Endocardial approach for substrate ablation in Brugada Syndrome

Autores
Tauber, Pablo E.; Mansilla, Virginia; Brugada, Pedro; Sanchez, Sara Serafina del V.; Honore, Stella Maris; Elizari, Marcelo; Chain Molina, Sergio; Albano, Felix A.; Corbalán, Ricardo R.; Figueroa Castellanos, Federico; Alzugaray Bioeng, Damian
Año de publicación
2018
Idioma
inglés
Tipo de recurso
parte de libro
Estado
versión publicada
Descripción
Radiofrequency ablation (RFA) in Brugada syndrome (BrS) has been performed by both endocardial and epicardial. The substrate in BrS is not completely understood. We investigate the functional endocardial substrate and its correlation with clinical, electrophysiological and ECG findings in order to guide an endocardial ablation. Two patients agreed to undergo an endocardial biopsy and the samples were examined with transmission electron microscopy (TEM) to investigate the correlation between functional and ultrastructural alterations. About 13 patients (38.7 ± 12.3 years old) with spontaneous type 1 ECG BrS pattern, inducible VF with programmed ventricular stimulation (PVS) and syncope without prodromes were enrolled. Before endocardial mapping, the patients underwent flecainide testing with the purpose of measuring the greatest ST-segment elevation for to be correlated with the size and location of substrate in the electro-anatomic map. Patients underwent endocardial bipolar and electro-anatomic mapping with the purpose of identify areas of abnormal electrograms (EGMs) as target for RFA and determine the location and size of the substrate. When the greatest ST-segment elevation was in the third intercostal space (ICS), the substrate was located upper in the longitudinal plane of the right ventricular outflow tract (RVOT) and a greatest ST-segment elevation in fourth ICS correspond with a location of substrate in lower region of longitudinal plane of RVOT. A QRS complex widening on its initial and final part, with prolonged transmural and regional depolarization time of RVOT corresponded to the substrate located in the anterior-lateral region of RVOT. A QRS complex widening rightwards and only prolonged transmural depolarization time corresponded with a substrate located in the anterior, anterior-septal or septal region of RVOT. RFA of endocardial substrate suppressed the inducibility and ECG BrS pattern during 34.7 ± 15.5 months. After RFA, flecainide testing confirmed elimination of the ECG BrS pattern. Endocardial biopsy showed a correlation between functional and ultrastructural alterations. Endocardial RFA can eliminate the BrS phenotype and inducibility during programmed ventricular stimulation (PVS).
Fil: Tauber, Pablo E.. Model Heart Center. Electrophysiology Division; Argentina
Fil: Mansilla, Virginia. Model Heart Center. Electrophysiology Division; Argentina
Fil: Brugada, Pedro. Université Libre de Bruxelles; Bélgica
Fil: Sanchez, Sara Serafina del V.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; Argentina
Fil: Honore, Stella Maris. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; Argentina. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia; Argentina
Fil: Elizari, Marcelo. Academia Nacional de Medicina de Buenos Aires; Argentina
Fil: Chain Molina, Sergio. Model Heart Center. Electrophysiology Division; Argentina
Fil: Albano, Felix A.. Model Heart Center. Electrophysiology Division; Argentina
Fil: Corbalán, Ricardo R.. Model Heart Center. Electrophysiology Division; Argentina
Fil: Figueroa Castellanos, Federico. Clinica Mayo de UMCB; Argentina
Fil: Alzugaray Bioeng, Damian. Abbott; Argentina
Materia
Brugada syndrome
Mapping
Radiofrequency catheter ablation
Electrocardiography
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/199965
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/199965
