Idiopathic Epicardial Ventricular Arrhythmias: Diagnosis and Ablation Technique from the Aortic Sinus of Valsalva
Idiopathic outflow tract arrhythmias (ventricular tachycardias or symptomatic premature ventricular contractions; OT-VT/PVCs) can originate from the left ventricular (LV) epicardium (Epi-VT/PVCs), and radiofrequency (RF) energy applications from the aortic sinus of Valsalva can eliminate Epi-VT/PVCs...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2005-04-01
|
| Series: | Indian Pacing and Electrophysiology Journal |
| Subjects: | |
| Online Access: | http://www.ipej.org/0502/tada.htm |
| _version_ | 1819202535740669952 |
|---|---|
| author | Hiroshi Tada |
| author_facet | Hiroshi Tada |
| author_sort | Hiroshi Tada |
| collection | DOAJ |
| description | Idiopathic outflow tract arrhythmias (ventricular tachycardias or symptomatic premature ventricular contractions; OT-VT/PVCs) can originate from the left ventricular (LV) epicardium (Epi-VT/PVCs), and radiofrequency (RF) energy applications from the aortic sinus of Valsalva can eliminate Epi-VT/PVCs in selected patients. Among the various ECG findings, the R-wave duration index and R/S amplitude index in leads V1 or V2 are useful for identifying Epi-VT/PVCs, and the Q-wave ratio of leads aVL to aVR and S-wave amplitude in lead V1 are useful for differentiating between an Epi-VT/PVC originating from the LV epicardium remote from the left sinus of Valsalva (LSV) and that from the LSV. Tissue tracking imaging is a promising modality for identifying the origin of OT-VT/PVCs and for differentiating between an Epi-VT/PVC originating from the LV epicardium remote from the LSV and that from the LSV. If the origin of the Epi-VT/PVC is identified within the LSV, coronary and aortic angiography should be performed to assess the anatomic relationships between the Epi-VT/PVC origin and coronary arteries and aortic valve before the RF energy delivery. To avoid potential complications, RF ablation should be performed at the LSV using a maximum power of 35 watts and maximum temperature of 55°C. Epicardial mapping through the coronary venous system and the presence of potentials recorded from the ablation site within the LSV and their changes before and after the RF energy applications may be useful for diagnosing Epi-VT/PVCs or predicting a successful catheter ablation from the LSV. |
| first_indexed | 2024-12-23T04:05:34Z |
| format | Article |
| id | doaj.art-a8487ad114394a8b83cfc34cd99dc8d9 |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-12-23T04:05:34Z |
| publishDate | 2005-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-a8487ad114394a8b83cfc34cd99dc8d92022-12-21T18:00:38ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922005-04-015296105Idiopathic Epicardial Ventricular Arrhythmias: Diagnosis and Ablation Technique from the Aortic Sinus of ValsalvaHiroshi TadaIdiopathic outflow tract arrhythmias (ventricular tachycardias or symptomatic premature ventricular contractions; OT-VT/PVCs) can originate from the left ventricular (LV) epicardium (Epi-VT/PVCs), and radiofrequency (RF) energy applications from the aortic sinus of Valsalva can eliminate Epi-VT/PVCs in selected patients. Among the various ECG findings, the R-wave duration index and R/S amplitude index in leads V1 or V2 are useful for identifying Epi-VT/PVCs, and the Q-wave ratio of leads aVL to aVR and S-wave amplitude in lead V1 are useful for differentiating between an Epi-VT/PVC originating from the LV epicardium remote from the left sinus of Valsalva (LSV) and that from the LSV. Tissue tracking imaging is a promising modality for identifying the origin of OT-VT/PVCs and for differentiating between an Epi-VT/PVC originating from the LV epicardium remote from the LSV and that from the LSV. If the origin of the Epi-VT/PVC is identified within the LSV, coronary and aortic angiography should be performed to assess the anatomic relationships between the Epi-VT/PVC origin and coronary arteries and aortic valve before the RF energy delivery. To avoid potential complications, RF ablation should be performed at the LSV using a maximum power of 35 watts and maximum temperature of 55°C. Epicardial mapping through the coronary venous system and the presence of potentials recorded from the ablation site within the LSV and their changes before and after the RF energy applications may be useful for diagnosing Epi-VT/PVCs or predicting a successful catheter ablation from the LSV.http://www.ipej.org/0502/tada.htmVentricular tachycardialeft sinus of Valsalvapotentialpremature ventricular contractioncatheter ablationtissue tracking imaging |
| spellingShingle | Hiroshi Tada Idiopathic Epicardial Ventricular Arrhythmias: Diagnosis and Ablation Technique from the Aortic Sinus of Valsalva Indian Pacing and Electrophysiology Journal Ventricular tachycardia left sinus of Valsalva potential premature ventricular contraction catheter ablation tissue tracking imaging |
| title | Idiopathic Epicardial Ventricular Arrhythmias: Diagnosis and Ablation Technique from the Aortic Sinus of Valsalva |
| title_full | Idiopathic Epicardial Ventricular Arrhythmias: Diagnosis and Ablation Technique from the Aortic Sinus of Valsalva |
| title_fullStr | Idiopathic Epicardial Ventricular Arrhythmias: Diagnosis and Ablation Technique from the Aortic Sinus of Valsalva |
| title_full_unstemmed | Idiopathic Epicardial Ventricular Arrhythmias: Diagnosis and Ablation Technique from the Aortic Sinus of Valsalva |
| title_short | Idiopathic Epicardial Ventricular Arrhythmias: Diagnosis and Ablation Technique from the Aortic Sinus of Valsalva |
| title_sort | idiopathic epicardial ventricular arrhythmias diagnosis and ablation technique from the aortic sinus of valsalva |
| topic | Ventricular tachycardia left sinus of Valsalva potential premature ventricular contraction catheter ablation tissue tracking imaging |
| url | http://www.ipej.org/0502/tada.htm |
| work_keys_str_mv | AT hiroshitada idiopathicepicardialventriculararrhythmiasdiagnosisandablationtechniquefromtheaorticsinusofvalsalva |