Reversibility of tachycardiomyopathy after successful radiofrequency catheter ablation: intermediate results.

Left ventricular function in patients with tachycardia induced cardiomypopathy can improve after cessation of the arrhythmia. We reported the intermediate results of 10 patients, 6 men and 4 women, with tachycardiomyopathy who successfully underwent radiofrequency catheter ablation (RFCA) for incessant tachycardia. Three had right atrial tachycardia, 5 ventricular tachycardia (2 and 3 from the right and left ventricles, respectively), 1 atrial flutter and 1 right accessory pathway. During the mean follow-up period of 19 months (range 11-38 months), one patient, right atrial tachycardia, had recurrence and reablation was successfully done without recurrence. Left ventricular ejection fraction, endsystolic and diastolic diameters from echocardiography gradually improved from 35 per cent, 51 and 61 mm to 58 per cent, 36 and 52 mm, respectively (p<0.001). The mean duration of reversibility was 7 months (range 1-15 months). There was no recurrence of tachycardiomyopathy after the return of left ventricular function. Conclusion, RFCA can terminate tachyarrhythmia and lead to significant improvement of left ventricular diameters and systolic function in patients with tachycardia induced cardiomyopathy.

The use of nonfluoroscopic catheter-based mapping system to perform radiofrequency ablation in complex ventricular tachycardia after cardiac surgery in congenital heart disease: a case report.

A nonfluoroscopic electroanatomical cardiac mapping system (CARTO) integrates anatomical and electrophysiological information to reconstruct a three-dimensional activation map. Information from the CARTO system helps to reveal the mechanism and perform successful ablation in scar re-entry ventricular tachycardia after cardiac surgery. Three-dimensional activation and propagation mapping was performed in a patient with ventricular tachycardia after surgical correction of a double outlet right ventricle. The ventricular tachycardia appeared in two morphologies and were refractory to antiarrhythmic medication including amiodarone. Both ventricular tachycardias were re-entered using the ventriculotomy scar but rotated in different directions. Successful radiofrequency ablation was performed by creating a line of conduction block from the pulmonic valve to the ventriculotomy scar using entrainment mapping and the ablation lesion tagging technique. The CARTO system is useful in mapping and guiding the ablation of complex ventricular tachycardia after surgical correction in congenital heart disease

Biosense mapping for ablation of ventricular tachycardia in cardiomyopathy.

Using conventional technology, radiofrequency ablation of ventricular tachycardia in cardiomyopathy is frequently unsuccessful because of hemodynamic instability, multiple foci and recurrences. The Biosense CARTO nonfluoroscopic mapping and navigation system, when used to locate the area of the scar or reentry circuit, has the potential to improve the successful ablation, and reduce the rate of recurrence. We report 2 cases here of ventricular tachycardia in cardiomyopathy in which Biosense mapping was useful to identify the area of scar in 1 case, and the area of microreentry circuits in another. Radiofrequency ablation was possible and successful, while the use of conventional mapping was impossible or had recurrence.

Successful implantation of transvenous automatic implantable cardioverter defibrillator (AICD): the first case report in Thailand.

We successfully implanted transvenously the AICD in a case of sudden cardiac arrest survivor. Though the device is very expensive, it is useful in some selected cases. With its diagnostic capabilities, the device may be useful in elucidating the underlying mechanism of Lai Tai.

Radiofrequency catheter ablation in idiopathic ventricular tachycardia with structurally normal heart.

In conclusion, we reported two cases of idiopathic right and left VT who presented with syncope and palpitation. The surface QRS during VT and electrophysiologic studies showed the site of origin at RVOT in the first case and inferoapical area of left ventricle in the other. RF ablation was an effective treatment in both patients without any serious complication. Both of them are free of symptoms without any medication.