674 results match your criteria re-entry tachycardia

Evaluation of Directed Graph-Mapping in Complex Atrial Tachycardias.

JACC Clin Electrophysiol 2021 Mar 25. Epub 2021 Mar 25.

Department of Physics and Astronomy, Ghent University, Ghent, Belgium.

Objectives: Directed graph mapping (DGM) is a novel operator-independent automatic tool that can be applied to the identification of the atrial tachycardia (AT) mechanism. In the present study, for the first time, DGM was applied in complex AT cases, and diagnostic accuracy was evaluated.

Background: Catheter ablation of ATs still represents a challenge, as the identification of the correct mechanism can be difficult. Read More

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Electrophysiologic and electroanatomic characterization of ventricular arrhythmias in non-compaction cardiomyopathy: A systematic review.

J Cardiovasc Electrophysiol 2021 Apr 1. Epub 2021 Apr 1.

Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.

Background: Non-compaction cardiomyopathy (NCCM) is a form of structural heart disease prone to ventricular arrhythmias (VAs) and sudden cardiac death. Non-compacted myocardium may harbor VA substrate, though some reports suggest otherwise.

Objective: This study aimed to characterize the electrophysiologic (EP) features of VA in NCCM. Read More

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Transition during radiofrequency ablation of manifest preexcitation. What is the mechanism?

J Electrocardiol 2021 Mar 9;66:49-53. Epub 2021 Mar 9.

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, Kerala, India.

A 45-year-old lady was evaluated for recurrent episodes of palpitation. Her 12‑lead electrocardiogram (ECG) showed manifest but incomplete pre-excitation consistent with left sided accessory pathway. There was no structural heart disease by echocardiogram. Read More

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Recurrent ventricular tachycardia associated with lipomatous metaplasia of a myocardial scar.

BMJ Case Rep 2021 Mar 19;14(3). Epub 2021 Mar 19.

Cardiology, UCSF Fresno Center for Medical Education and Research Edward and Ann Hildebrand Medical Library, Fresno, California, USA.

Lipomatous metaplasia in chronic postmyocardial infarction scars is a common and underappreciated finding seen in histopathology and cardiac MRI. Evidence suggests that lipomatous metaplasia is capable of altering the electroconductivity of the myocardium leading to re-entry pathways that are implicated in the pathogenesis of postmyocardial infarction arrhythmogenesis. We report a case of a patient who presented with non-sustained ventricular tachycardia and was found to have lipomatous metaplasia of a prior myocardial infarct-related scar. Read More

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The Left Atrial Appendage Ostium: Hotspots for Localized Re-Entry.

JACC Clin Electrophysiol 2021 Mar 25;7(3):333-342. Epub 2020 Nov 25.

Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York, USA.

Objectives: The goal of this study was to characterize the location and electrophysiological properties of left atrial appendage (LAA) atrial tachycardia (AT).

Background: The LAA has been reported to be a source of AT and atrial fibrillation (AF) triggers.

Methods: This study retrospectively reviewed ATs mapped to the LAA. Read More

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Supraventricular tachycardias in the first year of life: what is the best pharmacological treatment? 24 years of experience in a single centre.

BMC Cardiovasc Disord 2021 Mar 15;21(1):137. Epub 2021 Mar 15.

Cardiology Unit, Anna Meyer Children's University Hospital, Viale Gaetano Pieraccini 24, 50139, Florence, Italy.

Background: Supraventricular tachycardias (SVTs) are common in the first year of life and may be life-threatening. Acute cardioversion is usually effective, with both pharmacological and non-pharmacological procedures. However, as yet no international consensus exists concerning the best drug required for a stable conversion to sinus rhythm (maintenance treatment). Read More

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Re-entrant ventricular tachycardia in a postoperative case of tetralogy of Fallot - Ablated successfully under the three-dimensional mapping system.

Ann Pediatr Cardiol 2021 Jan-Mar;14(1):107-112. Epub 2020 Nov 25.

