The Experts below are selected from a list of 201 Experts worldwide ranked by ideXlab platform
Feifan Ouyang - One of the best experts on this subject based on the ideXlab platform.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branch
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background—Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce...
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branchclinical perspective
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background— Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients’ symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions— RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branchclinical perspective unusual type of ventricular arRhythmia
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background— Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients’ symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions— RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branch unusual type of ventricular arRhythmia
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and results Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients' symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
Minglong Chen - One of the best experts on this subject based on the ideXlab platform.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branch
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background—Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce...
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branchclinical perspective
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background— Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients’ symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions— RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branchclinical perspective unusual type of ventricular arRhythmia
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background— Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients’ symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions— RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branch unusual type of ventricular arRhythmia
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and results Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients' symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
Jan J Piek - One of the best experts on this subject based on the ideXlab platform.
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acute haemodynamic effects of accelerated Idioventricular Rhythm in primary percutaneous coronary intervention
Eurointervention, 2011Co-Authors: Ronak Delewi, Maurice Remmelink, Martijn Meuwissen, Niels Van Royen, Karel T. Koch, José P.s. Henriques, Robbert J. De Winter, Jan G.p. Tijssen, Jan Baan, Jan J PiekAbstract:Aims: Accelerated Idioventricular Rhythm (AIVR) is very frequently observed in primary percutaneous coronary intervention (PCI), however knowledge of the haemodynamic effects is lacking. Methods and results: We studied an ST-segment elevation myocardial infarction cohort of 128 consecutive patients (aged 62±11 years) in whom AIVR occurred following reperfusion during primary PCI. Mean systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate were determined during periods of AIVR and sinus Rhythm. We grouped patients according to the infarct-related artery and the site of the coronary occlusion. AIVR caused an immediate reduction in SBP (130±27 vs. 98±22 mmHg, p<0.001) and DBP (80±19 vs. 69±16 mmHg, p<0.001) and a small increase in heart rate (78±12 vs. 83±11 bpm, p<0.001) as compared to sinus Rhythm, irrespective of infarct-related artery. Both absolute as well as relative reduction in SBP were more pronounced in distal than proximal left coronary artery (LCA) occlusions (36±16 vs. 27±12 mmHg, p<0.01, respectively 25±9 vs. 20±8%, p<0.05). These haemodynamic differences between proximal and distal occlusion sites were not observed in the right coronary artery. Conclusions: AIVR following reperfusion is associated with marked reduction in both SBP and DBP, irrespective of infarct-related artery. These haemodynamic effects are accompanied by only a very modest increase in heart rate during AIVR. Patients with a culprit lesion in the proximal LCA showed a smaller reduction in systolic blood pressure than distal LCA lesions.
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more pronounced diastolic left ventricular dysfunction in patients with accelerated Idioventricular Rhythm after reperfusion by primary percutaneous coronary intervention
Journal of Invasive Cardiology, 2010Co-Authors: Maurice Remmelink, Ronak Delewi, Jan J Piek, Ze Yie Yong, Jan BaanAbstract:Objective. Reperfusion-induced accelerated Idioventricular Rhythm (AIVR) during primary percutaneous coronary intervention (pPCI) may be a sign of left Ventricular (LV) dysfunction. We compared LV dynamic effects of reperfusion between patients with and without reperfusion-induced AIVR during pPCI for ST-elevation myocardial infarction (STEMI). Methods. We studied 15 consecutive patients, who presented with their first acute anterior STEMI within 6 hours after onset of symptoms, and in whom LV pressure-volume (PV) loops were directly obtained during pPCI. Immediate effects of pPCI on LV function were compared between patients with (n = 5) and without (n = 10) occurrence of AIVR after reperfusion, as well as the direct effects of AIVR on LV function compared to sinus Rhythm. Results. Patients with reperfusion-induced AIVR showed more pronounced diastolic LV dysfunction before the onset of the arRhythmia, i.e., a delayed active relaxation expressed by Tau (53 +/- 15 vs. 39 +/- 6 ms; p = 0.03), a worse compliance curve (p = 0.01), and a higher end-diastolic stiffness (p = 0.07). At the end of the procedure, AIVR patients showed less improvement in diastolic LV function, indicated by a downward shift of the compliance curve (-3.1 +/- 2.3 vs. -7.5 +/- 1.4 mmHg; p = 0.001), a decrease in end-diastolic stiffness (13 +/- 18 vs. 34 +/- 15%; p = 0.03) and end-diastolic pressure (12 +/- 8 vs. 29 +/- 19%; p = 0.07). Conclusion. STEMI patients with reperfusion-induced AIVR after pPCI showed more pronounced diastolic LV dysfunction before and after AIVR than patients without AIVR, which suggests that diastolic LV dysfunction contributes to the occurrence of AIVR and that AIVR is a sign of diastolic LV dysfunction
Kai Gu - One of the best experts on this subject based on the ideXlab platform.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branch
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background—Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce...
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branchclinical perspective
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background— Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients’ symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions— RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branchclinical perspective unusual type of ventricular arRhythmia
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background— Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients’ symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions— RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branch unusual type of ventricular arRhythmia
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and results Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients' symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
Bing Yang - One of the best experts on this subject based on the ideXlab platform.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branch
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background—Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce...
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branchclinical perspective
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background— Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients’ symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions— RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branchclinical perspective unusual type of ventricular arRhythmia
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background— Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients’ symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions— RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
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idiopathic accelerated Idioventricular Rhythm or ventricular tachycardia originating from the right bundle branch unusual type of ventricular arRhythmia
Circulation-arrhythmia and Electrophysiology, 2014Co-Authors: Minglong Chen, Kai Gu, Bing Yang, Hongwu Chen, Weizhu Ju, Fengxiang Zhang, Gang Yang, Mingfang Li, Xinzheng Lu, Feifan OuyangAbstract:Background Accelerated Idioventricular Rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arRhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arRhythmia. Methods and results Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arRhythmias, which demonstrated chronotropic variability, were often isoRhythmic with sinus Rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arRhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arRhythmia with subsequent RBB block morphology during sinus Rhythm. During follow-up, patients' symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions RBB-AIVR/VT is an unusual type of ventricular arRhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.
