Mapping and Ablation of Ventricular Fibrillation Associated With Long-QT and Brugada Syndromes
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- Michel Haïssaguerre
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Fabrice Extramiana
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Mélèze Hocini
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Bruno Cauchemez
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Pierre Jaïs
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Jose Angel Cabrera
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Geronimo Farre
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Antoine Leenhardt
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Prashanthan Sanders
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Christophe Scavée
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Li-Fern Hsu
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Rukshen Weerasooriya
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Dipen C. Shah
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Robert Frank
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Philippe Maury
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Marc Delay
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Stéphane Garrigue
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
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- Jacques Clémenty
- From the Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
Abstract
<jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> The long-QT and Brugada syndromes are important substrates of malignant ventricular arrhythmia. The feasibility of mapping and ablation of ventricular arrhythmias in these conditions has not been reported. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> Seven patients (4 men; age, 38±7 years; 4 with long-QT and 3 with Brugada syndrome) with episodes of ventricular fibrillation or polymorphic ventricular tachycardia and frequent isolated or repetitive premature beats were studied. These premature beats were observed to trigger ventricular arrhythmias and were localized by mapping the earliest endocardial activity. In 4 patients, premature beats originated from the peripheral right (1 Brugada) or left (3 long-QT) Purkinje conducting system and were associated with variable Purkinje-to-muscle conduction times (30 to 110 ms). In the remaining 3 patients, premature beats originated from the right ventricular outflow tract, being 25 to 40 ms ahead of the QRS. The accuracy of mapping was confirmed by acute elimination of premature beats after 12±6 minutes of radiofrequency applications. During a follow-up of 17±17 months using ambulatory monitoring and defibrillator memory interrogation, no patients had recurrence of symptomatic ventricular arrhythmia but 1 had persistent premature beats. </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusion—</jats:italic> </jats:bold> Triggers from the Purkinje arborization or the right ventricular outflow tract have a crucial role in initiating ventricular fibrillation associated with the long-QT and Brugada syndromes. These can be eliminated by focal radiofrequency ablation. </jats:p>
Journal
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- Circulation
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Circulation 108 (8), 925-928, 2003-08-26
Ovid Technologies (Wolters Kluwer Health)
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Details 詳細情報について
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- CRID
- 1362825895153357568
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- NII Article ID
- 30022668960
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- ISSN
- 15244539
- 00097322
- http://id.crossref.org/issn/00097322
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- Data Source
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- Crossref
- CiNii Articles