Prolonged Right Ventricular Outflow Tract Endocardial Activation Duration and Presence of Deceleration Zones in Patients With Idiopathic Premature Ventricular Contractions. Association With Low Voltage Areas
Background and AimsThe wavefront propagation velocity in the myocardium with fibrosis is characterized by the presence of deceleration zones and late activated zones, that are absent in the normal myocardium. Our aim was to study the right ventricular outflow tract (RVOT) endocardial activation dura...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2021.699559/full |
| _version_ | 1819242373736038400 |
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| author | Leonor Parreira Leonor Parreira Pedro Carmo Rita Marinheiro Dinis Mesquita José Farinha Ana Esteves Pedro Amador António Ferreira Marta Fonseca Rui Caria Pedro Adragao |
| author_facet | Leonor Parreira Leonor Parreira Pedro Carmo Rita Marinheiro Dinis Mesquita José Farinha Ana Esteves Pedro Amador António Ferreira Marta Fonseca Rui Caria Pedro Adragao |
| author_sort | Leonor Parreira |
| collection | DOAJ |
| description | Background and AimsThe wavefront propagation velocity in the myocardium with fibrosis is characterized by the presence of deceleration zones and late activated zones, that are absent in the normal myocardium. Our aim was to study the right ventricular outflow tract (RVOT) endocardial activation duration in sinus rhythm, and assess the presence of deceleration zones, in patients with premature ventricular contractions (PVCs) and in controls.MethodsWe studied 29 patients with idiopathic PVCs from the outflow tract, subjected to catheter ablation that had an activation and voltage map of the RVOT in sinus rhythm. A control group of 15 patients without PVCs that underwent ablation of supraventricular arrhythmias was also studied. RVOT endocardial activation duration and number of 10 ms isochrones across the RVOT were assessed. Propagation speed was calculated at the zone with the higher number of isochrones per cm radius. Deceleration zones were defined as zones with >3 isochrones within 1 cm radius. Low voltage areas were defined as areas with local electrogram with amplitude <1.5 mV.ResultsThe two groups did not differ in relation to age, gender or number of points in the map. RVOT endocardial activation duration and number of 10 ms isochrones were higher in the PVC group; 56 (41–66) ms vs. 39 (35–41) ms, p = 0.001 and 5 (4–8) vs. 4 (4–5), p = 0.001. Presence of deceleration zones and low voltage areas were more frequent in the PVC group; 20 (69%) vs. 0 (0%), p < 0.0001 and 21 (72%) vs. 0 (0%), p < 0.0001. The wavefront propagation speed was significantly lower in patients with PVCs than in the control group, 0.35 (0.27–0.40) vs. 0.63 (0.56–0.66) m/s, p < 0.0001. Patients with low voltage areas had longer activation duration 60 (52–67) vs. 36 (32–40) ms, p < 0.0001, more deceleration zones, 20 (95%) vs. 0 (0%), p < 0.0001, and lower wavefront propagation speed, 0.30 (0.26–0.36) vs. 0.54 (0.36–0.66) m/s, p = 0.002, than patients without low voltage areas.ConclusionRight ventricular outflow tract endocardial activation duration was longer, propagation speed was lower and deceleration zones were more frequent in patients with PVCs than in controls and were associated with the presence of low voltage areas. |
| first_indexed | 2024-12-23T14:38:47Z |
| format | Article |
| id | doaj.art-ec76c96dbb2e473299ec485fc4ca8104 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-23T14:38:47Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-ec76c96dbb2e473299ec485fc4ca81042022-12-21T17:43:17ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2021-07-011210.3389/fphys.2021.699559699559Prolonged Right Ventricular Outflow Tract Endocardial Activation Duration and Presence of Deceleration Zones in Patients With Idiopathic Premature Ventricular Contractions. Association With Low Voltage AreasLeonor Parreira0Leonor Parreira1Pedro Carmo2Rita Marinheiro3Dinis Mesquita4José Farinha5Ana Esteves6Pedro Amador7António Ferreira8Marta Fonseca9Rui Caria10Pedro Adragao11Department of Cardiology, Hospital Centre of Setubal, Setubal, PortugalDepartment of Cardiology, Luz Hospital Lisboa, Lisbon, PortugalDepartment of Cardiology, Luz Hospital Lisboa, Lisbon, PortugalDepartment of Cardiology, Hospital Centre of Setubal, Setubal, PortugalDepartment of Cardiology, Hospital Centre of Setubal, Setubal, PortugalDepartment of Cardiology, Hospital Centre of Setubal, Setubal, PortugalDepartment of Cardiology, Hospital Centre of Setubal, Setubal, PortugalDepartment of Cardiology, Hospital Centre of Setubal, Setubal, PortugalDepartment of Cardiology, Luz Hospital Lisboa, Lisbon, PortugalDepartment