Experimental Findings and Clinical-Pathologic Correlation of Radiofrequency Catheter Ablation at the Left Ventricle Para-Hisian Region
BackgroundCatheter ablation target at the site with large His activation in the left ventricle poses a high risk of atrioventricular (AV) block. We aimed to identify far-field (FF) and near-field (NF) His activation at left upper septum (LUS).MethodsThree-D mapping of the aortic root and left ventri...
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.793903/full |
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| author | Zuyi Fu Zili Liao Jinlin Zhang Xianzhang Zhan Weidong Lin Fang Zhou Liu Xi Su Hai Deng Xianhong Fang Hongtao Liao Hongyue Wang Shulin Wu Yumei Xue Yumei Xue Feifan Ouyang Feifan Ouyang Feifan Ouyang |
| author_facet | Zuyi Fu Zili Liao Jinlin Zhang Xianzhang Zhan Weidong Lin Fang Zhou Liu Xi Su Hai Deng Xianhong Fang Hongtao Liao Hongyue Wang Shulin Wu Yumei Xue Yumei Xue Feifan Ouyang Feifan Ouyang Feifan Ouyang |
| author_sort | Zuyi Fu |
| collection | DOAJ |
| description | BackgroundCatheter ablation target at the site with large His activation in the left ventricle poses a high risk of atrioventricular (AV) block. We aimed to identify far-field (FF) and near-field (NF) His activation at left upper septum (LUS).MethodsThree-D mapping of the aortic root and left ventricle was performed in 12 dogs. Two sites located at either the base or apex of the triangle interposed between the hinges of the the noncornary coronary cusp (NCC) - right coronary cusp (RCC) were chosen for a single radiofrequency (RF) application. Bipolar and unipolar pacing with different outputs at both sites was attempted to discern NF and FF His activation.ResultsThe sites chosen for NF and FF ablation were located at the base and apex of the triangle, which were 8.03 ± 1.18 mm (group 1) and 3.42 ± 0.61 mm (group 2) away from the RCC-NCC junction. Lower A/V ratios were found in group 1. Pacing could not differentiate NF from FF His activation. In group 1, ablation resulted in III degree AV block in all 6 dogs, whereas neither PR prolongation nor AV block occurred in group 2. Pathologic examination of group 1 showed complete/partial necrosis of the His bundle (HB) and left bundle branch in all 6 dogs. In group 2, no necrosis of the HB was seen in the 6/6 dogs.ConclusionAnatomical localization in the triangle of RCC-NCC junction can help differentiate NF from FF His activation. |
| first_indexed | 2024-04-11T18:07:24Z |
| format | Article |
| id | doaj.art-392a305849434289a6abb4b60897b243 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-11T18:07:24Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-392a305849434289a6abb4b60897b2432022-12-22T04:10:16ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-01-01810.3389/fcvm.2021.793903793903Experimental Findings and Clinical-Pathologic Correlation of Radiofrequency Catheter Ablation at the Left Ventricle Para-Hisian RegionZuyi Fu0Zili Liao1Jinlin Zhang2Xianzhang Zhan3Weidong Lin4Fang Zhou Liu5Xi Su6Hai Deng7Xianhong Fang8Hongtao Liao9Hongyue Wang10Shulin Wu11Yumei Xue12Yumei Xue13Feifan Ouyang14Feifan Ouyang15Feifan Ouyang16Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Wuhan Asian Heart Hospital, Wuhan, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Wuhan Asian Heart Hospital, Wuhan, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Pathology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaSouthern Medical University, Guangzhou, ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Wuhan Asian Heart Hospital, Wuhan, ChinaUniversitäres Herz- und Gefäßzentrum, University Hospital Eppendorf, Hamburg, GermanyBackgroundCatheter ablation target at the site with large His activation in the left ventricle poses a high risk of atrioventricular (AV) block. We aimed to identify far-field (FF) and near-field (NF) His activation at left upper septum (LUS).MethodsThree-D mapping of the aortic root and left ventricle was performed in 12 dogs. Two sites located at either the base or apex of the triangle interposed between the hinges of the the noncornary coronary cusp (NCC) - right coronary cusp (RCC) were chosen for a single radiofrequency (RF) application. Bipolar and unipolar pacing with different outputs at both sites was attempted to discern NF and FF His activation.ResultsThe sites chosen for NF and FF ablation were located at the base and apex of the triangle, which were 8.03 ± 1.18 mm (group 1) and 3.42 ± 0.61 mm (group 2) away from the RCC-NCC junction. Lower A/V ratios were found in group 1. Pacing could not differentiate NF from FF His activation. In group 1, ablation resulted in III degree AV block in all 6 dogs, whereas neither PR prolongation nor AV block occurred in group 2. Pathologic examination of group 1 showed complete/partial necrosis of the His bundle (HB) and left bundle branch in all 6 dogs. In group 2, no necrosis of the HB was seen in the 6/6 dogs.ConclusionAnatomical localization in the triangle of RCC-NCC junction can help differentiate NF from FF His activation.https://www.frontiersin.org/articles/10.3389/fcvm.2021.793903/fullhis bundle3-D anatomicalcatheter ablationpathologypacing |
| spellingShingle | Zuyi Fu Zili Liao Jinlin Zhang Xianzhang Zhan Weidong Lin Fang Zhou Liu Xi Su Hai Deng Xianhong Fang Hongtao Liao Hongyue Wang Shulin Wu Yumei Xue Yumei Xue Feifan Ouyang Feifan Ouyang Feifan Ouyang Experimental Findings and Clinical-Pathologic Correlation of Radiofrequency Catheter Ablation at the Left Ventricle Para-Hisian Region Frontiers in Cardiovascular Medicine his bundle 3-D anatomical catheter ablation pathology pacing |
| title | Experimental Findings and Clinical-Pathologic Correlation of Radiofrequency Catheter Ablation at the Left Ventricle Para-Hisian Region |
| title_full | Experimental Findings and Clinical-Pathologic Correlation of Radiofrequency Catheter Ablation at the Left Ventricle Para-Hisian Region |
| title_fullStr | Experimental Findings and Clinical-Pathologic Correlation of Radiofrequency Catheter Ablation at the Left Ventricle Para-Hisian Region |
| title_full_unstemmed | Experimental Findings and Clinical-Pathologic Correlation of Radiofrequency Catheter Ablation at the Left Ventricle Para-Hisian Region |
| title_short | Experimental Findings and Clinical-Pathologic Correlation of Radiofrequency Catheter Ablation at the Left Ventricle Para-Hisian Region |
| title_sort | experimental findings and clinical pathologic correlation of radiofrequency catheter ablation at the left ventricle para hisian region |
| topic | his bundle 3-D anatomical catheter ablation pathology pacing |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.793903/full |
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