Gerhard Hindricks

Venice Chart International Consensus Document on Atrial Fibrillation Ablation

Venice Chart International Consensus Document on Atrial Fibrillation Ablation ANDREA NATALE, M.D.,∗ ANTONIO RAVIELE, M.D.,† THOMAS ARENTZ, M.D.,‡ HUGH CALKINS, M.D.,¶ SHIH-ANN CHEN, M.D.,∗∗ MICHEL HAISSAGUERRE, M.D.,†† GERHARD HINDRICKS, M.D.,‡‡ YEN HO, M.D.,¶¶ KARL HEINZ KUCK, M.D.,∗∗∗ FRANCIS MARCHLINSKI, M.D.,††† CARLO NAPOLITANO, M.D.,‡‡‡ DOUGLAS PACKER, M.D.,¶¶¶ CARLO PAPPONE, M.D.,∗∗∗∗ ERIC N. PRYSTOWSKY, M.D.,†††† RICHARD SCHILLING, M.D.,‡‡‡‡ DIPEN SHAH, M.D.,¶¶¶¶ SAKIS THEMISTOCLAKIS, M.D.,† and ATUL VERMA, M.D.,∗∗∗∗∗ for the Venice Chart members From the ∗Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, USA; †Department of Cardiology, Arrhythmologic Section, Umberto I Hospital, Venice-Mestre, Italy; ‡Arrhythmia Service, Herz-Zentrum, Bad Krozingen, Germany; ¶Department of Cardiology, The Johns Hopkins Hospital, Baltimore, USA; ∗∗Division of Cardiology, Department of Medicine, National Yang-Ming University School of Medicine and Taipei Veterans General Hospital, Taipei, Taiwan; ††Hospital du Haut Leveque, CHU Bordeaux, Bordeaux, France; ‡‡University Leipzig, Heart Center, Department of Cardiology, Leipzig, Germany; ¶¶National Heart and Lung Institute, Imperial College and Royal Brompton & Harefield Hospitals, London, UK; ∗∗∗Second Medical Department, St Georg General Hospital, Hamburg, Germany; †††Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, USA; ‡‡‡Molecular Cardiology Laboratory, University of Pavia, Salvatore Maugeri Foundation, Pavia, Italy; ¶¶¶Department of Clinical Cardiac Electrophysiology and Internal Medicine, Mayo Clinic, Rochester, USA; ∗∗∗∗Department of Cardiology, Electrophysiology and Cardiac Pacing Unit, San Raffaele University Hospital, Milan, Italy; ††††St. Vincent Hospital and Health Care Center Program, Indianapolis, USA; ‡‡‡‡St. Bartholomew’s Hospital, London, UK; ¶¶¶¶Cardiology Cantonal Hospital of Geneva, Geneva, Switzerland; ∗∗∗∗∗University of Toronto, Toronto, Canada.

Catheter Ablation of Recurrent Scar‐Related Ventricular Tachycardia Using Electroanatomical Mapping and Irrigated Ablation Technology: Results of the Prospective Multicenter Euro‐VT‐Study

Catheter Ablation of Ventricular Tachycardia.u2002Introduction: Ventricular tachycardia (VT) late after myocardial infarction is an important contributor to morbidity and mortality. This prospective multicenter study assessed the efficacy and safety of electroanatomical mapping in combination with open‐saline irrigated ablation technology for ablation of chronic recurrent mappable and unmappable VT in remote myocardial infarction.

Clinical Performance of the St. Jude Medical Riata Defibrillation Lead in a Large Patient Population

Clinical Performance of the St. Jude Medical Riata Defibrillation Lead in a Large Patient Population.u2002Objective: The purpose of this large multicenter study was to evaluate the long‐term reliability of an implantable cardioverter defibrillator (ICD) lead to determine the incidence of adverse events (AEs).

Variants of preexcitation--specialized atriofascicular pathways, nodofascicular pathways, and fasciculoventricular pathways: electrophysiologic findings and target sites for radiofrequency catheter ablation.

Variants of Preexcitation. introduction: In the present report, the electrophysiiologic findings in patients with different types of variants of preeexcitwtion, i.e., atriofascicualr, nodofacicular, and fasciculoventricular fibers, and the results of radiofrequency catheter ablation using different target sites are described.

