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rvot ecg

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https://www.readbyqxmd.com/read/29280039/left-ventricular-outflow-tract-arrhythmias-with-divergent-qrs-morphology-mapping-of-different-exits-and-ablation-strategy
#1
Christopher Reithmann, Michael Fiek
BACKGROUND: Ventricular arrhythmias (VAs) from the left ventricular outflow tract (LVOT) can have multiple exits exhibiting divergent ECG features. METHODS: In a series of 131 patients with VAs with LVOT origin, 10 patients presented with divergent QRS morphologies. Multisite endo- and epicardial mapping of different exit sites was performed. RESULTS: The earliest ventricular activity of 23 LVOT VAs in 10 patients was detected in the endocardium of the LV in 7 patients, the aortic sinuses of Valsalva (SoV) in 3 patients, the distal coronary sinus in 6 patients, the anterior interventricular vein in 3 patients, and the posterior right ventricular outflow tract (RVOT) in 4 patients...
December 27, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29277286/the-relationship-between-the-s-wave-in-lead-1-and-recurrence-of-rvot-pvc-ablation
#2
Hacı Murat Güneş, Gültekin Günhan Demir, Oğuz Karaca, Filiz Kızılırmak Yılmaz, Ersin İbişoğlu, Tayyar Gökdeniz, Mehmet Onur Omaygenç, Ekrem Güler, Gamze Babur Güler, Ümeyir Savur, Beytullah Çakal, İrfan Barutçu, Fethi Kılıçaslan
BACKGROUND: Radiofrequency catheter ablation (CA) is a common non-pharmacological treatment option for ventricular premature contractions (PVCs) originating from right ventricular outflow tract (RVOT). In this study, we aimed to investigate the relationship between recurrence after CA for RVOT-PVC and S-wave in lead 1 that was shown to be associated with RVOT depolarization. METHODOLOGY: A total of 104 patients who were referred to our clinic for CA for idiopathic RVOT-PVC between 2012 and 2015years were enrolled...
December 14, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29226502/s-r-difference-in-v1-v2-is-a-novel-criterion-for-differentiating-the-left-from-right-ventricular-outflow-tract-arrhythmias
#3
Onur Kaypakli, Hasan Koca, Durmus Yıldıray Sahin, Fadime Karataş, Suleyman Ozbicer, Mevlüt Koç
AIM: The correct estimation of the VA origin as RVOT or LVOT results in reduced ablation duration reduced radiation exposure and decreased number of vascular access. In our study, we aimed to detect the predictive value of S-R difference in V1-V2 for differentiating the left from right ventricular outflow tract arrhythmias. METHODS: We included 123 patients with symptomatic frequent premature ventricular outflow tract contractions who underwent successful catheter ablation (70 male, 53 female; mean age 46...
December 10, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29145303/epicardial-radiofrequency-catheter-ablation-of-brugada-syndrome-with-electrical-storm-during-ventricular-fibrillation-a-case-report
#4
Shufen Jiang, Xiaomeng Yin, Chang Dong, Yunlong Xia, Jinqiu Liu
RATIONALE: Brugada syndrome (BrS) is characterized by ST segment elevation at the J point ≥2 mm in the right precordial electrocardiogram (ECG) leads, in the absence of structural heart disease, electrolyte disturbances, or ischemia. It is a well-described cause of sudden death in young patients, especially in the age of between 30 and 40 years old. Here, we reported an unusual case of electrical storm (ES) of ventricular fibrillation (VF) caused by BrS with complete right bundle-branch block (CRBBB) in a 75-year-old male patient...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29038102/st-elevation-magnitude-correlates-with-right-ventricular-outflow-tract-conduction-delay-in-type-i-brugada-ecg
#5
Kevin M W Leong, Fu Siong Ng, Cheng Yao, Caroline Roney, Patricia Taraborrelli, Nicholas W F Linton, Zachary I Whinnett, David C Lefroy, D Wyn Davies, Phang Boon Lim, Sian E Harding, Nicholas S Peters, Prapa Kanagaratnam, Amanda M Varnava
BACKGROUND: The substrate location and underlying electrophysiological mechanisms that contribute to the characteristic ECG pattern of Brugada syndrome (BrS) are still debated. Using noninvasive electrocardiographical imaging, we studied whole heart conduction and repolarization patterns during ajmaline challenge in BrS individuals. METHODS AND RESULTS: A total of 13 participants (mean age, 44±12 years; 8 men), 11 concealed patients with type I BrS and 2 healthy controls, underwent an ajmaline infusion with electrocardiographical imaging and ECG recordings...
