Importance of “Initial Upright Component” of Local Bipolar Electrogram in Catheter Ablation of Arrhythmogenic Foci: A Novel Criterion for Success
スポンサーリンク
概要
- 論文の詳細を見る
<B>Background:</B> Optimal ablation site for arrhythmia foci is conventionally determined by localizing the earliest activation site and sites exhibiting QS-pattern with steep downstroke in local unipolar electrogram (LUE). Morphological characteristics of local bipolar electrogram (LBE) recorded from arrhythmogenic foci, however, remain to be elucidated. Initial component of LBE recorded from arrhythmogenic foci theoretically exhibits upright deflection with steep upstroke (R-pattern), because it represents inversed form of LUE from distal electrode (QS-pattern). <B>Methods and Results:</B> This study included 120 cases with focal arrhythmias (AT=48, RVOT-PVC=72) who underwent catheter ablation. LUE and LBE recorded from successful (120 sites) and unsuccessful ablation sites (320 sites) were reviewed in terms of 1) precedence from the onset of surface P/QRS (δ); 2) morphology of initial component of LUE; and 3) morphology of initial component of LBE. Ablation was successful in all cases. δ was significantly larger in successful sites than in unsuccessful sites (31±7 vs 13±10 msec; P<.0001). Incidence of QS-pattern with steep downstroke in LUE was significantly higher in successful sites than in unsuccessful sites (115(96%)/120 sites vs. 38(12%)/320 sites; P<.0001). Incidence of initial upright deflection with steep upstroke (R-pattern) in LBE was also significantly higher in successful sites than in unsuccessful sites (115(96%)/120 sites vs. 54(17%)/320 sites; P<.0001). Sensitivity and specificity of R-pattern in LBE for predicting successful ablation (96% and 83%) were similar to those of δ=/>21 msec (92% and 86%) and QS-pattern in LUE (96% and 88%). <B>Conclusion:</B> Initial upright deflection with steep upstroke in LBE can be another important predictor for successful ablation of arrhythmogenic foci.
著者
-
Iesaka Yoshito
Cardiology Division Cardiovascular Center Tsuchiura Kyodo Hospital
-
Otomo Kiyoshi
Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital Tsuchiura
-
IESAKA Yoshito
Cardiovascular Center, Tsuchiura Kyodo Hospital
-
Takayama Kei
Cardiovascular Center, Tsuchiura Kyodo Hospital
-
Taniguchi Hiroshi
Cardiovascular Center, Tsuchiura Kyodo Hospital
-
Kusa Shigeki
Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital
-
TANIGUCHI Hiroshi
Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital
関連論文
- Electroanatomic Substrate Mapping of the Left Ventricle in Patients with Ventricular Tachycardia Related to Dilated Cardiomyopathy
- Electrophysiological Characteristics of the Left Bundle Branch-Purkinje Systems in Patients with Bundle Branch Reentrant Tachycardia
- Acute Pulmonary Vein Stenosis and Progression of the Narrowing after the Isolation Procedure
- Catheter Ablation of Ventricular Tachycardia Related to Old Myocardial Infarction : Tachycardia Mapping vs. Substrate Mapping
- Electroanatomical Mapping and Catheter Ablation of Breakthroughs from the RA to the SVC in Patients with Atrial Fibrillation
- Clinical Usefulness of I-123 MIBG Imaging to Predict the Genesis of Fatal Arrhythmias in Patients with an Implantable Cardioverter Defibrillator (Nuclear Cardiology 13 (I), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- Novel Method to Search Residual Conduction Gaps Through the Ablation Lines Encircling lpsilateral Pulmonary Veins in Patients with Atrial Fibrillation(Arrhythmia, Non-pharmacological Therapy 10 (A), The 69th Annual Scientific Meeting of the Japanese Circu
- PE-273 Effects of Corticosteroid Therapy on Cardiac Sarcoidosis with Ventricular Tachycardia(Cardiomyopathy, Clinical 2 (M) : PE47)(Poster Session (English))
- Clinical Study of the Efficacy of a Cooled-Tip Catheter Ablation System for Common Atrial Flutter
- PE-022 Low Septal Right Ventricular Outflow Tract Tachycardia Characterzed with Unexpectedly Tall R-wave in Inferior Leads(Arrhythmia, diagnosis/pathophysiology/EPS-6 (A) PE4,Poster Session (English),The 70th Anniversary Annual Scientific Meeting of the J
