Updates in Ventricular Tachycardia Ablation

Campbell, Timothy; Bennett, Richard G.; Kotake, Yojiro; Kumar, Saurabh

doi:10.4070/kcj.2020.0436

Cited by 8 publications

(4 citation statements)

References 123 publications

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“…Patients with NICM, who have failed prior endocardial ablations, often have more extensive scar in the epicardium with more than 50% of these patients requiring an epicardial ablation ( 6 , 7 ). In addition, these substrates can progress, especially in conditions like sarcoidosis, hypertrophic cardiomyopathy, and arrhythomgenic right ventricular dysplasia ( 8 ). Treatment of the underlying disease is important to prevent disease progression, recurrence of arrhythmias and heart failure hospitalizations.…”

Section: Pre-procedural Planningmentioning

confidence: 99%

Catheter ablation of ventricular tachycardia: strategies to improve outcomes

Subramanian,

Atreya,

Saggu

et al. 2023

Front. Cardiovasc. Med.

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Catheter ablation of ventricular arrhythmias has evolved considerably since it was first described more than 3 decades ago. Advancements in understanding the underlying substrate, utilizing pre-procedural imaging, and evolving ablation techniques have improved the outcomes of catheter ablation. Ensuring safety and efficacy during catheter ablation requires adequate planning, including analysis of the 12 lead ECG and appropriate pre-procedural imaging. Defining the underlying arrhythmogenic substrate and disease eitology allow for the developed of tailored ablation strategies, especially for patients with non-ischemic cardiomyopathies. During ablation, the type of anesthesia can affect VT induction, the quality of the electro-anatomic map, and the stability of the catheter during ablation. For high risk patients, appropriate selection of hemodynamic support can increase the success of VT ablation. For patients in whom VT is hemodynamically unstable or difficult to induce, substrate modification strategies can aid in safe and successful ablation. Recently, there has been an several advancements in substrate mapping strategies that can be used to identify and differentiate local late potentials. The incorporation of high-definition mapping and contact-sense technologies have both had incremental benefits on the success of ablation procedures. It is crucial to harness newer technology and ablation strategies with the highest level of peri-procedural safety to achieve optimal long-term outcomes in patients undergoing VT ablation.

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Section: Pre-procedural Planningmentioning

confidence: 99%

Catheter ablation of ventricular tachycardia: strategies to improve outcomes

Subramanian,

Atreya,

Saggu

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…ADAS-VT uses pixel signal intensity to characterize myocardial fibrosis in 3 dimensions within the layers of the myocardium. 50 This can distinguish between dense zones of fibrosis and border zones, and allows identification of conduction channels. 28 Targeting ADAS-VT-identified channels for ablation improves immediate and medium-term success rates while reducing radiofrequency lesions and delivery time.…”

Section: Alternative Imaging Techniquesmentioning

confidence: 99%

Intracardiac echocardiography techniques to identify ventricular arrhythmia substrate

et al. 2022

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“…A potential solution is to perform RFCA under magnetic resonance imaging (MRI) guidance, utilizing advanced 3D real-time MRI to precisely and accurately guide catheters to ablation targets to improve the surgical success rate of RFCA. 4 In this procedure, 3D image navigators (3D iNAVs) and catheter position information are concurrently acquired in diastole of each heartbeat, allowing intraoperative visualization of RFCA catheter and heart anatomy. 5 However, acquiring high-resolution fully sampled 3D real-time cardiac MR data in diastole of each heartbeat is challenging, and accelerated MR acquisitions and highly undersampled reconstructions are urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Accelerated reconstruction of highly undersampled 3D cardiac MRI image navigators

Guo,

Sheagren,

Patel

et al. 2024

Medical Imaging 2024: Image Processing

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Intraprocedural 3D real-time magnetic resonance imaging (MRI) provides a way for accurate and precise radiofrequency catheter targeting during ventricular tachycardia ablation. However, the limited data acquisition time needed to freeze cardiac motion results in highly undersampled k-space data that are challenging to reconstruct. In this work, we evaluated several deep learning (DL) based methods for real-time reconstruction of highly undersampled 3D real-time cardiac MRI. Algorithm reconstruction performance and speed were compared between classical algorithms and DL-based methods. Generative adversarial networks with attention layers in the generator were used to perform reconstructions in the image domain, which strived to balance reconstruction speed and image quality. In addition, variational networks were implemented by iterating data consistency in k-space and enforcing image smoothness via neural network-based regularization. In a preliminary study of heartbeatresolved highly undersampled 3D cardiac MRI for 11 healthy volunteers, we observed that DL reconstruction methods provided good image quality with a significant increase in computational speed.

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Updates in Ventricular Tachycardia Ablation

Cited by 8 publications

References 123 publications

Catheter ablation of ventricular tachycardia: strategies to improve outcomes

Catheter ablation of ventricular tachycardia: strategies to improve outcomes

Intracardiac echocardiography techniques to identify ventricular arrhythmia substrate

Accelerated reconstruction of highly undersampled 3D cardiac MRI image navigators

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