HRS 40th Anniversary Viewpoints: Historical Aspects of the Use of Radiofrequency Energy to Treat Arrhythmias
I first observed the treatment of arrhythmias by catheter ablation in Paris when I did a sabbatical in 1979-1980 under the supervision of Dr. Guy Fontaine. At that time, catheter ablation was performed using high energy DC shock (fulguration) by inserting a catheter localized to the site of ventricular arrhythmias (VA). Fulguration was limited to areas of thick myocardium to avoid perforation. Therefore, only ablation of the AV node, septal accessory pathways and left ventricular tachycardia (VT) could be performed.
Identifying targets for the successful ablation of ventricular tachycardia is a major challenge despite recent advances such as targeting zones of conduction slowing or MRI-identified fibrosis1,2. Once targets are identified, impediments to successful catheter ablation include deep substrates, mid-myocardial locations, and ill-defined anatomic barriers. In an effort to ablate intramural arrhythmia substrates deep to the endocardium, irrigated radiofrequency needle catheters have recently been developed.
ConclusionsAll MVT cases were successfully treated by catheter ablation. We observed high ventricular arrhythmia free rate following catheter ablation during the long-term follow-up period. BrS patients who developed MVT should consider catheter ablation.
Conditions: Inherited Cardiac Arrhythmias; Long QT Syndrome; Arrhythmogenic Right Ventricular Cardiomyopathy; Brugada Syndrome; Catecholaminergic Polymorphic Ventricular Tachycardia Intervention: Sponsors: University of British Columbia; Kingston Health Sciences Centre; Quebec Heart Institute; Montreal Heart Institute Recruiting
On Saturday morning at the breakfast table surrounded by my husband and kids, I suddenly felt chest pain, palpitations, and was about to collapse. Being an internist, I knew it: arrhythmia. Paramedics at arrival confirmed it. I was running ventricular tachycardia. Out of the chaos surrounding me at that moment, my physician’s brain assessed the […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Conclusion: Video-assisted CSD should be considered as a treatment option for patients with potentially dangerous arrhythmias that do not respond to conventional treatment, especially in recurrent ventricular tachycardia. PMID: 31588139 [PubMed - in process]
This article provides a review of the aforementioned mechanisms of arrhythmogenesi s in heart failure; the role and impact of HF therapy such as cardiac resynchronization therapy (CRT), including the role, if any, of CRT-P and CRT-D in preventing VAs; the utility of both non-invasive parameters as well as multiple implant-based parameters for telemonitoring in HF; and the effect o f left ventricular assist device implantation on VAs.
ConclusionsWnt signalling inhibits Na+ channel by direct and indirect (via Tbx3) suppression of Scn5a transcription. Strategies to block TCF4 binding to Tbx3 and Scn5a promoters would represent novel strategies for cardiac-specific inhibition of Wnt pathway to rescue INa and prevent sudden cardiac deaths.
The demonstrated effectiveness of implantable cardioverter-defibrillators (ICDs) for primary and secondary preventions of sudden cardiac death has resulted in an increasing number of patients presenting with recurrent, appropriate ICD shocks for ventricular tachycardia VT.(1) In a selected group of VT patients such as those included in the study by Bradfield and colleagues (2) in this issue of Heart Rhythm, autonomic modulation is considered as adjunctive treatment option after failed catheter-based VT ablation and anti-arrhythmic drug therapy.
ConclusionThe use of the S-ICD ™ was safe in patients with borderline or unclear indication for ICD implantation in our study. Of note, during a relatively short mean follow-up there were several appropriate therapies, especially for VF in these patients. On the other hand, oversensing also occurred in about 10% of patients, wh ile lead problems were not problematic in this collective. S-ICD™ implantation may be considered as a possible alternative in cases of borderline indications and clinical uncertainty when decision pro-ICD implantation is made. Incidence of arrhythmias was quite high and mostly consisted ...
Adults with repaired Tetralogy of Fallot (rTOF) are at increased risk of ventricular tachycardia (VT) due to fibrotic remodeling of the myocardium. However, the current clinical guidelines for VT risk stratification and subsequent ICD deployment for primary prevention of sudden cardiac death in rTOF remain inadequate.