OBJECTIVES: The aim of this study was to define the role of papillary muscles (PAPs) in post-infarction ventricular arrhythmias. BACKGROUND: Papillary muscles have been implicated in arrhythmogenesis; however, their role in post-infarction ventricular arrhythmias has not been well-defined. METHODS: In a series of 9 patients (age 65 +/- 9 years, ejection fraction 0.36 +/- 0.1) with post-infarction ventricular arrhythmias, electroanatomic mapping in conjunction with intracardiac echocardiography demonstrated that 1 of the PAPs was involved in the arrhythmia. Magnetic resonance imaging with delayed enhancement (DEMRI) was performed in all patients without contraindications. A consecutive series of 9 patients (age 64 +/- 8 years, ejection fraction 0.32 +/- 0.14) with ventricular arrhythmias that did not originate from the PAP served as a control group and also underwent DEMRI. RESULTS: Heterogeneous uptake of gadolinium during magnetic resonance imaging was observed more frequently in arrhythmogenic PAPs than in PAPs that were not involved in ventricular arrhythmias (p = 0.01). The PAPs in the control patients did not take up contrast or show homogeneous contrast uptake. Radiofrequency ablation eliminated all arrhythmias originating from PAPs. Echocardiography after the ablation showed no new or worsened mitral regurgitation. CONCLUSIONS: Papillary muscles that lie within an infarct zone might give rise to ventricular arrhythmias. Heterogeneous uptake of gadolinium in magnetic resonance images might be predictive of arrhythmogenic PAPs. Radiofrequency catheter ablation of ventricular tachycardia and ventricular ectopy arising in a PAP has a high success rate.
OBJECTIVES: The aim of this study was to define the role of papillary muscles (PAPs) in post-infarction ventricular arrhythmias. BACKGROUND: Papillary muscles have been implicated in arrhythmogenesis; however, their role in post-infarction ventricular arrhythmias has not been well-defined. METHODS: In a series of 9 patients (age 65 +/- 9 years, ejection fraction 0.36 +/- 0.1) with post-infarction ventricular arrhythmias, electroanatomic mapping in conjunction with intracardiac echocardiography demonstrated that 1 of the PAPs was involved in the arrhythmia. Magnetic resonance imaging with delayed enhancement (DEMRI) was performed in all patients without contraindications. A consecutive series of 9 patients (age 64 +/- 8 years, ejection fraction 0.32 +/- 0.14) with ventricular arrhythmias that did not originate from the PAP served as a control group and also underwent DEMRI. RESULTS: Heterogeneous uptake of gadolinium during magnetic resonance imaging was observed more frequently in arrhythmogenic PAPs than in PAPs that were not involved in ventricular arrhythmias (p = 0.01). The PAPs in the control patients did not take up contrast or show homogeneous contrast uptake. Radiofrequency ablation eliminated all arrhythmias originating from PAPs. Echocardiography after the ablation showed no new or worsened mitral regurgitation. CONCLUSIONS: Papillary muscles that lie within an infarct zone might give rise to ventricular arrhythmias. Heterogeneous uptake of gadolinium in magnetic resonance images might be predictive of arrhythmogenic PAPs. Radiofrequency catheter ablation of ventricular tachycardia and ventricular ectopy arising in a PAP has a high success rate.
Authors: Edmond M Cronin; Frank M Bogun; Philippe Maury; Petr Peichl; Minglong Chen; Narayanan Namboodiri; Luis Aguinaga; Luiz Roberto Leite; Sana M Al-Khatib; Elad Anter; Antonio Berruezo; David J Callans; Mina K Chung; Phillip Cuculich; Andre d'Avila; Barbara J Deal; Paolo Della Bella; Thomas Deneke; Timm-Michael Dickfeld; Claudio Hadid; Haris M Haqqani; G Neal Kay; Rakesh Latchamsetty; Francis Marchlinski; John M Miller; Akihiko Nogami; Akash R Patel; Rajeev Kumar Pathak; Luis C Saenz Morales; Pasquale Santangeli; John L Sapp; Andrea Sarkozy; Kyoko Soejima; William G Stevenson; Usha B Tedrow; Wendy S Tzou; Niraj Varma; Katja Zeppenfeld Journal: J Interv Card Electrophysiol Date: 2020-10 Impact factor: 1.900
Authors: Riccardo Proietti; Santiago Rivera; Charles Dussault; Vidal Essebag; Martin L Bernier; Felix Ayala-Paredes; Mariano Badra-Verdu; Jean-François Roux Journal: Europace Date: 2016-08-02 Impact factor: 5.214
Authors: Edmond M Cronin; Frank M Bogun; Philippe Maury; Petr Peichl; Minglong Chen; Narayanan Namboodiri; Luis Aguinaga; Luiz Roberto Leite; Sana M Al-Khatib; Elad Anter; Antonio Berruezo; David J Callans; Mina K Chung; Phillip Cuculich; Andre d'Avila; Barbara J Deal; Paolo Della Bella; Thomas Deneke; Timm-Michael Dickfeld; Claudio Hadid; Haris M Haqqani; G Neal Kay; Rakesh Latchamsetty; Francis Marchlinski; John M Miller; Akihiko Nogami; Akash R Patel; Rajeev Kumar Pathak; Luis C Sáenz Morales; Pasquale Santangeli; John L Sapp; Andrea Sarkozy; Kyoko Soejima; William G Stevenson; Usha B Tedrow; Wendy S Tzou; Niraj Varma; Katja Zeppenfeld Journal: Europace Date: 2019-08-01 Impact factor: 5.214
Authors: Miki Yokokawa; Eric Good; Benoit Desjardins; Thomas Crawford; Krit Jongnarangsin; Aman Chugh; Frank Pelosi; Hakan Oral; Fred Morady; Frank Bogun Journal: Heart Rhythm Date: 2010-07-14 Impact factor: 6.343
Authors: Takumi Yamada; Paul B Tabereaux; Harish Doppalapudi; H Thomas McElderry; G Neal Kay Journal: J Interv Card Electrophysiol Date: 2008-10-31 Impact factor: 1.900