BACKGROUND AND AIMS: Slow conduction scarred areas are related with ventricular tachycardia (VT) arrhythmogenesis in nonischemic cardiomyopathy. The purpose of this study was to characterize the substrate in both epicardial and endocardial surfaces of the left ventricle and to evaluate the effectiveness of substrate mapping and ablation for VT in Chagas cardiomyopathy. METHODS AND RESULTS: Seventeen patients were evaluated prospectively using a simultaneous epicardial and endocardial electroanatomical substrate mapping and ablation. With a mean of 201 +/- 94 epicardial and 169 +/- 77 endocardial points, the epicardial voltage areas < or =0.5 mV were 56.8 +/- 40.6 (range 4.4 to 154.8 cm(2)) as compared to 22.5 +/- 15.8 cm(2) (range 5.4 to 61.0 cm(2); p = 0.004) in the endocardium. Analyzing the epicardial surface, there was a strong correlation between the bipolar voltage electrograms and the electrogram duration at the epicardium during sinus rhythm (r = 0.897, p < 0.0001). Acute success was obtained in 83.3% of patients with no serious complications. At the end of follow-up from 14 patients with acute success, 11 (78.6%) had been event-free based on implantable cardioverter defibrillator (ICD) interrogation logs. CONCLUSION: Chronic Chagas cardiomyopathy patients have larger epicardial as compared to endocardial substrate areas. Combined epicardial endocardial substrate mapping and ablation during sinus rhythm proves effective in preventing VT recurrences and appropriate ICD therapies.
BACKGROUND AND AIMS: Slow conduction scarred areas are related with ventricular tachycardia (VT) arrhythmogenesis in nonischemic cardiomyopathy. The purpose of this study was to characterize the substrate in both epicardial and endocardial surfaces of the left ventricle and to evaluate the effectiveness of substrate mapping and ablation for VT in Chagas cardiomyopathy. METHODS AND RESULTS: Seventeen patients were evaluated prospectively using a simultaneous epicardial and endocardial electroanatomical substrate mapping and ablation. With a mean of 201 +/- 94 epicardial and 169 +/- 77 endocardial points, the epicardial voltage areas < or =0.5 mV were 56.8 +/- 40.6 (range 4.4 to 154.8 cm(2)) as compared to 22.5 +/- 15.8 cm(2) (range 5.4 to 61.0 cm(2); p = 0.004) in the endocardium. Analyzing the epicardial surface, there was a strong correlation between the bipolar voltage electrograms and the electrogram duration at the epicardium during sinus rhythm (r = 0.897, p < 0.0001). Acute success was obtained in 83.3% of patients with no serious complications. At the end of follow-up from 14 patients with acute success, 11 (78.6%) had been event-free based on implantable cardioverter defibrillator (ICD) interrogation logs. CONCLUSION: Chronic Chagas cardiomyopathypatients have larger epicardial as compared to endocardial substrate areas. Combined epicardial endocardial substrate mapping and ablation during sinus rhythm proves effective in preventing VT recurrences and appropriate ICD therapies.
Authors: Kyoko Soejima; William G Stevenson; John L Sapp; Andrew P Selwyn; Gregory Couper; Laurence M Epstein Journal: J Am Coll Cardiol Date: 2004-05-19 Impact factor: 24.094
Authors: Edmond M Cronin; Frank M Bogun; Philippe Maury; Petr Peichl; Minglong Chen; Narayanan Namboodiri; Luis Aguinaga; Luiz Roberto Leite; Sana M Al-Khatib; Elad Anter; Antonio Berruezo; David J Callans; Mina K Chung; Phillip Cuculich; Andre d'Avila; Barbara J Deal; Paolo Della Bella; Thomas Deneke; Timm-Michael Dickfeld; Claudio Hadid; Haris M Haqqani; G Neal Kay; Rakesh Latchamsetty; Francis Marchlinski; John M Miller; Akihiko Nogami; Akash R Patel; Rajeev Kumar Pathak; Luis C Saenz Morales; Pasquale Santangeli; John L Sapp; Andrea Sarkozy; Kyoko Soejima; William G Stevenson; Usha B Tedrow; Wendy S Tzou; Niraj Varma; Katja Zeppenfeld Journal: J Interv Card Electrophysiol Date: 2020-10 Impact factor: 1.900
Authors: Edmond M Cronin; Frank M Bogun; Philippe Maury; Petr Peichl; Minglong Chen; Narayanan Namboodiri; Luis Aguinaga; Luiz Roberto Leite; Sana M Al-Khatib; Elad Anter; Antonio Berruezo; David J Callans; Mina K Chung; Phillip Cuculich; Andre d'Avila; Barbara J Deal; Paolo Della Bella; Thomas Deneke; Timm-Michael Dickfeld; Claudio Hadid; Haris M Haqqani; G Neal Kay; Rakesh Latchamsetty; Francis Marchlinski; John M Miller; Akihiko Nogami; Akash R Patel; Rajeev Kumar Pathak; Luis C Sáenz Morales; Pasquale Santangeli; John L Sapp; Andrea Sarkozy; Kyoko Soejima; William G Stevenson; Usha B Tedrow; Wendy S Tzou; Niraj Varma; Katja Zeppenfeld Journal: Europace Date: 2019-08-01 Impact factor: 5.214
Authors: Mindy Vroomen; Bart Maesen; Mark La Meir; Justin G L Luermans; Kevin Vernooy; Jos G Maessen; Harry J Crijns; Laurent Pison Journal: J Atr Fibrillation Date: 2019-02-28
Authors: Fernando A Botoni; Antonio Luiz P Ribeiro; Carolina Coimbra Marinho; Marcia Maria Oliveira Lima; Maria do Carmo Pereira Nunes; Manoel Otávio C Rocha Journal: Biomed Res Int Date: 2013-11-24 Impact factor: 3.411