- OJ-257 Modification of Autonomic Nervous System by Extensive Encircling Pulmonary Vein Isolation in Patients with Paroxysmal Atrial Fibrillation(ECG/Body Surface Potential Mapping/Holter 3 (A) : OJ30)(Oral Presentation (Japanese))
- PE-416 Catheter Ablation Improves Exercise Tolerance in Patients with Chronic Atrial Fibrillation(Exercise test/Cardiac rehabilitation(03)(H),Poster Session(English),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
- PE-023 Catheter ablation of ventricular tachycardia associated with structural heart disease : comparison between ischemic and non-ischemic heart disease(Arrhythmia, therapy(11)(A),Poster Session(English),The 72nd Annual Scientific Meeting of the Japanese
- PE-022 Is catheter ablation of ventricular tachycardia equally effective in patients with severely impaired LV function?(Arrhythmia, therapy(11)(A),Poster Session(English),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
- PE-287 Safety and Efficacy of Radiofrequency Ablation Using 8-mm Tip Catheter Targeting Ventricular Tachycardia Resistant to Ablation Using Conventional 4-mm Tip(Arrhythmia, therapy-13, The 71st Annual Scientific Meeting of the Japanese Circulation Societ
- PE-285 Electroanatimical Map Based Catheter Ablation of Ventricular Tachycardia Associated with Arrythmogenic Right Ventricular Tachycardia and Its Short- and Long-term Results(Arrhythmia, therapy-13, The 71st Annual Scientific Meeting of the Japanese Cir
- PJ-215 Safe Pericardial Puncture When Mapping Epicardial Arrhythmias : Useful ST Elevation Recorded from the Needle as Unipolar Lead(Arrhythmia, therapy-18, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- 0585 SUDDEN PROLONGATION OF FLUTTER CYCLE LENGTH DURING LINEAR CATHETER ABLATION AT INFERIOR VENA CAVA AND TRICUSPID ANNULUS IN COMMON ATRIAL FLUTTER : THE MEANING AND CLINICAL RELEVANCE
- 0114 MORPHOLOGY OF SURFACE ELECTROCARDIOGRAM OF ORTHODROMIC AND ANTIDROMIC COMMON ATRIAL FLUTTER : PREDICTIVITY BY PACING FROM SEPTAL AND LATERAL SIDE OF LINEAR ABLATION LINE AT IVC-TA ISTHMUS
- Radiofrequency Catheter Ablation of Posteroseptal Atrioventricular Accessory Pathways : Location-Specific Electrographic Characteristics of Successful Ablation Sites
- Thrombolytic Therapy can Reduce the Arrhythmogenic Substrate After Acute Myocardial Infarction : A Study Using the Signal-Averaged Electrocardiogram, Endocardial Catheter Mapping and Programmed Ventricular Stimulation
- Radiofrequency Catheter Ablation for Sinoatrial Node Reentrant Tachycardia : Electrophysiologic Features of Ablation Sites
- P660 PREDICTIVE FACTORS OF SUCCESSFUL RADIOFREQUENCY CATHETER ABLATION OF VENTRICULAR TACHYCARDIA POST MYOCARDIAL INFARCTION : SIGNIFICANCE OF EXTENT OF COMMON PATHWAY IN REENTRY CIRCUIT
- P655 ATRIOVENTRICULAR NODE RADIOFREQUENCY ABLATION IN PATIENTS WITH UNCONTROLLABLE SUPRAVENTRICULAR TACHYARRHYTHMIAS : SAFETY AND LONG TERM EFFICACY
- PJ-270 Assessment of Pre-procedual Plaque Distribution in Target Lesions by Multislice Computed Tomography(X-ray/CT/MRI/DSA4 (I) : PJ45)(Poster Session (Japanese))
- PJ-269 Quantitative Evaluation of Coronary Lumen Diameter and Area by Multislice Computed Tomography in Normal Coronary Arteries(X-ray/CT/MRI/DSA4 (I) : PJ45)(Poster Session (Japanese))
- PJ-266 Effects of Stent Diameter and Design on In-stent Lumen Visualization by 16-detector Multislice Computed Tomography(X-ray/CT/MRI/DSA4 (I) : PJ45)(Poster Session (Japanese))
- OJ-379 Noninvasive Assesment of Coronary In-stent Restenosis by 16-slice Computed Tomography(Restenosis after Angioplasty, Basic/Clinical 3 (IHD) : OJ46)(Oral Presentation (Japanese))
- OJ-342 Electrophysiologic and Electroanatomical Characteristics and Catheter Ablation of Left Atrial and Right Atrial Macro-reentrant Tachycardia : Is There Any Difference?(Arrhythmia, Non-Pharmacological Therapy 11 (A) : OJ41)(Oral Presentation (Japanese
