Is Moderator Band Originating from the Right Ventricular Outflow an Arrhythmogenic Substrate for Idiopathic Ventricular Tachyarrhythmias?
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概要
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<B>Introduction:</B> It remains controversial whether moderator band (MB) originating from right ventricular outflow tract (RVOT) might be an arrhythmogenic substrate of idiopathic ventricular tachyarrhythmias originating in the RVOT (RVOT-VAs). <B>Methods:</B> We enrolled 17 patients (52.7±15.7 year-old, 5 men) with RVOT-VAs who underwent contrast-mediated multidetector computed tomography (MDCT) followed by successful ablation using CARTO X-P, and examined an anatomical relationship between the successful ablation site (the origin of RVOT-VAs) and the location of MB. <B>Results:</B> The successful ablation was obtained at anterior/lateral/posterior free wall and anterior/middle/posterior septum in 1/1/3/2/8/2 patients, respectively. The distance calipering between pulmonary valve annulus and the origin ranged between －10 and 18 mm (4.8±7.3). MB bridging the anterior and/or posterior attachment of RVOT was observed. In 14 patients, but was away from the origin except 3 patients. Presystolic potential preceding the onset of VAs was detected in 5 patients (free wall in 1 patient and septum in 4 patients) who had no MB near the origin. <B>Conclusion:</B> MB is commonly located in anterior and posterior attachment below the origin of RVOT-VAs, and does not appear to be an arrhythmogenic substrate for RVOT-VAs in most patients. The presence of presystolic potential on VAs is not indicative of MB as the origin.
著者
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Ota Masaki
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine
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Iijima Takafumi
Department Of Medicine And Biological Science Gunma University Graduate School Of Medicine
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Tamura Mio
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Japan
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Kato Toshimitsu
Department Of Medicine And Biological Science Gunma University Graduate School Of Medicine
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Kaneko Yoshiaki
Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical College
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Nakahara Takehiro
Department Of Medicine And Biological Science Gunma University Graduate School Of Medicine
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Kurabayashi Masahiko
Department Of Cardiology Kanazawa Medical University
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Nakajima Tadashi
Department Of Applied Biology Faculty Of Textile Science And Technology Shinshu University
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Kobayashi Hiroaki
Department Of Applied Chemistry School Of Engineering The University Of Tokyo
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Nakahara Takehiro
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine
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Tamura Mio
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine
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Kato Toshimitsu
Department of Medicine and Biological Medicine, Gunma University Graduate School of Medicine, Japan
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