Left ventricular summit premature ventricular contractions treated by venous ethanol infusion: Scar assessment by magnetic resonance imaging.
| Title: | Left ventricular summit premature ventricular contractions treated by venous ethanol infusion: Scar assessment by magnetic resonance imaging. |
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| Authors: | Limite LR; Service de Cardiologie, Hôpital Privé Les Franciscaines, ELSAN, Nîmes, France.; Laborie G; Service de Cardiologie, Hôpital Privé Les Franciscaines, ELSAN, Nîmes, France.; Constantin J; Biosense Webster France, Johnson & Johnson, Issy les Moulineaux, France.; Maubon A; Service de Radiologie, Hôpital Privé Les Franciscaines, ELSAN, Nîmes, France.; Arcari L; Cardiology Unit, Madre Giuseppina Vannini Hospital, Rome, Italy.; Hebert C; Biosense Webster France, Johnson & Johnson, Issy les Moulineaux, France.; Bortone A; Service de Cardiologie, Hôpital Privé Les Franciscaines, ELSAN, Nîmes, France. |
| Source: | Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2023 Oct; Vol. 46 (10), pp. 1235-1238. Date of Electronic Publication: 2023 Mar 12. |
| Publication Type: | Case Reports; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Futura Pub. Co Country of Publication: United States NLM ID: 7803944 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8159 (Electronic) Linking ISSN: 01478389 NLM ISO Abbreviation: Pacing Clin Electrophysiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Mount Kisco, N. Y. : Futura Pub. Co., c1978- |
| MeSH Terms: | Ventricular Premature Complexes*/surgery ; Catheter Ablation*/methods; Cicatrix/surgery ; Female ; Humans ; Adult ; Ethanol ; Magnetic Resonance Imaging ; Treatment Outcome |
| Abstract: | Left ventricular (LV) summit premature ventricular contractions (PVCs) are often unresponsive to radiofrequency (RF) ablation. Retrograde venous ethanol infusion (RVEI) can be a valuable alternative in this scenario. A 43-year-old woman without structural heart disease presented with LV summit PVCs unresponsive to RF ablation because of their deep-seated origin. Unipolar pace mapping performed through a wire inserted into a branch of the distal great cardiac vein (GCV) demonstrated 12/12 concordance with the clinical PVCs thus indicating close proximity to PVCs' origin. RVEI abolished the PVCs without complications. Subsequently, magnetic resonance imaging (MRI) evidenced an intramural myocardial scar produced by ethanol ablation. In conclusion, RVEI effectively and safely treated PVC arising from a deep site in the LVS. The scar provoked by chemical damage was well characterized by MRI imaging.; (© 2023 Wiley Periodicals LLC.) |
| References: | Tavares L, Lador A, Fuentes S, et al. Intramural venous ethanol infusion for refractory ventricular arrhythmias: outcomes of a multicenter experience. JACC Clin Electrophysiol. 2020;6:1420-1431.; Enriquez A, Malavassi F, Saenz LC, et al. How to map and ablate left ventricular summit arrhythmias. Heart Rhythm. 2017;14:141-148.; Garg L, Daubert T, Lin A, et al. Utility of prolonged duration endocardial ablation for ventricular arrhythmias originating from the left ventricular summit. JACC Clin Electrophysiol. 2022;8:465-476.; Hutchinson MD, Garcia FC. An organized approach to the localization, mapping, and ablation of outflow tract ventricular arrhythmias. J Cardiovasc Electrophysiol. 2013;24:1189-1197.; Yamada T, McElderry HT, Doppalapudi H, et al. Idiopathic ventricular arrhythmias originating from the left ventricular summit: anatomic concepts relevant to ablation. Circ Arrhythm Electrophysiol. 2010;3:616-623.; Zhou B, Yu J, Ju W, et al. Bipolar catheter ablation strategies for outflow tract ventricular arrhythmias refractory to unipolar ablation. J Cardiovasc Electrophysiol. 2022;33:1769-1778.; Chung FP, Vicera JJB, Lin YJ, et al. Clinical efficacy of open-irrigated electrode cooled with half-normal saline for initially failed radiofrequency ablation of idiopathic outflow tract ventricular arrhythmias. J Cardiovasc Electrophysiol. 2019;30:1508-1516.; Robinson CG, Samson PP, Moore KMS, et al. Phase I/II trial of electrophysiology-guided noninvasive cardiac radioablation for ventricular tachycardia. Circulation. 2019;139:313-321.; Della Bella P, Peretto G, Paglino G, et al. Bipolar radiofrequency ablation for ventricular tachycardias originating from the interventricular septum: safety and efficacy in a pilot cohort study. Heart Rhythm. 2020;17:2111-2118.; Creta A, Earley MJ, Schilling RJ, et al. Ethanol ablation for ventricular arrhythmias: a systematic review and meta-analysis. J Cardiovasc Electrophysiol. 2022;33:510-526.; Lozano-Granero C, Franco E, Matía-Francés R, et al. Characterization of high-power and very-high-power short-duration radiofrequency lesions performed with a new-generation catheter and a temperature-control ablation mode. J Cardiovasc Electrophysiol. 2022;33(12):2528-2537. doi: 10.1111/jce.15676.; Acosta J, Fernández-Armenta J, Borràs R, et al. Scar characterization to predict life-threatening arrhythmic events and sudden cardiac death in patients with cardiac resynchronization therapy. JACC Cardiovasc Imaging. 2018;11:561-572. |
| Contributed Indexing: | Keywords: deep substrate; late gadolinium enhancement; left ventricular summit; premature ventricular contractions; retrograde coronary venous ethanol infusion |
| Substance Nomenclature: | 3K9958V90M (Ethanol) |
| Entry Date(s): | Date Created: 20230222 Date Completed: 20231023 Latest Revision: 20231025 |
| Update Code: | 20260130 |
| DOI: | 10.1111/pace.14680 |
| PMID: | 36811180 |
| Database: | MEDLINE |
Case Reports; Journal Article