Catheter ablation of ventricular premature depolarizations originating from the mid interventricular septum: Significance of electrocardiographic morphology for predicting origin

医学 室间隔 心脏病学 QRS波群 内科学 心脏传导系统 导管消融 心前检查 烧蚀 房室传导阻滞 心电图 心室
作者
Zhuo Liang,Tao Zhang,Lifeng Liu,Shuying Qi,Xu Liu,Qiaoyuan Li,Dongping Fang,Yunlong Wang,Changsheng Ma
出处
期刊:Heart Rhythm [Elsevier BV]
卷期号:20 (8): 1101-1110 被引量:2
标识
DOI:10.1016/j.hrthm.2023.05.023
摘要

BackgroundVentricular premature depolarizations (VPDs) originating from the mid interventricular septum (IVS) adjacent to the atrioventricular annulus between the His bundle and the coronary sinus ostium (mid IVS VPDs) have not been characterized.ObjectiveThe aim of this study was to investigate the electrophysiological characteristics of mid IVS VPDs.MethodsThirty-eight patients with mid IVS VPDs were enrolled. VPDs were divided into different types according to precordial transition of the electrocardiogram (ECG) and QRS morphology in lead V1.ResultsFour types of VPDs were divided. The precordial transition zone appeared earlier and earlier from types 1 to 4. The notch in lead V1 moved gradually backward, and its amplitude gradually became higher, resulting in the transition from left to right bundle branch block morphology in lead V1 from types 1 to 4. Based on activation and pace mapping, ablation response, and 3830 electrode pacing morphology in the mid IVS, the 4 types of ECG morphology corresponded to an origin in the right endocardial side, right/mid intramural region, left intramural region, and left endocardial side of the mid IVS, respectively. An intramural origin was identified for 50% of VPDs. Eighty-nine percent of mid IVS VPDs could be eliminated. Bilateral ablation (waiting for delayed efficacy) or bipolar ablation was sometimes needed for intramural VPDs.ConclusionMid IVS VPDs were found to have unique electrophysiological characteristics. The ECG characteristics of mid IVS VPDs were important in terms of prediction of its exact origin, the choice of ablation method, and the likelihood of treatment being successful. Ventricular premature depolarizations (VPDs) originating from the mid interventricular septum (IVS) adjacent to the atrioventricular annulus between the His bundle and the coronary sinus ostium (mid IVS VPDs) have not been characterized. The aim of this study was to investigate the electrophysiological characteristics of mid IVS VPDs. Thirty-eight patients with mid IVS VPDs were enrolled. VPDs were divided into different types according to precordial transition of the electrocardiogram (ECG) and QRS morphology in lead V1. Four types of VPDs were divided. The precordial transition zone appeared earlier and earlier from types 1 to 4. The notch in lead V1 moved gradually backward, and its amplitude gradually became higher, resulting in the transition from left to right bundle branch block morphology in lead V1 from types 1 to 4. Based on activation and pace mapping, ablation response, and 3830 electrode pacing morphology in the mid IVS, the 4 types of ECG morphology corresponded to an origin in the right endocardial side, right/mid intramural region, left intramural region, and left endocardial side of the mid IVS, respectively. An intramural origin was identified for 50% of VPDs. Eighty-nine percent of mid IVS VPDs could be eliminated. Bilateral ablation (waiting for delayed efficacy) or bipolar ablation was sometimes needed for intramural VPDs. Mid IVS VPDs were found to have unique electrophysiological characteristics. The ECG characteristics of mid IVS VPDs were important in terms of prediction of its exact origin, the choice of ablation method, and the likelihood of treatment being successful.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
kirazou完成签到,获得积分10
1秒前
阿湫发布了新的文献求助10
1秒前
wjswift完成签到,获得积分10
2秒前
李健应助袁翰将军采纳,获得10
2秒前
Rollei发布了新的文献求助10
2秒前
Rollei发布了新的文献求助10
2秒前
Rollei发布了新的文献求助10
2秒前
Rollei发布了新的文献求助10
3秒前
Rollei发布了新的文献求助10
3秒前
Rollei发布了新的文献求助10
3秒前
淡然靖柔完成签到,获得积分10
3秒前
清脆怜寒完成签到,获得积分10
3秒前
赖雅绿完成签到,获得积分10
4秒前
辞树完成签到,获得积分10
4秒前
ugly_20201208完成签到,获得积分10
4秒前
大意的凝云完成签到,获得积分10
5秒前
HH完成签到,获得积分10
6秒前
7秒前
9秒前
珈蓝完成签到,获得积分10
9秒前
嘟嘟请让一让完成签到,获得积分10
10秒前
莫x莫完成签到 ,获得积分10
11秒前
bubble完成签到,获得积分10
12秒前
12秒前
万能图书馆应助sl采纳,获得10
12秒前
河丫应助sl采纳,获得10
12秒前
量子星尘发布了新的文献求助10
13秒前
科研人发布了新的文献求助10
13秒前
13秒前
魏莱关注了科研通微信公众号
14秒前
dd发布了新的文献求助10
15秒前
yifan92完成签到,获得积分10
16秒前
17秒前
灵巧的孤容完成签到,获得积分10
18秒前
袁翰将军发布了新的文献求助10
18秒前
a雪橙完成签到 ,获得积分10
20秒前
超帅的碱完成签到,获得积分10
20秒前
21秒前
陈大海完成签到,获得积分20
21秒前
LaTeXer给积极行天的求助进行了留言
21秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
Research on Disturbance Rejection Control Algorithm for Aerial Operation Robots 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038446
求助须知:如何正确求助?哪些是违规求助? 3576149
关于积分的说明 11374627
捐赠科研通 3305875
什么是DOI,文献DOI怎么找? 1819354
邀请新用户注册赠送积分活动 892680
科研通“疑难数据库(出版商)”最低求助积分说明 815048