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Konstantinos P. Letsas - One of the best experts on this subject based on the ideXlab platform.
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Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
BMC cardiovascular disorders, 2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Background The ECG characteristics of the distal coronary venous system ventricular arrhythmias (VAs) share common features with VAs arising from the aortic cusps or the endocardial left ventricular outflow tract (LVOT) beneath the cusps. The purpose of this study was to identify specific electrocardiographic and electrophysiological characteristics of VAs originating from the distal Great Cardiac Vein (GCV).
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unique electrocardiographic pattern w wave in lead i of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
BMC Cardiovascular Disorders, 2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Background The ECG characteristics of the distal coronary venous system ventricular arrhythmias (VAs) share common features with VAs arising from the aortic cusps or the endocardial left ventricular outflow tract (LVOT) beneath the cusps. The purpose of this study was to identify specific electrocardiographic and electrophysiological characteristics of VAs originating from the distal Great Cardiac Vein (GCV).
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Additional file 2: of Unique electrocardiographic pattern âwâ wave in lead I of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Figure S2. A schematic representation of the anatomic distribution of successful ablation sites in the 15 GCV-VAs. Left lateral view of the heart. Black circles represented the successful ablation sites. GCV, Great Cardiac Vein; LAD, left anterior descending; CS, coronary sinus; LV, left ventricle; LAA, left atrial appendage; LSPV, left superior pulmonary Vein; LIPV, left inferior pulmonary Vein; RV, right ventricle. (JPG 177 kb
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Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
BMC, 2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Abstract Background The ECG characteristics of the distal coronary venous system ventricular arrhythmias (VAs) share common features with VAs arising from the aortic cusps or the endocardial left ventricular outflow tract (LVOT) beneath the cusps. The purpose of this study was to identify specific electrocardiographic and electrophysiological characteristics of VAs originating from the distal Great Cardiac Vein (GCV). Methods Based on the successful ablation site, patients with idiopathic VAs from the distal GCV, left coronary cusp (LCC) or the subvalvular left ventricular outflow tract (LVOT) area were included in the present study. Results The final population consisted of 39 patients (35 males, mean age 51 ± 23 years). All VAs displayed a right bundle branch block (RBBB) morphology with inferior axis. Among these patients, 15 were successfully ablated at the GCV, 15 at the LCC and 9 at the subvalvular region. A “w” pattern in lead I was present in 12 out of 15 (80%) VAs originating from the distal GCV compared to none of VAs arising from the other two sites (p
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Additional file 1: of Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Figure S1. Example of three successful ablations of premature ventricular contractions originating from the distal GCV, LCC, and subvalvular LVOT, respectively. A: Activation time (30 ms before QRS onset) at the GCV of case 1 with VAs originated from the distal GCV. B: Activation time (24 ms before QRS onset) at the LCC of case 2 with VAs originated from LCC. C: Activation time (28 ms before QRS onset) beneath LCC of case 3 with VAs originated from the distal GCV. B: Activation time (24 ms before QRS onset) at the LCC of case 2 with VAs originated from subvalvular LVOT. ABL d (p), the distal and proximal electrode pairs of the ablation catheter; GCV, Great Cardiac Vein; LCC, left coronary cusp; LVOT, left ventricular outflow tract. (JPG 162 kb
Yoshio Kobayashi - One of the best experts on this subject based on the ideXlab platform.
