Idiopathic ventricular arrhythmias originating from the moderator band: Electrocardiographic characteristics and treatment by catheter ablation
| Autor: | Francis E. Marchlinski, Mouhannad M. Sadek, Gregory E. Supple, Mathew D. Hutchinson, David J. Callans, Lidia Carballeira, Rupa Bala, Vickas V. Patel, Daniel Benhayon, Pasquale Santangeli, Erica S. Zado, William Chik, Ravi Sureddi, Fermin C. Garcia |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Mean QRS Duration Catheter ablation Ventricular tachycardia Cohort Studies Electrocardiography QRS complex Physiology (medical) Internal medicine medicine Humans cardiovascular diseases medicine.diagnostic_test business.industry Left bundle branch block Middle Aged Right bundle branch block medicine.disease Ventricular Premature Complexes Treatment Outcome Ventricular Fibrillation Ventricular fibrillation Catheter Ablation Tachycardia Ventricular cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heart Rhythm. 12:67-75 |
| ISSN: | 1547-5271 |
| Popis: | Background The moderator band (MB) can be a source of premature ventricular contractions (PVCs), monomorphic ventricular tachycardia (VT), and idiopathic ventricular fibrillation (IVF). Objective The purpose of this study was to define the electrocardiographic (ECG) characteristics and procedural techniques to successfully identify and ablate MB PVCs/VT. Methods In 10 patients with left bundle branch block morphology PVCs/VT, electroanatomic mapping in conjunction with intracardiac echocardiography (ICE) localized the site of origin of the PVCs to the MB. Clinical characteristics of the patients, ECG features, and procedural data were collected and analyzed. Results Seven patients presented with IVF and 3 presented with monomorphic VT. In all patients, the ventricular arrhythmias (VAs) had a left bundle branch block QRS with a late precordial transition (>V4), a rapid downstroke of the QRS in the precordial leads, and a left superior frontal plane axis. Mean QRS duration was 152.7 ± 15.2 ms. Six patients required a repeat procedure. After mean follow-up of 21.5 ± 11.6 months, all patients were free of sustained VAs, with only 1 patient requiring antiarrhythmic drug therapy and 1 patient having isolated PVCs no longer inducing VF. There were no procedural complications. Conclusion VAs originating from the MB have a distinctive morphology and often are associated with PVC-induced ventricular fibrillation. Catheter ablation can be safely performed and is facilitated by ICE imaging. |
| Databáze: | OpenAIRE |
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