BACKGROUND: Most right ventricular arrhythmias (VA) originate from the outflow tract. Experiences of VA arising from the basal septum of the right ventricle (RV) are limited. We aimed to describe the ablation procedure and results, focusing on the characteristics and clinical significance of junctional rhythm (JR) appearing during radiofrequency application. METHODS AND RESULTS: Among 86 consecutive patients undergoing radiofrequency ablation for VA from the RV, 12 (14%) (mean age, 71 ± 7 years) had their origin in the basal septum of the RV defined as the region from 1 to 5 o'clock of the tricuspid annulus (TA) in the left anterior oblique view and extending anteriorly from the TA to 2 cm. A mean QRS duration of VA was 137 ± 8 msec with normal (10/12, 83%) or left-deviated axis (2/12, 17%). Five patients (41%) had structural heart diseases including three dilated cardiomyopathies. Radiofrequency energy was applied to the sites showing the earliest activation during VA and/or best pacemap. Complete elimination of VA was achieved in 11 (92%) patients. The successful ablation site was 12 ± 4 mm away from the His-bundle electrogram recording site. Among 11 patients with successful ablation, 10 (91 %) exhibited JR (mean cycle length, 638 ± 172 ms) during ablation without subsequent atrioventricular conduction disturbance (AVCD) except for one showing high-rate JR (181 beats/min) and transient AVCD. All these patients were free from VA during 32 ± 21 months. CONCLUSIONS: VA originating from the basal septum of the RV can be ablated effectively. JR appears in most cases without causing AVCD, unless the rate is high.
BACKGROUND: Most right ventricular arrhythmias (VA) originate from the outflow tract. Experiences of VA arising from the basal septum of the right ventricle (RV) are limited. We aimed to describe the ablation procedure and results, focusing on the characteristics and clinical significance of junctional rhythm (JR) appearing during radiofrequency application. METHODS AND RESULTS: Among 86 consecutive patients undergoing radiofrequency ablation for VA from the RV, 12 (14%) (mean age, 71 ± 7 years) had their origin in the basal septum of the RV defined as the region from 1 to 5 o'clock of the tricuspid annulus (TA) in the left anterior oblique view and extending anteriorly from the TA to 2 cm. A mean QRS duration of VA was 137 ± 8 msec with normal (10/12, 83%) or left-deviated axis (2/12, 17%). Five patients (41%) had structural heart diseases including three dilated cardiomyopathies. Radiofrequency energy was applied to the sites showing the earliest activation during VA and/or best pacemap. Complete elimination of VA was achieved in 11 (92%) patients. The successful ablation site was 12 ± 4 mm away from the His-bundle electrogram recording site. Among 11 patients with successful ablation, 10 (91 %) exhibited JR (mean cycle length, 638 ± 172 ms) during ablation without subsequent atrioventricular conduction disturbance (AVCD) except for one showing high-rate JR (181 beats/min) and transient AVCD. All these patients were free from VA during 32 ± 21 months. CONCLUSIONS: VA originating from the basal septum of the RV can be ablated effectively. JR appears in most cases without causing AVCD, unless the rate is high.
Authors: C F Tsai; S A Chen; C T Tai; C E Chiang; S H Lee; Z C Wen; J L Huang; Y A Ding; M S Chang Journal: Int J Cardiol Date: 1997-11-20 Impact factor: 4.164
Authors: J H Jentzer; R Goyal; B D Williamson; K C Man; M Niebauer; E Daoud; S A Strickberger; J D Hummel; F Morady Journal: Circulation Date: 1994-12 Impact factor: 29.690
Authors: C Movsowitz; D Schwartzman; D J Callans; M Preminger; E Zado; C D Gottlieb; F E Marchlinski Journal: Am Heart J Date: 1996-05 Impact factor: 4.749
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