Electrophysiological Characteristics and Radiofrequency Catheter Ablation Treatment of Idiopathic Ventricular Arrhythmias Successfully Ablated From the Ostium of the Coronary Sinus

Yui, Yoshiaki; Sekiguchi, Yukio; Nogami, Akihiko; Yamasaki, Hiro; Machino, Takeshi; Kuroki, Kenji; Igarashi, Miyako; Aonuma, Kazutaka

doi:10.1253/circj.cj-16-1263

Cited by 11 publications

(4 citation statements)

References 23 publications

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“…Sustained monomorphic VT arising from the crux of the heart is typically very rapid, based on a focal catecholamine-sensitive mechanism, and often produces syncope ( S4.2.40 – S4.2.43 ). The QRS morphology is characterized by an abrupt transition from negative in lead V1, to positive in lead V2, to more negative in lead V3 ( S4.2.40 ).…”

Section: Clinical Evaluationmentioning

confidence: 99%

“…The QRS morphology is characterized by an abrupt transition from negative in lead V1, to positive in lead V2, to more negative in lead V3 ( S4.2.40 ). Ablation can be achieved within the coronary venous system, including the middle cardiac vein ( S4.2.40 , S4.2.41 , S4.2.43 ) and the adjacent endocardium, or might require epicardial access ( S4.2.40 – S4.2.42 ). The proximity of the coronary venous system to the posterior descending coronary artery requires imaging to prevent arterial injury.…”

Section: Clinical Evaluationmentioning

confidence: 99%

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2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

et al. 2020

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Representative of the European Heart Rhythm Association (EHRA) †Representative of the American College of Cardiology (ACC) ‡Representative of the Sociedade Brasileira de Arritmias Cardíacas (SOBRAC) xRepresentative of the American Heart Association (AHA) {Representative of the Latin American Heart Rhythm Society (LAHRS) #Representative of the Asia Pacific Heart Rhythm Society (APHRS) **Representative of the Japanese Heart Rhythm Society (JHRS) † †Representative of the Pediatric and Congenital Electrophysiology Society (PACES)

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Section: Clinical Evaluationmentioning

confidence: 99%

Section: Clinical Evaluationmentioning

confidence: 99%

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

et al. 2020

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“…However, Doppalapudi et al described four patients with idiopathic crux‐VA and all patients had the MDI ≥ 0.55. Furthermore, Yui et al also described six patients with idiopathic‐VA originating from the ostium of CS and all patients had an MDI ≥ 0.55. Therefore, MDI ≥ 0.55 was assessed for the ability to identify epicardial origin of idiopathic‐VA.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with MA-VA presented more frequently with PVC-induced cardiomyopathy compared to those with basal crux-VA. We speculated that the reason for this result was the burden of PVC and CI dispersion was higher as compared to those with other VA. 24 PVC-induced cardiomyopathy might be related to the PVC burden foci. 25…”

Section: Clinical and Ablation Findingsmentioning

confidence: 97%

Idiopathic basal crux ventricular arrhythmias with left bundle branch block and superior axis: A comparison with inferior‐septal valvular arrhythmias

Kawamura

Arai

Gokan

et al. 2019

Cardiovasc electrophysiol

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Introduction Left bundle branch block (LBBB) with superior axis is common in patients with idiopathic‐ventricular arrhythmia (VA) originating from the tricuspid annulus (TA) and rarely from the cardiac basal crux and mitral annulus (MA). We described the electrocardiography and electrophysiological findings of idiopathic‐VA presenting with LBBB and superior axis. Methods and Results We described 42 idiopathic‐VA patients who had an LBBB and superior axis; 15 basal crux‐VA, 17 TA‐VA, and 10 MA‐VA. No patient had a structural heart disease. Among patients with idiopathic‐VA referred for ablation, we investigated the electrocardiogram and clinical characteristics of basal crux‐VA as compared with other LBBB and superior axis‐VA. The left ventricular ejection fraction with MA‐VA was significantly lower in comparison with basal crux‐VA (P = .01). All patients had a positive R wave in lead I and aVL. The maximum deflection index with basal crux‐VA was significantly higher in comparison with TA‐VA or MA‐VA (P = .01). Patients with basal crux‐VA presented with QS wave in lead II more frequently as compared with TA‐VA or MA‐VA (P = .001). All MA‐VA patients had Rs wave in V6, and basal crux‐VA, and TA‐VA patients had a monophasic R wave or Rs wave in V6. Basal crux‐VA patients underwent ablation in the middle cardiac vein (MCV) or coronary sinus (success rate: 94%, recurrence rate: 6%). Conclusions We could distinguish basal crux‐VA, TA‐VA, and MA‐VA, using a combination of clinical and electrocardiographic findings. These findings might be useful for counseling patients about an ablation strategy. Ablation via the MCV is effective for eliminating basal crux‐VA.

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Left Posteroseptal PVC

Madadi

2021

Case-Based Clinical Cardiology

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Electrophysiological Characteristics and Radiofrequency Catheter Ablation Treatment of Idiopathic Ventricular Arrhythmias Successfully Ablated From the Ostium of the Coronary Sinus

Abstract: The idiopathic VAs in our study were eliminated by RFCA within the CS, where a clear atrial amplitude was recorded.

Cited by 11 publications

References 23 publications

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

Idiopathic basal crux ventricular arrhythmias with left bundle branch block and superior axis: A comparison with inferior‐septal valvular arrhythmias

Left Posteroseptal PVC

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