Cargando…
Updated results on catheter ablation of ventricular arrhythmias arising from the papillary muscles of the left ventricle
BACKGROUND: Catheter ablation of ventricular arrhythmias (VAs) arising from the left ventricle`s (LV) papillary muscles (PM) is challenging. In this study we present results of catheter ablation using multiple energy sources and image‐based approaches. METHODS: Fifty‐three patients (49 ± 17 years ol...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373649/ https://www.ncbi.nlm.nih.gov/pubmed/30805050 http://dx.doi.org/10.1002/joa3.12137 |
_version_ | 1783395027294093312 |
---|---|
author | Rivera, Santiago Tomas, Leandro Ricapito, Maria de la Paz Nicolas, Vecchio Reinoso, Marcelo Caro, Milagros Mondragon, Ignacio Albina, Gaston Giniger, Alberto Scazzuso, Fernando |
author_facet | Rivera, Santiago Tomas, Leandro Ricapito, Maria de la Paz Nicolas, Vecchio Reinoso, Marcelo Caro, Milagros Mondragon, Ignacio Albina, Gaston Giniger, Alberto Scazzuso, Fernando |
author_sort | Rivera, Santiago |
collection | PubMed |
description | BACKGROUND: Catheter ablation of ventricular arrhythmias (VAs) arising from the left ventricle`s (LV) papillary muscles (PM) is challenging. In this study we present results of catheter ablation using multiple energy sources and image‐based approaches. METHODS: Fifty‐three patients (49 ± 17 years old; 34% females; median LV ejection fraction 53 ± 11%) underwent catheter cryoablation or radiofrequency (RF) ablation with non‐contact force sensing (Non‐CFS) catheters and cardiac computed tomography integration (CTII) into the electroanatomical mapping system or contact force sensing RF (CFS RF) ablation catheters and intracardiac echo‐facilitated 3D electroanatomical mapping. Ventricular arrhythmias foci were mapped at either the anterolateral (ALPM) or posteromedial papillary muscles (PMPM). Ablation was performed using an 8‐mm cryoablation catheter (CRYO); a Non‐CFS 4‐mm open‐irrigated RF catheter; or a CFS RF 3.5‐mm open‐irrigated tip catheter, via transmitral or transaortic approach. RESULTS: Acute success rate was 83% for Non‐CFS RF/CTII; 100% for CRYO/CTII (n = 16) and CFS RF/ICE3D (n = 14) (P = 0.03). Catheter stability was achieved in all patients treated with Cryo/CTII. VA recurrence at 12 months follow‐up was 48% (n = 11) for Non‐CFS RF/CTII; 19% (n = 3) for CRYO/CTII; and 7% (n = 1) for CFS RF/ICE3D (P = 0.02). CONCLUSIONS: Non‐CFS/CTII was associated with an increased risk of recurrence of the clinical arrhythmia. Ablation with either CFS RF/ICE3D or CRYO/CTII showed high acute success rates and low recurrence rates during follow‐up. Cryoablation provided stable contact and was less arrhythmogenic. |
format | Online Article Text |
id | pubmed-6373649 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-63736492019-02-25 Updated results on catheter ablation of ventricular arrhythmias arising from the papillary muscles of the left ventricle Rivera, Santiago Tomas, Leandro Ricapito, Maria de la Paz Nicolas, Vecchio Reinoso, Marcelo Caro, Milagros Mondragon, Ignacio Albina, Gaston Giniger, Alberto Scazzuso, Fernando J Arrhythm Original Articles BACKGROUND: Catheter ablation of ventricular arrhythmias (VAs) arising from the left ventricle`s (LV) papillary muscles (PM) is challenging. In this study we present results of catheter ablation using multiple energy sources and image‐based approaches. METHODS: Fifty‐three patients (49 ± 17 years old; 34% females; median LV ejection fraction 53 ± 11%) underwent catheter cryoablation or radiofrequency (RF) ablation with non‐contact force sensing (Non‐CFS) catheters and cardiac computed tomography integration (CTII) into the electroanatomical mapping system or contact force sensing RF (CFS RF) ablation catheters and intracardiac echo‐facilitated 3D electroanatomical mapping. Ventricular arrhythmias foci were mapped at either the anterolateral (ALPM) or posteromedial papillary muscles (PMPM). Ablation was performed using an 8‐mm cryoablation catheter (CRYO); a Non‐CFS 4‐mm open‐irrigated RF catheter; or a CFS RF 3.5‐mm open‐irrigated tip catheter, via transmitral or transaortic approach. RESULTS: Acute success rate was 83% for Non‐CFS RF/CTII; 100% for CRYO/CTII (n = 16) and CFS RF/ICE3D (n = 14) (P = 0.03). Catheter stability was achieved in all patients treated with Cryo/CTII. VA recurrence at 12 months follow‐up was 48% (n = 11) for Non‐CFS RF/CTII; 19% (n = 3) for CRYO/CTII; and 7% (n = 1) for CFS RF/ICE3D (P = 0.02). CONCLUSIONS: Non‐CFS/CTII was associated with an increased risk of recurrence of the clinical arrhythmia. Ablation with either CFS RF/ICE3D or CRYO/CTII showed high acute success rates and low recurrence rates during follow‐up. Cryoablation provided stable contact and was less arrhythmogenic. John Wiley and Sons Inc. 2018-11-18 /pmc/articles/PMC6373649/ /pubmed/30805050 http://dx.doi.org/10.1002/joa3.12137 Text en © 2018 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Rivera, Santiago Tomas, Leandro Ricapito, Maria de la Paz Nicolas, Vecchio Reinoso, Marcelo Caro, Milagros Mondragon, Ignacio Albina, Gaston Giniger, Alberto Scazzuso, Fernando Updated results on catheter ablation of ventricular arrhythmias arising from the papillary muscles of the left ventricle |
title | Updated results on catheter ablation of ventricular arrhythmias arising from the papillary muscles of the left ventricle |
title_full | Updated results on catheter ablation of ventricular arrhythmias arising from the papillary muscles of the left ventricle |
title_fullStr | Updated results on catheter ablation of ventricular arrhythmias arising from the papillary muscles of the left ventricle |
title_full_unstemmed | Updated results on catheter ablation of ventricular arrhythmias arising from the papillary muscles of the left ventricle |
title_short | Updated results on catheter ablation of ventricular arrhythmias arising from the papillary muscles of the left ventricle |
title_sort | updated results on catheter ablation of ventricular arrhythmias arising from the papillary muscles of the left ventricle |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373649/ https://www.ncbi.nlm.nih.gov/pubmed/30805050 http://dx.doi.org/10.1002/joa3.12137 |
work_keys_str_mv | AT riverasantiago updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle AT tomasleandro updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle AT ricapitomariadelapaz updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle AT nicolasvecchio updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle AT reinosomarcelo updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle AT caromilagros updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle AT mondragonignacio updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle AT albinagaston updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle AT ginigeralberto updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle AT scazzusofernando updatedresultsoncatheterablationofventriculararrhythmiasarisingfromthepapillarymusclesoftheleftventricle |