Substrate mapping vs. tachycardia mapping using CARTO in patients with coronary artery disease and ventricular tachycardia: impact on outcome of catheter ablation

Volkmer, Marius; Ouyang, Feifan; Deger, Florian T.; Ernst, Sabine; Goya, Masahiko; Bänsch, Dietmar; Berodt, Katharina; Kück, Karl‐Heinz; Antz, Matthias

doi:10.1093/europace/eul109

Cited by 83 publications

(74 citation statements)

References 16 publications

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“…We have previously demonstrated that the spatial location of ventricular HFLPs might be correlated with intracardiac fragmented activity in patients with sustained VT. 9) Volkmer, et al have reported an overall success rate with VT ablation using 3D electro-anatomical mapping (CARTO) in 47 patients, with a subgroup analysis comparing VT mapping performed during sinus rhythm or pacing (substrate mapping). 23) In the present study, we have demonstrated that a synthesized 187-ch SAVP-ECG can detect the spatial distribution of HFLPs and ventricular depolarization. Interestingly, the spatial distribution of HFLP in cases with ARVC is in agreement with an increased RT dispersion that suggests a right ventricular outflow region.…”

Section: Discussionmentioning

confidence: 54%

Development of a Signal-Averaged Vector-Projected 187-Channel High-Resolution Electrocardiogram for the Evaluation of the Spatial Location of High-Frequency Potentials and Abnormal Ventricular Repolarization

et al. 2007

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SUMMARYNoninvasive risk stratification is important for screening for lethal arrhythmia. We developed a 187-channel signal-averaged vector-projected high-resolution electrocardiograph (187-ch SAVP-ECG) for detecting abnormalities in the spatial location of ventricular high-frequency late potentials (HFLPs) and ventricular repolarization.The subjects consisted of 30 normal controls (CONTROL) and 13 patients with HFLPs (6 with myocardial infarction [MI], 6 with cardiomyopathy, and 1 with Brugada syndrome). The modified X, Y, Z-lead ECG and the synthesized signals from vector-projected 187-channel ECGs were amplified and passed through a digital filter. We calculated the integration of the HFLPs area between QRS end and 30 ms before QRS end . The integrated HFLPs map was superimposed on the corrected recovery time (RTc) and Tpeak-end dispersion maps composed by 187-ch SAVP-ECG. All patients received an examination by 64-channel magnetocardiography (64-ch MCG) on the same day.The spatial distribution of HFLPs by the 187-ch SAVP-ECG map was in agreement with the location of increased RT dispersion in MI. The spatial distribution of HFLPs in DCM demonstrated a wide variety of patterns. Interestingly, the spatial distribution of HFLPs in cases with ARVC was located at around a right ventricular outflow region. The spatial distribution of HFLPs by 187-ch SAVP-ECG was in agreement with those determined by 64-ch MCG.The 187-ch SAVP-ECG might be useful for evaluating the spatial distribution of nonuniform conduction and ventricular repolarization heterogeneity. (Int Heart J 2007; 48: 701-713)

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Section: Discussionmentioning

confidence: 54%

Development of a Signal-Averaged Vector-Projected 187-Channel High-Resolution Electrocardiogram for the Evaluation of the Spatial Location of High-Frequency Potentials and Abnormal Ventricular Repolarization

et al. 2007

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“…Although the percentage of patients with recurrences varied between 17% and 36% in these studies, a considerable reduction in the frequency of ICD interventions was observed post-ablation. In a single center non-randomized study [43] , substrate mapping during sinus rhythm and activation mapping during VT was compared in patients with coronary artery disease. The results of the two strategies in term of clinical outcome were similar: success rate during follow-up was 80% and 71% for the activation and the substrate mapping groups, respectively.…”

Section: Resultsmentioning

confidence: 99%

Role of catheter ablation of ventricular tachycardia associated with structural heart disease

Ponti

2011

WJC

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In patients with structural heart disease, ventricular tachycardia (VT) worsens the clinical condition and may severely affect the short-and long-term prognosis. Several therapeutic options can be considered for the management of this arrhythmia. Among others, catheter ablation, a closed-chest therapy, can prevent arrhythmia recurrences by abolishing the arrhythmogenic substrate. Over the last two decades, different techniques have been developed for an effective approach to both tolerated and untolerated VTs. The clinical outcome of patients undergoing ablation has been evaluated in multiple studies. This editorial gives an overview of the role, methodology, clinical outcome and innovative approaches in catheter ablation of VT. De Ponti R. Role of catheter ablation of ventricular tachycardia associated with structural heart disease.

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“…The endpoint for linear ablation was the completion of the designed lines. Acute success was defined as the achievement of the ablation endpoint, but allowed for the induction of non-clinical hemodynamically unstable VTs or ventricular fibrillation (VF) [6]. In both groups, chronic success during the follow-up period was defined as the absence of any sustained VT, VF, or ICD therapy.…”

Section: Mapping and Ablationmentioning

confidence: 99%

Long‐term outcomes of catheter ablation of ventricular tachycardia in patients with structural heart disease

Goya

Fukunaga

Hiroshima

et al. 2014

Journal of Arrhythmia

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a b s t r a c tBackground: Catheter ablation of ventricular tachycardia (VT) is feasible. However, the long-term outcomes for different underlying diseases have not been well defined. Methods: Eighty-eight consecutive patients who underwent catheter ablation of VT using a threedimensional mapping system were analyzed. The primary endpoint was any VT or ventricular fibrillation (VF) recurrence. Secondary endpoints were a composite of death or any VT/VF recurrence. Underlying heart diseases were remote myocardial infarction (remote MI) in 51 patients and non-ischemic cardiomyopathy in 37 (arrhythmogenic right ventricular cardiomyopathy [ARVC] in 18 patients, and dilated cardiomyopathy [NIDCM] in 19). Results: Acute success was achieved in 82 of 88 (93%) patients. During a follow-up period of 39.2 74.6 months, VT recurred in 26 of 87 (30%), and VT/VF recurrence or death occurred in 39 of 87 (45%) patients. ARVC had better outcomes than NIDCM for the primary (p o 0.05) and secondary endpoints (po 0.05). Remote MI-VT revealed a midrange outcome. Conclusions: The long-term outcomes after catheter ablation of VT varied according to the underlying heart disease. ARVC-VT ablation was associated with better long-term prognosis than NIDCM. Remote MI-VT demonstrated a midrange outcome.

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Substrate mapping vs. tachycardia mapping using CARTO in patients with coronary artery disease and ventricular tachycardia: impact on outcome of catheter ablation

Cited by 83 publications

References 16 publications

Development of a Signal-Averaged Vector-Projected 187-Channel High-Resolution Electrocardiogram for the Evaluation of the Spatial Location of High-Frequency Potentials and Abnormal Ventricular Repolarization

Development of a Signal-Averaged Vector-Projected 187-Channel High-Resolution Electrocardiogram for the Evaluation of the Spatial Location of High-Frequency Potentials and Abnormal Ventricular Repolarization

Role of catheter ablation of ventricular tachycardia associated with structural heart disease

Long‐term outcomes of catheter ablation of ventricular tachycardia in patients with structural heart disease

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