Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Jun 2009
ReviewStrategies for epicardial mapping and ablation of ventricular tachycardia.
Catheter ablation for ventricular tachycardia (VT) is becoming an essential component of the successful management of patients with structural heart disease and refractory ventricular arrhythmias. Despite detailed mapping and ablation from the endocardium, nearly a third of VT circuits remain inaccessible. ⋯ Potential risks include risk of injury to an epicardial coronary artery, the phrenic nerve, subdiaphragmatic vessels, and right ventricle. We describe the indications for and approach to catheter ablation of VT for the pericardial space.
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J. Cardiovasc. Electrophysiol. · Jun 2009
Clinical TrialClinical application of PET/CT fusion imaging for three-dimensional myocardial scar and left ventricular anatomy during ventricular tachycardia ablation.
Integration of 3D PET with Voltage Map for VT Ablation. Background: Image integration has the potential to display three-dimensional (3D) scar anatomy and facilitate substrate characterization for ventricular tachycardia (VT) ablation. However, the current generation of clinical mapping systems cannot display 3D left ventricle (LV) anatomy with embedded 3D scar reconstructions or allow display of border zone and high-resolution anatomic scar features. ⋯ Real-time display of registered high-resolution CT images allowed the simultaneous characterization of scar-related anatomic changes. Conclusion: Integration of PET/CT reconstruction allows simultaneous 3D display of myocardial scar and border zone embedded into the LV anatomy as well as the display of detailed scar anatomy. Multimodality imaging may enable a new image-guided approach to substrate-guided VT ablation.