Noncentrifugal activation patterns in focal RVOT PVC/VT: New insights from high density multielectrode mapping
| Autor: | Arieh Keren, Tobias Reichlin, J. Ng, Binita Chhachhi, Sohail Popal, Paul Stobie |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Electroanatomic mapping medicine.medical_specialty medicine.medical_treatment High density 030204 cardiovascular system & hematology Ventricular tachycardia 03 medical and health sciences QRS complex Electrocardiography 0302 clinical medicine Interquartile range Physiology (medical) Internal medicine Medicine Ventricular outflow tract Humans 030212 general & internal medicine Polyvinyl Chloride 610 Medicine & health Premature ventricular complexes business.industry Body Surface Potential Mapping Middle Aged medicine.disease Ablation Cardiology Catheter Ablation Tachycardia Ventricular Female Cardiology and Cardiovascular Medicine business Boston |
| DOI: | 10.48350/163312 |
| Popis: | BACKGROUND Activation from an automatic focus is thought to show centrifugal spread. In patients with premature ventricular complex/ventricular tachycardia (PVC/VT) from the right ventricular outflow tract (RVOT), the presence of preferential conduction and epicardial connections could however also lead to noncentrifugal wavefront propagation. OBJECTIVE To study endocardial activation in RVOT PVC/VT using high-resolution 3D activation mapping. METHODS Consecutive patients with frequent idiopathic PVC/VT were studied. High-resolution 3D activation maps were acquired using a multielectrode mapping catheter (Orion, Rhythmia, Boston Scientific). Noncentrifugal activation was defined as a pattern of wavefront propagation which does not show uniform propagation in all directions from one focus. Patients without sustained ablation success and patients with a left-sided PVC origin or with insufficient map density were excluded from the analysis. RESULTS Sixteen patients (44% female) with a median age of 54 years (interquartile range [IQR], 47-64) and a median PVC burden of 19% (IQR, 15-27) were studied. High-resolution activation maps consisting of a median number of 1863 mapping points (IQR, 1195-2463 points) demonstrated a centrifugal activation in 6/16 (38%) and a noncentrifugal activation in 10/16 (62%). When comparing patients with centrifugal and noncentrifugal activation, patients with centrifugal activation were older (p���=���.01), but no differences were found in age, gender, QRS duration of the PVC's and sites of origin in the RVOT. No procedural complications occurred. CONCLUSIONS High-resolution multielectrode mapping demonstrates the presence of noncentrifugal activation patterns in some of the patients with idiopathic RVOT PVC/VT. This may indicate the presence of preferential conduction and or epicardial/intramural connections in the outflow tract. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|