We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Hybrid Ablation of Ventricular Tachycardia: A Single-Centre Experience.
- Authors
Vroomen, Mindy; Maesen, Bart; Meir, Mark La; Luermans, Justin G. L.; Vernooy, Kevin; Maessen, Jos G.; Crijns, Harry J.; Pison, Laurent
- Abstract
Background: The long-term results of endocardial and percutaneous epicardial catheter ablation of ventricular tachycardia (VT) in patients with structural heart disease are disappointing. Arrhythmia recurrence after ablation, and VTs with an epicardial substrate remain a clinical challenge. The purpose of this manuscript is to elaborate on feasibility and potential advantages of a surgical hybrid ablation (i.e., combined endocardial and surgical epicardial ablation) based on our initial experience consisting of five cases. Methods: Endocardial electro-anatomical voltage and activation maps were created (Carto, Biosense Webster, California, USA), and endocardial radiofrequency applications were applied at exit sites, low voltage areas and isthmi. Next, after surgical access, epicardial voltage and activation maps were produced in combination with visual assessment of the epicardial substrate. Epicardial low voltage areas, isthmi and exit sites were identified and ablated using radiofrequency energy. Results: After the procedure, VT was non-inducible in 80% of the cases (4/5, in one case no induction was performed). No peri-procedural complications occurred. After a mean follow-up of 18 months, one patient remained in sinus rhythm without, and 2 with use of antiarrhythmic drugs. One patient needed a redo procedure after 21 months, and in one patient the amiodarone dose was raised because of 2 sustained VTs. After this additional treatment, both kept sinus rhythm. Conclusions: Hybrid VT ablation is a safe and effective patient tailored procedure that comprises the major advantage of combining direct anatomical visualization and enhanced catheter stability with high-density 3D mapping. As a consequence, this procedure should be considered as a valid treatment option in complex VT management.
- Subjects
BODY surface mapping; VENTRICULAR tachycardia; CATHETER ablation; TACHYARRHYTHMIAS; ARRHYTHMIA; THERAPEUTICS; LOW voltage systems; CARDIAC patients
- Publication
JAFIB: Journal of Atrial Fibrillation, 2019, Vol 11, Issue 5, p1
- ISSN
1941-6911
- Publication type
Article