第72回日本不整脈心電学会学術大会

EN

Featured Sessions

特別企画

Meet the Super Mapper1(Ensite)

7月24日(金) 8:30~9:30 第8会場(アネックスホールB)

座長

篠田 康俊

筑波大学医学医療系循環器内科

徳留 大剛

横浜労災病院臨床工学部

前半(講演:AI翻訳付)
Dr. Rod Tung’s VT Mapping Strategy:A Toolkit for Localizing VT Circuitry
演者

Nathaniel Shatz

Abbott

抄録
VT is known to be a high-risk, complex, and time-consuming procedure. Unlike atrial arrhythmia, mapping in VT often brings hemodynamic risk to patients.
To reduce risk, scar homogenization in a baseline rhythm has emerged as the gold standard for VT ablation.
But in patients with extensive scar, not all scar contributes to VT circuitry, and significant regions may be unnecessarily ablated.
In addition, treating all scar, critical and non-critical, as equal may reduce ablation intentionality in critical VT circuitry regions, especially for intramural and 3D VT circuits.
There is a clinical need to improve the specificity of identifying VT circuitry without compromising patient hemodynamics.
Over the years, many strategies have emerged in locating and targeting the VT circuit with more specificity than scar mapping.
Dr. Tung has published that critical circuitry depends on locating lines of block (LOB) that contribute to the VT circuitry.
But about 50% of the time, lines of block are concealed or inaccessible. Thus, Dr. Tung utilizes many “tools” to uncover critical VT circuitry and lines of block.
This “tool kit” includes but is not limited to Isochronal Late Activation Mapping (ILAM), frequency analysis, pace-mapping, differential pacing, multiple wavefront mapping, Strategic Multielectrode Positioning (STaMP), Entrainment, and ICE visualization.
Not only do each of these VT mapping tools further specify critical VT circuitry, but also, they each gain new meaning and utility in the context of the information gained from each of the other tools.
Understanding the entire VT Mapping Toolkit and how each of the tools interact and aid each other is crucial for developing a streamlined VT mapping and ablation strategy.
Dr. Tung’s workflow recognizes that VT cases are widely variable, and not all tools can be applied in the same way for each patient.
This variance includes 3D vs 2D VT, substrate size and characteristics, baseline wavefronts, and VT inducibility. Under these circumstances, knowing how and when to apply each tool greatly improves trajectory of the entire VT procedure.
Though an understanding and intentional utilization of the VT mapping toolkit, critical VT circuitry can be reliably identified with improved specificity, improving our understanding of VT mechanisms and potentially reducing unnecessary ablation.
後半(症例ディスカッション)
Maximizing Ensite X Features in VT Mapping and Ablation
講師

濵﨑 誠之

横須賀共済病院臨床工学科

Meet the Super Mapper2(CARTO)

7月25日(土) 8:30~9:30 第7会場(アネックスホールA)

座長

倉田 征昭

昭和医科大学藤が丘病院循環器内科

新城 卓美

亀田総合病院ME室

前半(講演:AI翻訳付)
Beyond the Map:The Role of CARTO Clinical Support in VT Ablation
演者

Steven Touchton Jr.

Johnson & Johnson MedTech

後半(症例ディスカッション)
Mastering VT Mapping:Case-Based Learning from CARTO expert
講師

三浦 健太朗

筑波大学附属病院臨床工学部