Relationship between successful ablation sites and the scar border zone defined by substrate mapping for ventricular tachycardia post-myocardial infarction.

作者: ATUL VERMA , NASSIR F MARROUCHE , ROBERT A. SCHWEIKERT , WALID SALIBA , OUSSAMA WAZNI

DOI: 10.1046/J.1540-8167.2005.40443.X

关键词: Catheter ablationMedicineTachycardiaSinus rhythmVentricular tachycardiaSubstrate mappingMyocardial infarction complicationsInternal medicineVentricleCardiologyAblation

摘要: Ventricular Tachycardia and the Scar Border Zone. Introduction: It is unknown if identification of scar border zones by electroanatomical mapping correlates with successful ablation sites determined from during ventricular tachycardia (VT) post-myocardial infarction (MI). We sought to assess relationship between hemodynamically stable post-MI VTs VT zone defined in sinus rhythm. Methods Results: Forty-six patients presenting stable, mappable monomorphic who had at least one such successfully ablated were prospectively included study. In each patient, was targeting regions that exhibited early activation, ′ isolated mid-diastolic potentials, concealed entrainment suggesting a critical isthmus site. Prior ablation, detailed sinus-rhythm CARTO voltage map left ventricle obtained. A <0.5 mV dense scar. Successful registered on their zone. Of 86 VTs, 68% endocardial The remaining within (18%), normal myocardium (4%), epicardial surface (10%). There no significant differences recurrence amongst different groups. Conclusion: are often located as substrate mapping. However, sizable minority, scar, epicardially, even myocardium.

参考文章(27)
Francis E. Marchlinski, David J. Callans, Charles D. Gottlieb, Erica Zado, Linear Ablation Lesions for Control of Unmappable Ventricular Tachycardia in Patients With Ischemic and Nonischemic Cardiomyopathy Circulation. ,vol. 101, pp. 1288- 1296 ,(2000) , 10.1161/01.CIR.101.11.1288
Louise Harris, Eugene Downar, Lynda Mickleborough, Nisar Shaikh, Ian Parson, Activation sequence of ventricular tachycardia: Endocardial and epicardial mapping studies in the human ventricle Journal of the American College of Cardiology. ,vol. 10, pp. 1040- 1047 ,(1987) , 10.1016/S0735-1097(87)80344-3
Vivek Y Reddy, Petr Neuzil, Milos Taborsky, Jeremy N Ruskin, Short-term results of substrate mapping and radiofrequency ablation of ischemic ventricular tachycardia using a saline-irrigated catheter. Journal of the American College of Cardiology. ,vol. 41, pp. 2228- 2236 ,(2003) , 10.1016/S0735-1097(03)00492-3
J M de Bakker, F J van Capelle, M J Janse, S Tasseron, J T Vermeulen, N de Jonge, J R Lahpor, Slow conduction in the infarcted human heart. 'Zigzag' course of activation. Circulation. ,vol. 88, pp. 915- 926 ,(1993) , 10.1161/01.CIR.88.3.915
Frank Bogun, Marwan Bahu, Bradley P. Knight, Raul Weiss, Walter Paladino, Mark Harvey, Rajiva Goyal, Emile Daoud, K. Ching Man, S. Adam Strickberger, Fred Morady, Comparison of Effective and Ineffective Target Sites That Demonstrate Concealed Entrainment in Patients With Coronary Artery Disease Undergoing Radiofrequency Ablation of Ventricular Tachycardia Circulation. ,vol. 95, pp. 183- 190 ,(1997) , 10.1161/01.CIR.95.1.183
Frank Bogun, Marwan Bahu, Bradley P Knight, Raul Weiss, Rajiva Goyal, Emile Daoud, K.Ching Man, S.Adam Strickberger, Fred Morady, Response to Pacing at Sites of Isolated Diastolic Potentials During Ventricular Tachycardia in Patients With Previous Myocardial Infarction Journal of the American College of Cardiology. ,vol. 30, pp. 505- 513 ,(1997) , 10.1016/S0735-1097(97)00177-0
Gerard M. Guiraudon, Ranjan K. Thakur, George J. Klein, Raymond Yee, Colette M. Guiraudon, Arjun Sharma, Encircling endocardial cryoablation for ventricular tachycardia after myocardial infarction: Experience with 33 patients American Heart Journal. ,vol. 128, pp. 982- 989 ,(1994) , 10.1016/0002-8703(94)90598-3
ETIENNE DELACRETAZ, WILLIAM G. STEVENSON, Catheter ablation of ventricular tachycardia in patients with coronary heart disease: part I: Mapping. Pacing and Clinical Electrophysiology. ,vol. 24, pp. 1261- 1277 ,(2001) , 10.1046/J.1460-9592.2001.01261.X
Arthur J. Moss, Wojciech Zareba, W. Jackson Hall, Helmut Klein, David J. Wilber, David S. Cannom, James P. Daubert, Steven L. Higgins, Mary W. Brown, Mark L. Andrews, Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. The New England Journal of Medicine. ,vol. 346, pp. 877- 883 ,(2002) , 10.1056/NEJMOA013474
Eugene Downar, Shane Kimber, Louise Harris, Lynda Mickleborough, Elias Sevaptsidis, Stephane Masse, Thomas C.K. Chen, Adriana Genga, Endocardial mapping of ventricular tachycardia in the intact human heart. II. Evidence for multiuse reentry in a functional sheet of surviving myocardium. Journal of the American College of Cardiology. ,vol. 20, pp. 869- 878 ,(1992) , 10.1016/0735-1097(92)90187-R