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Herzschrittmacherther Elektrophysiol. 2019 Feb 14. doi: 10.1007/s00399-019-0607-1. [Epub ahead of print]

[Premature ventricular contractions and tachycardia in a structurally normal heart : Idiopathic PVC and VT].

[Article in German]

Author information

1
II. Med. Klinik, Klinik für Kardiologie, Angiologie, Pneumologie, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Deutschland. sonia.busch@sebar.net.
2
Klinik für Kardiologie II - Rhythmologie, Universitätsklinikum Münster, Münster, Deutschland.
3
Klinik für Elektrophysiologie/Rhythmologie, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Deutschland.
4
Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Hamburg, Deutschland.
5
Klinik für Innere Medizin III, Kardiologie, Angiologie, Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland.
6
Department of Cardiology, Medical University Hospital, Heidelberg, Deutschland.
7
HCR (Heidelberg Center for Heart Rhythm Disorders), Heidelberg, Deutschland.
8
partner site Heidelberg/Mannheim, DZHK (German Center for Cardiovascular Research), Heidelberg, Deutschland.
9
Kardiologie-Rhythmologie, Klinikum Traunstein, Traunstein, Deutschland.
10
Medizinische Klinik II (Kardiologie, Angiologie, Intensivmedizin) - Universitäres Herzzentrum Lübeck, Universitätsklinikum Schleswig-Holstein (UKSH), Lübeck, Deutschland.
11
Herzzentrum, Abteilung für Elektrophysiologie, Uniklinik Köln, Köln, Deutschland.
12
Medizinische Klinik I, Rotkreuzklinikum München - Akademisches Lehrkrankenhaus der Technischen Universität München, München, Deutschland.
13
Abteilung für Kardiologie, Kerckhoff-Klinik GmbH, Bad Nauheim, Deutschland.
14
Innere Medizin 3, Krankenhaus der Barmherzigen Brüder Trier, Trier, Deutschland.
15
Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität München (LMU München), München, Deutschland.

Abstract

Premature ventricular contractions (PVC) are a common, often incidental and mostly benign finding. Treatment is indicated in frequent and symptomatic PVC or in cases of worsening of left ventricular function. Idiopathic ventricular tachycardia (VT) is mostly found in patients with a structurally healthy heart. These PVC/VT usually have a focal origin. The most likely mechanism is delayed post-depolarization. Localization of the origin is based on the creation of an activation map with or without combination of pace mapping. Idiopathic PVC/VT are most frequently located on the outflow tracts of the right and left ventricles, including the aortic root. Other typical locations include the annulus of the tricuspid or mitral valve, papillary muscles and Purkinje fibers. Catheter ablation is an alternative to antiarrhythmic medication in symptomatic monomorphic PVC/VT. The success rate is good whereby mapping and ablation can often represent a challenge. This article is the fifth part of a series dedicated to specific advanced training in the field of special rhythmology and invasive electrophysiology. It describes the pathophysiological principles, types and typical findings that can be obtained during an electrophysiological investigation.

KEYWORDS:

Ablation; Idiopathic; Mapping; Pathophysiology; Ventricular arrhythmias

PMID:
30767064
DOI:
10.1007/s00399-019-0607-1

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