Premature ventricular contractions originating from the left ventricular septum: Results of Radiofrequency Catheter Ablation in twenty patients

BMC Cardiovascular Disorders

Research Article

Ji Kang-Ting¹  Tang Ji-Fei¹  Yang Peng-Lin¹  Zhang Wen-Wu¹  Li Jia¹  Lin Jia-Xuan¹  Zhou Na-Dan¹  Li Yue-Chun¹  Lin Jia-Feng¹ 

[1] Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, 325000, Wenzhou, China;

关键词: Catheter Ablation;    Structural Heart Disease;    Premature Ventricular Contraction;    Sustained Ventricular Tachycardia;    Radiofrequency Catheter Ablation;   

DOI  :  10.1186/1471-2261-11-27

 received in 2011-01-25, accepted in 2011-06-02,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundRFCA has been established as an effective and curative therapy for severely symptomatic PVC from the outflow tract in structurally normal hearts. However, it is unknown whether PVCs originating from the left ventricular septum, are effectively eliminated by RFCA. This study aimed to investigate electrophysiologic characteristics and effects of Radiofrequency catheter ablation (RFCA) for patients with symptomatic premature ventricular contraction (PVC) originating from the left ventricular septum without including fascicular PVCs.MethodsCharacteristics of body surface electrocardiogram (ECG) and electrophysiologic recordings endocardiogram in a successful RFCA target were analyzed in 20 patients with symptomatic PVCs originating from the left ventricular septum. RFCA was performed using pace mapping and activation mapping.ResultsThe QRS morphology of PVCs originating from the left ventricular septum is similar to that seen in fascicular tachycardia. Most of the PVCs originated from the left septum appears in the form of ventricular parasystole. The incidence of ventricular parasystole was 70%. Sustained ventricular tachycardia was not inducible by electrical stimulation and isoproterenol infusion in all 20 patients, ablation at the site recording the earliest Purkinje potential was not effective in all 20 patients, and Purkinje potentials were not identified at successful sites during point mapping. Sixteen patients were successful with RFCA using pace mapping and activation mapping, 3 failed, and 1 recurrent.ConclusionAlthough the ECG characteristics of the PVCs arising from the left ventricular septum are similar to that seen in fascicular tachycardia, the electrophysiologic characteristics are different between the two types of PVCs. The distinguishing characteristic of the PVCs is that Purkinje potentials were not present at the site of successful ablation, suggesting a myocardial as opposed to fascicular substrate. RFCA is an effective curative therapy for symptomatic PVCs originating from the left ventricular septum (not from the left anterior and posterior fascicle).

【 授权许可】

Unknown   
© Jia et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.