The tip of the muscle is a dominant location of ventricular ectopy originating from papillary muscles in the left ventricle
Language English Country United States Media print-electronic
Document type Journal Article, Multicenter Study
PubMed
28884872
DOI
10.1111/jce.13338
Knihovny.cz E-resources
- Keywords
- cardiomyopathy, catheter ablation, intracardiac echocardiography, papillary muscle, ventricular premature complex,
- MeSH
- Action Potentials MeSH
- Time Factors MeSH
- Echocardiography MeSH
- Electrophysiologic Techniques, Cardiac MeSH
- Ventricular Function, Left * MeSH
- Catheter Ablation MeSH
- Ventricular Premature Complexes diagnosis physiopathology surgery MeSH
- Middle Aged MeSH
- Humans MeSH
- Papillary Muscles diagnostic imaging physiopathology surgery MeSH
- Aged MeSH
- Heart Rate * MeSH
- Heart Ventricles diagnostic imaging physiopathology surgery MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe MeSH
INTRODUCTION: Frequent ventricular premature complexes (VPCs) may cause symptoms and/or lead to deterioration of LV systolic function. Although frequent VPCs may be abolished by catheter ablation, it may be challenging in case of their origin from the LV papillary muscles (PMs). Our collaborative study aimed to analyze in detail the site of origin and the outcome of ablation. METHODS: Consecutive 34 patients (males: 68%; aged 62 ± 12 years; LV ejection fraction: 50 ± 9%) undergoing catheter ablation of VPCs originating from PMs were included. All procedures were guided by intracardiac echocardiography. RESULTS: The size and shape of PMs were highly variable. The length of anterolateral and posteromedial PM was 23 ± 4 mm and 28 ± 7 mm, respectively. In about one-third of patients, the PM was formed by two distinctly separate heads. The ectopic foci were located on anterolateral, posteromedial or both PM in 35%, 56% and 9% of cases, respectively. Their location was found within the distal, mid, or proximal (basal) third of PM in the 67%, 19%, and 14%, respectively. A total of 86% of PM foci were acutely abolished and long-term success was achieved in 65% of patients. Absence of VPCs of other morphologies and a high burden of ectopic activity before ablation were associated with favorable clinical outcome. CONCLUSION: VPCs originate predominantly from the distal portion of the PM. This knowledge may facilitate the mapping in patients with infrequent ectopic beats. Intracardiac echocardiography is of crucial importance for navigation of the ablation catheter and for assessment of its stability at PM target sites.
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Internal Medicine 1 Cardiology University Hospital Olomouc Olomouc Czech Republic
References provided by Crossref.org
2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias
2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias
2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias
