Biventricular, endocardial, and epicardial substrate characterization for ventricular tachycardia and correlation with whole-heart macropathology and.

Slides:

Advertisements

Similar presentations

Date of download: 5/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: Left atrial tachycardia after circumferential pulmonary.

Advertisements

Epicardial access and ventricular tachycardia ablation in a postmyocarditis patient using a nonfluoroscopic catheter visualization system Akiko Ueda,

Volume 4, Issue 1, Pages (January 2007)

Abnormal epicardial electrophysiologic substrate in patients with early repolarization pattern and reduced left ventricular systolic function: A report.

Kim H. Chan, MBBS, PhD, Raymond W. Sy, MBBS, PhD

Epicardial Catheter Ablation Through Subxiphoid Surgical Approach in a Patient With Implanted Left Ventricular Assist Device and Cannula-Related Ventricular.

Transcoronary ethanol for incessant epicardial ventricular tachycardia

Volume 9, Issue 1, Pages (January 2012)

Radiofrequency ablation of premature ventricular contractions originating from the aortomitral continuity localized by use of a novel noninvasive epicardial.

Pulmonary sinus cusp mapping and ablation: A new concept and approach for idiopathic right ventricular outflow tract arrhythmias Jinlin Zhang, MD, Cheng.

Lyme disease and cardiac sarcoidosis: Management of associated ventricular arrhythmias Jorge Romero, MD, FHRS, Ulrich Jorde, MD, Juan Carlos Diaz, MD,

Successful ablation of ventricular tachycardia arising from a midmyocardial septal outflow tract site utilizing a simplified bipolar ablation setup Peter.

Volume 11, Issue 4, Pages (April 2014)

Successful ablation of premature ventricular contractions originating from the inferoseptal process of the left ventricle using a coronary sinus approach

Ablation of ventricular tachycardia from the aortic root after transcatheter aortic valve replacement Uma N. Srivatsa, MBBS, MAS, FHRS, Eric J. Nordsieck,

Successful atrial fibrillation ablation without pulmonary vein isolation utilizing focal impulse and rotor mapping in an atriopulmonary Fontan Madhukar.

Jeremy W. Docekal, MD, Gregory Francisco, MD, Joseph C. Lee, MD, FHRS

Multimodality imaging, electrophysiologic, electroanatomic, and histopathologic characterization of atrial sarcoidosis presenting with sinus arrest and.

First case of epicardial ablation to coexistent J waves in the inferior leads in a patient with clinical diagnosis of Brugada syndrome Shingo Maeda,

Successful catheter ablation of recipient left ventricular tachycardia 26 years after heterotopic heart transplantation Mikael Laredo, MD, Shaida Varnous,

A case of scar-related ventricular tachycardia demonstrating termination with nonglobal capture at the site of concealed entrainment with dual slow conduction.

To the Editor— Leftward on left anterior oblique is not always septal!

Successful elimination of recurrent ventricular tachycardia by epicardial ablation over coronary artery supplying postinfarction aneurysm Kenichiro Yamagata,

Substrate mapping for unstable ventricular tachycardia

Epicardial substrate ablation for Brugada syndrome

Ablation of epicardial ventricular tachycardia in a chagasic patient with situs inversus totalis: A case report Lucas Hollanda Oliveira, MD, MSc, Enia.

Radiofrequency catheter ablation for drug-refractory paroxysmal atrial fibrillation in a patient with Ebstein’s anomaly Yong-Giun Kim, MD, Shin-Jae Kim,

Local activation delay exacerbates local J-ST elevation in the epicardium: Electrophysiological substrate in Brugada syndrome Naoya Kataoka, MD, PhD,

Fractionated electrograms with ST-segment elevation recorded from the human right ventricular outflow tract Edward J. Vigmond, PhD, Igor R. Efimov, PhD,

B-cell lymphoma of the pericardium presenting with ventricular tachycardia with a successful catheter ablation Takumi Yamada, MD, Franjo Siric, MD, Vishnu.

Yuichiro Kawamura, MDa,, Pierre L

Correlation between functional electrical gaps identified by ultrahigh-density mapping and by late gadolinium enhancement cardiac magnetic resonance in.

