Premature outflow tract ventricular contraction combined with complete bundle branch block:the characteristic electrocardiographic and ablation target potential features
10.3760/cma.j.issn.0578-1426.2017.12.006
- VernacularTitle:完全性左/右束支传导阻滞合并流出道室性早搏的心电图和消融靶点图特征
- Author:
Chengye DI
1
;
Zheng WAN
;
Kang LI
;
Yansheng DING
;
Wenhua LIN
Author Information
1. 300457,天津医科大学心血管病临床学院泰达国际心血管病医院
- Keywords:
Bundle-branch block;
Electrocardiogram;
Ventricular premature;
Radiofrequency catheter ablation
- From:
Chinese Journal of Internal Medicine
2017;56(12):919-923
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the characteristics of electrocardiogram(ECG) and target potential features of premature ventricular contraction (PVC) in patients with complete left/right bundle branch block (CL/RBBB) and compare with those without CL/RBBB. Methods A retrospective analysis was done in 8 outflow tract PVC patients with CL/RBBB, who successfully underwent radiofrequency ablation from August 2009 to June 2017. According to the bundle branch block chamber, patients were divided into the complete right bundle branch block (CRBBB) group (n=4) and the complete left bundle branch block (CLBBB) group (n=4). The control group were those who successfully underwent ablation at the same position as the above two groups but without CL/RBBB. The characteristics of ECG and target potential features were compared among groups. Results One case in the CRBBB group was successfully ablated in the great cardiac vein with precordial R/S>1 transition at V1 and one case in the CLBBB group was successfully ablated in the right coronary cusp with precordial R/S>1 transition at V2, while other 6 cases were all with precordial R/S>1 transition at lead V4. Precordial R/S>1 transition was not later than sinus rhythm (SR) in the CLBBB group. No statistical difference was found in the QRS complex duration between SR and PVC in the CL/RBBB patients [(134.38 ± 23.80)ms vs (156.75 ± 25.93)ms, P>0.05], while statistical difference was shown in the control group [ (92.63 ± 5.76)ms vs (140.25 ± 15.97)ms,P<0.05]. Conclusion Bundle branch block can lead to misjudgment of PVC origin with CL/RBBB during sinus rhythm, thus the origin chamber of the PVC should be determined according to the mapping and ablation result.
