Intramural Ventricular Recording and Pacing in Patients With Refractory Ventricular Tachycardia: Initial Findings and Feasibility With a Retractable Needle Catheter

作者: Amir AbdelWahab , William Stevenson , Kara Thompson , Ratika Parkash , Christopher Gray

DOI: 10.1161/CIRCEP.115.002940

关键词:

摘要: Background— Ablation of ventricular arrhythmias (VA) can be limited by intramural substrate not amenable to endocardial or epicardial ablation. Feasibility irrigated needle ablation has been shown, but optimal means identifying targets is clear. We analyzed electrograms in relation electrograms. Methods and Results— Eight sequential patients (mean age, 56 years) who had failed 1 4 prior ablations underwent were included. At selected sites, the was advanced into myocardium. Bipolar unipolar from catheter tip analyzed. The deployed at 75 sites with suspected among 2309 mapping sites. Intramural bipolar electrogram amplitude duration correlated closely electrograms, greater (1.5±1.4 versus 0.6±0.5 mV 131±66 112±51 ms; P =0.001 for both). During sinus rhythm late potentials tended more common than (53.6% 35.7%; =0.12). during VA preceded (−29±34 −15±21 =0.001). Irrigated terminated 12 28 VA. Termination site earlier nontermination (−54±37 −36±33 ms pre-QRS; =0.15). Pacemapping 19 matched 18 showed stimulus QRS 60±51 ms. Conclusions— Recordings may useful selecting tachycardia mapping. Further study needed develop methods guide selection deployment

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