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

Slides:

Advertisements

Similar presentations

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

Advertisements

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.

Radiofrequency Ablation for Atrial Tachycardia and Atrial Flutter

The Journal of Heart and Lung Transplantation

Transcoronary ethanol for incessant epicardial ventricular tachycardia

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

Wolff-Parkinson-White syndrome due to a left atrial appendage–to–left ventricular connection: A case of a successful pathway elimination from inside of.

Incessant bundle branch reentrant ventricular tachycardia in a patient with corrected transposition of the great arteries Ken Kato, MD, Daigo Yagishita,

Intraatrial reentrant tachycardia originating from the prior suture line of the baffle in a patient who underwent the Mustard operation: Ultra-high-density.

Volume 11, Issue 1, Pages (January 2014)

Atypical inferoseptal accessory pathway connection associated with an aneurysm of the coronary sinus: Insight from a three-dimensional combined image.

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

A subtype of idiopathic ventricular fibrillation and its relevance to catheter ablation and genetic variants Takahiko Nishiyama, MD, Yoshiyasu Aizawa,

Volume 15, Issue 1, Pages (January 2018)

Peri–coronary sinus atrial flutter associated with prior slow pathway ablation Mitsunori Maruyama, MD, PhD, FHRS, Shunsuke Uetake, MD, PhD, Yasushi Miyauchi,

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

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

Irregular wide QRS complex tachycardia in a patient with pulmonary hypertension: What is the mechanism? Abigail Louise D. Te, MD, Fa-Po Chung, MD, Yenn-Jiang.

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

Catheter ablation of atypical flutter using new 3-dimensional electroanatomic mapping software focusing on areas of conduction block Camilla Asferg,

Limitations of 12-lead electrocardiogram wide complex tachycardia algorithms in a patient with left atrial flutter and large myocardial infarction Carlos.

Perimitral atrial flutter associated with a protected coronary sinus after a Maze IV procedure and concomitant mitral annulus repair Gaku Kanda, MD,

Atrial fibrillation originating from recipient left atrium after an orthotopic heart transplantation Auroa Badin, MD, Jaret Tyler, MD, FHRS, Steven J.

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

Bradley D. Brochu, MD, Ahmed Abdi-Ali, MD, Jeffrey Shaw, MD, F

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

Successful catheter ablation using real-time ultrasound-assisted 3-D electroanatomical mapping system for atrioventricular accessory pathway in a 1-year-old.

Wide complex tachycardia in an elderly woman due to Ebstein’s anomaly with two accessory pathways Vlad Radulescu, MD, Joseph Donnelly, MD, Jonathan Willner,

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

An unusual atrioventricular accessory pathway with an oblique course

Finding the right pathway is the key to success

Adenosine-sensitive atrial tachycardia originating from the anterior mitral annulus Dai Inagaki, MD, Rintaro Hojo, MD, Seiji Fukamizu, MD, PhD, Harumizu.

Cavotricuspid isthmus ablation using multimodality imaging in Ebstein anomaly with a mechanical tricuspid valve replacement Sang Hyun Lee, MD, Hyung.

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

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

Tina Baykaner, MD, MPH, Joshua M. Cooper, MD, FHRS

Electroanatomical high-density mapping of different tachycardias in the right atrium after heart transplantation Alexandra Schratter, MD, Valentina Schirripa,

Cardiac magnetic resonance imaging for coregistration during ablation of ischemic ventricular tachycardia for identification of the critical isthmus

Ablation of parahisian ventricular focus

Atrial Tachycardia in a Patient With Fabry’s Disease

Bundle branch reentry: A novel mechanism for sustained ventricular tachycardia in Chagas heart disease Alvaro V. Sarabanda, MD, PhD, Wagner L. Gali,

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

Hiroko Asakai, MD, Laura Fenwick, BSc, Robert M. Hamilton, MD, FRCP(C)

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

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,

Adam J. Small, MD, Eric F. Buch, MD, FHRS, FACC, Daniel R

Abnormal atrial strain with speckle-tracking echocardiography predicts the arrhythmic substrate of atypical right atrial flutter Hiroshi Kawakami, MD,

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.

Colin Yeo, MBBS, Martin S. Green, MD, Girish M

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

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

Usefulness of a multi-spline duodecapolar catheter with smaller electrodes and closer spacings for mapping and ablation of Purkinje-related premature.

Clinical problem solving: Maneuvering around a narrow complex tachycardia in a patient with Mustard repair for transposition of the great arteries Nicholas.

