Successful ablation of premature ventricular contractions originating from the inferoseptal process of the left ventricle using a coronary sinus approach

Tavares, Liliana; Dave, Amish S.; Valderrábano, Miguel

doi:10.1016/j.hrcr.2018.05.008

Cited by 7 publications

(3 citation statements)

References 3 publications

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“…However, VAs arising from this region can also be successfully ablated from the inferior septal surface of the right atrium, where a small atrial signal and a larger ventricular signal, earlier than the earliest site in the LV endocardium, can be recorded ( S4.2.50 ). Reports also describe ablation from within the CS ( S4.2.52 ). Successful ablation can be achieved with either RF or cryoablation energies.…”

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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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%

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

et al. 2020

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“…2 Several reports have demonstrated the feasibility and safety of the different approaches (endocardial and epicardial from CS and RA) for the ablation of PVC originating from ISP‐LV (Figure 5 ). 1 , 7 , 8 , 9 While endocardial access is associated with all the inherent risks of access to the left heart–vascular access complications, embolism, etc. a major safety issue with RA and CS approaches is thought to be the potential risk for AV block following RF application in the pyramidal space, where the AV node artery runs and in the slow pathway region with the RA approaches.…”

Section: Discussionmentioning

confidence: 99%

“…1,[7][8][9] While endocardial access is associated with all the inherent risks of access to the left heart-vascular access complications, embolism, etc. a major safety issue with RA and CS approaches is thought to be the potential risk for AV block following RF application in the pyramidal space, where the AV node artery runs and in the slow pathway region with the RA approaches.…”

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confidence: 99%

Endocardial, epicardial, and right atrial approach for catheter ablation of premature ventricular contractions from the inferoseptal process of the left ventricle

Martinov,

Marchov,

Marinov

et al. 2023

Journal of Arrhythmia

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BackgroundInferoseptal process of the left ventricle (ISP‐LV) might be a source of idiopathic ventricular arrhythmias. In these cases, ectopic foci are accessible from the LV endocardium, epicardially from the middle cardiac vein as well as from the right atrium (RA). This study reports a series of patients with premature ventricular contractions (PVCs) arising from the ISP‐LV that were successfully ablated following access from different structures.Methods and ResultsFive patients (4 males, age 61 ± 12.8 years) with PVCs arising from the ISP‐LV were successfully ablated using three different approaches for ablation—endocardial, epicardial (through coronary sinus or its branches), and RA approaches. Endocardial LV mapping, RA, and coronary sinus (CS) mapping were performed in all five cases. PVCs demonstrated RBBB or LBBB‐like morphology and left superior axis. The three patients ablated endocardially had a maximum deflection index (MDI) of 0.36, 0.43, and 0.54, whereas in the remaining 2 patients, MDI was 0.57 and both demonstrated QS morphology in the inferior leads. Local activation time at the successful ablation site was 35 ± 8.9 (26–55) msec pre‐QRS. Pacemapping at the successful ablation site resulted in a good (11/12) or perfect (12/12) QRS match in all cases. Three of the patients demonstrated frequent monomorphic PVCs of another morphology suggesting a remote exit site. All patients remained arrhythmia‐free after a mean follow‐up of 21 ± 15 (6–36) months.ConclusionSuccessful ablation of PVCs from ISP‐LV may require access from the CS or even RA apart from LV endocardial approach. Not infrequently patients demonstrate additional PVC foci.

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

Cronin

Bogun

Peichl

et al. 2020

J Interv Card Electrophysiol

110

155

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Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta-analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow-up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias.

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Successful ablation of premature ventricular contractions originating from the inferoseptal process of the left ventricle using a coronary sinus approach

Cited by 7 publications

References 3 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

Endocardial, epicardial, and right atrial approach for catheter ablation of premature ventricular contractions from the inferoseptal process of the left ventricle

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

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