Simultaneous Endocardial and Epicardial Delineation of 3D Reentrant Ventricular Tachycardia

Journal of the American College of Cardiology
Roderick TungShulin Wu

Abstract

Mechanisms of scar-related ventricular tachycardia (VT) are largely based on computational and animal models that portray a 2-dimensional view. The authors sought to delineate the human VT circuit with a 3-dimensional perspective from recordings obtained by simultaneous endocardial and epicardial mapping. High-resolution mapping was performed during 97 procedures in 89 patients with structural heart disease. Circuits were characterized by systematic isochronal analysis to estimate the dimensions of the isthmus and extent of the exit region recorded on both myocardial surfaces. A total of 151 VT morphologies were mapped, of which 83 underwent simultaneous endocardial and epicardial mapping; 17% of circuits activated in a 2-dimensional plane, restricted to 1 myocardial surface. Three-dimensional activation patterns with nonuniform transmural propagation were observed in 61% of circuits with only 4% showing transmurally uniform activation, and 18% exhibiting focal activation patterns consistent with mid-myocardial reentry. The dimensions of the central isthmus were 17 mm (12 to 28 mm) × 10 mm (9 to 19 mm) with 55% exhibiting a minimal dimension of <1.5 cm. QRS activation was transmural in 63% and located 43 mm (34 to 52 mm) from t...Continue Reading

References

Mar 1, 1979·Circulation·M E JosephsonA M Greenspan
Nov 1, 1987·Journal of the American College of Cardiology·L HarrisI Parson
Dec 1, 1985·Journal of the American College of Cardiology·J M MillerM E Josephson
Jul 18, 1913·The Journal of Physiology·G R Mines
May 22, 2010·Journal of the American College of Cardiology·Frédéric SacherWilliam G Stevenson
Oct 1, 2011·Journal of Cardiovascular Electrophysiology·Martin MartinekUsha B Tedrow
Nov 24, 2016·Circulation. Arrhythmia and Electrophysiology·Edward J CiaccioHasan Garan
Apr 15, 2017·Circulation. Arrhythmia and Electrophysiology·Roderick Tung
Dec 14, 2017·The New England Journal of Medicine·Phillip S CuculichClifford G Robinson
Oct 26, 2018·Circulation. Arrhythmia and Electrophysiology·Ruairidh MartinFrédéric Sacher

❮ Previous
Next ❯

Citations

Jun 17, 2020·Journal of Cardiovascular Electrophysiology·Paolo Della Bella, Antonio Frontera
Aug 7, 2020·Circulation. Arrhythmia and Electrophysiology·Alexios HadjisPaolo Della Bella
Oct 11, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Beatriz JáureguiAntonio Berruezo
Nov 18, 2020·Circulation. Arrhythmia and Electrophysiology·Eric SungNatalia A Trayanova
Jan 20, 2021·Circulation·Arvindh N KanagasundramWilliam G Stevenson
Feb 3, 2021·Pacing and Clinical Electrophysiology : PACE·Shijie ZhouNatalia A Trayanova
Mar 5, 2020·Journal of the American College of Cardiology·William G StevensonArvindh Kanagasundram
Feb 20, 2021·Journal of the American College of Cardiology·Valentin Fuster
Apr 24, 2021·JACC. Clinical Electrophysiology·Elad Anter
May 10, 2021·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Takuro NishimuraRoderick Tung
May 18, 2021·Frontiers in Cardiovascular Medicine·Alessia GimelliRiccardo Liga
Jun 19, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Levio QuintoIvo Roca-Luque
Aug 10, 2021·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Edward J CiaccioHasan Garan
Jul 28, 2021·Pacing and Clinical Electrophysiology : PACE·Eugene DownarKumaraswamy Nanthakumar
Sep 3, 2021·JACC. Case Reports·Piotr Futyma, Shaojie Chen
Sep 21, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Yuichi HanakiMasaki Ieda

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.