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anatomical relationship of coronary sinus Great Cardiac Vein and left circumflex coronary artery along mitral annulus in atrial fibrillation before radiofrequency catheter ablation using 320 slice ct
International Journal of Cardiology, 2013Co-Authors: Kohki Nakamura, Kenichi Kaseno, Shigeto Naito, Shigeru Oshima, Nobusada Funabashi, Masae Uehara, Hiroyuki Takaoka, Koji Kumagai, Yoshio KobayashiAbstract:Abstract Purpose We evaluated anatomical relationships between the coronary sinus and Great Cardiac Vein (CS/GCV) and left circumflex coronary artery (LCX) along the mitral annulus (MA) in patients with atrial fibrillation (AF) using 320-slice CT. Methods Fifty-three patients with AF (44 males; mean 63±11years; 28 paroxysmal, 10 persistent, and 15 permanent AF) underwent 320-slice CT. Double-oblique CT images perpendicular to the MA short axis were created every 10° for 36 circumferential sections. The angle of 0° corresponded to the 12 o'clock position. Results CS/GCV-MA distance was Greatest in the posterolateral MA. CS/GCV diverged from the LCX more widely in the lateral through posterolateral MA than the anterior through anterolateral MA. CS/GCV crossed the LCX in 51 patients (96.2%) and left main coronary artery in 2 patients (3.8%). Median angle of the CS/GCV-LCX crossing point was at 40° but ranged widely (0° to 150°) and was more frequent in the anterior and anterolateral MA than in the lateral, posterolateral, and posterior MA (31.4%, 45.1%, 11.8%, 11.8%, and 0%, respectively; P Conclusions Anatomical relationships between CS/GCV and LCX Greatly varied in location and proximity among AF patients. Interventional electrophysiologists should know the potential risk for LCX injury when radiofrequency energy is delivered within the CS/GCV.
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Anatomical relationship of coronary sinus/Great Cardiac Vein and left circumflex coronary artery along mitral annulus in atrial fibrillation before radiofrequency catheter ablation using 320-slice CT.
International journal of cardiology, 2013Co-Authors: Kohki Nakamura, Kenichi Kaseno, Shigeto Naito, Shigeru Oshima, Nobusada Funabashi, Masae Uehara, Hiroyuki Takaoka, Koji Kumagai, Yoshio KobayashiAbstract:Abstract Purpose We evaluated anatomical relationships between the coronary sinus and Great Cardiac Vein (CS/GCV) and left circumflex coronary artery (LCX) along the mitral annulus (MA) in patients with atrial fibrillation (AF) using 320-slice CT. Methods Fifty-three patients with AF (44 males; mean 63±11years; 28 paroxysmal, 10 persistent, and 15 permanent AF) underwent 320-slice CT. Double-oblique CT images perpendicular to the MA short axis were created every 10° for 36 circumferential sections. The angle of 0° corresponded to the 12 o'clock position. Results CS/GCV-MA distance was Greatest in the posterolateral MA. CS/GCV diverged from the LCX more widely in the lateral through posterolateral MA than the anterior through anterolateral MA. CS/GCV crossed the LCX in 51 patients (96.2%) and left main coronary artery in 2 patients (3.8%). Median angle of the CS/GCV-LCX crossing point was at 40° but ranged widely (0° to 150°) and was more frequent in the anterior and anterolateral MA than in the lateral, posterolateral, and posterior MA (31.4%, 45.1%, 11.8%, 11.8%, and 0%, respectively; P Conclusions Anatomical relationships between CS/GCV and LCX Greatly varied in location and proximity among AF patients. Interventional electrophysiologists should know the potential risk for LCX injury when radiofrequency energy is delivered within the CS/GCV.
Xianzhang Zhan - One of the best experts on this subject based on the ideXlab platform.
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Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
BMC cardiovascular disorders, 2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Background The ECG characteristics of the distal coronary venous system ventricular arrhythmias (VAs) share common features with VAs arising from the aortic cusps or the endocardial left ventricular outflow tract (LVOT) beneath the cusps. The purpose of this study was to identify specific electrocardiographic and electrophysiological characteristics of VAs originating from the distal Great Cardiac Vein (GCV).
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unique electrocardiographic pattern w wave in lead i of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
BMC Cardiovascular Disorders, 2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Background The ECG characteristics of the distal coronary venous system ventricular arrhythmias (VAs) share common features with VAs arising from the aortic cusps or the endocardial left ventricular outflow tract (LVOT) beneath the cusps. The purpose of this study was to identify specific electrocardiographic and electrophysiological characteristics of VAs originating from the distal Great Cardiac Vein (GCV).
