Imaging and epicardial substrate ablation of ventricular tachycardia in patients late after myocarditis

Giuseppe Maccabelli, Dimitris Tsiachris, John Silberbauer, Antonio Esposito, Caterina Bisceglia, Francesca Baratto, Caterina Colantoni, Nicola Trevisi, Anna Palmisano, Pasquale Vergara, Francesco De Cobelli, Alessandro Del Maschio, Paolo Della Bella

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: We present clinical, electroanatomical mapping (EAM), imaging, and catheter ablation (CA) strategies in patients with myocarditis-related ventricular tachycardia (VT). Methods and results: Between January 2010 and July 2012, 26 consecutive patients underwent imaging-guided CAof myocarditis-related ventricular arrhythmias, 23 of 26 using a combined endo-epicardial approach. Segment per segment correspondence of late enhanced (LE) scar localization with EAM scar was assessed in all patients with available uni/bipolar maps (n = 19). Induced VTs were targeted prior to substrate modification. Late potentials (LPs) abolition constituted a procedural end-point independently from VT inducibility. Clinical monomorphic VT was induced in 15 of 26 patients (57.7%) and was associated with epicardial LPs in 10 of 15, completely abolished in 7 of 10 patients. Of the 10 patients rendered non-inducible VTs were ablated epicardially in 7. Late potentials were also detected in 7 of 11 initially non-inducible patients and completely abolished in 4. After a median follow-up of 23 (15-31) months, 20 of 26 patients (76.9%) remained free from VT recurrence. Bipolar mapping revealed low-voltage scar (

Original languageEnglish
Pages (from-to)1363-1372
Number of pages10
JournalEuropace
Volume16
Issue number9
DOIs
Publication statusPublished - 2014

Keywords

  • Catheter ablation
  • Electroanatomical mapping
  • Late enhancement imaging
  • Myocarditis
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

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