Catheter Evaluation for Endocardial Ablation in Patients With Ventricular Tachycardia
Ventricular TachycardiaThe primary objective is to provide additional corroborative safety and efficacy data for the Navistar ThermoCool catheter for the treatment of subjects with ischemic Ventricular Tachycardia.
Computed Tomography Targets for Efficient Guidance of Catheter Ablation in Ventricular Tachycardia...
Ventricular TachycardiaThe hypothesis of MAP IN HEART is that catheter ablation for post-infarction ventricular tachycardia (VT) can be largely improved through a direct definition of primary ablation targets from pre-operative CT scan imaging. The objective of is to demonstrate that catheter ablation of post-infarction VT targeting left ventricular wall thickness channels as defined from CT scan is feasible and associated with favorable efficacy, efficiency and safety profiles. A single-arm prospective cohort study will be conducted, including 40 patients over 3 European centres. Baseline, procedural and 6-month follow-up data will be analyzed
Application of High Power Radio Frequency Energy in the Ventricular Tachycardia Treatment
Ventricular TachycardiaHeart DiseasesBackground: Patient's freedom from VT after RFA remains non-optimal and it depends on many factors. One of them is the effective reduction of the myocardium with RF energy during the operation. The standardization of the parameters of RF will help to increase the success of the procedure. Hypothesis: Radiofrequency ablation of ventricular tachycardias with high power parameters has comparable safety and leads to greater efficacy (absence of ventricular tachycardias and all types of cardioverter-defibrillator therapies) in the long-term compared with ablation with standard parameters in patients with structural heart disease. Purpose: to evaluate the safety and the efficiency of ablation of ventricular tachycardia in patients with structural heart disease using high power RF energy.
Adenosine Versus Verapamil for Management of Supraventricular Tachycardia Post- Coronary Artery...
Supraventricular TachycardiaThis prospective study was conducted in 268 patients aged from 65-70 years posted for coronary artery bypass grafting. Patients were randomly allocated to either adenosine or verapamil(control) groups. In the adenosine group, patients received IV adenosine 6 mg bolus then wait 2 minutes, if it failed to return to sinus rhythm then another 12 mg IV bolus of adenosine was administered, if supraventricular tachycardia persisted then the patient was shifted to verapamil. In verapamil group, patients received IV verapamil 5mg bolus slowly over 2 minutes followed by a second IV bolus dose of 5 mg ,10 minutes after the initial dose in case of persistence of supraventricular tachycardia (SVT). If SVT persisted, the patient was shifted to adenosine. The efficacy of the study drug, ICU stay length, systolic blood pressure, hospital- stay length, duration of extubation, the total dose of the study drug used, the total cost of the study drugs and the incidence of adverse events were recorded.
Hemodynamic Effects of Compression in POTS
Postural Tachycardia SyndromeWhen an individual with Postural Tachycardia Syndrome (POTS) stands up, their heart rate increases significantly (>30BPM) and they may experience symptoms such as lightheadedness, dizziness, shortness of breath, nausea and mental confusion. One commonly prescribed treatment for POTS is compression garments. Compression garments squeeze veins to help return blood back to the heart, which may decrease heart rate and symptoms on standing. However, there is little research about the effectiveness of compression in adults with POTS. In this study, the investigators will use the Lifewrap garment, which compresses the abdomen, pelvis and lower extremities, to evaluate the effectiveness of compression in POTS. The investigators will use a head up tilt (HUT) which will simulate standing. The study participant will participate in 4x 10 minute HUTs wearing 4 different compression configurations: full abdomen and lower extremity compression abdominal only compression leg only compression No compression The investigators hypothesize that with full compression, the participant's heart rate increase from lying down to upright will be lower than when they are not wearing any compression. The investigators will also ask the participant about their symptoms when they are upright. The results of this study could demonstrate the potential benefits of compression and what configuration is most effective. These findings could rapidly translate to the clinical setting, providing improved care.
As Low As Reasonable Achievable Fluoroscopy for SVT Ablation
Symptomatic Supraventricular TachycardiaSupraventricular tachycardia ablations of the Conformité Européenne (CE)-certified (since 2013) CartoUnivuTM module (Biosense Webster, Diamond Bar, USA) allows a seamless combination of a fluoro image and Carto® 3 System maps into a single view. This helps to reduce fluoroscopy levels and reduce exposure time for physicians, staff and patients to as low as reasonably achievable. The UnivuTM technology will be compared in a randomized manner to the conventional radiofrequency Ablation.
The Impact of Improved Vagal Function on Periaqueductal Gray Connectivity
Postural Tachycardia SyndromeThis study is being to see if participating in breathing exercise training and practicing this training will help with Postural tachycardia syndrome (POTS). The information may help doctors to learn more about how the different parts of people's brains communicate.
In Silico Pace Mapping To Optimise Ventricular Tachycardia Ablation
Ventricular TachycardiaPeople who suffer from incessant cardiac arrhythmias receive a small electrical device implanted into their chest that automatically senses when the heart beats arrhythmically and applies electrical pulse to re-establish normal activity. However, if problems persist, people can have an operation called catheter ablation therapy, which involves 'burning' small areas of the heart tissue in order to permanently disrupt the problematic electrical pathways driving these arrhythmias. However, procedure times and complication rates are high, whist success rates are punitively low (~50% success), largely due to the significant challenge clinicians face in identifying the ideal 'target' to ablate within the patient's heart. In this project, the investigators aim to develop, and clinically validate, an in silico tool that reconstructs a personalised computational model of a patient's heart using advanced MRI data, upon which a virtual 'mapping' procedure is then performed in order to identify (in the model) the optimal ablation target. This pre-procedural planning tool utilises stored information about the patient's specific arrhythmia from their implanted device, ensuring optimal targets are selected. The approach aims to reduce procedure times whilst increasing their safety, and ensure significantly increased long-term effectiveness of these invasive ablation procedures, increasing survival rates and quality-of-life. This study is concerned with the clinical arm of the study, specifically, in the collection of data from patients in order to (retrospectively) validate the computational model. The model itself will not be applied or used to treat these patients.
REnal SympathetiC Denervation to sUpprEss Tachyarrhythmias in ICD Recipients
Ventricular TachycardiaThe objective of this trial is to determine the efficacy and safety of adjunctive catheter-based renal sympathetic denervation (RSDN) in the primary prevention of implantable cardioverter defibrillator (ICD) therapy in patients with ischemic or non-ischemic ventricular dysfunction, who are to receive an ICD for either i) secondary prevention, or ii) primary prevention + inducible ventricular tachycardia (VT) by programmed ventricular stimulation at the time of ICD implantation. These patients will be randomized to ICD alone or ICD + RSDN.
Remifentanil Intravenous Patient Controlled Analgesia (IVPCA) for Ablation of Idiopathic Ventricular...
TachycardiaVentricularDetermine effects of remifentanil conscious sedation in patients undergoing Electrophysiological (EP) studies for the ablation of idiopathic ventricular tachycardia and/or persistent frequent premature ventricular contractions (PVCs) of non-ischemic origin