Elimination of Ventricular Arrhythmia in Catecholaminergic Polymorphic Ventricular Tachycardia by Targeting “Catecholamine‐Sensitive Area”: A Dominant‐Subordinate Relationship between Origin Sites of Bidirectional Ventricular Premature Contractions
We report on a patient diagnosed with catechoaminergic polymorphic ventricular tachycardia (CPVT) who underwent catheter ablation of ventricular premature contractions (VPCs) induced by epinephrine. VPCs were classified roughly into three types. Type 1 and Type 2 VPCs (right bundle branch block [RBB...
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| Veröffentlicht in: | Pacing and clinical electrophysiology 2017-05, Vol.40 (5), p.600-604 |
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| creator | SHIRAI, YASUHIRO GOYA, MASAHIKO OHNO, SEIKO HORIE, MINORU DOI, SHOZABURO ISOBE, MITSUAKI HIRAO, KENZO |
| description | We report on a patient diagnosed with catechoaminergic polymorphic ventricular tachycardia (CPVT) who underwent catheter ablation of ventricular premature contractions (VPCs) induced by epinephrine. VPCs were classified roughly into three types. Type 1 and Type 2 VPCs (right bundle branch block [RBBB] configuration and inferior axis) were eliminated by radiofrequency applications at the left aortic sinus of Valsalva and the anterolateral papillary muscle (APM), respectively. Although no spontaneous VPCs were seen after the elimination of Type 1 and 2 VPCs, pacing resulting in capture at the APM induced Type 3 VPC (RBBB configuration and superior axis) reproducibly. The electrophysiological findings observed in our representative case have important implications both for understanding the pathophysiology of CPVT and for considering therapeutic strategies. |
| doi_str_mv | 10.1111/pace.13006 |
| format | Article |
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VPCs were classified roughly into three types. Type 1 and Type 2 VPCs (right bundle branch block [RBBB] configuration and inferior axis) were eliminated by radiofrequency applications at the left aortic sinus of Valsalva and the anterolateral papillary muscle (APM), respectively. Although no spontaneous VPCs were seen after the elimination of Type 1 and 2 VPCs, pacing resulting in capture at the APM induced Type 3 VPC (RBBB configuration and superior axis) reproducibly. The electrophysiological findings observed in our representative case have important implications both for understanding the pathophysiology of CPVT and for considering therapeutic strategies.</description><identifier>ISSN: 0147-8389</identifier><identifier>EISSN: 1540-8159</identifier><identifier>DOI: 10.1111/pace.13006</identifier><identifier>PMID: 28012210</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aorta ; Arrhythmia ; bidirectional ventricular premature contraction ; Bundle-Branch Block - complications ; Bundle-Branch Block - diagnosis ; Bundle-Branch Block - surgery ; Cardiac arrhythmia ; catecholaminergic polymorphic ventricular tachycardia ; Catecholamines ; catheter ablation ; Catheter Ablation - methods ; Catheters ; Electrocardiography ; Epinephrine ; Female ; Heart Conduction System - surgery ; Humans ; Sinus ; Subordination ; Tachycardia ; Tachycardia, Ventricular - complications ; Tachycardia, Ventricular - diagnosis ; Tachycardia, Ventricular - surgery ; Treatment Outcome ; Ventricle ; Ventricular Premature Complexes - complications ; Ventricular Premature Complexes - diagnosis ; Ventricular Premature Complexes - surgery</subject><ispartof>Pacing and clinical electrophysiology, 2017-05, Vol.40 (5), p.600-604</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><rights>2017 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4236-d71bd90042fc4292976ae99ea42805cea415c9f675922de168bd255e592f779d3</citedby><cites>FETCH-LOGICAL-c4236-d71bd90042fc4292976ae99ea42805cea415c9f675922de168bd255e592f779d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpace.13006$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpace.13006$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28012210$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SHIRAI, YASUHIRO</creatorcontrib><creatorcontrib>GOYA, MASAHIKO</creatorcontrib><creatorcontrib>OHNO, SEIKO</creatorcontrib><creatorcontrib>HORIE, MINORU</creatorcontrib><creatorcontrib>DOI, SHOZABURO</creatorcontrib><creatorcontrib>ISOBE, MITSUAKI</creatorcontrib><creatorcontrib>HIRAO, KENZO</creatorcontrib><title>Elimination of Ventricular Arrhythmia in Catecholaminergic Polymorphic Ventricular Tachycardia by Targeting “Catecholamine‐Sensitive Area”: A Dominant‐Subordinate Relationship between Origin Sites of Bidirectional Ventricular Premature Contractions</title><title>Pacing and clinical electrophysiology</title><addtitle>Pacing Clin Electrophysiol</addtitle><description>We report on a patient diagnosed with catechoaminergic polymorphic ventricular tachycardia (CPVT) who underwent catheter ablation of ventricular premature contractions (VPCs) induced by epinephrine. VPCs were classified roughly into three types. Type 1 and Type 2 VPCs (right bundle branch block [RBBB] configuration and inferior axis) were eliminated by radiofrequency applications at the left aortic sinus of Valsalva and the anterolateral papillary muscle (APM), respectively. Although no spontaneous VPCs were seen after the elimination of Type 1 and 2 VPCs, pacing resulting in capture at the APM induced Type 3 VPC (RBBB configuration and superior axis) reproducibly. The electrophysiological findings observed in our representative case have important implications both for understanding the pathophysiology of CPVT and for considering therapeutic strategies.