Three-dimensional myocardial scar characterization from the endocardium: Usefulness of endocardial unipolar electroanatomic mapping
Por:
Bazan, V, Frankel, DS, Santangeli, P, Garcia, FC, Tschabrunn, CM and Marchlinski, FE
Publicada:
1 mar 2019
Ahead of Print:
12 ene 2019
Resumen:
Epicardial ablation may be required to eliminate ventricular tachycardia (VT) in patients with underlying structural heart disease. The decision to gain epicardial access is frequently based on the suspicion of an epicardial origin for the VT and/or presence of an arrhythmogenic substrate. Epicardial pathology and VT is frequently present in patients with nonischemic right and/or left cardiomyopathies even in the setting of modest or no endocardial bipolar voltage substrate. In this setting, unipolar voltage mapping from the endocardium serves to help identify midmyocardial and/or epicardial VT substrate. The additional value of endocardial unipolar mapping includes its usefulness to predict the clinical outcome after VT ablation, to determine the irreversibility of myocardial disease, and to guide endomyocardial biopsy procedures to specific areas of intramural scarring. In this review, we aim to provide a guide to the use of endocardial unipolar mapping and its appropriate interpretation in a variety of clinical situations.
Filiaciones:
:
Hosp Badalona Germans Trias & Pujol, Badalona, Spain
Frankel, DS:
Hosp Univ Penn, Electrophysiol Sect, 9 Founders Pavil Cardiol,3400 Spruce St, Philadelphia, PA 19104 USA
Santangeli, P:
Hosp Univ Penn, Electrophysiol Sect, 9 Founders Pavil Cardiol,3400 Spruce St, Philadelphia, PA 19104 USA
Garcia, FC:
Hosp Univ Penn, Electrophysiol Sect, 9 Founders Pavil Cardiol,3400 Spruce St, Philadelphia, PA 19104 USA
Tschabrunn, CM:
Hosp Univ Penn, Electrophysiol Sect, 9 Founders Pavil Cardiol,3400 Spruce St, Philadelphia, PA 19104 USA
Marchlinski, FE:
Hosp Univ Penn, Electrophysiol Sect, 9 Founders Pavil Cardiol,3400 Spruce St, Philadelphia, PA 19104 USA
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