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Updated: Nov 5, 2025

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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The effect of catheter ablation for ventricular arrhythmias originating from the left ventricular papillary muscles

Joshua Sink1, Alexander Turin2, Joseph Cytron2

  • 1Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois, USA.

Journal of Cardiovascular Electrophysiology
|May 16, 2021
PubMed
Abstract

Insights

Radiofrequency ablation of ventricular arrhythmias from papillary muscles did not significantly worsen mitral regurgitation. This study found no significant increase in mitral regurgitation severity after papillary muscle ablation for ventricular arrhythmias.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Surgery

Background:

  • Ventricular arrhythmias (VA) originating from left ventricular (LV) papillary muscles (PM) pose a risk of mitral regurgitation (MR) due to potential damage to the mitral valve apparatus.
  • Radiofrequency (RF) ablation is a common treatment for VA, but its effect on MR when targeting PM is not fully understood.

Purpose of the Study:

  • To evaluate the impact of RF ablation of PM on the severity of MR.
  • To compare MR changes in patients undergoing PM ablation versus non-PM ablation for VA.

Main Methods:

  • Retrospective analysis of patients undergoing PM ablation for VA, compared to a control group undergoing ablation at non-PM sites.
  • Transthoracic echocardiograms were used to assess MR severity (graded 0-3) pre- and postablation in both groups.

Main Results:

  • 45 patients in the PM group and 49 in the non-PM group were analyzed. PM ablation involved longer RF times (22.3 vs. 13.3 min).
  • No statistically significant change in MR severity was observed within the PM group postablation (p=0.46).
  • Logistic regression indicated no significant increase in the odds of worsening MR in the PM group compared to the non-PM group (OR=0.19, p=0.29).

Conclusions:

  • RF ablation of VA originating from PM, guided by intracardiac echocardiography, does not lead to clinically significant worsening of MR.
  • The procedure appears safe concerning mitral valve function in the context of MR severity.
Keywords:
ablationmitralpapillarypremature ventricular contractionsregurgitationventricular tachycardia

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