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Titolo:
ENDOCARDIAL AND EPICARDIAL ABLATION GUIDED BY NONSURGICAL TRANSTHORACIC EPICARDIAL MAPPING TO TREAT RECURRENT VENTRICULAR-TACHYCARDIA
Autore:
SOSA E; SCANAVACCA M; DAVILA A; PICCIONI J; SANCHEZ O; VELARDE JL; SILVA M; REOLAO B;
Indirizzi:
INST CORACAO,GRP ARRITMIA,AV ENEAS CARVALHO AGUIAR,44-CERQUEIRA CESARBR-05403000 SAO PAULO BRAZIL UNIV SAO PAULO,SCH MED,INST HEART SAO PAULO BRAZIL
Titolo Testata:
Journal of cardiovascular electrophysiology
fascicolo: 3, volume: 9, anno: 1998,
pagine: 229 - 239
SICI:
1045-3873(1998)9:3<229:EAEAGB>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
RADIOFREQUENCY CATHETER ABLATION; CORONARY-ARTERY-DISEASE; ISCHEMIC-HEART-DISEASE; MYOCARDIAL-INFARCTION; LASER PHOTOABLATION; ENTRAINMENT; TERMINATION; MECHANISM; REENTRY;
Keywords:
VENTRICULAR TACHYCARDIA; CATHETER ABLATION; RADIOFREQUENCY; MAPPING; EPICARDIUM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
28
Recensione:
Indirizzi per estratti:
Citazione:
E. Sosa et al., "ENDOCARDIAL AND EPICARDIAL ABLATION GUIDED BY NONSURGICAL TRANSTHORACIC EPICARDIAL MAPPING TO TREAT RECURRENT VENTRICULAR-TACHYCARDIA", Journal of cardiovascular electrophysiology, 9(3), 1998, pp. 229-239

Abstract

Nonsurgical Epicardial Ablation. Introduction: An epicardial site of origin of ventricular tachycardia (VT) may explain unsuccessful endocardial radiofrequency (RF) catheter ablation, A new technique to map the epicardial surface of the heart through pericardial puncture was presented recently and opened the possibility of using epicardial mappingto guide endocardial ablation or epicardial catheter ablation, We report the efficacy and safety of these two approaches to treat 10 consecutive patients with VT and Chagas' disease. Methods and Results: Epicardial mapping was carried out with a regular steerable catheter introduced into the pericardial space, An epicardial circuit was found in 14of 18 mapable VTs induced in 10 patients, Epicardial mapping was usedto guide endocardial ablation in 4 patients and epicardial ablation in 6, The epicardial earliest activation site occurred 107 +/- 60 msec earlier than the onset of the QRS complex, At the epicardial site usedto guide endocardial ablation, earliest activation occurred 75 +/- 55msec before the QRS complex, Epicardial mid-diastolic potentials and/or continuous electrical activity were seen in 7 patients, After 4.8 +/- 2.9 seconds of epicardial RF applications, VT was rendered noninducible, Hemopericardium requiring drainage occurred in 1 patient; 3 others developed pericardial friction without hemopericardium. Patients remain asymptomatic 5 to 9 months after the procedure, Interruption during endocardial pulses occurred after 20.2 +/- 14 seconds (P = 0.004), but VT was always reinducible and the patients experienced a poor outcome. Conclusion: Epicardial mapping does not enhance the effectivenessof endocardial pulses of RF, Epicardial applications of RF energy cansafely and effectively treat patients with VT and Chagas' disease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 01:44:12