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https://www.readbyqxmd.com/read/29778240/the-autonomic-neural-mechanism-of-right-ventricular-outflow-tract-tachycardia
#1
Hung-Yu Chang, Li-Wei Lo, Yu-Ruey Chen, Yu-Hui Chou, Wei-Lun Lin, Yenn-Jiang Lin, Wei-Hsian Yin, An-Ning Feng, Shih-Ann Chen
BACKGROUND: Ventricular tachycardia (VT) and ventricular premature complexes (VPCs) originating from the right ventricular outflow tract (RVOT) are generally considered as benign arrhythmias, with ECG morphology showing LBBB pattern and inferior axis. Pathogenic mechanisms in the genesis of RVOT VT/VPC remain largely unknown. We aimed to investigate the neural mechanism in RVOT ventricular arrhythmias in canine model. METHODS: Twelve mongrel dogs (13.7 ± 1...
July 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29737447/predicting-value-of-coupling-interval-variability-in-determining-the-origin-of-ventricular-premature-contractions-with-v3-transition
#2
Umut Celikyurt, Aysen Agir, Irem Karauzum, Kurtulus Karauzum, Tayfun Sahin, Ahmet Vural
PURPOSE: We aimed to investigate the predictive value of coupling interval variability (ΔCI) in determining the origin of idiopathic outflow tract ventricular tachycardia (OTVT) with V3 transition. METHODS: We reviewed data from 126 patients who underwent catheter ablation of OTVT between 2015 and 2018 at our institution. We identified 32 patients of successful OTVT ablation with a precordial transition at V3 derivation. The ΔCI (maximum - minimum CI) was measured...
May 8, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29716710/catheter-ablation-for-electrical-storm-in-brugada-syndrome-results-of-substrate-based-ablation
#3
Abhijeet Shelke, Ajit Tachil, Daljeet Saggu, Masilamani Lawrance Jesuraj, Sachin Yalagudri, Calambur Narasimhan
BACKGROUND: Brugada syndrome (BrS) is known to cause malignant ventricular arrhythmia (VA) and sudden cardiac death (SCD). Patients with implantable cardioverter defibrillator (ICD) may experience recurrent shocks from ICD. Recent reports indicate that radiofrequency ablation (RFA) in BrS is feasible, and effective. Catheter ablation of premature ventricular complexes (PVCs) triggering VA and substrate modification of right ventricular outflow tract (RVOT) has been described. METHODS AND RESULTS: Five patients (4 males, age-23 to 32 years) with BrS and electrical storm (ES) despite being on isoprenaline infusion and cilostazol (phosphodiestrase-3 inhibitor) underwent 3 dimensional electroanatomic mapping and RFA...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29659078/mechanistic-subtypes-of-focal-right-ventricular-tachycardia
#4
REVIEW
Bruce B Lerman, Jim W Cheung, James E Ip, Christopher F Liu, George Thomas, Steven M Markowitz
Idiopathic sustained focal right ventricular tachycardia (VT) is most frequently due to outflow tract (OT) tachycardia. This arrhythmia is recognized by its characteristic ECG pattern and sensitivity to adenosine. However, there are other forms of idiopathic, focal sustained VT that originate from the right ventricle (RV), which are less well appreciated and easily overlooked. This review will identify the characteristic features and electrophysiologic properties of these forms of RV VT, including those originating from the tricuspid annulus, right ventricular papillary muscles, and moderator band as well as variants of classic RVOT tachycardia and those due to microreentry in the presence of preclinical disease...
April 16, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29652902/relations-between-right-ventricular-morphology-and-clinical-electrical-and-genetic-parameters-in-brugada-syndrome
#5
Belinda Gray, Ganesh Kumar Gnanappa, Richard D Bagnall, Giuseppe Femia, Laura Yeates, Jodie Ingles, Charlotte Burns, Rajesh Puranik, Stuart M Grieve, Christopher Semsarian, Raymond W Sy
BACKGROUND: Increasing evidence suggests the presence of structural changes affecting the right ventricular outflow tract (RVOT) in patients with Brugada Syndrome (BrS). The aim of this study was to characterise the RV morphology in BrS and explore associations between morphologic, clinical, electrical, and genetic parameters using non-invasive multimodality testing. METHODS: Consecutive BrS patients (recruited 2013-2015) underwent clinical assessment, dedicated RV imaging using cardiac magnetic resonance (CMR) imaging (unless contra-indicated), electrical assessment (electrocardiogram, Holter monitoring, signal-averaged ECG[SAECG]) and genotyping...