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29016800/the-prognostic-impact-of-single-extra-stimulus-on-programmed-ventricular-stimulation-in-brugada-patients-without-previous-cardiac-arrest-multi-centre-study-in-japan
#6
Masahiko Takagi, Yukio Sekiguchi, Yasuhiro Yokoyama, Naohiko Aihara, Masayasu Hiraoka, Kazutaka Aonuma
Aims: The prognostic value of programmed electrical stimulation (PES) in Brugada syndrome (BrS) remains controversial. One of the reasons for discrepant results may be due to the selection of stimulation protocol. We evaluated the prognostic value of a positive PES result (PES+) according to the inducible pacing sites and the number of extra-stimuli in BrS patients without previous cardiac arrest (CA). Methods and results: We enrolled 224 consecutive BrS patients without previous CA (mean age 51 ± 14 years, 209 males), who underwent PES with the identical protocol...
June 16, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28988456/electrocardiographic-features-of-failed-and-recurrent-right-ventricular-outflow-tract-catheter-ablation-of-idiopathic-ventricular-arrhythmias
#7
Shinya Yamada, Fa-Po Chung, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Chung-Hsing Lin, Chin-Yu Lin, Yao-Ting Chang, Ting-Yung Chang, Abigail Louise D Te, Shih-Ann Chen
INTRODUCTION: Various ECG algorithms have been proposed to identify the origin of idiopathic outflow tract (OT)-ventricular arrhythmia (VA). However, electrocardiographic features of failed and recurrent right ventricular outflow tract (RVOT) ablation of idiopathic OT-VAs have not been clearly elucidated. METHODS AND RESULTS: A total of 264 consecutive patients (mean age: 44.0±13.0 years, 96 male) undergoing RVOT ablation for OT-VAs with a transition ≥ V3 , including 241 patients (91...
October 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28919593/electrocardiographic-algorithms-to-guide-a-management-strategy-of-idiopathic-outflow-tract-ventricular-arrhythmias
#8
Bartosz Ludwik, Karol Deutsch, Mariusz Mazij, Janusz Śledź, Aleksandra Morka, Michał Labus, Michał Chrabąszcz, Bartosz Szafran, Jerzy Śpikowski, Lesław Szydłowski, Sebastian M Stec
INTRODUCTION    The current guidelines of the European Society of Cardiology outlined electrocardiographic (ECG) differentiation of site of origin (SOO) in patients with idiopathic ventricular arrhythmias (IVA).  OBJECTIVES    The aim of this study was to compare three ECG algorithms for differentiating SOO and to determine their diagnostic value for the management of outflow tract IVA. PATIENTS AND METHODS    Patients with IVA with inferior axis who underwent successful radiofrequency catheter ablation (RFCA) using the 3D-electroanatomical system were analyzed...
September 6, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28917557/idiopathic-ventricular-arrhythmias-originating-from-the-right-coronary-sinus-prevalence-electrocardiographic-and-electrophysiological-characteristics-and-catheter-ablation
#9
Yunlong Wang, Zhuo Liang, Shaoqin Wu, Zhihong Han, Xuejun Ren
BACKGROUND: Ventricular arrhythmias (VAs) of the right coronary cusp (RCC) are not fully characterized. OBJECTIVES: To investigate the electrocardiographic and electrophysiological characteristics, mapping and ablation of RCC-VAs. METHODS: Among 256 consecutive patients undergoing electrophysiological evaluation and ablation of VAs of ventricular outflow tract origin, data were compared among 27 RCC-VAs, 50 VAs of the septal aspect of right ventricular outflow tract (RVOT), including from pulmonary artery, and 9 VAs of left coronary cusp (LCC)...
September 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28842979/epicardial-ablation-utilizing-remote-magnetic-navigation-in-a-patient-with-brugada-syndrome-and-inferior-early-repolarization
#10
Paul Chun Yih Lim, Koonlawee Nademanee, Edward Chun Yi Lee, Wee Siong Teo
We report a case of epicardial ablation in a combined Brugada and inferior early repolarization syndrome patient with recurrent defibrillator therapy for spontaneous ventricular fibrillation. Electroanatomic mapping and ablation were achieved with remote magnetic navigation. Highly fractionated electrograms were seen epicardially in the anterior right ventricular outflow tract (RVOT) and at the anterior-inferior right ventricle. Ablation of the RVOT region resulted in resolution Brugada pattern electrocardiogram...
