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- Title
Effect of radiofrequency on epicardial myocardium after ablation of ventricular arrhythmias from within coronary sinus.
- Authors
Candemir, Basar; Ozyurek, Elif; Vurgun, Kutay; Turan, Nazli; Duzen, Veysel; Goksuluk, Huseyin; Ozyuncu, Nil; Kurklu, Seda; Altin, Timucin; Akyurek, Omer; Erol, Cetin
- Abstract
Abstract: Background: Radiofrequency (RF) ablation of idiopathic ventricular arrhythmias (IVA) from the coronary venous system (CVS) has been increasingly performed, but real effect of ablation lesions from CVS on epicardial myocardium has not been studied. Objective: To compare effects of RF delivered inside the distal CVS during ablation of IVAs originating from left ventricular summit (LVS) with IVAs ablated from right ventricular outflow tract (RVOT) using cardiac magnetic resonance imaging (CMRI). Methods: Twenty consecutive patients with IVAs who underwent acutely successful RF ablation at initial appropriate sites, i.e., distal CVS (Group 1, n = 10) or RVOT (Group 2; n = 10) were enrolled. Detailed contrast‐enhanced CMRI of each patient was performed 3 months later. Presence and location of scars, distance of CVS to epicardial ventricular myocardium were measured and analyzed. Results: Group 1 consisted of 10 and Group 2 consisted of 10 patients. Three months after the ablation, only three patients in Group 1 had detectable late gadolinium enhancement (LGE) on CMRI while nine out of 10 patients in Group 2 had evident LGE on CMRI (P: 0.02). The mean distance of distal CVS to epicardial anterobasal myocardium was measured to be 8.8 ± 1.6 mm in Group 1. In three cases that had detectable scar on superior anterobasal LV epicardium, the mean distance was 7.4 ± 1.1 mm. Conclusions: RF delivery inside the CVS is less likely to produce detectable LGE on CMRI compared to RVOT. This may partially explain less than ideal long‐term results after ablation of LVS IVAs from within the great cardiac vein/anterior interventricular vein.
- Subjects
SCARS; CATHETER ablation; CORONARY arteries; LEFT heart ventricle; RIGHT heart ventricle; MAGNETIC resonance imaging; MYOCARDIUM; PERICARDIUM; POSTOPERATIVE period; TREATMENT effectiveness; CONTRAST media; VENTRICULAR arrhythmia; DIAGNOSIS
- Publication
Pacing & Clinical Electrophysiology, 2018, Vol 41, Issue 9, p1060
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.13429