Electrocardiographic and electrophysiologic characteristics of ventricular tachycardia originating within the pulmonary artery

Sekiguchi, Yukio; Aonuma, Kazutaka; Takahashi, Atsushi; Yamauchi, Yasuteru; Hishida, Hitoshi; Yokoyama, Yasuhiro; Iesaka, Yoshito; Isobe, Mitsuaki

doi:10.1016/j.jacc.2004.10.071

Cited by 144 publications

(133 citation statements)

References 18 publications

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“…[4] On the other hand, no significant differences were detected in other parameters including aVL/aVR ratio of Q-wave amplitude and R/S ratio on lead V2 (Table 3), probably because of a small number of patients in our study. A recent study reported that an initial PVC with positive QRS complex in lead I was observed in about 70 % (10 out of 14) of patients with idiopathic polymorphic VT / VF arising from RVOT.…”

Section: Discussioncontrasting

confidence: 61%

“…However, there were no significant differences in the ECG characteristics such as QRS duration, R/S ratio and R-wave duration index in lead V2, aVL/aVR of Q-wave amplitude, and the incidence of positive QRS wave in lead I [4,13,14] (Table 3). 2B).…”

Section: Patient Characteristicsmentioning

confidence: 94%

“…Compared to VTs or premature ventricular contractions (PVCs) arising from RVOT (RVOT-VT/PVC), R-wave amplitudes on inferior ECG leads, aVL/aVR ratio of Q-wave amplitude, and R/S ratio on lead V2 were larger in the PA-VT/PVCs. [4] Although these ECG parameters were significantly different between the groups, there are still some overlaps in each value, thereby precluding us from determining a clear cutoff. enlargement, regional RV akinesia, dyskinesia, or aneurysm were detected by echocardiogram in any patients.…”

Section: Introductionmentioning

confidence: 96%

“…[3] After this initial study, surface ECG characteristics and / or intracardiac electrograms regarding premature ventricular contraction (PVC) / VT originating above pulmonary valve were investigated. [4][5][6][7] However, little is known about the characteristics of PA-VT in terms of clinical symptoms and morphological alterations during VT.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve

et al. 2015

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AbstractsPanoptic studies of ventricular tachycardia (VT) originating above the pulmonary valve are scarce. The purpose of this study is to clarify the characteristic of idiopathic VT arising above pulmonary valve. We analyzed 15 consecutive patients with idiopathic VT that was successfully abolished by catheter ablation at the right ventricular outflow tract (RVOT-VT, n = 11) and above the pulmonary valve (PA-VT, n = 4). Incidence of syncope was higher in PA-VT than RVOT-VT (100 % vs 27 %, P < 0.05) and polymorphic VT was also more prevalent in PA-VT (75 % vs 0 %, P < 0.05). The coupling interval (315 ± 29 ms vs 449 ± 32 ms, mean ± SE) at the onset of VT and minimum cycle length (CL) (192 ± 13 ms vs 344 ± 37 ms) during VT were shorter in PA-VT (both P < 0.05). Among 12-lead ECG parameters, only R-wave amplitude in lead II was different between groups (2.05 ± 0.17 mV in PA-VT vs 1.44 ± 0.05 mV in RVOT-VT, P < 0.005). At the successful ablation site, the activation time from the onset of QRS complex did not differ between groups ( -37 ± 3 ms vs -31 ± 4 ms, P = 0.405), whereas the amplitude of intracardiac electrograms was significantly lower in PA-VT (0.83 ± 0.38 mV vs 2.39 ± 0.36 mV, P < 0.05). Although the number of patients in this study is limited, VT originating above the pulmonary valve demonstrated rapid excitation and often degenerated into polymorphic VT, suggesting its malignant electrophysiological characteristics.

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Section: Discussioncontrasting

confidence: 61%

Section: Patient Characteristicsmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve

et al. 2015

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“…14 It should be noted that ventricular myocardial extensions never occur in the aorta. 10 IVAs can originate from the AV annuli including the mitral annulus 7,8 and tricuspid annulus.…”

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confidence: 99%

Anatomical Consideration in Catheter Ablation of Idiopathic Ventricular Arrhythmias

Yamada

Kay

2016

Arrhythmia &Amp; Electrophysiology Review

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Idiopathic ventricular arrhythmias (VAs) are ventricular tachycardias (VTs) or premature ventricular contractions (PVCs) with a mechanism that is not related to myocardial scar. The sites of successful catheter ablation of idiopathic VA origins have been progressively elucidated and include both the endocardium and, less commonly, the epicardium. Idiopathic VAs usually originate from specific anatomical structures such as the ventricular outflow tracts, aortic root, atrioventricular (AV) annuli, papillary muscles, Purkinje network and so on, and exhibit characteristic electrocardiograms based on their anatomical background. Catheter ablation of idiopathic VAs is usually safe and highly successful, but can sometimes be challenging because of the anatomical obstacles such as the coronary arteries, epicardial fat pads, intramural and epicardial origins, AV conduction system and so on. Therefore, understanding the relevant anatomy is important to achieve a safe and successful catheter ablation of idiopathic VAs. This review describes the anatomical consideration in the catheter ablation of idiopathic VAs.

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Ablation of Idiopathic Right Ventricular Tachycardia

Wilber¹,

Joshi²

2007

Catheter Ablation of Cardiac Arrhythmias

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Electrocardiographic and electrophysiologic characteristics of ventricular tachycardia originating within the pulmonary artery

Cited by 144 publications

References 18 publications

Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve

Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve

Anatomical Consideration in Catheter Ablation of Idiopathic Ventricular Arrhythmias

Ablation of Idiopathic Right Ventricular Tachycardia

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