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- Title
Approach selection of radiofrequency catheter ablation for ventricular arrhythmias originating from the left ventricular summit: potential relevance of Pseudo Delta wave, Intrinsicoid deflection time, maximal deflection index.
- Authors
Cheng Zheng; Jin Li; Jia Li; De-Pu Zhou; Xiao-Wei Li; Shu-Jie Wu; Jia-Feng Lin; Zheng, Cheng; Li, Jin; Li, Jia; Zhou, De-Pu; Li, Xiao-Wei; Wu, Shu-Jie; Lin, Jia-Feng
- Abstract
<bold>Background: </bold>Ventricular arrhythmias (VAs) originating from the left ventricular summit is a challenge for radiofrequency catheter ablation (RFCA). The present study aimed to investigate the appropriate RFCA strategy for VAs originating from the left ventricular summit.<bold>Methods: </bold>Forty-five consecutive patients with VAs arising from the left ventricular summit were successfully ablated at our cardiac electrophysiology center and reviewed in the study.<bold>Results: </bold>Thirty-two cases of VAs were eliminated in the left ventricular endocardium by retrograde transaortic (n = 22, 22/45, 48.9%) or antegrade transseptal (n = 10, 10/45, 22.2%) approaches, the other 13 cases were eliminated in the left ventricular epicardium by distal great cardiac vein (DGCV) approach (n = 13, 13/45, 28.9%). Though these VAs were similar in electrocardiographic (ECG) morphology, the pseudo delta waves (PDW), intrinsicoid deflection time (IDT), maximal deflection index (MDI) differed among them, PDW >53 ms, IDT > 74 ms, MDI > 0.45 strongly indicated that ablating left ventricular summit VAs by DGCV approach. During mean follow-up of 19.5 ± 13.2 (range, 3-60) months, 2 (4.4%) patients experienced VAs recurrence.<bold>Conclusion: </bold>This retrospective study showed that VAs of left ventricular summit origin can be effectively cured with RFCA. For these VAs, prolonged PdW, IDT, MDI indicating RFCA by DGCV approach can be attempted firstly.
- Subjects
CATHETER ablation; ELECTROPHYSIOLOGY; VENTRICULAR arrhythmia; ABLATION techniques; ARRHYTHMIA; ARRHYTHMIA diagnosis; ACTION potentials; ELECTROCARDIOGRAPHY; LEFT heart ventricle; HEART physiology; HEART beat; HEART ventricles; HEART function tests; RISK assessment; TIME; VENTRICULAR tachycardia; DISEASE relapse; TREATMENT effectiveness; PREDICTIVE tests; RETROSPECTIVE studies; PATIENT selection; DIAGNOSIS; SURGERY
- Publication
BMC Cardiovascular Disorders, 2017, Vol 17, p1
- ISSN
1471-2261
- Publication type
journal article
- DOI
10.1186/s12872-017-0575-5