Combined Approach Improves the Outcomes of Catheter Ablation of Idiopathic Ventricular Arrhythmias Originating from the Vicinity of Tricuspid Annulus
Background Ablation of idiopathic ventricular arrhythmias (VAs) originating from the vicinity of tricuspid annulus (TA) is often unsuccessful via inferior approach. We report the initial experience with catheter ablation of VAs arising from the vicinity of the TA via superior approach. Methods We re...
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| Published in | Pacing and clinical electrophysiology Vol. 37; no. 5; pp. 624 - 629 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Blackwell Publishing Ltd
01.05.2014
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Background
Ablation of idiopathic ventricular arrhythmias (VAs) originating from the vicinity of tricuspid annulus (TA) is often unsuccessful via inferior approach. We report the initial experience with catheter ablation of VAs arising from the vicinity of the TA via superior approach.
Methods
We retrospectively studied 36 patients with VAs arising from the vicinity of TA who underwent ablation via transfemoral vein approach first. If patients had a failed prior ablation or VAs recurred during follow‐up, they were referred for repeat ablation via transsubclavian vein approach.
Results
Among 36 patients, 11 (30.6%) patients (five failed during the index procedure and six recurred during the follow‐up) were assigned to perform repeat ablation via the transsubclavian vein approach. After the final procedure two patients recurred again, and success rate increased from 69.5% (25/36) to 94.4% (34/36). Amplitudes of the atrial electrograms of all successful ablation sites via the transsubclavian vein approach was <0.036 mV.
Conclusions
The transsubclavian vein approach plus transfemoral vein approach improve the outcomes of catheter ablation of idiopathic VAs originating from the vicinity of TA. The transsubclavian vein approach is a feasible alternative for VAs, which has been refractory to ablation via the inferior approach. |
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| AbstractList | Background
Ablation of idiopathic ventricular arrhythmias (VAs) originating from the vicinity of tricuspid annulus (TA) is often unsuccessful via inferior approach. We report the initial experience with catheter ablation of VAs arising from the vicinity of the TA via superior approach.
Methods
We retrospectively studied 36 patients with VAs arising from the vicinity of TA who underwent ablation via transfemoral vein approach first. If patients had a failed prior ablation or VAs recurred during follow‐up, they were referred for repeat ablation via transsubclavian vein approach.
Results
Among 36 patients, 11 (30.6%) patients (five failed during the index procedure and six recurred during the follow‐up) were assigned to perform repeat ablation via the transsubclavian vein approach. After the final procedure two patients recurred again, and success rate increased from 69.5% (25/36) to 94.4% (34/36). Amplitudes of the atrial electrograms of all successful ablation sites via the transsubclavian vein approach was <0.036 mV.
Conclusions
The transsubclavian vein approach plus transfemoral vein approach improve the outcomes of catheter ablation of idiopathic VAs originating from the vicinity of TA. The transsubclavian vein approach is a feasible alternative for VAs, which has been refractory to ablation via the inferior approach. Ablation of idiopathic ventricular arrhythmias (VAs) originating from the vicinity of tricuspid annulus (TA) is often unsuccessful via inferior approach. We report the initial experience with catheter ablation of VAs arising from the vicinity of the TA via superior approach.BACKGROUNDAblation of idiopathic ventricular arrhythmias (VAs) originating from the vicinity of tricuspid annulus (TA) is often unsuccessful via inferior approach. We report the initial experience with catheter ablation of VAs arising from the vicinity of the TA via superior approach.We retrospectively studied 36 patients with VAs arising from the vicinity of TA who underwent ablation via transfemoral vein approach first. If patients had a failed prior ablation or VAs recurred during follow-up, they were referred for repeat ablation via transsubclavian vein approach.METHODSWe retrospectively studied 36 patients with VAs arising from the vicinity of TA who underwent ablation via transfemoral vein approach first. If patients had a failed prior ablation or VAs recurred during follow-up, they were referred for repeat ablation via transsubclavian vein approach.Among 36 patients, 11 (30.6%) patients (five failed during the index