real-time-cardiac-mapping-with-noninvasive-imageless

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Rapid, safe, and effective cardiac mapping is critical for the management of complex arrhythmias, yet current methods face significant limitations. The ...

Hospital Universitari i Politècnic La Fe

The number of congenital heart disease (CHD) patients transplanted to date is small. The results are comparable to those undergoing heart transplantation (HT) for other etiologies. However, advances in pediatric surgery over recent years (eg, the Fontan procedure) has increased the demand for HT by a growing number of children who reach adulthood and who also have a different profile. We analyzed the clinical profile and survival of our CHD patients compared with other etiologies.

Mortality after heart transplantation in adults with congenital heart disease: a single-center experience.

Many studies have shown a detrimental effect of female donor gender on heart transplantation (HT) outcome.

Analysis of the impact of donor gender on early mortality.

Electrical storm (ES) is a life-threatening condition that predicts bad prognosis. Treatment includes antiarrhythmic drugs (AAD) and catheter ablation (CA). The present study aims to retrospectively compare prognosis in terms of survival and ES recurrence in 52 consecutive patients experiencing a first ES episode.

Ablation or conservative management of electrical storm due to monomorphic ventricular tachycardia: differences in outcome.

The recommendations for complete lead extraction because of local complications at the site of implantable devices have changed in the last 10 years. We analyze the outcome of patients who required an intervention because of a local complication between 2002 and 2010, in our Hospital.

[Outcome of patients with local complications at the site of an implantable device].

Epicardial ablation has shown improvement in clinical outcomes of patients with ischemic heart disease (IHD) after ventricular tachycardia (VT) ablation. However, usually epicardial access is only performed when endocardial ablation has failed. Our aim was to compare the efficacy of endocardial+epicardial ablation versus only endocardial ablation in the first procedure in patients with IHD.

Endo-epicardial versus only-endocardial ablation as a first line strategy for the treatment of ventricular tachycardia in patients with ischemic heart disease.

Purkinje cells (PCs) are more resistant to ischemia than myocardial cells, and are suspected to participate in ventricular arrhythmias following myocardial infarction (MI). Histological studies afford little evidence on the behavior and adaptation of PCs in the different stages of MI, especially in the chronic stage, and no quantitative data have been reported to date beyond subjective qualitative depictions. The present study uses a porcine model to present the first quantitative analysis of the distal cardiac conduction system and the first reported change in the spatial distribution of PCs in three representative stages of MI: an acute model both with and without reperfusion; a subacute model one week after reperfusion; and a chronic model one month after reperfusion. Purkinje cells are able to survive after 90 minutes of ischemia and subsequent reperfusion to a greater extent than cardiomyocytes. A decrease is observed in the number of PCs, which suffer reversible subcellular alterations such as cytoplasm vacuolization, together with redistribution from the mesocardium-the main localization of PCs in the heart of ungulate species-towards the endocardium and perivascular epicardial areas. However, these changes mainly occur during the first week after ischemia and reperfusion, and are maintained in the chronic stages. This anatomical substrate can explain the effectiveness of endo-epicardial catheter ablation of monomorphic ventricular tachycardias in the chronic scar after infarction, and sets a basis for further electrophysiological and molecular studies, and future therapeutic strategies.

Changes in the spatial distribution of the Purkinje network after acute myocardial infarction in the pig.

Stand-alone substrate ablation has become a standard ventricular tachycardia (VT) ablation strategy. We sought to evaluate the influence of baseline VT inducibility and activation mapping on ablation outcomes in patients with structural heart disease (SHD) undergoing VT ablation.

Influence of baseline inducibility and activation mapping on ablation outcomes in patients with structural heart disease and ventricular tachycardia.

Conduction system pacing (CSP) has emerged as an ideal physiologic pacing strategy for patients with permanent pacing indications. We sought to evaluate the safety and feasibility of CSP in a consecutive series of unselected patients with congenital heart disease (CHD).

Safety and feasibility of conduction system pacing in patients with congenital heart disease.

Implant procedure features and clinical implications of left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) have not been yet fully described. We sought to compare two different left bundle branch area pacing (LBBAP) implant strategies: the first one accepting LVSP as a procedural endpoint and the second one aiming at achieving LBBP in every patient in spite of evidence of previous LVSP criteria.

Left bundle branch pacing versus left ventricular septal pacing as a primary procedural endpoint during left bundle branch area pacing: Evaluation of two different implant strategies.

Cardiac resynchronization therapy (CRT) via biventricular pacing (BiVP-CRT) is considered a mainstay treatment for symptomatic heart failure patients with reduced ejection fraction and wide QRS. However, up to one-third of patients receiving BiVP-CRT are considered non-responders to the therapy. Multiple strategies have been proposed to maximize the percentage of CRT responders including two new physiological pacing modalities that have emerged in recent years: His bundle pacing (HBP) and left bundle branch area pacing (LBBAP). Both pacing techniques aim at restoring the normal electrical activation of the ventricles through the native conduction system in opposition to the cell-to-cell activation of conventional right ventricular myocardial pacing. Conduction system pacing (CSP), including both HBP and LBBAP, appears to be a promising pacing modality for delivering CRT and has proven to be safe and feasible in this particular setting. This article will review the current state of the art of CSP-based CRT, its limitations, and future directions.

Conduction System Pacing for Cardiac Resynchronization Therapy.

Lumenless leads (LLLs) are widely used for left bundle branch area pacing (LBBAP). Recently, stylet-driven leads (SDLs) have also been used for LBBAP.

Article	Year
Mortality after heart transplantation in adults with congenital heart disease: a single-center experience. Transplantation proceedings\| PubMed ID: 17889188	2007
Analysis of the impact of donor gender on early mortality. Transplantation proceedings\| PubMed ID: 17889194	2007
Ablation or conservative management of electrical storm due to monomorphic ventricular tachycardia: differences in outcome. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology\| PubMed ID: 22696517	2012
[Outcome of patients with local complications at the site of an implantable device]. Archivos de cardiologia de Mexico\| PubMed ID: 24636049	2014
Endo-epicardial versus only-endocardial ablation as a first line strategy for the treatment of ventricular tachycardia in patients with ischemic heart disease. Circulation. Arrhythmia and electrophysiology\| PubMed ID: 26056239	2015
Changes in the spatial distribution of the Purkinje network after acute myocardial infarction in the pig. PloS one\| PubMed ID: 30742681	2019
Influence of baseline inducibility and activation mapping on ablation outcomes in patients with structural heart disease and ventricular tachycardia. Journal of cardiovascular electrophysiology\| PubMed ID: 33834564	2021
Safety and feasibility of conduction system pacing in patients with congenital heart disease. Journal of cardiovascular electrophysiology\| PubMed ID: 34405485	2021
Left bundle branch pacing versus left ventricular septal pacing as a primary procedural endpoint during left bundle branch area pacing: Evaluation of two different implant strategies. Journal of cardiovascular electrophysiology\| PubMed ID: 37962088	2024
Conduction System Pacing for Cardiac Resynchronization Therapy. Journal of cardiovascular development and disease\| PubMed ID: 37998506	2023
Acute performance of stylet driven leads for left bundle branch area pacing: A comparison with lumenless leads. Heart rhythm O2\| PubMed ID: 38204462	2023
Importance of sudden cardiac death risk assessment: the wearable cardioverter defibrillator as a bridge to transplant. Revista espanola de cardiologia (English ed.)\| PubMed ID: 38871230	2024

Maite Izquierdo

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