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

A 47-year-old female underwent cardiac repair for tetralogy of Fallot at the age of 12 years. Subsequently, she was asymptomatic on follow-up. Recently, she presented elsewhere with palpitations and presyncope with documented ventricular tachycardia (VT) having left bundle branch block morphology with inferior QRS axis and late precordial transition. Read More

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November 2020

Late-Gadolinium Enhancement Interface Area and Electrophysiological Simulations Predict Arrhythmic Events in Patients With Nonischemic Dilated Cardiomyopathy.

JACC Clin Electrophysiol 2021 02 29;7(2):238-249. Epub 2020 Oct 29.

Department of Biomedical Engineering, School of Biomedical & Imaging Sciences, King's College London, United Kingdom. Electronic address:

Objectives: This study sought to investigate whether shape-based late gadolinium enhancement (LGE) metrics and simulations of re-entrant electrical activity are associated with arrhythmic events in patients with nonischemic dilated cardiomyopathy (NIDCM).

Background: The presence of LGE predicts life-threatening ventricular arrhythmias in NIDCM; however, risk stratification remains imprecise. LGE shape and simulations of electrical activity may be able to provide additional prognostic information. Read More

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February 2021

Catheter Ablation in Patients With Neuroendocrine (Carcinoid) Tumors and Carcinoid Heart Disease: Outcomes, Peri-Procedural Complications, and Management Strategies.

JACC Clin Electrophysiol 2021 02 29;7(2):151-160. Epub 2020 Oct 29.

Division of Cardiovascular Disease, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address:

Objectives: This report describes a series of patients with neuroendocrine tumors with or without carcinoid heart disease undergoing catheter ablation at the authors' institution.

Background: Neuroendocrine (carcinoid) tumors are a rare form of neoplasm with the potential for systemic vasoactive effects and cardiac valvular involvement. These tumors can create peri-operative management challenges for the electrophysiologist. Read More

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February 2021

ATP - A friend with benefits.

J Electrocardiol 2021 Mar-Apr;65:102-104. Epub 2021 Feb 1.

Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Anti-tachycardia pacing (ATP) has gained widespread acceptance to treat ventricular tachyarrhythmias and prevent implantable defibrillator shocks. A 63-year-old lady with nonischemic cardiomyopathy underwent insertion of a primary prevention biventricular implantable cardioverter defibrillator (BIV-ICD). Post implant she was found to have recurrent episodes of atrioventricular nodal re-entry tachycardia (AVNRT) based on device electrograms. Read More

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February 2021

Delayed radiofrequency ablation efficacy in slow pathway ablation: a case report.

Eur Heart J Case Rep 2021 Feb 4;5(2):ytaa489. Epub 2021 Feb 4.

Department of Cardiology, Sestre Milosrdnice University Hospital, Vinogradska cesta 29, 10 000 Zagreb, Croatia.

Background: The delayed effect of radiofrequency (RF) ablation was described in cases of accessory pathway and premature ventricular contraction ablation, as well as delayed atrioventricular (AV) block after slow pathway ablation.

Case Summary: We report a case of a female patient with AV nodal re-entry tachycardia (AVNRT), in whom the first electrophysiology study ended with acute failure of slow pathway ablation, despite using long steerable sheath, both right and left-sided ablation with >15 min of RF energy application and repeatedly achieving junctional rhythm. Six weeks afterwards, during scheduled three-dimensional electroanatomical mapping procedure, there was no proof of dual AV nodal conduction nor could the tachycardia be induced. Read More

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February 2021

Use of high-density activation and voltage mapping in combination with entrainment to delineate gap-related atrial tachycardias post atrial fibrillation ablation.

Europace 2021 Feb 10. Epub 2021 Feb 10.

Electrophysiology and Ablation Unit, Hôpital Cardiologique du Haut Lévêque, Avenue de Magellan, 33604 Pessac Cedex, France.

Aims: An incomplete understanding of the mechanism of atrial tachycardia (AT) is a major determinant of ablation failure. We systematically evaluated the mechanisms of AT using ultra-high-resolution mapping in a large cohort of patients.

Methods And Results: We included 107 consecutive patients (mean age: 65. Read More

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February 2021

Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered.

Pediatr Cardiol 2021 Jan 29. Epub 2021 Jan 29.

