Reappraisal of the clinical and anatomic characteristics of idiopathic outflow tract ventricular arrhythmias with an R wave pattern break in precordial lead: A multi-center study

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-03-25 DOI:10.1016/j.ijcha.2025.101664

Muhammad Rafdi Amadis , Satoshi Higa , Chin-Yu Lin , Yuen Hoong Phang , Chia-Hsin Chiang , Jose Antonio Lopez Bautista , Yenn-Jiang Lin , Shih-Lin Chang , Li-Wei Lo , Yu-Feng Hu , Fa-Po Chung , Ting-Yung Chang , Ling Kuo , Cheng-I Wu , Chih-Min Liu , Shin-Huei Liu , Ming-Jen Kuo , Thien-Chuong Nguyen-Khac , Guan-Yi Li , Yu-Shan Huang , Shih-Ann Chen

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引用次数: 0

Abstract

Background

Idiopathic outflow tract ventricular arrhythmia (OT-VA) with a pattern break (PB) in the precordial leads is challenging to treat and is associated with low success rates.

Objective

Describe the anatomic characteristics and outcomes of patients with PB idiopathic OT-VA underwent catheter ablation.

Methods

We retrospectively reviewed the electronic medical records of idiopathic OT-VA patients underwent catheter ablation at Taipei Veterans General Hospital, Taiwan, and Makiminato Central Hospital, Japan. Patients with a documented left bundle branch block (LBBB) pattern and inferior axis VA QRS morphology with PB were included. Clinical data, VA morphology, electrophysiological parameters, and anatomic characteristics were analyzed.

Results

A total of 66 patients (6.7 %) had a PB in V2 (N = 60) or V3 (N = 6) were identified. The acute and long-term success rates (after a median follow-up of 37 months) were 92.4 % and 78.8 %, respectively, higher than previously reported. The successful ablation sites were mainly the right ventricular outflow tract (RVOT, 81.8 % [54/66]). The earliest activation site in the LVOT was mainly the left coronary cusp (LCC)/right coronary cusp (RCC) commissure (95.7 %, 22/23). A long anatomic distance from the LCC/RCC commissure to the RVOT and diabetes mellitus (DM) independently predicted acute procedural failure or recurrence.

Conclusion

OT-VA with PB in the Asian population may not have worse clinical outcomes than previously reported in Western countries. The most common site of acute success for ablation was the RVOT. A long anatomic distance from the LCC/RCC commissure to the RVOT and DM diagnosis was associated with an unsatisfied ablation outcome.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.