Utility of high resolution mapping to guide ablation of ventricular arrhythmias from the aortic sinuses of Valsalva
Purpose Left ventricular outflow tract (LVOT) arrhythmias are commonly targeted from the aortic sinuses of Valsalva (SOV). Both presystolic potentials during ventricular arrhythmia (VA) and late diastolic potentials during sinus rhythm have been recognized as markers of successful ablation sites. Th...
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Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2023-01, Vol.66 (1), p.51-59 |
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creator | Matto, Faisal Venugopal, Dev Bhave, Prashant D. Rhodes, Troy E. Mazur, Alexander |
description | Purpose
Left ventricular outflow tract (LVOT) arrhythmias are commonly targeted from the aortic sinuses of Valsalva (SOV). Both presystolic potentials during ventricular arrhythmia (VA) and late diastolic potentials during sinus rhythm have been recognized as markers of successful ablation sites. The study aimed to evaluate the utility of high resolution mapping (HRM) with small and closely spaced electrodes for guiding ablation of VA from the SOV.
Methods
Seventeen patients with LVOT VA underwent HRM in the SOV with either PentaRay (13) or Orion (4) catheters. Ablation was guided by low amplitude high frequency potentials that were identified with HRM and tagged on the electroanatomic map.
Results
High frequency low amplitude potentials during sinus rhythm (late) or VA (early) were demonstrated with HRM in all 17 consecutive patients; while these potentials were either absent or usually had a far-field appearance in the recordings obtained at the same sites with a 3.5-mm standard ablation catheter. On intracardiac echocardiogram, sites with these potentials corresponded to the bases of the sinuses adjacent to the LV ostium. Ablation was acutely successful in 16 out of 17 patients. Significant reduction in VA burden (≥ 90%) was noted in 15 patients.
Conclusions
High frequency low amplitude potentials during sinus rhythm (late) and VA (early) are consistently recorded using HRM in the SOV in patients with VA arising from the aortic sinuses of Valsalva. Standard ablation catheters have limited resolution for detecting these potentials. HRM may potentially improve outcomes of ablation of VA originating from the aortic SOV. |
doi_str_mv | 10.1007/s10840-021-01040-9 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2559427990</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2776876834</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-749fb22d48faacf34183dbd20b7ca1156c1bab26741ab1dfa4ef051ff60fffc73</originalsourceid><addsrcrecordid>eNp9kUFr3DAQhUVJaJJt_0APRdBLLm5GsmXZxxLaNBDoJZurGMvSWsG2NpIc2H8fJbttQw4BgR7M994IPUK-MPjOAORFZNBUUABnBTDIqv1ATpmQvGhEK45e6RNyFuM9ALTA64_kpKzKuhS1PCVxndzo0o56Swe3GWgw0Y9Lcn6mE263bt7Q5Olmcb2h2I34Msnwo5lTcHoZMVAMYdilYXIYqQ1-omnIsA_JaRrdvEQTny13OEYcH_ETObZZms-He0XWv37eXv4ubv5cXV_-uCl0KUUqZNXajvO-aiyitmXFmrLveg6d1MiYqDXrsOO1rBh2rLdYGQuCWVuDtVbLckXO97nb4B8WE5OaXNRmHHE2fomKC9FWXLYtZPTbG_TeL2HOr1NcyrrJJ__ZivA9pYOPMRirtsFNGHaKgXquRO0rUbkS9VKJarPp6yF66SbT_7P87SAD5R6IeTRvTPi_-53YJ-NxmTM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2776876834</pqid></control><display><type>article</type><title>Utility of high resolution mapping to guide ablation of ventricular arrhythmias from the aortic sinuses of Valsalva</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Matto, Faisal ; Venugopal, Dev ; Bhave, Prashant D. ; Rhodes, Troy E. ; Mazur, Alexander</creator><creatorcontrib>Matto, Faisal ; Venugopal, Dev ; Bhave, Prashant D. ; Rhodes, Troy E. ; Mazur, Alexander</creatorcontrib><description>Purpose
Left ventricular outflow tract (LVOT) arrhythmias are commonly targeted from the aortic sinuses of Valsalva (SOV). Both presystolic potentials during ventricular arrhythmia (VA) and late diastolic potentials during sinus rhythm have been recognized as markers of successful ablation sites. The study aimed to evaluate the utility of high resolution mapping (HRM) with small and closely spaced electrodes for guiding ablation of VA from the SOV.
