Analysis during sinus rhythm and ventricular pacing of reentry circuit isthmus sites in right ventricular cardiomyopathy.
Background: The entrainment mapping algorithm is used for ablation of ventricular tachycardia (VT) in right ventricular (RV) cardiomyopathy, but ablation at endocardial isthmus sites has only a moderate success rate. This study was performed to identify additional local electrogram characteristics a...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 31; no. 12; pp. 1535 - 1546 |
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| Autores principales: | , , , , , |
| Formato: | diagnostic images research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105576376&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105576376 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Dec2008 vid: 31 iid: 12 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105576376 105576376 2010103526 10.1111/j.1540-8159.2008.01224.x NLM19067805 105576376 ppf: 1535 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Analysis during sinus rhythm and ventricular pacing of reentry circuit isthmus sites in right ventricular cardiomyopathy. aug: au: Reithmann C Ulbrich M Hahnefeld A Huber A Matis T Steinbeck G sug: subj: Cardiac Pacing, Artificial Methods Heart Ventricle, Right Physiology Heart Ventricle, Right Physiopathology Myocardial Diseases Therapy After Care Methods Arrhythmia, Sinus Diagnosis Catheter Ablation Methods Electrophysiology Methods Female Male Outcomes (Health Care) Human Female Male ab: Background: The entrainment mapping algorithm is used for ablation of ventricular tachycardia (VT) in right ventricular (RV) cardiomyopathy, but ablation at endocardial isthmus sites has only a moderate success rate. This study was performed to identify additional local electrogram characteristics associated with successful ablation. Patients and Methods: Using entrainment mapping, 45 reentry circuit isthmus sites were detected in 11 patients with RV cardiomyopathy presenting with 13 monomorphic VTs. Local bipolar electrograms were retrospectively analyzed at reentry circuit isthmus sites during VT, sinus rhythm, and programmed stimulation from the right ventricular apex (RVA), and compared between successful and unsuccessful ablation sites. Results: Ablation was successful at 10 reentry circuit isthmus sites and unsuccessful at 35 isthmus sites. During VT, a longer endocardial activation time relative to QRS onset, an increased electrogram-QRS interval as a percentage of VT cycle length, and a longer electrogram duration were found at successful in comparison to unsuccessful ablation sites. The presence of isolated diastolic potentials during sinus rhythm at reentry circuit isthmus sites, consistent with slow conduction or unidirectional conduction block, was associated with successful catheter ablation. Prolongation of the duration of the local multipotential electrogram by >100 ms during programmed RVA pacing at reentry circuit exit sites, indicating functional conduction disorder was also a marker of successful ablation. Conclusions: The demonstration of multipotential electrogram characteristics indicating fixed or functional conduction block may increase the likelihood of successful VT ablation at exit and central isthmus sites of reentry circuits in RV cardiomyopathy. pubtype: Academic Journal doctype: diagnostic images research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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