can be used far after occurrence of MI and can acutely reduce burden of these arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

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Parasympathetic dysfunction and antiarrhythmic effect of vagal nerve stimulation following myocardial infarction

Vaseghi¹,

Salavatian²,

Rajendran³

et al. 2017

JCI Insight

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Section: Discussionmentioning

confidence: 99%

“…Implications of this therapy are critical for the many patients with heart failure who experience recurrent internal, cardiac defibrillator shocks due to VT, despite catheter ablation and medical therapies (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Parasympathetic dysfunction and antiarrhythmic effect of vagal nerve stimulation following myocardial infarction

Vaseghi¹,

Salavatian²,

Rajendran³

et al. 2017

JCI Insight

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“…However, efficacy of this treatment is limited [6,7]. In our study recurrence of ventricular tachyarrhythmias in seven patients with history of RFA before treatment with mexiletine occurred after an average of five months (range from one to 16 months).…”

Section: Discussionmentioning

confidence: 68%

Efficacy and tolerability of mexiletine treatment in patients with recurrent ventricular tachyarrhythmias and implantable cardioverter-defibrillator shocks

Sobiech¹,

Lewandowski²,

Zając³

et al. 2017

Kardiol Pol

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A b s t r a c tBackground: Antiarrhythmic treatment of patients with recurrent ventricular tachyarrhythmia, in whom catheter ablation and amiodarone treatment were ineffective or contraindicated, is an unsolved clinical problem. Aim:The study aims to evaluate the efficacy and tolerability of mexiletine in patients with recurrent ventricular tachyarrhythmias and/or electrical storm events, in whom standard treatment strategies failed to prevent ventricular tachyarrhythmia. Methods:We performed a retrospective cohort analysis of all patients treated with mexiletine for recurrent ventricular tachycardia and/or ventricular fibrillation in our institution between January 2011 and September 2015. The primary endpoints were total number of electrical storm events and ventricular tachycardia/ventricular fibrillation (VT/VF) episodes after the beginning of mexiletine therapy. Secondary endpoints were total number of implantable cardioverter-defibrillator (ICD) therapies and discontinuation of the therapy. Events were compared with a matched duration period before initiating mexiletine. Patients served as self-controls.Results: Seventeen patients were included in the study; 11 patients were males. Mean age was 64.2 ± 15.4 years. The median time of mexiletine treatment was eight months (interquartile range [IR]: 1-22 months). The mexiletine dose was 600 mg/day in 13 patients and 400 mg/day in four patients. In four patients the dose was modified during treatment in a range from 400 to 600 mg/day depending on clinical decision. Treatment with mexiletine significantly reduced the number of electrical storm events (14 episodes Conclusions:Mexiletine was a sufficiently tolerated antiarrhythmic drug in short-term treatment of ventricular tachyarrhythmias in the studied population. Mexiletine may be effective in the treatment of recurring ventricular tachyarrhythmias or electrical storm events.

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“…Saline‐irrigated catheters create deeper and larger ablation lesions than nonirrigated catheters and improve the outcome of RFA 4. However, despite the use of open‐irrigated ablation catheters, creating transmural ablation lesions is difficult, and the management of VTs in patients with NICM is still challenging 5, 6, 7, 8, 9…”

Section: Introductionmentioning

confidence: 99%

Pathology after a combination of sequential and simultaneous unipolar radiofrequency ablation of ventricular tachycardia in a postmortem heart with cardiac sarcoidosis

Miyamoto

Matsuyama

Noda

et al. 2018

Clinical Case Reports

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Key Clinical MessageThis report shows a postmortem examination of a heart performed in a patient with cardiac sarcoidosis undergoing a sequential and simultaneous unipolar radiofrequency ablation. A combination of a sequential and simultaneous unipolar radiofrequency ablation might be useful for creating transmural ablation lesions on the interventricular septum in patients with cardiac sarcoidosis.

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Long-term outcomes after catheter ablation of ventricular tachycardia in patients with and without structural heart disease

Cited by 132 publications

References 23 publications

Parasympathetic dysfunction and antiarrhythmic effect of vagal nerve stimulation following myocardial infarction

Parasympathetic dysfunction and antiarrhythmic effect of vagal nerve stimulation following myocardial infarction

Efficacy and tolerability of mexiletine treatment in patients with recurrent ventricular tachyarrhythmias and implantable cardioverter-defibrillator shocks

Pathology after a combination of sequential and simultaneous unipolar radiofrequency ablation of ventricular tachycardia in a postmortem heart with cardiac sarcoidosis

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