Methods
Seventeen patients with LVOT VA underwent HRM in the SOV with either PentaRay (13) or Orion (4) catheters. Ablation was guided by low amplitude high frequency potentials that were identified with HRM and tagged on the electroanatomic map.
Results
High frequency low amplitude potentials during sinus rhythm (late) or VA (early) were demonstrated with HRM in all 17 consecutive patients; while these potentials were either absent or usually had a far-field appearance in the recordings obtained at the same sites with a 3.5-mm standard ablation catheter. On intracardiac echocardiogram, sites with these potentials corresponded to the bases of the sinuses adjacent to the LV ostium. Ablation was acutely successful in 16 out of 17 patients. Significant reduction in VA burden (≥ 90%) was noted in 15 patients.
Conclusions
High frequency low amplitude potentials during sinus rhythm (late) and VA (early) are consistently recorded using HRM in the SOV in patients with VA arising from the aortic sinuses of Valsalva. Standard ablation catheters have limited resolution for detecting these potentials. HRM may potentially improve outcomes of ablation of VA originating from the aortic SOV.</description><identifier>ISSN: 1572-8595</identifier><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-021-01040-9</identifier><identifier>PMID: 34363567</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Ablation ; Amplitudes ; Aorta ; Aorta - surgery ; Arrhythmia ; Arrhythmias, Cardiac - surgery ; Cardiac arrhythmia ; Cardiology ; Catheter Ablation ; Catheters ; Echocardiography ; Electrocardiography ; Heart ; Heart Ventricles - surgery ; High frequencies ; High resolution ; Humans ; Mapping ; Medical instruments ; Medicine ; Medicine & Public Health ; Rhythm ; Sinus of Valsalva - diagnostic imaging ; Sinus of Valsalva - surgery ; Sinuses ; Tachycardia, Ventricular - diagnostic imaging ; Tachycardia, Ventricular - surgery ; Treatment Outcome ; Ventricle ; Ventricular Premature Complexes - surgery</subject><ispartof>Journal of interventional cardiac electrophysiology, 2023-01, Vol.66 (1), p.51-59</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2021</rights><rights>2021. Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-749fb22d48faacf34183dbd20b7ca1156c1bab26741ab1dfa4ef051ff60fffc73</citedby><cites>FETCH-LOGICAL-c375t-749fb22d48faacf34183dbd20b7ca1156c1bab26741ab1dfa4ef051ff60fffc73</cites><orcidid>0000-0003-4345-0071</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10840-021-01040-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-021-01040-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34363567$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Matto, Faisal</creatorcontrib><creatorcontrib>Venugopal, Dev</creatorcontrib><creatorcontrib>Bhave, Prashant D.</creatorcontrib><creatorcontrib>Rhodes, Troy E.</creatorcontrib><creatorcontrib>Mazur, Alexander</creatorcontrib><title>Utility of high resolution mapping to guide ablation of ventricular arrhythmias from the aortic sinuses of Valsalva</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><addtitle>J Interv Card Electrophysiol</addtitle><description>Purpose
Left ventricular outflow tract (LVOT) arrhythmias are commonly targeted from the aortic sinuses of Valsalva (SOV). Both presystolic potentials during ventricular arrhythmia (VA) and late diastolic potentials during sinus rhythm have been recognized as markers of successful ablation sites. The study aimed to evaluate the utility of high resolution mapping (HRM) with small and closely spaced electrodes for guiding ablation of VA from the SOV.
