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Disappearance of Idiopathic Outflow Tract Premature Ventricular Contractions After Catheter Ablation of Overt

Tamas Szili Torok1, Lennart J DE Vries1, Emin E Özcan2

  • 1Department of Cardiology, Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands.

Journal of Cardiovascular Electrophysiology
|September 15, 2016
PubMed
Abstract

Insights

Idiopathic premature ventricular contractions (PVCs) from the outflow tracts may be linked to accessory pathways (APs). Ablating APs often resolves these PVCs, suggesting a shared origin for both conditions.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Arrhythmias

Background:

  • Idiopathic premature ventricular contractions (PVCs) originating from the outflow tracts (OTs) have multiple proposed mechanisms.
  • Coexistence with atrioventricular nodal reentrant tachycardias and association with successful ablation sites suggest a common link.

Purpose of the Study:

  • To highlight a unique association between accessory pathways (APs) and idiopathic PVCs originating from the OTs.
  • To investigate the effect of AP ablation on these PVCs.

Main Methods:

  • A case series of 6 patients with pre-excitation and outflow tract (OT) PVCs identified.
  • Analysis of 12-lead surface ECGs and outcomes after accessory pathway ablation.

Main Results:

  • Six cases showed pre-excitation and PVCs, mostly from the right ventricular outflow tract (RVOT).
  • Catheter ablation of the accessory pathway resolved PVCs in 5 out of 6 cases, with ablation sites remote from the OTs.
  • PVC occurrence was closely associated with the presence of pre-excitation.

Conclusions:

  • The coexistence of pre-excitation and OT PVCs suggests a common mechanism for their genesis.
  • Successful AP ablation leading to PVC resolution supports a shared pathway in arrhythmia development.
Keywords:
accessory pathwaycase seriescatheter ablationidiopathic ventricular arrhythmiasinternational

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