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Additional file 2: of Unique electrocardiographic pattern âwâ wave in lead I of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Figure S2. A schematic representation of the anatomic distribution of successful ablation sites in the 15 GCV-VAs. Left lateral view of the heart. Black circles represented the successful ablation sites. GCV, Great Cardiac Vein; LAD, left anterior descending; CS, coronary sinus; LV, left ventricle; LAA, left atrial appendage; LSPV, left superior pulmonary Vein; LIPV, left inferior pulmonary Vein; RV, right ventricle. (JPG 177 kb
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Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
BMC, 2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Abstract Background The ECG characteristics of the distal coronary venous system ventricular arrhythmias (VAs) share common features with VAs arising from the aortic cusps or the endocardial left ventricular outflow tract (LVOT) beneath the cusps. The purpose of this study was to identify specific electrocardiographic and electrophysiological characteristics of VAs originating from the distal Great Cardiac Vein (GCV). Methods Based on the successful ablation site, patients with idiopathic VAs from the distal GCV, left coronary cusp (LCC) or the subvalvular left ventricular outflow tract (LVOT) area were included in the present study. Results The final population consisted of 39 patients (35 males, mean age 51 ± 23 years). All VAs displayed a right bundle branch block (RBBB) morphology with inferior axis. Among these patients, 15 were successfully ablated at the GCV, 15 at the LCC and 9 at the subvalvular region. A “w” pattern in lead I was present in 12 out of 15 (80%) VAs originating from the distal GCV compared to none of VAs arising from the other two sites (p
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Additional file 1: of Unique electrocardiographic pattern “w” wave in lead I of idiopathic ventricular arrhythmias arising from the distal Great Cardiac Vein
2019Co-Authors: Xianzhang Zhan, Yumei Xue, Hongtao Liao, Konstantinos P. LetsasAbstract:Figure S1. Example of three successful ablations of premature ventricular contractions originating from the distal GCV, LCC, and subvalvular LVOT, respectively. A: Activation time (30 ms before QRS onset) at the GCV of case 1 with VAs originated from the distal GCV. B: Activation time (24 ms before QRS onset) at the LCC of case 2 with VAs originated from LCC. C: Activation time (28 ms before QRS onset) beneath LCC of case 3 with VAs originated from the distal GCV. B: Activation time (24 ms before QRS onset) at the LCC of case 2 with VAs originated from subvalvular LVOT. ABL d (p), the distal and proximal electrode pairs of the ablation catheter; GCV, Great Cardiac Vein; LCC, left coronary cusp; LVOT, left ventricular outflow tract. (JPG 162 kb
Jia-xuan Lin - One of the best experts on this subject based on the ideXlab platform.
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An electrocardiographic sign of idiopathic ventricular tachycardia ablatable from the distal Great Cardiac Vein
Heart rhythm, 2020Co-Authors: Yuan-nan Lin, Yang-qi Pan, Cheng Zheng, Jia-xuan Lin, Jiafeng LinAbstract:Background Idiopathic ventricular arrhythmias (IVAs) can originate from the distal Great Cardiac Vein (DGCV). However, inadequate distinction sometimes occurs when electrocardiographic (ECG) characteristics are used to distinguish ventricular arrhythmias (VAs) arising from the DGCV from those arising from the adjacent left ventricular endocardium (LV ENDO). Objective The purpose of this study was to identify distinct ECG features in patients with idiopathic IVAs originating from the DGCV. Methods A total of 32 patients with IVAs originating from the DGCV were identified from a consecutive group of 874 patients undergoing IVAs ablation. Patients with IVAs from the DGCV were compared with a consecutively chosen series of 40 patients with IVAs in whom the site of origin was the adjacent LV ENDO. Results Of the 32 patients with IVAs arising from the DGCV, 13 had distinct ECG characteristics compared with the LV ENDO group. Notches in both the upstroke and downstroke of the R wave in lead III were found in all 13 patients. However, the characteristic ECG pattern in lead III was found in 1 of 40 patients in the LV ENDO group. The ECG characteristic of both early notch and late notches in lead III has sensitivity of 40.6%, specificity of 97.5%, negative predictive value of 67.2%, and positive predictive value of 92.9% to predict VAs arising from the DGCV. Conclusion The distinct ECG characteristics of VAs originating from the DGCV can help differentiate from adjacent LV ENDO sites of origin.
