Problems And Emerging Solutions For Scarrelated Tachycardias

In some idiopathic and scar-related tachycardias the ablation target is not located on the endocardium, but is intramural or epicardial in location. In these cases, epicardial mapping can be attempted in one of two ways. Electrode catheters can be introduced into the cardiac venous system via the coronary sinus (CS). Small, 2 French multielectrode catheters are available that allow extensive epicardial mapping over regions of the left ventricle by canulating the branches of the CS and great...

Classification Of Nsvt

Waves With Wide Complex

NSVT can be categorized by morphology, clinical presentation, underlying substrate, and symptoms. Nonsustained tachycardias may present many appearances. The possibility that a nonsustained wide-complex tachycardia may be caused by supraventricular tachycardia with aberrancy should also be considered see Fig. 2B . Multiple algorithms have been proposed to aid in diagnosis from a practical perspective, wide-complex tachycardia is more likely VT than SVT with aberrancy, particularly in patients...

Vt Related To Regions Of Scar

Scar Related Reentry

The most common cause of VT is reentry through regions of scar, most commonly an old MI Fig. 4 . Other scar-related VTs occur because of arrhythmogenic right ventricular dysplasia, sarcoidosis, Chagas' disease, and other nonischemic cardiomyopathies. Two features of ventricular scarring lead to reentrant VT 40-42 . First, dense scarring creates regions of anatomic conduction block. Second, the scar is not comprised completely of dense fibrotic tissue, but also contains surviving myocyte bundles...

Atrial Tachycardia With Variable Block

Multifocal Atrial Tachycardia

ECGs in three patients with atrial tachycardia. A Atrial activity is most prominent in lead Vi. Note that the P wave is closer to the next QRS complex than the previous QRS complex a so-called long-RP tachycardia. There is 1 1 conduction until the end of the tracing, when AV nodal block reveals low amplitude P waves. B Atrial tachycardia with 2 1 A V conduction, and left bundle-branch block LBBB aberrancy in a patient with dilated cardiomyopathy. P-wave activity is most evident in lead...

Pharmacologic Treatment Of Patients With Nsvt

Electro Physiology

For patients at high risk, the concept of primary prevention of death is valid as long as an effective, proven, prophylactic approach exists. Several methods have been attempted antiarrhythmic drug suppression and ICD therapy. ACE inhibitors, spironolactone, and beta-blockers improve survival in high-risk patients with NSVT who have CAD, heart failure and or impaired ventricular function. Even so, death rates in these high-risk groups remain high. Beta-blockers are effective in reducing overall...