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Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart Christie, Simon; Idris, Sami; Bennett, Richard G.; Deyell, Marc W.; Roston, Thomas; Laksman, Zachary
Abstract
Sudden cardiac death (SCD) represents approximately 50% of all cardiovascular mortality in the United States. The majority of SCD occurs in individuals with structural heart disease; however, around 5% of individuals have no identifiable cause on autopsy. This proportion is even higher in those <40 years old, where SCD is particularly devastating. Ventricular fibrillation (VF) is often the terminal rhythm leading to SCD. Catheter ablation for VF has emerged as an effective tool to alter the natural history of this disease among high-risk individuals. Important advances have been made in the identification of several mechanisms involved in the initiation and maintenance of VF. Targeting the triggers of VF as well as the underlying substrate that perpetuates these lethal arrhythmias has the potential to eliminate further episodes. Although important gaps remain in our understanding of VF, catheter ablation has become an important option for individuals with refractory arrhythmias. This review outlines a contemporary approach to the mapping and ablation of VF in the structurally normal heart, specifically focusing on the following major conditions: idiopathic ventricular fibrillation, short-coupled ventricular fibrillation, and the J-wave syndromes—Brugada syndrome and early-repolarization syndrome.
Item Metadata
Title |
Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart
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Creator | |
Publisher |
Multidisciplinary Digital Publishing Institute
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Date Issued |
2023-05-02
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Description |
Sudden cardiac death (SCD) represents approximately 50% of all cardiovascular mortality
in the United States. The majority of SCD occurs in individuals with structural heart disease; however,
around 5% of individuals have no identifiable cause on autopsy. This proportion is even higher
in those <40 years old, where SCD is particularly devastating. Ventricular fibrillation (VF) is often
the terminal rhythm leading to SCD. Catheter ablation for VF has emerged as an effective tool to
alter the natural history of this disease among high-risk individuals. Important advances have been
made in the identification of several mechanisms involved in the initiation and maintenance of
VF. Targeting the triggers of VF as well as the underlying substrate that perpetuates these lethal
arrhythmias has the potential to eliminate further episodes. Although important gaps remain in our
understanding of VF, catheter ablation has become an important option for individuals with refractory
arrhythmias. This review outlines a contemporary approach to the mapping and ablation of VF in
the structurally normal heart, specifically focusing on the following major conditions: idiopathic
ventricular fibrillation, short-coupled ventricular fibrillation, and the J-wave syndromes—Brugada
syndrome and early-repolarization syndrome.
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Subject | |
Genre | |
Type | |
Language |
eng
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Date Available |
2023-11-15
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Provider |
Vancouver : University of British Columbia Library
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Rights |
CC BY 4.0
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DOI |
10.14288/1.0437651
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URI | |
Affiliation | |
Citation |
Journal of Cardiovascular Development and Disease 10 (5): 200 (2023)
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Publisher DOI |
10.3390/jcdd10050200
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Peer Review Status |
Reviewed
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Scholarly Level |
Faculty; Researcher; Other
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Rights URI | |
Aggregated Source Repository |
DSpace
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Item Media
Item Citations and Data
Rights
CC BY 4.0