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RISS 인기검색어
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- 저자 : Timothy Campbell (검색결과 4 건)
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Updates in Ventricular Tachycardia Ablation
Timothy Campbell,Richard G. Bennett,Yasuhito Kotake,Saurabh Kumar 대한심장학회 2021 Korean Circulation Journal Vol.51 No.1
Sudden cardiac death (SCD) due to recurrent ventricular tachycardia is an important clinical sequela in patients with structural heart disease. As a result, ventricular tachycardia (VT) has emerged as a major clinical and public health problem. The mechanism of VT is predominantly mediated by re-entry in the presence of arrhythmogenic substrate (scar), though focal mechanisms are also important. Catheter ablation for VT, when compared to standard medical therapy, has been shown to improve VT-free survival and burden of device therapies. Approaches to VT ablation are dependent on the underlying disease process, broadly classified into idiopathic (no structural heart disease) or structural heart disease (ischemic or non-ischemic heart disease). This update aims to review recent advances made for the treatment of VT ablation, with respect to current clinical trials, peri-procedure risk assessments, pre-procedural cardiac imaging, electro-anatomic mapping and advances in catheter and non-catheter based ablation techniques.
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McGann, Brendan,Carter, Campbell D.,Ombrello, Timothy M.,Hammack, Stephen,Lee, Tonghun,Do, Hyungrok Elsevier 2017 Proceedings of the Combustion Institute Vol.36 No.2
<P>Gas density and fuel mole fraction in a cavity flameholder of a supersonic combustor with ethylene (C<SUB>2</SUB>H<SUB>4</SUB>) fueling are simultaneously measured using nanosecond gated (10ns) laser-induced breakdown spectroscopy (n-LIBS). Emission spectra from the laser-induced plasma over a range (550nm–830nm) containing multiple emission lines of O, H, N, and C are captured and used to quantify the gas conditions. A direct spectrum matching (DSM) process is employed for the gas property quantification in which an unknown spectrum is matched to a spectrum from a database, constructed through n-LIBS analysis of well-known gas conditions. A <I>back-scattering</I> collection method is implemented to allow for measurements using a single optical access point. Fuel mole fraction and gas density are mapped within a cavity flameholder on planes parallel to the Mach 2 freestream flow above the cavity. With C<SUB>2</SUB>H<SUB>4</SUB> injection from the closeout ramp of the cavity toward the front step, a high fuel mole fraction region appears near the front step where density and flow velocity are low, and thus favorable for cavity flame ignition. The fuel mole fraction at a location in the cavity is found to be nearly proportional to fueling rate; the gas density, on the other hand, is not affected by the fueling rate, under the typical operating conditions.</P>
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Richard Bennett,Samual Turnbull,Yasuhito Kotake,Timothy Campbell,Saurabh Kumar 대한심장학회 2021 Korean Circulation Journal Vol.51 No.5
Background and Objectives: There is little emphasis on the efficacy of catheter ablation for ventricular arrhythmia (VA) when using VA burden reduction as a marker for success. We examined the efficacy of catheter ablation using VA burden, rather than VA recurrence as a marker of success, following catheter ablation of structural heart disease (SHD) related VA. Methods: Catheter ablation of SHD related VA was performed at a single centre over 4-years. VA episodes and implantable cardioverter defibrillator (ICD) therapies were recorded over the 6-months before and after final ablation. Outcomes were reported in terms of burden reduction and compared to singular VA recurrence. Results: Overall, 108 patients were included in the study. Mean age 64.2±13.9 years, 86% male, mean left ventricular ejection fraction (LVEF) 42±16%. Median VA episodes and ICD therapy were significantly reduced after ablation (VA before: 10 [interquartile range, IQR: 2–38] vs. VA after: 0 [IQR: 0–2], p<0.001; anti–tachycardia pacing [ATP] before: 16 (IQR: 1.5–57) vs. ATP after: 0 [IQR: 0–2], p<0.001; shocks before: 1 [IQR: 0–5] vs. shocks after: 0 [IQR: 0–0], p<0.001). Procedural success at 6-months was significantly higher when considering ≥75% reduction in VA burden, rather than a singular VA-free survival (83% vs. 67%, p=0.001). Conclusions: The vast majority (>80%) of patients achieve reduction in VA burden (≥75% reduction) after catheter ablation for VA. This data suggests that catheter ablation is highly therapeutic when procedure success is defined as reduction in VA, rather than using a single VA recurrence as a metric for failure.
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Ventricular Tachycardia Ablation in Non-ischemic Cardiomyopathy
Ashwin Bhaskaran,Kasun De Silva,Karan Rao,Timothy Campbell,Ivana Trivic,Richard G. Bennett,Eddy Kizana,Saurabh Kumar 대한심장학회 2020 Korean Circulation Journal Vol.50 No.3
Non-ischemic cardiomyopathies are a heterogeneous group of diseases of the myocardium that have a distinct proclivity to ventricular arrhythmias. Of these, ventricular tachycardias pose significant management challenges with the risk of sudden cardiac death and morbidity from multiple causes. Catheter ablation of ventricular tachycardias is becoming an increasingly utilised intervention that has been found to have significant benefits with improving symptoms, reducing anti-arrhythmic drug burden and debilitating device therapies, thereby improving quality of life. Nonetheless, the approach to the ablation of ventricular tachycardias in non-ischemic cardiomyopathies is governed heavily by the disease process, with several distinct differences from ischemic cardiomyopathy including a preponderance to epicardial and deep intramural substrate. This contemporary review aims to present the various disease processes within non-ischemic cardiomyopathies, catheter ablation techniques which have been developed to target ventricular tachycardia and more novel adjunctive therapeutic measures.
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