|
|
||||||||||
|
J Am Coll Cardiol, 2005; 45:877-886, doi:10.1016/j.jacc.2004.12.025 © 2005 by the American College of Cardiology Foundation |





* Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan
Division of Cardiology, Kanazawa Cardiovascular Hospital, Kanazawa, Japan
Fukui Chuo Clinic, Fukui, Japan
Division of Cardiology, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
Manuscript received July 15, 2004; revised manuscript received October 20, 2004, accepted December 6, 2004.
* Reprint requests and correspondence: Dr. Hiroshi Tada, Division of Cardiology, Gunma Prefectural Cardiovascular Center, 3-12 Kameizumi, Maebashi, Gunma 371-0004, Japan (Email: tada.h{at}cvc.pref.gunma.jp).
OBJECTIVES: We sought to clarify the prevalence and characteristics of idiopathic ventricular tachycardia or premature ventricular contraction originating from the mitral annulus (MAVT/PVC).
BACKGROUND: Recent case reports have presented patients with MAVT/PVC.
METHODS: Electrocardiographic (ECG) characteristics and the results of electrophysiologic investigation and radiofrequency catheter ablation (RFCA) were analyzed in 352 patients with symptomatic idiopathic ventricular tachycardia (IVT)/premature ventricular contraction (PVC).
RESULTS: Nineteen cases of IVT/PVC (5%) represented MAVT/PVC. Of these, 11 (58%) originated from the anterolateral portion of the mitral annulus (AL-MAVT/PVC), and 2 (11%) arose from the posterior portion (Pos-MAVT/PVC). The remaining six cases of MAVT/PVC (31%) had posteroseptal origin (PS-MAVT/PVC). In all patients, an S-wave was present in lead V6. The QRS polarity in inferior leads and leads I and aVL was useful for differentiating AL-MAVT/PVC from Pos-MAVT/PVC or PS-MAVT/PVC. The Pos-MAVT/PVC had an Rs pattern in lead I and an R pattern in lead V1, whereas PS-MAVT/PVC invariably had an R pattern in lead I and a negative QRS component in lead V1. The AL-MAVT/PVC and Pos-MAVT/PVC showed a longer QRS duration than the PS-MAVT/PVC (p < 0.001), and all had late-phase "notching" of the QRS complex in inferior leads. In all patients, RFCA eliminated MAVT/PVC, with no recurrences during follow-up for 21 ± 15 months.
CONCLUSIONS: Mitral annular VT/PVC is a rare but distinct subgroup of IVT/PVC. MAVT/PVC origin could be determined by ECG analysis. The AL and PS sites of the MA were preferential.
| ||||||||||||||
This article has been cited by other articles:
![]() |
K. Van Beeumen, F. Ouyang, R. Tavernier, W. De Caluwe, and M. Duytschaever Ablation of an idiopathic left ventricular tachycardia originating from the posterior mitral annulus in a toddler Europace, August 1, 2008; 10(8): 1015 - 1017. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Doppalapudi, T. Yamada, H. T. McElderry, V. J. Plumb, A. E. Epstein, and G. N. Kay Ventricular Tachycardia Originating From the Posterior Papillary Muscle in the Left Ventricle: A Distinct Clinical Syndrome Circ Arrhythmia Electrophysiol, April 1, 2008; 1(1): 23 - 29. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. G. Stevenson and K. Soejima Catheter Ablation for Ventricular Tachycardia Circulation, May 29, 2007; 115(21): 2750 - 2760. [Full Text] [PDF] |
||||
![]() |
Catheter Ablation for More Than One Type of Idiopathic VT Journal Watch Cardiology, April 29, 2005; 2005(429): 4 - 4. [Full Text] |
||||
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |