Radiofrequency catheter ablation of idiopathic right ventricular outflow tract arrhythmias.

Naiara Calvo, Monique Jongbloed, Katja Zeppenfeld
Author Information
  1. Naiara Calvo: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

Abstract

Idiopathic ventricular Arrhythmias (VA) consist of various subtypes of VA that occur in the absence of clinically apparent structural heart disease. Affected patients account for approximately 10% of all patients referred for evaluation of ventricular tachycardia (VT). Arrhythmias arising from the outflow tract (OT) are the most common subtype of idiopathic VA and more than 70-80% of idiopathic VTs or premature ventricular contractions (PVCs) originate from the right ventricular (RV) OT. Idiopathic OT Arrhythmias are thought to be caused by adenosine-sensitive, cyclic adenosine monophosphate (cAMP) mediated triggered activity and, in general, manifest at a relatively early age. Usually they present as salvos of paroxysmal ventricular ectopic beats and are rarely life-threatening. When highly symptomatic and refractory to antiarrhythmic therapy or causative for ventricular dysfunction, ablation is a recommended treatment with a high success rate and a low risk of complications.

Keywords

References

  1. Pacing Clin Electrophysiol. 2005 May;28(5):397-403 [PMID: 15869671]
  2. Heart. 2005 Feb;91(2):136-8 [PMID: 15657214]
  3. Heart Rhythm. 2008 Mar;5(3):419-26 [PMID: 18313601]
  4. Int J Cardiol. 1989 Mar;22(3):289-300 [PMID: 2651326]
  5. Am J Cardiol. 1997 Jan 15;79(2):213-6 [PMID: 9193030]
  6. Circulation. 1998 Oct 13;98(15):1525-33 [PMID: 9769306]
  7. Am J Cardiol. 1999 Nov 15;84(10):1266-8, A9 [PMID: 10569344]
  8. J Cardiovasc Electrophysiol. 2003 Dec;14(12):1280-6 [PMID: 14678101]
  9. J Cardiovasc Electrophysiol. 2012 May;23(5):521-6 [PMID: 22136173]
  10. Pacing Clin Electrophysiol. 1997 Jul;20(7):1826-33 [PMID: 9249838]
  11. Am Heart J. 1995 Nov;130(5):1107-13 [PMID: 7484743]
  12. J Cardiovasc Electrophysiol. 2003 Jun;14(6):602-8 [PMID: 12875421]
  13. J Cardiovasc Electrophysiol. 2004 Mar;15(3):349-55 [PMID: 15030427]
  14. Am Heart J. 2000 Jun;139(6):1009-13 [PMID: 10827381]
  15. J Am Coll Cardiol. 2011 May 31;57(22):2255-62 [PMID: 21616286]
  16. Birth Defects Res A Clin Mol Teratol. 2011 Jun;91(6):477-84 [PMID: 21591244]
  17. Dev Cell. 2003 Dec;5(6):877-89 [PMID: 14667410]
  18. Pacing Clin Electrophysiol. 1989 Dec;12(12):1851-6 [PMID: 2481280]
  19. J Cardiovasc Electrophysiol. 2005 Aug;16(8):912-6 [PMID: 16101636]
  20. J Cardiovasc Electrophysiol. 2005 Sep;16(9):1017-22 [PMID: 16174026]
  21. Am J Cardiol. 2004 Dec 1;94(11):1441-5 [PMID: 15566923]
  22. Europace. 2011 May;13(5):696-700 [PMID: 21307021]
  23. J Am Coll Cardiol. 2003 Jun 4;41(11):2046-53 [PMID: 12798580]
  24. J Cardiovasc Electrophysiol. 2003 Jan;14(1):1-7 [PMID: 12625602]
  25. J Electrocardiol. 2003 Oct;36(4):327-32 [PMID: 14661169]
  26. Am Heart J. 1983 Mar;105(3):357-66 [PMID: 6829398]
  27. Heart Rhythm. 2011 May;8(5):665-71 [PMID: 21215326]
  28. Heart Rhythm. 2011 Aug;8(8):1254-63 [PMID: 21421080]
  29. Am J Cardiol. 1997 Feb 1;79(3):309-14 [PMID: 9036750]
  30. Circulation. 1986 Aug;74(2):270-80 [PMID: 3015453]
  31. J Am Coll Cardiol. 1998 Jul;32(1):181-6 [PMID: 9669268]
  32. Pediatr Res. 2005 Feb;57(2):169-76 [PMID: 15611355]
  33. J Am Coll Cardiol. 2005 Mar 15;45(6):887-95 [PMID: 15766825]
  34. Jpn Circ J. 1998 Jun;62(6):399-404 [PMID: 9652313]
  35. J Cardiovasc Electrophysiol. 2003 Apr;14(4):383-91 [PMID: 12741710]
  36. J Cardiovasc Electrophysiol. 2005 Oct;16(10):1041-8 [PMID: 16191113]
  37. Heart Rhythm. 2011 Feb;8(2):207-11 [PMID: 20920602]