August 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28728260/-clinical-analysis-of-pacing-therapy-and-treatment-of-complications-during-follow-up-in-children
#11
P J Zhao, Y W Chen, F Li, Y Li, J P Yang, J J Wu
Objective: To analyze characteristics of permanent pacemaker implantation in children as well as treatment and prognosis of complications. Method: Clinical data of children who underwent endocardial or epicardial permanent pacemaker implantation between April 2000 and June 2016 in Shanghai Xinhua Hospital and Shanghai Children's Medical Center were analyzed retrospectively. These patients were discharged 5 days after implantation. Electrocardiogram, chest X ray, echocardiography and pacemaker programming were performed during follow-up...
July 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28667170/isolated-cardiac-sarcoidosis-masquerading-as-right-ventricular-outflow-tract-ventricular-tachycardia
#12
Auras R Atreya, Mitkumar Patel, Senthil K Sivalingam, Mathias L Stoenescu
A 67-year-old man with coronary artery disease (CAD) and left anterior descending artery (LAD) stent presented with symptomatic monomorphic ventricular tachycardia (VT) at a rate of 190 bpm requiring cardioversion. ECG showed left bundle branch block pattern and inferior axis, suggestive of a right ventricular outflow tract (RVOT) focus rather than left ventricular scar due to LAD territory myocardial infarction (MI). Echocardiography showed normal wall motion. Angiography revealed a patent mid-LAD stent. Cardiac MRI with delayed postcontrast sequence revealed several regions of hyperenhancement abnormality within the basal portion of the interventricular septum...
June 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28585685/pulmonary-artery-a-pivotal-site-for-catheter-ablation-in-idiopathic-rvot-ventricular-arrhythmias
#13
REVIEW
Chunmiao Wang, Yawen Zhang, Fangde Hong, Ying Huang
In patients without associated myocardial diseases, characterized by left bundle branch block and inferior axis morphologies, repetitive idiopathic right ventricular tachycardias and ventricular premature contractions typically arise from right ventricular outflow tract (RVOT). Accumulated evidences have shown that radiofrequency catheter ablation is a useful treatment for patients with RVOT ventricular arrhythmias (VAs). Interestingly, several medical centers have shown that pulmonary artery (PA) is a potential novel site for catheter ablation in RVOT-like VAs, particularly in patients where termination of RVOT VAs at the usual site fails...
July 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28506214/origins-location-of-the-outflow-tract-ventricular-arrhythmias-exhibiting-qrs-pattern-or-qs-pattern-with-a-notch-on-the-descending-limb-in-lead-v1
#14
Cong Lin, Cheng Zheng, De-Pu Zhou, Xiao-Wei Li, Shu-Jie Wu, Jia-Feng Lin
BACKGROUND: Ventricular outflow tract(VOT) ventricular arrhythmias(VAs) presenting qrS pattern or QS pattern with a notch on the descending limb in lead V1 were consistently thought of arising from the commissure between left and right coronary cusp (L-RCC) by previous studies. However, we found they could originate from other anatomic structures in VOT. This study aimed to investigate the exact origin of this kind VAs. METHODS: Forty-nine patients of VOT premature ventricular contrations/ventricular tachycardia(PVCs/VT) with lead V1 presenting qrS pattern or QS pattern with a notch on the descending limb undergoing successful radiofrequency catheter ablation(RFCA) in our center were analyzed...
May 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28472282/right-ventricular-outflow-tract-high-density-endocardial-unipolar-voltage-mapping-in-patients-with-brugada-syndrome-evidence-for-electroanatomical-abnormalities
#15
Konstantinos P Letsas, Michael Efremidis, Konstantinos Vlachos, Stamatis Georgopoulos, Nikolaos Karamichalakis, Dimitrios Asvestas, Kosmas Valkanas, Panagiotis Korantzopoulos, Tong Liu, Antonios Sideris
Aims: Epicardial structural abnormalities at the right ventricular outflow tract (RVOT) may provide the arrhythmia substrate in Brugada syndrome (BrS). Electroanatomical endocardial unipolar voltage mapping is an emerging tool that accurately identifies epicardial abnormalities in different clinical settings. This study investigated whether endocardial unipolar voltage mapping of the RVOT detects electroanatomical abnormalities in patients with BrS. Methods and results: Ten asymptomatic patients (8 males, 34...
