ABSTRACT
Objective@#To analyze the clinical characteristics of patients with idiopathic right ventricular outflow tract (RVOT) ventricular arrhythmias (VA) and factors related to the immediate success rate of radiofrequency ablation.@*Methods@#Patients diagnosed as idiopathic RVOT arrhythmia in Fuwai Hospital from February 2009 to January 2013 were retrospectively screened. Patients with structural heart disease or inherited arrhythmia were excluded. All patients underwent endocardial electrophysiological study and radiofrequency catheter ablation. Baseline clinical and operation records were collected and analyzed. Immediate success rate was defined as no inducible ventricular arrhythmia by isoprinosine and electrophysiological induction at the end of ablation. The origins of idiopathic RVOT were classified as septal, anterior, posterior, free wall site, epicardial and RVOT-aorta root site.@*Results@#A total of 468 patients were finally included, and the age was (40.4±13.3) years old and 60.5%(283/468) patients were female. Immediate radiofrequency success rate was 89.3%(418/468). Patients were divided into ablation success group (n=418) and ablation failure group (n=50). Percent of female patients and patients with interventricular septal origin was significantly higher in the ablation success group than in ablation failure group (261(62.4%) vs. 22 (44.0%) , P=0.01, and 233(55.7%) vs. 18(36.0%), P=0.005), while percent of patients with epicardial origin was significantly lower in the ablation success group than in ablation failure group (17(4.1%) vs. 11(22.0%), P<0.001). Immediate success rate was the highest for patients with the septal origin and the lowest for patients with epicardial origin (92.8%(233/251) vs. 60.7%(17/28), P<0.05). Multivariate analysis showed that the origin site of VAs was the most important independent factor related to the success rate of ablation. Compared with the septal origin patients, patients with RVOT-aorta root and epicardial origin VAs faced with 1.82-fold and 8.26-fold increased risk of failed ablation, respectively (OR=2.82, 95%CI 1.05-7.57, and OR=9.26, 95%CI 3.60-23.86). Sex category was not the independent risk factor for failed ablation(OR=1.76, 95%CI 0.93-3.33, P=0.08) .@*Conclusions@#The immediate success rate of radiofrequency catheter ablation for idiopathic RVOT ventricular arrhythmia is relative high, however, immediate success rate of radiofrequency catheter ablation is relatively low for patients with epicardial and RVOT-aorta root origin arrhythmia and VAs origin is an independent risk factor of immediate ablation success rate.
ABSTRACT
Objective: To analyze the relationship between high-sensitivity C-reactive protein (hs-CRP) and P wave dispersion (Pd) in patients with lone atrial ifbrillation (AF), and to explore the effect of inlfammation on atrial electrophysiological remodeling. Methods: Our research included 2 groups. AF group, containing 71 consecutive paroxysmal lone AF patients, and Control group, containing 71 paroxysmal supra ventricular tachycardia patients with the matched age and gender. The clinical characteristics, electrocardiographic Pd assessment and plasma hs-CRP levels were compared between 2 groups. The relationship between hs-CRP and Pd was studied by linear and multi linear regression analysis. Results: Compared with Control group, AF group showed increased left atrial diameter, Pd and hs-CRP, all P Conclusion: Plasma hs-CRP level and electrocardiographic Pd were the important risk factors for paroxysmal lone AF, the interaction between hs-CRP and AF occurrence could be mediated by Pd, suggesting that inlfammation might be involved in atrial electrophysiological remodeling.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the unipolar electrogram from successful and unsuccessful ablation sites of focal atrial tachycardia (AT), and to evaluate its value in the identification of successful targets.</p><p><b>METHODS</b>Fifteen consecutive patients with focal AT were referred for radiofrequency catheter ablation (RFCA). Both unipolar (from the tip electrode of ablating catheter) and bipolar (from the distal pair of electrode of ablating catheter) electrograms were used to identify the ablation targets of focal AT.</p><p><b>RESULTS</b>Successful ablation was echieved in 14 patients. Radiofrequency energy was delivered at a total of 27 sites. The bipolar electrograms associated with successful ablation sites showed earlier atrial deflection relative to P wave onset (36 ms +/- 15 ms vs 30 ms +/- 11 ms, P < 0.05) than the electrograms associated with failed ablation sites. At the 14 successful ablation sites, the unipolar electrograms displayed a completely negative atrial wave ("QS" morphology) beginning with intrinsic deflection. However, at the 13 unsuccessful ablation sites, a "rS" morphology of atrial wave was shown on the unipolar electrogram.</p><p><b>CONCLUSION</b>The "QS" morphology of the atrial wave on unipolar electrograms appears to represent a reliable marker for identifying the successful ablation targets of focal AT, with a high sensitivity and specificity.</p>