Coronary artery vasospasm during catheter cryoablation of left ventricular summit nonsustained ventricular tachycardia Santiago Rivera, MD, Maria de.

Slides:

Advertisements

Similar presentations

How to map and ablate left ventricular summit arrhythmias

Advertisements

Volume 15, Issue 1, Pages (January 2018)

Volume 13, Issue 1, Pages (January 2016)

Rachel D. Torok, MD, Benjamin Wei, MD, Ronald J. Kanter, MD, Robert D

Volume 9, Issue 1, Pages (January 2012)

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

Intramyocardial radiofrequency ablation of ventricular arrhythmias using intracoronary wire mapping and a coronary reentry system: Description of a novel.

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

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

Volume 11, Issue 1, Pages (January 2014)

Cardiac resynchronization therapy device implantation guided by electroanatomic mapping system when contrast medium infusion is contraindicated Vittorio.

Implantation of a cardiac resynchronization therapy device using the anchor balloon technique in a patient with a tortuous coronary sinus branch Yu Kumagai,

Volume 15, Issue 1, Pages (January 2018)

Premature ventricular contractions with two QRS morphologies originate from one focus in great cardiac vein Juan Ma, MD, Ke-Xiang Wu, MD, Yu-Bin Wang,

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,

Maged F. Nageh, MD,FHRS, Kamal Kotak, MD HeartRhythm Case Reports

Vein of Marshall partially isolated with radiofrequency ablation from the endocardium Shin Kashimura, MD, Takahiko Nishiyama, MD, Takehiro Kimura, MD,

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

Successful ethanol injection into the anterior interventricular cardiac vein for ventricular premature contractions arising from the left ventricular.

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

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

Isolation of the conduction between the Marshall bundle and distal coronary sinus and the entire coronary sinus for an atrial tachycardia after catheter.

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

T. Raymond Foley, MD, Mori J. Krantz, MD HeartRhythm Case Reports

HeartRhythm Case Reports

Incessant intraseptal ventricular tachycardia ablated utilizing extracorporeal membrane oxygenation and bipolar ablation Ali B.A.K. Al-Hadithi, BA(Hons),

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

Novel technique to avoid diaphragmatic paralysis during focal ablation of a non– pulmonary vein trigger mapped to the crista terminalis Jason Misher,

Cardiac resynchronization therapy in coronary sinus atresia delivered using leadless endocardial pacing Dewi E. Thomas, MD, MRCP, Nicholas M. Child,

A case of successful termination of an atrial tachycardia ablated from the pulmonary artery during rapid ventricular pacing Toshiya Kurotobi, MD, PhD,

Protecting the right phrenic nerve during catheter ablation: Techniques and anatomical considerations Stephen Stark, MD, David K. Roberts, MD, Thomas.

An atypical journey during a “typical” EP case

Cryoablation of an atrioventricular nodal reentrant tachycardia in a patient with an implanted deep brain stimulator Melanie Gunawardene, MD, Christian.

A case of ventricular fibrillation triggered by ventricular premature depolarizations exiting from different sites of the Purkinje network Stavros E.

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

An unusual approach to intractable AVNRT in a pediatric patient

A case series and review of the literature regarding coronary artery complications associated with coronary sinus catheter ablation Paul J. Garabelli,

Ablation of parahisian ventricular focus

Relevance of electrical connectivity between the coronary sinus and the left atrial appendage for the intentional electrical isolation of the left atrial.

Atrial Tachycardia in a Patient With Fabry’s Disease

Overcoming left bundle branch block by permanent His bundle pacing: Evidence of longitudinal dissociation in the His via recordings from a permanent pacing.

A simple method to ablate left-sided accessory pathways in a patient with coronary sinus ostial atresia and persistent left superior vena cava: A case.

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

Radiofrequency ablation of common atrial flutter via right subclavian/jugular vein access in a patient with bilateral lower limb venous obstruction: Importance.

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

Cryoballoon pulmonary vein isolation and voltage mapping for symptomatic atrial fibrillation 9 months after Watchman device implantation Henry D. Huang,

Miki Yokokawa, MD, Fred Morady, MD, FACC, Frank Bogun, MD, FACC

Discrete prepotentials with an isoelectric segment at the successful ablation site in the right ventricular outflow tract and pulmonary artery junction.

