A 33-year-old man had verapamil-sensitive ventricular tachycardia (VT) with a right bundle branch block (RBBB) and right axis deviation. Programmed stimulation from the para-Hisian region induced ventricular tachycardias (VT1 or VT2). VT1 was entrained during pacing from the para-Hisian region. A single para-Hisian stimulation antidromically captured the proximal portion of the left anterior fascicle (LAF), but the cycle length of VT2 remained unchanged. This observation indicated that the upper limb of the LAF was a bystander of the reentry circuit. We have clarified this mechanism with applying a single premature stimulation from the para-Hisian region.
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http://dx.doi.org/10.1016/j.jelectrocard.2021.07.011 | DOI Listing |
Arrhythm Electrophysiol Rev
December 2024
Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center Nashville, TN, US.
Idiopathic arrhythmias originating from the mitral and tricuspid annuli are commonly encountered in clinical practice. This review focuses on distinguishing features of ventricular arrhythmias arising from these structures and the importance of distinguishing idiopathic arrhythmias from those associated with structural heart disease. Each region along the mitral and tricuspid annuli (including the cardiac crux and para-Hisian region) is then discussed separately, with a particular emphasis on the ablation strategies and pitfalls for each.
View Article and Find Full Text PDFHeart Rhythm
December 2024
Department of Cardiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:
Background: The electrocardiogram-based algorithm for predicting paraseptal atrial tachycardia (PSAT) is limited by the significant overlaps in P-wave morphology originating from various paraseptal sites.
Objectives: The goals of this study were to investigate the endocardial activation characteristics of PSAT and to seek an endocardial activation-derived predictor for the ablation site.
Methods: Forty-four patients [11 men (25%); mean age 62.
J Cardiovasc Electrophysiol
August 2024
Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Heart Rhythm
November 2024
Department of Cardiology, Japan Red Cross Yokohama City Bay Hospital, Kanagawa, Japan.
Background: The anatomical approach for the management of para-Hisian ventricular arrhythmias (VAs) with QRS morphological changes after catheter ablation (CA) has not been well investigated.
Objective: We aimed to evaluate the electrocardiographic and electrophysiological findings and ablation outcomes of para-Hisian VAs with QRS morphological changes after CA.
Methods: Of the 30 patients who underwent CA for para-Hisian VAs at 4 institutions, 10 (33%) had QRS morphological changes after ablation.
Am J Case Rep
December 2023
Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland).
BACKGROUND Pre-excitation cardiomyopathy is a specific type of cardiac disease related to asymptomatic pre-excitation. It is rarely reported and is prone to misdiagnosis; therefore, the actual incidence of pre-excitation cardiomyopathy may be underestimated. The purpose of this case report is to present a case of pre-excitation cardiomyopathy caused by an accessory pathway.
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