procedure and six recurred during the follow-up) were assigned to perform repeat ablation via the transsubclavian vein approach. After the final procedure two patients recurred again, and success rate increased from 69.5% (25/36) to 94.4% (34/36). Amplitudes of the atrial electrograms of all successful ablation sites via the transsubclavian vein approach was <0.036 mV.RESULTSAmong 36 patients, 11 (30.6%) patients (five failed during the index procedure and six recurred during the follow-up) were assigned to perform repeat ablation via the transsubclavian vein approach. After the final procedure two patients recurred again, and success rate increased from 69.5% (25/36) to 94.4% (34/36). Amplitudes of the atrial electrograms of all successful ablation sites via the transsubclavian vein approach was <0.036 mV.The transsubclavian vein approach plus transfemoral vein approach improve the outcomes of catheter ablation of idiopathic VAs originating from the vicinity of TA. The transsubclavian vein approach is a feasible alternative for VAs, which has been refractory to ablation via the inferior approach.CONCLUSIONSThe transsubclavian vein approach plus transfemoral vein approach improve the outcomes of catheter ablation of idiopathic VAs originating from the vicinity of TA. The transsubclavian vein approach is a feasible alternative for VAs, which has been refractory to ablation via the inferior approach. Ablation of idiopathic ventricular arrhythmias (VAs) originating from the vicinity of tricuspid annulus (TA) is often unsuccessful via inferior approach. We report the initial experience with catheter ablation of VAs arising from the vicinity of the TA via superior approach. We retrospectively studied 36 patients with VAs arising from the vicinity of TA who underwent ablation via transfemoral vein approach first. If patients had a failed prior ablation or VAs recurred during follow-up, they were referred for repeat ablation via transsubclavian vein approach. Among 36 patients, 11 (30.6%) patients (five failed during the index procedure and six recurred during the follow-up) were assigned to perform repeat ablation via the transsubclavian vein approach. After the final procedure two patients recurred again, and success rate increased from 69.5% (25/36) to 94.4% (34/36). Amplitudes of the atrial electrograms of all successful ablation sites via the transsubclavian vein approach was <0.036 mV. The transsubclavian vein approach plus transfemoral vein approach improve the outcomes of catheter ablation of idiopathic VAs originating from the vicinity of TA. The transsubclavian vein approach is a feasible alternative for VAs, which has been refractory to ablation via the inferior approach. |
| Author | SHU-LIN, WU HAI, DENG YU-MEI, XUE HONG-TAO, LIAO TENG, LI WEI, WEI XIAN-ZHANG, ZHAN XIAN-HONG, FANG |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24456278$$D View this record in MEDLINE/PubMed |
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| Keywords | catheter ablation ventricular tachycardia ventricular arrhythmias premature ventricular contractions |
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| Notes | ArticleID:PACE12341 istex:01254DFDA32764AF4C20AFF41F225414F1311702 ark:/67375/WNG-68260364-N Li Teng and Zhan Xian‐Zhang are co‐first authors for this work. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
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| References_xml | – reference: Jastrzebski M, Bacior B, Olszanecka A, Kawecka-Jaszcz K. [Cryoablation of ventricular arrhythmias originating from septal aspects of mitral and tricuspid annulus]. Kardiol Pol 2011; 69:409-412. – reference: Daniels DV, Lu YY, Morton JB, Santucci PA, Akar JG, Green A, Wilber DJ. Idiopathic epicardial left ventricular tachycardia originating remote from the sinus of Valsalva: Electrophysiological characteristics, catheter ablation, and identification from the 12-lead electrocardiogram. Circulation 2006; 113:1659-1666. – reference: Yamada T, Allison JS, McElderry HT, Doppalapudi H, Epstein AE, Plumb VJ, Kay GN. Successful catheter ablation of premature ventricular contractions originating from the tricuspid annulus using a Halo-type catheter. Europace 2008; 10:1228-1229. – reference: Salem YS, Burke MC, Kim SS, Morady F, Knight BP. Slow pathway ablation for atrioventricular nodal reentry using a right internal jugular vein approach: A case series. Pacing Clin Electrophysiol 2006; 29:59-62. – reference: Chun JK, Schmidt B, Kuck KH, Ernst S. Remote-controlled magnetic ablation of a right anterolateral accessory pathway-The superior caval vein approach. J Interv Card Electrophysiol 2006; 16:65-68. – reference: Yue-Chun L, Wen-Wu Z, Na-Dan Z, Teng Z, Pin-Xiao W, Bei G, Jia L, et al. Idiopathic premature ventricular contractions and ventricular tachycardias originating from the vicinity of tricuspid annulus: Results of radiofrequency catheter ablation in thirty-five patients. BMC Cardiovasc Disord 2012; 12:32-42. – reference: Bian C, Ma J, Yao S, Lv X, Wang J. Transjugular approach for radiofrequency ablation of premature ventricular contractions originating from the superior tricuspid annulus. Pacing Clin Electrophysiol 2012; 35:e358-e360. – reference: Tada H, Tadokoro K, Ito S, Naito S, Hashimoto T, Kaseno K, Miyaji K, et al. 