Electrocardiographic Characteristics and Catheter Ablation of Ventricular Arrhythmias Originating From the Moderator Band in Children
Copyright © 2022 Jiang, Lv, Han, Yang, Zhao, Yi, Long and Sang..
AIMS: To investigate the electrocardiographic (ECG) characteristics and catheter ablation of ventricular arrhythmias (VAs) originating from the moderator band (MB) in children.
METHODS: A total of six children who had VAs originating from the MB-as confirmed by electrophysiological study-and who underwent catheter ablation between January 2016 and December 2020 were retrospectively reviewed. During the procedure, a three-dimensional electroanatomic mapping system was used to facilitate three-dimensional anatomical reconstruction, mapping and ablation. Patients' clinical characteristics, ECG features and procedural data were collected and analyzed.
RESULTS: The mean age was 8.4 ± 2.6 years (range: 5.3-11 years) and mean weight was 27.7 ± 11.4 kg (range: 17-47 kg). Four patients presented with frequent premature ventricular contraction (PVC), one patient presented with frequent PVC and non-sustained ventricular tachycardia, and one patient presented with sustained monomorphic ventricular tachycardia. The QRS duration averaged 126.3 ± 4.6 ms. In all patients, the VAs had left bundle branch block QRS with left superior frontal plane axes, rapid downstrokes of the QRS in the precordial leads, and late precordial transitions (>V4). During the same period, 10 cases of VAs originated from the posterior-lateral wall of the tricuspid annulus, with a mean QRS duration of 152.8 ± 6.4 ms. Compared to that, VAs of MB origin have narrower QRS widths, downstroke slopes in the inferior lead, sharper downstroke slopes in the precordial lead, and smaller R-wave amplitudes in the V6 lead. All patients experienced immediate ablation success with activations earlier than QRS by 26.0 ± 3.5 ms, and no procedural complications occurring. Only one case had recurrent PVC during a follow-up period ranging from 6 to 36 months.
CONCLUSION: MB VAs in children have distinctive ECG morphology and electrophysiological characteristics. Catheter ablation using a three-dimensional electroanatomic mapping system is safe and effective in these patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Frontiers in pediatrics - 10(2022) vom: 01., Seite 740230 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jiang, Diandong [VerfasserIn] |
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| Links: |
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| Themen: |
Catheter ablation |
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| Anmerkungen: |
Date Revised 02.05.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fped.2022.740230 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM337551502 |
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| 100 | 1 | |a Jiang, Diandong |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Electrocardiographic Characteristics and Catheter Ablation of Ventricular Arrhythmias Originating From the Moderator Band in Children |
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| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2022 Jiang, Lv, Han, Yang, Zhao, Yi, Long and Sang. | ||
| 520 | |a AIMS: To investigate the electrocardiographic (ECG) characteristics and catheter ablation of ventricular arrhythmias (VAs) originating from the moderator band (MB) in children | ||
| 520 | |a METHODS: A total of six children who had VAs originating from the MB-as confirmed by electrophysiological study-and who underwent catheter ablation between January 2016 and December 2020 were retrospectively reviewed. During the procedure, a three-dimensional electroanatomic mapping system was used to facilitate three-dimensional anatomical reconstruction, mapping and ablation. Patients' clinical characteristics, ECG features and procedural data were collected and analyzed | ||
| 520 | |a RESULTS: The mean age was 8.4 ± 2.6 years (range: 5.3-11 years) and mean weight was 27.7 ± 11.4 kg (range: 17-47 kg). Four patients presented with frequent premature ventricular contraction (PVC), one patient presented with frequent PVC and non-sustained ventricular tachycardia, and one patient presented with sustained monomorphic ventricular tachycardia. The QRS duration averaged 126.3 ± 4.6 ms. In all patients, the VAs had left bundle branch block QRS with left superior frontal plane axes, rapid downstrokes of the QRS in the precordial leads, and late precordial transitions (>V4). During the same period, 10 cases of VAs originated from the posterior-lateral wall of the tricuspid annulus, with a mean QRS duration of 152.8 ± 6.4 ms. Compared to that, VAs of MB origin have narrower QRS widths, downstroke slopes in the inferior lead, sharper downstroke slopes in the precordial lead, and smaller R-wave amplitudes in the V6 lead. All patients experienced immediate ablation success with activations earlier than QRS by 26.0 ± 3.5 ms, and no procedural complications occurring. Only one case had recurrent PVC during a follow-up period ranging from 6 to 36 months | ||
| 520 | |a CONCLUSION: MB VAs in children have distinctive ECG morphology and electrophysiological characteristics. Catheter ablation using a three-dimensional electroanatomic mapping system is safe and effective in these patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a catheter ablation | |
| 650 | 4 | |a electrocardiographic morphology | |
| 650 | 4 | |a electrophysiological characteristics | |
| 650 | 4 | |a moderator band | |
| 650 | 4 | |a ventricular arrhythmias | |
| 700 | 1 | |a Lv, Jianli |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Bo |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Xiaofei |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Lijian |e verfasserin |4 aut | |
| 700 | 1 | |a Yi, Yingchun |e verfasserin |4 aut | |
| 700 | 1 | |a Long, Deyong |e verfasserin |4 aut | |
| 700 | 1 | |a Sang, Caihua |e verfasserin |4 aut | |
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