Novel electrophysiological criteria for septal ventricular outflow tract tachycardias requiring a sequential bilateral ablation

Chin Yu Lin, Fa Po Chung, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Jo Nan Liao, Ta Chuan Tuan, Tze Fan Chao, Yao Ting Chang, Yun Yu Chen, Abigail Louise D. Te, Shinya Yamada, Ling Kuo, Jennifer Jeanne B. Vicera, Ting Yung Chang, Hoang Quang Minh, Simon Salim, Ting Chung Huang, Shih Ann Chen

研究成果: Article同行評審

摘要

Background: Septal ventricular outflow tract ventricular arrhythmias (OT-VAs) are defined as septal origin VAs from the right ventricular or left ventricular OT. Patients with septal OT-VAs may require a sequential bilateral OT ablation. This study aimed to evaluate the electrophysiological characteristics and ablation outcome in patients with septal OT-VAs. Methods: We retrospectively analyzed the electrocardiography and electrophysiological parameters in 96 patients (mean age 49 ± 15 years, 49 male) undergoing bilateral activation mapping before catheter ablation of idiopathic septal OT-VAs. The patients were categorized into three groups based on the successful ablation sites, including the right ventricular outflow tract (RVOT), RVOT/left ventricular outflow tract (LVOT), and LVOT. Results: Mapping in the three groups demonstrated a gradually decreasing and increasing trend in the earliest activation time obtained from the RVOT and LVOT, respectively. The absolute earliest activation time discrepancy (AEAD) of ≤18 milliseconds could predict the requirement for a sequential bilateral ablation with a sensitivity and specificity of 100.0% and 93.7%, respectively. The small AEAD (≤21 milliseconds) was associated with a higher recurrence rate in patients receiving a successful unilateral ablation, while patients with a longer distance between the bilateral OT earliest activation sites (DEA > 26 mm) increased future recurrences after an initially successful sequential bilateral ablation. Conclusions: The application of bilateral OT-VA activation mapping and the measurement of the AEAD and DEA provided not only pivotal information for the ablation strategy, but also prognostic implications for recurrences in patients with septal OT-VAs.

原文English
頁(從 - 到)298-307
頁數10
期刊Journal of Cardiovascular Electrophysiology
29
發行號2
DOIs
出版狀態Published - 2018 2月

All Science Journal Classification (ASJC) codes

  • 心臟病學與心血管醫學
  • 生理學(醫學)

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