Browse
Submit Data
Databases
API
Help

Dataset Information

29 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Variation of QRS morphology of premature ventricular contractions originate from the left-ventricular outflow tract during ablation.

ABSTRACT: Idiopathic ventricular arrhythmias originating from the aortic sinus of Valsalva often show preferential conduction to the right-ventricular outflow tract, which may render radiofrequency ablation more difficult. We describe a patient with symptomatic premature ventricular contractions of left-ventricular outflow tract origin presenting with a variation of QRS morphology during ablation. The correlation between the characteristics of local voltage potentials and the real origin site of the ventricular arrhythmia is discussed.

SUBMITTER: Qifang L

PROVIDER: S-EPMC6916391 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Similar Datasets

Isolated diastolic potentials as predictors of success in ablation of right ventricular outflow tract idiopathic premature ventricular contractions.

Project description:BACKGROUND AND AIMS:Discrete potentials, low voltage and fragmented electrograms, have been previously reported at ablation site, in patients with premature ventricular contractions (PVCs) originating in the right ventricular outflow tract (RVOT). The aim of this study was to review the electrograms at ablation site and assess the presence of diastolic potentials and their association with success. METHODS:We retrospectively reviewed the electrograms obtained at the radiofrequency (RF) delivery sites of 48 patients subjected to ablation of RVOT frequent PVCs. We assessed the duration and amplitude of local electrogram, local activation time, and presence of diastolic potentials and fragmented electrograms. RESULTS:We reviewed 134 electrograms, median 2 (1-4) per patient. Success was achieved in 40 patients (83%). At successful sites the local activation time was earlier- 54 (-35 to -77) ms vs -26 (-12 to -35) ms, p<0.0001; the local electrogram had lower amplitude 1 (0.45-1.15) vs 1.5 (0.5-2.1) mV, p = 0.006, and longer duration 106 (80-154) vs 74 (60-90) ms, p<0.0001. Diastolic potentials and fragmented electrograms were more frequently present, respectively 76% vs 9%, p <0.0001 and 54% vs 11%, p<0.0001. In univariable analysis these variables were all associated with success. In multivariable analysis only the presence of diastolic potentials [OR 15.5 (95% CI: 3.92-61.2; p<0.0001)], and the value of local activation time [OR 1.11 (95% CI: 1.049-1.172 p<0.0001)], were significantly associated with success. CONCLUSION:In this group of patients the presence of diastolic potentials at the ablation site was associated with success.

| S-EPMC6364967 | biostudies-literature

Bilateral cardiac sympathetic denervation of a recurrent refractory ventricular tachycardia occurring after catheter ablation of atrial fibrillation and outflow tract premature ventricular contractions.

Project description:Recent studies have demonstrated the utility of cardiac sympathetic denervation (CSD) in patients with ventricular tachycardia (VT) refractory to antiarrhythmic drugs and catheter or surgical ablation. We present our experience with bilateral CSD in a patient with a recurrent VT despite attempts at treatment with catheter ablation and antiarrhythmic drugs, and this is the first description of the successful management of an idiopathic refractory VT with a bilateral CSD and concomitant oral amiodarone, occurring after catheter ablation of persistent atrial fibrillation and idiopathic outflow tract premature ventricular contractions.

| S-EPMC6457378 | biostudies-literature

Huge Multilobulated Left Ventricular Outflow Tract Pseudoaneurysm Presenting with Ventricular Tachycardia.

Project description: Not available

| S-EPMC4707317 | biostudies-literature

Transcatheter Closure of Left Ventricular Outflow Tract-to-Left Atrium Fistula.

Project description:Surgical and rarely transcatheter aortic valve replacement can be complicated by intracardiac fistula. Transcatheter closure of those shunts has been previously reported with favorable results. We describe a case of percutaneous closure of left ventricular outflow tract-to-left atrium fistula after surgical aortic valve replacement using an Amplatzer Vascular Plug II. (Level of Difficulty: Advanced.).

| S-EPMC8311196 | biostudies-literature

Innocent left ventricular outflow tract membrane masquerading as vegetation.

