Ventricular arrhythmias originating from left ventricle posterior papillary muscle:electrocardiographic characteristics and catheter ablation / 中国介入心脏病学杂志

ABSTRACT

Objective To investigate the clinical characteristics, electrocardiography, electrophysiological features and the eff ectiveness of catheter ablation of ventricular arrhythmias originating from left ventricle posterior papillary muscles. Methods Clinical features and electrocardiography of 16 patients with ventricular arrhythmias arising from left ventricular posterior papillary muscles underwent catheter ablation were retrospectively analyzed. Activation mapping and/or pace mapping were performed to identify the site of origin and transthoracic echocardiography were used to demonstrate ablation catheter position and contact. The immediate success and recurrence rates were evaluated. Results During arrhythmias, QRS wave duration of 16 patients [5 men, mean age (45.0±18.2) years] was (155.1±9.0)ms. The prevalence of R>r' and r<R' of V1QRS morphology was 6/16 and 9/16, respectively. Earliest local ventricular electrogram preceded QRS wave by (30.8±8.4)ms at successful ablation site. Immediate success were achieved in 14 patients (14/16) ,11 patients(11/16) had full clinical follow-up and recurrences occurred in 5 patients (5/11). Conclusions Electrocardiography of ventricular arrhythmias originating from left ventricular posterior papillary muscles has its specifi c features. Earliest focal electrogram indicates successful ablation site and transthoracic echocardiography can demonstrate ablation catheter position and increase success rate but recurrence rate is still high.