Reality EP: Pulling the "Trigger" on Ablation for Ventricular Fibrillation/Polymorphic Ventricular Tachycardia
| Supported by an educational grant from: |
 |
Wednesday, September 9, 2009
Brigham & Women's Hospital
Boston, MA
Program Description
On Wednesday, September 9, 2009 the Heart Rhythm Society broadcast a live webcast of a physician and allied professional panel that convened to discuss a pre-recorded ablation procedure in a patient with idiopathic ventricular fibrillation. The panel discussed patient selection for, and approaches to, mapping and ablation of PVC triggers of VF/PMVT as well as the mechanism and common locations of these triggers.
| Previously on Reality EP: |
Patient Medical History
The patient featured is a middle aged male who was resuscitated from a VT cardiac arrest. Extensive cardiac evaluation showed no coronary artery disease, normal left and right ventricular function, normal cardiac MRI, and no inducible arrhythmias at EP study. Frequent PVCs were noted on cardiac monitoring. An ICD was implanted and continued to record episodes of nonsustained polymorphic VT, culminating in a sustained episode terminated by shock. Catheter ablation was performed targeting the ventricular ectopy.
Procedure Highlights
- Assessment of PVC origin from 12-lead ECG and limited intracardiac recordings
- Left ventricular mapping using a transseptal approach
- Advantages and disadvantages of multi-spine electrodes combined with a mapping system
- Pace-mapping for PVCs
- Defining the ablation target and endpoint
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:
- Describe the evaluation of patients to exclude known causes of polymorphic VT/VF
- Identify and map PVCs which initiate polymorphic VT/VF, with particular attention to the common sites for VF triggers
- Illustrate the potential difficulties that must be overcome to map PVCs in the left ventricle
- Predict the site of origin of ventricular ectopy, based on PVC morphology on 12-lead electrocardiography
- Describe methods of inducing PVCs and evaluate the appropriate endpoints of the ablation procedure
- Identify patients who may benefit from VF trigger ablation
- Explain the basic electrophysiological principles of PVC trigger mapping
- Integrate the role of 3-D mapping systems in PVC trigger ablation
Expert Faculty
Bruce A. Koplan, MD, MPH
Brigham & Women's Hospital
Boston, MA
Jason T. Jacobson, MD
Northwestern University Feinberg School of Medicine
Chicago, IL
William G. Stevenson, MD, FHRS
Brigham & Women's Hospital
Boston, MA
Cynthia Warner, RT
Brigham & Women's Hospital
Boston, MA
Disclosure of Faculty's Commercial Relationship(s)
Faculty Disclosures (11KB, PDF)
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 7M7R3X-PRV-09-02.
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
This Reality EP program is part of the Heart Rhythm Society's AF 360° Initiative.
