Practical Guide to Ablation for Epicardial Ventricular Tachycardia: When to Get Access, How to Deal with Anticoagulation and How to Prevent Complications

Ventricular tachycardia (VT) is one of the most challenging medical conditions faced by cardiac patients and physicians treating them. Antiarrhythmic medications have limited effectiveness and are frequently poorly tolerated.1–4 Catheter ablation is increasingly used to treat patients successfully.1,5–7 Most VTs can be ablated endocardially but some require epicardial mapping and ablation.

At the Atrioventricular Crossroads: Dual Pathway Electrophysiology in the Atrioventricular Node and its underlying Heterogeneities

More than 100 years have passed since the atrioventricular node (AVN) was first discovered by Sunao Tawara1 and described as a “Knoten” of tissue located at the proximal end of the Bundle of His (BoH).2 Despite the numerous advances in knowledge regarding the structure and function of the AVN, there are still several controversies that need to be addressed in both clinical and scientific settings.

Electrophysiological Testing for the Investigation of Bradycardias

In patients with syncope or episodes of palpitations and heart disease, an electrophysiology study (EPS) may be of value by means of potential induction of sustained ventricular tachyarrhythmias.1,2 Programmed ventricular stimulation may be useful in the context of risk stratification of ischaemic patients with left ventricular ejection fraction (LVEF) 30–40 %, and there has been some evidence that it might also be of predictive value in revascularised patients with ST-segment elevation myocardial infarction and LVEF ≤30 %.3,4 In patients investigated

Reduction of Fluoroscopy Time and Radiation Dosage During Catheter Ablation for Atrial Fibrillation

The number of catheter ablations for atrial fibrillation (AF) treatment has gradually increased over the last 15 years since the first report on the importance of pulmonary vein (PV) foci for triggering AF.1 Catheter ablation for AF is a complex procedure with multiple steps, such as transseptal puncture, mapping of the left atrium and PVs and extensive linear ablation around PV ostia.

Holter Monitoring and Loop Recorders: From Research to Clinical Practice

Since the 1960s, Holter monitoring has been a cornerstone for diagnosing suspected arrhythmias in patients of all ages.1 The most common monitoring systems allow the continuous registration of three or more leads for 24–48 hours; newer Holter monitors allow continuous electrocardiogram (ECG) registration for 2 weeks.1 Extending the time of ECG registration will increase the diagnostic yield of Holter monitoring, especially for those rhythm disturbances that are infrequent but recurrent.1,2 This need for a prolonged ECG monitoring has been a

Post-extrasystolic Potentiation: Link between Ca2+ Homeostasis and Heart Failure?

The concept of post-extrasystolic potentiation (PESP), which describes the phenomenon of increased contractility of the beat following an extrasystole, has intrigued physiologists and clinicians for more than 120 years. Since its first description in 1885 by Oskar Langendorff,1 PESP has become a widely debated concept, not only for its fundamental basis but also because of the potential diagnostic and therapeutic properties.