Project description:Innocent left ventricular outflow tract (LVOT) membranes are a rare entity and found incidentally on echocardiography. The authors report a case of innocent LVOT membrane in a patient who was admitted with ischaemic stroke. Initial transthoracic echocardiography showed a possible valvular vegetation which was thought to be the cause of embolic stroke. Anticoagulation with coumadin and antibiotics were started. Subsequent Transesophageal echocardiography showed that it was more consistent with innocent LVOT membrane and not vegetation. Anticoagulation and antibiotics were discontinued, and on a follow-up over 5 years later, the membrane was stable in size and location without any complications.

| S-EPMC3863084 | biostudies-other

An unusual cause of left ventricular outflow tract obstruction.

Project description:Left ventricular outflow tract obstruction (LVOTO) has been reported with bio-prosthetic and mechanical mitral valves (MV), though it is more common with the former. The obstruction can be dynamic or fixed. We hereby report a case of fixed LVOTO following bio-prosthetic MV replacement (MVR).

| S-EPMC4561759 | biostudies-literature

Re-entrant ventricular tachycardia as a complication of ablation of idiopathic ventricular premature beats from the right outflow tract: a case report.

Project description:BackgroundWe report an unusual case of non-sustained ventricular tachycardia (NSVT) from the epicardial part of the right ventricular outflow tract (RVOT).Case summaryA 37-year-old woman who underwent in 2006 an ablation for idiopathic ventricular premature beats (VPBs) from the RVOT presented with pre-syncopal NSVT in 2016. A cardiac workup showed no coronary disease, normal biventricular function, and no enhancement on cardiac magnetic resonance imaging. A metabolic positron emission tomography scan excluded inflammation. Biopsies revealed normal desmosomal proteins. An endocardial mapping revealed an area of low voltage potential (<0.5 mV) at the antero-septal aspect of the RVOT corresponding to the initial site of ablation from 2006. Activation mapping revealed poor prematurity and pace-mapping showed unsatisfactory morphologies in the RVOT, the left ventricle outflow tract and the right coronary cusp. An epicardial map revealed a low voltage area at the antero-septal aspect of the RVOT with fragmented potentials opposite to the endocardial scar. Pace-mapping demonstrated perfect match. An NSVT was induced and local electrocardiogram showed mid-diastolic potentials. Ablation was applied epicardially and endocardially without any complication. The patient was arrhythmia free at 4-year follow-up.DiscussionCardiac workup allowed to exclude specific conditions such as arrhythmogenic cardiomyopathy, tetralogy of Fallot, sarcoidosis, or myocarditis as a cause for NSVT from the RVOT. The epi and endocardial map showed residual scar subsequent to the first ablation which served as substrate for the re-entrant NSVT. This is the first case which describes NSVT from the epicardial RVOT as a complication from a previous endocardial ablation for idiopathic VPB.

| S-EPMC7793188 | biostudies-literature

Unstable angina complicated with dynamic left ventricular outflow tract obstruction.

Project description:Left ventricular outflow tract obstruction (LVOTO) complicated with unstable angina (uAP) has not been described widely, but patients with these two conditions have several problems. Differentiation of the two conditions is also often difficult because the chest symptoms are similar. Moreover, nitrates are commonly used for ischemic heart disease, but have the effect of worsening LVOTO. We experienced three cases of dynamic LVOTO with a sigmoid-shaped septum, and without typical hypertrophic obstructive cardiomyopathy, that were complicated with uAP. In all cases, LVOTO was improved after initial percutaneous coronary intervention (PCI) for the left anterior descending artery lesion. Next, a dobutamine stress test was performed and LVOTO was provoked again in two cases, but not in a case with small acute myocardial infarction of the basal septum during PCI. All cases remained asymptomatic with beta-blocker therapy. Therefore, PCI and beta-blocker administration for LVOTO with uAP resulted in favorable clinical courses in all three cases. These outcomes suggest that revascularization including PCI should have priority in the therapeutic strategy for a case of acute coronary syndrome with LVOTO.

| S-EPMC8020068 | biostudies-literature

Noninvasive electrocardiographic mapping to guide ablation of outflow tract ventricular arrhythmias.

