Skip to main content
SpringerLink
Log in

Ventrikuläre Extrasystolen und Tachykardien bei strukturell normalem Herz

Idiopathische VES und VT

Premature ventricular contractions and tachycardia in a structurally normal heart

Idiopathic PVC and VT

  • Elektrophysiologische Weiterbildung für Kardiologen
  • Published:
Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

Ventrikuläre Extrasystolen (VES) sind ein häufiger, oft zufälliger und meist harmloser Befund. Bei sehr häufigem Auftreten mit Beschwerden oder Verschlechterung der linksventrikulären Funktion besteht eine Behandlungsindikation. Idiopathische ventrikuläre Tachykardien (VT) finden sich überwiegend bei Patienten mit strukturell gesundem Herz. Diese VES/VT haben meist einen fokalen Ursprung. Der wahrscheinlichste Mechanismus sind verzögerte Nachdepolarisationen. Die Lokalisation des Ursprungortes basiert auf der Erstellung eines Aktivierungsmaps mit oder ohne Kombination eines Pacemappings. Die charakteristischen anatomischen Ursprungsstellen idiopathischer VES/VT sind die Ausflussbahnen des rechten und linken Ventrikels einschließlich der Aortenwurzel. Weitere typische Lokalisationen sind der Trikuspidal- oder Mitralklappenring, Papillarmuskeln und Purkinje-Fasern. Die Katheterablation ist bei symptomatischen, monomorphen VES/VT eine Alternative zu antiarrhythmischer Medikation. Die Erfolgsrate ist hoch, wobei das Mapping und die Ablation oftmals eine Herausforderung darstellen können. Dieser Artikel ist der fünfte Teil einer Serie zur gezielten Fort- und Weiterbildung im Bereich „Spezielle Rhythmologie – Invasive Elektrophysiologie“. Er beschreibt pathophysiologische Grundlagen, Formen sowie typische Befunde, die bei einer elektrophysiologischen Untersuchung erhoben werden können.

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7
Abb. 8

Literatur

  1. Aliot EM, Stevenson WG, Almendral-Garrote JM et al (2009) EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias: developed in a partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA). Europace. https://doi.org/10.1093/europace/eup098

    Article  PubMed  Google Scholar 

  2. American College of Cardiology, American Heart Association Task Force on Clinical Data Standards, ACC/AHA/HRS Writing Committee to Develop Data Standards on Electrophysiology, Buxton AE, Calkins H et al (2006) ACC/AHA/HRS 2006 key data elements and definitions for electrophysiological studies and procedures: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (ACC/AHA/HRS Writing Committee to Develop Data Standards on Electrophysiology). Circulation 114:2534–2570

    Article  Google Scholar 

  3. Aquaro GD, Pingitore A, Strata E et al (2010) Cardiac magnetic resonance predicts outcome in patients with premature ventricular complexes of left bundle branch block morphology. J Am Coll Cardiol 56:1235–1243. https://doi.org/10.1016/j.jacc.2010.03.087

    Article  PubMed  Google Scholar 

  4. Asirvatham SJ (2009) Correlative anatomy for the invasive electrophysiologist: outflow tract and supravalvar arrhythmia. J Cardiovasc Electrophysiol 20:955–968. https://doi.org/10.1111/j.1540-8167.2009.01472.x

    Article  PubMed  Google Scholar 

  5. Ataklte F, Erqou S, Laukkanen J, Kaptoge S (2013) Meta-analysis of ventricular premature complexes and their relation to cardiac mortality in general populations. Am J Cardiol 112:1263–1270. https://doi.org/10.1016/j.amjcard.2013.05.065

    Article  PubMed  Google Scholar 

  6. Azegami K, Wilber DJ, Arruda M et al (2005) Spatial resolution of pacemapping and activation mapping in patients with idiopathic right ventricular outflow tract tachycardia. J Cardiovasc Electrophysiol 16:823–829. https://doi.org/10.1111/j.1540-8167.2005.50041.x

