Kazuo Miyazawa1, Marehiko Ueda2, Yusuke Kondo3, Tomohiko Hayashi2, Miyo Nakano2, Masayuki Ishimura2, Masahiro Nakano2, Yoshio Kobayashi2. 1. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. adta4127@chiba-u.jp. 2. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. 3. Department of Advanced Cardiovascular Therapeutics, Chiba University Graduate School of Medicine, Chiba, Japan.
Abstract
PURPOSE: Ventricular outflow tract arrhythmias (VOTAs) can be successfully treated by catheter ablation. However, it is sometimes difficult to differentiate the origin of VOTAs between the right ventricular outflow tract (RVOT) and the other sites, leading to a long fluoroscopy time and unnecessary radiofrequency applications. This study aimed to clarify distinguishable characteristics of the propagation pattern obtained from non-contact mapping (NCM) for VOTA ablation. METHODS: Consecutive 45 patients with VOTAs who underwent catheter ablation using the NCM system were included in this study. We analyzed an isopotential map on three-dimensional geometry of the RVOT obtained from the virtual unipolar electrograms (VUEs) and assessed mapping data of the isopotential area with an initial negative VUE of -1 mV. RESULTS: Successful ablation was achieved from the endocardial RVOT in 34 patients (RVOT group) and the non-RVOT in 11 (non-RVOT group). Major and minor axis diameters of the isopotential area did not significantly differ between the two groups. However, a ratio of major/minor axis diameter was greater in the RVOT group (1.9 ± 0.1 versus 1.3 ± 0.1; P < 0.001). In addition, the propagation velocity defined as an increase of the isopotential area per millisecond was significantly slower in the RVOT group (2.2 ± 0.4 versus 4.2 ± 0.7 mm2/ms; P = 0.02). CONCLUSIONS: The isopotential area of VOTAs originating from the RVOT, as compared to the other sites, spread more elliptically and slowly. The propagation pattern obtained from NCM can provide useful information and efficient strategy for VOTA ablation.
PURPOSE:Ventricular outflow tract arrhythmias (VOTAs) can be successfully treated by catheter ablation. However, it is sometimes difficult to differentiate the origin of VOTAs between the right ventricular outflow tract (RVOT) and the other sites, leading to a long fluoroscopy time and unnecessary radiofrequency applications. This study aimed to clarify distinguishable characteristics of the propagation pattern obtained from non-contact mapping (NCM) for VOTA ablation. METHODS: Consecutive 45 patients with VOTAs who underwent catheter ablation using the NCM system were included in this study. We analyzed an isopotential map on three-dimensional geometry of the RVOT obtained from the virtual unipolar electrograms (VUEs) and assessed mapping data of the isopotential area with an initial negative VUE of -1 mV. RESULTS: Successful ablation was achieved from the endocardial RVOT in 34 patients (RVOT group) and the non-RVOT in 11 (non-RVOT group). Major and minor axis diameters of the isopotential area did not significantly differ between the two groups. However, a ratio of major/minor axis diameter was greater in the RVOT group (1.9 ± 0.1 versus 1.3 ± 0.1; P < 0.001). In addition, the propagation velocity defined as an increase of the isopotential area per millisecond was significantly slower in the RVOT group (2.2 ± 0.4 versus 4.2 ± 0.7 mm2/ms; P = 0.02). CONCLUSIONS: The isopotential area of VOTAs originating from the RVOT, as compared to the other sites, spread more elliptically and slowly. The propagation pattern obtained from NCM can provide useful information and efficient strategy for VOTA ablation.
Authors: F Morady; A H Kadish; L DiCarlo; W H Kou; S Winston; M deBuitlier; H Calkins; S Rosenheck; J Sousa Journal: Circulation Date: 1990-12 Impact factor: 29.690
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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