Dr. J.L. Mont Girbau: ¿Cómo reducir las descargas en pacientes portadores de DAI?
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¿Cómo reducir las descargas en pacientes portadores de DAI?
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Dr. J.L. Mont Girbau: ¿Cómo reducir las descargas en pacientes portadores de DAI?
- 1. How to decrease Shock Therapy: Present and future of Catheter ablation Thorax Institute. Hospital Clinic University of Barcelona
- 5. Prophylactic Catheter Ablation for the Prevention of Defibrillator Therapy Reddy et al. N Engl J Med 2007 Decrease the number of appropriate shocks!
- 6. Stevenson et al. Circulation 2008
- 8. Tools to overcome unstable VT Mapping activation with a single beat Non-contact mapping
- 10. Carbuccicchio et al. Circulation 2009
- 12. Relationship of frequent VPB’s to the reentry circuit of scar-related tachycardia Bogun et al. Heart and Rhythm 2008
- 14. De Bakker et al. JACC 1990
- 15. Defining Channels of conduction within the scar during sinus rythm Arenal et al.Circulation 2004
- 18. ECG recognition of epicardial origin Berruezo et al. Circ 2004 Pseudo delta in V2 > 34ms Intrinsecoid deflection in V2 > 85 ms Epicardial Endocardial
- 19. Contraste en saco Catéter ablación
- 20. RV EPI
- 21. RF on
- 22. Bogun et al JACC 2009
- 23. Bogun et al JACC 2009
- 24. Cardiac Image by ce-CMR Value in identifying scar location Epicardial VT in a patient with a noncompaction of the LV - Hyperenhancement (scar) - Abnormal electrograms
- 25. Codreanu et al JACC 2008
- 26. Khaykin et al Heart and Rhythm 2008
- 27. Mapping inside the CS GCV-AIV CS RVd 33 msec
- 28. Endocardial lesions (RF and fulguration) Epicardial lesions
- 31. Noninvasive Evaluation of RF Lesions in the Human Ventricular Myocardium by Ce-CMR Berruezo A, et al. Circulation Arrhythmia 2009.
- 32. Berruezo et al. Circ Arryth 2009 B A C D
- 33. Cardiac Image by ce-CMR Value in identifying scar location Epicardial hyperenhancement Endocardial normal EGs Epicardial re-entrant VTs
- 34. Cardiac Image by ce-CMR Tissue characterization 50%
- 35. Cardiac Image by ce-CMR Tissue characterization 60%
- 36. Cardiac Image by ce-CMR Tissue characterization
Editor's Notes
- In 2004 we demonstrated that it is posible to identify the epicardial origin of the ventricular activation on the surface ECG. To demonstrate the hypothesis that epicardial pacing increases the initial duration of the QRS with respect to the endocardial pacing, we paced several patients from the epicardium and the endocardium of the LV free wall at a similar site When pacing was performed from the epicardium, as compared when the stimulus was delivered from the endocardium: 1) Although we obtained a similar QRS configuration 2) the presence of a pseudo delta wave increased the duration of the initial part of the QRS complex and 3) this pseudo delta wave matched with the transmural activation time.
- DURÁN PORRAS Ejemplo (Martí Recover): - Previous failed ablation - ECG - Mapa Endo - Resonancia - Finalmente mapa Epi