    Article  PubMed  Google Scholar 

  7. Bala R, Marchlinski FE (2007) Electrocardiographic recognition and ablation of outflow tract ventricular tachycardia. Heart Rhythm 4:366–370. https://doi.org/10.1016/j.hrthm.2006.11.012

    Article  PubMed  Google Scholar 

  8. Baman TS, Lange DC, Ilg KJ et al (2010) Relationship between burden of premature ventricular complexes and left ventricular function. Heart Rhythm 7:865–869. https://doi.org/10.1016/j.hrthm.2010.03.036

    Article  PubMed  Google Scholar 

  9. Ban J‑E, Park H‑C, Park J‑S et al (2013) Electrocardiographic and electrophysiological characteristics of premature ventricular complexes associated with left ventricular dysfunction in patients without structural heart disease. Europace 15:735–741. https://doi.org/10.1093/europace/eus371

    Article  PubMed  Google Scholar 

  10. Barsky AJ, Ahern DK, Bailey ED, Delamater BA (1996) Predictors of persistent palpitations and continued medical utilization. J Fam Pract 42:465–472

    CAS  PubMed  Google Scholar 

  11. Bas HD, Baser K, Hoyt J et al (2016) Effect of circadian variability in frequency of premature ventricular complexes on left ventricular function. Heart Rhythm 13:98–102. https://doi.org/10.1016/j.hrthm.2015.07.038

    Article  PubMed  Google Scholar 

  12. Betensky BP, Park RE, Marchlinski FE et al (2011) The V(2) transition ratio: a new electrocardiographic criterion for distinguishing left from right ventricular outflow tract tachycardia origin. J Am Coll Cardiol 57:2255–2262. https://doi.org/10.1016/j.jacc.2011.01.035

    Article  PubMed  Google Scholar 

  13. Bogun F, Crawford T, Reich S et al (2007) Radiofrequency ablation of frequent, idiopathic premature ventricular complexes: comparison with a control group without intervention. Heart Rhythm 4:863–867. https://doi.org/10.1016/j.hrthm.2007.03.003

    Article  PubMed  Google Scholar 

  14. Bogun F, Desjardins B, Crawford T et al (2008) Post-infarction ventricular arrhythmias originating in papillary muscles. J Am Coll Cardiol 51:1794–1802. https://doi.org/10.1016/j.jacc.2008.01.046

    Article  PubMed  Google Scholar 

  15. Bogun F, Taj M, Ting M et al (2008) Spatial resolution of pace mapping of idiopathic ventricular tachycardia/ectopy originating in the right ventricular outflow tract. Heart Rhythm 5:339–344. https://doi.org/10.1016/j.hrthm.2007.11.011

    Article  PubMed  Google Scholar 

  16. Bomma C, Rutberg J, Tandri H et al (2004) Misdiagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy. J Cardiovasc Electrophysiol 15:300–306. https://doi.org/10.1046/j.1540-8167.2004.03429.x

    Article  PubMed  Google Scholar 

  17. Buxton AE, Waxman HL, Marchlinski FE et al (1983) Right ventricular tachycardia: clinical and electrophysiologic characteristics. Circulation 68:917–927

    Article  CAS  Google Scholar 

  18. Carballeira Pol L, Deyell MW, Frankel DS et al (2014) Ventricular premature depolarization QRS duration as a new marker of risk for the development of ventricular premature depolarization-induced cardiomyopathy. Heart Rhythm 11:299–306. https://doi.org/10.1016/j.hrthm.2013.10.055

    Article  PubMed  Google Scholar 

  19. Cheriyath P, He F, Peters I et al (2011) Relation of atrial and/or ventricular premature complexes on a two-minute rhythm strip to the risk of sudden cardiac death (the Atherosclerosis Risk in Communities [ARIC] study). Am J Cardiol 107:151–155. https://doi.org/10.1016/j.amjcard.2010.09.002

    Article  PubMed  Google Scholar 

  20. Chinushi M, Aizawa Y, Ohhira K et al (1998) Repetitive ventricular responses induced by radiofrequency ablation for idiopathic ventricular tachycardia originating from the outflow tract of the right ventricle. Pacing Clin Electrophysiol 21:669–678