- OJ-288 Role of Persistent Left Atrium-Pulmonary Vein Conduction Block after Extensive Isolation Encircling Ipsilateral Pulmonary Veins in Atrial Fibrillation Patients(Arrhythmia, Non-Pharmacological Therapy 10 (A) : OJ34)(Oral Presentation (Japanese))
- OJ-287 Role of Non-Pulmonary Vein Focus on Recurrent Atrial Fibrillation after Pulmonary Vein Isolation(Arrhythmia, Non-Pharmacological Therapy 10 (A) : OJ34)(Oral Presentation (Japanese))
- OJ-165 Coronary Artery Remodeling Evaluated by Multislice Computed Tomography(X-ray/CT/MRI/DSA2 (I) : OJ19)(Oral Presentation (Japanese))
- OJ-164 Detection of Angiographically Silent Stenoses by Multislice Computed Tomography(X-ray/CT/MRI/DSA2 (I) : OJ19)(Oral Presentation (Japanese))
- OE-223 Direct Evidence of Electrical Connections Between Pulmonary Veins Demonstrated by Encircling Isolation of Ipsilateral Pulmonary Veins(Arrhythmia, Diagnosis/Pathophysiology/EPS 10 (A) : OE28)(Oral Presentation (English))
- OE-222 Catheter Ablation of Ventricular Tachycardia Associated with Structural Heart Disease Tachycardia Mapping v.s. Substrate Mapping(Arrhythmia, Non-Pharmacological Therapy 9 (A) : OE27)(Oral Presentation (English))
- Radiofrequence Catheter Ablation : Indication and Trouble-shooting
- Pulmonary Vein Isolation during Atrial Fibrillation-Suppressive Effect of Atrial Fibrillation Development by Catheter Ablation
- Efficacy and Feasibility of Extensive Ablation Encircling Two Ipsilateral Pulmonary Veins in Patients with Paroxysmal Atrial Fibrillation
- Anatomical and Electrophysiological Properties of Left Pulmonary Veins with Common Trunk in Patients with Atrial Fibrillation
- Angiographical Evaluation of Pulmonary Vein Narrowing after Catheter Ablation : Is It Possible to Prevent Stenosis by Radiofrequency Power Limit?
- Usefulness of Intra-Pulmonary Vein Pacing for the Assessment of the Pulmonary Vein-Left Atrium Conduction during Pulmonary Vein Ostial Ablation
- Sustained Tachycardia in Electrically Isolated Pulmonary Vein
- Efficacy of electrical isolation of 3 pulmonary veins in patients with paroxysmal atrial fibrillation
- Bradycardia and hypotension evoked by radiofrequency energy application during pulmonary vein isolation procedure : its prerequisite and clinical implication
- Clinical and Electrophysiological Features of Focal Atrial Tachycardia of Left Atrium Origin without Structural Heart Disease
- Role of solitary pulmonary vein isolation in patients with paroxymal atrial fibrillation associated with common atrial flutter
- Local Electrogram Characteristics Indicative of the Recovery of Conduction Between Pulmonary Vein and Left Atrium After Pulmonary Vein Isolation
- Electrical connections between pulmonary veins during pulmonary vein isolation in patients with paroxysmal atrial fibrillation
- Effect of electrical pulmonary vein isolation on atrial substrate maintaining atrial fibrillation in patients with paroxysmal atrial fibrillation
- Efficacy of pulmonary vein electrical isolation in patients with symptomatic bradycardia-tachycardia syndrome
- Clinical Implication of Presystolic Bipolar Potential for Successful Catheter Ablation of Repetitive Ventricular Tachycardia Originating from the Aortic Sinus Cusp
- High Clinical Success Rate of Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation after Capable Identification of Arrhythmogenic Pulmonary Vein
- Catheter Ablation of Repetitive Ventricular Premature Beat Originating from Left Ventricular Outflow Tract, Inflow Tract, and Left Bundle Fascicle
- Electrocardiographic Characteristics of Ventricular Tachycardia Originating from Pulmonary Artery
- Idiopathic Left Repetitive Ventricular Premature Beats with a Delta Wave-Like Morphology Originating from the Mitral Annulus
- PE-015 The detailed electrocardiographic characteristics of ventricular tachycardia originating from the ventricular outflow tract(Arrhythmia, Diagnosis/Pathophysiology/EPS 1 (A) : PE3)(Poster Session (English))
- OE-276 Clinical Implication of Reconnection between Left Atrium and Isolated Pulmonary Veins Provoked by ATP Post Extensive Encircling Isolation(Arrhythmia, diagnosis/pathophysiology/EPS-2 (A) OE47,Oral Presentation (English),The 70th Anniversary Annual S
