Why the study?
Ventricular arrhythmias with right bundle branch block morphology are uncommonly terminated from the left sinus of Valsalva, and their electrocardiographic and electrophysiologic characteristics required investigation.
What are the electrocardiographic and electrophysiologic characteristics and long-term ablation success rates of ventricular arrhythmias with RBBB morphology originating from the left sinus of Valsalva compared to those with LBBB morphology?
What are the electrocardiographic and electrophysiologic characteristics and long-term ablation success rates of ventricular arrhythmias with RBBB morphology originating from the left sinus of Valsalva compared to those with LBBB morphology?
Ventricular arrhythmias with RBBB morphology and predominant monophasic 'R' waves in precordial leads can be successfully ablated from the nadir of the left sinus of Valsalva, achieving similar long-term success as LBBB VAs.
Answers are grounded in this paper and cite their sources.
May support left SOV ablation for RBBB-morphology VAs; leaves open prospective confirmation of long-term efficacy.
BACKGROUND: While the left sinus of Valsalva (LSV) is a frequent origin of ventricular arrhythmias (VAs). Uncommonly, VAs with right bundle branch block (RBBB) morphology may be successfully terminated from the LSV. OBJECTIVE: We aimed to investigate the electrocardiographic and electrophysiologic characteristics of VAs with RBBB which were successfully eliminated from the LSV. METHODS: We identified patients with VAs successfully ablated from the LSV from January 2014 to December 2017 and compared electrophysiologic characteristics and ablation sites of those VAs with RBBB versus a control group of patients with left bundle branch block morphology. RESULTS: We identified 18 patients with RBBB and predominant "R" waves in the precordial leads. In 12 (66.7%) patients, a small "s" wave in lead V2 and positive "R" in the remaining pericardial leads could be seen. Overall, a single "V" potential was seen in 72.2% of patients in the study group, while discrete potentials were recorded in 80% of the patients in the control group. The majority (88.9%) of the VAs could only be terminated at the nadir of the LSV in the study group. After mean follow-up of 33 ± 14 months, 93.8% and 92% were free of VAs after initial ablation in study and control group, respectively (P = 0.99). CONCLUSION: Some VAs with predominant monophasic "R" wave in precordial leads could be terminated from LSV, especially a small "s" wave in lead V2 was recorded. The nadir of LSV is highly successful for RBBB VAs and single electrogram was recorded at the target for most of the cases.
No takes yet. Share an insight, caveat, or question.
Yang et al. (2019) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: