Electrophysiological characteristics and radiofrequency catheter ablation treatment of idiopathic ventricular arrhythmias successfully ablated from the ostium of the coronary sinus

Yoshiaki Yui, Yukio Sekiguchi, Akihiko Nogami, Hiro Yamasaki, Takeshi Machino, Kenji Kuroki, Miyako Igarashi, Kazutaka Aonuma

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10 Scopus citations

Abstract

Background: Idiopathic ventricular arrhythmias (VAs) rarely arise from the epicardium at the crux of the heart. However, the electrophysiological characteristics of VAs successfully ablated from the ostium of the coronary sinus (CSO) have not yet been documented. Methods and Results: Electrocardiographic and electrophysiological data were analyzed in patients with idiopathic VAs successfully ablated from the CSO. Among 309 patients with idiopathic VAs treated with radiofrequency catheter ablation (RFCA), 6 (1.94%; 3 men; age: 66.3±9.7 years) had VAs successfully ablated from the CSO. Only 1 patient had sustained ventricular tachycardia. The morphology of the QRS showed a left superior axis and QS pattern in leads III and aVF. Furthermore, the precordial maximum deflection index was >0.55 in all patients and a right bundle branch block pattern was recorded in 5 of 6 patients. All VAs were successfully eliminated by RFCA within the CSO. Intracardiac ECGs at sites where VAs were eliminated by RFCA showed clear atrial and ventricular potentials (atrial amplitude: 0.21±0.11 mV; ventricular amplitude: 0.43±0.24 mV), except in 1 case of atrial fibrillation. No patients had recurrence during the 3.4±1.8-year follow-up period. Conclusions: The idiopathic VAs in our study were eliminated by RFCA within the CS, where a clear atrial amplitude was recorded.

Original languageEnglish
Pages (from-to)1807-1815
Number of pages9
JournalCirculation Journal
Volume81
Issue number12
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • Catheter ablation
  • Coronary sinus
  • Electrophysiology
  • Ventricular arrhythmias

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