Project description:BackgroundLocalizing the origin of outflow tract ventricular tachycardias (OTVT) is hindered by lack of accuracy of electrocardiographic (ECG) algorithms and infrequent spontaneous premature ventricular complexes (PVCs) during electrophysiological studies.ObjectivesTo prospectively assess the performance of noninvasive electrocardiographic mapping (ECM) in the pre-/periprocedural localization of OTVT origin to guide ablation and to compare the accuracy of ECM with that of published ECG algorithms.MethodsPatients with symptomatic OTVT/PVCs undergoing clinically indicated ablation were recruited. The OTVT/PVC origin was mapped preprocedurally by using ECM, and 3 published ECG algorithms were applied to the 12-lead ECG by 3 blinded electrophysiologists. Ablation was guided by using ECM. The OTVT/PVC origin was defined as the site where ablation caused arrhythmia suppression. Acute success was defined as abolition of ectopy after ablation. Medium-term success was defined as the abolition of symptoms and reduction of PVC to less than 1000 per day documented on Holter monitoring within 6 months.ResultsIn 24 patients (mean age 50 ± 18 years) recruited ECM successfully identified OTVT/PVC origin in 23/24 (96%) (right ventricular outflow tract, 18; left ventricular outflow tract, 6), sublocalizing correctly in 100% of this cohort. Acute ablation success was achieved in 100% of the cases with medium-term success in 22 of 24 patients. PVC burden reduced from 21,837 ± 23,241 to 1143 ± 4039 (P < .0001). ECG algorithms identified the correct chamber of origin in 50%-88% of the patients and sublocalized within the right ventricular outflow tract (septum vs free-wall) in 37%-58%.ConclusionsECM can accurately identify OTVT/PVC origin in the left and the right ventricle pre- and periprocedurally to guide catheter ablation with an accuracy superior to that of published ECG algorithms.

| S-EPMC4067940 | biostudies-literature

Symptomatic Premature Ventricular Contractions in Vasovagal Syncope Patients: Autonomic Modulation and Catheter Ablation.

Project description:IntroductionThere has been limited reports about the comorbid premature ventricular contractions (PVCs) and vasovagal syncope (VVS). Deceleration capacity (DC) was demonstrated to be a quantitative evaluation to assess the cardiac vagal activity. This study sought to report the impact of autonomic modulation on symptomatic PVCs in VVS patients.Methods and resultsTwenty-six VVS patients with symptomatic idiopathic PVCs were consecutively enrolled. Identification and catheter ablation of left atrial ganglionated plexi (GP) and PVCs were performed in 26 and 20 patients, respectively. Holter 24 h-electrocardiograms were performed before and after the procedure to evaluate DC and PVCs occurrence. Eighteen patients were subtyped as DC-dependent PVCs (D-PVCs) and eight as DC-independent PVCs groups (I-PVCs). In D-PVCs group, circadian rhythm of hourly PVCs was positively correlated with hourly DC (P < 0.05) while there was no correlation in I-PVCs group (P > 0.05). Fifty-three GPs with positive vagal response were successfully elicited (2.0 ± 0.8 per patient). PVCs failed to occur spontaneously nor to be induced in six patients. In the remaining 20 patients, PVCs foci identified were all located in the ventricular outflow tract region. Post-ablation DC decreased significantly from baseline (P < 0.05). During mean follow-up of 10.64 ± 6.84 months, syncope recurred in one patient and PVCs recurred in another. PVCs burden of the six patients in whom neither catheter ablation nor antiarrhythmic drugs were applied demonstrated a significant decrease during follow-up (P = 0.037).ConclusionAutonomic activities were involved in the occurrence of symptomatic idiopathic PVCs in some VVS patients. D-PVCs might be facilitated by increased vagal activities. Catheter ablation of GP and PVCs foci may be an effective, safe treatment in patients with concomitant VVS and idiopathic PVCs.

| S-EPMC8126685 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data