- PJ-462 Evaluation of the Esophageal Temperature Using Different Esophageal Thermometers during Left Atrial Ablation for Atrial Fibrillation(Arrhythmia, therapy-16 (A) PJ78,Poster Session (Japanese),The 70th Anniversary Annual Scientific Meeting of the Jap
- OE-216 Role of the Catheter Ablation of Atrial Fibrillation in the Management of Congestive Heart Failure(Arrhythmia, therapy-03, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- PE-221 Electrophysiological Feature in Incidence of Atrial Flutter rotating around the Mitral Annulus after Pulmonary Vein Isolation(Arrhythmia, diagnosis/pathophysiology/EPS-9 (A) PE37,Poster Session (English),The 70th Anniversary Annual Scientific Meeti
- PE-030 Evaluation of Difficult Cases to Achieve Pulmonary Vein Isolation of Atrial Fibrillation(Arrhythmia, diagnosis/pathophysiology/EPS-7 (A) PE5,Poster Session (English),The 70th Anniversary Annual Scientific Meeting of the Japanese Circulation Society
- OJ-400 Assessment of Anatomical Relationship between the Left Atrium and the Esophagus Using 64-Slice Cardiac CT(Arrhythmia, diagnosis/pathophysiology/EPS-5 (A) OJ67,Oral Presentation (Japanese),The 70th Anniversary Annual Scientific Meeting of the Japane
- FRS-036 Cure of Atrial Fibrillation by Extensive Encircling Isolation of Ipsilateral Pulmonary Veins Associated with Aggressive Search for Non-Pulmonary Vein Foci(Arrhythmia-Clinical : Advances in Diagnosis and Management (A) : FRS5)(Featured Research Ses
- FRS-035 Incidence and Ablation Outcome of Non-Pulmonary Vein Ectopies as Triggers of Atrial Fibrillatio(Arrhythmia-Clinical : Advances in Diagnosis and Management (A) : FRS5)(Featured Research Session (English))
- PJ-200 Epicardial Cryothermal Ablation Using Subxyphoidal Centesis Approach : the Efficacy and the Safety of the Methodology.(Arrhythmia, Non-Pharmacological Therapy 7 (A) : PJ34)(Poster Session (Japanese))
- Edrophonium induced right ventricular outflow tract tachycardia
- Remarkable improvement of left ventricular function after catheter ablation of frequent ventricular premature beats originating from right ventricular outflow tract
- The electrocardiographic algorithm to clarify the sites of origin of idiopathic outflow tract ventricular tachycardia
- FRS-033 Comparison of Extensive Encircling Ablation of Ipsilateral Pulmonary Veins with Individual Pulmonary Vein Ablation in Patients with Atrial Fibrillation(Arrhythmia-Clinical : Advances in Diagnosis and Management (A) : FRS5)(Featured Research Sessio
- OJ-341 Potential Reversibility of Structural Remodeling by Maintaining Sinus Rhythm in Patients with Enlarged Left Atrium in Chronic Atrial Fibrillation(Arrhythmia, Non-Pharmacological Therapy 11 (A) : OJ41)(Oral Presentation (Japanese))
- OE-141 Arrhythmogenic Roles of Posterior Junction between Left Atrium and Pulmonary Veins in Persistent Atrial Fibrillation(Arrhythmia, Non-Pharmacological Therapy 8 (A) : OE17)(Oral Presentation (English))
- Evaluation of Anatomical Relationship between Esophagus and Heart Using Esophagram : Implications for Pulmonary Vein Isolation in Atrial Fibrillation Patients(Non-pharmacological Therapy of Arrhythmia (A), The 69th Annual Scientific Meeting of the Japanes
- Clinical Predictor of Atrial Fibrillation Recurrence after Initial Procedure of Extensive Encircling Isolation of Ipsilateral Pulmonary Veins(Clinical Arrhythmias : Pathophysiology and Treatment (A), The 69th Annual Scientific Meeting of the Japanese Circ
- -P261- EVALUATION OF THE PROPRIETY AND THE SAFETY OF VENTRICULAR PROGRAMMED STIMULATION IN PATIENTS WITHOUT APPARENT ORGANIC HEART DISEASE
- -P119- SUPERIORITY OF VENTRICULAR PROGRAMMED STIMULATION FOR THE IDENTIFICATION OF GROUPS AT HIGH RISK OF SUDDEN CARDIAC DEATH IN POST ACUTE MYOCARDIAL INFARCTION PATIENTS : COMPARISON BETWEEN PROGRAMMED VENTRICULAR STIMULATION AND HOLTER MONITORING
- Cure of Atrial Fibrillation by Extensive Encircling Isolation of Ipsilateral Pulmonary Veins Associated with Aggressive Search and Ablation of Extra-foci(Atrial Fibrillation : Innovation of the Therapeutic Strategies, The 69th Annual Scientific Meeting of
