Authors: Hisashi Yokoshiki Kazuya Mizukami Hirofumi Mitsuyama Masaya Watanabe Taro Tenma Hiroyuki Tsutsui
Publish Date: 2015/03/03
Volume: 31, Issue: 4, Pages: 599-607
Abstract
Panoptic studies of ventricular tachycardia VT originating above the pulmonary valve are scarce The purpose of this study is to clarify the characteristic of idiopathic VT arising above pulmonary valve We analyzed 15 consecutive patients with idiopathic VT that was successfully abolished by catheter ablation at the right ventricular outflow tract RVOTVT n = 11 and above the pulmonary valve PAVT n = 4 Incidence of syncope was higher in PAVT than RVOTVT 100 vs 27 P 005 and polymorphic VT was also more prevalent in PAVT 75 vs 0 P 005 The coupling interval 315 ± 29 vs 449 ± 32 ms mean ± SE at the onset of VT and minimum cycle length CL 192 ± 13 vs 344 ± 37 ms during VT were shorter in PAVT both P 005 Among 12lead ECG parameters only Rwave amplitude in lead II was different between groups 205 ± 017 mV in PAVT vs 144 ± 005 mV in RVOTVT P 0005 At the successful ablation site the activation time from the onset of QRS complex did not differ between groups −37 ± 3 vs −31 ± 4 P = 0405 whereas the amplitude of intracardiac electrograms was significantly lower in PAVT 083 ± 038 mV vs 239 ± 036 mV P 005 Although the number of patients in this study is limited VT originating above the pulmonary valve demonstrated rapid excitation and often degenerated into polymorphic VT suggesting its malignant electrophysiological characteristics
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