Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Apr 2009
ReviewInsights into energy delivery to myocardial tissue during radiofrequency ablation through application of the first law of thermodynamics.
The approach to catheter-based radiofrequency ablation of atrial fibrillation has evolved, and as a consequence, more energy is delivered in the posterior left atrium, exposing neighboring tissue to untoward thermal injury. Simultaneously, catheter technology has advanced to allow more efficient energy delivery into the myocardium, which compounds the likelihood of collateral injury. This review focuses on the basic principles of thermodynamics as they apply to energy delivery during radiofrequency ablation. These principles can be used to titrate energy delivery and plan ablative approaches in an effort to minimize complications during the procedure.
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J. Cardiovasc. Electrophysiol. · Apr 2009
Case ReportsSuccessful catheter ablation of hemodynamically unstable monomorphic ventricular tachycardia in a patient with hypertrophic cardiomyopathy and apical aneurysm.
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular (LV) apical aneurysm represent a previously under-recognized but important subgroup within this heterogeneous disease spectrum. Apical aneurysms and the contiguous areas of myocardial fibrosis have been associated with monomorphic ventricular tachycardia (VT) and increased risk for adverse clinical events including sudden cardiac death, prioritizing the application of primary prevention implantable defibrillators. However, VT may be repetitive, thereby raising considerations for additional treatment strategies such as radiofrequency ablation. In this report, we describe such a patient with HCM and apical aneurysm in whom the mapping and ablation procedure was effective in identifying and abolishing the VT focus.
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J. Cardiovasc. Electrophysiol. · Apr 2009
Predicting recurrence of vasovagal syncope: a simple risk score for the clinical routine.
Predictors for recurrence of syncope are lacking in patients with vasovagal syncope. The aim of this study was to identify risk factors for recurrence of syncope and develop a simple prognostic risk score of clinical value. ⋯ In patients with vasovagal syncope, risk of recurrence can be stratified and is predictable based on a simple risk score.