Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve

Hisashi Yokoshiki, Kazuya Mizukami, Hirofumi Mitsuyama, Masaya Watanabe, Taro Tenma, Hiroyuki Tsutsui

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Panoptic studies of ventricular tachycardia (VT) originating above the pulmonary valve are scarce. The purpose of this study is to clarify the characteristic of idiopathic VT arising above pulmonary valve. We analyzed 15 consecutive patients with idiopathic VT that was successfully abolished by catheter ablation at the right ventricular outflow tract (RVOT-VT, n = 11) and above the pulmonary valve (PA-VT, n = 4). Incidence of syncope was higher in PA-VT than RVOT-VT (100 vs 27 %, P < 0.05) and polymorphic VT was also more prevalent in PA-VT (75 vs 0 %, P < 0.05). The coupling interval (315 ± 29 vs 449 ± 32 ms, mean ± SE) at the onset of VT and minimum cycle length (CL) (192 ± 13 vs 344 ± 37 ms) during VT were shorter in PA-VT (both P < 0.05). Among 12-lead ECG parameters, only R-wave amplitude in lead II was different between groups (2.05 ± 0.17 mV in PA-VT vs 1.44 ± 0.05 mV in RVOT-VT, P < 0.005). At the successful ablation site, the activation time from the onset of QRS complex did not differ between groups (−37 ± 3 vs −31 ± 4, P = 0.405), whereas, the amplitude of intracardiac electrograms was significantly lower in PA-VT (0.83 ± 0.38 mV vs 2.39 ± 0.36 mV, P < 0.05). Although the number of patients in this study is limited, VT originating above the pulmonary valve demonstrated rapid excitation and often degenerated into polymorphic VT, suggesting its malignant electrophysiological characteristics.

Original languageEnglish
Pages (from-to)599-607
Number of pages9
JournalHeart and Vessels
Volume31
Issue number4
DOIs
Publication statusPublished - Apr 1 2016
Externally publishedYes

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Pulmonary Valve
Ventricular Tachycardia
Cardiac Electrophysiologic Techniques
Catheter Ablation

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve. / Yokoshiki, Hisashi; Mizukami, Kazuya; Mitsuyama, Hirofumi; Watanabe, Masaya; Tenma, Taro; Tsutsui, Hiroyuki.

In: Heart and Vessels, Vol. 31, No. 4, 01.04.2016, p. 599-607.

Research output: Contribution to journalArticle

Yokoshiki, Hisashi ; Mizukami, Kazuya ; Mitsuyama, Hirofumi ; Watanabe, Masaya ; Tenma, Taro ; Tsutsui, Hiroyuki. / Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve. In: Heart and Vessels. 2016 ; Vol. 31, No. 4. pp. 599-607.
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abstract = "Panoptic studies of ventricular tachycardia (VT) originating above the pulmonary valve are scarce. The purpose of this study is to clarify the characteristic of idiopathic VT arising above pulmonary valve. We analyzed 15 consecutive patients with idiopathic VT that was successfully abolished by catheter ablation at the right ventricular outflow tract (RVOT-VT, n = 11) and above the pulmonary valve (PA-VT, n = 4). Incidence of syncope was higher in PA-VT than RVOT-VT (100 vs 27 {\%}, P < 0.05) and polymorphic VT was also more prevalent in PA-VT (75 vs 0 {\%}, P < 0.05). The coupling interval (315 ± 29 vs 449 ± 32 ms, mean ± SE) at the onset of VT and minimum cycle length (CL) (192 ± 13 vs 344 ± 37 ms) during VT were shorter in PA-VT (both P < 0.05). Among 12-lead ECG parameters, only R-wave amplitude in lead II was different between groups (2.05 ± 0.17 mV in PA-VT vs 1.44 ± 0.05 mV in RVOT-VT, P < 0.005). At the successful ablation site, the activation time from the onset of QRS complex did not differ between groups (−37 ± 3 vs −31 ± 4, P = 0.405), whereas, the amplitude of intracardiac electrograms was significantly lower in PA-VT (0.83 ± 0.38 mV vs 2.39 ± 0.36 mV, P < 0.05). Although the number of patients in this study is limited, VT originating above the pulmonary valve demonstrated rapid excitation and often degenerated into polymorphic VT, suggesting its malignant electrophysiological characteristics.",
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