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RVOT tachycardia

Ivo Roca, Nuria Rivas, Jaume Francisco, Jordi Perez, Gabriel Acosta, Gerard Oristrell, Maria Terricabres, David Garcia-Dorado, Angel Moya
BACKGROUND: Ablation in aortic cusps could be necessary in up to 15% of the patients, especially in para-Hisian atrial tachycardia and ventricular arrhythmias arising from outflow tracts. Risk of coronary damage has led to recommendation of systematic coronary angiography (CA) during the procedure. Other image tests as intravascular (ICE) or transesophageal echocardiography (TEE) have been proposed. Both methods have limitations: additional vascular access for ICE and needing for additional CA in some patients in case of TEE...
October 19, 2016: Journal of Cardiovascular Electrophysiology
Robert W Loar, Athar M Qureshi, Christina Y Miyake, Santiago O Valdes, Jeffrey J Kim, Caridad M De la Uz
BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is utilized for dysfunctional right ventricular outflow tracts (RVOT) to relieve obstruction, regurgitation, and RV dysfunction. PPVI has not been reported to induce arrhythmias. This study is the first to report the incidence of ventricular tachycardia (VT) after PPVI. METHODS: This was a retrospective study of all patients who had PPVI at a single institution. All patients were admitted after PPVI for overnight telemetry monitoring...
September 26, 2016: Journal of Interventional Cardiology
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
Xiangmin Shi, Zhuo Liang, Jian Li, Jianping Guo, Zhaoliang Shan, Yutang Wang
Ventricular tachycardia (VT) and premature contraction originating from the right ventricular outflow tract (RVOT) usually appear in healthy individuals. Radiofrequency ablation (RFA) is highly effective at resolving this type of arrhythmia. Refractory VT of RVOT is uncommon and occasionally results from cardiac metastasis of extraskeletal mesenchymal chondrosarcomas (ESMC). ESMC is a rare malignant tumor arising from soft tissues. The current study presents the case of a 25-year-old male with severe VT arising from RVOT due to metastasis of an ESMC that originally occurred in the retroperitoneum...
September 2016: Experimental and Therapeutic Medicine
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...
July 22, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Akira Ueoka, Hiroshi Morita, Atsuyuki Watanabe, Koji Nakagawa, Nobuhiro Nishii, Satoshi Nagase, Tohru Ohe, Hiroshi Ito
BACKGROUND: Clinical and experimental studies have shown the existence of an arrhythmogenic substrate in the right ventricular outflow tract (RVOT) in patients with Brugada syndrome (BrS). To evaluate the importance of the RVOT, we evaluated the activation pattern of induced ventricular tachyarrhythmias using body surface mapping (BSM) in patients with BrS. METHODS AND RESULTS: We examined 14 patients with BrS in whom ventricular tachyarrhythmias were induced by programmed electrical stimulation...
July 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Celal Akdeniz, Enes Elvin Gul, Nida Celik, Mehmet Karacan, Volkan Tuzcu
INTRODUCTION: Definitive therapy of idiopathic right ventricular arrhythmias (VA) remains a challenge in interventional electrophysiology. The aim of this study was to evaluate the utility of EnSite Velocity system in the catheter ablation of RV tachycardia in children. METHODS: Thirty-five children with idiopathic right VA underwent catheter ablation procedure using the EnSite Velocity system guidance. RESULTS: The mean patient age was 12...
September 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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
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)...
February 21, 2016: European Heart Journal Cardiovascular Imaging
Shuenn-Nan Chiu, Chia-Ti Tsai, Lian-Yu Lin, Shu-Chien Huang, Yih-Sharng Chen, Jou-Kou Wang, Mei-Hwan Wu, Ling-Ping Lai, Jiunn-Lee Lin
BACKGROUND: Ventricular arrhythmia is an important cause of late death in patients with repaired tetralogy of Fallot (rTOF). By using an rTOF canine model, we investigated the role of repolarization alternans and its electrophysiological mechanisms. METHODS AND RESULTS: Six dogs received right ventricular outflow tract (RVOT) transannular patch, pulmonary valve destruction, and right bundle branch ablation to simulate rTOF. After 1 year, we performed high-resolution dual-voltage and calcium optical mapping to record action potentials and calcium transients on the excised right ventricular outflow tract wedges...
December 2015: Journal of the American Heart Association
Kivanc Yalin, Ebru Golcuk, Tolga Aksu, Selma K Tiryakioglu, Ahmet K Bilge, Kamil Adalet
BACKGROUND: The 2 predominant etiologies of right ventricular tachycardia (VT) are arrhythmogenic right ventricular cardiomyopathy (ARVC) and idiopathic VT arising from the right ventricular outflow tract. Discrimination between these 2 entities is critical, as their prognoses and therapeutic options differ. The microvolt T-wave alternans (TWA) is widely used to predict lethal ventricular arrhythmias in various diseases. However, the clinical significance of TWA in patients with VT originating from the right ventricle has been unknown...
