Teresa Oloriz - Academia.edu (original) (raw)

Papers by Teresa Oloriz

Research paper thumbnail of The value of the 12-lead electrocardiogram in localizing the scar in non-ischaemic cardiomyopathy

Europace, 2015

Patients with non-ischaemic cardiomyopathy (NICM) and ventricular tachycardia can be categorized ... more Patients with non-ischaemic cardiomyopathy (NICM) and ventricular tachycardia can be categorized as anteroseptal (AS) or inferolateral (IL) scar sub-types based on imaging and voltage mapping studies. The aim of this study was to correlate the baseline electrocardiogram (ECG) with endo-epicardial voltage maps created during ablation procedures and identify the ECG characteristics that may help to distinguish the scar as AS or IL. We assessed 108 baseline ECGs; 72 patients fulfilled criteria for dilated cardiomyopathy whereas 36 showed minimal structural abnormalities. Based on the unipolar low-voltage distribution, the scar pattern was classified as predominantly AS (n = 59) or IL (n = 49). Three ECG criteria (PR interval < 170 ms or QRS voltage in inferior leads <0.6 mV or a lateral q wave) resulted in 92% sensitivity and 90% specificity for predicting an IL pattern in patients with preserved ejection fraction (EF). The four-step algorithm for dilated cardiomyopathy included a paced ventricular rhythm or PR > 230 ms or QRS > 170 ms or an r ≤ 0.3 mV in V3 having 92 and 81% of sensitivity and specificity, respectively, in predicting AS scar pattern. A significant negative correlation was found between the extension of the endocardial unipolar low voltage area and left ventricular EF (rs = -0.719, P < 0.001). The extent of endocardial AS unipolar low voltage was correlated with PR interval and QRS duration (rs = 0.583 and rs = 0.680, P < 0.001, respectively) and the IL epicardial unipolar low voltage with the mean voltage of the limb leads (rs = -0.639, P < 0.001). Baseline ECG features are well correlated with the distribution of unipolar voltage abnormalities in NICM and may help to predict the location of scar in this population.

Research paper thumbnail of Successful radiofrequency ablation of an anteroseptal accessory pathway from the right coronary cusp

Research paper thumbnail of Noninducibility and Late Potential Abolition: A Novel Combined Prognostic Procedural End Point for Catheter Ablation of Postinfarction Ventricular Tachycardia

Circulation: Arrhythmia and Electrophysiology, 2014

Background-Successful late potential (LP) abolition and postprocedural ventricular tachycardia (V... more Background-Successful late potential (LP) abolition and postprocedural ventricular tachycardia (VT) noninducibility constitute significant end points after catheter ablation for VT. We investigated the prognostic impact of a combined procedural end point of VT noninducibility and LP abolition in a large series of post-myocardial infarction patients with VT.

Research paper thumbnail of Catheter Ablation of Ventricular Arrhythmia in Nonischemic Cardiomyopathy: Anteroseptal Versus Inferolateral Scar Sub-Types

Circulation: Arrhythmia and Electrophysiology, 2014

Research paper thumbnail of Electrical Storm Induced by Cardiac Resynchronization Therapy Is Determined by Pacing on Epicardial Scar and Can be Successfully Managed by Catheter Ablation

Circulation: Arrhythmia and Electrophysiology, 2014

Research paper thumbnail of Impact of a chronic total occlusion in an infarct-related artery on the long-term outcome of ventricular tachycardia ablation

Journal of Cardiovascular Electrophysiology, 2015

In patients with a prior myocardial infarction (MI), angiographic predictors of ventricular tachy... more In patients with a prior myocardial infarction (MI), angiographic predictors of ventricular tachycardia (VT) recurrence after ablation are lacking. Recently, a pro-arrhythmic effect of a chronic total occlusion (CTO) in a coronary artery has been suggested. 191 patients with prior MI were referred to our Hospital between 2010 and June 2013 for a first ablation of VT. Of these, 84 patients (44%) with stable coronary artery disease that underwent a coronary angiography during the index hospitalization were included in this study. A CTO in an infarct-related artery (IRA-CTO) was present in 47 patients (56%). Patients with and without IRA-CTO did not differ in terms of comorbidities, severity of heart failure, presentation of VT or acute outcome of ablation, that was completely successful in 93% of cases. At electroanatomic mapping, IRA-CTO was associated with greater scar and especially with greater area of border zone (34cm(2) vs 19cm(2) , p = 0.001). Median follow-up was 19 months (IQR 18). At follow-up, patients with IRA-CTO had a significantly higher rate of VT recurrence (47% vs 16%, p = 0.003). At multivariate analysis, IRA-CTO resulted to be an independent predictor of VT recurrence after ablation (HR 4.05, p = 0.004). IRA-CTO is an independent predictor of VT recurrence after ablation and identifies a subgroup of patients with high recurrence rate despite a successful procedure. IRA-CTO is associated with greater scars and border zone area; however, this association does not completely justify its pro-arrhythmic effect. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Substrate mapping strategies for successful ablation of ventricular tachycardia: A review

Archivos de Cardiología de México, 2013

Catheter ablation of ventricular tachycardia (VT) currently has an important role in the treatmen... more Catheter ablation of ventricular tachycardia (VT) currently has an important role in the treatment of incessant ventricular tachycardia and reduction of the number of episodes of recurrent ventricular tachycardia.

