+1 Recommend
1 collections
      • Record: found
      • Abstract: found
      • Article: found

      Stable and Unstable Ventricular Tachycardias in Patients with Previous Myocardial Infarction: A Clinically Oriented Strategy for Catheter Ablation

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


          Objective: Catheter ablation of ventricular tachycardia (VT) after myocardial infarction (MI) can be complex and time-consuming. We only targeted the previously documented VTs and those with similar or longer cycle lengths. Methods: 30 patients with VTs after MI were included in the study. Voltage mapping was performed using an electro-anatomic mapping system (CARTOT). Stable VTs were mapped during tachycardia and unstable VTs during sinus rhythm. Results: Clinical VTs were stable in 16 (53%) and unstable in 14 (47%) patients, and ablation was successful in 11 (69%) and 9 patients (64%), respectively (p = 0.42). During follow-up (14 ± 6 months), 4 patients (25%) treated for stable and 6 (43%) for unstable VTs had recurrences (p = 0.82); ablation was successful in none and 2 (33%) of them, respectively. Non-target VTs were inducible in 11 (55%) of 20 patients after successful ablation and non-inducible in 9 (45%). During follow-up, inducibility of non-target VTs did not predict recurrences (9 vs. 11%, p = 0.88). Conclusions: Catheter ablation of VTs after MI can be successfully performed. Acute success rates seem to be similar for stable and unstable VTs. VTs faster than those documented clinically exert a minor effect on VT recurrences during follow-up.

          Related collections

          Most cited references 6

          • Record: found
          • Abstract: found
          • Article: not found

          Identification of the ventricular tachycardia isthmus after infarction by pace mapping.

          Ventricular tachycardia (VT) isthmuses can be defined by fixed or functional block. During sinus rhythm, pace mapping near the exit of an isthmus should produce a QRS similar to that of VT. Pace mapping at sites proximal to the exit may produce a similar QRS with a longer stimulus-to-QRS interval (S-QRS). The aim of the study was to determine whether a VT isthmus could be identified and followed by pace mapping. Left ventricular pace mapping during sinus rhythm was performed at 819 sites in 11 patients with VT late after infarction, and corresponding CARTO maps were reconstructed. An isthmus site was defined by entrainment and/or VT termination by ablation. Pace-mapping data were analyzed from the identified isthmus site and from sites at progressively increasing distances from this initial isthmus site. Sites where pace mapping produced the same QRS with different S-QRS delays were identified to attempt to trace the course of the isthmus. In 11 patients, 13 confluent low-voltage infarct regions were present. In all these regions, parts of VT isthmuses were identified by pace mapping. In 11 of 13 of the identified isthmus parts, the QRS morphology of the pace map matched a VT QRS. In 10 of 11 patients, radiofrequency ablation rendered clinical VTs noninducible. Successful ablation sites were localized within an isthmus identified by pace mapping in all of these 10 patients. VT isthmuses can be identified and part of their course delineated by pace mapping during sinus rhythm. This method could help target isthmus sites for ablation during stable sinus rhythm.
            • Record: found
            • Abstract: not found
            • Article: not found

            Catheter Ablation of Ventricular Tachycardia in Remote Myocardial Infarction:

              • Record: found
              • Abstract: not found
              • Article: not found

              Long-Term Follow-Up After Radiofrequency Catheter Ablation of Ventricular Tachycardia: A Successful Approach?


                Author and article information

                S. Karger AG
                December 2007
                10 July 2007
                : 109
                : 1
                : 52-61
                Departments of Cardiology and Cardiac Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
                105326 Cardiology 2008;109:52–61
                © 2007 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 3, Tables: 4, References: 13, Pages: 10
                Original Research


                Comment on this article