    Article  CAS  Google Scholar 

  21. Coggins DL, Lee RJ, Sweeney J et al (1994) Radiofrequency catheter ablation as a cure for idiopathic tachycardia of both left and right ventricular origin. J Am Coll Cardiol 23:1333–1341

    Article  CAS  Google Scholar 

  22. Corrado D, Basso C, Leoni L et al (2005) Three-dimensional electroanatomic voltage mapping increases accuracy of diagnosing arrhythmogenic right ventricular cardiomyopathy/dysplasia. Circulation 111:3042–3050. https://doi.org/10.1161/CIRCULATIONAHA.104.486977

    Article  PubMed  Google Scholar 

  23. Dagres N, Bongiorni MG, Larsen TB et al (2015) Current ablation techniques for persistent atrial fibrillation: results of the European Heart Rhythm Association Survey. Europace 17:1596–1600. https://doi.org/10.1093/europace/euv323

    Article  PubMed  Google Scholar 

  24. Daniels DV, Lu Y‑Y, Morton JB et al (2006) Idiopathic epicardial left ventricular tachycardia originating remote from the sinus of Valsalva: electrophysiological characteristics, catheter ablation, and identification from the 12-lead electrocardiogram. Circulation 113:1659–1666. https://doi.org/10.1161/CIRCULATIONAHA.105.611640

    Article  PubMed  Google Scholar 

  25. Del Carpio Munoz F, Syed FF, Noheria A et al (2011) Characteristics of premature ventricular complexes as correlates of reduced left ventricular systolic function: study of the burden, duration, coupling interval, morphology and site of origin of PVCs. J Cardiovasc Electrophysiol 22:791–798. https://doi.org/10.1111/j.1540-8167.2011.02021.x

    Article  PubMed  Google Scholar 

  26. Delacretaz E, Soejima K, Gottipaty VK et al (2001) Single catheter determination of local electrogram prematurity using simultaneous unipolar and bipolar recordings to replace the surface ECG as a timing reference. Pacing Clin Electrophysiol 24:441–449

    Article  CAS  Google Scholar 

  27. Dixit S, Gerstenfeld EP, Callans DJ, Marchlinski FE (2003) Electrocardiographic patterns of superior right ventricular outflow tract tachycardias: distinguishing septal and free-wall sites of origin. J Cardiovasc Electrophysiol 14:1–7

    Article  Google Scholar 

  28. Gami AS, Noheria A, Lachman N et al (2011) Anatomical correlates relevant to ablation above the semilunar valves for the cardiac electrophysiologist: a study of 603 hearts. J Interv Card Electrophysiol 30:5–15. https://doi.org/10.1007/s10840-010-9523-3

    Article  PubMed  Google Scholar 

  29. Gill JS, Mehta D, Ward DE, Camm AJ (1992) Efficacy of flecainide, sotalol, and verapamil in the treatment of right ventricular tachycardia in patients without overt cardiac abnormality. Br Heart J 68:392–397

    Article  CAS  Google Scholar 

  30. Hachiya H, Aonuma K, Yamauchi Y et al (2000) Electrocardiographic characteristics of left ventricular outflow tract tachycardia. Pacing Clin Electrophysiol 23:1930–1934

    Article  CAS  Google Scholar 

  31. Hasdemir C, Ulucan C, Yavuzgil O et al (2011) Tachycardia-induced cardiomyopathy in patients with idiopathic ventricular arrhythmias: the incidence, clinical and electrophysiologic characteristics, and the predictors. J Cardiovasc Electrophysiol 22:663–668. https://doi.org/10.1111/j.1540-8167.2010.01986.x

    Article  PubMed  Google Scholar 

  32. Hayashi H, Fujiki A, Tani M et al (1997) Role of sympathovagal balance in the initiation of idiopathic ventricular tachycardia originating from right ventricular outflow tract. Pacing Clin Electrophysiol 20:2371–2377

