Document Detail

Clinical and electrophysiological difference between idiopathic right ventricular outflow tract arrhythmias and pulmonary artery arrhythmias.
MedLine Citation:
PMID:  19793144     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The precise incidence and characteristics of ventricular arrhythmias originating from the pulmonary artery have not been fully described. The purpose of this prospective study was to clarify these points. METHODS: Thirty-three consecutive patients with an idiopathic left bundle branch block and inferior-axis deviation type ventricular arrhythmia were included. All patients underwent detailed electroanatomical mapping (CARTO, Biosense-Webster, Diamond Bar, CA, USA) during sinus rhythm prior to the catheter ablation. The precise location of the catheter tip at the successful ablation site was confirmed by both electroanatomical mapping and contrast radiography. The clinical and electrophysiological data were compared between the right ventricular outflow tract (RVOT) arrhythmia patients (RVOT group) and PA arrhythmia patients (PA group). RESULTS: Eight patients (8/33 patients: 24.2%) had their ventricular arrhythmias successfully ablated within the PA. The local bipolar electrogram at the successful ablation sites in the PA group exhibited a significantly greater duration (P < 0.05) and lower amplitude (P < 0.05) than did those in the RVOT group (n = 19). In the PA group, all patients exhibited a multicomponent electrograms composed of a spiky potential and a dull potential, which might have consisted of near-field PA activation and a far-field ventricular activation, respectively, at the successful ablation site. Direct ablation to the spiky electrogram was able to eliminate the arrhythmias in all the PA group patients. CONCLUSIONS: PA arrhythmias may be more common than previously recognized. Careful mapping and interpretation of low amplitude and multicomponent electrograms are important for recognizing ventricular arrhythmias originating from the PA.
Yoshihiro Yamashina; Tetsuo Yagi; Akio Namekawa; Akihiko Ishida; Hirokazu Sato; Takashi Nakagawa; Manjirou Sakuramoto; Eiji Sato; Tomoyuki Yambe
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-09-28
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  21     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  163-9     Citation Subset:  IM    
Division of Cardiology, Sendai City Hospital, Sendai, Japan.
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MeSH Terms
Body Surface Potential Mapping / methods*
Bundle-Branch Block / complications,  diagnosis
Middle Aged
Pulmonary Artery*
Reproducibility of Results
Sensitivity and Specificity
Tachycardia, Ventricular / diagnosis*,  etiology*
Ventricular Outflow Obstruction / complications*,  diagnosis*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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