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rvot ecg

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
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
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
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
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
Pei Zhang, Roderick Tung, Zuwen Zhang, Xia Sheng, Qiang Liu, Ruhong Jiang, Yaxun Sun, Shiquan Chen, Lu Yu, Yang Ye, Guosheng Fu, Kalyanam Shivkumar, Chenyang Jiang
BACKGROUND: Catheter ablation in the right ventricular outflow tract (RVOT) may modify the electrophysiologic substrate for recurrent ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with Brugada syndrome (BrS). OBJECTIVE: The purpose of this study was to investigate the mechanism and arrhythmogenic substrate of VT/VF and to evaluate the long-term outcomes of catheter ablation in patients with BrS. METHODS: Eleven consecutive patients with BrS referred to 2 academic medical centers underwent combined epicardial-endocardial electroanatomic mapping...
November 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
N Alessandri, B L Nguyen, F Tufano, R Sergiacomi, F Tersigni, F Urciuoli, S De Angelis, A Dei Giudici
OBJECTIVE: The role of electrophysiology study in Brugada syndrome (BS) sudden cardiac death risk stratification remains controversial and seems to depend on the phenotypic expression of the channelopathy. Ajmaline has a key role in the diagnosis of BS. We observed that programmed electrical stimulation (PES) of the right ventricular outflow tract (RVOT), only when type 1 BS ECG is unmasked by ajmaline administration, induces ventricular arrhythmias. CASE REPORT: We describe a case of ventricular fibrillation induction by PES of the RVOT when type 1 BS ECG is revealed by ajmaline, in a patient with a baseline dynamic intermittent type 1 and 2 BS ECG...
May 2016: European Review for Medical and Pharmacological Sciences
Saurabh Kumar, Jonathan M Kalman
No abstract text is available yet for this article.
August 2016: Journal of Cardiovascular Electrophysiology
Gautam Sharma, Salman Salahuddin, Prashanthan Sanders, Himanshu Gupta, Gurpreet Gulati, Priya Jagia, V K Bahl
BACKGROUND: Electrocardiographic (ECG) and fluoroscopic criteria, which are the only available guides to achieve a true septal position during right ventricular outflow tract (RVOT) pacing, have been infrequently validated. We sought to validate these using cardiac computed tomographic angiography (CTA) to confirm lead position within the RVOT septum. METHODS: Forty-four patients with permanent pacemaker leads in the RVOT position underwent CTA. Lead positions in RVOT were classified as anterior, free wall, or septal location...
March 2016: Indian Heart Journal
Haifeng Pei, Qiujun Yu, Xiaohua Su, Zhen Wang, Heng Zhao, Dachun Yang, Yongjian Yang, De Li
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a crucial health problem. With sudden death often being the first presentation, early diagnosis for ARVC is essential. Up to date, electrocardiogram (ECG) is a widely used diagnostic method without invasive harms. To diagnose and treat ARVC as well as possible, we should clearly elucidate its pathophysiological alterations. A 66-year-old farmer presented to the Emergency Department with continuous palpitation, chest tightness, profuse sweating, and nausea with no obvious predisposing causes...
April 2016: Medicine (Baltimore)
Christian-Hendrik Heeger, Kentaro Hayashi, Karl-Heinz Kuck, Feifan Ouyang
Ventricular arrhythmias (VA), like premature ventricular contractions (PVC) and ventricular tachycardia (VT) in patients without structural heart disease (idiopathic VA), mainly arise from the right and left ventricular outflow tracts (RVOT/LVOT). The prognosis for OT VA is generally good in the majority of patients, but there is potential for developing dilated cardiomyopathies from the high burden of VA, as well as a certain risk for sudden cardiac death because of fast monomorphic VT or polymorphic VT triggered by short-coupling PVC...
April 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Dinesh Choudhary, Amit Kumar Chaurasia, S Mahesh Kumar, Ajeet Arulkumar, Anees Thajudeen, Narayanan Namboodiri, G Sanjay, S P Abhilash, V K Ajitkumar, Tharakan Ja
INTRODUCTION: To study effects of various sites of right ventricular pacing lead implantation on left ventricular function by 2-dimensional (2D) speckle tracking for radial strain and LV dyssynchrony. METHODS: This was retrospective prospective study. Fifteen patients each with right ventricular (RV) apical (RV apex and apical septum) and non-apical (mid septal and low right ventricular outflow tract [RVOT]) were programmed to obtain 100% ventricular pacing for evaluation by echo...
2016: Journal of Cardiovascular and Thoracic Research
Bulent Deveci, Kazim Baser, Murat Gul, Fatih Sen, Habibe Kafes, Sedat Avci, Orkun Temizer, Ozcan Ozeke, Omac Tufekcioglu, Zehra Golbasi
BACKGROUND: Heart failure (HF) is a common, progressive, complex clinical syndrome and a subset of HF patients has symptoms out of proportion to the resting hemodynamics and left ventricular ejection fraction (LVEF). Right ventricular (RV) function is a powerful prognostic factor in HF, but assessing it is a challenge because of the right ventricle's complex geometry. OBJECTIVE: The aim of this study was to investigate the clinical application value of RV outflow tract (RVOT) function measured by transthoracic echocardiography in HF patients...
