Key result
Isolated diastolic potentials were recorded in 100% of patients with RVOT-IVAs compared to 10% of control subjects, and were located in the vicinity of successful ablation sites.
Why the study?
Do isolated diastolic potentials (IDPs) characterize successful ablation sites in patients with idiopathic ventricular arrhythmias arising from the right ventricular outflow tract?
Case-Control (n=35)
Do isolated diastolic potentials (IDPs) characterize successful ablation sites in patients with idiopathic ventricular arrhythmias arising from the right ventricular outflow tract?
Answers are grounded in this paper and cite their sources.
Isolated diastolic potentials are consistently found near successful ablation sites in patients with RVOT-IVAs, suggesting they may help guide ablation therapy.
OBJECTIVE: The significance of isolated diastolic potentials (IDPs) in patients with idiopathic ventricular arrhythmias (IVAs) arising from right ventricular outflow tract (RVOT) is currently unknown. The objective of this study was to clarify the characteristics of IDPs and its role in guiding ablation in RVOT-IVAs. METHODS AND RESULTS: Twenty-five consecutive patients with RVOT-IVAs and ten control subjects were studied. Electro-anatomical mapping was performed in RVOT during sinus rhythm. The electrophysiological characteristics of IDPs and its relation to successful ablation site were evaluated. Successful ablation was achieved during IVAs in 22 patients and during sinus rhythm in the remaining three. IDPs were recorded in all patients in the vicinity of successful ablation sites during sinus rhythm before ablation, with the area of 1.44 /- 0.28 cm2, maximal amplitude of 0.32 +/- 0.06 mV and the distance to pulmonary valve of 1.39 +/- 0.25 cm. IDPs could still be recorded after ablation except one. Moreover, IDPs were characterized by decremental and/or automatic property by studying intervals between ventricular activation and IDPs (V-IDPs) during sinus rhythm. And V-IDPs intervals during sinus rhythm were longerthan those during IVAs (P = 0.012). However, IDPs were only recorded in one patient in the control group and the incidence of IDPs was remarkably lower than that in the RVOT-IVAs group (1/10 vs. 25/25, P < 0.001). CONCLUSIONS: IDPs were present in patients with RVOT-IVAs. IDPs area and/or border region might be the successful ablation site and their precise mechanism remains to be clarified.
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Liu et al. (2014) conducted a case-control in Idiopathic ventricular arrhythmias arising from right ventricular outflow tract (RVOT-IVAs) (n=35). Idiopathic ventricular arrhythmias arising from the right ventricular outflow tract vs. Control subjects was evaluated on Incidence of isolated diastolic potentials (IDPs) (p=< 0.001). Isolated diastolic potentials were recorded in 100% of patients with RVOT-IVAs compared to 10% of control subjects, and were located in the vicinity of successful ablation sites.
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