A multicenter review of ablation in the aortic cusps in young people

Nguyen, Minh; Ceresnak, Scott R.; Janson, Christopher M.; Fishberger, Steven B.; Love, Barry A.; Blaufox, Andrew D.; Motonaga, Kara S.; Dubin, Anne M.; Nappo, Lynn; Pass, Robert H.

doi:10.1111/pace.13126

Cited by 10 publications

(4 citation statements)

References 20 publications

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“…However, recent experience in the adult population has demonstrated that non-coronary aortic cusp ablation can be performed safely and effectively. Nguyen 3 et al reported the aortic cusp procedure in various arrhythmia substrates results from 5 EPS centres in 13 young patients (<21 years). 100% success with the procedure, no complications or valve damage were observed.…”

Section: Discussionmentioning

confidence: 99%

“…Here, we present a case of Wolff-Parkinson-White syndrome with an oblique and deep-seated anteroseptal accessory pathway in which ablation was successfully performed from non-coronary aortic cusp. [1][2][3][4] Case presentation A 10-year-old male patient was admitted to a paediatrician with a complaint of palpitations. Wolff-Parkinson-White syndrome was detected in his ECG, and sotalol treatment was started.…”

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confidence: 99%

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A challenging catheter ablation of anteroseptal manifest accessory pathway from non-coronary aortic cusp in a paediatric patient

2023

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Twelve-lead ECG of a child with Wolff–Parkinson–White syndrome and systolic dysfunction was consistent with the anteroseptal accessory pathway. The earliest atrial activation during electrophysiological study was found between the right anteroseptal region near the HIS. Multiple femoral tract right-sided cryotest lesions followed by radiofrequency catheter irrigated through the jugular vein route were unsuccessful. Then, non-coronary aortic cusp mapping and cryoablation were successfully performed with a retroartic approach.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

A challenging catheter ablation of anteroseptal manifest accessory pathway from non-coronary aortic cusp in a paediatric patient

2023

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“…Current indications for ablation of PVCs or VT include hemodynamic compromise or ventricular dysfunction (class I) and symptoms related to either tachycardia or frequent ventricular ectopy (class IIa) 9 . Reported acute success rates for PVC or VT ablation in children is variable (60‐100%) 10‐13 and lower than reported in adults with no structural heart disease 14 . Limitations to PVC ablation in children include arrhythmia frequency during the procedure, accuracy of catheter mapping, and whether the site of origin (SOO) is in a safe location for ablation 10,12 …”

Section: Introductionmentioning

confidence: 99%

“…8 Current indications for ablation of PVCs or VT include hemodynamic compromise or ventricular dysfunction (class I) and symptoms related to either tachycardia or frequent ventricular ectopy (class IIa). 9 Reported acute success rates for PVC or VT ablation in children is variable (60-100%) [10][11][12][13] and lower than reported in adults with no structural heart disease. 14…”

Section: Introductionmentioning

confidence: 99%

Can the 12‐lead ECG distinguish RVOT from aortic cusp PVCs in pediatric patients?

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Ceresnak²,

Pass³

et al. 2020

Pacing Clinical Electrophis

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Background The ability to differentiate right ventricular outflow tract (RVOT) from coronary cusp (CC) site of origin (SOO) by 12‐lead ECG in pediatric patients may impact efficacy and procedural time. The objective of this study was to predict RVOT versus CC SOO by ECG in pediatric patients. Methods Pediatric patients (<21 years) without structural heart disease with RVOT or CC premature ventricular contraction (PVC) ablations performed (2014‐2018) were evaluated through multi‐institution retrospective review. Demographics, ECG PVC parameters, ablation site, recurrence, and repeat procedures were collected. Results Thirty‐seven patients were evaluated (mean age 14.6 years, weight 60.6 kg): 11 CC and 26 RVOT PVC SOO. CC PVCs were less likely to exhibit left bundle branch block (64% vs 100%, P = .005), had larger R‐wave amplitude in V1 (0.27 vs 0.11 mV, P = .03), larger R/S ratio in V1 (0.37 vs 0.09, P = .003), and had precordial transition in V3 or earlier (73% vs 15%, P = .002). A composite score was created with the following variables: isodiphasic or positive QRS in V1, R/S ratio in V1 > 0.05, S wave in V1 < 0.9 mV, and precordial transition at or before V3. Composite score ≥ 2 was associated with a CC SOO (OR 42.0, P = .001, and AUC 0.86). Conclusions 12‐lead ECG of PVCs from the CC was associated with larger V1 R‐wave amplitude, larger R/S ratio in V1, and precordial transition at or before V3. A composite score may help predict PVC/VT arising from the CC.

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Mapping and Ablation Approaches for Left-Sided Accessory Pathways

Hluchý

2022

Wolff-Parkinson-White and Other Preexcitation Syndromes

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A multicenter review of ablation in the aortic cusps in young people

Abstract: Arrhythmias originating from the coronary cusps in this series were successfully and safely ablated in young people without injury to the coronary arteries or the aortic valve.

Cited by 10 publications

References 20 publications

A challenging catheter ablation of anteroseptal manifest accessory pathway from non-coronary aortic cusp in a paediatric patient

A challenging catheter ablation of anteroseptal manifest accessory pathway from non-coronary aortic cusp in a paediatric patient

Can the 12‐lead ECG distinguish RVOT from aortic cusp PVCs in pediatric patients?

Mapping and Ablation Approaches for Left-Sided Accessory Pathways

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