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Catheter ablation (CA) is an invasive adjunctive therapeutic option for atrial and ventricular arrhythmias, in uncontrolled cases, following optimal medical therapy.1,2 The validation of 3D mapping and its implementation into clinical usage has been a remarkable achievement in the field of complex ablation of scar-related ventricular tachycardia (VT) in the early 2000s.3 In the setting of atrial […]

Radiofrequency (RF) ablation involves delivering medium-to-high-frequency alternating current, which is electrically conducted to cardiac tissue that constitutes a part of the circuit. The unipolar circuitry contains the generator, transmission lines, catheter, cardiac tissue, interposed tissue and dispersive electrode (ground pad/indifferent electrode). Bipolar systems, whereby the RF current flows between two electrodes, either on the same […]

Pericarditis is the most common form of pericardial disease, with an incidence of 27.7 cases per 100,000 population per year.1 Approximately 15–30% of patients with acute pericarditis will have a first recurrence within 18 months despite optimal medical therapy. Half of these patients will fail to achieve complete remission and will continue to have recurrent […]

Background: Patients with adult congenital heart disease (ACHD) are more prone to atrial arrhythmia, which increases their morbidity and mortality and risk of hospital admissions when compared with the same population where atrial arrhythmias are absent. Objective: Compare the use of OCTARAY™ to PENTARAY™ for atrial tachycardia mapping in a patient with ACHD to understand […]

Idiopathic left posterior fascicular ventricular tachycardia (ILPFVT) is rare form of ventricular tachycardia (VT) that is characterised by right bundle‐branch block (RBBB) morphology and superior axis in the presence of a structurally normal heart.1–3 The tachycardia is exquisitely sensitive to intravenous verapamil,1 and predominantly affects young adults.2,3,5 The most common symptoms include palpitations, presyncope, syncope […]

  Atrial fibrillation (AF) is one of the most frequent arrhythmias worldwide, and, despite progress in the management of patients with AF, remains one of the major causes of stroke, heart failure, sudden death, and cardiovascular morbidity.1 The incidence and prevalence of AF is still increasing with higher numbers in developed countries, which is probably […]

The clinical introduction of cardiac electrophysiology (EP) studies in the 1980s was a cornerstone in how to understand, diagnose and treat specific arrhythmias. Anatomic orientation and positioning of catheters was achieved by fluoroscopic guidance. Signals were derived from intracardiac EP-catheters and interpretation of these, in combination with specific stimulation manoeuvres, led to successful therapies. Increasing […]

With the introduction of invasive and noninvasive phase mapping in humans, visualisation of rotor activity during atrial fibrillation has emerged as a new concept.1–3 However, phase maps rendered during human atrial fibrillation using noninvasive information from body-surface electrocardiograms (ECGs) versus data from unipolar electrograms (EGs) acquired during invasive contact mapping may show distinct differences. Thus, […]

The atrial transseptal puncture (TSP) technique is an indispensable procedure in the invasive cardiac catheterisation laboratory. TSP was initially developed in 1959 by Ross, Braunwald and Morrow at the National Institutes of Health, to allow for catheter access to the left atrium (LA) and left ventricle (LV) for the evaluation of valvular heart disease.1 However, […]