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Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve

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Title: Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve
Authors: Yokoshiki, Hisashi Browse this author →KAKEN DB
Mizukami, Kazuya Browse this author
Mitsuyama, Hirofumi Browse this author
Watanabe, Masaya Browse this author
Tenma, Taro Browse this author
Tsutsui, Hiroyuki Browse this author →KAKEN DB
Keywords: Ventricular tachycardia
Pulmonary valve
Catheter ablation
Issue Date: Apr-2016
Publisher: Springer
Journal Title: Heart and vessels
Volume: 31
Issue: 4
Start Page: 599
End Page: 607
Publisher DOI: 10.1007/s00380-015-0653-5
PMID: 25733016
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.
Rights: The final publication is available at
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 横式 尚司

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