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Left atrial voltage remodeling after pulmonary venous isolation with multipolar radiofrequency ablation

World Journal of Cardiovascular Diseases 2013年第8期3卷 493-498页

作者： Francesco Laurenzi Piergiuseppe De Girolamo Augusto Pappalardo Andrea Avella Department of Cardiology Cardiac Arrhythmia Center St. Camillo-Forlanini Hospital Rome Italy

Purpose: Pulmonary vein isolation (PVI) is the accepted primary endpoint for catheter ablation of atrial fibrillation (AF). The aim of this study was to evaluate the level of PVI by PVAC, a multipolar circular catheter utilizing bipolar/unipolar radiofrequency (RF) energy. Methods: Twenty patients with paroxysmal AF underwent PVAC ablation. PVI was validated by voltage reduction and pacing tests. Before and after RF ablation, left atrium (LA) and PV electroanatomic mapping (EAM) were performed by EnSite NavX system. Voltage abatement was considered for potentials 24mm: 9/20 (45%) vs 11/57 (19%),

关键词： Atrial Fibrillation Pulmonary Vein Isolation Multipolar Circular Ablation Catheter electroanatomic Mapping

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Role of catheter ablation of ventricular tachycardia associated with structural heart disease

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World Journal of Cardiology 2011年第11期3卷 339-350页

作者： Roberto De Ponti Department of Heart Brain and Vessels Ospedale di Circolo e Fondazione Macchi University of Insubria

In patients with structural heart disease, ventricular tachycardia (VT) worsens the clinical condition and may severely affect the shortand long-term prognosis. Several therapeutic options can be considered for the management of this arrhythmia. Among others, catheter ablation, a closed-chest therapy, can prevent arrhythmia recurrences by abolishing the arrhythmogenic substrate. Over the last two decades, different techniques have been developed for an effective approach to both tolerated and untolerated VTs. The clinical outcome of patients undergoing ablation has been evaluated in multiple studies. This editorial gives an overview of the role, methodology, clinical outcome and innovative approaches in catheter ablation of VT.

关键词： Catheter ablation electroanatomic mapping Implantable cardioverter-defibrillator Radio-frequency energy Sudden cardiac death Ventricular tachycardia

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Changing the Way We“See”Scar:How Multimodality Imaging Fits in the Electrophysiology Laboratory

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Cardiovascular Innovations and Applications 2016年第B2期 169-178页

作者： Anita Wokhlu,MD North Florida/South Georgia VA Medical Center Gainesville FLUSA Cardiology Department of MedicineUniversity of FloridaGainesville FLUSA

Substrate characterization is the mainstay of ablation for ventricular tachycardia(VT).Although the use of electroanatomic voltage mapping(EAVM)in the electrophysiology(EP)laboratory has enabled real-time approximation of myocardial scar,it has *** is related to the subjective and tedious nature of voltage mapping and the challenges of defi ning the transmurality of *** noninvasive methods of scar assessment have emerged,with magnetic resonance imaging(MRI)being the most *** MRI and electroanatomic voltage mapping studies demonstrate good ***,MRI has *** include(1)preprocedure identifi cation of epicardial and intramural scar,(2)assessment of ablative lesion formation after unsuccessful ablations,(3)identifi-cation of heterogeneous regions of scar,where critical conducting channels are likely to occur,and(4)predictive value in the assessment of sudden cardiac death(SCD).Integration of scar imaging in ventricular tachycardia ablation and risk stratifi cation has great potential to advance the practice of arrhythmia management.

关键词： ablation electroanatomic voltage mapping late gadolinium enhancement magnetic resonance imaging myocardial scar substrate sudden cardiac death ventricular tachycardia

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Role of three-dimensional imaging integration in atrial fibrillation ablation

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World Journal of Cardiology 2010年第8期2卷 215-222页

作者： Roberto De Ponti Raffaella Marazzi Domenico Lumia Giuseppe Picciolo Roberto Biddau Carlo Fugazzola Jorge A Salerno-Uriarte Department of Heart Brain and VesselsOspedale di Circolo e Fondazione MacchiUniversity of Insubria Department of Radiology Ospedale di Circolo e Fondazione MacchiUniversity of Insubria

Atrial fibrillation is the most common arrhythmia and in symptomatic patients with a drug-refractory form,catheter ablation aimed at electrically disconnecting the pulmonary veins(PVs) has proved more effective than use of antiarrhythmic drugs in maintaining sinus rhythm during *** the other hand,this ablation procedure is complex,requires specific training and adequate clinical experience.A main challenge is represented by the need for accurate sequential positioning of the ablation catheter around each veno-atrial junction to deliver point-by-point radiofrequency energy applications in order to achieve complete and persistent electrical disconnection of the *** integration is a new technology that enables guidance during this procedure by showing a three-dimensional,pre-acquired computed tomography or magnetic resonance image and the relative real-time position of the ablation catheter on the screen of the electroanatomic *** in the literature suggest that imaging integration provides accurate visual information with improvement in the procedure parameters and/or clinical outcomes of the procedure.

关键词： Catheter ablation Atrial fibrillation electroanatomic mapping Multislice computed tomography Magnetic resonance imaging

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