Research paper thumbnail of Electroanatomical Voltage and Morphology Characteristics in Post-Infarction Patients Undergoing Ventricular Tachycardia Ablation: A Pragmatic Approach Favoring Late Potentials Abolition

Circulation: Arrhythmia and Electrophysiology, 2015

Pag ag agl lino no no, , , MD MD MD; ; ; Pa Pa Patr tr trizio Mazzone, MD; Nicola Tre re evi vi v... more Pag ag agl lino no no, , , MD MD MD; ; ; Pa Pa Patr tr trizio Mazzone, MD; Nicola Tre re evi vi visi s s , MD; Paolo Della a Be Be B lla, MD Ar A Arrhythm m mia i i U U Un n nit an an nd d d Elec c ctr tr rop ophy hy ysi s s o o olo og ogy y La La Labor rato ori i ies es s, O O Osp p peda a ale e e San R R Raf affa fa fae el ele, M M Mil il lan n n, I I Italy y y Co Co Corr rr rres es espo po pond nd nden en ence ce ce: : : by guest on Abstract: Background -Catheter ablation is an important therapeutic option in post-myocardial infarction (MI) patients with ventricular tachycardia (VT). We analyzed the endo-epicardial electroanatomical mapping (EAM) voltage and morphology characteristics, their association with clinical data and their prognostic value in a large cohort of post-MI patients. Methods and Results -We performed total and segmental analysis of voltage (bipolar dense scar-DS and low voltage areas, unipolar low voltage and penumbra areas) and morphology characteristics (presence of abnormal late-LPs and early potentials-EPs) in 100 post-MI patients undergoing EAM-based VT ablation (26 endo-epicardial procedures) from 2010-12. All patients had unipolar low voltage areas while 18% had no identifiable endocardial bipolar DS areas.

Research paper thumbnail of The value of the 12-lead electrocardiogram in localizing the scar in non-ischaemic cardiomyopathy

Europace, 2015

Patients with non-ischaemic cardiomyopathy (NICM) and ventricular tachycardia can be categorized ... more Patients with non-ischaemic cardiomyopathy (NICM) and ventricular tachycardia can be categorized as anteroseptal (AS) or inferolateral (IL) scar sub-types based on imaging and voltage mapping studies. The aim of this study was to correlate the baseline electrocardiogram (ECG) with endo-epicardial voltage maps created during ablation procedures and identify the ECG characteristics that may help to distinguish the scar as AS or IL. We assessed 108 baseline ECGs; 72 patients fulfilled criteria for dilated cardiomyopathy whereas 36 showed minimal structural abnormalities. Based on the unipolar low-voltage distribution, the scar pattern was classified as predominantly AS (n = 59) or IL (n = 49). Three ECG criteria (PR interval < 170 ms or QRS voltage in inferior leads <0.6 mV or a lateral q wave) resulted in 92% sensitivity and 90% specificity for predicting an IL pattern in patients with preserved ejection fraction (EF). The four-step algorithm for dilated cardiomyopathy included a paced ventricular rhythm or PR > 230 ms or QRS > 170 ms or an r ≤ 0.3 mV in V3 having 92 and 81% of sensitivity and specificity, respectively, in predicting AS scar pattern. A significant negative correlation was found between the extension of the endocardial unipolar low voltage area and left ventricular EF (rs = -0.719, P < 0.001). The extent of endocardial AS unipolar low voltage was correlated with PR interval and QRS duration (rs = 0.583 and rs = 0.680, P < 0.001, respectively) and the IL epicardial unipolar low voltage with the mean voltage of the limb leads (rs = -0.639, P < 0.001). Baseline ECG features are well correlated with the distribution of unipolar voltage abnormalities in NICM and may help to predict the location of scar in this population.

Research paper thumbnail of Successful radiofrequency ablation of an anteroseptal accessory pathway from the right coronary cusp

Research paper thumbnail of Noninducibility and Late Potential Abolition: A Novel Combined Prognostic Procedural End Point for Catheter Ablation of Postinfarction Ventricular Tachycardia

Circulation: Arrhythmia and Electrophysiology, 2014

Background-Successful late potential (LP) abolition and postprocedural ventricular tachycardia (V... more Background-Successful late potential (LP) abolition and postprocedural ventricular tachycardia (VT) noninducibility constitute significant end points after catheter ablation for VT. We investigated the prognostic impact of a combined procedural end point of VT noninducibility and LP abolition in a large series of post-myocardial infarction patients with VT.

