Document Detail

Reversed polarity of bipolar electrograms to predict a successful ablation site in focal idiopathic right ventricular outflow tract arrhythmias.
MedLine Citation:
PMID:  21215326     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Radiofrequency catheter ablation (RFCA) for idiopathic right ventricular outflow tract (RVOT) arrhythmias is typically guided by local activation time (LAT) mapping and unipolar electrogram morphology (QS-configuration). However, LAT mapping is limited by the large variation among patients and the area demonstrating a QS-configuration of the unipolar electrogram may be larger than the focal source. Reversed polarity has been proposed as criterion to guide RFCA. OBJECTIVE:: The aim of this study was to investigate the value of reversed polarity of adjacent bipolar electrograms to predict a successful ablation site in idiopathic RVOT arrhythmias. METHODS:: Twenty-five consecutive patients (12 male [48%], 43±15 years) undergoing RFCA for RVOT arrhythmia were studied. Electrograms of ablation sites and of points within a 15mm radius to the successful site were evaluated for LAT, unipolar electrogram morphology and the presence of reversed polarity of adjacent bipolar electrograms. Electrogram characteristics of successful ablation sites were compared to non-successful ablation sites. The spatial distribution of each electrogram characteristic was studied. RESULTS:: Successful ablation sites more often demonstrated reversed polarity and had an earlier LAT than non-successful sites. A wide spatial distribution was observed for unipolar electrograms with a QS-configuration around the successful ablation site. Mapping based on LAT and reversed polarity had a higher predictive value for a successful ablation site than mapping based on LAT and QS-configuration. CONCLUSION:: The presence of reversed polarity has a high predictive value for successful ablation sites in focal idiopathic RVOT arrhythmias and is likely to reduce the number of RFCA applications.
Carine F B van Huls van Taxis; Adrianus P Wijnmaalen; Dennis W den Uijl; Marcin Gawrysiak; Hein Putter; Martin J Schalij; K Zeppenfeld
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-4
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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