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Ventricular tachycardia is one of the commonest cause of sudden death in chronic chagas disease. As most ventricular tachycardias originate from scar in patients with heart disease, catheter ablation is an important step in patient treatment. Identification of fibrosis prior to ablation of sustained ventricular tachycardia (SVT) might reduce the time of anesthesia, procedure time, radiation exposure and possibly the risk of complications. Knowledge of arrhythmia circuit within scar allows planning strategies for each procedure. Condreanu et al. stablished that voltages inferior to 6.52 mV (unipolar) and 1.54mV (bipolar) are useful tools in detecting scar during electroanatomic mapping. Accuracy, however when compared to magnetic resonance imaging is limited due to difficulties in maintaining good contact between ablation catheter and ventricular wall. Contact force catheters might help increase accuracy of voltage mapping because they allow detection of poor contact areas. Although the threshold for identification of scar in ischemic and non ischemic patients during electroanatomical mapping is already known, this parameters still lacking for chronic chagasic individuals. A marked qualitative histological difference between these fibrous scars supports the hypothesis that voltage scar in chagasics might be different. Catheter ablation contact with endo and epicardial surface is an important issue when ablating arrhythmias. Conventional catheter ablation is not equipped with sensors capable of detecting degree of contact with the target. To our knowledge, the literature lacks information in regard to late lesions produced by a known contact force pressure "in vivo". The pattern of electrical activation in these patients and their relationship with local coronary veins for resynchronization likely to approach through the coronary sinus can be useful in defining chagasic that can benefit from resynchronization.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Catheter ablation | Patients with chronic chagasic disease and documented monomorphic ventricular tachycardia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Catheter ablation | Procedure | During mapping and ablation tissue voltage and impedance will be stored and analyzed thereafter. The same procedure will be done in regard to activating maps. |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate the feasibility of mapping and ablating ventricular tachycardias in endocardial and epicardial using a contact force catheter | The feasibility will be evaluated immediatly after the procedure | Immediatly after the procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate the impedance and voltage threshold for scar in chronic chagasic cardiomyopathy | After the procedure |
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Inclusion Criteria:
Exclusion Criteria:
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Chagasic patients with symptomatic documented ventricular tachycardia
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lucas H Oliveira, MD | Contact | +55(11)99750937 | 55 | lucas.hollanda@unifesp.br |
| Enia L Coutinho, Coordinator | Contact | +55(11)992914070 | coutinho.enia@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Claudio Cirenza, MD, PhD | Federal University of São Paulo | Study Director |
| Angelo AV de Paola, MD, PhD | Federal University of São Paulo | Study Chair |
| Lucas H Oliveira, MD |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Federal University of São Paulo, São Paulo Hospital | Recruiting | São Paulo | São Paulo | 04024-002 | Brazil |
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| ID | Term |
|---|---|
| D017180 | Tachycardia, Ventricular |
| D003645 | Death, Sudden |
| D013575 | Syncope |
| D002637 | Chest Pain |
| D014355 | Chagas Disease |
| ID | Term |
|---|---|
| D013610 | Tachycardia |
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D017115 | Catheter Ablation |
| ID | Term |
|---|---|
| D000078703 | Radiofrequency Ablation |
| D000078702 | Radiofrequency Therapy |
| D013812 | Therapeutics |
| D055011 | Ablation Techniques |
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| Federal University of São Paulo |
| Principal Investigator |
| Federal University of São Paulo | Recruiting | São Paulo | São Paulo | 04024-002 | Brazil |
|
| Federal University of São Paulo | Not yet recruiting | São Paulo | São Paulo | SP | Brazil |
|
| D000075224 |
| Cardiac Conduction System Disease |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003643 | Death |
| D014474 | Unconsciousness |
| D003244 | Consciousness Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D010146 | Pain |
| D014352 | Trypanosomiasis |
| D056986 | Euglenozoa Infections |
| D011528 | Protozoan Infections |
| D010272 | Parasitic Diseases |
| D007239 | Infections |
| D000079426 | Vector Borne Diseases |
| D013514 |
| Surgical Procedures, Operative |