These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.
Pubmed for Handhelds
PUBMED FOR HANDHELDS
Search MEDLINE/PubMed
Title: Imaging and epicardial substrate ablation of ventricular tachycardia in patients late after myocarditis. Author: Maccabelli G, Tsiachris D, Silberbauer J, Esposito A, Bisceglia C, Baratto F, Colantoni C, Trevisi N, Palmisano A, Vergara P, De Cobelli F, Del Maschio A, Della Bella P. Journal: Europace; 2014 Sep; 16(9):1363-72. PubMed ID: 24558183. Abstract: AIMS: We present clinical, electroanatomical mapping (EAM), imaging, and catheter ablation (CA) strategies in patients with myocarditis-related ventricular tachycardia (VT). METHODS AND RESULTS: Between January 2010 and July 2012, 26 consecutive patients underwent imaging-guided CA of myocarditis-related ventricular arrhythmias, 23 of 26 using a combined endo-epicardial approach. Segment per segment correspondence of late enhanced (LE) scar localization with EAM scar was assessed in all patients with available uni/bipolar maps (n = 19). Induced VTs were targeted prior to substrate modification. Late potentials (LPs) abolition constituted a procedural endpoint independently from VT inducibility. Clinical monomorphic VT was induced in 15 of 26 patients (57.7%) and was associated with epicardial LPs in 10 of 15, completely abolished in 7 of 10 patients. Of the 10 patients rendered non-inducible VTs were ablated epicardially in 7. Late potentials were also detected in 7 of 11 initially non-inducible patients and completely abolished in 4. After a median follow-up of 23 (15-31) months, 20 of 26 patients (76.9%) remained free from VT recurrence. Bipolar mapping revealed low-voltage scar (<1.5 mV) in 1 patient endocardially and in 14 of 19 epicardially. Unipolar mapping revealed low-voltage scar (<8 mV) in 12 of 19 patients endocardially and in 18 of 19 epicardially. Correspondence of LE scar localization with endocardial bipolar scar was 1%, with endocardial unipolar scar 23.7%, with epicardial bipolar scar 39.8%, and with epicardial unipolar scar 66.2%. CONCLUSION: Pre-procedural scar imaging and EAM findings support the necessity of an epicardial approach in patients with prior myocarditis. Epicardial unipolar mapping (<8 mV) is superior in scar identification and CA based on substrate modification is safe and effective in this setting.[Abstract] [Full Text] [Related] [New Search]