Ablation of ventricular arrhythmias with predominant monophasic 'R' waves in precordial leads from the left sinus of Valsalva: Electrocardiographic and electrophysiologic characteristics

Autor:	Bin Luo, Qi Sun, Jackson J. Liang, Hui-Qiang Wei, Gong-Bu Zhou, Xiao-Gang Guo, Xu Liu, Jian Ma, Hai-yang Xie, Jian-Du Yang
Rok vydání:	2019
Předmět:	Adult Male medicine.medical_specialty medicine.medical_treatment Bundle-Branch Block Action Potentials Precordial examination 030204 cardiovascular system & hematology Electrocardiography Young Adult 03 medical and health sciences 0302 clinical medicine Heart Rate Predictive Value of Tests Physiology (medical) Internal medicine medicine Humans 030212 general & internal medicine Lead (electronics) Sinus (anatomy) Aged Retrospective Studies Left bundle branch block business.industry Middle Aged Sinus of Valsalva Right bundle branch block Ablation medicine.disease Ventricular Premature Complexes Treatment Outcome medicine.anatomical_structure Catheter Ablation Tachycardia Ventricular Cardiology Female Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine business
Zdroj:	Journal of Cardiovascular Electrophysiology. 30:541-549
ISSN:	1540-8167 1045-3873
Popis:	Background While the left sinus of Valsalva (LSV) is a frequent origin of ventricular arrhythmias (VAs). Uncommonly, VAs with right bundle branch block (RBBB) morphology may be successfully terminated from the LSV. Objective We aimed to investigate the electrocardiographic and electrophysiologic characteristics of VAs with RBBB which were successfully eliminated from the LSV. Methods We identified patients with VAs successfully ablated from the LSV from January 2014 to December 2017 and compared electrophysiologic characteristics and ablation sites of those VAs with RBBB versus a control group of patients with left bundle branch block morphology. Results We identified 18 patients with RBBB and predominant "R" waves in the precordial leads. In 12 (66.7%) patients, a small "s" wave in lead V2 and positive "R" in the remaining pericardial leads could be seen. Overall, a single "V" potential was seen in 72.2% of patients in the study group, while discrete potentials were recorded in 80% of the patients in the control group. The majority (88.9%) of the VAs could only be terminated at the nadir of the LSV in the study group. After mean follow-up of 33 ± 14 months, 93.8% and 92% were free of VAs after initial ablation in study and control group, respectively (P = 0.99). Conclusion Some VAs with predominant monophasic "R" wave in precordial leads could be terminated from LSV, especially a small "s" wave in lead V2 was recorded. The nadir of LSV is highly successful for RBBB VAs and single electrogram was recorded at the target for most of the cases.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9979768168be79f4ed9a503b6772f11c https://doi.org/10.1111/jce.13845 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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