Autonomic and Pharmacological Responses of Idiopathic Ventricular Tachycardia Arising from the Left Ventricular Outflow Tract

Yamawake, Noriyoshi; Nishizaki, Mitsuhiro; Hayashi, Tatsuya; Niki, Saori; Maeda, Shingo; Tanaka, Yasuaki; Fujii, H.; Ashikaga, Takashi; Sakurada, Harumizu; Hiraoka, Masayasu

doi:10.1111/j.1540-8167.2007.00929.x

Cited by 19 publications

(18 citation statements)

References 19 publications

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“…The RVOT VAs present with a distinct ECG pattern of left bundle branch block and inferior axis (Fig. 2) (23)(24)(25)(26). In general, LVOT VAs manifest an early precordial R-wave transition (in V 2 or V 3 ) because of its more posterior location compared with the RVOT (Fig.…”

Section: Non-life-threatening Ventricular Arrhythmias Typically Monomentioning

confidence: 97%

“…ELECTROPHYSIOLOGIC MECHANISM. It is well established that outflow tract arrhythmia (OTA) is due to triggered activity secondary to cyclic adenosine monophosphatemediated delayed after depolarizations (23,24,27,28). Increased cyclic adenosine monophosphate due to betaadrenergic receptor stimulation, for example, with exertion, results in release of calcium from the sarcoplasmic reticulum and delayed afterdepolarizations.…”

Section: Non-life-threatening Ventricular Arrhythmias Typically Monomentioning

confidence: 99%

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Ventricular Arrhythmias in the Absence of Structural Heart Disease

Prystowsky

Padanilam

Joshi

et al. 2012

Journal of the American College of Cardiology

139

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Ventricular arrhythmia (VA) in structurally normal hearts can be broadly considered under non-life-threatening monomorphic and life-threatening polymorphic rhythms. Monomorphic VA is classified on the basis of site of origin in the heart, and the most common areas are the ventricular outflow tracts and left ventricular fascicles. The morphology of the QRS complexes on electrocardiogram is an excellent tool to identify the site of origin of the rhythm. Although these arrhythmias are common and generally carry an excellent prognosis, rare sudden death events have been reported. Very frequent ventricular ectopy may also result in a cardiomyopathy in a minority of patients. Suppression of VA may be achieved using calcium-channel blockers, beta-adrenergic blockers, and class I or III antiarrhythmic drugs. Radiofrequency ablation has emerged as an excellent option to eliminate these arrhythmias, although certain foci including aortic cusps and epicardium may be technically challenging. Polymorphic ventricular tachycardia (VT) is rare and generally occurs in patients with genetic ion channel disorders including long QT syndrome, Brugada syndrome, catecholaminergic polymorphic VT, and short QT syndrome. Unlike monomorphic VT, these arrhythmic syndromes are associated with sudden death. While the cardiac gross morphology is normal, suggesting a structurally normal heart, abnormalities exist at the molecular level and predispose them to arrhythmias. Another fascinating area, idiopathic ventricular fibrillation and early repolarization syndrome, are undergoing research for a genetic basis.

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Section: Non-life-threatening Ventricular Arrhythmias Typically Monomentioning

confidence: 97%

Section: Non-life-threatening Ventricular Arrhythmias Typically Monomentioning

confidence: 99%

Ventricular Arrhythmias in the Absence of Structural Heart Disease

Prystowsky

Padanilam

Joshi

et al. 2012

Journal of the American College of Cardiology

139

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“…A transient inward (ITi) current and corresponding DAD are generated from the Na + -Ca 2+ exchanger. 23 Moreover, Yamawake et al investigated the vagal stimulation and pharmacological responses of I-VA arising from the LVOT and suggested that the mechanism of the LVOT-VA was mostly due to cAMPmediated triggered activity, similar to that of RVOT-VA. 24 However, the mechanism of left-sided I-VA might be not only DAD but also re-entry. 25 This is because sometimes discrete sharp potentials were recorded at the ablation site of the left-sided VA. 26 The pathological mechanisms for gender related differences in I-VA remains unknown.…”

Section: Gender and Age Differencesmentioning

confidence: 99%

Gender and Age Differences in Candidates for Radiofrequency Catheter Ablation of Idiopathic Ventricular Arrhythmias