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factors affecting the success rate of catheter ablation of ventricular arrhythmia originating from the transitional area of distal Great Cardiac Vein
Chin J Cardiac Arrhyth, 2018Co-Authors: Yang-qi Pan, Jia-xuan Lin, Ripeng YinAbstract:Objective To investigate factors that affect the success rate of radiofrequency catheter ablation (RFCA) of ventricular arrhythmia (VA) originating from the transitional area of distal Great Cardiac Vein (DGCV) . Methods A total of 1 642 patients [ (48.49±17.19) years old] received the RFCA treatment for VA in Department of Cardiology, The Second Affiliated Hospital of Wenzhou Medical University from December 2009 to December 2017. Among them, 95 cases of VA were found arising from the transitional area of DGCV. The patients were divided into 2 groups according to ablation results, the success group [78 patients, 47 men, (55.07±16.24) years old] and the failure or quitting group [17 patients, 11 men, (54.51±14.22) years old]. Effects of site of the earliest ventricular activation, the A/V ratio in intraCardiac bipolar electrocardiogram, items like Cardiac chamber capture by pacing target sites, leads of pace match, ablation phase, supporting methods and mapping on the success rate of ablation were observed. Results It was revealed that the site of the earliest ventricular activation, the A/V ratio in intraCardiac bipolar electrocardiogram, and the mapping methods had no significant effects on the success rate (χ2=1.98, 1.41, 2.36, respectively, P>0.05) . The ablation success rate (88.10%, 74/84) of group that pacing target site leading to ventricular capture only or an alternating capture of atrium and ventricle was significantly higher than the rate (36.36%, 4/11) of those pacing target site leading to atrium capture only or nothing (χ2=17.72, P<0.01) . There was better pace match in the success group than in failure or quitting group (11.52±0.59 vs. 9.73±1.37, t=6.34, P<0.01) . In later phase of operation, the success rate of 88.00% (66/75) was apparently higher than that in earlier phase (60.00%, 12/20, χ2=8.43, P<0.01) . Also, there’s an obviously higher success rate in the group that applicating Swartz sheath supportting in comparison with that without application of supporting sheath [87.32% (62/71) vs. 66.67% (16/24) , χ2=5.21, P<0.05]. Conclusions The success rate of catheter ablation of VA originating from the transitional area of DGCV was influenced by factors such as Cardiac chamber capture by pacing target sites, leads of pace match, ablation phase, and supporting methods. Key words: Catheter ablation; Ventricular arrhythmia; Great Cardiac Vein
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Factors affecting the success rate of catheter ablation of ventricular arrhythmia originating from the transitional area of distal Great Cardiac Vein
2018Co-Authors: Yang-qi Pan, Jia-xuan Lin, Ripeng YinAbstract:Objective To investigate factors that affect the success rate of radiofrequency catheter ablation (RFCA) of ventricular arrhythmia (VA) originating from the transitional area of distal Great Cardiac Vein (DGCV) . Methods A total of 1 642 patients [ (48.49±17.19) years old] received the RFCA treatment for VA in Department of Cardiology, The Second Affiliated Hospital of Wenzhou Medical University from December 2009 to December 2017. Among them, 95 cases of VA were found arising from the