Pseudo typical atrial flutter occurring after cavotricuspid isthmus ablation in a patient with a prior history of Senning operation Naoki Yoshida, MD,

Left axillary active can positioning markedly reduces defibrillation threshold of a transvenous defibrillator failing to defibrillate at maximum output

Parasternal intercostal approach as an alternative to subxiphoid approach for epicardial catheter ablation: A case report Koji Miyamoto, MD, Takashi.

Multiple monomorphic ventricular tachycardias in a structurally normal heart: A case report Daljeet Kaur Saggu, MD, DM, Mandar Shah, MD, DNB, Abhijeet.

Isolated, premature ventricular complex–induced right ventricular dysfunction mimicking arrhythmogenic right ventricular cardiomyopathy Antonio Berruezo,

Volume 13, Issue 1, Pages (January 2016)

Finding the right pathway is the key to success

Catheter ablation of ventricular tachycardia in the setting of electrical storm after revascularization of a chronic total occlusion of the right coronary.

Gordon Ho, MD, Kurt S. Hoffmayer, MD, PharmD, FHRS, Christopher T

Epicardial access and ventricular tachycardia ablation in a postmyocarditis patient using a nonfluoroscopic catheter visualization system Akiko Ueda,

Unconventional warfare: Successful ablation of ventricular tachycardia by direct ventricular puncture in a patient with double mechanical heart valves

Dual intraventricular response after cardiac resynchronization

Samuel H. Baldinger, MD, Saurabh Kumar, MD, PhD, Alan D

Ablation of parahisian ventricular focus

Atrial Tachycardia in a Patient With Fabry’s Disease

Intentional anodal capture of a left ventricular quadripolar lead enhances resynchronization equally with multipoint pacing Itsuro Morishima, MD, PhD,

Mapping of a postinfarction left ventricular aneurysm–dependent macroreentrant ventricular tachycardia Elad Anter, MD, Jianqing Li, MD, Cory M. Tschabrunn,

Nonreentrant proximal fascicular ventricular tachycardia, with normal QRS duration and normal axis, originating from a region remote from the His bundle

Brugada syndrome—Malignant phenotype associated with acute cardiac inflammation? Anthony Li, MBBS, MD, Roderick Tung, MD, FHRS, Kalyanam Shivkumar, MD,

HeartRhythm Case Reports

Successful catheter ablation of idiopathic ventricular tachycardia originating from the top of the left ventricular posterior papillary muscle near the.

Atsuyuki Watanabe, MD, Atsuko Seki, MD, Michael C

Incremental value of electroanatomical mapping for the diagnosis of arrhythmogenic right ventricular cardiomyopathy in a patient with sustained ventricular.

Utility of entrainment pacing to clarify the circuit of macroreentrant tachycardia with dual early sites on activation maps Koichi Nagashima, MD, PhD,

Abnormal epicardial electrophysiologic substrate in patients with early repolarization pattern and reduced left ventricular systolic function: A report.

A case of incessant VT from an intramural septal focus: Ethanol or bipolar ablation? Benjamin Berte, MD, Nicolas Derval, MD, Frederic Sacher, MD, PhD,

Radiofrequency ablation of ventricular tachycardia originating from a lipomatous hamartoma localized in the right ventricle cavity Jin Xu, PhD, Yingmin.

Peter Kabunga, MBChB, MRCP, George J. Klein, MD, FHRS, Raymond W

Nishaki Mehta, MD, Benjamin E. Peterson, MD, Roy M. John, MD, PhD

Successful ventricular tachycardia ablation in a patient with a biventricular ventricular assist device and heparin-induced thrombocytopenia using bivalirudin

Saurabh Kumar, BSc(Med)/MBBS, PhD, William G. Stevenson, MD, Usha B

High-power bipolar ablation for incessant ventricular tachycardia utilizing a deep midmyocardial septal circuit William H. Sauer, MD, FHRS, David A.

