Stepwise approach to substrate modification of ventricular tachycardia after myocardial infarction

来源 :中华医学杂志(英文版) | 被引量 : 0次 | 上传用户:hunyuan
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Background Recently, substrate mapping (SM) has been described to facilitate catheter ablation of stable and unstable ventricular tachycardia (VT) after myocardial infarction. However, SM is time consuming with potential disadvantages of multiple ablation lines such as impairment of ventricular function or proarrhythmia. The aim of the present study was to delineate a stepwise approach to SM to shorten procedure time and limit the possibility of complications.Methods SM was performed in 14 infarct survivors referred for VT ablation using an electroanatomical mapping system (CARTO) to define infarct regions. A new stepwise approach for SM was designed as follows.The initial ablation site was identified by pace- and entrainment mapping in case of stable VT and by pace mapping only in case of unstable VT. Based on the CARTO voltage mapping, linear ablation was done from this site to the center of the scar and perpendicular to the boundary of the scar or to the mitral annulus. Additional lines were performed only when VT remained inducible. A maximum of 3 ablation lines were created during one procedure.Results A total of 57 VTs (21 stable, 36 unstable) were induced during the procedures. VT was no longer inducible after the first linear ablation in 2 patients, after the second linear ablation in 6 patients and after the third linear ablation in 3 patients. Either VT or ventricular fibrillation was still inducible at the end of the procedure in 3 patients. Procedure time averaged (291±85) minutes, fluoroscopy time (10±7) minutes. VT recurred in 3patients. Following a second procedure in 2 patients, there were no further VT recurrences. Overall, there was a significant reduction in VT episodes 3 months after [median: 0, interquartile ranges (IQR): 0-1] compared with 3months before ablation (median: 25, IQR: 16-105, P<0.01).Conclusions This stepwise approach to SM is effective in facilitating ablation of stable and unstable VT. It reduces procedure and fluoroscopy time, and may help to improve the risk-benefit ratio of VT ablation.
其他文献
期刊
本试验采用尼龙线栓塞大鼠大脑中动脉造成局灶性脑缺血模型,观察了通心络胶囊的作用,现将实验报道如下。 1 实验材料 1.1 动物 SD大鼠、雄性,体重330.5g±18.2g,由河北省
安尔乐在今年夏天植入了《爱情回来了》,剧内通过戚薇的女一号,剧外通过各大传播渠道,一里一外,里应外合地给安尔乐注入新的品牌活力。
我们 1997年 11月~ 1999年 3月在西医常规综合治疗的基础上 ,采用自制的中药消肿化瘀膏外搽治疗新生儿硬肿症 2 0例 ,取得较好的治疗效果 ,现报告如下。1 临床资料1.1 一般
随着社会经济的发展和人们生活工作节奏的加快,原属于老年疾病的颈椎病越来越趋于年轻化.
再过一年,两家中国生活用纸巨头恒安和维达将同时迎来自己的三十岁“生日”。在过去的历史中,它们沿着截然不同的轨迹,逐渐成长为行业中风格迥异的两极。即将到来的而立之年对它
冠心病是中老年人群的常见多发病,中医理论认为气虚血瘀、年老肾虚是冠心病的主要发病机理之一.正心泰颗粒剂的主要功效是益气活血、补肾通脉.我们近年来应用正心泰颗粒剂治
Lucart集团位于意大利卢卡,是一家生活用纸生产商,它关注消费者对产品柔软性和便利性的需求,推出了三重特柔型产品。  Engraving Solutions公司同样位于意大利卢卡,它专注于压
公益诉讼广东首例rn海珠区石榴岗河曾是一条清澈的小河,从华洲街土华村穿村而过.2007年9月以后,小河突然变得黑臭逼人.村民们在小河边发现了一家名叫新中兴的洗水厂,于是聚集