Quantitative Analysis and Characteristics of the Electrograms Recorded Within the Non-Coronary Aortic Sinus of Valsalva

Shigeki Hiramatsu; Hiroshi Tada; Yuichiro Sakamoto; Kenichi Kaseno; Chizuru Sato; Tadanobu Irie; Miki Yokokawa; Satoshi Nagase; Shigeto Naito; Kengo Fukushima Kusano; Masakazu Yamagishi; Tohru Ohe; Kazutaka Aonuma; Shigeru Oshima; Koichi Taniguchi

doi:10.1253/circj.CJ-08-0866

Arrhythmia/Electrophysiology

Quantitative Analysis and Characteristics of the Electrograms Recorded Within the Non-Coronary Aortic Sinus of Valsalva

Shigeki Hiramatsu, Hiroshi Tada, Yuichiro Sakamoto, Kenichi Kaseno, Chizuru Sato, Tadanobu Irie, Miki Yokokawa, Satoshi Nagase, Shigeto Naito, Kengo Fukushima Kusano, Masakazu Yamagishi, Tohru Ohe, Kazutaka Aonuma, Shigeru Oshima, Koichi Taniguchi

Author information

Shigeki Hiramatsu
Department of Cardiovascular Medicine, Okayama University Graduated School of Medicine, Density and Pharmaceutical Science
Hiroshi Tada
Division of Cardiology, Tsukuba University Hospital, Graduate School of Comprehensive Human Sciences, University of Tsukuba
Yuichiro Sakamoto
Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science
Kenichi Kaseno
Division of Cardiology, Gunma Prefectural Cardiovascular Center
Chizuru Sato
Division of Cardiology, Gunma Prefectural Cardiovascular Center
Tadanobu Irie
Division of Cardiology, Gunma Prefectural Cardiovascular Center
Miki Yokokawa
Division of Cardiology, Gunma Prefectural Cardiovascular Center
Satoshi Nagase
Department of Cardiovascular Medicine, Okayama University Graduated School of Medicine, Density and Pharmaceutical Science
Shigeto Naito
Division of Cardiology, Gunma Prefectural Cardiovascular Center
Kengo Fukushima Kusano
Department of Cardiovascular Medicine, Okayama University Graduated School of Medicine, Density and Pharmaceutical Science
Masakazu Yamagishi
Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science
Tohru Ohe
Department of Cardiovascular Medicine, Okayama University Graduated School of Medicine, Density and Pharmaceutical Science
Kazutaka Aonuma
Division of Cardiology, Tsukuba University Hospital, Graduate School of Comprehensive Human Sciences, University of Tsukuba
Shigeru Oshima
Division of Cardiology, Gunma Prefectural Cardiovascular Center
Koichi Taniguchi
Division of Cardiology, Gunma Prefectural Cardiovascular Center

Keywords: Catheter ablation, Electrogram, His-bundle region, Non-coronary aortic sinus of Valsalva, Tachycardia

JOURNAL FREE ACCESS

2009 Volume 73 Issue 5 Pages 838-845

DOI https://doi.org/10.1253/circj.CJ-08-0866

View "Advance Publication" version (March 31, 2009).

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Abstract

Background: Some supraventricular tachycardias could be ablated from the non-coronary sinus of Valsalva (NSV). However, the characteristics of the NSV electrograms have not been clarified. Methods and Results: A quantitative analysis of the NSV electrograms was performed in 5 patients with tachycardias arising from near the atrioventricular node (AVN) and the His-bundle region, and in 20 control subjects. In another 7 control subjects, the NSV electrograms were compared with those recorded at the left and right sinus of Valsalva (LSV and RSV). The NSV electrograms during sinus rhythm had a larger atrial amplitude than ventricular amplitude, and the ratio of the atrial amplitude to the ventricular amplitude was usually >1, which was apparently different from the LSV and RSV electrograms. A tiny but distinct His-bundle deflection was sometimes recorded at the NSV during sinus rhythm while it was not during the tachycardia. The distance to the His-bundle region in the anteroseptal right atrium was shorter from the NSV than from the RSV or LSV. Conclusions: The precise identification of the catheter position at the NSV is possible using the characteristics of the electrograms. Much attention should be paid during ablation to the NSV because of its vicinity to the AVN and His-bundle region. (Circ J 2009; 73: 838 - 845)

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