Mapping and Ablation of Idiopathic Ventricular Fibrillation

Cheniti, Ghassen; Vlachos, Konstantinos; Meo, Marianna; Puyo, Stéphane; Thompson, Nathaniel; Denis, Arnaud; Duchâteau, Josselin; Takigawa, Masateru; Martin, Claire; Frontera, Antonio; Kitamura, Τakeshi; Lam, Anna; Bourier, Félix; Klotz, Nicolas; Derval, Nicolas; Sacher, Frédéric; Jaı̈s, Pierre; Dubois, Rémi; Hocini, Mélèze; Haı̈ssaguerre, Michel

doi:10.3389/fcvm.2018.00123

Cited by 28 publications

(14 citation statements)

References 73 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In VF patients with ischemic heart disease, non-ischemic cardiomyopathies, valvulopathies, amyloidosis, long QT syndromes and IVF, short-coupling triggering ventricular premature beats originating from the Purkinje system were identified and ablated (Cheniti et al, 2018;Singh and Noheria, 2018). In 2011, successful epicardial ablations of premature beats of the right ventricular outflow tract (RVOT) were published in patients with BrS.…”

Section: Ablation Of Vf Triggers and Substratesmentioning

confidence: 99%

Handling of Ventricular Fibrillation in the Emergency Setting

et al. 2020

View full text Add to dashboard Cite

Ventricular fibrillation (VF) and sudden cardiac death (SCD) are predominantly caused by channelopathies and cardiomyopathies in youngsters and coronary heart disease in the elderly. Temporary factors, e.g., electrolyte imbalance, drug interactions, and substance abuses may play an additive role in arrhythmogenesis. Ectopic automaticity, triggered activity, and reentry mechanisms are known as important electrophysiological substrates for VF determining the antiarrhythmic therapies at the same time. Emergency need for electrical cardioversion is supported by the fact that every minute without defibrillation decreases survival rates by approximately 7%-10%. Thus, early defibrillation is an essential part of antiarrhythmic emergency management. Drug therapy has its relevance rather in the prevention of sudden cardiac death, where early recognition and treatment of the underlying disease has significant importance. Cardioprotective and antiarrhythmic effects of beta blockers in patients predisposed to sudden cardiac death were highlighted in numerous studies, hence nowadays these drugs are considered to be the cornerstones of the prevention and treatment of life-threatening ventricular arrhythmias. Nevertheless, other medical therapies have not been proven to be useful in the prevention of VF. Although amiodarone has shown positive results occasionally, this was not demonstrated to be consistent. Furthermore, the potential proarrhythmic effects of drugs may also limit their applicability. Based on these unfavorable observations we highlight the importance of arrhythmia prevention, where echocardiography, electrocardiography and laboratory testing play a significant role even in the emergency setting. In the following we provide a summary on the latest developments on cardiopulmonary resuscitation, and the evaluation and preventive treatment possibilities of patients with increased susceptibility to VF and SCD.

show abstract

Section: Ablation Of Vf Triggers and Substratesmentioning

confidence: 99%

Handling of Ventricular Fibrillation in the Emergency Setting

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Accordingly, removing the trigger by ablation of regions showing Purkinje activity reduces recurrence of ventricular fibrillation in the majority of patients ( Haissaguerre et al, 2002 ; Bänsch et al, 2003 ; Bogun et al, 2006 ). The treatment, however, is intriguing because “pruning” of sites with Purkinje spikes around the target area adds to the success ( Cheniti et al, 2018 ; Haïssaguerre et al, 2020 ). Therefore, we provide an alternative hypothesis stating that ablation of Purkinje fibers prevents arrhythmia reoccurrence by reducing the amount of Purkinje tissue and not, or not only, by removing the trigger.…”

Section: Introductionmentioning

confidence: 99%

Why Ablation of Sites With Purkinje Activation Is Antiarrhythmic: The Interplay Between Fast Activation and Arrhythmogenesis

et al. 2021

Self Cite

View full text Add to dashboard Cite

Ablation of sites showing Purkinje activity is antiarrhythmic in some patients with idiopathic ventricular fibrillation (iVF). The mechanism for the therapeutic success of ablation is not fully understood. We propose that deeper penetrance of the Purkinje network allows faster activation of the ventricles and is proarrhythmic in the presence of steep repolarization gradients. Reduction of Purkinje penetrance, or its indirect reducing effect on apparent propagation velocity may be a therapeutic target in patients with iVF.

show abstract

“…Idiopathic ventricular fibrillation (IVF) is a leading cause of unexplained sudden cardiac death (SCD) in the absence of structural heart disease, particularly in young adults 1 . Current guidelines define IVF as a diagnosis of exclusion in patients who have survived a VF episode without any identifiable structural or metabolic cause, as assessed by clinical evaluation of known cardiac, respiratory, metabolic and toxicological etiologies that may lead to cardiac arrest 2 .…”

Section: Introductionmentioning

confidence: 99%

“…It evolves, in most cases, to VF causing SCD. Most scTdP originate from Purkinje fibres 1 , 4 , 6 , 8 , 9 . In the first reported series of 14 patients, 30% of scTdP patients had a family history of sudden death, suggesting a genetic susceptibility to this pathology 10 .…”

Section: Introductionmentioning

confidence: 99%

A SPRY1 domain cardiac ryanodine receptor variant associated with short-coupled torsade de pointes

Touat-Hamici

Blancard

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Idiopathic ventricular fibrillation (IVF) causes sudden death in young adult patients without structural or ischemic heart disease. Most IVF cases are sporadic and some patients present with short-coupled torsade de pointes, the genetics of which are poorly understood. A man who had a first syncope at the age of 35 presented with frequent short-coupled premature ventricular beats with bursts of polymorphic ventricular tachycardia and then died suddenly. By exome sequencing, we identified three rare variants: p.I784F in the SPRY1 of the ryanodine receptor 2 (RyR2), p.A96S in connexin 40 (Cx40), reported to affect electrical coupling and cardiac conduction, and a nonsense p.R244X in the cardiac-specific troponin I-interacting kinase (TNNI3K). We assessed intracellular Ca2+ handling in WT and mutant human RYR2 transfected HEK293 cells by fluorescent microscopy and an enhanced store overload-induced Ca2+ release in response to cytosolic Ca2+ was observed in RyR2-I784F cells. In addition, crystal structures and thermal melting temperatures revealed a conformational change in the I784F-SPRY1 domain compared to the WT-domain. The novel RyR2-I784F variant in SPRY1 domain causes a leaky channel under non-stress conditions. The presence of several variants affecting Ca2+ handling and cardiac conduction suggests a possible oligogenic origin for the ectopies originating from Purkinje fibres.

show abstract

Mapping and Ablation of Idiopathic Ventricular Fibrillation

Cited by 28 publications

References 73 publications

Handling of Ventricular Fibrillation in the Emergency Setting

Handling of Ventricular Fibrillation in the Emergency Setting

Why Ablation of Sites With Purkinje Activation Is Antiarrhythmic: The Interplay Between Fast Activation and Arrhythmogenesis

A SPRY1 domain cardiac ryanodine receptor variant associated with short-coupled torsade de pointes

Contact Info

Product

Resources

About