Outflow tract ventricular arrhythmia originating from the aortic cusps: our approach for challenging ablation

Autor: Ibrahim Marai, Mahmoud Suleiman, Monther Boulos, Jonathan Lessick, Miry Blich, Sobhi Abadi
Rok vydání: 2015
Předmět:
Adult
Male
Aortic valve
medicine.medical_specialty
Ventricular Premature Complexes
Heart Ventricles
medicine.medical_treatment
Catheter ablation
030204 cardiovascular system & hematology
Multimodal Imaging
Cohort Studies
03 medical and health sciences
0302 clinical medicine
stomatognathic system
Heart Conduction System
Pregnancy
Physiology (medical)
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Multimodal imaging
business.industry
Body Surface Potential Mapping
fungi
food and beverages
Middle Aged
Ablation
Treatment Outcome
Tomography x ray computed
medicine.anatomical_structure
Surgery
Computer-Assisted
Aortic Valve
Case-Control Studies
Catheter Ablation
Tachycardia
Ventricular
cardiovascular system
Cardiology
Female
Outflow
Electrical conduction system of the heart
Tomography
X-Ray Computed
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of Interventional Cardiac Electrophysiology. 45:57-62
ISSN: 1572-8595
1383-875X
Popis: Ablation of outflow flow ventricular arrhythmia (VA) originating from aortic cusps can be challenging. The aim of this study was to describe our approach for this ablation.All patients with outflow VA suspected to originate from aortic cusps according to ECG or after failed ablation from right ventricular outflow tract (RVOT) underwent cardiac CT and radiofrequency ablation. CT image of aortic cusps and coronary arteries was integrated into electroanatomic mapping system by point (left main ostium)-based registration. Ablation was performed at the earliest activation site.Ten patients were included in this case cohort. The ablation catheter was easily maneuvered above and below the aortic valve after registration. Two patients who had previous failed ablation of RVOT focus had successful ablation at right coronary cusp (RCC) and at left coronary cusp (LCC). A patient who had previous failed ablations of RVOT and LCC focuses had successful ablation at RCC-LCC junction. A patient who had previous failed ablation at LCC had successful ablation at RCC-LCC junction. Three patients had successful ablation at RCC-LCC junction, and one patient at LCC. One patient had successful ablation at anterior interventricular vein-great cardiac vein junction. One patient had successful ablation at non-coronary cusp. During follow-up (12-30 months), one patient had recurrence of VA controlled by flecainide. The remaining patients were free of VA without medications.Catheter ablation of VA originating from aortic cusps is safe and effective. CT image integration into electroanatomic mapping system can be helpful in this challenging ablation.
Databáze: OpenAIRE
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