Catheter ablation and electrocardiogram characteristics of ventricular arrhythmias originating from the tricuspid annulus

Abstract

Objective To observe the electrocardiographic characteristics and to evaluate the efficacy of radiofrequency catheter ablation (RFCA) for idiopathic premature ventricular contractions (PVC) and ventricular tachycardia (VT) originating from tricuspid annulus. Methods From July 2006 to February 2016, one hundred and forty-six patients with idiopathic VA originating from tricuspid annulus who underwent the RFCA in the Second Affiliated Hospital of Wenzhou Medical University were selected. Based on the mapped and ablated sites assessed their electrocardiographic characteristics. Results RFCA of ventricular arrhythmias originating from tricuspid annulus was succeeded in 132 cases, with a success rate of 90.41% and was failured in 14 cases. The electrocardiogram analysis showed that the ventricular arrhythmia from tricuspid valve was no difference in lead I and precordial leads (P>0.05) . The lead I, aVL and V5-V6 were R type, lead V1-V3 showed rS type, precordial transitional zone in or later lead V3, inferior lead showed rS or Rs and R pattern; the tricuspid annulus septal origin site ofventricular arrhythmia in lead I, V5-V6 showed Rtype, QS in lead V1, R or Rs in lead Ⅱ, Rs or rS or QS in lead Ⅲ, rs, rS or R in lead aVF. And precordial transitional zone was in lead V2-V3 or V3. Conclusion There were some specific electrocardiogram characteristics of ventricular arrhythmia in different origin sites of tricuspid annulus. Unders Knowing and familiarity with these characteristics is beneficial to the preliminary judgment of its origin and effective TA target favor of radiofrequency catheter ablation, reducing the ablation andexposure time. Key words: Electrocardiography; Tricuspid annulus; Ventricular arrhythmias; Catheter ablation