Publications by authors named "Tixier R"
Background: Cardioneuroablation (CNA) targets ganglionated plexus (GP) to treat neurally-mediated syncope, yet a standardized GP identification method is lacking. Post-processing of cardiac computed tomography (CT) identifies epicardial fat thus allowing for fat pad identification. While CT-guided CNA's feasibility is documented, data about GP anatomy and comprehensive evaluations of GP targeting methods remain scarce.
View Article and Find Full Text PDFCurrently, pulmonary vein isolation (PVI) is the gold standard in catheter ablation for atrial fibrillation (AF). However, PVI alone may be insufficient in the management of persistent AF, and complementary methods are being explored. One such method takes an anatomical approach-improving both its success rate and lesion durability may lead to improved treatment outcomes.
View Article and Find Full Text PDFBackground: Idiopathic ventricular fibrillation (IVF) can be associated with undetected distinct conditions such as microstructural cardiomyopathic alterations (MiCM) or Purkinje (Purk) activities with structurally normal hearts.
Objectives: This study sought to evaluate the characteristics of recurrent VF recorded on implantable defibrillator electrograms, associated with these substrates.
Methods: This was a multicenter collaboration study.
Article Synopsis
- The study aims to differentiate atypical atrioventricular nodal reentrant tachycardia (AVNRT) from orthodromic reciprocating tachycardia using a new method called the "local VA index," based on coronary sinus signals during arrhythmia.
- The retrospective analysis involved 75 patients with 37 diagnosed with AVRT and 38 with AVNRT, revealing significant differences in specific measurements between the two groups.
- The local VA index showed potential as an effective tool for distinguishing these arrhythmias, with a suggested threshold of 40 ms, while also highlighting limitations in traditional pacing methods due to variability in patient results.
Background: Stereotactic arrhythmia radioablation (STAR) is a potential new therapy for patients with refractory ventricular tachycardia (VT). The arrhythmogenic substrate (target) is synthesized from clinical and electro-anatomical information. This study was designed to evaluate the baseline interobserver variability in target delineation for STAR.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the relationship between abnormal atrial potentials (AAPs) and reentrant atrial tachycardia (AT), focusing on how AAPs can indicate areas of slow conduction that support AT circuits.
- Analysis of 123 ATs in 104 patients shows a significant overlap (93±13%) between AAP areas during sinus rhythm and regions of slow conduction during AT, with variations in AAP distribution based on the type of AT.
- Findings suggest that AAPs may help identify AT circuit characteristics, particularly in challenging mapping situations, with localized-reentrant ATs having smaller AAP areas compared to macro-reentrant ATs.
Article Synopsis
- Substrate abnormalities can change how atrial tachycardias (ATs) activate, affecting their wave patterns on electrocardiograms.
- This study examined high-density activation maps of 126 ATs to determine factors influencing periods of no electrical activity (isoelectric intervals) during these complex activation patterns.
- Results showed that smaller activated areas and larger low-voltage regions were significant predictors of these isoelectric intervals, with specific metrics indicating a strong ability to predict the presence of these intervals during atrial tachycardias.
Article Synopsis
- * Researchers evaluated 22 patients with recurrent ventricular arrhythmias, finding that all had abnormal substrate in the RV, while 45% also exhibited abnormalities in the LV epicardium.
- * Results show that patients with LV abnormalities had longer arrhythmia histories and higher rates of SCN5A mutations, suggesting a significant link between these substrates and genetic factors in BrS.
Background: Omnipolar technology (OT) was recently proposed to generate electroanatomic voltage maps with orientation-independent electrograms. We describe the first cohort of patients undergoing ventricular tachycardia (VT) ablation guided by OT.
Objective: The purpose of this study was to compare omnipolar and bipolar high-density maps with regard to voltage amplitude, late potential (LP) annotation, and isochronal late activation mapping distribution.
