Hui-Qiang Wei1, Xiao-Gang Guo1, Xu Liu2, Gong-Bu Zhou3, Qi Sun1, Jian-Du Yang1, Bin Luo1, Shu Zhang1, Jian Ma4. 1. State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. 2. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 3. Department of Cardiology, Peking University Third Hospital, Beijing, China. 4. State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. Electronic address: majian_fuwai@126.com.
Abstract
BACKGROUND: Catheter ablation of ventricular arrhythmias (VAs) originating from the para-Hisian region could be challenging because of a potential damage to atrioventricular conduction system. OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of catheter ablation of VAs originating from the para-Hisian region via a systematic direct approach from aortic sinus cusps (ASCs). METHODS: Twenty-one consecutive patients with VAs with para-Hisian origin were included. Electrophysiological mapping of the entire right ventricle was initially performed, and then retrograde ASC mapping was performed when the earliest ventricular activation was recorded in the His bundle region. Ablation was preferentially performed within ASCs in all patients. RESULTS: Radiofrequency energy delivery resulted in the elimination of VAs in 17 of 21 patients (81%). In the remaining 4 patients, radiofrequency application was initiated at the target site of the right ventricular septum around the His bundle region and clinical VAs were finally successfully eliminated without junctional rhythm in 2 of 4 patients. During a mean follow-up of 34.8 ± 11.3 months, 1 of the 19 acute successful patients had VA recurrence. No procedure-related complications occurred during ablation or follow-up. CONCLUSION: Catheter ablation of VAs originating from the para-Hisian region via a direct approach from ASCs may be safe and effective in most unselected patients.
BACKGROUND: Catheter ablation of ventricular arrhythmias (VAs) originating from the para-Hisian region could be challenging because of a potential damage to atrioventricular conduction system. OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of catheter ablation of VAs originating from the para-Hisian region via a systematic direct approach from aortic sinus cusps (ASCs). METHODS: Twenty-one consecutive patients with VAs with para-Hisian origin were included. Electrophysiological mapping of the entire right ventricle was initially performed, and then retrograde ASC mapping was performed when the earliest ventricular activation was recorded in the His bundle region. Ablation was preferentially performed within ASCs in all patients. RESULTS: Radiofrequency energy delivery resulted in the elimination of VAs in 17 of 21 patients (81%). In the remaining 4 patients, radiofrequency application was initiated at the target site of the right ventricular septum around the His bundle region and clinical VAs were finally successfully eliminated without junctional rhythm in 2 of 4 patients. During a mean follow-up of 34.8 ± 11.3 months, 1 of the 19 acute successful patients had VA recurrence. No procedure-related complications occurred during ablation or follow-up. CONCLUSION: Catheter ablation of VAs originating from the para-Hisian region via a direct approach from ASCs may be safe and effective in most unselected patients.
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