    Article  CAS  Google Scholar 

  33. Hoffmayer KS, Bhave PD, Marcus GM et al (2013) An electrocardiographic scoring system for distinguishing right ventricular outflow tract arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia. Heart Rhythm 10:477–482. https://doi.org/10.1016/j.hrthm.2012.12.009

    Article  PubMed  Google Scholar 

  34. Hoffmayer KS, Gerstenfeld EP (2013) Diagnosis and management of idiopathic ventricular tachycardia. Curr Probl Cardiol 38:131–158. https://doi.org/10.1016/j.cpcardiol.2013.02.002

    Article  PubMed  Google Scholar 

  35. Ito S, Tada H, Naito S et al (2003) Development and validation of an ECG algorithm for identifying the optimal ablation site for idiopathic ventricular outflow tract tachycardia. J Cardiovasc Electrophysiol 14:1280–1286

    Article  Google Scholar 

  36. Jadonath RL, Schwartzman DS, Preminger MW et al (1995) Utility of the 12-lead electrocardiogram in localizing the origin of right ventricular outflow tract tachycardia. Am Heart J 130:1107–1113

    Article  CAS  Google Scholar 

  37. Joshi S, Wilber DJ (2005) Ablation of idiopathic right ventricular outflow tract tachycardia: current perspectives. J Cardiovasc Electrophysiol 16(Suppl 1):S52–S58. https://doi.org/10.1111/j.1540-8167.2005.50163.x

    Article  PubMed  Google Scholar 

  38. Kamioka M, Mathew S, Lin T et al (2015) Electrophysiological and electrocardiographic predictors of ventricular arrhythmias originating from the left ventricular outflow tract within and below the coronary sinus cusps. Clin Res Cardiol 104:544–554. https://doi.org/10.1007/s00392-015-0817-4

    Article  PubMed  Google Scholar 

  39. Krittayaphong R, Bhuripanyo K, Punlee K et al (2002) Effect of atenolol on symptomatic ventricular arrhythmia without structural heart disease: a randomized placebo-controlled study. Am Heart J 144:e10–e15. https://doi.org/10.1067/mhj.2002.125516

    Article  CAS  PubMed  Google Scholar 

  40. Kumagai K, Yamauchi Y, Takahashi A et al (2005) Idiopathic left ventricular tachycardia originating from the mitral annulus. J Cardiovasc Electrophysiol 16:1029–1036. https://doi.org/10.1111/j.1540-8167.2005.40749.x

    Article  PubMed  Google Scholar 

  41. Kuroki K, Tada H, Seo Y et al (2012) Prediction and mechanism of frequent ventricular premature contractions related to haemodynamic deterioration. Eur J Heart Fail 14:1112–1120. https://doi.org/10.1093/eurjhf/hfs095

    Article  CAS  PubMed  Google Scholar 

  42. Kurosaki K, Nogami A, Sakamaki M et al (2009) Automated template matching to pinpoint the origin of right ventricular outflow tract tachycardia. Pacing Clin Electrophysiol 32(Suppl 1):S47–S51. https://doi.org/10.1111/j.1540-8159.2008.02226.x

    Article  PubMed  Google Scholar 

  43. Lahat H, Eldar M, Levy-Nissenbaum E et al (2001) Autosomal recessive catecholamine- or exercise-induced polymorphic ventricular tachycardia: clinical features and assignment of the disease gene to chromosome 1p13-21. Circulation 103:2822–2827

    Article  CAS  Google Scholar 

  44. Lakkireddy D, Di Biase L, Ryschon K et al (2012) Radiofrequency ablation of premature ventricular ectopy improves the efficacy of cardiac resynchronization therapy in nonresponders. J Am Coll Cardiol 60:1531–1539. https://doi.org/10.1016/j.jacc.2012.06.035

    Article  PubMed  Google Scholar 

  45. Lerman BB, Belardinelli L, West GA et al (1986) Adenosine-sensitive ventricular tachycardia: evidence suggesting cyclic AMP-mediated triggered activity. Circulation 74:270–280