Steerable Sheath Catheter Navigation for Ablation of Atrial Fibrillation : A Case-Control Study

Background: Lack of stable access to all desired ablation target sites is one of the limitations for efficacious circumferential left atrial (LA) pulmonary vein (PV) ablation. Targeting that, new catheter navigation technologies have been developed. The aim of this study was to describe atrial fibrillation (AF) mapping and ablation using manually controlled steerable sheath catheter navigation and to compare it against an ablation approach with a nonsteerable sheath.

Acute and Long‐Term Clinical Outcome After Endoscopic Pulmonary Vein Isolation: Results from the First Prospective, Multicenter Study

Clinical Outcome After Endoscopic PVI.u2002Introduction: The acute and long‐term outcome of pulmonary vein isolation (PVI) using an endoscopic ablation system (EAS) has only been reported in single‐center studies. The current prospective, multicenter study assessed the acute and 1‐year outcome following PVI using the EAS.

Atrial arrhythmias following surgical AF ablation: electrophysiological findings, ablation strategies, and clinical outcome.

Intraoperative atrial fibrillation (AF) ablation during cardiac surgery is a well‐established treatment. However, tachycardia mechanisms, ablation strategies, and long‐term follow‐up of atrial arrhythmias (AA) following intraoperative AF ablation (AFA) have not been previously studied in a large cohort of patients.

Catheter Ablation of Ischemic Ventricular Tachycardia With Remote Magnetic Navigation: STOP-VT Multicenter Trial.

Catheter ablation is an effective treatment of scar‐related ventricular tachycardia (VT), but the overall complexity of the procedure has precluded its widespread use. Remote magnetic navigation (RMN) has been shown to facilitate cardiac mapping and ablation of VT in a retrospective series. STOP‐VT is the first multicenter, prospective, single‐arm and single‐procedure study evaluating RMN‐based mapping and ablation of post‐infarction VT.

Catheter Ablation of Idiopathic Left Ventricular Tachycardia: Use of New Mapping Technologies– When and Why

Sustained monomorphic ventricular tachycardias most commonly occur in patients with coronary artery disease, dilated cardiomyopathy, or other structural cardiac abnormalities, whereas so-called idiopathic ventricular tachycardias constitute a relatively small distinct subset occurring in patients without detectable underlying heart disease. In the majority of patients with idiopathic ventricular tachycardias, the arrhythmias exhibit a left bundle branch block pattern with an inferior frontal plane axis, and most originate from the right ventricular outfiow tract. A second peculiar type of idiopathic ventricular tachycardia has been characterized by a right bundle branch block pattern with left-axis deviation. These so-called idiopathic left ventricular tachycardias exhibit unique electrophysiologic properties when compared with ventricular tachycardias in the setting of structural heart disease, including termination by intravenous verapamil (verapamil-sensitive ventricular tachycardia), early retrograde His-bundle activation and participation of one of the left specialized fascicles (fascicular ventricular tachycardia), induction with atrial electrical stimulation, and precipitation by exercise and catecholamines. More than 20 years ago, Zipes et al. first described a subset of patients with this distinct type of ventricular tachycardia. Those authors discussed the pathophysiology 0! the arrhythmia and postulated protected areas in the posteroinferior left ventricle where reentry or triggered activity could take place. Within the last 2 decades, patients with idiopathic left ventricular tachycardia were studied in many electrophysiologic laboratories around the world. Detailed catheter mapping within the left ventricle during initiation of the arrhythmia and during ongoing ventricular tachycardia confirmed reentrant activation as the underlying mechanism in most of the cases, whereas it seems difficult to rule out cyclic AMP-mediated triggered activity in a subset of this type of ventricular tachycardia.-

Beyond pulmonary vein isolation: the issue of reconduction.

Since the milestone publication from Haı̈ssaguerre and co-workers1 describing the role of ectopic foci within the pulmonary veins (PVs) little more than a decade ago, a lot of progress has been achieved in the field of (potentially) curative ablation of atrial fibrillation (AF). PV isolation has developed as the core piece for most of the available ablation strategies. In the recently published report of the Heart Rhythm Society Task Force on Catheter and Surgical Ablation of Atrial Fibrillation,2 it was therefore recommended that “1. Ablation strategies which target the PVs and/or PV antrum are the cornerstone for most AF ablation procedures and 2. If the PVs are targeted, complete electrical isolation should be the goal.” However, the story of PV isolation is not at all trivial, and in part still unclear.