Research paper thumbnail of Catheter Ablation of Ventricular Arrhythmia in Nonischemic Cardiomyopathy: Anteroseptal Versus Inferolateral Scar Sub-Types

Circulation: Arrhythmia and Electrophysiology, 2014

Research paper thumbnail of Electrical Storm Induced by Cardiac Resynchronization Therapy Is Determined by Pacing on Epicardial Scar and Can be Successfully Managed by Catheter Ablation

Circulation: Arrhythmia and Electrophysiology, 2014

Research paper thumbnail of Impact of a chronic total occlusion in an infarct-related artery on the long-term outcome of ventricular tachycardia ablation

Journal of Cardiovascular Electrophysiology, 2015

In patients with a prior myocardial infarction (MI), angiographic predictors of ventricular tachy... more In patients with a prior myocardial infarction (MI), angiographic predictors of ventricular tachycardia (VT) recurrence after ablation are lacking. Recently, a pro-arrhythmic effect of a chronic total occlusion (CTO) in a coronary artery has been suggested. 191 patients with prior MI were referred to our Hospital between 2010 and June 2013 for a first ablation of VT. Of these, 84 patients (44%) with stable coronary artery disease that underwent a coronary angiography during the index hospitalization were included in this study. A CTO in an infarct-related artery (IRA-CTO) was present in 47 patients (56%). Patients with and without IRA-CTO did not differ in terms of comorbidities, severity of heart failure, presentation of VT or acute outcome of ablation, that was completely successful in 93% of cases. At electroanatomic mapping, IRA-CTO was associated with greater scar and especially with greater area of border zone (34cm(2) vs 19cm(2) , p = 0.001). Median follow-up was 19 months (IQR 18). At follow-up, patients with IRA-CTO had a significantly higher rate of VT recurrence (47% vs 16%, p = 0.003). At multivariate analysis, IRA-CTO resulted to be an independent predictor of VT recurrence after ablation (HR 4.05, p = 0.004). IRA-CTO is an independent predictor of VT recurrence after ablation and identifies a subgroup of patients with high recurrence rate despite a successful procedure. IRA-CTO is associated with greater scars and border zone area; however, this association does not completely justify its pro-arrhythmic effect. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Substrate mapping strategies for successful ablation of ventricular tachycardia: A review

Archivos de Cardiología de México, 2013

Catheter ablation of ventricular tachycardia (VT) currently has an important role in the treatmen... more Catheter ablation of ventricular tachycardia (VT) currently has an important role in the treatment of incessant ventricular tachycardia and reduction of the number of episodes of recurrent ventricular tachycardia.

Research paper thumbnail of Electroanatomical Voltage and Morphology Characteristics in Post-Infarction Patients Undergoing Ventricular Tachycardia Ablation: A Pragmatic Approach Favoring Late Potentials Abolition

Circulation: Arrhythmia and Electrophysiology, 2015

Pag ag agl lino no no, , , MD MD MD; ; ; Pa Pa Patr tr trizio Mazzone, MD; Nicola Tre re evi vi v... more Pag ag agl lino no no, , , MD MD MD; ; ; Pa Pa Patr tr trizio Mazzone, MD; Nicola Tre re evi vi visi s s , MD; Paolo Della a Be Be B lla, MD Ar A Arrhythm m mia i i U U Un n nit an an nd d d Elec c ctr tr rop ophy hy ysi s s o o olo og ogy y La La Labor rato ori i ies es s, O O Osp p peda a ale e e San R R Raf affa fa fae el ele, M M Mil il lan n n, I I Italy y y Co Co Corr rr rres es espo po pond nd nden en ence ce ce: : : by guest on Abstract: Background -Catheter ablation is an important therapeutic option in post-myocardial infarction (MI) patients with ventricular tachycardia (VT). We analyzed the endo-epicardial electroanatomical mapping (EAM) voltage and morphology characteristics, their association with clinical data and their prognostic value in a large cohort of post-MI patients. Methods and Results -We performed total and segmental analysis of voltage (bipolar dense scar-DS and low voltage areas, unipolar low voltage and penumbra areas) and morphology characteristics (presence of abnormal late-LPs and early potentials-EPs) in 100 post-MI patients undergoing EAM-based VT ablation (26 endo-epicardial procedures) from 2010-12. All patients had unipolar low voltage areas while 18% had no identifiable endocardial bipolar DS areas.