In:
Europace, Oxford University Press (OUP)
Abstract:
The electrocardiographic and electrophysiological characteristics of ventricular arrhythmia (VA) arising from intramural basal inferior septum (BIS) have not been specifically addressed. The current study was to characterize intramural BIS VA from those with endocardial origins and clarify the anatomical configurations of pyramidal space. Methods Fifty-five consecutive patients undergoing catheter ablation of VAs from BIS were identified and divided into three groups: left ventricular BIS group (LV-BIS, n=28), right ventricular BIS group (RV-BIS, n=8), and intramural group (Intra, n=19). Results Compared to LV-BIS and RV-BIS, patients in Intra group presented no adequate earliest activation time (EAT) at the two-sided BIS and epicardial coronary system [right: 7.79±2.38ms vs. left: 7.16±2.59ms vs. middle cardiac vein (MCV): 6.26±1.73ms, P=0.173] and poor-matched pacing-produced QRS at each site. Under the intracardiac echocardiography view, pyramidal base is the broadest part of septum and serves as the division of two-sided BIS. Focal ablation yielded promising acute- and long-term procedural success in LV-BIS and RV-BIS group. But for Intra group, VAs disappeared only after stepwise ablation successively targeting early preferential exit. After follow-up, three patients in Intra group had recurrent VA, and all of them were treated well by redo procedure or drug therapy. Conclusions Intramural VAs are relatively common in the BIS region in our series. Intra-procedural mapping is important to distinguish the intramural VAs from other VAs by comparing the local activation time and pacing mapping. Procedural success could be achieved by stepwise ablation on counterpart sides of BIS and within MCV.
Type of Medium:
Online Resource
ISSN:
1099-5129
,
1532-2092
DOI:
10.1093/europace/euae001
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2024
detail.hit.zdb_id:
2002579-8