Sport Sciences and Cardiovascular Research, Faculty of Engineering and Sport Sciences, Swansea University, Swansea, UK.

To investigate prenatal and postnatal outcomes of atrial flutter and its association with the development of a second tachycardia, following restoration of sinus rhythm, in the fetus or newborn. This study is a retrospective review of all fetuses that presented with atrial flutter from January 2001 to December 2019 at the University Hospital of Wales, Cardiff, UK. The specific type of arrhythmia, its time of appearance and clinical characteristics, echocardiographic findings, medical management, and postnatal outcomes were evaluated. Read More

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January 2021

An improved window of interest for electroanatomical mapping of atrial tachycardia.

J Interv Card Electrophysiol 2021 Jan 27. Epub 2021 Jan 27.

Ramsay Santé, Hôpital Privé Clairval, Service Cardiologie-Rythmologie, Marseille, France.

Purpose: Diagnosis of atrial tachycardia (AT) with 3D mapping system remains challenging due to fibrosis or previous ablation. This study aims to evaluate a new electroanatomical mapping annotation setting using a window of interest adjusted at the end of the P wave (WOI) to identify the AT mechanism more accurately.

Methods: Twenty patients with successful ablation of left AT using navigation system CARTO3 were evaluated. Read More

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January 2021

Characteristics of antegrade-only accessory pathways in children and adolescents.

Cardiol Young 2021 Jan 25:1-5. Epub 2021 Jan 25.

The Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA.

There is minimal data regarding antegrade-only accessory pathways in young patients. Given evolving recommendations and treatments, retrospective analysis of the clinical and electrophysiologic properties of antegrade-only pathways in patients <21 years old was performed, with subsequent comparison of electrophysiology properties to age-matched controls with bidirectional pathways. Of 522 consecutive young patients with ventricular pre-excitation referred for electrophysiology study, 33 (6. Read More

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January 2021

Updates in Ventricular Tachycardia Ablation.

Korean Circ J 2021 Jan;51(1):15-42

Department of Cardiology, Westmead Hospital, Sydney, Australia.

Sudden cardiac death (SCD) due to recurrent ventricular tachycardia is an important clinical sequela in patients with structural heart disease. As a result, ventricular tachycardia (VT) has emerged as a major clinical and public health problem. The mechanism of VT is predominantly mediated by re-entry in the presence of arrhythmogenic substrate (scar), though focal mechanisms are also important. Read More

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January 2021

Narrow Complex Tachycardia With Ventriculoatrial Dissociation: Keep Your Eye on the His.

JACC Clin Electrophysiol 2020 12;6(14):1808-1811

Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

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December 2020

Multicenter Study of Dynamic High-Density Functional Substrate Mapping Improves Identification of Substrate Targets for Ischemic Ventricular Tachycardia Ablation.

JACC Clin Electrophysiol 2020 12 16;6(14):1783-1793. Epub 2020 Sep 16.

Department of Cardiac Electrophysiology, The Barts Heart Center, St. Bartholomew's Hospital, London, United Kingdom; Institute of Cardiovascular Science, University College London, London, United Kingdom.

Objectives: The goal of this study was to evaluate the role of dynamic substrate changes in facilitating conduction delay and re-entry in ventricular tachycardia (VT) circuits.

Background: The presence of dynamic substrate changes facilitate functional block and re-entry in VT but are rarely studied as part of clinical VT mapping.

Methods: Thirty patients (age 67 ± 9 years; 27 male subjects) underwent ablation. Read More

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December 2020

Pathogenesis of Ventricular Arrhythmias and Its Effect on Long-Term Prognosis in Patients With Takotsubo Cardiomyopathy.

Cureus 2020 Oct 26;12(10):e11171. Epub 2020 Oct 26.

