Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease.

Klein, Lawrence S.; Shih, Hue Teh; Hackett, F K; Zipes, Douglas P.; Miles, William M.

doi:10.1161/01.cir.85.5.1666

Cited by 423 publications

(59 citation statements)

References 35 publications

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“…One patients experienced significant recurrence of PVCs with associated symptoms. The overall success rate for ablation of PVCs originating from the left ventricular septum in the present study nearly corresponded with the results of previous reports for ablation of PVCs originating from RVOT and/or other sites of origin [4,15,16]. The mapping techniques in our study were basically the same as those described in previous studies [4,5], which included pace mapping and activation mapping.…”

Section: Discussionsupporting

confidence: 89%

Premature ventricular contractions originating from the left ventricular septum: Results of Radiofrequency Catheter Ablation in twenty patients

et al. 2011

BMC Cardiovasc Disord

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BackgroundRFCA has been established as an effective and curative therapy for severely symptomatic PVC from the outflow tract in structurally normal hearts. However, it is unknown whether PVCs originating from the left ventricular septum, are effectively eliminated by RFCA. This study aimed to investigate electrophysiologic characteristics and effects of Radiofrequency catheter ablation (RFCA) for patients with symptomatic premature ventricular contraction (PVC) originating from the left ventricular septum without including fascicular PVCs.MethodsCharacteristics of body surface electrocardiogram (ECG) and electrophysiologic recordings endocardiogram in a successful RFCA target were analyzed in 20 patients with symptomatic PVCs originating from the left ventricular septum. RFCA was performed using pace mapping and activation mapping.ResultsThe QRS morphology of PVCs originating from the left ventricular septum is similar to that seen in fascicular tachycardia. Most of the PVCs originated from the left septum appears in the form of ventricular parasystole. The incidence of ventricular parasystole was 70%. Sustained ventricular tachycardia was not inducible by electrical stimulation and isoproterenol infusion in all 20 patients, ablation at the site recording the earliest Purkinje potential was not effective in all 20 patients, and Purkinje potentials were not identified at successful sites during point mapping. Sixteen patients were successful with RFCA using pace mapping and activation mapping, 3 failed, and 1 recurrent.ConclusionAlthough the ECG characteristics of the PVCs arising from the left ventricular septum are similar to that seen in fascicular tachycardia, the electrophysiologic characteristics are different between the two types of PVCs. The distinguishing characteristic of the PVCs is that Purkinje potentials were not present at the site of successful ablation, suggesting a myocardial as opposed to fascicular substrate. RFCA is an effective curative therapy for symptomatic PVCs originating from the left ventricular septum (not from the left anterior and posterior fascicle).

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Section: Discussionsupporting

confidence: 89%

Premature ventricular contractions originating from the left ventricular septum: Results of Radiofrequency Catheter Ablation in twenty patients

et al. 2011

BMC Cardiovasc Disord

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“…The majority of idiopathic ventricular arrhythmias (VAs), including ventricular tachycardia and premature ventricular contractions (PVCs), have a right ventricular outflow tract or left ventricular outflow tract origin [1-4], but some originate from the aortic sinus cusp [5], coronary venous system [6], or mitral annulus [7]. A small number of cases of idiopathic VAs have been reported to originate from the tricuspid annulus [8].…”

Section: Introductionmentioning

confidence: 99%

Trans-subclavian approach for radiofrequency ablation of premature ventricular contractions originating from subtricuspid annulus: a case report

Zhan

Yang

et al. 2013

BMC Cardiovasc Disord

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BackgroundCatheter ablation has been established as a curative treatment strategy for ventricular arrhythmias. The standard procedure of most ventricular arrhythmias originating from the right ventricle is performed via the femoral vein. However, a femoral vein access may not achieve a successful ablation in some patients.Case presentationWe reported a case of a 29-year old patient with symptomatic premature ventricular contractions was referred for catheter ablation. Radiofrequency energy application at the earliest endocardial ventricular activation site via the right femoral vein could not eliminate the premature ventricular contractions. Epicardial mapping could not obtain an earlier ventricular activation when compared to the endocardial mapping, and at the earliest epicardial site could not provide an identical pace mapping. Finally, we redeployed the ablation catheter via the right subclavian vein by a long sheath. During mapping of the subvalvular area of the right ventricle, a site with a good pace mapping and early ventricular activation was found, and premature ventricular contractions were eliminated successfully.ConclusionVentricular arrhythmias originating from the subtricuspid annulus may be successfully abolished via a trans-subclavian approach and a long sheath. Although access via the right subclavian vein for mapping and ablation is an effective alternative, it is not a routine approach.

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“…It is estimated that 10% of patients presenting with ventricular arrhythmias (VA) have no obvious structural heart disease ( 10 ). RVOT PVCs, RVOT ventricular tachycardia (VT), left ventricular outfl ow VT, idiopathic left ventricular VT, and propranolol-sensitive VT are types of VT commonly called " idiopathic VAs, " and they are generally not associated with underlying structural heart disease ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Frequent Premature Ventricular Contractions in an Orbital Spaceflight Participant

Jennings¹,

J²,

Scott³

et al. 2010

aviat space environ med

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The spaceflight participant's PVCs were incompletely suppressed with a low-dose selective beta-1 blocker, but were well suppressed by a calcium channel blocker. He tolerated in-flight periodic use of a nonselective beta blocker in combination with a calcium channel blocker. In-flight ECG and blood pressure monitoring results were normal, and an ECG obtained midmission and on landing day showed successful PVC suppression. He did not have any cardiac difficulty with launch, on-orbit operations, entry, or recovery

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Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease.

Abstract: Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease is effective and safe and may be considered as early therapy in these patients.

Cited by 423 publications

References 35 publications

Premature ventricular contractions originating from the left ventricular septum: Results of Radiofrequency Catheter Ablation in twenty patients

Premature ventricular contractions originating from the left ventricular septum: Results of Radiofrequency Catheter Ablation in twenty patients

Trans-subclavian approach for radiofrequency ablation of premature ventricular contractions originating from subtricuspid annulus: a case report

Frequent Premature Ventricular Contractions in an Orbital Spaceflight Participant

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