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ORIGINAL ARTICLE
Year : 2021  |  Volume : 6  |  Issue : 2  |  Page : 85-89

Feasibility of the transseptal approach for mapping and ablation in patients with ventricular aneurysm-related ventricular tachycardia with a steerable sheath: A retrospective study


State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Correspondence Address:
Dr. Min Tang
State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhr.ijhr_15_21

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Background: A retrograde transaortic access might be limited in mapping and ablation for some left ventricular (LV) arrhythmias. We examined the feasibility and safety of a transseptal approach for catheter ablation of LV aneurysm (LVA)-related ischemic ventricular tachycardia (VT). Subjects and Methods: Five consecutive patients with postinfarction LVA-related VT were selected for catheter ablation at Fuwai Hospital from April 2011 to October 2015 in this retrospective study. After a routine transaortic LV-mapping approach was failed, a transseptal approach with a steerable sheath was performed in all these cases. The study was approved by the Ethics Committee of Fuwai Cardiovascular Hospital (approval No. 2016-768) on May 24, 2016. Results: In these five patients, four had LVAs located in the LV apical area, and one in the septum. Acute ablation successes were all failed to achieve through the transaortic route. Two were due to aortic stenosis and tortuous peripheral arteries and the others were due to failure to target the effective sites. While all ablation procedures succeeded through the sequent transseptal approach with a steerable sheath, and no major complications related to the transseptal approach were reported. During the 12-month (10–12 months) follow-up, no electrical storm or episode of VT was documented. One VT recurrence occurred, yet acute success was obtained again through the transseptal approach. Conclusions: Transseptal approach appears a feasible, safe, and effective method in catheter ablation for VT with LVA and could be considered as an elective approach.


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