April 2016: Indian Heart Journal
Jørg Saberniak, Ida S Leren, Trine F Haland, Jan Otto Beitnes, Einar Hopp, Rasmus Borgquist, Thor Edvardsen, Kristina H Haugaa
AIMS: Differentiation between early-phase arrhythmogenic right ventricular cardiomyopathy (ARVC) and right ventricular outflow tract (RVOT)-ventricular tachycardia (VT) can be challenging, and correct diagnosis is important. We compared electrocardiogram (ECG) parameters and morphological right ventricular (RV) abnormalities and investigated if ECG and cardiac imaging can help to discriminate early-phase ARVC from RVOT-VT patients. METHODS AND RESULTS: We included 44 consecutive RVOT-VT (47 ± 14 years) and 121 ARVC patients (42 ± 17 years)...
January 2017: European Heart Journal Cardiovascular Imaging
Kusha Nag, Amrutha Bindu Nagella, V R Hemanth Kumar, Dewan Roshan Singh, M Ravishankar
A 60-year-old woman posted for percutaneous nephrolithotomy with ureterolithotripsy was found to have a history of hypertension and ischemic heart disease from past 6 months on regular treatment. Pulse rate was irregularly irregular in a range of 56-60/min, unresponsive to atropine, with a sinus pause on the electrocardiogram. Although the patient was asymptomatic, anticipating unmasking of the sick sinus syndrome during general anesthesia in the prone position, a temporary pacemaker was implanted at right ventricular outflow tract (RVOT) septum before the scheduled surgery...
September 2015: Anesthesia, Essays and Researches
Ibrahim Marai, Monther Boulos, Jonathan Lessick, Sobhi Abadi, Miry Blich, Mahmoud Suleiman
BACKGROUND: Ablation of outflow flow ventricular arrhythmia (VA) originating from aortic cusps can be challenging. The aim of this study was to describe our approach for this ablation. METHODS: All patients with outflow VA suspected to originate from aortic cusps according to ECG or after failed ablation from right ventricular outflow tract (RVOT) underwent cardiac CT and radiofrequency ablation. CT image of aortic cusps and coronary arteries was integrated into electroanatomic mapping system by point (left main ostium)-based registration...
January 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Zheng Liu, Yu-He Jia, Lan Ren, Pi-Hua Fang, Gong-Bu Zhou, Jia He, Shu Zhang
BACKGROUND: Multiple intercostal recordings were supposed to get a more comprehensive view of the depolarization vector of the outflow tract ventricular arrhythmia (OT-VA), which may help to identify the OT-VA more accurately. This study was undertaken to develop a more accurate electrocardiogram (ECG) criterion for differentiating between left and right OT-VA origins. METHODS: We studied OT-VA with a left bundle branch block pattern and inferior axis QRS morphology in 47 patients with successful catheter ablation in the right ventricular OT (RVOT; n = 37) or aortic coronary cusp (ACC; n = 10)...
February 2016: Pacing and Clinical Electrophysiology: PACE
Koonlawee Nademanee, Hariharan Raju, Sofia V de Noronha, Michael Papadakis, Laurence Robinson, Stephen Rothery, Naomasa Makita, Shinya Kowase, Nakorn Boonmee, Vorapot Vitayakritsirikul, Samrerng Ratanarapee, Sanjay Sharma, Allard C van der Wal, Michael Christiansen, Hanno L Tan, Arthur A Wilde, Akihiko Nogami, Mary N Sheppard, Gumpanart Veerakul, Elijah R Behr
BACKGROUND: The right ventricular outflow tract (RVOT) is acknowledged to be responsible for arrhythmogenesis in Brugada syndrome (BrS), but the pathophysiology remains controversial. OBJECTIVES: This study assessed the substrate underlying BrS at post-mortem and in vivo, and the role for open thoracotomy ablation. METHODS: Six whole hearts from male post-mortem cases of unexplained sudden death (mean age 23.2 years) with negative specialist cardiac autopsy and familial BrS were used and matched to 6 homograft control hearts by sex and age (within 3 years) by random risk set sampling...
November 3, 2015: Journal of the American College of Cardiology
Qing Zhao, Jin-Shan Wo, Jie Guo, Shang-Lang Cai
OBJECTIVE: This study utilized Doppler ultrasonography cardiograms in patients with third-degree atrioventricular (III-AV) block to compare right ventricular apex (RVA) pacing and right ventricular outflow tract (RVOT) pacing with respect to their effects on synchronization of contraction between the two ventricles, as well as on timing of specific left-ventricular electrical and mechanical events and their impact on left ventricular function. METHODS: Thirty-eight patients with (III-AV) block were implanted with dual-chamber pacemakers, in 20 cases, implantation occurring in the RVOT (RVOT group), while in 18 cases implantation occurred in the RVA (RVA group)...
2015: International Journal of Clinical and Experimental Medicine
Alexandros Protonotarios, Aris Anastasakis, Adalena Tsatsopoulou, Loizos Antoniades, Efstathia Prappa, Petros Syrris, Dimitrios Tousoulis, William J McKENNA, Nikos Protonotarios
INTRODUCTION: Epsilon waves are hallmark features of arrhythmogenic cardiomyopathy (ACM) but information about their clinical significance is variable. We evaluated epsilon wave prevalence, characteristics, and their clinical significance in an ACM population. METHODS AND RESULTS: Eighty-six unselected patients fulfilling the 2010 Task Force criteria were enrolled. Seventy-six of them were carriers of desmosomal mutations. All subjects were serially evaluated with standard 12-lead ECG and 2-dimensional echocardiography...
July 16, 2015: Journal of Cardiovascular Electrophysiology
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