Discrete potentials guided ablation for idiopathic outflow tract ventricular arrhythmias
10.3760/cma.j.issn.0253-3758.2015.08.011
- VernacularTitle:碎裂电位指导下特发性流出道室性心律失常消融
- Author:
Enzhao LIU
1
;
Qitong ZHANG
;
Gang XU
;
Tong LIU
;
Lan YE
;
Yanshu ZHAO
;
Guangping LI
Author Information
1. 300211,天津市心血管病离子与分子机能重点实验室天津医科大学第二医院心脏科天津心脏病学研究所
- Keywords:
Ventricular premature complexes;
Catheter ablation;
Discrete potentials
- From:
Chinese Journal of Cardiology
2015;43(8):700-704
- CountryChina
- Language:Chinese
-
Abstract:
Objective Discrete potentials (DPs) have been recorded and targeted as the site of ablation of the outflow tract arrhythmias.The aim of the present study was to investigate the significance of DPs with respect to mapping and ablation for idiopathic outflow tract premature ventricular contractions (PVCs) or ventricular tachycardias (VTs).Methods Seventeen out of 24 consecutive patients with idiopathic right or left ventricular outflow tract PVCs/VTs who underwent radiofrequency catheter ablation between September 2012 and December 2013 in our department were included.Intracardiac electrograms during the mapping and ablation were analyzed.Results During sinus rhythm,sharp high-frequency DPs that displayed double or multiple components were recorded following or buried in the local ventricular elec0trograms in all of the 17 patients,peak amplitude was (0.51 ± 0.21) mV.The same potential was recorded prior to the local ventricular potential of the PVCs/VTs.Spontaneous reversal of the relationship of the DPs to the local ventricular electrogram was noted during the arrhythmias.The DPs were related to a region of low voltage showed by intracardiac high-density contact mapping.At the sites with DPs,unipolar and bipolar ventricular voltage of sinus beats were lower compared with the adjacent regions without DPs (unipolar:(6.1 ± 1.8)mV vs.(8.3 ±2.3)mV,P ＜0.05;bipolar:(0.62 ±0.45)mY vs.(1.03 ±0.60) mV,P ＜ 0.05).The targeted DPs were still present in 12 patients after successful elimination of the ectopies.Discrete potentials were not present in seven controls.Conclusions Discrete potentials and related low-voltage regions were common in idiopathic outflow tract ventricular arrhythmias.Discrete potential-and substrate-guided ablation strategy could help to reduce the recurrence of idiopathic outflow tract arrhythmias.
