BACKGROUND: Idiopathic ventricular arrhythmias (VAs) rarely arise from the epicardium at the crux of the heart. However, the electrophysiological characteristics of VAs successfully ablated from the ostium of the coronary sinus (CSO) have not yet been documented.Methods and Results: Electrocardiographic and electrophysiological data were analyzed in patients with idiopathic VAs successfully ablated from the CSO.Among 309 patients with idiopathic VAs treated with radiofrequency catheter ablation (RFCA), 6 (1.94%; 3 men; age: 66.3±9.7 years) had VAs successfully ablated from the CSO. Only 1 patient had sustained ventricular tachycardia. The morphology of the QRS showed a left superior axis and QS pattern in leads III and aVF. Furthermore, the precordial maximum deflection index was >0.55 in all patients and a right bundle branch block pattern was recorded in 5 of 6 patients. All VAs were successfully eliminated by RFCA within the CSO. Intracardiac ECGs at sites where VAs were eliminated by RFCA showed clear atrial and ventricular potentials (atrial amplitude: 0.21±0.11 mV; ventricular amplitude: 0.43±0.24 mV), except in 1 case of atrial fibrillation. No patients had recurrence during the 3.4±1.8-year follow-up period. CONCLUSIONS: The idiopathic VAs in our study were eliminated by RFCA within the CS, where a clear atrial amplitude was recorded.
BACKGROUND:Idiopathic ventricular arrhythmias (VAs) rarely arise from the epicardium at the crux of the heart. However, the electrophysiological characteristics of VAs successfully ablated from the ostium of the coronary sinus (CSO) have not yet been documented.Methods and Results: Electrocardiographic and electrophysiological data were analyzed in patients with idiopathic VAs successfully ablated from the CSO.Among 309 patients with idiopathic VAs treated with radiofrequency catheter ablation (RFCA), 6 (1.94%; 3 men; age: 66.3±9.7 years) had VAs successfully ablated from the CSO. Only 1 patient had sustained ventricular tachycardia. The morphology of the QRS showed a left superior axis and QS pattern in leads III and aVF. Furthermore, the precordial maximum deflection index was >0.55 in all patients and a right bundle branch block pattern was recorded in 5 of 6 patients. All VAs were successfully eliminated by RFCA within the CSO. Intracardiac ECGs at sites where VAs were eliminated by RFCA showed clear atrial and ventricular potentials (atrial amplitude: 0.21±0.11 mV; ventricular amplitude: 0.43±0.24 mV), except in 1 case of atrial fibrillation. No patients had recurrence during the 3.4±1.8-year follow-up period. CONCLUSIONS: The idiopathic VAs in our study were eliminated by RFCA within the CS, where a clear atrial amplitude was recorded.
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
Authors: Philip L Mar; Mamta Barmeda; Marcelle A Stucky; Subodh R Devabahktuni; Jason Garlie; John M Miller; Rahul Jain Journal: Indian Pacing Electrophysiol J Date: 2020-02-18