Am J Transl Res. 2021 Aug 15;13(8):8952-8964. eCollection 2021.
Matrix mapping of different idiopathic right ventricular outflow arrhythmias.
American journal of translational research
Zhiyong Zhang, Xiaofeng Hou, Zhiyong Qian, Jianghong Guo, Jiangang Zou
Affiliations
Affiliations
- Department of Cardiology, Suqian First People's Hospital Suqian 223800, Jiangsu, China.
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University Nanjing 210029, Jiangsu, China.
- Department of Cardiology, Rugao First People's Hospital Suqian 223800, Jiangsu, China.
PMID: 34540007
PMCID: PMC8430148
Abstract
OBJECTIVE: To explore the characteristics of optimal ablation site and its surrounding tissue in terms of unipolar and bipolar voltage mapping in idiopathic arrythmias from right ventricular outflow tract (RVOT) to understand if there is any difference between the two arrhythmias in matrix.
METHOD: A total of 40 patients with idiopathic arrhythmias originated from RVOT (28 PVCs/12 VT) were enrolled in the study group. The control group consisted of five patients with supraventricular tachycardia (SVT). Before ablation, the CARTO system was applied to establish a detailed three-dimensional electroanatomic voltage map (EVM) of RVOT during the sinus rhythm.
RESULTS: A band-like LVA of similar size was observed under the pulmonary valve on not only the bipolar map, but also unipolar map, for every patient. Both unipolar and bipolar voltage values in areas within 5 mm were significantly different from those in other areas above ablation targets, whereas similar differences were observed only in unipolar voltage values below the optimal ablation site for either of the two arrhythmias. Significant difference was present between VT group and VPCs group in voltage values for every area including target site. In terms of the overall LVA areas and the scar areas displayed on the unipolar and bipolar voltage maps, there was a significant difference between the unipolar value and bipolar value for the LVA areas and the scar areas in the VT or PVC group (
CONCLUSIONS: There was focal micro-scarring around the optimal ablation site. The ectopic focus is probably located in mid- or epi-myocardium. The distributions of majority of optimal ablation sites were regular especially at the noteworthy border of the band-like LVA on bipolar voltage map, or in the band-like LVA on unipolar voltage map.
AJTR Copyright © 2021.
Keywords: Electroanatomic voltage mapp (EVM); premature ventricular contractions (PVCs); right ventricular outflow tract (RVOT); ventricular tachycardia (VT)
Conflict of interest statement
None.
References
- Heart Rhythm. 2011 May;8(5):665-71 - PubMed
- Circ Arrhythm Electrophysiol. 2013 Feb;6(1):167-76 - PubMed
- Heart Rhythm. 2011 Jan;8(1):76-83 - PubMed
- Circ Arrhythm Electrophysiol. 2014 Aug;7(4):691-700 - PubMed
- J Am Coll Cardiol. 2001 Aug;38(2):364-70 - PubMed
- Heart Rhythm. 2008 Mar;5(3):345-7 - PubMed
- J Am Coll Cardiol. 2015 Dec 15;66(23):2633-2644 - PubMed
- Circulation. 1992 May;85(5):1666-74 - PubMed
- Pacing Clin Electrophysiol. 2007 Apr;30(4):534-9 - PubMed
- Heart Rhythm. 2008 Mar;5(3):339-44 - PubMed
- Tex Heart Inst J. 2012;39(4):526-8 - PubMed
- J Interv Card Electrophysiol. 2011 Jan;30(1):5-15 - PubMed
- J Int Med Res. 2020 Dec;48(12):300060520977634 - PubMed
- Int J Cardiol. 1997 Nov 20;62(2):143-50 - PubMed
- Heart Rhythm. 2018 Jan;15(1):38-45 - PubMed
- Pacing Clin Electrophysiol. 1997 Sep;20(9 Pt 1):2188-92 - PubMed
- J Am Coll Cardiol. 2012 Nov 20;60(21):2194-204 - PubMed
- J Cardiovasc Electrophysiol. 2017 Jul;28(7):768-775 - PubMed
- J Am Coll Cardiol. 2008 Feb 19;51(7):731-9 - PubMed
- J Am Coll Cardiol. 2005 Apr 19;45(8):1259-65 - PubMed
- Am J Cardiol. 2005 Apr 15;95(8):935-40 - PubMed
- Europace. 2010 Jun;12(6):850-60 - PubMed
- Pacing Clin Electrophysiol. 2009 Jun;32(6):727-33 - PubMed
- Circulation. 2005 Jun 14;111(23):3042-50 - PubMed
- Heart Rhythm. 2014 Feb;11(2):187-93 - PubMed
- Circulation. 2005 Jun 21;111(24):3209-16 - PubMed
- J Atr Fibrillation. 2014 Dec 31;7(4):1161 - PubMed
Publication Types