Methods
Seventeen patients with LVOT VA underwent HRM in the SOV with either PentaRay (13) or Orion (4) catheters. Ablation was guided by low amplitude high frequency potentials that were identified with HRM and tagged on the electroanatomic map.
Results
High frequency low amplitude potentials during sinus rhythm (late) or VA (early) were demonstrated with HRM in all 17 consecutive patients; while these potentials were either absent or usually had a far-field appearance in the recordings obtained at the same sites with a 3.5-mm standard ablation catheter. On intracardiac echocardiogram, sites with these potentials corresponded to the bases of the sinuses adjacent to the LV ostium. Ablation was acutely successful in 16 out of 17 patients. Significant reduction in VA burden (≥ 90%) was noted in 15 patients.
Conclusions
High frequency low amplitude potentials during sinus rhythm (late) and VA (early) are consistently recorded using HRM in the SOV in patients with VA arising from the aortic sinuses of Valsalva. Standard ablation catheters have limited resolution for detecting these potentials. HRM may potentially improve outcomes of ablation of VA originating from the aortic SOV.</description><subject>Ablation</subject><subject>Amplitudes</subject><subject>Aorta</subject><subject>Aorta - surgery</subject><subject>Arrhythmia</subject><subject>Arrhythmias, Cardiac - surgery</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Catheter Ablation</subject><subject>Catheters</subject><subject>Echocardiography</subject><subject>Electrocardiography</subject><subject>Heart</subject><subject>Heart Ventricles - surgery</subject><subject>High frequencies</subject><subject>High resolution</subject><subject>Humans</subject><subject>Mapping</subject><subject>Medical instruments</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Rhythm</subject><subject>Sinus of Valsalva - diagnostic imaging</subject><subject>Sinus of Valsalva - surgery</subject><subject>Sinuses</subject><subject>Tachycardia, Ventricular - diagnostic imaging</subject><subject>Tachycardia, Ventricular - surgery</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><subject>Ventricular Premature Complexes - surgery</subject><issn>1572-8595</issn><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUFr3DAQhUVJaJJt_0APRdBLLm5GsmXZxxLaNBDoJZurGMvSWsG2NpIc2H8fJbttQw4BgR7M994IPUK-MPjOAORFZNBUUABnBTDIqv1ATpmQvGhEK45e6RNyFuM9ALTA64_kpKzKuhS1PCVxndzo0o56Swe3GWgw0Y9Lcn6mE263bt7Q5Olmcb2h2I34Msnwo5lTcHoZMVAMYdilYXIYqQ1-omnIsA_JaRrdvEQTny13OEYcH_ETObZZms-He0XWv37eXv4ubv5cXV_-uCl0KUUqZNXajvO-aiyitmXFmrLveg6d1MiYqDXrsOO1rBh2rLdYGQuCWVuDtVbLckXO97nb4B8WE5OaXNRmHHE2fomKC9FWXLYtZPTbG_TeL2HOr1NcyrrJJ__ZivA9pYOPMRirtsFNGHaKgXquRO0rUbkS9VKJarPp6yF66SbT_7P87SAD5R6IeTRvTPi_-53YJ-NxmTM</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Matto, Faisal</creator><creator>Venugopal, Dev</creator><creator>Bhave, Prashant D.</creator><creator>Rhodes, Troy E.</creator><creator>Mazur, Alexander</creator><general>Springer US</general><general>Springer Nature B.V</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>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4345-0071</orcidid></search><sort><creationdate>20230101</creationdate><title>Utility of high resolution mapping to guide ablation of ventricular arrhythmias from the aortic sinuses of Valsalva</title><author>Matto, Faisal ; Venugopal, Dev ; Bhave, Prashant D. ; Rhodes, Troy E. ; Mazur, Alexander</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-749fb22d48faacf34183dbd20b7ca1156c1bab26741ab1dfa4ef051ff60fffc73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ablation</topic><topic>Amplitudes</topic><topic>Aorta</topic><topic>Aorta - surgery</topic><topic>Arrhythmia</topic><topic>Arrhythmias, Cardiac - surgery</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Catheter Ablation</topic><topic>Catheters</topic><topic>Echocardiography</topic><topic>Electrocardiography</topic><topic>Heart</topic><topic>Heart Ventricles - surgery</topic><topic>High