transitional area of DGCV. The patients were divided into 2 groups according to ablation results, the success group [78 patients, 47 men, (55.07±16.24) years old] and the failure or quitting group [17 patients, 11 men, (54.51±14.22) years old]. Effects of site of the earliest ventricular activation, the A/V ratio in intraCardiac bipolar electrocardiogram, items like Cardiac chamber capture by pacing target sites, leads of pace match, ablation phase, supporting methods and mapping on the success rate of ablation were observed. Results It was revealed that the site of the earliest ventricular activation, the A/V ratio in intraCardiac bipolar electrocardiogram, and the mapping methods had no significant effects on the success rate (χ2=1.98, 1.41, 2.36, respectively, P>0.05) . The ablation success rate (88.10%, 74/84) of group that pacing target site leading to ventricular capture only or an alternating capture of atrium and ventricle was significantly higher than the rate (36.36%, 4/11) of those pacing target site leading to atrium capture only or nothing (χ2=17.72, P
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Catheter ablation of idiopathic ventricular arrhythmias originating from left ventricular epicardium adjacent to the transitional area from the Great Cardiac Vein to the anterior interventricular Vein
International journal of cardiology, 2012Co-Authors: Jiafeng Lin, Jia-xuan LinAbstract:Abstract Objectives This study aimed to investigate electrocardiographic characteristics and effects of radiofrequency catheter ablation (RFCA) for patients with symptomatic premature ventricular complexes (PVCs) and idiopathic ventricular tachycardias (IVTs), originating from the different portions of the left coronary Veins. Background Inadequate distinction was made in the past for the PVC/IVTs located in the different portions of the left coronary Veins, especially the distal Great Cardiac Vein (DGCV) and the proximal portion of the anterior interventricular Vein (PAIV) and the extended tributary of DGCV located distal to the origin of AIV (EDGCV). Methods Characteristics of body surface electrocardiogram (ECG) and electrophysiologic recordings were analyzed in 12 patients with symptomatic PVCs/IVTs originating from the vicinity of the left coronary Veins. Results Among 490 patients with PVCs/IVTs, the incidence of ventricular arrhythmias originating from the left ventricular epicardium adjacent to the transitional area from the GCV to the AIV was 2.45%. Four had PVCs/IVTs from DGCV, 5 from PAIV, and 3 from EDGCV. There were different characteristics of ECG of PVCs/VT originating from the DGCV and PAIV and EDGCV. Successful RFCA in all 12 patients could be achieved (100% acute procedural success). No complications were observed. During a median follow up of 17months (range 6–45months), 2 had recurrent ventricular arrhythmia (recurrence rate: 16.67%). Conclusions ECG characteristics of PVCs/VTs originating from the different portions of the left coronary Veins (DGCV and PAIV and EDGCV) are different, and can help regionalize the origin of these arrhythmias. RFCA within the coronary venous system was relatively effective and safe for the PVCs/IVTs and should be seen as an alternative approach, when the left-sided PVCs/IVTs could not be eliminated by RFCA from the endocardium or aortic sinus of Valsalva.
Kenichi Kaseno - One of the best experts on this subject based on the ideXlab platform.