December 2015: American Journal of the Medical Sciences
Van Buu Dan Do, Wen-Chin Tsai, Yenn-Jiang Lin, Satoshi Higa, Nobumori Yagi, Shih-Lin Chang, Li-Wei Lo, Fa-Po Chung, Jo-Nan Liao, Yen-Chang Huang, Chao-Shun Chan, Hung-Kai Huang, Yu-Feng Hu, Hsuan-Ming Tsao, Shih-Ann Chen
BACKGROUND: The aim of this study was to investigate the different substrate characteristics of repetitive premature ventricular complexed (PVC) trigger sites by the non-contact mapping (NCM). METHODS: Thirty-five consecutive patients, including 14 with arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC) and 21 with idiopathic right ventricular outflow tract tachycardia (RVOT VT), were enrolled for electrophysiological study and catheter ablation guided by the NCM...
2015: PloS One
Sergio Dubner, Claudio Hadid, Damian Azocar, Carlos Labadet, Cecilia Valsecchi, Agustin Dominguez
BACKGROUND: The noncontact mapping system facilitates the mapping of premature ventricular contractions (PVCs) and ventricular tachycardia (VT) using a 64-electrode expandable balloon catheter (ARRAY, St. Jude Medical). The aim of this study is to analyze the results and follow-up of the PVC ablation using this system. METHODS AND RESULTS: Prospective and consecutive patients with frequent PVCs (6,000 or more) or monomorphic VT, suspected to be originated on the right ventricular outflow tract (RVOT), were included...
2016: Cardiology Journal
Jeffrey M Landreville, Gary I Joubert, Eva Welisch, Krista Helleman, Naveen P Poonai
BACKGROUND: Ventricular tachycardia (VT) in the pediatric population is rare, has a wide differential diagnosis, and can present in numerous ways. In the absence of underlying heart disease, VT is considered idiopathic and is associated with an excellent prognosis. Right ventricular outflow tract ventricular tachycardia (RVOT-VT) represents the most common form of idiopathic VT. The differential diagnosis, mechanism, presentation, management, and prognosis of RVOT-VT in the pediatric population will be discussed...
October 2015: Journal of Emergency 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
Cüneyt Kocaş, Yusuf Türkmen, Gökhan Çetinkal, Sait Mesut Doğan
Amantadine hydrochloride is an antiviral agent that is also effective in the treatment of Parkinson's disease. In the literature, cardiac arrhythmia is reported in toxic doses of amantadine, but in this paper we report a patient with right ventricular outflow tract (RVOT) tachycardia after an initial dose of amantadine. A 47-year-old female patient was admitted to the emergency department with the complaint of palpitation and dizziness after taking 200 mg amantadine. A 12-lead standard ECG showed wide QRS complex tachycardia with a heart rate of 167/min...
July 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
B Bellmann, V Tscholl, P Nagel, M Roser
This case report describes a 31-year-old man with a sustained wide complex tachycardia with left bundle brunch block morphology after surgical repair of a tetralogy of Fallot. The tachycardia was inducible after orciprenaline administration after ventricular stimulation with one extra beat. In combination with the three-dimensional electroanatomic mapping system and pace mapping technique the origin of the tachycardia was identified at the lateral free wall of the right ventricular outflow tract tachycardia (RVOT) inferior of the pulmonary valve...
September 2015: Herzschrittmachertherapie & Elektrophysiologie
Fengxiang Zhang, Bing Yang, Hongwu Chen, Weizhu Ju, Pipin Kojodjojo, Mingfang Li, Kai Gu, Gang Yang, Kejiang Cao, Minglong Chen
AIMS: To identify unique electrophysiological characteristics of pulmonary artery (PA) ventricular arrhythmias (VA) and determine long-term clinical outcomes following non-contact mapping (NCM)-guided ablation. METHODS AND RESULTS: The NCM array was deployed in consecutive patients undergoing clinically indicated ablation of outflow tract (OT) VA with left bundle branch block morphology, inferior axis and the precordial lead transition zone ≥ V3. Activation, pace and NCM mapping parameters, and electrocardiogram analysis of PA VA patients were compared with 50 patients with right ventricular OT (RVOT) or aortic coronary cusps (ACC) foci...
February 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Wen-Chin Tsai, Yen-Yu Lu, Yao-Chang Chen, Chien-Jung Chang, Yu-Hsun Kao, Yung-Kuo Lin, Yu-Hsin Chen, Shih-Ann Chen, Liang-Yo Yang, Yi-Jen Chen
BACKGROUND: Sex hormones and calcium (Ca(2+)) regulation play roles in the pathophysiology of ventricular tachycardia from right ventricular outflow tract (RVOT). The purpose of this study was to evaluate whether androgen receptor knockout (ARKO) can increase RVOT arrhythmogenesis through modulating RVOT electrophysiology and Ca(2+) homeostasis. METHODS: Conventional microelectrodes were used to study the action potential (AP) in RVOT tissues prepared from wild type (WT) and ARKO mice (aged 6-10 months) before and after caffeine (1mM), isoproterenol (1 μM), adenosine (10 μM) and flecainide (5 μM) administration...
June 15, 2015: International Journal of Cardiology
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