Anatomical vs. electrophysiological approach for ablation of premature ventricular contractions originating from the left ventricular summit (ISESHIMA-SUMMIT Study)
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Le résumé fourni par la source
AIMS: Catheter ablation (CA) of idiopathic ventricular arrhythmias (VAs) from the epicardial left ventricular summit is challenging. The endocardial approach targets two sites: the endocardial closest site (ECS) to the epicardial earliest activation site (epi-EAS) and the endocardial earliest activation site (endo-EAS). We aimed to differentiate between cases where CA at the ECS was effective and where CA at the endo-EAS yielded success. METHODS AND RESULTS: Fifty-eight patients (47 men; age 60 ± 13 years) were analysed with VAs in which the EAS was observed in the coronary venous system (CVS). Overall, VAs were successfully eliminated in 42 (72%) patients: 8 in the CVS, 8 where the ECS matched with the endo-EAS, 11 at the ECS, and 15 at the endo-EAS. A successful ECS ablation was associated with a shorter epi-EAS-ECS distance (10.2 ± 4.7 vs. 18.8 ± 5.3 mm; P < 0.001) and shorter epi-EAS-left main coronary trunk (LMT) ostial distance (20.3 ± 7.6 vs. 30.3 ± 8.4 mm; P = 0.005), with optimal cut-off values of ≤12.6 and ≤24.0 mm, respectively. A successful endo-EAS ablation was associated with an earlier electrogram at the endo-EAS [23 (8, 36) vs. 15 (0, 19) ms preceding the QRS; P < 0.001] and shorter epi-EAS-endo-EAS interval [6 (1, 8) vs. 22 (12, 25) ms; P < 0.001], with optimal cut-off values of ≥18 and ≤9 ms, respectively. CONCLUSION: Shorter anatomical distances between the epi-EAS and ECS, and between the epi-EAS and LMT ostium, predict a successful ECS ablation. The prematurity of the endo-EAS electrogram and a shorter interval between the epi-EAS and endo-EAS predicted a successful endo-EAS ablation.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Anatomical vs. electrophysiological approach for ablation of premature ventricular contractions originating from the left ventricular summit (ISESHIMA-SUMMIT Study)
- Date Crossref
- 01/11/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Nihon University Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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National Disaster Medical Center Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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Sapporo Science Center pays non établi dans la noticeInstitution
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Jikei University School of Medicine Department of Cardiology pays non établi dans la noticeUniversité ou école supérieure
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Kokura Memorial Hospital Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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Gunma Prefectural Cardiovascular Center pays non établi dans la noticeÉtablissement de santé
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Keio University Department of Cardiology pays non établi dans la noticeUniversité ou école supérieure
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Tokyo Metropolitan Hiroo Hospital Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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Saitama International Medical Center pays non établi dans la noticeÉtablissement de santé
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Saitama Medical University Department of Cardiology pays non établi dans la noticeUniversité ou école supérieure
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Japan Community Healthcare Organization Division of Cardiology pays non établi dans la noticeOrganisme public
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Chukyo Hospital pays non établi dans la noticeÉtablissement de santé
Department of Medicine — Nihon University, Department of Cardiology — National Disaster Medical Center et Sapporo Science Center, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.