Skip to main content
SpringerLink
Log in

Endocardial and epicardial mapping and catheter ablation of post myocardial infarction ventricular tachycardia

A substrate modification approach

  • Review
  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Ventricular tachycardia associated with prior myocardial infarction account for significant morbidity, mortality, and health care costs despite the favorable outcomes shown by ICD clinical trials. Catheter ablation has been increasingly used as an adjunctive therapy in the management of scar-related ventricular tachycardia. Novel technologies have facilitated the outcomes of current ablation strategies. Three-dimensional mapping systems have allowed identification of the scar substrate, its critical sites in the tachycardia circuit, and selection of ablation sites based on fairly precise electroanatomic substrate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Newby, K. H., Thompson, T., Stebbins, A., Topol, E. J., & Califf, R. M. (1998). Sustained ventricular arrhythmias in patients receiving thrombolytic therapy: incidence and outcomes. The GUSTO Investigators. Circulation, 98(23), 2567–2573.

    PubMed  CAS  Google Scholar 

  2. Moss, A. J., Zareba, W., Hall, W. J., Klein, H., Wilber, D. J., Cannom, D. S., et al. (2002). Multicenter automatic defibrillator implantation trial II Investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. New England Journal of Medicine, 346(12), 877–883.

    Article  PubMed  Google Scholar 

  3. Kim, Y. H., Sosa-Suarez, G., Trouton, T. G., O'Nunain, S. S., Osswald, S., McGovern, B. A., et al. (1994). Treatment of ventricular tachycardia by transcatheter radiofrequency ablation in patients with ischemic heart disease. Circulation, 89(3), 1094–1102.

    PubMed  CAS  Google Scholar 

  4. Rothman, S. A., Hsia, H. H., Cossu, S. F., Chmielewski, I. L., Buxton, A. E., & Miller, J. M. (1997). Radiofrequency catheter ablation of postinfarction ventricular tachycardia: long-term success and the significance of inducible nonclinical arrhythmias. Circulation, 96(10), 3499–3508.

    PubMed  CAS  Google Scholar 

  5. El-Shalakany, A., Hadjis, T., Papageorgiou, P., Monahan, K., Epstein, L., & Josephson, M. E. (1999). Entrainment/mapping criteria for the prediction of termination of ventricular tachycardia by single radiofrequency lesion in patients with coronary artery disease. Circulation, 99(17), 2283–2289.

    PubMed  CAS  Google Scholar 

  6. Arenal, A., del Castillo, S., Gonzalez-Torrecilla, E., Atienza, F., Ortiz, M., Jimenez, J., et al. (2004). Tachycardia-related channel in the scar tissue in patients with sustained monomorphic ventricular tachycardias: influence of the voltage scar definition. Circulation, 110(17), 2568–2574.

    Article  PubMed  Google Scholar 

  7. Marchlinski, F. E., Callans, D. J., Gottlieb, C. D., & Zado, E. (2000). Linear ablation lesions for control of unmappable ventricular tachycardia in patients with ischemic and nonischemic cardiomyopathy. Circulation, 101(11), 1288–1296.

    PubMed  CAS  Google Scholar 

  8. Marchlinski, F., Garcia, F., Siadatan, A., Sauer, W., Beldner, S., Zado, E., et al. (2005). Ventricular tachycardia/ventricular fibrillation ablation in the setting of ischemic heart disease. Journal of Cardiovascular Electrophysiology, 16(Suppl 1), S59–S70.

    Article  PubMed  Google Scholar 

  9. Stevenson, W. G., Khan, H., Sager, P., Saxon, L. A., Middlekauff, H. R., Natterson, P. D., et al. (1993). Identification of reentry circuit sites during catheter mapping and radiofrequency ablation of ventricular tachycardia late after myocardial infarction. Circulation, 88(4 Pt 1), 1647–1670.

    PubMed  CAS  Google Scholar 

  10. Stevenson, W. G., Friedman, P. L., Sager, P. T., Saxon, L. A., Kocovic, D., Harada, T., et al. (1997). Exploring postinfarction reentrant ventricular tachycardia with entrainment mapping. Journal of the American College of Cardiology, 29(6), 1180–1189.

    Article  PubMed  CAS  Google Scholar 

  11. Soejima, K., Stevenson, W. G., Maisel, W. H., Sapp, J. L., & Epstein, L. M. (2002). Electrically unexcitable scar mapping based on pacing threshold for identification of the reentry circuit isthmus: feasibility for guiding ventricular tachycardia ablation. Circulation, 106(13), 1678–1683.

    Article  PubMed  Google Scholar 

  12. Wilber, D. J., Kopp, D. E., Glascock, D. N., Kinder, C. A., & Kall, J. G. (1995). Catheter ablation of the mitral isthmus for ventricular tachycardia associated with inferior infarction. Circulation, 92(12), 3481–3489.

    PubMed  CAS  Google Scholar 

  13. Berruezo, A., Mont, L., Nava, S., Chueca, E., Bartholomay, E., & Brugada, J. (2004). Electrocardiographic recognition of the epicardial origin of ventricular tachycardias. Circulation, 109(15), 1842–1847.

    Article  PubMed  Google Scholar 

  14. Swarup, V., Morton, J. B., Arruda, M., & Wilber, D. J. (2002). Ablation of epicardial macroreentrant ventricular tachycardia associated with idiopathic nonischemic dilated cardiomyopathy by a percutaneous transthoracic approach. Journal of Cardiovascular Electrophysiology, 13(11), 1164–1168.

