Reality EP: Role of 3-D ICE and Epicardial Mapping in the Ablation of Ventricular Outflow Tract Tachycardia
Wednesday, March 4, 2009
Loyola University Health System
Maywood, IL
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Program Description
This Heart Rhythm Society live webcast featured a panel discussion of an ablation of ventricular outflow tract tachycardia procedure utilizing 3-D ultrasound, coronary venous mapping, and possible percutaneous epicardial mapping in determining the site of origin of the ectopic beats, and in guiding ablation.
Patient Medical History
The patient is a 37-year-old woman with frequent PVCs noted on routine examination several months ago. She complained of progressive generalized fatigue and an irregular pulse. She had no history of dizziness, syncope or sustained palpitations. A 24-hour Holter Monitor demonstrated frequent uniform PVCs comprising 23% of all QRS complexes. A 12-lead electrocardiogram documented a LBBB - right inferior axis QRS configuration with a broad R wave in V1 and V2 most compatible with an origin in the left ventricular outflow tract or pulmonary artery. An echocardiogram demonstrated global left ventricular hypokinesis with an ejection fraction of 40%. A coronary angiogram performed in January 2009 was unremarkable. Treatment with beta blockers resulted in no change in symptoms, ventricular function, or the frequency of ectopic beats. She was considered to have a possible tachycardia mediated myopathy, and was referred for catheter ablation.
Target Audience
This program is intended for a professional audience.
- Cardiac electrophysiologists
- Cardiology and cardiac electrophysiology fellows
- Cardiac surgeons
- Other cardiologists and radiologists
- PAs and nurses
- Pediatric electrophysiologists
- Members of industry
Learning Objectives
Upon completion of this educational activity, participants will be able to:
- Use the surface ECG to identify potential sites of VT origin, and plan optimal mapping strategies prior to the procedure
- Recognize the differences between, and limitations of, both transvenous and percutaneous transpericardial approaches to epicardial mapping of outflow tract VT
- Use 3-D echo to construct anatomic mapping templates, and guide ablation of outflow tract VT
Expert Faculty
William G. Stevenson, MD, FHRS
Brigham & Women's Hospital
Boston, MA
David J. Wilber, MD, CCDS
Loyola University Medical Center
Maywood, IL
Neil Brysiewicz, BSE
Loyola University Medical Center
Maywood, IL
Disclosure of Faculty's Commercial Relationship(s)
Faculty Disclosures
It is the policy of the Heart Rhythm Society to ensure balance, independent objectivity, and scientific rigor in all its sponsored educational programs. All faculty members participating in continuing medical education activities are required to disclose to the program audience any real or apparent conflict of interest related to the content of their presentations. In accordance with the ACCME's Standards for Commercial Support of Continuing Medical Education, all faculty and planning partners must disclose any financial relationship(s) or other relationship(s) held within the past 12 months. The Heart Rhythm Society implements a mechanism to identify and resolve all conflicts of interest prior to delivering the educational activity to learners.
Accreditation
The Heart Rhythm Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Continuing Medical Education (CME)
The Heart Rhythm Society designates this educational activity for a maximum of 2.0 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
The AMA has determined that physicians not licensed in the USA who participate in this CME activity are eligible for AMA PRA Category 1 CreditsTM.
Continuing Education (CE) for Nurses
The Heart Rhythm Society is an approved provider of continuing nursing education by the New York State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
It has been assigned code 6GDPMX-PRV-077.
A maximum of 2.0 credit hours are available for this educational activity.
Disclaimer This program provides a forum for the open exchange and discussion of research results and scientific advancements in the field of cardiovascular pacing and electrophysiology; however, the Society makes no representation or warranty as to the truth, originality, or accuracy of the information presented in this program or in materials distributed in connection with them. Nor are the views expressed by the individual speakers necessarily the views of the Society. The Heart Rhythm Society supports the ACCME’s policy on evidence-based content and encourages faculty to adhere to these standards when planning a presentation.
Copyright © 2009 Heart Rhythm Society.
Reality EP
Bringing the Latest in EP Directly from the Lab to Your Laptop
The Role of 3-D ICE and Epicardial Mapping in the Ablation of Ventricular Outflow Tract Tachycardia Reality EP program is part of the Heart Rhythm Society's SCA 360° Initiative.
