The features of distinctive bipolar intracardiac electrograms for ventricular arrhythmias in the DGCV system origin.

IF 2 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

BMC Cardiovascular Disorders Pub Date : 2025-03-05 DOI:10.1186/s12872-025-04606-x

Weiqian Lin, Jiasheng Yu, Cheng Zheng, Jiafeng Lin, Guojuan Xu

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引用次数: 0

Abstract

Aims: To investigate the characteristics of bipolar intracardiac electrograms (bi-EGMs) in target sites of ventricular arrhythmias (VAs) originating from the distal great vein system (DGCVs).

Methods: 169 patients undergoing first-time ablation for VAs originated from DGCVs were enrolled in present study. Successful ablation was achieved in 146 patients. Bi-EGMs on successful sites were recorded and analyzed.

Results: In the 146 cases, the DGCVs was subdivided into DGCV (100 cases), AIV (28cases), and summit-CV (18 cases) subgroup based on anatomic location of final target site. An A and V wave were consistently recorded in Bi-EGM of target sites. A total of 59 cases showed A/V ≥ 1 while 87 patients were < 1. The incidence of A/V ≥ 1 recorded in target sites was higher in the DGCV subgroup (52%, 52/100) compared to the AIV (10.71%, 3/28) and summit-CV (22.22%, 4/18) subgroups (all p < 0.05). In A/V > 1 cases, pacing-induced ventricle capture, atrium capture or alternate atrium and ventricle capture, and no chamber capture were 83.05%(49/59), 6.78%(4/59),10.19%(6/59), respectively, and they were 90.80%(79/87), 1.15%(1/87), 8.05%(7/87) (p > 0.05) in 87 cases of A/V < 1. A presystolic multicomponent fractionated potential was frequently observed in target sites of DGCVs VAs(102/146, 69.86%), with the DGCV subgroup being more frequent than the AIV and summit-CV subgroups (74/100, 74% vs. 19/28, 67.86% vs. 9/18, 50%).

Conclusion: Catheter ablation of VAs arising from DGCV system is challenging. Different from traditional concept of atrioventricular annulus VAs, whose AV ratio of target sites should be less than 1, A/V ≥ 1 could be observed in VAs arising from DGCVs. In this region, target site identification should not be restrained by AV ratio. In addition, the presence of specific potentials in Bi-EGMs, can serve as an indicator for identifying target sites.

Clinical trial number: Not applicable.

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来源期刊

BMC Cardiovascular Disorders CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.50

自引率

0.00%

发文量

480

审稿时长

1 months

期刊介绍： BMC Cardiovascular Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the heart and circulatory system, as well as related molecular and cell biology, genetics, pathophysiology, epidemiology, and controlled trials.