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Catheter ablation of supraventricular tachycardia
Published in Ever D. Grech, Practical Interventional Cardiology, 2017
Christopher Madias, Mark S Link
Three-dimensional electroanatomic mapping has evolved into a very accurate method of visualizing the cardiac anatomy and physiology. Multiple systems exist and are now widely utilised for AF ablation as well as in mapping and ablation of atypical AFL, AT and other SVTs. These systems share similar abilities to create three-dimensional maps of cardiac structures and incorporate electrophysiologic information, including tachycardia activation patterns and local voltage. Multipole catheters of different shapes have been developed, allowing for more efficient and accurate mapping of cardiac anatomy and arrhythmic activation.
Multi-modality management of hypertrophic cardiomyopathy
Published in Hospital Practice, 2023
Shiavax J. Rao, Shaikh B. Iqbal, Arjun S. Kanwal, Wilbert S. Aronow, Srihari S. Naidu
A recent systematic review and meta-analysis comparing ERASH and SM reported both groups having significant efficacy in changing the resting LVOT gradient, but the SM group had a larger reduction in interventricular septal thickness compared to ERASH. Both groups had similar improvement of NYHA class during follow-up. Notably, hospital stay and need for pacemaker implantation were less in the ERASH group [81]. Significant complications have been reported with retroperitoneal hemorrhage following sheath removal, paradoxical LVOT gradient increase resulting in pulmonary edema, and development of LBBB that progressed to complete heart block at 6-month follow-up [82]. This modest reduction may be limited due to RF delivered to subendocardium [83]. Due to the heterogeneity of techniques, there is no clear correlation between different guiding modalities (electroanatomic mapping, intracardiac echocardiography, transesophageal echocardiography) and complications [84].
New developments in catheter ablation for patients with congenital heart disease
Published in Expert Review of Cardiovascular Therapy, 2021
Mathieu Le Bloa, Sylvia Abadir, Krishnakumar Nair, Blandine Mondésert, Paul Khairy
Electroanatomic mapping systems have emerged as indispensable tools in guiding ablation in patients with complex arrhythmia substrates or complex anatomies, and have contributed to substantial improvements in success rates [34,35]. These systems allow the position of specific catheters to be tracked in real time through a low-level magnetic or impedance field created around the patient. Color-coded voltage, activation, and propagation maps are reconstructed based on local electrical information and superimposed on real-time 3D anatomical maps. These maps can be further integrated/merged with imaging data derived from real-time ultrasonography, fluoroscopic images, angiography, or pre-procedural CT or MRI. Several experimental dedicated software packages are exploring integrating automated characterization of 3D scar to facilitate identification of arrhythmogenic substrates [36].
Contact force sensors in minimally invasive catheters: current and future applications
Published in Expert Review of Medical Devices, 2021
Weyland Cheng, Manye Yao, Bo Zhai, Penggao Wang
Similarly, CF can also be beneficial in electroanatomic three-dimensional mapping for the reconstruction of electrophysiological mechanisms and detection of scar tissue in patients with idiopathic right ventricular arrhythmias. Sciarra et al. (2020) examined the effects of monitoring contact force during right ventricular bipolar and unipolar voltage mapping using the SmartTouch catheter [71]. After performing an electroanatomic mapping procedure to generate a voltage map and to identify scarred regions, the generated maps were reevaluated taking into consideration CF. The authors excluded poor catheter tip contact (<5 g) from the map, which resulted in higher electroanatomic mapping accuracy and eliminated incidences of falsely detecting scar tissue.