Abstract
Objective: There are few reports of ventricular arrhythmias (VAs) originating from the pulmonary sinus cusp (PSC) in pediatric patients. Thus, we investigated the ablation of PSC-VAs in pediatric patients.Study Design: Clinical, echocardiographic, and ablation data were reviewed in 10 consecutive symptomatic children who underwent successful ablation of VAs of PSC origin at our center between March 2014 and June 2018.Results: The 10 patients' weights ranged from 29 to 63.5 kg, and all had structurally normal hearts and VAs with left bundle branch block (LBBB) morphologies and inferior axes. The initial ablation was performed in the right ventricular outflow tract (RVOT) or the aortic sinus cusp, which failed to terminate the VAs in nine patients. The successful ablation site was in the right cusp (RC) in seven patients, the anterior cusp in two patients, and the left cusp (LC) in one patient. The earliest potential recorded at the PSC ablation site preceded the onset of the QRS complex during VAs by 29.4 ± 4.9 ms.Conclusions: VAs with a LBBB morphologies and inferior axes may originate within the PSC of children. Ablation was effective and safe for the eradication of VAs originating from the PSCs in children. Due to the particularity of ablations in pediatric patients, mapping of PSCs should be considered when ablation fails in the RVOT.
Highlights
Ventricular arrhythmias (VAs) are prevalent in pediatric patients and most occur without underlying heart disease
We investigated the catheter ablation of outflow tract ventricular arrhythmias, as well as focusing on the ECG characteristics, mapping, and ablation of VAs arising from the pulmonary sinus cusp (PSC) in pediatric patients
The sharp potential recorded at the PSC ablation site preceded the onset of the QRS complex during VAs by 29.4 ± 4.9 ms, which was significantly greater than the earliest activation time recorded in the right ventricular outflow tract (RVOT) and aortic sinus cusp (p
Summary
There are few reports of ventricular arrhythmias (VAs) originating from the pulmonary sinus cusp (PSC) in pediatric patients. We investigated the ablation of PSC-VAs in pediatric patients. Study Design: Clinical, echocardiographic, and ablation data were reviewed in 10 consecutive symptomatic children who underwent successful ablation of VAs of PSC origin at our center between March 2014 and June 2018
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