Key result
Idiopathic aortic root VAs predominantly originate from the left coronary cusp in ~55% of cases.
Why the study?
Idiopathic ventricular arrhythmias originating from the ostium of the left ventricle may be ablated at the base of the aortic cusps, but their prevalence and electrocardiographic and electrophysiologic characteristics required investigation.
What are the electrocardiographic and electrophysiologic characteristics of idiopathic ventricular arrhythmias originating from the aortic root?
Population
265 patients with idiopathic VAs with an inferior QRS-axis morphology
Design
Observational study
Authors
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“In their series, Yamada and coworkers, evaluating the origin of idiopathic ventricular arrhythmias arising in structurally normal hearts, found that only one (2.3%) out of 265 patients had a focal VA arising from the NCC. The left coronary cusp was far more common (54.5%), and the right coronary cusp was involved in 11.4% of the PVCs found to arise within the aortic root.”
Supports considering aortic cusp sites in inferior-axis idiopathic VAs; leaves open prospective validation of mapping strategies.
Observational (n=265)
What are the electrocardiographic and electrophysiologic characteristics of idiopathic ventricular arrhythmias originating from the aortic root?
Idiopathic ventricular arrhythmias originating from the aortic root most commonly arise from the left coronary cusp and can be differentiated by specific electrocardiographic features.
Yamada et al. (2008) conducted an observational in Idiopathic ventricular arrhythmias (n=265). Aortic root origin of ventricular arrhythmias vs. Other sites of origin was evaluated on Prevalence and electrocardiographic characteristics of aortic root ventricular arrhythmias. Idiopathic ventricular arrhythmias originating from the aortic root occurred in 16.6% of patients and were more common in the left coronary cusp (54.5%) than the right coronary cusp (31.8%).
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