frequencies</topic><topic>High resolution</topic><topic>Humans</topic><topic>Mapping</topic><topic>Medical instruments</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Rhythm</topic><topic>Sinus of Valsalva - diagnostic imaging</topic><topic>Sinus of Valsalva - surgery</topic><topic>Sinuses</topic><topic>Tachycardia, Ventricular - diagnostic imaging</topic><topic>Tachycardia, Ventricular - surgery</topic><topic>Treatment Outcome</topic><topic>Ventricle</topic><topic>Ventricular Premature Complexes - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matto, Faisal</creatorcontrib><creatorcontrib>Venugopal, Dev</creatorcontrib><creatorcontrib>Bhave, Prashant D.</creatorcontrib><creatorcontrib>Rhodes, Troy E.</creatorcontrib><creatorcontrib>Mazur, Alexander</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matto, Faisal</au><au>Venugopal, Dev</au><au>Bhave, Prashant D.</au><au>Rhodes, Troy E.</au><au>Mazur, Alexander</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility of high resolution mapping to guide ablation of ventricular arrhythmias from the aortic sinuses of Valsalva</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>66</volume><issue>1</issue><spage>51</spage><epage>59</epage><pages>51-59</pages><issn>1572-8595</issn><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract>Purpose
Left ventricular outflow tract (LVOT) arrhythmias are commonly targeted from the aortic sinuses of Valsalva (SOV). Both presystolic potentials during ventricular arrhythmia (VA) and late diastolic potentials during sinus rhythm have been recognized as markers of successful ablation sites. The study aimed to evaluate the utility of high resolution mapping (HRM) with small and closely spaced electrodes for guiding ablation of VA from the SOV.
Methods
Seventeen patients with LVOT VA underwent HRM in the SOV with either PentaRay (13) or Orion (4) catheters. Ablation was guided by low amplitude high frequency potentials that were identified with HRM and tagged on the electroanatomic map.
Results
High frequency low amplitude potentials during sinus rhythm (late) or VA (early) were demonstrated with HRM in all 17 consecutive patients; while these potentials were either absent or usually had a far-field appearance in the recordings obtained at the same sites with a 3.5-mm standard ablation catheter. On intracardiac echocardiogram, sites with these potentials corresponded to the bases of the sinuses adjacent to the LV ostium. Ablation was acutely successful in 16 out of 17 patients. Significant reduction in VA burden (≥ 90%) was noted in 15 patients.
Conclusions
High frequency low amplitude potentials during sinus rhythm (late) and VA (early) are consistently recorded using HRM in the SOV in patients with VA arising from the aortic sinuses of Valsalva. Standard ablation catheters have limited resolution for detecting these potentials. HRM may potentially improve outcomes of ablation of VA originating from the aortic SOV.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>34363567</pmid><doi>10.1007/s10840-021-01040-9</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4345-0071</orcidid></addata></record> |
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source | MEDLINE; SpringerNature Journals |
subjects | Ablation Amplitudes Aorta Aorta - surgery Arrhythmia Arrhythmias, Cardiac - surgery Cardiac arrhythmia Cardiology Catheter Ablation Catheters Echocardiography Electrocardiography Heart Heart Ventricles - surgery High frequencies High resolution Humans Mapping Medical instruments Medicine Medicine & Public Health Rhythm Sinus of Valsalva - diagnostic imaging Sinus of Valsalva - surgery Sinuses Tachycardia, Ventricular - diagnostic imaging Tachycardia, Ventricular - surgery Treatment Outcome Ventricle Ventricular Premature Complexes - surgery |
title | Utility of high resolution mapping to guide ablation of ventricular arrhythmias from the aortic sinuses of Valsalva |
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