Ablation of a symptomatic spontaneous automatic focus arising from an atriofascicular fiber Sandrine Venier, MD, Paul Khairy, MD, PhD, Bernard Thibault,

Intramural anterolateral mitral annular idiopathic ventricular tachycardia successfully ablated from the atrium Tawseef Dar, MD, Bharath Yarlagadda,

Recurrent polymorphic ventricular tachycardia initiated by Purkinje ectopy in a patient with cardiac sarcoidosis Faisal Matto, MD, Mohsan Chaudhry, MD,

Chance M. Witt, MD, Samuel J. Asirvatham, MD, FHRS, Carole A

HeartRhythm Case Reports

Epicardial ablation of ventricular tachycardia in a patient with Becker muscular dystrophy Siva Mohan Krothapalli, MD, Elaine Demetroulis, MD, Gardar.

Presentation transcript:

Biventricular, endocardial, and epicardial substrate characterization for ventricular tachycardia and correlation with whole-heart macropathology and histopathology in a patient with lamin A/C cardiomyopathy Ashwin Bhaskaran, MBBS, MSc (Int Med), Aditya Bhat, MBBS, Ivana Trivic, BSc, Kavitha Muthiah, MBChB, PhD, Wade Barrett, MBBS, Sharron Liang, MBBS, Ajita Kanthan, MBBS, BMedSc, PhD, Saurabh Kumar, BSc(Med)/MBBS, PhD HeartRhythm Case Reports Volume 5, Issue 3, Pages 128-133 (March 2019) DOI: 10.1016/j.hrcr.2018.11.009 Copyright © 2018 Terms and Conditions

Figure 1 The 12-lead electrogram morphologies of the clinical (VT1) and inducible ventricular tachycardias. HeartRhythm Case Reports 2019 5, 128-133DOI: (10.1016/j.hrcr.2018.11.009) Copyright © 2018 Terms and Conditions

Figure 2 Right anterior oblique (RAO) views (first row) and posteroanterior views (second row) of the left ventricular (LV) endocardial (Endo) bipolar (left) and unipolar (right) voltage maps showing normal bipolar voltages and abnormal unipolar voltages consistent with intramural scar. Third row illustrates posteroanterior (PA) view of right ventricle (RV) with bipolar (left) and unipolar (right) voltage maps, and fourth row illustrates RAO views of the RV, with both rows showing extensive RV septa scar. Fifth row shows RAO and inferior (Inf) views of the extensive epicardial (Epi) low voltage of the surface of the RV (left), which failed to capture with high-output pacing (10 mA and 9 ms) with absence of electrical signals, suggestive of dense scar or fat. Red and pink dots denote ablation lesions. In all voltage maps, purple indicates normal tissue whereas red indicates scar tissue; yellow, green, and violet indicate border zones between scar and normal tissue. HeartRhythm Case Reports 2019 5, 128-133DOI: (10.1016/j.hrcr.2018.11.009) Copyright © 2018 Terms and Conditions

Figure 3 A: Explanted heart in anteroposterior view (left) and posteroanterior view (right). The left panel shows extensive fatty replacement (red arrow). B: Cross-sections through the basal left ventricle (LV) / right ventricle (RV) (top), basal-mid LV/RV (middle), and mid-LV/RV (bottom). Transmural scar is seen in the basal-mid anterior and inferior septal LV (top panel, red arrows), and septal RV and RV outflow tract (middle panel, red arrow). These may have resulted from a combination of intrinsic disease, endocardial radiofrequency ablation, and transcoronary ethanol embolization. C: Histopathology slide taken at the septum showing fibrofatty (black arrow) replacement of myocardial tissue (white arrow), previously described by others.1,4–6 D: Histology shows elongated nuclei (black arrow) with chromatin clumping (white arrow), previously described by Nikolova and colleagues,3 felt to be classic for LMNA cardiomyopathic hearts. E: Histology of the right atrium showing similar cardiomyopathic changes seen in the ventricles, with evidence of chromatin clumping (black arrow) to a lesser degree. HeartRhythm Case Reports 2019 5, 128-133DOI: (10.1016/j.hrcr.2018.11.009) Copyright © 2018 Terms and Conditions

Supplemental Figure 1 Voltage maps as per Figure 2 (without PA view of the RV) with arrows indicating the sites corresponding with clinical VT with their associated pace maps (PMVT1-6). HeartRhythm Case Reports 2019 5, 128-133DOI: (10.1016/j.hrcr.2018.11.009) Copyright © 2018 Terms and Conditions