Journal: CJC Pediatric and Congenital Heart Disease

Article Title: Navigating Arrhythmias in Tetralogy of Fallot Throughout the Lifespan: A Case-based Review

doi: 10.1016/j.cjcpc.2023.09.006

Figure Lengend Snippet: Nonautomatic focal atrial tachycardia (NAFAT). ( A ) A 3-dimensional electroanatomic activation map in a left anterior oblique view with a caudal tilt. Activation times are color-coded, from red (earliest) to purple (latest). Radial spread of activation from a focal source at the anterior margin of the inferior vena cava (IVC) is observed. The yellow spheres indicate the position of the His bundle. ( B ) Termination of the NAFAT during the first radiofrequency application (≤1.1 seconds). Shown are surface leads II, avF, V1, and V6, and intracardiac electrograms recorded from distal (ABL d ) and proximal electrode pairs of the ablation catheter (ABL d ), distal (HIS d ) and proximal (HIS p ) His bundle catheter, proximal (CS 9-10 ) to distal (CS 1-2 ) coronary sinus, and right ventricular apex (RVA). The red As and blue Vs indicate atrial and ventricular electrograms, respectively. SVC, superior vena cava.

Article Snippet: Potential critical isthmuses for the sustained ventricular tachycardia were identified by 3-dimensional electroanatomic voltage mapping in sinus rhythm (Carto3; Biosense Webster, Inc) to delineate surgical scars (VSD patch and RVOT patch) and the position of tricuspid and pulmonary valves ( , B and C).

Techniques: Activation Assay

Journal: CJC Pediatric and Congenital Heart Disease

Article Title: Navigating Arrhythmias in Tetralogy of Fallot Throughout the Lifespan: A Case-based Review

doi: 10.1016/j.cjcpc.2023.09.006

Figure Lengend Snippet: Electrophysiology study before peripulmonary valve replacement. ( A ) Monomorphic ventricular tachycardia (VT) at a cycle length of 257 milliseconds is induced. Activation mapping could not be performed in VT due to haemodynamic instability, prompting antitachycardia overdrive pacing. Three-dimensional electroanatomic maps in sinus rhythm are shown in anteroposterior ( B ) and posteroanterior ( C ) views. Voltages ≥1.5 mV are represented in purple (normal tissue), whereas scar (≤0.5 mV) is color-coded red. Right (RPA) and left (LPA) pulmonary arteries, right ventricular outflow tract (RVOT) patch, right ventricular (RV) apex, pulmonary valve annulus, ventricular septal defect (VSD) patch, and the tricuspid valve are identified. Pace mapping was performed at the potential critical isthmuses for macroreentrant VT. The best pace map ( D ; 92% match) was obtained at the level of the asterisk along the isthmus between the VSD patch and pulmonary valve annulus.

Article Snippet: Potential critical isthmuses for the sustained ventricular tachycardia were identified by 3-dimensional electroanatomic voltage mapping in sinus rhythm (Carto3; Biosense Webster, Inc) to delineate surgical scars (VSD patch and RVOT patch) and the position of tricuspid and pulmonary valves ( , B and C).

Techniques: Activation Assay

Journal: HeartRhythm Case Reports

Article Title: Surgical ablation after stereotactic body radiation therapy for ventricular arrhythmias

doi: 10.1016/j.hrcr.2021.10.006

Figure Lengend Snippet: Open chest surgical ablation. A: Intraoperative photograph following median sternotomy and cardiopulmonary bypass cannulation. Large apical left ventricular aneurysm is shown (hatched outline with yellow shading). A Livewire 2-2-2 duodecapolar catheter (Abbott, Chicago, IL) was utilized for intraoperative high-density mapping. B: Epicardial electroanatomic voltage map (EnSite; Abbott, Chicago, IL) at standard scar settings (0.5–1.5 mV) from a left posterior oblique view. The duodecapolar catheter was placed with proximal end within the aneurysm, with distal end extending radially outward from the aneurysm. Various positions illustrated in (1) apical anterolateral, (2) apical inferolateral, and (3) apical inferior orientations showing late potentials and fractionated electrograms in the border zone regions.

Article Snippet: B: Epicardial electroanatomic voltage map (EnSite; Abbott, Chicago, IL) at standard scar settings (0.5–1.5 mV) from a left posterior oblique view.

Techniques: