Intracardiac echocardiography guided anatomical ablation of the arcuate ridge for drug refractory inappropriate sinus tachycardia
Introduction Inappropriate sinus tachycardia (IST) is a common condition with frequently not tolerated beta‐blockers or ivabradine and a high rate of complication in ablation strategy; we describe an alternative anatomical approach of sinus node (SN) modulation. Methods This retrospective study desc...
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Veröffentlicht in: | Journal of cardiovascular electrophysiology 2024-07, Vol.35 (7), p.1393-1400 |
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creator | Cabrera, Juan Sebastian Tapias, Carlos Adams, Christian Hernandez, Boris Bautista, William Stozitzky, Valentina Restrepo, Alejandro Jimenez Saenz, Luis |
description | Introduction
Inappropriate sinus tachycardia (IST) is a common condition with frequently not tolerated beta‐blockers or ivabradine and a high rate of complication in ablation strategy; we describe an alternative anatomical approach of sinus node (SN) modulation.
Methods
This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing SN ablation.
Results
The mean age was 40.6 ± 13.9 years; five of the six patients were female, 100% of patients reported heart palpitations, and 66% reported dizziness, the average heart rate (HR) on a 24‐h Holter was 93.2 ± 7.9 bpm. HR during the first stage of a stress test using a standard Bruce protocol was 150 ± 70 bpm, The average HR on 24‐h Holter postablation was 75 ± 5.6 bpm, the sinus rate HR during stage 1 of a Bruce protocol exercise stress test was 120 ± 10 bpm.
Conclusion
This is the first case series reporting the acute and long‐term results of a novel anatomical approach for SN modulation to treat IST targeting the arcuate ridge (AR) under intracardiac echography (ICE) guidance. The novel anatomic ICE‐guided catheter ablation approach aimed to identify the earliest activation at the AR with an extension of RF lesions toward its septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.
Ablation set for modulation of the sinus node (SN) starting in the most septal portion of the arcuate ridge to the point of greatest precocity achieved with isoproterenol. |
doi_str_mv | 10.1111/jce.16285 |
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Inappropriate sinus tachycardia (IST) is a common condition with frequently not tolerated beta‐blockers or ivabradine and a high rate of complication in ablation strategy; we describe an alternative anatomical approach of sinus node (SN) modulation.
Methods
This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing SN ablation.
Results
The mean age was 40.6 ± 13.9 years; five of the six patients were female, 100% of patients reported heart palpitations, and 66% reported dizziness, the average heart rate (HR) on a 24‐h Holter was 93.2 ± 7.9 bpm. HR during the first stage of a stress test using a standard Bruce protocol was 150 ± 70 bpm, The average HR on 24‐h Holter postablation was 75 ± 5.6 bpm, the sinus rate HR during stage 1 of a Bruce protocol exercise stress test was 120 ± 10 bpm.
Conclusion
This is the first case series reporting the acute and long‐term results of a novel anatomical approach for SN modulation to treat IST targeting the arcuate ridge (AR) under intracardiac echography (ICE) guidance. The novel anatomic ICE‐guided catheter ablation approach aimed to identify the earliest activation at the AR with an extension of RF lesions toward its septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.
Ablation set for modulation of the sinus node (SN) starting in the most septal portion of the arcuate ridge to the point of greatest precocity achieved with isoproterenol.</description><identifier>ISSN: 1045-3873</identifier><identifier>ISSN: 1540-8167</identifier><identifier>EISSN: 1540-8167</identifier><identifier>DOI: 10.1111/jce.16285</identifier><identifier>PMID: 38741382</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Ablation ; Action Potentials ; Adult ; Anti-Arrhythmia Agents - therapeutic use ; arcuate ridge ; Cardiac arrhythmia ; Cardiac stress tests ; Catheter Ablation ; Drug Resistance ; Echocardiography ; Electrocardiography, Ambulatory ; Female ; Heart Rate ; Humans ; inappropriate sinus tachycardia ; intracardiac echography ; Male ; Medical treatment ; Middle Aged ; Patients ; Predictive Value of Tests ; Retrospective Studies ; Sinoatrial Node - physiopathology ; Sinoatrial Node - surgery ; sinus node ; Sinuses ; Tachycardia ; Tachycardia, Sinus - physiopathology ; Tachycardia, Sinus - surgery ; Time Factors ; Treatment Outcome ; Ultrasonography, Interventional</subject><ispartof>Journal of cardiovascular electrophysiology, 2024-07, Vol.35 (7), p.1393-1400</ispartof><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3135-d43ab1d57f01ef1c65fafdcea1ed11048de4671e3cb4f2a55d51e44e15d341943</cites><orcidid>0000-0003-2089-1843 ; 0000-0002-9538-8583</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjce.16285$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjce.16285$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38741382$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cabrera, Juan Sebastian</creatorcontrib><creatorcontrib>Tapias, Carlos</creatorcontrib><creatorcontrib>Adams, Christian</creatorcontrib><creatorcontrib>Hernandez, Boris</creatorcontrib><creatorcontrib>Bautista, William</creatorcontrib><creatorcontrib>Stozitzky, Valentina</creatorcontrib><creatorcontrib>Restrepo, Alejandro Jimenez</creatorcontrib><creatorcontrib>Saenz, Luis</creatorcontrib><title>Intracardiac echocardiography guided anatomical ablation of the arcuate ridge for drug refractory inappropriate sinus tachycardia</title><title>Journal of cardiovascular electrophysiology</title><addtitle>J Cardiovasc Electrophysiol</addtitle><description>Introduction
Inappropriate sinus tachycardia (IST) is a common condition with frequently not tolerated beta‐blockers or ivabradine and a high rate of complication in ablation strategy; we describe an alternative anatomical approach of sinus node (SN) modulation.
