scholarly journals Middle Cardiac Vein

2020 ◽  
Author(s):  
Keyword(s):  
Middle Cardiac Vein

Abstract 5690: Idiopathic Catecholamine-sensitive Epicardial Ventricular Tachycardia At The Crux Of The Heart

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Harish Doppalapudi ◽  
Karthik Ramaswamy ◽  
Joon Ahn ◽  
Takumi Yamada ◽  
G Neal Kay
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Coronary Sinus ◽  
Clinical Syndrome ◽  
Epicardial Surface ◽  
Surface Ecg ◽  
Coronary Venous System ◽  
The Right ◽  
Mean Cycle ◽  
Middle Cardiac Vein

Idiopathic ventricular tachycardia (VT) has been described from the epicardial surface of the left ventricle (LV), usually near the summit of the LV in the outflow tract. Ablation of these VTs may be possible by delivery of energy within the coronary venous system or directly on the epicardial surface. We describe a distinct syndrome of focal epicardial VT induced by catecholamine infusion that arises from the crux of the heart. Among 340 cases of idiopathic VT referred for catheter ablation, 4 patients were identified with a clinical syndrome of catecholamine sensitive VT that was mapped to the epicardial surface at the crux of the heart. There were 3 males and 1 female (age 31–79 yrs, mean 58). VT was sustained in all patients and associated with syncope or near syncope in 3 of 4 pts. The LVEF was >0.55 in 3 pts and mildly depressed (0.45) in 1 pt. In all pts VT could be induced with programmed stimulation or burst pacing from the right ventricular apex but required the infusion of isoproterenol for induction in 3. The VT was very rapid with a mean cycle length of 264 msec. The surface ECG during VT demonstrated a left superior axis QRS morphology in all pts, with an abrupt precordial tansition from V1 to V2 in 3 pts and R waves across the precordium in one. The precordial maximal deflection index was > 0.55 in all pts (mean 0.67). The site of earliest activation during intracardiac mapping occurred at the crux of the heart with activation in the middle cardiac vein or proximal coronary sinus recorded 20 –50 msec (mean −38 msec) prior to the onset of the surface QRS. Catheter ablation with irrigated RF was attempted within the middle cardiac vein or proximal coronary sinus in all pts and was successful in 1. In 2 of 3 remaining pts, percutaneous epicardial RF ablation was attempted and was successful. Simultaneous coronary angiography demonstrated the site of earliest activation within 5–10 mm of the proximal posterior descending coronary artery (PDA). There was no acute narrowing of the PDA in any pt following ablation. Idiopathic VT may arise from the epicardial surface at the crux of the heart in close proximity to the PDA. This syndrome can result in very rapid, catecholamine sensitive VT, and may require careful attention to the PDA during ablation.

scholarly journals Passive electrode effect reduces defibrillation threshold in bi-filament middle cardiac vein defibrillation

EP Europace ◽  
2006 ◽  
Vol 8 (2) ◽  
pp. 113-117 ◽  
Author(s):  
John R. Paisey ◽  
Arthur M. Yue ◽  
Frederick Bessoule ◽  
Paul R. Roberts ◽  
John M. Morgan
Keyword(s):  
Defibrillation Threshold ◽  
Electrode Effect ◽  
Passive Electrode ◽  
Middle Cardiac Vein

Biventricular implantable cardioverter-defibrillator device placement in patients with hostile tricuspid valve anatomy: two case reports and review of the literature

EP Europace ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. 1520-1525 ◽  
Author(s):  
Waddah Maskoun ◽  
Mohamad Raad ◽  
Arfaat Khan ◽  
Ramy Mando ◽  
Mohamed Homsi
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Case Reports ◽  
Viable Option ◽  
Icd Implantation ◽  
Lead Placement ◽  
Ventricular Lead ◽  
Device Placement ◽  
Middle Cardiac Vein

Abstract Aims Right ventricular (RV) lead placement can be contraindicated in patients after tricuspid valve (TV) surgery. Placement of the implantable cardiac-defibrillator (ICD) lead in the middle cardiac vein (MCV) can be a viable option in these patients who have an indication for biventricular (BiV) ICD. We aim to describe the case of two patients with MCV lead placement and provide a comprehensive review of patients with complex TV pathology and indications for RV lead placement. Methods and results We describe the cases of two patients with TV pathology unsuitable for the standard transvenous or surgical RV lead placement and undergoing BiV ICD implantation. Their characteristics, procedure, and outcomes are summarized. The BiV ICD was successfully placed with the RV lead positioned in the MCV in both patients. The procedures had no complications and were well-tolerated. On follow-up, both patients had appropriate tachytherapy with no readmissions for heart failure or worsening of cardiac function. Conclusion Right ventricular lead placement of BiV ICD in the MCV can be an excellent alternative in patients with significant TV pathology and poor surgical candidacy.

Catheterization of the Coronary Sinus and the Middle Cardiac Vein in Man.

1947 ◽  
Vol 66 (1) ◽  
pp. 239-240 ◽  
Author(s):  
R. J. Bing ◽  
L. D. Vandam ◽  
F. Gregoire ◽  
J. C. Handelsman ◽  
W. T. Goodale ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Middle Cardiac Vein

scholarly journals Outcomes of Middle Cardiac Vein Arterialization via Internal Mammary/Thoracic Artery Anastomosis

PLoS ONE ◽  
2013 ◽  
Vol 8 (11) ◽  
pp. e80963
Author(s):  
Yang Yu ◽  
Hai-tao Li ◽  
Ming-xin Gao ◽  
Fan Zhang ◽  
Cheng-xiong Gu
Keyword(s):  
Internal Mammary ◽  
Middle Cardiac Vein
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