    Article  CAS  Google Scholar 

  46. Lerman BB, Stein KM, Markowitz SM (1997) Mechanisms of idiopathic left ventricular tachycardia. J Cardiovasc Electrophysiol 8:571–583

    Article  CAS  Google Scholar 

  47. Liao Z, Zhan X, Wu S et al (2015) Idiopathic ventricular arrhythmias originating from the pulmonary sinus cusp: prevalence, electrocardiographic/electrophysiological characteristics, and catheter ablation. J Am Coll Cardiol 66:2633–2644. https://doi.org/10.1016/j.jacc.2015.09.094

    Article  PubMed  Google Scholar 

  48. Lin C‑Y, Chung F‑P, Lin Y‑J et al (2016) Radiofrequency catheter ablation of ventricular arrhythmias originating from the continuum between the aortic sinus of Valsalva and the left ventricular summit: electrocardiographic characteristics and correlative anatomy. Heart Rhythm 13:111–121. https://doi.org/10.1016/j.hrthm.2015.08.030

    Article  PubMed  Google Scholar 

  49. Massing MW, Simpson RJ, Rautaharju PM et al (2006) Usefulness of ventricular premature complexes to predict coronary heart disease events and mortality (from the Atherosclerosis Risk In Communities cohort). Am J Cardiol 98:1609–1612. https://doi.org/10.1016/j.amjcard.2006.06.061

    Article  PubMed  Google Scholar 

  50. Mehta D, Davies MJ, Ward DE, Camm AJ (1994) Ventricular tachycardias of right ventricular origin: markers of subclinical right ventricular disease. Am Heart J 127:360–366

    Article  CAS  Google Scholar 

  51. Merino JL, Jiménez-Borreguero J, Peinado R et al (1998) Unipolar mapping and magnetic resonance imaging of “idiopathic” right ventricular outflow tract ectopy. J Cardiovasc Electrophysiol 9:84–87

    Article  CAS  Google Scholar 

  52. Mont L, Seixas T, Brugada P et al (1991) Clinical and electrophysiologic characteristics of exercise-related idiopathic ventricular tachycardia. Am J Cardiol 68:897–900

    Article  CAS  Google Scholar 

  53. Morady F, Kadish AH, DiCarlo L et al (1990) Long-term results of catheter ablation of idiopathic right ventricular tachycardia. Circulation 82:2093–2099

    Article  CAS  Google Scholar 

  54. Mountantonakis SE, Frankel DS, Gerstenfeld EP et al (2011) Reversal of outflow tract ventricular premature depolarization-induced cardiomyopathy with ablation: effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome. Heart Rhythm 8:1608–1614. https://doi.org/10.1016/j.hrthm.2011.04.026

    Article  PubMed  Google Scholar 

  55. Olgun H, Yokokawa M, Baman T et al (2011) The role of interpolation in PVC-induced cardiomyopathy. Heart Rhythm 8:1046–1049. https://doi.org/10.1016/j.hrthm.2011.02.034

    Article  PubMed  Google Scholar 

  56. Ouyang F, Fotuhi P, Ho SY et al (2002) Repetitive monomorphic ventricular tachycardia originating from the aortic sinus cusp: electrocardiographic characterization for guiding catheter ablation. J Am Coll Cardiol 39:500–508

    Article  Google Scholar 

  57. Ouyang F, Mathew S, Wu S et al (2014) Ventricular arrhythmias arising from the left ventricular outflow tract below the aortic sinus cusps: mapping and catheter ablation via transseptal approach and electrocardiographic characteristics. Circ Arrhythm Electrophysiol 7:445–455. https://doi.org/10.1161/CIRCEP.114.001690

    Article  PubMed  Google Scholar 

  58. Pedersen CT, Kay GN, Kalman J et al (2014) EHRA/HRS/APHRS expert consensus on ventricular arrhythmias. Europace 16:1257–1283. https://doi.org/10.1093/europace/euu194