of Cardiology, Hospital Centre of Setubal, Setubal, PortugalDepartment of Cardiology, Hospital Centre of Setubal, Setubal, PortugalDepartment of Cardiology, Luz Hospital Lisboa, Lisbon, PortugalBackground and AimsThe wavefront propagation velocity in the myocardium with fibrosis is characterized by the presence of deceleration zones and late activated zones, that are absent in the normal myocardium. Our aim was to study the right ventricular outflow tract (RVOT) endocardial activation duration in sinus rhythm, and assess the presence of deceleration zones, in patients with premature ventricular contractions (PVCs) and in controls.MethodsWe studied 29 patients with idiopathic PVCs from the outflow tract, subjected to catheter ablation that had an activation and voltage map of the RVOT in sinus rhythm. A control group of 15 patients without PVCs that underwent ablation of supraventricular arrhythmias was also studied. RVOT endocardial activation duration and number of 10 ms isochrones across the RVOT were assessed. Propagation speed was calculated at the zone with the higher number of isochrones per cm radius. Deceleration zones were defined as zones with >3 isochrones within 1 cm radius. Low voltage areas were defined as areas with local electrogram with amplitude <1.5 mV.ResultsThe two groups did not differ in relation to age, gender or number of points in the map. RVOT endocardial activation duration and number of 10 ms isochrones were higher in the PVC group; 56 (41–66) ms vs. 39 (35–41) ms, p = 0.001 and 5 (4–8) vs. 4 (4–5), p = 0.001. Presence of deceleration zones and low voltage areas were more frequent in the PVC group; 20 (69%) vs. 0 (0%), p < 0.0001 and 21 (72%) vs. 0 (0%), p < 0.0001. The wavefront propagation speed was significantly lower in patients with PVCs than in the control group, 0.35 (0.27–0.40) vs. 0.63 (0.56–0.66) m/s, p < 0.0001. Patients with low voltage areas had longer activation duration 60 (52–67) vs. 36 (32–40) ms, p < 0.0001, more deceleration zones, 20 (95%) vs. 0 (0%), p < 0.0001, and lower wavefront propagation speed, 0.30 (0.26–0.36) vs. 0.54 (0.36–0.66) m/s, p = 0.002, than patients without low voltage areas.ConclusionRight ventricular outflow tract endocardial activation duration was longer, propagation speed was lower and deceleration zones were more frequent in patients with PVCs than in controls and were associated with the presence of low voltage areas.https://www.frontiersin.org/articles/10.3389/fphys.2021.699559/fullpremature ventricular beatidiopathicright ventricular outflow tractdeceleration zonelow voltage areas |
| spellingShingle | Leonor Parreira Leonor Parreira Pedro Carmo Rita Marinheiro Dinis Mesquita José Farinha Ana Esteves Pedro Amador António Ferreira Marta Fonseca Rui Caria Pedro Adragao Prolonged Right Ventricular Outflow Tract Endocardial Activation Duration and Presence of Deceleration Zones in Patients With Idiopathic Premature Ventricular Contractions. Association With Low Voltage Areas Frontiers in Physiology premature ventricular beat idiopathic right ventricular outflow tract deceleration zone low voltage areas |
| title | Prolonged Right Ventricular Outflow Tract Endocardial Activation Duration and Presence of Deceleration Zones in Patients With Idiopathic Premature Ventricular Contractions. Association With Low Voltage Areas |
| title_full | Prolonged Right Ventricular Outflow Tract Endocardial Activation Duration and Presence of Deceleration Zones in Patients With Idiopathic Premature Ventricular Contractions. Association With Low Voltage Areas |
| title_fullStr | Prolonged Right Ventricular Outflow Tract Endocardial Activation Duration and Presence of Deceleration Zones in Patients With Idiopathic Premature Ventricular Contractions. Association With Low Voltage Areas |
| title_full_unstemmed | Prolonged Right Ventricular Outflow Tract Endocardial Activation Duration and Presence of Deceleration Zones in Patients With Idiopathic Premature Ventricular Contractions. Association With Low Voltage Areas |
| title_short | Prolonged Right Ventricular Outflow Tract Endocardial Activation Duration and Presence of Deceleration Zones in Patients With Idiopathic Premature Ventricular Contractions. Association With Low Voltage Areas |
| title_sort | prolonged right ventricular outflow tract endocardial activation duration and presence of deceleration zones in patients with idiopathic premature ventricular contractions association with low voltage areas |
| topic | premature ventricular beat idiopathic right ventricular outflow tract deceleration zone low voltage areas |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2021.699559/full |
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