AIMS: We report the features of focal ventricular arrhythmias (VAs) arising from the left ventricle (LV) adjacent to the membranous septum. METHODS AND RESULTS: We studied eight patients (five men, 65 ± 10 years) with (n = 2) or without structural heart disease (n = 6) who had ventricular tachycardia (n = 4) or premature ventricular contractions (n = 4) originating from the LV septum underneath the aorta. Ventricular arrhythmias exhibited a focal activation pattern, left (n = 4) or right bundle branch block (n = 4), respectively, left superior (n = 4) or inferior axis QRS morphology (n = 4), negative QRS polarity in lead III and early or no precordial transition in all. During all of these VAs, far-field electrograms in the His bundle (HB) region preceded the QRS onset. In all patients, ventricular pre-potentials were recorded during VAs while late potentials were recorded in sinus rhythm at the border of a localized low-voltage area underneath the aorta. Radiofrequency catheter ablation at the presumed sites of origin successfully eliminated VAs in five patients and was abandoned in the remaining three because the HB electrogram was recorded at that site. CONCLUSION: Focal VAs may arise from the LV adjacent to the membranous septum as a part of the LV ostium, and broadens the spectrum of LV ostium VAs.
AIMS: We report the features of focal ventricular arrhythmias (VAs) arising from the left ventricle (LV) adjacent to the membranous septum. METHODS AND RESULTS: We studied eight patients (five men, 65 ± 10 years) with (n = 2) or without structural heart disease (n = 6) who had ventricular tachycardia (n = 4) or premature ventricular contractions (n = 4) originating from the LV septum underneath the aorta. Ventricular arrhythmias exhibited a focal activation pattern, left (n = 4) or right bundle branch block (n = 4), respectively, left superior (n = 4) or inferior axis QRS morphology (n = 4), negative QRS polarity in lead III and early or no precordial transition in all. During all of these VAs, far-field electrograms in the His bundle (HB) region preceded the QRS onset. In all patients, ventricular pre-potentials were recorded during VAs while late potentials were recorded in sinus rhythm at the border of a localized low-voltage area underneath the aorta. Radiofrequency catheter ablation at the presumed sites of origin successfully eliminated VAs in five patients and was abandoned in the remaining three because the HB electrogram was recorded at that site. CONCLUSION: Focal VAs may arise from the LV adjacent to the membranous septum as a part of the LV ostium, and broadens the spectrum of LV ostium VAs.
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: 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