    Article  PubMed  Google Scholar 

  59. Penela D, Fernández-Armenta J, Aguinaga L et al (2017) Clinical recognition of pure premature ventricular complex-induced cardiomyopathy at presentation. Heart Rhythm. https://doi.org/10.1016/j.hrthm.2017.07.025

    Article  PubMed  Google Scholar 

  60. Priori SG, Blomström-Lundqvist C, Mazzanti A et al (2015) 2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 36:2793–2867. https://doi.org/10.1093/eurheartj/ehv316

    Article  PubMed  Google Scholar 

  61. Priori SG, Napolitano C, Tiso N et al (2001) Mutations in the cardiac ryanodine receptor gene (hRyR2) underlie catecholaminergic polymorphic ventricular tachycardia. Circulation 103:196–200

    Article  CAS  Google Scholar 

  62. Prystowsky EN, Padanilam BJ, Joshi S, Fogel RI (2012) Ventricular arrhythmias in the absence of structural heart disease. J Am Coll Cardiol 59:1733–1744. https://doi.org/10.1016/j.jacc.2012.01.036

    Article  PubMed  Google Scholar 

  63. Sekiguchi Y, Aonuma K, Takahashi A et al (2005) Electrocardiographic and electrophysiologic characteristics of ventricular tachycardia originating within the pulmonary artery. J Am Coll Cardiol 45:887–895. https://doi.org/10.1016/j.jacc.2004.10.071

    Article  PubMed  Google Scholar 

  64. Simantirakis EN, Koutalas EP, Vardas PE (2012) Arrhythmia-induced cardiomyopathies: the riddle of the chicken and the egg still unanswered? Europace 14:466–473. https://doi.org/10.1093/europace/eur348

    Article  PubMed  Google Scholar 

  65. Simpson RJ, Cascio WE, Schreiner PJ et al (2002) Prevalence of premature ventricular contractions in a population of African American and white men and women: the Atherosclerosis Risk in Communities (ARIC) study. Am Heart J 143:535–540

    Article  Google Scholar 

  66. Sirichand S, Killu AM, Padmanabhan D et al (2017) Incidence of idiopathic ventricular arrhythmias: a population-based study. Circ Arrhythm Electrophysiol 10:e4662. https://doi.org/10.1161/CIRCEP.116.004662

    Article  PubMed  PubMed Central  Google Scholar 

  67. Soejima Y, Aonuma K, Iesaka Y, Isobe M (2004) Ventricular unipolar potential in radiofrequency catheter ablation of idiopathic non-reentrant ventricular outflow tachycardia. Jpn Heart J 45:749–760

    Article  Google Scholar 

  68. Stec S, Sikorska A, Zaborska B et al (2012) Benign symptomatic premature ventricular complexes: short- and long-term efficacy of antiarrhythmic drugs and radiofrequency ablation. Kardiol Pol 70:351–358

    PubMed  Google Scholar 

  69. Steven D, Pott C, Bittner A et al (2013) Idiopathic ventricular outflow tract arrhythmias from the great cardiac vein: challenges and risks of catheter ablation. Int J Cardiol 169:366–370. https://doi.org/10.1016/j.ijcard.2013.09.008

    Article  CAS  PubMed  Google Scholar 

  70. Tada H, Tadokoro K, Ito S et al (2007) Idiopathic ventricular arrhythmias originating from the tricuspid annulus: prevalence, electrocardiographic characteristics, and results of radiofrequency catheter ablation. Heart Rhythm 4:7–16. https://doi.org/10.1016/j.hrthm.2006.09.025

    Article  PubMed  Google Scholar 

  71. Tanaka Y, Tada H, Ito S et al (2011) Gender and age differences in candidates for radiofrequency catheter ablation of idiopathic ventricular arrhythmias. Circ J 75:1585–1591

    Article  Google Scholar 

  72. Tanner H, Hindricks G, Schirdewahn P et al (2005) Outflow tract tachycardia with R/S transition in lead V3: six different anatomic approaches for successful ablation. J Am Coll Cardiol 45:418–423. https://doi.org/10.1016/j.jacc.2004.10.037