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Endocardial approach for substrate ablation in Brugada SyndromeTauber, Pablo E.Mansilla, VirginiaBrugada, PedroSanchez, Sara Serafina del V.Honore, Stella MarisElizari, MarceloChain Molina, SergioAlbano, Felix A.Corbalán, Ricardo R.Figueroa Castellanos, FedericoAlzugaray Bioeng, DamianBrugada syndromeMappingRadiofrequency catheter ablationElectrocardiographyhttps://purl.org/becyt/ford/1.6https://purl.org/becyt/ford/1Radiofrequency ablation (RFA) in Brugada syndrome (BrS) has been performed by both endocardial and epicardial. The substrate in BrS is not completely understood. We investigate the functional endocardial substrate and its correlation with clinical, electrophysiological and ECG findings in order to guide an endocardial ablation. Two patients agreed to undergo an endocardial biopsy and the samples were examined with transmission electron microscopy (TEM) to investigate the correlation between functional and ultrastructural alterations. About 13 patients (38.7 ± 12.3 years old) with spontaneous type 1 ECG BrS pattern, inducible VF with programmed ventricular stimulation (PVS) and syncope without prodromes were enrolled. Before endocardial mapping, the patients underwent flecainide testing with the purpose of measuring the greatest ST-segment elevation for to be correlated with the size and location of substrate in the electro-anatomic map. Patients underwent endocardial bipolar and electro-anatomic mapping with the purpose of identify areas of abnormal electrograms (EGMs) as target for RFA and determine the location and size of the substrate. When the greatest ST-segment elevation was in the third intercostal space (ICS), the substrate was located upper in the longitudinal plane of the right ventricular outflow tract (RVOT) and a greatest ST-segment elevation in fourth ICS correspond with a location of substrate in lower region of longitudinal plane of RVOT. A QRS complex widening on its initial and final part, with prolonged transmural and regional depolarization time of RVOT corresponded to the substrate located in the anterior-lateral region of RVOT. A QRS complex widening rightwards and only prolonged transmural depolarization time corresponded with a substrate located in the anterior, anterior-septal or septal region of RVOT. RFA of endocardial substrate suppressed the inducibility and ECG BrS pattern during 34.7 ± 15.5 months. After RFA, flecainide testing confirmed elimination of the ECG BrS pattern. Endocardial biopsy showed a correlation between functional and ultrastructural alterations. Endocardial RFA can eliminate the BrS phenotype and inducibility during programmed ventricular stimulation (PVS).Fil: Tauber, Pablo E.. Model Heart Center. Electrophysiology Division; ArgentinaFil: Mansilla, Virginia. Model Heart Center. Electrophysiology Division; ArgentinaFil: Brugada, Pedro. Université Libre de Bruxelles; BélgicaFil: Sanchez, Sara Serafina del V.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; ArgentinaFil: Honore, Stella Maris. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; Argentina. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia; ArgentinaFil: Elizari, Marcelo. Academia Nacional de Medicina de Buenos Aires; ArgentinaFil: Chain Molina, Sergio. Model Heart Center. Electrophysiology Division; ArgentinaFil: Albano, Felix A.. Model Heart Center. Electrophysiology Division; ArgentinaFil: Corbalán, Ricardo R.. Model Heart Center. Electrophysiology Division; ArgentinaFil: Figueroa Castellanos, Federico. Clinica Mayo de UMCB; ArgentinaFil: Alzugaray Bioeng, Damian. Abbott; ArgentinaIntechOpenLakshmanadoss, Umashankar2018info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bookParthttp://purl.org/coar/resource_type/c_3248info:ar-repo/semantics/parteDeLibroapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/199965Tauber, Pablo E.; Mansilla, Virginia; Brugada, Pedro; Sanchez, Sara Serafina del V.; Honore, Stella Maris; et al.; Endocardial approach for substrate ablation in Brugada Syndrome; IntechOpen; 2018; 121-143978-1-78923-303-2CONICET DigitalCONICETenghttps://ri.conicet.gov.ar/handle/11336/101940info:eu-repo/semantics/altIdentifier/url/https://www.intechopen.com/chapters/61238info:eu-repo/semantics/altIdentifier/doi/10.5772/intechopen.75932info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:05:14Zoai:ri.conicet.gov.ar:11336/199965instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 10:05:14.581CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Endocardial approach for substrate ablation in Brugada Syndrome
title Endocardial approach for substrate ablation in Brugada Syndrome
spellingShingle Endocardial approach for substrate ablation in Brugada Syndrome
Tauber, Pablo E.
