Radiofrequency catheter ablation of premature ventricular contractions from the mitral annulus in patients without structural heart disease

Autor: Atsushi Tanaka, Takafumi Ueno, Akihiro Masumoto, Takahiro Mito, Masao Takemoto, Yoshibumi Antoku, Takuya Tsuchihashi
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Epicardial Mapping
Male
medicine.medical_specialty
Heart disease
medicine.medical_treatment
Catheter ablation
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
clinical status
Left atrial
Internal medicine
Mitral valve
catheter ablation
medicine
Ventricular outflow tract
Humans
In patient
030212 general & internal medicine
Mitral annulus
cardiovascular diseases
trans‐interatrial septal approach
clinical characteristics
Aged
business.industry
mitral annulus
General Medicine
Middle Aged
medicine.disease
Ventricular Premature Complexes
Electrophysiology
medicine.anatomical_structure
Radiofrequency catheter ablation
Cardiology
Electrocardiography
Ambulatory
Mitral Valve
Female
premature ventricular contraction
Cardiology and Cardiovascular Medicine
business
Zdroj: Pacing and Clinical Electrophysiology
ISSN: 1540-8159
0147-8389
Popis: INTRODUCTION: We previously reported the clinical benefits of radiofrequency catheter ablation (RFCA) of premature ventricular contractions (PVCs) from the right ventricular outflow tract or near the His-bundle, which can often deteriorate the clinical status. PVCs from the mitral valve (MA-PVCs) also often deteriorate the patients' clinical status. This study aimed to evaluate the effect of ablating MA-PVCs with RFCA from a trans-interatrial septal approach on the clinical status in symptomatic patients with frequent MA-PVCs without structural heart disease. METHODS: The frequency of PVCs per the total heart beats by 24-h Holter monitoring and New York Heart Association (NYHA) functional class in 22 patients with MA-PVCs were evaluated before and 6 months after RFCA. RESULTS: Procedural success was achieved in 20 (91%) of 22 patients. Of the 22 patients, in 15 (68%) and 1 (5%) patient a successful RFCA on the left ventricular side of the MA using the trans-interatrial septal approach and trans-coronary sinus approach was achieved. Interestingly, in 4 (18%) patients a successful RFCA on the left atrial (LA) side of the MA using a trans-interatrial septal approach was achieved. Ablating MA-PVCs readily improved the NYHA functional class compared to that before. A ≥ 0.62 peak deflection index and ≤ 30 years old may be one of the important predictors of successfully ablated MA-PVCs from the LA side of the MA. CONCLUSIONS: RFCA produces clinical benefits in patients with MA-PVCs. Further, it may be necessary to initially consider a trans-interatrial septal approach to ablate these PVCs. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
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