    Article  PubMed  Google Scholar 

  73. Timmermans C, Rodriguez L‑M, Crijns HJGM et al (2003) Idiopathic left bundle-branch block-shaped ventricular tachycardia may originate above the pulmonary valve. Circulation 108:1960–1967. https://doi.org/10.1161/01.CIR.0000095026.19339.BB

    Article  PubMed  Google Scholar 

  74. Tokuda M, Kojodjojo P, Epstein LM et al (2011) Outcomes of cardiac perforation complicating catheter ablation of ventricular arrhythmias. Circ Arrhythm Electrophysiol 4:660–666. https://doi.org/10.1161/CIRCEP.111.963413

    Article  PubMed  Google Scholar 

  75. Viskin S, Rosso R, Rogowski O, Belhassen B (2005) The “short-coupled” variant of right ventricular outflow ventricular tachycardia: a not-so-benign form of benign ventricular tachycardia? J Cardiovasc Electrophysiol 16:912–916. https://doi.org/10.1111/j.1540-8167.2005.50040.x

    Article  PubMed  Google Scholar 

  76. Wasmer K, Köbe J, Dechering DG et al (2013) Ventricular arrhythmias from the mitral annulus: patient characteristics, electrophysiological findings, ablation, and prognosis. Heart Rhythm 10:783–788. https://doi.org/10.1016/j.hrthm.2013.02.007

    Article  PubMed  Google Scholar 

  77. Yamada T, Litovsky SH, Kay GN (2008) The left ventricular ostium: an anatomic concept relevant to idiopathic ventricular arrhythmias. Circ Arrhythm Electrophysiol 1:396–404. https://doi.org/10.1161/CIRCEP.108.795948

    Article  PubMed  Google Scholar 

  78. Yarlagadda RK, Iwai S, Stein KM et al (2005) Reversal of cardiomyopathy in patients with repetitive monomorphic ventricular ectopy originating from the right ventricular outflow tract. Circulation 112:1092–1097. https://doi.org/10.1161/CIRCULATIONAHA.105.546432

    Article  PubMed  Google Scholar 

  79. Yokokawa M, Good E, Crawford T et al (2013) Reasons for failed ablation for idiopathic right ventricular outflow tract-like ventricular arrhythmias. Heart Rhythm 10:1101–1108. https://doi.org/10.1016/j.hrthm.2013.05.011

    Article  PubMed  Google Scholar 

  80. Yokokawa M, Kim HM, Good E et al (2012) Relation of symptoms and symptom duration to premature ventricular complex-induced cardiomyopathy. Heart Rhythm 9:92–95. https://doi.org/10.1016/j.hrthm.2011.08.015

    Article  PubMed  Google Scholar 

  81. Zhang F, Yang B, Chen H et al (2016) Non-contact mapping-guided ablation of ventricular arrhythmias originating from the pulmonary artery. Europace 18:281–287. https://doi.org/10.1093/europace/euv049

    Article  PubMed  Google Scholar 

  82. Zipes DP, Camm AJ, Borggrefe M et al (2006) ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114:e385–e484. https://doi.org/10.1161/CIRCULATIONAHA.106.178233

    Article  PubMed  Google Scholar 

  83. Ho SY (2009) Anatomic insights for catheter ablation of ventricular tachycardia. Heart Rhythm 6:S77–S80

    Article  Google Scholar 

  84. Tanawuttiwat T (2016) The role of catheter ablation in the management of ventricular tachycardia. Eur Heart J 37:594–609

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. II. Med. Klinik, Klinik für Kardiologie, Angiologie, Pneumologie, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Deutschland

    Sonia Busch

  2. Klinik für Kardiologie II – Rhythmologie, Universitätsklinikum Münster, Münster, Deutschland

    Lars Eckardt

  3. Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität München (LMU München), München, Deutschland