Brugada syndrome
Mapping
Radiofrequency catheter ablation
Electrocardiography
title_short Endocardial approach for substrate ablation in Brugada Syndrome
title_full Endocardial approach for substrate ablation in Brugada Syndrome
title_fullStr Endocardial approach for substrate ablation in Brugada Syndrome
title_full_unstemmed Endocardial approach for substrate ablation in Brugada Syndrome
title_sort Endocardial approach for substrate ablation in Brugada Syndrome
dc.creator.none.fl_str_mv Tauber, Pablo E.
Mansilla, Virginia
Brugada, Pedro
Sanchez, Sara Serafina del V.
Honore, Stella Maris
Elizari, Marcelo
Chain Molina, Sergio
Albano, Felix A.
Corbalán, Ricardo R.
Figueroa Castellanos, Federico
Alzugaray Bioeng, Damian
author Tauber, Pablo E.
author_facet Tauber, Pablo E.
Mansilla, Virginia
Brugada, Pedro
Sanchez, Sara Serafina del V.
Honore, Stella Maris
Elizari, Marcelo
Chain Molina, Sergio
Albano, Felix A.
Corbalán, Ricardo R.
Figueroa Castellanos, Federico
Alzugaray Bioeng, Damian
author_role author
author2 Mansilla, Virginia
Brugada, Pedro
Sanchez, Sara Serafina del V.
Honore, Stella Maris
Elizari, Marcelo
Chain Molina, Sergio
Albano, Felix A.
Corbalán, Ricardo R.
Figueroa Castellanos, Federico
Alzugaray Bioeng, Damian
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Lakshmanadoss, Umashankar
dc.subject.none.fl_str_mv Brugada syndrome
Mapping
Radiofrequency catheter ablation
Electrocardiography
topic Brugada syndrome
Mapping
Radiofrequency catheter ablation
Electrocardiography
purl_subject.fl_str_mv https://purl.org/becyt/ford/1.6
https://purl.org/becyt/ford/1
dc.description.none.fl_txt_mv Radiofrequency ablation (RFA) in Brugada syndrome (BrS) has been performed by both endocardial and epicardial. The substrate in BrS is not completely understood. We investigate the functional endocardial substrate and its correlation with clinical, electrophysiological and ECG findings in order to guide an endocardial ablation. Two patients agreed to undergo an endocardial biopsy and the samples were examined with transmission electron microscopy (TEM) to investigate the correlation between functional and ultrastructural alterations. About 13 patients (38.7 ± 12.3 years old) with spontaneous type 1 ECG BrS pattern, inducible VF with programmed ventricular stimulation (PVS) and syncope without prodromes were enrolled. Before endocardial mapping, the patients underwent flecainide testing with the purpose of measuring the greatest ST-segment elevation for to be correlated with the size and location of substrate in the electro-anatomic map. Patients underwent endocardial bipolar and electro-anatomic mapping with the purpose of identify areas of abnormal electrograms (EGMs) as target for RFA and determine the location and size of the substrate. When the greatest ST-segment elevation was in the third intercostal space (ICS), the substrate was located upper in the longitudinal plane of the right ventricular outflow tract (RVOT) and a greatest ST-segment elevation in fourth ICS correspond with a location of substrate in lower region of longitudinal plane of RVOT. A QRS complex widening on its initial and final part, with prolonged transmural and regional depolarization time of RVOT corresponded to the substrate located in the anterior-lateral region of RVOT. A QRS complex widening rightwards and only prolonged transmural depolarization time corresponded with a substrate located in the anterior, anterior-septal or septal region of RVOT. RFA of endocardial substrate suppressed the inducibility and ECG BrS pattern during 34.7 ± 15.5 months. After RFA, flecainide testing confirmed elimination of the ECG BrS pattern. Endocardial biopsy showed a correlation between functional and ultrastructural alterations. Endocardial RFA can eliminate the BrS phenotype and inducibility during programmed ventricular stimulation (PVS).