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Takotsubo cardiomyopathy (TTC), also known as broken heart syndrome, stress cardiomyopathy (SCM), or apical ballooning syndrome, is a non-ischemic cardiac disease with an initial clinical presentation that is very similar to acute coronary syndrome (ACS). Ventricular arrhythmias (VAs) contribute significantly to an increase in the rates of death in patients with TTC, especially during the acute phase, in which patients with TTC are more susceptible to develop life-threatening arrhythmias (LTA) such as ventricular tachycardia (VT), ventricular fibrillation (VF), torsades de pointes (TdP), and sudden cardiac death (SCD). However, the pathophysiology of TTC and how VA occurs are still a mystery. Read More

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October 2020

Complex Re-Entrant Arrhythmias Involving the His-Purkinje System: A Structured Approach to Diagnosis and Management.

JACC Clin Electrophysiol 2020 11 26;6(12):1488-1498. Epub 2020 Aug 26.

Division of Cardiology, University of California-San Francisco, San Francisco, California, USA. Electronic address:

Objectives: This study sought to characterize the presentations, electrophysiological features and diagnostic maneuvers for a series of unique arrhythmias involving the HPS.

Background: By virtue of its unique anatomy and ion channel composition, the His-Purkinje system (HPS) is prone to a variety of arrhythmic perturbations.

Methods: The authors present a collaborative multicenter case series of 6 patients with HPS-related arrhythmias. Read More

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November 2020

Ablation for idiopathic left ventricular tachycardia in a patient with double outlet right ventricle who underwent Fontan operation: a case report.

Eur Heart J Case Rep 2020 Oct 7;4(5):1-6. Epub 2020 Sep 7.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.

Background: The incidence of ventricular tachycardia (VT) in patients following Fontan operation is reported as 3.5%. Furthermore, in patients with repaired double outlet right ventricle (DORV), scar-related VT and outflow tract VT have been reported; however, Purkinje-related VT has not previously been reported. Read More

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October 2020

Significance of post-pacing intervals shorter than tachycardia cycle length for successful catheter ablation of atypical flutter.

Europace 2021 Apr;23(4):624-633

Cardiology Division, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.

Aims: During entrainment mapping of macro-reentrant tachycardias, the time difference (dPPI) between post-pacing interval (PPI) and tachycardia cycle length (TCL) is thought to be a function of the distance of the pacing site to the re-entry circuit and dPPI < 30 ms is considered within the re-entry circuit. This study assessed the importance of PPI < TCL as a successful target for atypical flutter ablation.

Methods And Results: A total of 177 ablation procedures were investigated. Read More

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Incessant Automatic Atrial Tachycardia in a Neonate Successfully Treated with Nadolol and Closely Spaced Doses of Flecainide: A Case Report.

Pediatr Rep 2020 Nov 11;12(3):108-113. Epub 2020 Nov 11.

Department of Pediatric Cardiology, Meyer Children's University Hospital, Viale Pieraccini 24, 50139 Florence, Italy.

Supraventricular tachyarrhythmia (SVT) is the most common type of arrhythmia in childhood. Management can be challenging with an associated risk of mortality. A female neonate was diagnosed with episodes of SVT, controlled antenatally with digoxin. Read More

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November 2020

Mechanism and interpretation of two-for-one response to premature atrial complexes during atrioventricular node re-entry tachycardia.

Europace 2021 Apr;23(4):634-639

Department of Cardiology, Ascension St. Vincent Hospital, 8333 Naab Road, #400, Indianapolis 46260, IN, USA.

Aims: The response to premature atrial complexes (PACs) during tachycardia has been shown to differentiate atrioventricular nodal re-entrant tachycardia (AVNRT) from focal junctional tachycardia (JT). His refractory PAC (HrPACs) perturbing the next His (resetting with fusion) is diagnostic of AVNRT and such a late PAC fusing with the native beat cannot reset the focal source of JT. Early PAC advancing the immediate His with continuation of tachycardia suggests JT but can also occur in AVNRT due to simultaneous conduction through the AV nodal fast and slow pathways [two-for-one response (TFOR)]. Read More

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Low-voltage bridge strategy to guide cryoablation of typical and atypical atrioventricular nodal re-entry tachycardia in children: mid-term outcomes in a large cohort of patients.

Europace 2021 Feb;23(2):271-277

Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Palidoro-Rome, Piazza Sant'Onofrio 4, 00165 Rome, Italy.