    Article  PubMed  Google Scholar 

  15. Sosa, E., & Scanavacca, M. (2005). Epicardial mapping and ablation techniques to control ventricular tachycardia. Journal of Cardiovascular Electrophysiology, 16(4), 449–452.

    PubMed  Google Scholar 

  16. Sosa, E., Scanavacca, M., d'Avila, A., Oliveira, F., & Ramires, J. A. (2000). Nonsurgical transthoracic epicardial catheter ablation to treat recurrent ventricular tachycardia occurring late after myocardial infarction. Journal of the American College of Cardiology, 35(6), 1442–1449.

    Article  PubMed  CAS  Google Scholar 

  17. Della Bella, P., Pappalardo, A., Riva, S., Tondo, C., & Fassini, G. (2002). Trevisi Non-contact mapping to guide catheter ablation of untolerated ventricular tachycardia. European Heart Journal, 23(9), 742–752.

    Article  PubMed  CAS  Google Scholar 

  18. Soejima, K., Delacretaz, E., Suzuki, M., Brunckhorst, C. B., Maisel, W. H., Friedman, P. L., et al. (2001). Saline-cooled versus standard radiofrequency catheter ablation for infarct-related ventricular tachycardias. Circulation, 103(14), 1858–1862.

    PubMed  CAS  Google Scholar 

  19. Cummings, J. E., Pacifico, A., Drago, J. L., Kilicaslan, F., & Natale, A. (2005). Alternative energy sources for the ablation of arrhythmias. Pacing and Clinical Electrophysiology, 28(5), 434–443.

    Article  PubMed  Google Scholar 

  20. Erdogan, A., Grumbrecht, S., Neumann, T., Neuzner, J., & Pitschner, H. F. (2003). Microwave, irrigated, pulsed, or conventional radiofrequency energy source: which energy source for which catheter ablation? Pacing and Clinical Electrophysiology, 26(1 Pt 2), 504–506.

    Article  PubMed  Google Scholar 

  21. Skanes, A. C., Klein, G. J., Krahn, A. D., & Yee, R. (2003). Advances in energy delivery. Coronary Artery Disease, 14(1), 15–23.

    Article  PubMed  Google Scholar 

  22. Natale, A., Pisano, E., Shewchik, J., Bash, D., Fanelli, R., Potenza, D., et al. (2000). First human experience with pulmonary vein isolation using a through-the-balloon circumferential ultrasound ablation system for recurrent atrial fibrillation. Circulation, 102(16), 1879–1882.

    PubMed  CAS  Google Scholar 

  23. Wang, J. A., Sun, Y., & He, H. (2003). Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Zhejiang Univ Sci, 4(6), 745–748.

    Article  Google Scholar 

  24. Meininger, G. R., Calkins, H., Lickfett, L., Lopath, P., Fjield, T., Pacheco, R., et al. (2003). Solomon SB.Initial experience with a novel focused ultrasound ablation system for ring ablation outside the pulmonary vein. J Interv Card Electrophysiol, 8(2), 141–148.

    Article  PubMed  Google Scholar 

  25. Khairy, P., Chauvet, P., Lehmann, J., Lambert, J., Macle, L., Tanguay, J. F., et al. (2003). Lower incidence of thrombus formation with cryoenergy versus radiofrequency catheter ablation. Circulation, 107(15), 2045–2050.

    Article  PubMed  Google Scholar 

  26. Pfeiffer, D., Moosdorf, R., Svenson, R. H., Littmann, L., Grimm, W., Kirchhoff, P. G., et al. (1996). Epicardial neodymium YAG laser photocoagulation of ventricular tachycardia without ventriculotomy in patients after myocardial infarction. Circulation, 94(12), 3221–3225.

    PubMed  CAS  Google Scholar 

  27. Saksena, S., Gielchinsky, I., & Tullo, N. G. (1989). Argon laser ablation of malignant ventricular tachycardia associated with coronary artery disease. American Journal of Cardiology, 64(19), 1298–1304.

    Article  PubMed  CAS  Google Scholar 

  28. VanderBrink, B. A., Gilbride, C., Aronovitz, M. J., Lenihan, T., Schorn, G., Taylor, K., et al. (2000). Safety and efficacy of a steerable temperature monitoring microwave catheter system for ventricular myocardial ablation. Journal of Cardiovascular Electrophysiology, 11(3), 305–310.

    Article  PubMed  CAS  Google Scholar 

  29. Knaut, M., Tugtekin, S. M., Spitzer, S., & Gulielmos, V. (2002). Combined atrial fibrillation and mitral valve surgery using microwave technology. Seminars in Thoracic and Cardiovascular Surgery, 14(3), 226–231.

    PubMed  Google Scholar 

  30. Lickfett, L., & Calkins, H. (2002). Catheter ablation for cardiac arrhythmias. Minerva Cardioangiologica, 50, 189–207.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University Hospitals, Harrington-McLaughlin Heart and Vascular Institute, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Lakeside 5038, Cleveland, OH, 44106, USA

    Mauricio Arruda

  2. Texas Cardiac Arrhythmias Institute, Austin, TX, USA

    Tamer Fahmy, Luciana Armaganijan, Luigi Di Biase, Dimpi Patel & Andrea Natale

Authors
  1. Mauricio Arruda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tamer Fahmy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luciana Armaganijan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luigi Di Biase
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dimpi Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andrea Natale
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mauricio Arruda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arruda, M., Fahmy, T., Armaganijan, L. et al. Endocardial and epicardial mapping and catheter ablation of post myocardial infarction ventricular tachycardia. J Interv Card Electrophysiol 28, 137–145 (2010). https://doi.org/10.1007/s10840-010-9469-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10840-010-9469-5

Keywords

Search

Navigation