In:
Journal of Arrhythmia, Wiley, Vol. 30, No. 1 ( 2014-02), p. 48-54
Abstract:
We investigated the prevalence and the electrocardiographic and electrophysiological characteristics of ventricular arrhythmias (VAs) originating from the para‐Hisian area. Methods Among 250 patients with idiopathic VAs, 8 (3.2%) had an ablation site in the para‐Hisian region. For comparison with right ventricular (RV) para‐Hisian VAs ( n =6), 27 patients with VAs originating from the posterior RV outflow tract (RVOT) were studied. Results Para‐Hisian VAs had an R wave in leads I and aVL. The VAs originating from the site below the His bundle region were determined to have a superior axis ( n =4, 50%). A His potential was recorded at the proximal bipole of the successful ablation site in 6 patients. RV para‐Hisian VAs had a narrower QRS width (114±12 ms vs. 139±12 ms, P =0.003), as well as a higher incidence of R waves in lead aVL (83.3% vs. 0%, P 〈 0.001) and QS waves in lead V 1 (83.3% vs. 22.2%, P =0.004) compared to posterior RVOT VAs. A greater R wave amplitude in lead I (1.15±0.34 mV vs. 0.34±0.18 mV, P =0.001) and a smaller R wave amplitude in the inferior leads (0.68±0.23 mV vs. 1.58±0.55 mV, P 〈 0.001), with a higher R wave amplitude ratio in leads II/III (4.2±2.0 vs. 1.1±0.2, P =0.01) were the major ECG characteristics. Conclusions Para‐Hisian VAs have distinctive electrocardiographic features and can be successfully eliminated without disturbance of atrioventricular conduction.
Type of Medium:
Online Resource
ISSN:
1880-4276
,
1883-2148
DOI:
10.1016/j.joa.2013.04.007
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2696593-8
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