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anatomical relationship of coronary sinus Great Cardiac Vein and left circumflex coronary artery along mitral annulus in atrial fibrillation before radiofrequency catheter ablation using 320 slice ct
International Journal of Cardiology, 2013Co-Authors: Kohki Nakamura, Kenichi Kaseno, Shigeto Naito, Shigeru Oshima, Nobusada Funabashi, Masae Uehara, Hiroyuki Takaoka, Koji Kumagai, Yoshio KobayashiAbstract:Abstract Purpose We evaluated anatomical relationships between the coronary sinus and Great Cardiac Vein (CS/GCV) and left circumflex coronary artery (LCX) along the mitral annulus (MA) in patients with atrial fibrillation (AF) using 320-slice CT. Methods Fifty-three patients with AF (44 males; mean 63±11years; 28 paroxysmal, 10 persistent, and 15 permanent AF) underwent 320-slice CT. Double-oblique CT images perpendicular to the MA short axis were created every 10° for 36 circumferential sections. The angle of 0° corresponded to the 12 o'clock position. Results CS/GCV-MA distance was Greatest in the posterolateral MA. CS/GCV diverged from the LCX more widely in the lateral through posterolateral MA than the anterior through anterolateral MA. CS/GCV crossed the LCX in 51 patients (96.2%) and left main coronary artery in 2 patients (3.8%). Median angle of the CS/GCV-LCX crossing point was at 40° but ranged widely (0° to 150°) and was more frequent in the anterior and anterolateral MA than in the lateral, posterolateral, and posterior MA (31.4%, 45.1%, 11.8%, 11.8%, and 0%, respectively; P Conclusions Anatomical relationships between CS/GCV and LCX Greatly varied in location and proximity among AF patients. Interventional electrophysiologists should know the potential risk for LCX injury when radiofrequency energy is delivered within the CS/GCV.
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Anatomical relationship of coronary sinus/Great Cardiac Vein and left circumflex coronary artery along mitral annulus in atrial fibrillation before radiofrequency catheter ablation using 320-slice CT.
International journal of cardiology, 2013Co-Authors: Kohki Nakamura, Kenichi Kaseno, Shigeto Naito, Shigeru Oshima, Nobusada Funabashi, Masae Uehara, Hiroyuki Takaoka, Koji Kumagai, Yoshio KobayashiAbstract:Abstract Purpose We evaluated anatomical relationships between the coronary sinus and Great Cardiac Vein (CS/GCV) and left circumflex coronary artery (LCX) along the mitral annulus (MA) in patients with atrial fibrillation (AF) using 320-slice CT. Methods Fifty-three patients with AF (44 males; mean 63±11years; 28 paroxysmal, 10 persistent, and 15 permanent AF) underwent 320-slice CT. Double-oblique CT images perpendicular to the MA short axis were created every 10° for 36 circumferential sections. The angle of 0° corresponded to the 12 o'clock position. Results CS/GCV-MA distance was Greatest in the posterolateral MA. CS/GCV diverged from the LCX more widely in the lateral through posterolateral MA than the anterior through anterolateral MA. CS/GCV crossed the LCX in 51 patients (96.2%) and left main coronary artery in 2 patients (3.8%). Median angle of the CS/GCV-LCX crossing point was at 40° but ranged widely (0° to 150°) and was more frequent in the anterior and anterolateral MA than in the lateral, posterolateral, and posterior MA (31.4%, 45.1%, 11.8%, 11.8%, and 0%, respectively; P Conclusions Anatomical relationships between CS/GCV and LCX Greatly varied in location and proximity among AF patients. Interventional electrophysiologists should know the potential risk for LCX injury when radiofrequency energy is delivered within the CS/GCV.
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Successful catheter ablation of left ventricular epicardial tachycardia originating from the Great Cardiac Vein: a case report and review of the literature.
Circulation journal : official journal of the Japanese Circulation Society, 2007Co-Authors: Kenichi Kaseno, Hiroshi Tada, Shinichi Tanaka, Koji Goto, Miki Yokokawa, Shigeki Hiramatsu, Shigeto Naito, Shigeru Oshima, Koichi TaniguchiAbstract:A patient underwent radiofrequency (RF) catheter ablation for a drug-refractory ventricular tachycardia, but RF energy application at an endocardial site of the left ventricular outflow tract and at the left sinus of Valsalva could not eliminate the tachycardia. The earliest ventricular activation during the arrhythmia, which preceded the onset of the QRS complex by 32 ms, was found within the Great Cardiac Vein and complete elimination of the tachycardia was finally achieved with RF application at that site. (Circ J 2007; 71: 1983 - 1988)