- RADIOFREQUENCY CATHETER ABLATION OF ATRIOVENTRICULAR ACCESSORY PATHWAYS IN WOLFF-PARKINSON-WHITE SYNDROME WITH DRUG-REFRACTORY AND SYMPTOMATIC SUPRAVENTRICULAR TACHYCARDIA : Its High Effectivenss Irrespective of Accessory Pathway Location and Properties
- Influence of radiofrequency catheter ablation from the coronary cusps in pigs : The relationship between lesion size and local ventricular electrogram
- Burst atriat pacing during cathter ablation of slow pathway of AVNRT : An effective method to aviod AV block
- PJ-013 Electrocardiographic Characteristics of Idiopathic Ventricular Tachycarrhythmia Originating from The Right Ventricular Inflow Tract(Arrhythmia, Diagnosis/Pathophysiology/EPS 5 (A) : PJ3)(Poster Session (Japanese))
- OJ-003 Catheter Ablation of Repetitive Ventricular Tachyarrhythmia Originating from the Right Ventricular Inflow Tract(Arrhythmia, Non-Pharmacological Therapy 1 (A) : OJ1)(Oral Presentation (Japanese))
- OE-090 Quantitative Assessment of Multislice Computed Tomography(X-ray/CT/MRI/DSA 1 (I) : OE11)(Oral Presentation (English))
- FRS-073 Usefulness of Multislice Computed Tomography for Risk Stratification in Patients With Non-ST-segment Elevation Acute Coronary Syndrome(New Diagnostic Strategies (I) : FRS9)(Featured Research Session (English))
- Efficacy of combination drug therapy with amiodarone and class I antiarrhythmics in comparison with catheter ablation for paroxysmal atrial fibrillation
- High output pacemapping of left ventricular outflow tract around the left fibrous trigone
- Characteristics of induction pattern of ventricular fibrillation in patients with Brugada syndrome and idiopathic ventricular fibrillation
- Algorithm to predict the focus by P wave configuration during atrial tachycardia
- Idiopathic left ventricular outflow tract tachyarrhythmia originating from the aortic sinus or the mitral annulus
- Reduction of mitral regurgitation by His-bundle pacing or right ventricular outflow septal pacing in comparison with right ventricular apical pacing
- Radiofrequency catheter ablation from the left coronary cusp for idiopathic ventricular tachycardia originating from left ventricular outflow tract
- Electrical activities of isolated pulmonary veins in paroxysmal atrial fibrillation patients
- OE-140 Persistent Atrial Fibrillation Can Be an Indication for Pulmonary Vein Isolation?(Arrhythmia, Non-Pharmacological Therapy 8 (A) : OE17)(Oral Presentation (English))
- OJ-097 Assessment of Pulmonary Vein Stenosis/Narrowing After Extensive Encircling Isolation of Ipsilateral Pulmonary Veins by Multi-slice Computed Tomography(Arrhythmia, Diagnosis/Pathophysiology/EPS 7 (A) : OJ12)(Oral Presentation (Japanese))
- OJ-005 Significance of presytolic bipolar potential for successful catheter ablation of ventricular tachycardia originating from the aortic sinus cusp(Arrhythmia, Non-Pharmacological Therapy 1 (A) : OJ1)(Oral Presentation (Japanese))
- OJ-004 Morphological evaluation of idiopathic left ventricular tachyarrhythmia from anterior aspects of mitral annulus compared with those from aortic sinus cusps(Arrhythmia, Non-Pharmacological Therapy 1 (A) : OJ1)(Oral Presentation (Japanese))
- OE-219 Evaluation of Clinical Predictor in Atrial Fibrillation Recurrence after Initial Procedure of Extensive Isolation Encircling Ipsilateral Pulmonary Veins(Arrhythmia, Non-Pharmacological Therapy 9 (A) : OE27)(Oral Presentation (English))
- OE-179 Benefits of Nocturnal Home Oxygen Therapy in Patients with Congestive Heart Failure(Heart Failure, Clinical 1 (M) : OE22)(Oral Presentation (English))
- Ostial Pulmonary Vein Isolation of Atrial Fibrillation : Is the 8 mm Tip Electrode Superior to the 4 mm Tip Electrode?
- Prevention of Awake Shock : Utility of Awake Ventricular Fibrillation Induction in Patients with Implantable Cardioverter-Defibrillator
- Clinical Implication of the Local Electrogram of Ventricular Tachycardia Originating from Pulmonary Artery