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Circ Arrhythm Electrophysiol. 2013 Oct;6(5):898-904. doi: 10.1161/CIRCEP.113.000157. Epub 2013 Aug 27.

Discrete prepotential as an indicator of successful ablation in patients with coronary cusp ventricular arrhythmia.

Author information

1
Department of Cardiology, Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Japan.

Erratum in

  • Circ Arrhythm Electrophysiol. 2013 Dec;6(6):e103.

Abstract

BACKGROUND:

Although coronary cusp (CC) ventricular arrhythmia (VA) can be treated by catheter ablation, reliable indicators of successful ablation sites have not been fully identified.

METHODS AND RESULTS:

This study comprised 392 patients undergoing radiofrequency catheter ablation for outflow tract-VA at 3 institutions from January 2007 to August 2012. The successful ablation site was on the left CC or right CC in 35 (8.9%) of the 392 patients. In 9 (26%) of these 35 patients, a discrete prepotential was recognized, 5 of whom had left CC-VAs and 4 of whom had right CC-VAs. Radiofrequency catheter ablation was successful at the site of the prepotential in all 9 of these patients. The duration of the isoelectric line between the end of the discrete prepotential and the onset of the ventricular electrogram was 27±13 ms. The time from onset of the discrete prepotential at the successful ablation site on the CC to the QRS onset (activation time) was 69±20 ms (range, 50-98 ms). Pace mapping was graded as excellent at the successful ablation site in only 1 patient. No discrete prepotential was recorded in any successful right outflow tract-VA ablation case in this study.

CONCLUSIONS:

A discrete prepotential was seen in 9 (26%) of 35 patients with CC-VA. In left and right CC-VA, the site of a discrete prepotential with ≥50 ms activation time may indicate a successful ablation site.

KEYWORDS:

ablation; coronary cusp; discrete prepotential; ventricular arrhythmia

PMID:
23983247
DOI:
10.1161/CIRCEP.113.000157
[Indexed for MEDLINE]

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