Article Synopsis
- Ventricular arrhythmias (VAs) are a leading cause of death in patients with repaired Tetralogy of Fallot (rTOF), and the study aimed to evaluate outcomes of patients who underwent programmed ventricular stimulation (PVS) followed by possible ablation before pulmonary valve replacement (PVR).
- The study included 77 patients between 2010 and 2018; ablation was performed in those deemed inducible or with slow conduction, and during follow-up, no sudden cardiac deaths were reported.
- Findings suggest that preoperative electrophysiological studies can identify rTOF patients at risk for VAs, enabling targeted ablation and better decision-making for implantable cardioverter-defibrillator (ICD)
Purpose Of Review: Imaging plays a crucial role in the therapy of ventricular tachycardia (VT). We offer an overview of the different methods and provide information on their use in a clinical setting.
Recent Findings: The use of imaging in VT has progressed recently.
Background: Bipolar voltage is widely used to characterize the atrial substrate but has been poorly validated, particularly during clinical tachycardias.
Objective: The purpose of this study was to evaluate the diagnostic performance of voltage thresholds for identifying regions of slow conduction during reentrant atrial tachycardias (ATs).
Methods: Thirty bipolar voltage and activation maps created during reentrant ATs were analyzed to (1) examine the relationship between voltage amplitude and conduction velocity (CV), (2) measure the diagnostic ability of voltage thresholds to predict CV, and (3) identify determinants of AT circuit dimensions.
Aims: Assess prevalence, risk factors, and management of patients with intra-cardiac thrombus referred for scar-related ventricular tachycardia (VT) ablation.
Methods And Results: Consecutive VT ablation referrals between January 2015 and December 2019 were reviewed (n = 618). Patients referred for de novo, scar-related VT ablation who underwent pre-procedure cardiac computed tomography (cCT) were included.
Background: Beyond pulmonary vein (PV) isolation, anatomic isthmus transection is an adjunctive strategy for persistent atrial fibrillation. Data on the durability of multiple lines of block remain scarce.
Objective: The purpose of this study was to evaluate the impact of gaps within such a lesion set.
Distribution of atrial low voltage induced by vein of Marshall ethanol infusion.
J Cardiovasc Electrophysiol
August 2022
Introduction: Systematic and quantitative descriptions of vein of Marshall (VOM)-induced tissue ablation are lacking. We sought to characterize the distribution of low voltage observed in the left atrium (LA) after VOM ethanol infusion.
Methods And Results: The distribution of ethanol-induced low voltage was evaluated by comparing high-density maps performed before and after VOM ethanol infusion in 114 patients referred for atrial fibrillation ablation.
Background: Syncope in patients with an early repolarization (ER) pattern presents a challenge for clinicians as it has been identified as an indicator of a higher risk of life-threatening ventricular arrhythmias (VAs).
Objectives: This study aimed to analyze the outcome of patients with an ER pattern and syncope and to evaluate the factors predictive of VAs.
Methods: Over a period of 5 years, we enrolled 143 patients with an ER pattern and syncope in a multicenter prospective registry.
Introduction: The optimal strategy after a failed ablation for persistent atrial fibrillation (perAF) is unknown. This study evaluated the value of an anatomically guided strategy using a systematic set of linear lesions with adjunctive ethanol infusion into the vein of Marshall (Et-VOM) in patients referred for second perAF ablation procedures.
Methods And Results: Patients with perAF who underwent a second procedure were grouped according to the two strategies.
Objectives: This study sought to introduce a computed tomography (CT) protocol for optimal planning of vein of Marshall (VOM) catheterization.
Background: Ethanol infusion into the VOM (Et-VOM) is increasingly used in atrial fibrillation ablation.
Methods: Preprocedural CT was performed with either a conventional (conv-CT; n = 132) or an optimized CT protocol (VOM-CT; n = 126) designed for obtaining on a single image both left atrial and coronary sinus (CS) enhancement.