  38. Pacing Clin Electrophysiol. 1998 Apr;21(4 Pt 1):669-78 [PMID: 9584296]
  39. J Am Coll Cardiol. 1994 May;23(6):1333-41 [PMID: 8176091]
  40. Heart Rhythm. 2009 Jun;6(6):886-933 [PMID: 19467519]
  41. Clin Res Cardiol. 2006 Nov;95(11):610-3 [PMID: 16998745]
  42. Circulation. 1997 Aug 19;96(4):1192-200 [PMID: 9286949]
  43. J Cardiovasc Electrophysiol. 2006 Jul;17(7):800-2 [PMID: 16836686]
  44. Int J Cardiol. 1991 Aug;32(2):213-30 [PMID: 1917172]
  45. Circulation. 2002 Aug 20;106(8):962-7 [PMID: 12186801]
  46. J Cardiovasc Electrophysiol. 2001 May;12(5):511-7 [PMID: 11386509]
  47. Circulation. 2005 Aug 23;112(8):1092-7 [PMID: 16103234]
  48. J Interv Card Electrophysiol. 2012 Mar;33(2):135-41 [PMID: 21993597]
  49. J Am Coll Cardiol. 2005 Oct 4;46(7):1288-94 [PMID: 16198845]
  50. Circulation. 1983 Nov;68(5):917-27 [PMID: 6137291]
  51. J Cardiovasc Electrophysiol. 2005 Sep;16 Suppl 1:S52-8 [PMID: 16138887]
  52. J Am Coll Cardiol. 2008 Feb 19;51(7):731-9 [PMID: 18279737]
  53. Heart. 1997 Sep;78(3):255-61 [PMID: 9391287]
  54. Pacing Clin Electrophysiol. 2002 Sep;25(9):1346-51 [PMID: 12380771]
  55. Eur Heart J. 2003 May;24(9):801-10 [PMID: 12727147]
  56. Europace. 2009 Sep;11(9):1214-20 [PMID: 19706640]
  57. J Am Coll Cardiol. 2005 Apr 19;45(8):1259-65 [PMID: 15837259]
  58. Heart Rhythm. 2007 Jul;4(7):973-6 [PMID: 17599688]
  59. Europace. 2006 Aug;8(8):601-6 [PMID: 16772366]
  60. Circulation. 2003 Oct 21;108(16):1960-7 [PMID: 14530199]
  61. Am J Cardiol. 1998 Feb 15;81(4):500-3 [PMID: 9485145]
  62. Circulation. 1992 May;85(5):1666-74 [PMID: 1572025]
  63. J Cardiovasc Electrophysiol. 2005 Aug;16(8):823-9 [PMID: 16101622]
  64. J Cardiovasc Electrophysiol. 1997 Sep;8(9):974-9 [PMID: 9300293]
  65. Pacing Clin Electrophysiol. 2009 Jun;32(6):727-33 [PMID: 19545334]
  66. Heart Rhythm. 2009 Oct;6(10):1507-11 [PMID: 19695964]
  67. J Am Coll Cardiol. 2002 Jun 5;39(11):1808-12 [PMID: 12039496]
  68. J Cardiovasc Electrophysiol. 2010 Jan;21(1):42-6 [PMID: 19656248]
  69. J Am Coll Cardiol. 2005 Feb 1;45(3):418-23 [PMID: 15680722]
  70. J Cardiovasc Electrophysiol. 2002 Jul;13(7):633-8 [PMID: 12139282]
  71. ScientificWorldJournal. 2008 Mar 03;8:239-69 [PMID: 18379704]
  72. Circulation. 1993 Jan;87(1):126-34 [PMID: 8418999]
  73. J Cardiovasc Electrophysiol. 2006 Jun;17(6):632-7 [PMID: 16836713]
  74. Circulation. 1996 Dec 1;94(11):2843-9 [PMID: 8941111]
  75. Circulation. 1997 Oct 21;96(8):2633-40 [PMID: 9355904]
  76. J Am Coll Cardiol. 1994 Sep;24(3):720-7 [PMID: 8077544]
  77. Heart Rhythm. 2008 Mar;5(3):339-44 [PMID: 18313589]
  78. Am J Cardiol. 1993 Apr 1;71(10):827-33 [PMID: 8456762]
  79. Jpn Heart J. 2004 Sep;45(5):749-60 [PMID: 15557716]
  80. Radiology. 1998 Jun;207(3):743-51 [PMID: 9609899]
  81. J Cardiovasc Electrophysiol. 2009 Aug;20(8):955-68 [PMID: 19490263]
  82. Am Heart J. 1996 May;131(5):930-6 [PMID: 8615312]
  83. Circ Res. 1992 Aug;71(2):240-50 [PMID: 1628384]
  84. Pacing Clin Electrophysiol. 2001 Feb;24(2):166-71 [PMID: 11270695]

Word Cloud

Created with Highcharts 10.0.0ventriculararrhythmiasVAoutflowtractOTidiopathicablationIdiopathicpatientsprematurecontractionsrightconsistvarioussubtypesoccurabsenceclinicallyapparentstructuralheartdiseaseAffectedaccountapproximately10%referredevaluationtachycardiaVTArrhythmiasarisingcommonsubtype70-80%VTsPVCsoriginateRVthoughtcausedadenosine-sensitivecyclicadenosinemonophosphatecAMPmediatedtriggeredactivitygeneralmanifestrelativelyearlyageUsuallypresentsalvosparoxysmalectopicbeatsrarelylife-threateninghighlysymptomaticrefractoryantiarrhythmictherapycausativedysfunctionrecommendedtreatmenthighsuccessratelowriskcomplicationsRadiofrequencycatheterICDs

Similar Articles

Cited By (16)