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BMC Cardiovasc Disord 2013; 13:7-11. – volume: 35 start-page: e358 year: 2012 end-page: e360 article-title: Transjugular approach for radiofrequency ablation of premature ventricular contractions originating from the superior tricuspid annulus publication-title: Pacing Clin Electrophysiol – volume: 13 start-page: 7 year: 2013 end-page: 11 article-title: Trans‐subclavian approach for radiofrequency ablation of premature ventricular contractions originating from subtricuspid annulus: A case report publication-title: BMC Cardiovasc Disord – volume: 113 start-page: 1659 year: 2006 end-page: 1666 article-title: Idiopathic epicardial left ventricular tachycardia originating remote from the sinus of Valsalva: Electrophysiological characteristics, catheter ablation, and identification from the 12‐lead electrocardiogram publication-title: Circulation – volume: 69 start-page: 409 year: 2011 end-page: 412 article-title: [Cryoablation of ventricular arrhythmias originating from septal aspects of mitral and tricuspid annulus] publication-title: Kardiol Pol – volume: 29 start-page: 59 year: 2006 end-page: 62 article-title: Slow pathway ablation for atrioventricular nodal reentry using a right internal jugular vein approach: A case series publication-title: Pacing Clin Electrophysiol – volume: 10 start-page: 1228 year: 2008 end-page: 1229 article-title: Successful catheter ablation of premature ventricular contractions originating from the tricuspid annulus using a Halo‐type catheter publication-title: Europace – volume: 16 start-page: 65 year: 2006 end-page: 68 article-title: Remote‐controlled magnetic ablation of a right anterolateral accessory pathway—The superior caval vein approach publication-title: J Interv Card Electrophysiol – volume: 4 start-page: 7 year: 2007 end-page: 16 article-title: Idiopathic ventricular arrhythmias originating from the tricuspid annulus: Prevalence, electrocardiographic characteristics, and results of radiofrequency catheter ablation publication-title: Heart Rhythm – volume: 12 start-page: 32 year: 2012 end-page: 42 article-title: Idiopathic premature ventricular contractions and ventricular tachycardias originating from the vicinity of tricuspid annulus: Results of radiofrequency catheter ablation in thirty‐five patients publication-title: BMC Cardiovasc Disord – ident: e_1_2_6_8_1 doi: 10.1093/europace/eun184 – ident: e_1_2_6_2_1 doi: 10.1186/1471-2261-12-32 – ident: e_1_2_6_9_1 doi: 10.1111/j.1540-8159.2006.00292.x – ident: e_1_2_6_4_1 doi: 10.1186/1471-2261-13-7 – ident: e_1_2_6_10_1 doi: 10.1007/s10840-006-9022-8 – ident: e_1_2_6_5_1 doi: 10.1161/CIRCULATIONAHA.105.611640 – volume: 69 start-page: 409 year: 2011 ident: e_1_2_6_7_1 article-title: [Cryoablation of ventricular arrhythmias originating from septal aspects of mitral and tricuspid annulus] publication-title: Kardiol Pol – ident: e_1_2_6_6_1 doi: 10.1111/j.1540-8159.2012.03380.x – ident: e_1_2_6_3_1 doi: 10.1016/j.hrthm.2006.09.025 |
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Ablation of idiopathic ventricular arrhythmias (VAs) originating from the vicinity of tricuspid annulus (TA) is often unsuccessful via inferior... Ablation of idiopathic ventricular arrhythmias (VAs) originating from the vicinity of tricuspid annulus (TA) is often unsuccessful via inferior approach. We... |
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| SubjectTerms | Adolescent Adult catheter ablation Catheter Ablation - methods Female Heart Conduction System - surgery Humans Male Middle Aged premature ventricular contractions Retrospective Studies Tachycardia, Ventricular - surgery Treatment Outcome Tricuspid Valve - surgery ventricular arrhythmias Ventricular Premature Complexes - diagnosis Ventricular Premature Complexes - surgery ventricular tachycardia Young Adult |
| Title | Combined Approach Improves the Outcomes of Catheter Ablation of Idiopathic Ventricular Arrhythmias Originating from the Vicinity of Tricuspid Annulus |
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