Methods
This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing SN ablation.
Results
The mean age was 40.6 ± 13.9 years; five of the six patients were female, 100% of patients reported heart palpitations, and 66% reported dizziness, the average heart rate (HR) on a 24‐h Holter was 93.2 ± 7.9 bpm. HR during the first stage of a stress test using a standard Bruce protocol was 150 ± 70 bpm, The average HR on 24‐h Holter postablation was 75 ± 5.6 bpm, the sinus rate HR during stage 1 of a Bruce protocol exercise stress test was 120 ± 10 bpm.
Conclusion
This is the first case series reporting the acute and long‐term results of a novel anatomical approach for SN modulation to treat IST targeting the arcuate ridge (AR) under intracardiac echography (ICE) guidance. The novel anatomic ICE‐guided catheter ablation approach aimed to identify the earliest activation at the AR with an extension of RF lesions toward its septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.
Ablation set for modulation of the sinus node (SN) starting in the most septal portion of the arcuate ridge to the point of greatest precocity achieved with isoproterenol.</description><subject>Ablation</subject><subject>Action Potentials</subject><subject>Adult</subject><subject>Anti-Arrhythmia Agents - therapeutic use</subject><subject>arcuate ridge</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac stress tests</subject><subject>Catheter Ablation</subject><subject>Drug Resistance</subject><subject>Echocardiography</subject><subject>Electrocardiography, Ambulatory</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>inappropriate sinus tachycardia</subject><subject>intracardiac echography</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Sinoatrial Node - physiopathology</subject><subject>Sinoatrial Node - surgery</subject><subject>sinus node</subject><subject>Sinuses</subject><subject>Tachycardia</subject><subject>Tachycardia, Sinus - physiopathology</subject><subject>Tachycardia, Sinus - surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Interventional</subject><issn>1045-3873</issn><issn>1540-8167</issn><issn>1540-8167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1rGzEQhkVpaD7aQ_9AEfSSHjbRWNLu-liM0yYYcknPy1ga2TLrlSvtEvaYfx7Fm_YQiC4axMOjeXkZ-wriCvK53hm6gnJW6w_sDLQSRQ1l9THPQulC1pU8Zecp7YQAWQr9iZ3mNwWynp2xp9uuj2gwWo-Gk9mG4xw2EQ_bkW8Gb8ly7LAPe2-w5bhusfeh48HxfkscoxmwJx693RB3IXIbhw2P5LK2D3HkvsPDIYZD9C9c8t2QeI9mO06_fmYnDttEX17vC_bnZvmw-F2s7n_dLn6uCiNB6sIqiWuwunICyIEptUNnDSGQhRy0tqTKCkiatXIz1NpqIKUItJUK5kpesMvJm3f5O1Dqm71PhtoWOwpDaqTQqpZzXemMfn-D7sIQu7xdpqpai1ml5pn6MVEmhpRy4CZH3GMcGxDNSy9N7qU59pLZb6_GYb0n-5_8V0QGrifg0bc0vm9q7hbLSfkMOsCZrg</recordid><startdate>202407</startdate><enddate>202407</enddate><creator>Cabrera, Juan Sebastian</creator><creator>Tapias, Carlos</creator><creator>Adams, Christian</creator><creator>Hernandez, Boris</creator><creator>Bautista, William</creator><creator>Stozitzky, Valentina</creator><creator>Restrepo, Alejandro Jimenez</creator><creator>Saenz, Luis</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2089-1843</orcidid><orcidid>https://orcid.org/0000-0002-9538-8583</orcidid></search><sort><creationdate>202407</creationdate><title>Intracardiac echocardiography guided anatomical ablation of the arcuate ridge for drug refractory inappropriate sinus tachycardia</title><author>Cabrera, Juan Sebastian ; Tapias, Carlos ; Adams, Christian ; Hernandez, Boris ; Bautista, William ; Stozitzky, Valentina ; Restrepo, Alejandro Jimenez ; Saenz, Luis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3135-d43ab1d57f01ef1c65fafdcea1ed11048de4671e3cb4f2a55d51e44e15d341943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Ablation</topic><topic>Action Potentials</topic><topic>Adult</topic><topic>Anti-Arrhythmia Agents - therapeutic use</topic><topic>arcuate ridge</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac stress tests</topic><topic>Catheter Ablation</topic><topic>Drug Resistance</topic><topic>Echocardiography</topic><topic>Electrocardiography, Ambulatory</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>inappropriate