A Rare Case of Arrhythmogenic Right Ventricular Cardiomyopathy Co-existing with Isolated Left Ventricular Non-compaction

ABSTRACT Arrhythmogenic right ventricular cardiomyopathy is a rare heart-muscle disorder characterized by progressive replacement of right ventricular myocardium by fibrofatty tissue. Noncompaction of the ventricular myocardium is also rare congenital cardiomyopathy, characterized by an arrest in intrauterine endomyocardial morphogenesis. We present an extremely rare patient who presented with incessant ventricular tachycardia and who had both of these two cardiomyopathies at the same time.

Catheter Ablation of Para-Hisian Atrial Tachycardia Guide by CARTO / 昆明医科大学学报

Objective To evaluate the feasibility of catheter ablation of Para-Hisian Atrial Tachycardia guide by CARTO. Method Catheter ablation guided by CARTO was performed after activation map in three patients with Para-Hisian Atrial Tachycardia. Result Successful ablation was got at right atrial in two patients and at non-coronary in one patient. Conclusion Catheter ablation guided by CARTO is safe and efficient for Para-Hisian Atrial Tachycardia.

Critérios prognósticos de sucesso e recorrência na ablação circunferencial para tratamento da fibrilação atrial / Prognostic criteria of success and recurrence in circumferential ablation for the treatment of atrial fibrillation

OBJETIVOS: Analisar o sucesso da ablação circunferencial da fibrilação atrial e investigar possíveis preditores, clínicos e eletroanatômicos, de recorrência da arritmia. MÉTODOS: Foram analisados 104 pacientes consecutivos, submetidos à ablação circunferencial para tratamento de fibrilação atrial paroxística/persistente, sem cardiopatia estrutural e refratários a pelo menos duas drogas antiarrítmicas. Eram do sexo masculino 72 pacientes e a idade média do grupo foi de 58,6 + 10,9 anos. O procedimento consistiu em punção transeptal única e mapeamento tridimensional, com o sistema CARTO® para a aquisição de pontos no átrio esquerdo e veias pulmonares. As aplicações de radiofreqüência foram realizadas ao redor dos óstios das veias pulmonares, até a redução > 80 por cento da amplitude dos potenciais atriais. Uma linha adicional foi criada no istmo mitral e outra no istmo cavotricuspídeo. Foram analisadas: volume total do átrio esquerdo, área ablacionada ao redor das veias pulmonares e a presença ou não de falhas na linha de ablação (linha completa ou incompleta). Foi considerada linha completa quando a distância entre dois pontos contíguos de aplicação de radiofreqüência foi inferior a 10 mm. RESULTADOS: Em acompanhamento médio de 18 meses, 87 pacientes estavam em ritmo sinusal (84 por cento) e 17 pacientes apresentaram recidiva (16 por cento). Na análise multivariada, somente o volume atrial esquerdo (p < 0,0001) e a ablação completa (p <0 ,05) foram preditores independentes de recorrência. CONCLUSÃO: Os resultados sugerem que o volume atrial esquerdo e a presença de ablação completa são preditores de recorrência da fibrilação atrial.

OBJECTIVES: To analyze the success of circumferential ablation on atrial fibrillation and investigate possible clinical and electro-anatomical predictors of the recurrence of cardiac arrhythmia. METHODS: Analysis was done of 104 consecutive patients, free of structural heart disease and refractory to at least 2 antiarrhythmic drugs, submitted to circumferential ablation for treatment of paroxysmal/persistent atrial fibrillation. Were males 72 of the patients and the average age of the group was 58.6 + 10.9. The procedure consisted in a single transeptal puncture and three-dimensional mapping using the CARTO® system. Images of the left atrium and pulmonary veins were reconstructed. Radiofrequency applications were performed around the pulmonary vein ostia, up to a > 80 percent reduction in atrial potential amplitude. An additional mitral isthmus line was created, as well as one in the cavo-tricuspid isthmus. Total left-atrial volume, area ablated around the pulmonary veins, and the presence or absence of flaws in the ablation line (complete or incomplete line) were analyzed. A line was considered complete when the distance between two contiguous radiofrequency application points was less than 10 mm. RESULTS: After an average follow-up period of 18 months, 87 patients were in sinus rhythm (84 percent), while 17 patients presented recidivism (16 percent). In the multivariate analysis only left-atrial volume (p < 0.0001) and complete ablation (p < 0.05) were independent predictors of success. CONCLUSION: These data suggest that the left-atrial volume and the presence of complete ablation are predictors of recurrence.

Radiofrequency ablation of atrioventricular nodal re-entrant tachycardia guided by the CARTO electroanatomic mapping system / 解放军医学杂志

0.05), while when the CARTO technology was used, the mean fluoroscopy time was significantly shorter (6.3?2.6min vs 16.2?7.0min,P

Radiofrequency ablation of frequent premature ventricular contractions guided by CARTO / 解放军医学杂志

Objective To assess the clinical efficacy of electroanatomically guided mapping and radiofrequency ablation under CARTO system for premature ventricular contraction. Methods The CARTO electroanatomical mapping system displays real time three dimensional chamber structure with electrical information related to signal amplitude and activation time. Drugrefractory and frequent premature ventricular contractions were ablated under CARTO system. Results Frequent premature ventricular contractions were successfully ablated in all 8 patients with mean 2.2?1.7 radiofrequency applications under CARTO system. 6/8 frequent premature ventricular contractions occured in right ventricule, and 2/8 in left ventricule. After ablation, the premature ventricular contractions declined from 24 711?5 612 beats/24h to 0-5 beats/24h, and patient′s symptoms almost disappeared. No recurrent case was found during a period of 3-12 months following observation, and the premature ventricular contractions remained ≤10 beats/24h. Conclusions The CARTO electroanatomical mapping system, referred to the electrophysiologic data, may be applied in guiding the radiofrequency ablation of drug-refractory and frequent premature ventricular contractions in those patients who have no organic heart disease for its safety and accurate orientation.