May 2, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28077814/life-threatening-ventricular-arrhythmia-and-brugada-type-st-segment-elevation-associated-with-acute-ischemia-of-the-right-ventricular-outflow-tract
#16
Rena Nakamura, Mitsuhiro Nishizaki, Kiko Lee, Masato Shimizu, Hiroyuki Fujii, Noriyoshi Yamawake, Harumizu Sakurada, Masayasu Hiraoka, Mitsuaki Isobe
BACKGROUND: Brugada-type ECG (Br-ECG) is occasionally observed during acute myocardial ischemia of the right ventricular outflow tract (RVOT). No studies have explored, however, the association of ventricular tachyarrhythmia and development of Br-ECG due to acute ischemia of the RVOT.Methods and Results:The study included 13 consecutive patients with acute ischemia of the RVOT during coronary catheterization. Patients were divided into 2 groups: those with Br-ECG (group B) and those without (group N)...
February 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27930354/simultaneous-non-invasive-epicardial-and-endocardial-mapping-in-patients-with-brugada-syndrome-new-insights-into-arrhythmia-mechanisms
#17
Boris Rudic, Maria Chaykovskaya, Alexey Tsyganov, Vitaly Kalinin, Erol Tülümen, Theano Papavassiliu, Christina Dösch, Volker Liebe, Jürgen Kuschyk, Susanne Röger, Ibrahim El-Battrawy, Ibrahim Akin, Marina Yakovleva, Elena Zaklyazminskaya, Anna Shestak, Stanislav Kim, Mikhail Chmelevsky, Martin Borggrefe
BACKGROUND: The underlying mechanisms of Brugada syndrome (BrS) are not completely understood. Recent studies provided evidence that the electrophysiological substrate, leading to electrocardiogram abnormalities and/or ventricular arrhythmias, is located in the right ventricular outflow tract (RVOT). The purpose of this study was to examine abnormalities of epicardial and endocardial local unipolar electrograms by simultaneous noninvasive mapping in patients with BrS. METHODS AND RESULTS: Local epicardial and endocardial unipolar electrograms were analyzed using a novel noninvasive epi- and endocardial electrophysiology system (NEEES) in 12 patients with BrS and 6 with right bundle branch block for comparison...
November 14, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27625076/disappearance-of-idiopathic-outflow-tract-premature-ventricular-contractions-after-catheter-ablation-of-overt-accessory-pathways
#18
Tamas Szili Torok, Lennart J DE Vries, Emin E Özcan, Can Hasdemir, Zsuzsanna Kis, Attila Kardos, Tamas Géczy, Istvan Kovacs, Imre Benedek, Erik Oosterwerff, Astrid A Hendriks, Muchtiar Khan, Sing-Chien Yap
BACKGROUND: Multiple mechanisms have been proposed for idiopathic premature ventricular contractions (PVCs) originating from the outflow tracts (OTs). Recent observations such as the coexistence of these arrhythmias with atrioventricular nodal reentrant tachycardias and the association between discrete prepotentials and successful ablation sites of ventricular arrhythmias (VAs) from the OTs suggest a common link. OBJECTIVE: In this case series we draw attention to a unique association between accessory pathways (APs) and idiopathic PVCs from the OTs, disappearing after AP ablation...
January 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27617087/arrhythmogenic-cardiomyopathy-electrical-and-structural-phenotypes
#19
Deniz Akdis, Corinna Brunckhorst, Firat Duru, Ardan M Saguner
This overview gives an update on the molecular mechanisms, clinical manifestations, diagnosis and therapy of arrhythmogenic cardiomyopathy (ACM). ACM is mostly hereditary and associated with mutations in genes encoding proteins of the intercalated disc. Three subtypes have been proposed: the classical right-dominant subtype generally referred to as ARVC/D, biventricular forms with early biventricular involvement and left-dominant subtypes with predominant LV involvement. Typical symptoms include palpitations, arrhythmic (pre)syncope and sudden cardiac arrest due to ventricular arrhythmias, which typically occur in athletes...
August 2016: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/27562132/effectiveness-of-radiofrequency-catheter-ablation-of-outflow-tract-ventricular-arrhythmias-in-children-and-adolescents
#20
Xiao-Mei Li, He Jiang, Yan-Hui Li, Yan Zhang, Hai-Ju Liu, Hai-Yan Ge, Yi Zhang, Mei-Ting Li
Outflow tract ventricular arrhythmias (OTVAs) are common in children; however, experience is limited on their radiofrequency catheter ablation (RFCA). The purpose of this study was to assess the outcomes of mapping and ablation of pediatric OTVAs and to evaluate the role of ECG algorithms in distinguishing the origin of OTVAs. We compared retrospectively collected single-center data on 92 consecutive pediatric patients (58 male; age, 8.2 ± 2.9 [range 3.6-18] years) who underwent RFCA for OTVAs from 2009 to 2015...
December 2016: Pediatric Cardiology
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