Predictors of Success in Ablation of Scar-Related Ventricular Tachycardia

Ghanem, Mazen T.; Ahmed, R; Moteleb, Ayman Morttada Abd El; Zarif, John K.

doi:10.4137/cmc.s11501

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…Various ablation strategies can be applied to reduce scar-related recurrent VT. Scar homogenization is an important trend to eliminate all abnormal electrograms by extensive and diffuse ablation at the scar ( 3 , 4 ). More extensive and linear ablations of large scar-related ventricular tachycardia are associated with a better success rate and a lower recurrence rate ( 5 ). Biophysical limitations of RF ablation are constituted by the thick ventricular walls with transmural circuits, where, besides the wall thickness, trabeculations and fat act as barriers to effective power delivery into a scar.…”

Section: Introductionmentioning

confidence: 99%

A Novel Laser Energy Ablation Catheter for Endocardial Cavo-Tricuspid Isthmus Ablation and Epicardial Ventricular Lesion Formation: An in vivo Proof-of-Concept Study

Krist¹,

Linz²,

Schotten³

et al. 2022

Front. Med. Technol.

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AimThis proof-of-concept study aimed to investigate atrial and ventricular lesion formation by a 20-mm linear laser ablation catheter, regarding lesion depth and tissue damage.MethodsIn total, 6 female swines underwent standard femoral vein access to introduce a novel 20-mm linear laser ablation catheter in the right atrium to perform endocardial cavotricuspid isthmus (CTI) ablations. The navigation took place under fluoroscopy with additional visualization by intracardiac echocardiograph. Via a sternotomy, epicardial ablations were performed on the surface of the left ventricle (LV), right ventricle (RV), and right atrial appendage (RAA). Procedural safety was assessed by registration of intraprocedural adverse events and by macroscopic examination of the excised hearts for the presence of charring or tissue disruption at the lesion site.ResultsAltogether 39 lesions were created, including 8 endocardial CTI (mean lesion length 20.6 ± 1.65 mm), 26 epicardial ventricle (mean lesion length LV: 25.3 ± 1.35 mm, RV: 24.9 ± 2.40 mm), and 5 epicardial appendage ablations (mean lesion length RAA: 26.0 ± 3.16 mm). Transmurality was achieved in all CTI and atrial appendage ablations, in 62% of the RV ablations and in none of the LV ablations. No perforation or steam pop occurred, and no animal died during the procedure.ConclusionIn this porcine study, the 20-mm linear laser ablation catheter has shown excellent results for endocardial cavotricuspid isthmus ablation, and it resulted in acceptable lesion depth during atrial and ventricular epicardial ablation. The absence of tissue charring, steam pops, or microbubbles under the experimental conditions suggests a high degree of procedural safety.

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Section: Introductionmentioning

confidence: 99%

A Novel Laser Energy Ablation Catheter for Endocardial Cavo-Tricuspid Isthmus Ablation and Epicardial Ventricular Lesion Formation: An in vivo Proof-of-Concept Study

Krist¹,

Linz²,

Schotten³

et al. 2022

Front. Med. Technol.

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Pre-procedural image-guided versus non-image-guided ventricular tachycardia ablation—a review

et al. 2020

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Background Magnetic resonance imaging and computed tomography in patients with ventricular tachycardia (VT) after myocardial infarction (MI) helps to delineate scar from healthy tissue. Image-guided VT ablation has not yet been studied on a large scale. Objective The aim of the meta-analysis was to compare the long-term outcome of image-guided VT ablation with a conventional approach for VT after MI. Methods Eight electronic bibliographic databases were searched to identify all relevant studies from 2012 until 2018. The search for scientific literature was performed for studies that described the outcome of VT ablation in patients with an ischaemic substrate. The outcome of image-guided ablation was compared with the outcome of conventional ablations. Results Of the 2990 citations reviewed for eligibility, 38 articles—enrolling a total of 7748 patients—were included into the meta-analysis. Five articles included patients with image-guided ablation. VT-free survival was 82% [74–90] in the image-guided VT ablation versus 59% [54–64] in the conventional ablation group (p < 0.001) during a mean follow-up of 35 months. Overall survival was 94% [90–98] in the image-guided versus 82% [76–88] in the conventional VT ablation group (p < 0.001). Conclusions Image-guided VT ablation in ischaemic VT was associated with a significant benefit in VT-free and overall survival as compared with conventional VT ablation. Visualising myocardial scar facilitates substrate-guided ablation procedures, pre-procedurally and by integrating imaging during the procedure, and may consequently improve long-term outcome.

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Predictors of Success in Ablation of Scar-Related Ventricular Tachycardia

Cited by 2 publications

References 26 publications

A Novel Laser Energy Ablation Catheter for Endocardial Cavo-Tricuspid Isthmus Ablation and Epicardial Ventricular Lesion Formation: An in vivo Proof-of-Concept Study

A Novel Laser Energy Ablation Catheter for Endocardial Cavo-Tricuspid Isthmus Ablation and Epicardial Ventricular Lesion Formation: An in vivo Proof-of-Concept Study

Pre-procedural image-guided versus non-image-guided ventricular tachycardia ablation—a review

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