2018: PloS One
https://www.readbyqxmd.com/read/29622988/outflow-tract-ventricular-premature-beats-ablation-in-the-presence-or-absence-of-structural-heart-disease-technical-considerations-and-clinical-outcomes
#6
Haitham Badran, Rania Samir, Mohamed Amin
Background: Premature ventricular beats (PVBs) are early depolarization of the myocardium originating in the ventricle. In case of very frequent PVBs, patients are severely symptomatic with impaired quality of life and are at risk of pre-syncope, syncope, heart failure, and sudden cardiac death particularly in the presence of structural heart disease. Ventricular outflow tracts are the most common sites of origin of idiopathic PVBs especially in patients without structural heart disease...
December 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29608225/prediction-of-ventricular-tachyarrhythmia-in-brugada-syndrome-by-right-ventricular-outflow-tract-conduction-delay-signs
#7
Ahmed A Y Ragab, Charlotte A Houck, Lisette J M E van der Does, Eva A H Lanters, Agnes J Q M Muskens, Natasja M S de Groot
BACKGROUND: Brugada syndrome (BrS) is an autosomal dominant disease responsible for sudden cardiac death in young individuals without structural anomalies. The most critical part in the management of this channelopathy is identification of high-risk patients, especially asymptomatic subjects. Prior studies have shown that conduction delay in the right ventricular outflow tract (RVOT) is the main mechanism for developing ventricular tachyarrhythmia (VTA) in BrS patients. The aim of this study was to investigate the significance of electrocardiographic RVOT conduction delay parameters as predictors for development of VTA in patients with BrS...
April 2, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29577347/electrocardiographic-predictors-of-validated-right-ventricular-outflow-tract-septal-pacing-for-correct-localization-of-transthoracic-echocardiography
#8
Huiqiang Wei, Jiaojiao Tang, Dongli Chen, Qianhuan Zhang, Yuanhong Liang, Lie Liu, Shulin Wu, Chunying Lin, Zhiming Yang, Chanjuan Chai
BACKGROUND: Electrocardiographic (ECG) characteristics of true right ventricular outflow tract (RVOT) septal pacing have not been clearly demonstrated. HYPOTHESIS: We hypothesized that ECG parameters would help operators differentiate true RVOT septum from non-septal septum. METHODS: We analyzed 151 patients who underwent pacemaker implantation with a ventricular lead in the RVOT. Transthoracic echocardiographic (TTE) determination of pacing sites was applied in all patients after implantation...
March 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29280039/left-ventricular-outflow-tract-arrhythmias-with-divergent-qrs-morphology-mapping-of-different-exits-and-ablation-strategy
#9
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...
January 2018: 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
January 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28919593/electrocardiographic-algorithms-to-guide-the-management-strategy-of-idiopathic-outflow-tract-ventricular-arrhythmias
#16
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 the site of origin (SoO) in patients with idiopathic ventricular arrhythmias (IVAs). OBJECTIVES    The aim of this study was to compare 3 ECG algorithms for differentiating the SoO and to determine their diagnostic value for the management of outflow tract IVA. PATIENTS AND METHODS    We analyzed 202 patients (mean age [SD]: 45 [16.7] years; 133 women [66%]) with IVAs with the inferior axis (130 premature ventricular contractions or ventricular tachycardias from the right ventricular outflow tract [RVOT]; 72, from the left ventricular outflow tract [LVOT]), who underwent successful radiofrequency catheter ablation (RFCA) using the 3‑dimensional electroanatomical system...
November 30, 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
#17
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)...
January 2018: 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
#18
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...
February 2018: 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
#19
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
#20
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
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