Noninvasive Mapping System for the Stereotactic Radioablation Treatment of Ventricular Tachycardia: A Case Description.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-08-05 DOI:10.3390/jcdd11080239

Imma Romanazzi, Antonio Di Monaco, Ilaria Bonaparte, Noemi Valenti, Alessia Surgo, Fiorella Di Guglielmo, Alba Fiorentino, Massimo Grimaldi

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引用次数: 0

Abstract

Objectives: Sustained monomorphic ventricular tachycardia (SMVT) is a life-threatening condition that is often observed in patients with structural heart disease. Catheter ablation (CA) ablation is an effective and well-established treatment for the scar-related ventricular tachycardias (VTs). Sometimes, due to patient fragility or contraindications to CA, a noninvasive procedure is required. In these cases, VT ablation with stereotactic arrhythmia radioablation (STAR) for SMVTs supported by the CardioInsight mapping system seems to be a promising and effective noninvasive approach.

Methods and results: We report a case of a 55-year-old male smoker and heavy alcohol consumer who developed ischemic heart disease and frequent refractory SMVT relative to antiarrhythmic drugs. Catheter ablation was not practicable due to the presence of an apical thrombosis in the left ventricle. The CardioInsight^TM system (Cardioinsight Technologies Inc., Cleveland, OH, USA) was useful for noninvasively mapping the VTs, identifying two target areas on the septum and anterior wall of the left ventricle. A personalized STAR treatment plan was carefully designed, and it was delivered in a few minutes. During follow-up, a significant reduction in the arrhythmia burden was documented.

Conclusions: Stereotactic arrhythmia radioablation supported by the CardioInsight system could be an alternative treatment for VTs when catheter ablation is not possible. Larger studies are needed to investigate this technique.

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用于室性心动过速立体定向射频消融治疗的无创绘图系统：病例描述。

目的：持续性单形室速（SMVT）是一种危及生命的疾病，通常见于结构性心脏病患者。导管消融术（CA）是治疗瘢痕相关性室性心动过速（VT）的有效且行之有效的方法。有时，由于患者体质虚弱或有 CA 的禁忌症，需要进行无创手术。在这些情况下，使用立体定向心律失常射频消融术（STAR）消融由 CardioInsight 制图系统支持的 SMVT 似乎是一种很有前景且有效的无创方法：我们报告了一例 55 岁男性吸烟者和酗酒者的病例，该患者患有缺血性心脏病，并经常出现抗心律失常药物治疗无效的难治性 SMVT。由于左心室存在心尖血栓，导管消融术不可行。CardioInsightTM 系统（美国俄亥俄州克利夫兰市 Cardioinsight Technologies Inc.精心设计的个性化 STAR 治疗方案在几分钟内就完成了。在随访期间，记录显示心律失常负荷明显减轻：结论：在导管消融术不可行的情况下，由 CardioInsight 系统支持的立体定向心律失常射频消融术可作为治疗 VT 的替代疗法。这项技术还需要更大规模的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464