Epicardial ventricular tachycardia substrate visualized by magnetic resonance imaging: need for a transpericardial ablation approach?

Autor: Bernhard Herkommer, Christopher Reithmann, Michael Fiek
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Myocarditis
medicine.medical_treatment
Epicardial ablation
030204 cardiovascular system & hematology
Ventricular tachycardia
Electrocardiography
Young Adult
03 medical and health sciences
QRS complex
0302 clinical medicine
Predictive Value of Tests
Internal medicine
Humans
Medicine
030212 general & internal medicine
Aged
Retrospective Studies
Aged
80 and over
Heart transplantation
medicine.diagnostic_test
business.industry
Cardiac Pacing
Artificial
Magnetic resonance imaging
General Medicine
Middle Aged
medicine.disease
Ablation
Fibrosis
Magnetic Resonance Imaging
Heart failure
Catheter Ablation
Tachycardia
Ventricular
Cardiology
Female
Cardiomyopathies
Electrophysiologic Techniques
Cardiac
Cardiology and Cardiovascular Medicine
business
Pericardium
Endocardium
Zdroj: Clinical Research in Cardiology. 105:827-837
ISSN: 1861-0692
1861-0684
Popis: Sustained ventricular tachycardia (VT) in patients with nonischemic cardiomyopathy (NICM) often involves midmyocardial and epicardial structures. Delayed-enhancement magnetic resonance imaging (DE-MRI) of scar and fibrosis is the method of choice to define the substrate of monomorphic VT. The aim of the study was to compare the outcome of endocardial vs. epicardial VT ablation in patients with epicardial DE-MRI substrates in NICM. Among 44 patients with NICM referred for VT ablation who underwent DE-MRI, 12 patients had an epicardial-only (n = 4) or predominantly epicardial DE-MRI substrate (n = 8). 9 of the 12 patients had a prior myocarditis. Endocardial-only VT ablation was successful in two patients with epicardial DE-MRI substrate. A pericardial access for epicardial mapping and ablation was attempted in 8 patients and could be accomplished in seven. Epicardial low voltage (
Databáze: OpenAIRE
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