Electrophysiological characteristics related to outcome after catheter ablation of idiopathic ventricular arrhythmia originating from the papillary muscle in the left ventricle

Ji Eun Ban, Hyun Soo Lee, Dae Ln Lee, Hwan Cheol Park, Jae Seok Park, Yasutsugu Nagamoto, Jong Ll Choi, Hong Euy Lim, Sang Weon Park, Young Hoon Kim

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    21 Citations (Scopus)

    Abstract

    Background and Objectives: The electrophysiological properties associated with favorable outcome of radiofrequency catheter ablation (RFCA) for idiopathic ventricular arrhythmia (VA) originating from the papillary muscle (PM) remain unclear. The purpose of this study was to investigate the relationships of eleetrophysiological characteristics and predictors with the outcome of RFCA in patients with VAs originating from PM in the left ventricle (LV). Subjects and Methods: Twelve (4.2%) of 284 consecutive patients with idiopathic VAs originating from LV PM were assessed. The electrophysiological data were compared between the patients in the successful group and patients in the recurrence group after RFCA. Results: In 12 patients with PM VAs, non-sustained ventricular tachycardias (VTs n=6), sustained VTs (n=4) and premature ventricular complexes n=2 were identified as the presenting arrhythmias. Seven of eight patients showing high-amplitude discrete potentials at the ablation site had a successful outcome (85.7%), while the remaining four patients who showed low-amplitude fractionated potentials at the ablation site experienced VA recurrence. The mean duration from onset to peak downstroke (At) on the unipolar electrogram was significantly longer in the successful group than in the recurrence group (58±8 ms vs. 37±9 ms, p=0.04). A slow downstroke >50 ms of the initial Q wave on the unipolar electrogram at ablation sites was also significantly associated with successful outcome (85.7% vs. 25.0%, p=0.03). Conclusion: In PM VAs, the high-amplitude discrete potentials before QRS and slow downstroke of the initial Q wave on the unipolar electrogram at ablation sites were related to favorable outcome after RFCA.

    Original languageEnglish
    Pages (from-to)811-818
    Number of pages8
    JournalKorean Circulation Journal
    Volume43
    Issue number12
    DOIs
    Publication statusPublished - 2013 Dec

    Keywords

    • Arrhythmia
    • Catheter ablation
    • Left ventricle
    • Papillary muscles

    ASJC Scopus subject areas

    • Internal Medicine
    • Cardiology and Cardiovascular Medicine

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