Aims: In the current literature, results of the low-voltage bridge (LVB) ablation strategy for the definitive treatment of atrioventricular nodal re-entry tachycardia (AVNRT) seem to be encouraging also in children. The aims of this study were (i) to prospectively evaluate the mid-term efficacy of LVB ablation in a very large cohort of children with AVNRT, and (ii) to identify electrophysiological factors associated with recurrence.

Methods And Results: One hundred and eighty-four children (42% male, mean age 13 ± 4 years) with AVNRT underwent transcatheter cryoablation guided by voltage mapping of the Koch's triangle. Read More

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February 2021

Outcome of catheter ablation in the very elderly-insights from a large matched analysis.

Clin Cardiol 2020 Dec 31;43(12):1423-1427. Epub 2020 Aug 31.

Department of Cardiology II-Electrophysiology, University Hospital Münster, Münster, Germany.

Background: Ablation emerged as first line therapy in the treatment of various arrhythmias. Nevertheless, in older patients (pts), decision is often made pro drug treatment as more complications and less benefit are suspected.

Hypothesis: We hypothesized that different kind of ablations can be performed safely regardless of the pts age. Read More

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December 2020

Periprocedural, early, and long-term risks of pacemaker implantation after atrioventricular nodal re-entry tachycardia ablation: a French nationwide cohort.

Europace 2020 10;22(10):1526-1536

GCS-Groupement des hôpitaux de l'institut Catholique de Lille/Faculté Libre de Médecine, Département de Cardiologie, Université Catholique de Lille, F-59000 Lille, France.

Aims: Pacemaker implantation (PI) after atrioventricular nodal re-entry tachycardia (AVNRT) ablation is a dreadful complication. We aimed to assess periprocedural, early, and late risks for PI.

Methods And Results: All 27 022 patients who underwent latest AVNRT ablation in France from 2009 to 2017, were identified in the nationwide medicalization database. Read More

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October 2020

Characterization of Complex Atrial Tachycardia in Patients With Previous Atrial Interventions Using High-Resolution Mapping.

JACC Clin Electrophysiol 2020 07 27;6(7):815-826. Epub 2020 May 27.

IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac, Bordeaux, France; Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), Pessac, France; Centre de recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France.

Objectives: This study systematically evaluated mechanisms of atrial tachycardia (AT) by using ultra-high-resolution mapping in a large cohort of patients.

Background: An incomplete understanding of the mechanism of AT is a major determinant of ablation failure.

Methods: Consecutive patients with ≥1 AT (excluding cavotricuspid isthmus-dependent flutter) were included. Read More

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From High-Density Mapping to Low-Density Mapping: Outlining the Active Circuit in Complex Atrial Re-Entrant Tachycardias.

JACC Clin Electrophysiol 2020 05 29;6(5):523-532. Epub 2020 Jan 29.

Arrhythmia Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, CIBERCV, Institut de Recerca HSCSP-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.

Objectives: The aim of this study was to describe a mapping approach for ablation of complex atrial re-entrant tachycardias (ARTs) in which high-density activation maps are transformed into low-density activation maps displaying only the active part of the tachycardia circuit.

Background: High-density activation maps during complex ARTs are challenging to interpret because they include the activation patterns of active and passive circuits. Entrainment mapping provides the identification of the active tachycardia circuit. Read More

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Benefit of ultra-high-density mapping-guided radiofrequency reablation in pulmonary vein isolation non-responders after initial cryoballoon procedure.

Europace 2020 06;22(6):906-915

Department of Cardiology and Internal Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich Municipal Hospital Group, Hospital Bogenhausen, Englschalkinger Str. 77, 81925 Munich, Germany.

Aims: Symptomatic atrial arrhythmias despite complete pulmonary vein isolation (PVI) are common. The purpose was to evaluate ultra-high-density multi-electrode electroanatomical mapping-guided radiofrequency ablation (RFA) in PVI non-responders.

Methods And Results: Ultra-high-density multi-electrode electroanatomical mapping-guided RFA in consecutive symptomatic atrial fibrillation (AF) patients after initial cryoballoon PVI was performed. Read More

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