Yufan Yang1,2, Qiming Liu1,2, Zhenjiang Liu1,2, Shenghua Zhou1,2. 1. Cardiac Catheterization Lab of Second Xiangya Hospital attached to Central South University, Changsha, Hunan, 410011, China. 2. Department of Cardiology of Second Xiangya Hospital attached to Central South University, Changsha, Hunan, 410011, China.
Abstract
BACKGROUND: The origin of pulmonary sinus cusp (PSC)-derived ventricular arrhythmia (VA) is a highly specialized anatomical structure; therefore, insertion of the radiofrequency ablation catheter tip to the target site to ensure safe ablation is a major challenge for clinicians. PURPOSE: To summarize ablation methods, and provide valuable experience for the treatment of PSC-derived VA with ablation. METHODS: A retrospective analysis and summary of the clinical data of 15 patients undergoing catheter ablation for PSC-derived VA in Cardiac Intervention Therapy Center, The Second Xiangya Hospital of Central South University between January 2013 and July 2015 was conducted. RESULTS: For the 15 patients, the PSC-derived VA originated from the lower regions of the pulmonary sinuses, leading from the right, left, and anterior sinuses of the PSC in 4, 6, and 5 patients, respectively. Nine patients with PSC-derived VAs originating from the right and anterior sinuses underwent successful reversed U-curve catheter ablation, while the other six cases with arrhythmias originating from the left sinus underwent successful ablation with the conventional method (nonreversed U-curve catheter ablation). All the patients were followed-up for 6-31 months, and no cases of recurrence or complications occurred. CONCLUSIONS: Reversed U-curve catheter ablation is suitable for VAs originating from the right and anterior PSCs, while conventional ablation can also be used for those originating from the left PSCs.
BACKGROUND: The origin of pulmonary sinus cusp (PSC)-derived ventricular arrhythmia (VA) is a highly specialized anatomical structure; therefore, insertion of the radiofrequency ablation catheter tip to the target site to ensure safe ablation is a major challenge for clinicians. PURPOSE: To summarize ablation methods, and provide valuable experience for the treatment of PSC-derived VA with ablation. METHODS: A retrospective analysis and summary of the clinical data of 15 patients undergoing catheter ablation for PSC-derived VA in Cardiac Intervention Therapy Center, The Second Xiangya Hospital of Central South University between January 2013 and July 2015 was conducted. RESULTS: For the 15 patients, the PSC-derived VA originated from the lower regions of the pulmonary sinuses, leading from the right, left, and anterior sinuses of the PSC in 4, 6, and 5 patients, respectively. Nine patients with PSC-derived VAs originating from the right and anterior sinuses underwent successful reversed U-curve catheter ablation, while the other six cases with arrhythmias originating from the left sinus underwent successful ablation with the conventional method (nonreversed U-curve catheter ablation). All the patients were followed-up for 6-31 months, and no cases of recurrence or complications occurred. CONCLUSIONS: Reversed U-curve catheter ablation is suitable for VAs originating from the right and anterior PSCs, while conventional ablation can also be used for those originating from the left PSCs.