Non-fluoroscopic catheter ablation of arrhythmias with origin at the summit of the left ventricle

Rivera, Santiago; Vecchio, Nicolás; Ricapito, Paz; Ayala‐Paredes, Felix

doi:10.1007/s10840-019-00522-1

Cited by 15 publications

(14 citation statements)

References 18 publications

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“…The procedural time was comparable to F-RFCA in each subgroup with a nonsignificant procedural time increase for F-RFCA. Similar observations with assessment of a learning curve were found in a different publications [ 16 ].…”

Section: Discussionsupporting

confidence: 89%

“…Nevertheless, navigation and ablation inside aortic bulb/cusps with hemodynamic/cardio-surgery backup should be considered. Optimally, NF-RFCA in the mentioned region should be facilitated by intracardiac echocardiography [ 16 , 17 ]. We suggest that operators should start training in NF-RFCA using right-sided VA cases from the very beginning.…”

Section: Discussionmentioning

confidence: 99%

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Non-fluoroscopic radiofrequency catheter ablation of right- and left-sided ventricular arrhythmias

Karkowski¹,

Kuniewicz²,

Koźluk³

et al. 2020

pwki

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Introduction Radiofrequency catheter ablation (RFCA) is an important method of treatment of ventricular arrhythmias (VAs). In the majority of RFCA, fluoroscopy is used, exposing patients and medical staff to all related side effects. Current experience of non-fluoroscopic (NF)-RFCA in VAs from the left side is limited. Aim Analysis of safety and effectiveness of NF-RFCA of VAs from left- and right-sided cardiac chambers. Material and methods From 2014 to 2018, a group of 128 patients who underwent RFCA of VAs were retrospectively divided into two groups: NF-RFCA and fluoroscopic (F)-RFCA. Patients in each group were then subsequently subdivided into two groups based on VAs localization – left- (LS-Va) and right-sided (RS-Va) VAs. In all patients the CARTO Biosense Webster mapping system was used. Results In group 1 (NF-RFCA n = 88) 66 (75%) patients underwent RFCA of RS-Va and 22 (25%) of LS-Va. Early success was achieved in 89.8% ( n = 79) and long term success in 81.8% ( n = 72). In group 2 (F-RFCA n = 40) 19 patients (47.5%) had RFCA of RS-Va and 21 (52.5%) patients of LS-Va. Acute procedural success rate was 80% ( n = 32) and long-term success 72.5% ( n = 29). There were 4 (4.6%) perioperative complications in NF-RFCA and 2 (5%) in F-RFCA. Success rate, procedure time and complications were not significantly different between groups and subgroups in follow-up. Conclusions NF-RFCA in VAs from the right and left cardiac chamber is safe and equally effective as F-RFCA, and it should be implemented as often as possible for protection of patients and electrophysiology staff.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Non-fluoroscopic radiofrequency catheter ablation of right- and left-sided ventricular arrhythmias

Karkowski¹,

Kuniewicz²,

Koźluk³

et al. 2020

pwki

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“…Catheter ablation can be performed with significant reduction of radiation exposure or even with zero fluoroscopy [5,6]. Zero fluoroscopy VT ablation is feasible using a combination of electroanatomic systems and ICE and achieving high acute success and low recurrence rates [5,7,8].…”

Section: Strengths Of Ice Imaging In Catheter Ablation Of Ventricular Arrhythmiasmentioning

confidence: 99%

The contribution of intracardiac echocardiography in catheter ablation of ventricular arrhythmias

Asvestas¹,

Xenos²,

Tzeis³

2022

Rev. Cardiovasc. Med.

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Catheter ablation is a well-established treatment option for patients with ventricular arrhythmias. Recent advances in various imaging modalities, including three-dimensional electroanatomic mapping systems, magnetic resonance imaging, transesophageal and intracardiac echocardiography (ICE) have been adopted in catheter ablation of ventricular arrhythmias improving procedural outcome and safety. ICE is an imaging tool which provides real-time visualization of anatomical structures of the heart, facilitating catheter manipulation and navigation during ablation procedures. In this review we aim to highlight the benefits of ICE use in catheter ablation of ventricular arrhythmias and to describe practical techniques for visualization of cardiac structures with ICE during ventricular tachycardia ablations.

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“…The LVS is located at the most superior, septal and epicardial aspects of LV, in close proximity to coronary arteries. The majority of epicardial LVS-VAs origins at the junction of the GCV/AIV or at the proximal AIV [39], where the earliest activation time is recorded. Coronary angiography is mandatory before radiofrequency catheter ablation (RFCA) to assess the distance between the coronary arteries and the ablation catheter: ablation is not recommended within 5 mm of a coronary artery and/or within 10 mm of a coronary ostia [8].…”

Section: Challenging Sites Of Originmentioning

confidence: 99%

Electrocardiographic features, mapping and ablation of idiopathic outflow tract ventricular arrhythmias

Lavalle

Mariani

Piro

et al. 2019

J Interv Card Electrophysiol

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Purpose Idiopathic outflow tract ventricular arrhythmias are ventricular tachycardias or premature ventricular contractions presumably not related to myocardial scar or disorders of ion channels. These arrhythmias have focal origin and display characteristic electrocardiographic features. The purpose of this article is to review the state of the art of diagnosis and treatment of idiopathic outflow tract ventricular arrhythmias. Methods We systematically reviewed scientific literature about idiopathic outflow tract ventricular arrhythmias selecting the most relevant papers on this topic. Results The right ventricle outflow tract is the most common site of origin for outflow tract ventricular arrhythmias, but also left ventricle outflow tract can harbour these arrhythmias. Outflow tract ventricular arrhythmias are generally benign and may require treatment if they are symptomatic, incessant or give rise to cardiomyopathy. Radiofrequency catheter ablation is an effective and safe therapeutic strategy. A successful procedure requires a thorough preoperative analysis of the 12-lead electrocardiogram of the spontaneous arrhythmia combined with a detailed electroanatomical mapping and intracardiac echocardiography. Conclusions Idiopathic outflow tract arrhythmias are frequent in daily clinical practice and can be successfully eliminated through discrete radiofrequency catheter ablation with low rates of complications. Keywords Idiopathic ventricular arrhythmias. Ventricular outflow tract. Catheter ablation. Electrocardiogram Abbreviations OT outflow tract VA ventricular arrhythmia RVOT right ventricle outflow tract LVOT left ventricle outflow tract RFCA radiofrequency catheter ablation PVC premature ventricular contraction LBBB left bundle branch block RBBB right bundle branch block ECG electrocardiogram * Carlo Lavalle

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Non-fluoroscopic catheter ablation of arrhythmias with origin at the summit of the left ventricle

Cited by 15 publications

References 18 publications

Non-fluoroscopic radiofrequency catheter ablation of right- and left-sided ventricular arrhythmias

Non-fluoroscopic radiofrequency catheter ablation of right- and left-sided ventricular arrhythmias

The contribution of intracardiac echocardiography in catheter ablation of ventricular arrhythmias

Electrocardiographic features, mapping and ablation of idiopathic outflow tract ventricular arrhythmias

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