Anatomical proximity dictates successful ablation from adjacent sites for outflow tract ventricular arrhythmias linked to the coronary venous system

EP Europace ◽  
2018 ◽  
Vol 21 (3) ◽  
pp. 484-491 ◽  
Author(s):  
Yasuhiro Shirai ◽  
Pasquale Santangeli ◽  
Jackson J Liang ◽  
Fermin C Garcia ◽  
Gregory E Supple ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Outflow Tract ◽  
Venous System ◽  
Successful Ablation ◽  
Coronary Venous System

scholarly journals Catheter Ablation of Ventricular Arrhythmias Originating From the Region of DGCV-AIV via a Swartz Sheath Support Approach

2021 ◽  
Vol 8 ◽  
Author(s):  
Cheng Zheng ◽  
Wei-Qian Lin ◽  
Yao-Ji Wang ◽  
Fang-Zhou Lv ◽  
Qi-Qi Jin ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Predictive Value ◽  
Ventricular Arrhythmias ◽  
Distal Portion ◽  
Left Ventricular ◽  
Venous System ◽  
Successful Ablation ◽  
Target Sites ◽  
Catheter Tip ◽  
Coronary Venous System

Aims: This study aimed to investigate an appropriate catheter manipulation approach for ventricular arrhythmias (VAs) originating from the left ventricular epicardium adjacent to the transitional area from the great cardiac vein to the anterior interventricular vein (DGCV-AIV).Methods: A total of 123 patients with DGCV-AIV VAs were retrospectively analyzed. All these patients underwent routine mapping and ablation by conventional approach [Non-Swartz sheath support (NS) approach] firstly. In the situation of the distal portion of the coronary venous system (CVS) not being accessed or a good target site not being obtained, the Swartz sheath support (SS) approach was attempted alternatively. If this still failed, the hydrophilic coated guidewire and left coronary angiographic catheter-guided deep engagement of Swartz sheath in GCV to support ablation catheter was performed.Results: A total of 103 VAs (103/123, 83.74%) were successfully eliminated in DGCV-AIV. By NS approach, the tip of the catheter reached DGCV in 39.84% VAs (49/123), reached target sites in 35.87% VAs (44/123), and achieved successful ablation in 30.89% VAs (38/123), which was significantly lower than by SS approach (88.61% (70/79), 84.81 % (67/79), and 75.95% (60/79), P < 0.05). There were no significant differences in complication occurrence between the NS approach and the SS approach (4/123, 3.25% vs. 7/79, 8.86%, p > 0.05). The angle between DGCV and AIV <83° indicated an inaccessible AIV by catheter tip with a predictive value of 94.5%. Width/height of coronary venous system>0.69 more favored a SS approach with a predictive value of 87%.Conclusion: For radiofrequency catheter ablation (RFCA) of VAs arising from DGCV-AIV, the SS approach facilitates the catheter tip to achieve target sites and contributes to a successful ablation.

scholarly journals Idiopathic Outflow Tract Ventricular Arrhythmia Ablation: Pearls and Pitfalls

2019 ◽  
Vol 8 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Jackson J Liang ◽  
Yasuhiro Shirai ◽  
Aung Lin ◽  
Sanjay Dixit
Keyword(s):  
Ventricular Arrhythmias ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Structural Heart Disease ◽  
Careful Analysis ◽  
Intracardiac Echocardiography ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Successful Ablation ◽  
Pace Mapping

Idiopathic outflow tract ventricular arrhythmias (VAs) occur typically in patients without structural heart disease. They are often symptomatic and can sometimes lead to left ventricular systolic dysfunction. Both activation and pace mapping are utilised for successful ablation of these arrhythmias. Pace mapping is particularly helpful when the VA is infrequent and/or cannot be elucidated during the ablation procedure. VAs originating from different sites in the outflow tract region have distinct QRS patterns on the 12-lead ECG and careful analysis of the latter can help predict the site of origin of these arrhythmias. Successful ablation of these VAs requires understanding of the detailed anatomy of the OT region, which can be accomplished through electroanatomic mapping tools and intracardiac echocardiography.

scholarly journals Mapping and Ablation of Epicardial Idiopathic Ventricular Arrhythmias From Within the Coronary Venous System

2010 ◽  
Vol 3 (3) ◽  
pp. 274-279 ◽  
Author(s):  
Timir S. Baman ◽  
Karl J. Ilg ◽  
Sanjaya K. Gupta ◽  
Eric Good ◽  
Aman Chugh ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Venous System ◽  
Coronary Venous System

scholarly journals Coronary Venous Mapping and Catheter Ablation for Ventricular Arrhythmias

2021 ◽  
pp. 13-18
Author(s):  
Jackson J Liang ◽  
Frank Bogun
Keyword(s):  
Catheter Ablation ◽  
Right Ventricular ◽  
Effective Treatment ◽  
Ventricular Arrhythmias ◽  
Treatment Method ◽  
Vantage Point ◽  
Venous System ◽  
Coronary Venous System ◽  
Left And Right

Catheter ablation is an effective treatment method for ventricular arrhythmias (VAs). These arrhythmias can often be mapped and targeted with ablation from the left and right ventricular endocardium. However, in some situations the VA site of origin or substrate may be intramural or epicardial in nature. In these cases, the coronary venous system (CVS) provides an effective vantage point for mapping and ablation. This review highlights situations in which CVS mapping may be helpful and discusses techniques for CVS mapping and ablation.

scholarly journals Trends in Successful Ablation Sites and Outcomes of Ablation for Idiopathic Outflow Tract Ventricular Arrhythmias

2020 ◽  
Vol 6 (2) ◽  
pp. 221-230 ◽  
Author(s):  
Tatsuya Hayashi ◽  
Jackson J. Liang ◽  
Yasuhiro Shirai ◽  
Ling Kuo ◽  
Daniele Muser ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Outflow Tract ◽  
Successful Ablation

The aortic cusps are the predominant successful ablation site of idiopathic outflow-tract ventricular arrhythmias

2020 ◽  
Vol 61 ◽  
pp. 63-65
Author(s):  
Konstantinos P. Letsas ◽  
Stylianos Dragasis ◽  
George Bazoukis ◽  
Efstathia Prappa ◽  
Athanasia Megarisiotou ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Outflow Tract ◽  
Successful Ablation

scholarly journals Unique features of epicardial ventricular arrhythmias/premature ventricular complexes ablated from coronary venous system in veteran population

2020 ◽  
Vol 20 (3) ◽  
pp. 97-104 ◽  
Author(s):  
Philip L. Mar ◽  
Mamta Barmeda ◽  
Marcelle A. Stucky ◽  
Subodh R. Devabahktuni ◽  
Jason Garlie ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Venous System ◽  
Premature Ventricular Complexes ◽  
Coronary Venous System

scholarly journals Anatomic Relationships Between the Coronary Venous System, Surrounding Structures, and the Site of Origin of Epicardial Ventricular Arrhythmias

2014 ◽  
Vol 25 (12) ◽  
pp. 1336-1342 ◽  
Author(s):  
THOMAS P. CARRIGAN ◽  
SMITA PATEL ◽  
MIKI YOKOKAWA ◽  
ERIC SCHMIDLIN ◽  
SCOTT SWANSON ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Venous System ◽  
Coronary Venous System
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