Getting to the right left atrium: Catheter ablation of atrial fibrillation and mitral annular flutter in cor triatriatum Ryan T. Borne, MD, Jaime Gonzalez,

Successful catheter ablation of focal ventricular tachycardia originating from right bundle branch without making right bundle branch block, using pharmacologic.

Two apparently remote types of ventricular tachycardia from a single right bundle branch focal source Jaromír Josiek, MD, Jaroslav Januška, MD, PhD,

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

Left atrial access via an unroofed coronary sinus to eliminate fast/slow atypical AVNRT: A case report Gustavo X. Morales, MD, Yousef H. Darrat, MD,

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

Left ventricular pseudoaneurysm as a complication of left ventricular summit premature ventricular contraction ablation Sanjay Dandamudi, MD, Susan S.

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:

Successful catheter ablation of recipient left ventricular tachycardia 26 years after heterotopic heart transplantation Mikael Laredo, MD, Shaida Varnous, MD, Pauline Balagny, MD, Pascal Leprince, MD, Françoise Hidden-Lucet, MD, Guillaume Duthoit, MD HeartRhythm Case Reports Volume 3, Issue 3, Pages 159-163 (March 2017) DOI: 10.1016/j.hrcr.2016.09.011 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Initial electrocardiogram (ECG) presentation and merging of the computed tomography scanner and voltage electroanatomic mapping of the native left ventricle. A: Standard 12-lead ECG showing 2 distinct superimposed patterns of ventricular activation: 1 wide QRS-complex tachycardia of right bundle branch block morphology at 136 beats per minute (bpm), consistent with ventricular tachycardia originating from recipient left ventricle, and a narrow QRS-complex rhythm at 65 bpm corresponding to the donor heart sinus rhythm. Negativity of the wide QRS complex in leads I, aVL, and V5 and V6 suggests left lateral origin. B: Three-dimensional computed tomography reformation of a left anterior oblique view of the heart merged with the bipolar voltage map of the recipient left ventricular (LV) endocardium using the electroanatomic CARTO 3 mapping system. Heterotopic heart transplantation is in its biventricular assist configuration: both donor aorta (light red) and pulmonary artery (deep blue) are directly connected to the corresponding recipient vessels. The native heart, at the right of the image, is markedly dilated compared with the donor heart. Mapping is achieved by both a transseptal approach under careful transesophageal echocardiography guidance and a retrograde aortic approach. Purple indicates voltage >0.25 mV, corresponding to viable endocardium, and red indicates low voltage <0.12 mV, corresponding to dense scar. A broad low-voltage scar area of the LV endocardium is identified on anteroseptoapical and lateral walls and corresponds to the infarcted territory. C: Posteroanterior view. Donor (white) and recipient (gray) left atria are widely anastomosed. Recipient right atrium receives the native inferior and superior vena cava (light blue). Note the presence of a protected isthmus within the lateral LV scar, bordered by anterolateral dense scar and laterobasal scar in contact with the lateral mitral annulus. HeartRhythm Case Reports 2017 3, 159-163DOI: (10.1016/j.hrcr.2016.09.011) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Mapping and ablation of left ventricular tachycardia (VT) in recipient heart. A: Posterolateral view of an activation map of the clinical VT. Red-colored areas correspond to the earliest points within the VT cycle length and purple areas to the latest points (see color scale in the upper right quadrant; LAT = location activation time). Presence of all colors in the recipient left ventricle suggests macroreentry. A slowly conducting laterobasal isthmus within the scar containing both purple and red is identified (flanked by 2 white lines). A 20-pole PentaRay mapping catheter is inserted in the recipient left ventricle via a retrograde approach. Local electrograms recorded by the PentaRay catheter positioned at the isthmus level (left quadrant) are low-voltage fragmented mid-diastolic potentials (particularly seen in PENTA 17-18 and 19-20). Other dipoles show signal covering the majority of VT cycle length. The green dot represents the position of the successful radiofrequency (RF) application targeting mid-diastolic potentials during VT. B: The clinical VT was terminated after 3 RF applications at 35 W. Solid arrow shows VT termination on surface electrocardiogram (ECG) followed by sinus rhythm of the donor heart. Dashed arrow shows asystole of the recipient heart after VT termination, recorded by a recipient right ventricular catheter. C: Twelve-lead ECG recorded the day after the procedure shows sinus rhythm of the donor heart at 70 beats per minute and a slow, wide QRS-complex activity corresponding to escape ventricular rhythm of the recipient heart owing to infrahisian third-degree atrioventricular block. HeartRhythm Case Reports 2017 3, 159-163DOI: (10.1016/j.hrcr.2016.09.011) Copyright © 2017 Heart Rhythm Society Terms and Conditions