Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal great cardiac vein
Abstract Background The ECG characteristics of the distal coronary venous system ventricular arrhythmias (VAs) share common features with VAs arising from the aortic cusps or the endocardial left ventricular outflow tract (LVOT) beneath the cusps. The purpose of this study was to identify specific e...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12872-019-1064-9 |
| _version_ | 1828896811978326016 |
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| author | Teng Li Qiong Xu Xian-zhang Zhan Yu-mei Xue Hong-tao Liao Yi-fu Li Konstantinos P. Letsas Shu-lin Wu |
| author_facet | Teng Li Qiong Xu Xian-zhang Zhan Yu-mei Xue Hong-tao Liao Yi-fu Li Konstantinos P. Letsas Shu-lin Wu |
| author_sort | Teng Li |
| collection | DOAJ |
| description | Abstract Background The ECG characteristics of the distal coronary venous system ventricular arrhythmias (VAs) share common features with VAs arising from the aortic cusps or the endocardial left ventricular outflow tract (LVOT) beneath the cusps. The purpose of this study was to identify specific electrocardiographic and electrophysiological characteristics of VAs originating from the distal great cardiac vein (GCV). Methods Based on the successful ablation site, patients with idiopathic VAs from the distal GCV, left coronary cusp (LCC) or the subvalvular left ventricular outflow tract (LVOT) area were included in the present study. Results The final population consisted of 39 patients (35 males, mean age 51 ± 23 years). All VAs displayed a right bundle branch block (RBBB) morphology with inferior axis. Among these patients, 15 were successfully ablated at the GCV, 15 at the LCC and 9 at the subvalvular region. A “w” pattern in lead I was present in 12 out of 15 (80%) VAs originating from the distal GCV compared to none of VAs arising from the other two sites (p < 0.01). VAs with a GCV origin exhibited more commonly increased intrinsicoid deflection time, higher maximum deflection index and wider QRS duration compared to LCC and subvalvular sites (p < 0.05). Acceptable pace mapping at the successful ablation site was achieved in 10 patients. After an average of 36 ± 24 months follow up, 14 (93.3%) patients were free from VAs recurrence. Conclusion A “w” pattern in lead I may distinguish distal GCV VAs from VAs arising from the LCC or the subvalvular region. |
| first_indexed | 2024-12-13T14:48:30Z |
| format | Article |
| id | doaj.art-d7ca9fa035894f24a0fd63ee5e698a5f |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-13T14:48:30Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-d7ca9fa035894f24a0fd63ee5e698a5f2022-12-21T23:41:25ZengBMCBMC Cardiovascular Disorders1471-22612019-04-011911810.1186/s12872-019-1064-9Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal great cardiac veinTeng Li0Qiong Xu1Xian-zhang Zhan2Yu-mei Xue3Hong-tao Liao4Yi-fu Li5Konstantinos P. Letsas6Shu-lin Wu7Arrhythmia Department, Fuwai Hospital Chinese Academy of Medical SciencesArrhythmia Department, Fuwai Hospital Chinese Academy of Medical SciencesCardiovascular Department, Guangdong Cardiovascular Institute, Guangdong General Hospital & Guangdong Academy of Medical SciencesCardiovascular Department, Guangdong Cardiovascular Institute, Guangdong General Hospital & Guangdong Academy of Medical SciencesCardiovascular Department, Guangdong Cardiovascular Institute, Guangdong General Hospital & Guangdong Academy of Medical SciencesArrhythmia Department, Fuwai Hospital Chinese Academy of Medical SciencesSecond Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of AthensCardiovascular Department, Guangdong Cardiovascular Institute, Guangdong General Hospital & Guangdong Academy of Medical SciencesAbstract Background The ECG characteristics of the distal coronary venous system ventricular arrhythmias (VAs) share common features with VAs arising from the aortic cusps or the endocardial left ventricular outflow tract (LVOT) beneath the cusps. The purpose of this study was to identify specific electrocardiographic and electrophysiological characteristics of VAs originating from the distal great cardiac vein (GCV). Methods Based on the successful ablation site, patients with idiopathic VAs from the distal GCV, left coronary cusp (LCC) or the subvalvular left ventricular outflow tract (LVOT) area were included in the present study. Results The final population consisted of 39 patients (35 males, mean age 51 ± 23 years). All VAs displayed a right bundle branch block (RBBB) morphology with inferior axis. Among these patients, 15 were successfully ablated at the GCV, 15 at the LCC and 9 at the subvalvular region. A “w” pattern in lead I was present in 12 out of 15 (80%) VAs originating from the distal GCV compared to none of VAs arising from the other two sites (p < 0.01). VAs with a GCV origin exhibited more commonly increased intrinsicoid deflection time, higher maximum deflection index and wider QRS duration compared to LCC and subvalvular sites (p < 0.05). Acceptable pace mapping at the successful ablation site was achieved in 10 patients. After an average of 36 ± 24 months follow up, 14 (93.3%) patients were free from VAs recurrence. Conclusion A “w” pattern in lead I may distinguish distal GCV VAs from VAs arising from the LCC or the subvalvular region.http://link.springer.com/article/10.1186/s12872-019-1064-9IdiopathicVentricular arrhythmiasGreat cardiac veinCatheter ablation |
| spellingShingle | Teng Li Qiong Xu Xian-zhang Zhan Yu-mei Xue Hong-tao Liao Yi-fu Li Konstantinos P. Letsas Shu-lin Wu Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal great cardiac vein BMC Cardiovascular Disorders Idiopathic Ventricular arrhythmias Great cardiac vein Catheter ablation |
| title | Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal great cardiac vein |
| title_full | Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal great cardiac vein |
| title_fullStr | Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal great cardiac vein |
| title_full_unstemmed | Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal great cardiac vein |
| title_short | Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal great cardiac vein |
| title_sort | unique electrocardiographic pattern w wave in lead i of idiopathic ventricular arrhythmias arising from the distal great cardiac vein |
| topic | Idiopathic Ventricular arrhythmias Great cardiac vein Catheter ablation |
| url | http://link.springer.com/article/10.1186/s12872-019-1064-9 |
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