Tanaka

Tada

Ito

et al. 2011

Circ J

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“…Az idiopathiás VT-k mechanizmusa fokális automácián vagy többnyire triggerelt aktivitáson alapul. Ez utóbbi magas intracelluláris Ca²-koncentrációhoz és ezáltal elhúzódó utódepo-larizációhoz vezet [29]. Ez megmagyarázza a ritmuszavar indulását fi zikai aktivitás során vagy isoproterenol adását követően.…”

Section: Idiopathiás Vt-k Ablatiójaunclassified

Kamrai tachycardiák katéterablatiós kezelése

2015

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Az utóbbi két évtizedben a katéterablatiós technológia és az ablatiós stratégiák fejlődésével jelentős előrelépés történt a kamrai tachycardiák ablatiós kezelésében. Jelen összefoglaló közlemény célja a kamrai ritmuszavarok aktuális katé-terablatiós kezelésének áttekintő ismertetése. A szerzők részletezik a katéterablatiós kezelés technikai alapjait, a kamrai tachycardiák ablatiós kezelésének javallatait és ellenjavallatait, a beavatkozás előtti és az azt követő vizsgálatokat. Ezt követően a kamrai tachycardiák csoportosításán keresztül az egyes típusok katéteres ablatiójának jellemzőit ismertetik. Ezzel párhuzamosan kitérnek az adott ritmuszavar kezelésével kapcsolatos eredményekre is. Összegzésképpen kiemelik, hogy a katéteres ablatio sikeresen alkalmazható eszközös beavatkozás a kamrai tachycardiák kezelésében. Megfelelő javallat esetén a kezelést lehetőleg minél korábban be kell iktatni a terápiás stratégiába. Orv. Hetil., 2015, 156(25), 995-1002. Kulcsszavak: kamrai tachycardia, ablatio, elektrofi ziológia Catheter ablation of ventricular tachycardiasCatheter ablation of ventricular tachycardias emerged signifi cantly as standard therapy in the past 20 years. In this review recent advances in catheter ablation of ventricular tachycardias are discussed. The authors fi rst present in details the technical aspects of ablation strategies, main indications and contraindications of ventricular tachycardia ablation and the necessary pre-and postinterventional diagnostic tests. Outcome is also discussed in different forms of ventricular tachycardias in detail. The authors summarize the safety and effi cacy of catheter ablation of ventricular arrhythmias. They recommend that ablation of ventricular tachycardias should be considered earlier in patients with and without structural heart disease. Keywords: ventricular tachycardia, ablation, electrophysiology ÖSSZEFOGLALÓ KÖZLEMÉNYRövidítések ARVC = arrhythmogen jobb kamrai cardiomyopathia; CMP = cardiomyopathia; CT = komputertomográfi a; EAM = elektroanatómiai térképezőrendszer; ECHO = echokardiográfi a; EGM = intracardialis elektrogram; EKG = elektrokardiogram; EP = elektrofi ziológia; ICD = implantálható cardioverter-defi brillátor; ICE = intracardialis ultrahang; LVEF = bal kamrai ejekciós frakció; LVOT = bal kamrai kiáramlási pálya tachycardia; MR = mágneses rezonancia; RF = rádiófrekvenciás; RMN = mágneses navigációs rendszer; RVOT = jobb kamrai kiáramlási pálya tachycardia; VF = kamrafi brilláció; VT = kamrai tachycardia A kamrai tachycardiák (VT) két nagy csoportját külön-böztetjük meg, amelyek patofi ziológia, prognózis és terápia szempontjából jól elkülöníthetők. Az idiopathiás VT-k strukturális szívizombetegséggel nem járó kamrai ritmuszavarok, és ezen csoport mintegy 10-20%-át teszik ki [1]. A VT-k túlnyomó többsége azonban strukturális szívizombetegséggel járó ritmuszavar, amely az előbbinél nagyobb mortalitással jellemezhető [2]. Az elmúlt évtizedekben természetesen mindkét csoport gyógyszeres és utóbb már eszközös terápiás kezelése is az orvostudomány n...

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Autonomic and Pharmacological Responses of Idiopathic Ventricular Tachycardia Arising from the Left Ventricular Outflow Tract

Abstract: The results suggest that the mechanism of VT from LVOT is mostly due to cAMP-mediated triggered activity as similar to that in VT from RVOT.

Cited by 19 publications

References 19 publications

Ventricular Arrhythmias in the Absence of Structural Heart Disease

Ventricular Arrhythmias in the Absence of Structural Heart Disease

Gender and Age Differences in Candidates for Radiofrequency Catheter Ablation of Idiopathic Ventricular Arrhythmias

Kamrai tachycardiák katéterablatiós kezelése

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