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

Successful atrioventricular junction ablation in a patient with situs inversus with dextrocardia and complex venous anatomy Iosif Kelesidis, MD, MSc,

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

Worsening of mitral valve regurgitation after radiofrequency catheter ablation of ventricular arrhythmia originating from a left ventricular papillary.

A transseptal puncture hazard that was close!

Hyper-response to cardiac resynchronization with permanent His bundle pacing: Is parahisian pacing sufficient? Olujimi A. Ajijola, MD, PhD, Jorge Romero,

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

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

Overcoming an impossible anatomy with a novel left ventricular active fixation lead in the coronary sinus: A case report Gabriele Giannola, MD, PhD,

A balloon occlusion technique to overcome the convective warming effect of coronary sinus blood flow on cryoablation Soledad Ascoeta, MD, Marc Dubuc,

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

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

Intraoperative Electroanatomic Mapping

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,

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

Prolonged high-power endocardial ablation of epicardial microreentrant VT from the LV summit in a patient with nonischemic cardiomyopathy Jorge Romero,

Ventricular fibrillation a rare complication during head-up tilt test

Percutaneous epicardial cryoablation of idiopathic premature ventricular contractions near the left anterior descending artery Victor A. Abrich, MD,

Atrial fibrillation ablation with persistent left superior vena cava detected during intracardiac echocardiography Victor A. Abrich, MD, Jeffrey Munro,

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

Presentation transcript:

Coronary artery vasospasm during catheter cryoablation of left ventricular summit nonsustained ventricular tachycardia Santiago Rivera, MD, Maria de la Paz Ricapito, MD, Josefina Parodi, MD, Pablo Spaletra, Gaston Albina, MD, Alberto Giniger, MD, Fernando Scazzuso, MD HeartRhythm Case Reports Volume 2, Issue 6, Pages 491-494 (November 2016) DOI: 10.1016/j.hrcr.2016.07.007 Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 1 Brocq-Mouchet triangle composed by the intersection of the great cardiac vein (GCV), the circumflex artery (LCX), and the left anterior descending coronary artery (LAD). These structures are located between conus arteriosus and left auricle, on the left side of anterior surface of the heart. AIV = anterior interventricular vein. HeartRhythm Case Reports 2016 2, 491-494DOI: (10.1016/j.hrcr.2016.07.007) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 2 A: Endocardial activation map of the same anatomical region. B: Activation map of the coronary sinus, showing the earliest activation at the LV summit epicardium, where the great cardiac vein receives the anterior interventricular vein (AIV). C: Clinical premature ventricular contraction with the earliest activity recorded at the AIV with a 46 ms ventricular electrogram-QRS. D: Pacemapping showing a 12/12 match and 24-point score. HeartRhythm Case Reports 2016 2, 491-494DOI: (10.1016/j.hrcr.2016.07.007) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 3 Fluoroscopic projections. Upper left image: Left anterior oblique (LAO) view of the coronary sinus phlebography showing the great cardiac vein (GCV) and anterior interventricular vein (AIV) distal to the inflated balloon. Upper right image: Right anterior oblique (view of the 6-mm focal cryoablation catheter placed at the most distal aspect of the GCV, toward the AIV. Lower left image: LAO view of the 6-mm focal cryoablation catheter placed at the bifurcation of a lateral branch of the circumflex (Cx) artery, where the earliest activity was recorded. Lower right image: LAO cranial view (Spider). A vasospasm of the lateral branch of the Cx is observed while cryoenergy is being delivered at the effective lesion site, reaching −82°C. A 4-mm irrigated-tip radiofrequency catheter was placed at the endocardial site (Kissing catheter). After cryoablation was completed and cryoenergy delivery discontinued (total dose of 240 seconds and 2 freeze-thaw-freeze cycles), a coronary angiogram was repeated. There was no vasospasm or coronary injury observed. HeartRhythm Case Reports 2016 2, 491-494DOI: (10.1016/j.hrcr.2016.07.007) Copyright © 2016 Heart Rhythm Society Terms and Conditions