Therapy is determined by pacing on epicardial scar and can be successfully managed by catheter ablation

Carla Roque, Nicola Trevisi, John Silberbauer, Teresa Oloriz, Hiroya Mizuno, Francesca Baratto, Caterina Bisceglia, Nicoleta Sora, Alessandra Marzi, Andrea Radinovic, Fabrizio Guarracini, Pasquale Vergara, Simone Sala, Gabriele Paglino, Simone Gulletta, Patrizio Mazzone, Manuela Cireddu, Giuseppe Maccabelli, Paolo Della Bella

Research output: Contribution to journalArticle

Abstract

Background: The mechanism of cardiac resynchronization therapy (CRT)-induced proarrhythmia remains unknown. We postulated that pacing from a left ventricular (LV) lead positioned on epicardial scar can facilitate re-entrant ventricular tachycardia. The aim of this study was to investigate the relationship between CRT-induced proarrhythmia and LV lead location within scar. Methods and Results: Twenty-eight epicardial and 63 endocardial maps, obtained from 64 CRT patients undergoing ventricular tachycardia ablation, were analyzed. A positive LV lead/scar relationship, defined as a lead tip positioned on scar/border zone, was determined by overlaying fluoroscopic projections with LV electroanatomical maps. CRTinduced proarrhythmia occurred in 8 patients (12.5%). They all presented early with electrical storm (100% versus 39% of patients with no proarrhythmia; P

Original languageEnglish
Pages (from-to)1064-1069
Number of pages6
JournalCirculation: Arrhythmia and Electrophysiology
Volume7
Issue number6
DOIs
Publication statusPublished - Dec 1 2014

Keywords

  • Cardiac resynchronization therapy
  • Catheter ablation
  • Tachycardia, ventricular

ASJC Scopus subject areas

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

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  • Cite this

    Roque, C., Trevisi, N., Silberbauer, J., Oloriz, T., Mizuno, H., Baratto, F., Bisceglia, C., Sora, N., Marzi, A., Radinovic, A., Guarracini, F., Vergara, P., Sala, S., Paglino, G., Gulletta, S., Mazzone, P., Cireddu, M., Maccabelli, G., & Della Bella, P. (2014). Therapy is determined by pacing on epicardial scar and can be successfully managed by catheter ablation. Circulation: Arrhythmia and Electrophysiology, 7(6), 1064-1069. https://doi.org/10.1161/CIRCEP.114.001796