scholarly journals Catheter ablation of premature ventricular contractions originating from kissing papillary muscles

2021 ◽  
Vol 9 (10) ◽  
Author(s):  
Takumi Yamada ◽  
Krittapoom Akrawinthawong
Keyword(s):  
Catheter Ablation ◽  
Papillary Muscles ◽  
Premature Ventricular Contractions

scholarly journals Catheter Ablation of Premature Ventricular Contractions Originating from Kissing Papillary Muscles

2021 ◽  
Author(s):  
Takumi Yamada ◽  
Krittapoom Akrawinthawong
Keyword(s):  
Catheter Ablation ◽  
Left Ventricular ◽  
Papillary Muscles ◽  
Premature Ventricular Contractions

A 73-year-old woman with premature ventricular contractions (PVCs) had very thick left ventricular papillary muscles (PAMs) kissing each other. The PVC origin at the septal side of the anterolateral PAM that faced the posteromedial PAM, rendered mapping confusing. This case illustrated an unusual challenge in catheter ablation of PAM PVCs.

scholarly journals Anatomical Consideration in Catheter Ablation of Idiopathic Ventricular Arrhythmias

2016 ◽  
Vol 5 (3) ◽  
pp. 203 ◽  
Author(s):  
Takumi Yamada ◽  
G Neal Kay ◽  
◽  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Myocardial Scar ◽  
Conduction System ◽  
Papillary Muscles ◽  
Premature Ventricular Contractions ◽  
Anatomical Structures ◽  
Av Conduction ◽  
Ventricular Tachycardias ◽  
Fat Pads

Idiopathic ventricular arrhythmias (VAs) are ventricular tachycardias (VTs) or premature ventricular contractions (PVCs) with a mechanism that is not related to myocardial scar. The sites of successful catheter ablation of idiopathic VA origins have been progressively elucidated and include both the endocardium and, less commonly, the epicardium. Idiopathic VAs usually originate from specific anatomical structures such as the ventricular outflow tracts, aortic root, atrioventricular (AV) annuli, papillary muscles, Purkinje network and so on, and exhibit characteristic electrocardiograms based on their anatomical background. Catheter ablation of idiopathic VAs is usually safe and highly successful, but can sometimes be challenging because of the anatomical obstacles such as the coronary arteries, epicardial fat pads, intramural and epicardial origins, AV conduction system and so on. Therefore, understanding the relevant anatomy is important to achieve a safe and successful catheter ablation of idiopathic VAs. This review describes the anatomical consideration in the catheter ablation of idiopathic VAs.

Sustained monomorphic ventricular tachycardia: the role of catheter ablation

ESC CardioMed ◽  
2018 ◽  
pp. 2279-2288
Author(s):  
Tilman Maurer ◽  
William G. Stevenson ◽  
Karl-Heinz Kuck
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Therapeutic Option ◽  
Structural Heart Disease ◽  
Premature Ventricular Contractions ◽  
Monomorphic Ventricular Tachycardia ◽  
Premature Beats

Monomorphic ventricular tachycardia (VT) may occur in the presence or absence of structural heart disease. The standard therapy for patients with structural heart disease at high risk of sudden cardiac death due to VT is the implantable cardioverter defibrillator (ICD). While ICDs effectively terminate VT and prevent sudden cardiac death, they do not prevent recurrent episodes of VT, since the underlying arrhythmogenic substrate remains unchanged. However, shocks from an ICD increase mortality and impair quality of life. These limitations as well as continuous advancements in technology have made catheter ablation an important treatment strategy for patients with structural heart disease presenting with VT. Idiopathic ventricular arrhythmias include premature ventricular contractions and VT occurring in the absence of overt structural heart disease. In this setting, catheter ablation has evolved as the primary therapeutic option for symptomatic ventricular premature beats and sustained VTs and is curative in most cases. This chapter presents an overview of the principles of invasive diagnosis and treatment of monomorphic VTs in patients with and without structural heart disease and delineates the clinical outcome of catheter ablation. Finally, the chapter provides an outlook to the future, discussing potential directions and upcoming developments in the field of catheter ablation of monomorphic VT.

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