Multicenter Experience With Catheter Ablation for Ventricular Tachycardia in Lamin A/C Cardiomyopathy

  title={Multicenter Experience With Catheter Ablation for Ventricular Tachycardia in Lamin A/C Cardiomyopathy},
  author={Saurabh Kumar and Alexander F.A. Androulakis and Jean Marc Sellal and Philippe Maury and Estelle Gandjbakhch and Xavier Waintraub and Anne Rollin and Pascale Richard and Philippe Charron and Samuel H. Baldinger and Ciorsti J Macintyre and Bruce Koplan and Roy M. John and Gregory F. Michaud and Katja Zeppenfeld and Fr{\'e}d{\'e}ric Sacher and Neal K. Lakdawala and William G. Stevenson and Usha B. Tedrow},
  journal={Circulation: Arrhythmia and Electrophysiology},
Background— Lamin A/C (LMNA) cardiomyopathy is a genetic disease with a proclivity for ventricular arrhythmias. We describe the multicenter experience with percutaneous catheter ablation of sustained monomorphic ventricular tachycardia (VT) in LMNA cardiomyopathy. Methods and Results— Twenty-five consecutive LMNA mutation patients from 4 centers were included (mean age, 55±9 years; ejection fraction, 34±12%; VT storm in 36%). Complete atrioventricular block was present in 11 patients; 3… 

Figures and Tables from this paper

Substrate Characterization and Outcomes of Ventricular Tachycardia Ablation in TTN (Titin) Cardiomyopathy

The arrhythmogenic substrate in TTN-related cardiomyopathy involves the basal septal and perivalvular regions and long-term outcomes of catheter ablation are modest, with high recurrence rate, likely related to an intramural location of VT circuits.

Ventricular Tachycardia in Dilated Cardiomyopathy: Is it Time for Genetic Testing in All Patients?

Ventricular Tachycardia Ablation in Nonischemic Cardiomyopathy.

Contemporary approach to catheter ablation of ventricular tachycardia in nonischemic cardiomyopathy

The use of cardiac imaging, electrocardiography, and electroanatomic mapping to define the VT substrate and the ablation techniques required to successfully prevent VT recurrence are discussed.



Outcome of Ventricular Tachycardia Ablation in Patients With Nonischemic Cardiomyopathy: The Impact of Noninducibility

Although 53% of patients with nonischemic cardiomyopathy had VT during follow-up, the 6-month VT burden was decreased by ≥75% in 79%, and non-complete procedural success was the strongest predictor of VT recurrence.

Linear ablation lesions for control of unmappable ventricular tachycardia in patients with ischemic and nonischemic cardiomyopathy.

Radiofrequency linear endocardial lesions extending from the dense scar to the normal myocardium or anatomic boundary seem effective in controlling unmappable VT.

Catheter Ablation of Ventricular Arrhythmia in Nonischemic Cardiomyopathy: Anteroseptal Versus Inferolateral Scar Sub-Types

Unipolar low-voltage distribution in nonischemic cardiomyopathy allows categorization of scar pattern as inferolateral, often requiring epicardial ablation mainly based on late potentials, and anteroseptal, which frequently involves an intramural septal substrate, leading to a higher VT recurrence.

Role of Alternative Interventional Procedures When Endo- and Epicardial Catheter Ablation Attempts for Ventricular Arrhythmias Fail

A collaborative strategy of alternative interventional procedures offers the possibility of achieving arrhythmia control in high-risk patients with VT that is otherwise uncontrollable with antiarrhythmic drugs and standard percutaneous catheter ablation techniques.

Elimination of Local Abnormal Ventricular Activities: A New End Point for Substrate Modification in Patients With Scar-Related Ventricular Tachycardia

Elimination of LAVAs is feasible and safe and is associated with superior survival free from recurrent VT, and can be identified in most patients with scar-related VT.

Reassessing Noninducibility as Ablation Endpoint of Post-Infarction Ventricular Tachycardia: The Impact of Left Ventricular Function

Noninducible patients with moderately depressed LV function have a favorable outcome compared with patients who remained inducible after ablation, on the contrary, patients with severely depressed LVfunction have a poor prognosis independent of the acute procedural outcome.

Contrast-Enhanced MRI–Derived Scar Patterns and Associated Ventricular Tachycardias in Nonischemic Cardiomyopathy: Implications for the Ablation Strategy

Two typical scar patterns (anteroseptal and inferolateral) account for 89% of arrhythmogenic substrates in patients with nonischemic cardiomyopathy.