Document Detail


Idiopathic ventricular arrhythmia arising from the mitral annulus: a distinct subgroup of idiopathic ventricular arrhythmias.
MedLine Citation:
PMID:  15766824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to clarify the prevalence and characteristics of idiopathic ventricular tachycardia or premature ventricular contraction originating from the mitral annulus (MAVT/PVC). BACKGROUND: Recent case reports have presented patients with MAVT/PVC. METHODS: Electrocardiographic (ECG) characteristics and the results of electrophysiologic investigation and radiofrequency catheter ablation (RFCA) were analyzed in 352 patients with symptomatic idiopathic ventricular tachycardia (IVT)/premature ventricular contraction (PVC). RESULTS: Nineteen cases of IVT/PVC (5%) represented MAVT/PVC. Of these, 11 (58%) originated from the anterolateral portion of the mitral annulus (AL-MAVT/PVC), and 2 (11%) arose from the posterior portion (Pos-MAVT/PVC). The remaining six cases of MAVT/PVC (31%) had posteroseptal origin (PS-MAVT/PVC). In all patients, an S-wave was present in lead V(6). The QRS polarity in inferior leads and leads I and aVL was useful for differentiating AL-MAVT/PVC from Pos-MAVT/PVC or PS-MAVT/PVC. The Pos-MAVT/PVC had an Rs pattern in lead I and an R pattern in lead V(1), whereas PS-MAVT/PVC invariably had an R pattern in lead I and a negative QRS component in lead V(1). The AL-MAVT/PVC and Pos-MAVT/PVC showed a longer QRS duration than the PS-MAVT/PVC (p < 0.001), and all had late-phase "notching" of the QRS complex in inferior leads. In all patients, RFCA eliminated MAVT/PVC, with no recurrences during follow-up for 21 +/- 15 months. CONCLUSIONS: Mitral annular VT/PVC is a rare but distinct subgroup of IVT/PVC. MAVT/PVC origin could be determined by ECG analysis. The AL and PS sites of the MA were preferential.
Authors:
Hiroshi Tada; Sachiko Ito; Shigeto Naito; Kenji Kurosaki; Shoichi Kubota; Aiko Sugiyasu; Taketsugu Tsuchiya; Kohei Miyaji; Minoru Yamada; Yasunori Kutsumi; Shigeru Oshima; Akihiko Nogami; Koichi Taniguchi
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  45     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-15     Completed Date:  2005-06-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  877-86     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan. tada.h@cvc.pref.gunma.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiac Pacing, Artificial
Catheter Ablation
Electrocardiography, Ambulatory
Electrophysiologic Techniques, Cardiac
Female
Follow-Up Studies
Heart Conduction System / pathology,  surgery
Heart Valve Diseases / epidemiology,  etiology*,  surgery
Heart Ventricles / pathology,  surgery
Humans
Male
Middle Aged
Mitral Valve / pathology*,  surgery
Prevalence
Tachycardia, Ventricular / epidemiology,  etiology*,  surgery
Treatment Outcome
Ventricular Premature Complexes / epidemiology,  etiology*,  surgery

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


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