Substrate-modification using electroanatomical mapping in sinus rhythm to treat ventricular tachycardia in patients with ischemic cardiomyopathy |
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| Authors: | T. Deneke P. H. Grewe T. Lawo B. Calcum A. Mügge B. Lemke |
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| Affiliation: | (1) Clinical Cardiac Electrophysiology, Cardiology Division Hospital S?o Paulo, Paulista School of Medicine, Federal University of S?o Paulo, Rua Napoleao de Barros 715 - S?o Paulo, 04024-002 S?o Paulo, Brazil;(2) Division of Cardiovascular Diseases, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA |
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| Abstract: | The treatment especially of frequent ischemic VT remains a challenge for medical and catheter ablation procedures. We evaluated the efficacy of a substrate-based procedure to eliminate clinical VTs in this patient collective.Methods In 25 consecutive patients (ejection fraction 37±12%) with frequent symptomatic medically refractory ischemic VT (with recurrent ICD-shocks), left ventricular anatomic scar mapping (Biosense Webster CARTO™) was performed in order to modify the underlying myocardial substrate. Scar tissue was identified as having bipolar voltages <0.5 mv.=" prior=" to=" the=" procedure=" an=" electrophysiological=" study=" (eps)=" to=" determine=" number=" and=" morphology=" of=" inducible=" vts=" was=" performed.=" linear=" ablation=" procedures=" (8=" mm=" tip,=" 70=" watts,=" 70=" °c)=" were=" based=" on=" the=" findings=" of=" scar=" areas=" and=" proximity=" to=" anatomic=" obstacles.=" correct=" location=" of=" ablation=" was=" documented=" by=" similarity=" of=" the=" morphology=" during=" pace-mapping.=" follow-up=" included=" clinical=" evaluation,=" icd=" holter=" interrogation=" plus=" holter=" ecg="> |
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