sinus tachycardia</topic><topic>intracardiac echography</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Sinoatrial Node - physiopathology</topic><topic>Sinoatrial Node - surgery</topic><topic>sinus node</topic><topic>Sinuses</topic><topic>Tachycardia</topic><topic>Tachycardia, Sinus - physiopathology</topic><topic>Tachycardia, Sinus - surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cabrera, Juan Sebastian</creatorcontrib><creatorcontrib>Tapias, Carlos</creatorcontrib><creatorcontrib>Adams, Christian</creatorcontrib><creatorcontrib>Hernandez, Boris</creatorcontrib><creatorcontrib>Bautista, William</creatorcontrib><creatorcontrib>Stozitzky, Valentina</creatorcontrib><creatorcontrib>Restrepo, Alejandro Jimenez</creatorcontrib><creatorcontrib>Saenz, Luis</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cabrera, Juan Sebastian</au><au>Tapias, Carlos</au><au>Adams, Christian</au><au>Hernandez, Boris</au><au>Bautista, William</au><au>Stozitzky, Valentina</au><au>Restrepo, Alejandro Jimenez</au><au>Saenz, Luis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intracardiac echocardiography guided anatomical ablation of the arcuate ridge for drug refractory inappropriate sinus tachycardia</atitle><jtitle>Journal of cardiovascular electrophysiology</jtitle><addtitle>J Cardiovasc Electrophysiol</addtitle><date>2024-07</date><risdate>2024</risdate><volume>35</volume><issue>7</issue><spage>1393</spage><epage>1400</epage><pages>1393-1400</pages><issn>1045-3873</issn><issn>1540-8167</issn><eissn>1540-8167</eissn><abstract>Introduction
Inappropriate sinus tachycardia (IST) is a common condition with frequently not tolerated beta‐blockers or ivabradine and a high rate of complication in ablation strategy; we describe an alternative anatomical approach of sinus node (SN) modulation.
Methods
This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing SN ablation.
Results
The mean age was 40.6 ± 13.9 years; five of the six patients were female, 100% of patients reported heart palpitations, and 66% reported dizziness, the average heart rate (HR) on a 24‐h Holter was 93.2 ± 7.9 bpm. HR during the first stage of a stress test using a standard Bruce protocol was 150 ± 70 bpm, The average HR on 24‐h Holter postablation was 75 ± 5.6 bpm, the sinus rate HR during stage 1 of a Bruce protocol exercise stress test was 120 ± 10 bpm.
Conclusion
This is the first case series reporting the acute and long‐term results of a novel anatomical approach for SN modulation to treat IST targeting the arcuate ridge (AR) under intracardiac echography (ICE) guidance. The novel anatomic ICE‐guided catheter ablation approach aimed to identify the earliest activation at the AR with an extension of RF lesions toward its septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.
Ablation set for modulation of the sinus node (SN) starting in the most septal portion of the arcuate ridge to the point of greatest precocity achieved with isoproterenol.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38741382</pmid><doi>10.1111/jce.16285</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2089-1843</orcidid><orcidid>https://orcid.org/0000-0002-9538-8583</orcidid></addata></record> |
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subjects | Ablation Action Potentials Adult Anti-Arrhythmia Agents - therapeutic use arcuate ridge Cardiac arrhythmia Cardiac stress tests Catheter Ablation Drug Resistance Echocardiography Electrocardiography, Ambulatory Female Heart Rate Humans inappropriate sinus tachycardia intracardiac echography Male Medical treatment Middle Aged Patients Predictive Value of Tests Retrospective Studies Sinoatrial Node - physiopathology Sinoatrial Node - surgery sinus node Sinuses Tachycardia Tachycardia, Sinus - physiopathology Tachycardia, Sinus - surgery Time Factors Treatment Outcome Ultrasonography, Interventional |
title | Intracardiac echocardiography guided anatomical ablation of the arcuate ridge for drug refractory inappropriate sinus tachycardia |
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