</description><subject>Adult</subject><subject>Aorta</subject><subject>Arrhythmia</subject><subject>bidirectional ventricular premature contraction</subject><subject>Bundle-Branch Block - complications</subject><subject>Bundle-Branch Block - diagnosis</subject><subject>Bundle-Branch Block - surgery</subject><subject>Cardiac arrhythmia</subject><subject>catecholaminergic polymorphic ventricular tachycardia</subject><subject>Catecholamines</subject><subject>catheter ablation</subject><subject>Catheter Ablation - methods</subject><subject>Catheters</subject><subject>Electrocardiography</subject><subject>Epinephrine</subject><subject>Female</subject><subject>Heart Conduction System - surgery</subject><subject>Humans</subject><subject>Sinus</subject><subject>Subordination</subject><subject>Tachycardia</subject><subject>Tachycardia, Ventricular - complications</subject><subject>Tachycardia, Ventricular - diagnosis</subject><subject>Tachycardia, Ventricular - surgery</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><subject>Ventricular Premature Complexes - complications</subject><subject>Ventricular Premature Complexes - diagnosis</subject><subject>Ventricular Premature Complexes - surgery</subject><issn>0147-8389</issn><issn>1540-8159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks9u1DAQxgMC0aVw4QGQJS4IaYvtxEnc27Isf6RKXdHCNXKcycZVEi-2Q5XbPgIPAC_XJ2GyWxDlgC_jGf_m82drougZoycM1-ut0nDCYkrT-9GMiYTOcybkg2hGWZLN8ziXR9Fj768oEjQRj6IjnlPGOaOze9GqNZ3pVTC2J7YmX6APzuihVY4snGvG0HRGEdOTpQqgG9sqxMFtjCZr246dddsG93_3XSrdjFq5ChvLEVO3gWD6DbnZ_bijcrP7fgG9N8F8A7wN1M3u5ylZkLd2stSH6XwoLQqhQSCfoN379I3ZkhLCNUBPzp3ZoLsLE8BPD3hjKuNAT5xq79haO-hUGByQpcWq2jP-SfSwVq2Hp7fxOPr8bnW5_DA_O3__cbk4m-uEx-m8ylhZSUoTXmNBcpmlCqQEleBfCo2RCS3rNBOS8wpYmpcVFwIwrbNMVvFx9PKgu3X26wA-FJ3xGtpW9WAHX7Bc8CxP0zhG9MU_6JUdHD4HKcmpEJzyBKlXB0o7672Dutg60yk3FowW01wU01wU-7lA-Pmt5FB2UP1Bfw8CAuwAXJsWxv9IFevFcnUQ_QW3p8xn</recordid><startdate>201705</startdate><enddate>201705</enddate><creator>SHIRAI, YASUHIRO</creator><creator>GOYA, MASAHIKO</creator><creator>OHNO, SEIKO</creator><creator>HORIE, MINORU</creator><creator>DOI, SHOZABURO</creator><creator>ISOBE, MITSUAKI</creator><creator>HIRAO, KENZO</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201705</creationdate><title>Elimination of Ventricular Arrhythmia in Catecholaminergic Polymorphic Ventricular Tachycardia by Targeting “Catecholamine‐Sensitive Area”: A Dominant‐Subordinate Relationship between Origin Sites of Bidirectional Ventricular Premature Contractions</title><author>SHIRAI, YASUHIRO ; 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VPCs were classified roughly into three types. Type 1 and Type 2 VPCs (right bundle branch block [RBBB] configuration and inferior axis) were eliminated by radiofrequency applications at the left aortic sinus of Valsalva and the anterolateral papillary muscle (APM), respectively. Although no spontaneous VPCs were seen after the elimination of Type 1 and 2 VPCs, pacing resulting in capture at the APM induced Type 3 VPC (RBBB configuration and superior axis) reproducibly. The electrophysiological findings observed in our representative case have important implications both for understanding the pathophysiology of CPVT and for considering therapeutic strategies.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28012210</pmid><doi>10.1111/pace.13006</doi><tpages>5</tpages></addata></record> |
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| ispartof | Pacing and clinical electrophysiology, 2017-05, Vol.40 (5), p.600-604 |
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| subjects | Adult Aorta Arrhythmia bidirectional ventricular premature contraction Bundle-Branch Block - complications Bundle-Branch Block - diagnosis Bundle-Branch Block - surgery Cardiac arrhythmia catecholaminergic polymorphic ventricular tachycardia Catecholamines catheter ablation Catheter Ablation - methods Catheters Electrocardiography Epinephrine Female Heart Conduction System - surgery Humans Sinus Subordination Tachycardia Tachycardia, Ventricular - complications Tachycardia, Ventricular - diagnosis Tachycardia, Ventricular - surgery Treatment Outcome Ventricle Ventricular Premature Complexes - complications Ventricular Premature Complexes - diagnosis Ventricular Premature Complexes - surgery |
| title | Elimination of Ventricular Arrhythmia in Catecholaminergic Polymorphic Ventricular Tachycardia by Targeting “Catecholamine‐Sensitive Area”: A Dominant‐Subordinate Relationship between Origin Sites of Bidirectional Ventricular Premature Contractions |
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