Fil: Tauber, Pablo E.. Model Heart Center. Electrophysiology Division; Argentina
Fil: Mansilla, Virginia. Model Heart Center. Electrophysiology Division; Argentina
Fil: Brugada, Pedro. Université Libre de Bruxelles; Bélgica
Fil: Sanchez, Sara Serafina del V.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; Argentina
Fil: Honore, Stella Maris. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; Argentina. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia; Argentina
Fil: Elizari, Marcelo. Academia Nacional de Medicina de Buenos Aires; Argentina
Fil: Chain Molina, Sergio. Model Heart Center. Electrophysiology Division; Argentina
Fil: Albano, Felix A.. Model Heart Center. Electrophysiology Division; Argentina
Fil: Corbalán, Ricardo R.. Model Heart Center. Electrophysiology Division; Argentina
Fil: Figueroa Castellanos, Federico. Clinica Mayo de UMCB; Argentina
Fil: Alzugaray Bioeng, Damian. Abbott; Argentina
description Radiofrequency ablation (RFA) in Brugada syndrome (BrS) has been performed by both endocardial and epicardial. The substrate in BrS is not completely understood. We investigate the functional endocardial substrate and its correlation with clinical, electrophysiological and ECG findings in order to guide an endocardial ablation. Two patients agreed to undergo an endocardial biopsy and the samples were examined with transmission electron microscopy (TEM) to investigate the correlation between functional and ultrastructural alterations. About 13 patients (38.7 ± 12.3 years old) with spontaneous type 1 ECG BrS pattern, inducible VF with programmed ventricular stimulation (PVS) and syncope without prodromes were enrolled. Before endocardial mapping, the patients underwent flecainide testing with the purpose of measuring the greatest ST-segment elevation for to be correlated with the size and location of substrate in the electro-anatomic map. Patients underwent endocardial bipolar and electro-anatomic mapping with the purpose of identify areas of abnormal electrograms (EGMs) as target for RFA and determine the location and size of the substrate. When the greatest ST-segment elevation was in the third intercostal space (ICS), the substrate was located upper in the longitudinal plane of the right ventricular outflow tract (RVOT) and a greatest ST-segment elevation in fourth ICS correspond with a location of substrate in lower region of longitudinal plane of RVOT. A QRS complex widening on its initial and final part, with prolonged transmural and regional depolarization time of RVOT corresponded to the substrate located in the anterior-lateral region of RVOT. A QRS complex widening rightwards and only prolonged transmural depolarization time corresponded with a substrate located in the anterior, anterior-septal or septal region of RVOT. RFA of endocardial substrate suppressed the inducibility and ECG BrS pattern during 34.7 ± 15.5 months. After RFA, flecainide testing confirmed elimination of the ECG BrS pattern. Endocardial biopsy showed a correlation between functional and ultrastructural alterations. Endocardial RFA can eliminate the BrS phenotype and inducibility during programmed ventricular stimulation (PVS).
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/bookPart
http://purl.org/coar/resource_type/c_3248
info:ar-repo/semantics/parteDeLibro
status_str publishedVersion
format bookPart
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/199965
Tauber, Pablo E.; Mansilla, Virginia; Brugada, Pedro; Sanchez, Sara Serafina del V.; Honore, Stella Maris; et al.; Endocardial approach for substrate ablation in Brugada Syndrome; IntechOpen; 2018; 121-143
978-1-78923-303-2
CONICET Digital
CONICET
url http://hdl.handle.net/11336/199965
identifier_str_mv Tauber, Pablo E.; Mansilla, Virginia; Brugada, Pedro; Sanchez, Sara Serafina del V.; Honore, Stella Maris; et al.; Endocardial approach for substrate ablation in Brugada Syndrome; IntechOpen; 2018; 121-143
978-1-78923-303-2
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://ri.conicet.gov.ar/handle/11336/101940
info:eu-repo/semantics/altIdentifier/url/https://www.intechopen.com/chapters/61238
info:eu-repo/semantics/altIdentifier/doi/10.5772/intechopen.75932
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv IntechOpen
publisher.none.fl_str_mv IntechOpen
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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