Related Experiment Video

Updated: Aug 19, 2026

Microdissection and Immunofluorescence Staining of Myocardial Sleeves in Murine Pulmonary Veins
08:52

Microdissection and Immunofluorescence Staining of Myocardial Sleeves in Murine Pulmonary Veins

Published on: November 21, 2023

Idiopathic ventricular arrhythmia arising from the mitral annulus: a distinct subgroup of idiopathic ventricular

Hiroshi Tada1, Sachiko Ito, Shigeto Naito

  • 1Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan. tada.h@cvc.pref.gunma.jp

Journal of the American College of Cardiology
|March 16, 2005
PubMed
Abstract

Insights

Idiopathic ventricular tachycardia originating from the mitral annulus (MAVT/PVC) is rare. Electrocardiogram (ECG) analysis can determine MAVT/PVC origin, with anterolateral and posteroseptal sites being most common. Radiofrequency catheter ablation is effective.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Idiopathic ventricular tachycardia or premature ventricular contraction (VT/PVC) originating from the mitral annulus (MAVT/PVC) has been increasingly reported in recent case studies.
  • Understanding the specific origins and characteristics of MAVT/PVC is crucial for effective diagnosis and treatment.

Purpose of the Study:

  • To determine the prevalence and specific characteristics of MAVT/PVC.
  • To identify electrocardiographic (ECG) patterns that can differentiate the origin of MAVT/PVC.
  • To evaluate the efficacy of radiofrequency catheter ablation (RFCA) for MAVT/PVC.

Main Methods:

  • Analysis of ECG characteristics, electrophysiologic investigation, and RFCA outcomes in 352 patients with symptomatic idiopathic VT/PVC.
  • Detailed examination of MAVT/PVC cases, categorizing origins into anterolateral (AL-MAVT/PVC), posterior (Pos-MAVT/PVC), and posteroseptal (PS-MAVT/PVC) regions.
  • Correlation of ECG findings with ablation success rates and patient follow-up data.

Main Results:

  • MAVT/PVC accounted for 5% (19 cases) of all idiopathic VT/PVC.
  • The anterolateral portion of the mitral annulus was the most common origin (58%), followed by the posteroseptal (31%) and posterior (11%) portions.
  • Distinct ECG patterns, including S-wave in lead V6, QRS polarity in inferior leads, and specific lead I and V1 morphologies, were identified for differentiating origins. Longer QRS duration was noted in AL-MAVT/PVC and Pos-MAVT/PVC compared to PS-MAVT/PVC. All patients experienced successful MAVT/PVC elimination with RFCA, with no recurrences during a mean follow-up of 21 months.

Conclusions:

  • MAVT/PVC represents a distinct and uncommon subgroup of idiopathic VT/PVC.
  • ECG analysis is a reliable method for determining the origin of MAVT/PVC.
  • The anterolateral and posteroseptal sites of the mitral annulus are preferential origins for MAVT/PVC, and RFCA is a highly effective treatment modality.

More Related Videos

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat07:42

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat

Published on: May 19, 2020

Assessing Intracardiac Vortices with High Frame-Rate Echocardiography-Derived Blood Speckle Imaging in Newborns07:13

Assessing Intracardiac Vortices with High Frame-Rate Echocardiography-Derived Blood Speckle Imaging in Newborns

Published on: December 22, 2023

Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
Mechanism of Cardiac Arrhythmias01:28

Mechanism of Cardiac Arrhythmias

Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.