    Heidi L. Estner

  4. Klinik für Elektrophysiologie/Rhythmologie, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Deutschland

    Philipp Sommer

  5. Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Hamburg, Deutschland

    Christian Meyer

  6. Klinik für Innere Medizin III, Kardiologie, Angiologie, Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland

    Hendrik Bonnemeier

  7. Department of Cardiology, Medical University Hospital, Heidelberg, Deutschland

    Dierk Thomas

  8. HCR (Heidelberg Center for Heart Rhythm Disorders), Heidelberg, Deutschland

    Dierk Thomas

  9. partner site Heidelberg/Mannheim, DZHK (German Center for Cardiovascular Research), Heidelberg, Deutschland

    Dierk Thomas

  10. Kardiologie-Rhythmologie, Klinikum Traunstein, Traunstein, Deutschland

    Hans-Ruprecht Neuberger

  11. Medizinische Klinik II (Kardiologie, Angiologie, Intensivmedizin) – Universitäres Herzzentrum Lübeck, Universitätsklinikum Schleswig-Holstein (UKSH), Lübeck, Deutschland

    Roland Richard Tilz

  12. Herzzentrum, Abteilung für Elektrophysiologie, Uniklinik Köln, Köln, Deutschland

    Daniel Steven

  13. Medizinische Klinik I, Rotkreuzklinikum München – Akademisches Lehrkrankenhaus der Technischen Universität München, München, Deutschland

    Christian von Bary

  14. Abteilung für Kardiologie, Kerckhoff-Klinik GmbH, Bad Nauheim, Deutschland

    Malte Kuniss

  15. Innere Medizin 3, Krankenhaus der Barmherzigen Brüder Trier, Trier, Deutschland

    Frederic Voss

Authors
  1. Sonia Busch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lars Eckardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Philipp Sommer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christian Meyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hendrik Bonnemeier
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dierk Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hans-Ruprecht Neuberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Roland Richard Tilz
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Daniel Steven
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Christian von Bary
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Malte Kuniss
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Frederic Voss
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Heidi L. Estner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sonia Busch.

Ethics declarations

Interessenkonflikt

L. Eckardt hat in den vergangenen 2 Jahren Vortragshonorare von den Firmen Bayer Health Care, Daiichi Sankyo, Pfizer, Bristol-Myers Squibb, Boehringer Ingelheim, Johnson&Johnson, Medtronic, Boston Scientific, Abbott, Novartis, Honorare für eine Beratertätigkeit von den Firmen Johnson &Johnson, Abbott, Boehringer Ingelheim, Novartis sowie Forschungsförderung von der DFG und der Deutschen Herzstiftung erhalten. P. Sommer: Referentenhonorare und Advisory Board Mitglied von Abbott und Biosense Webster. C. Meyer: Referent/advisory board Mitglied: Abbott, Biosense Webster, Boston Scientific. D. Thomas: Referentenhonorare von Bayer Vital, Boehringer Ingelheim Pharma, Bristol-Myers Squibb, Daiichi Sankyo, Medtronic, Pfizer Pharma, Sanofi-Aventis, St. Jude Medical and ZOLL CMS. R.R. Tilz: Referentenhonorare/Procotor: Biosense Webster, Medtronic, Abbot, Biotronik, Boston Scientific, Pfizer, Bristol-Myers Squibb; Bayer, Sanofi Aventis, AstraZeneca. F. Voss: Referententätigkeit für die Firmen Bayer Health Care, Boehringer Ingelheim, Bristol-Myers Squibb, Johnson & Johnson, Medtronic und Pfizer. Honorare für Beratertätigkeit für Boston Scientific und Medtronic. Studienunterstützung für die Teilnahme an internationalen, multizentrischen Studien von der Firma Abbott. H.L. Estner: Referentenhonorare: Medtronic, Abbot, Biotronik, Boston Scientific. S. Busch, H. Bonnemeier, H.-R. Neuberger, D. Steven, C. von Bary und M. Kuniss geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Busch, S., Eckardt, L., Sommer, P. et al. Ventrikuläre Extrasystolen und Tachykardien bei strukturell normalem Herz. Herzschr Elektrophys 30, 212–224 (2019). https://doi.org/10.1007/s00399-019-0607-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00399-019-0607-1

Schlüsselwörter

Keywords

Search

Navigation