Heart rhythm · 2018
Catheter ablation of premature ventricular complexes arising from the left fascicular system.
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Zhang Jinlin, Tang Cheng, Zhang Yonghua, Su Xi
Аннотация
BACKGROUND: Idiopathic premature ventricular complexes (PVCs) that originate from the left fascicular system have rarely been reported.
OBJECTIVE: The present study aimed to investigate the electrophysiological characteristics and the ablation strategy for this category of PVCs.
METHODS: Of 648 patients with idiopathic PVCs, 27 were enrolled in this study. All the PVCs presented with a relatively narrow QRS complex and right bundle branch block morphology. The mean QRS duration was 117.4 ± 8.6 ms. Radiofrequency catheter ablation was applied at the site recording the earliest fascicular potential (FP).
RESULTS: The origin of PVCs was as follows: 15 originating from the left anterior fascicle, 7 originating from the left posterior fascicle, 2 originating from the left middle fascicle, and 3 originating from the common trunk of the left bundle branch. The earliest local FP preceded the onset of the QRS complex by 32.7 ± 6.4 ms. The immediate ablation success rate was 100%. Three patients had recurrent PVCs during follow-up. The total success rate of a single procedure was 88.9%.
CONCLUSION: Ablation of PVCs originating from the left fascicular system guided by an earliest presystolic FP was found to be safe and effective.
OBJECTIVE: The present study aimed to investigate the electrophysiological characteristics and the ablation strategy for this category of PVCs.
METHODS: Of 648 patients with idiopathic PVCs, 27 were enrolled in this study. All the PVCs presented with a relatively narrow QRS complex and right bundle branch block morphology. The mean QRS duration was 117.4 ± 8.6 ms. Radiofrequency catheter ablation was applied at the site recording the earliest fascicular potential (FP).
RESULTS: The origin of PVCs was as follows: 15 originating from the left anterior fascicle, 7 originating from the left posterior fascicle, 2 originating from the left middle fascicle, and 3 originating from the common trunk of the left bundle branch. The earliest local FP preceded the onset of the QRS complex by 32.7 ± 6.4 ms. The immediate ablation success rate was 100%. Three patients had recurrent PVCs during follow-up. The total success rate of a single procedure was 88.9%.
CONCLUSION: Ablation of PVCs originating from the left fascicular system guided by an earliest presystolic FP was found to be safe and effective.