Preferential Conduction Across the Ventricular Outflow Septum in Ventricular Arrhythmias Originating From the Aortic Sinus Cusp

• Published in: Journal of the American College of Cardiology 2007-08, Vol.50 (9), p.884-891
• Main Authors: Yamada, Takumi, MD, Murakami, Yoshimasa, MD, Yoshida, Naoki, MD, Okada, Taro, MD, Shimizu, Takeshi, MD, Toyama, Junji, MD, Yoshida, Yukihiko, MD, Tsuboi, Naoya, MD, Muto, Masahiro, MD, Inden, Yasuya, MD, Hirai, Makoto, MD, Murohara, Toyoaki, MD, McElderry, Hugh T., MD, Epstein, Andrew E., MD, Plumb, Vance J., MD, Kay, G. Neal, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Biological and medical sciences; Cardiac arrhythmia; Cardiac dysrhythmias; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Catheter Ablation; Catheters; Electrocardiography; Electrophysiologic Techniques, Cardiac; Heart; Heart Conduction System - physiopathology; Heart Septum - physiopathology; Humans; Internal Medicine; Medical sciences; Middle Aged; Patients; Sinus of Valsalva - physiopathology; Tachycardia, Ventricular - physiopathology; Veins & arteries; Ventricular Premature Complexes - physiopathology
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2007.05.021

Preferential Conduction Across the Ventricular Outflow Septum in Ventricular Arrhythmias Originating From the Aortic Sinus Cusp Takumi Yamada, Yoshimasa Murakami, Naoki Yoshida, Taro Okada, Takeshi Shimizu, Junji Toyama, Yukihiko Yoshida, Naoya Tsuboi, Masahiro Muto, Yasuya Inden, Makoto Hirai, Toyoaki Murohara, Hugh T. McElderry, Andrew E. Epstein, Vance J. Plumb, G. Neal Kay The present study showed the relationship between the origin and breakout site of idiopathic ventricular tachycardia (VT) or premature ventricular contractions (PVCs) originating from the myocardium around the ventricular outflow tract using electroanatomical mapping and pace mapping. A VT or PVCs originating from the aortic sinus cusp often show preferential conduction to the right ventricular outflow tract, which may render pace mapping or some algorithms using the electrocardiographic characteristics to predict the origin less reliable. In some of those cases, an insulated myocardial fiber across the ventricular outflow septum may exist.