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Idiopathic Premature Ventricular Complexes Originating From Right Ventricular False Tendons
Jianwei Zhao1, Jie Yang1, Xia Wang1
1Department of Cardiology, Second Affiliated Hospital of Third Military Medical University (Army Medical University), Chongqing, China.
Right ventricular false tendons (RVFTs) can cause premature ventricular complexes (PVCs) originating from the right ventricular inflow tract (RVIT). Intracardiac echocardiography (ICE) helps identify these RVFTs for improved ablation success.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Medical Imaging
Background:
- Ablation for right ventricular inflow tract (RVIT) premature ventricular complexes (PVCs) presents challenges.
- The role of right ventricular false tendons (RVFTs) in RVIT PVCs is not well-established.
Purpose of the Study:
- To investigate RVFTs as potential arrhythmogenic substrates for RVIT PVCs.
- To develop an improved mapping and ablation protocol for RVIT PVCs using RVFT identification.
Main Methods:
- Retrospective analysis of 63 patients with RVIT PVCs, identifying 6 with RVFTs.
- Intracardiac echocardiography (ICE) for RVFT visualization, right ventricle geometry reconstruction, and ablation targeting.
- Morphological and histological examination of RVFTs from swine hearts.
Main Results:
- RVFTs were located in the right ventricle free wall, with consistent subvalvular myocardial connections.
- Three-dimensional ICE reconstruction aided in precise ablation target localization.
- Histological analysis revealed cardiac muscle and fibrous tissue components in RVFTs, suggesting arrhythmogenic potential.
Conclusions:
- RVFTs are identified as potential arrhythmogenic and electro-anatomical substrates for RVIT PVCs.
- ICE-guided identification and reconstruction of RVFTs can enhance the efficacy of PVC ablation procedures.
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